Evidence-based spine-care journal最新文献

{"title":"Commentary on: \"Hydrocephalus Following Bilateral Dumbbell-Shaped C2 Spinal Neurofibromas Resection and Postoperative Cervical Pseudomeningocele in a Patient with Neurofibromatosis Type 1: A Case Report\".","authors":"Andrew T Dailey","doi":"10.1055/s-0034-1387802","DOIUrl":"https://doi.org/10.1055/s-0034-1387802","url":null,"abstract":"In this report, Nicola and colleagues report the occurrence of hydrocephalus 1 month after resection of dumbbell C2 neurofibromas. Prior to surgical intervention, the patient had a mild progressive quadriparesis, which improved after tumor resection. At 1 month postoperatively, the patient had a pseudomeningocele and enlarging ventricles consistent with the symptomatic hydrocephalus. Hydrocephalus can occur in patients with neurofibromatosistype1 but is usuallyassociatedwith opticpathwaygliomas, thalamic and hypothalamic tumors, intrinsic brainstem gliomas, or aqueductal stenosis. 1 Furthermore, hydrocephalus is a well-described entity with spinal cord tumors, and it is estimated that 1% of patients with spinal cord tumors present have hydrocephalus at presentation. 2 Most commonly, hydrocephalus is associated with intrinsic spinal cord tumors (75%), though it can happen with extramedullary tumors. Several mechanisms have been implicated, including increased protein from tumor or hemorrhage, obstruction of cerebrospinal fluid(CSF) pathways, or even neoplastic seeding. However,if it is identified before surgery, it is important to resect the spinal cord tumor before inserting a shunt to avoid shunt-related neurological deterioration. The authors of this report suggest that there was no hydrocephalus on presentation, though it is uncertain if this was evaluated radiologically. The most likely etiology for the hydrocephalus is a postoperative pseudomeningocele or CSF fistula with compression of the foramina of Magendie and Luschka, preventing normal CSF flow. In large series of posterior fossa decompressions for etiologies such as Chiari malformations or tumors, CSF leaks and pseudomeningoceles can form at rates of 6 to 10% with delayed hydrocephalus presenting in 3 to 5% ofpatients. 3,4 Inchildrenwith posterior fossatumors, the rate of postoperative hydrocephalus is very high, with 30% needing additional intervention after the original operation. 5 The presence of a postoperative pseudomeningocele in these patients is a harbinger of hydrocephalus as it was in the current case. Hydrocephalus can also occur after closed head injury with estimatesof posttraumatic hydrocephalus as high as 30% in patients with severe closed head injury. If the patient has concomitant injury to the upper cervical spine that requires intervention, a pseudomeningocele may form at the site of cervical injury with cranial imaging revealing ventricular enlargement. 6,7 The mechanism of posttraumatic hydrocephalus formation is not dissimilar to the presumed mechanism in the current case with obstruction of CSF outflow from the cranium or decreased resorption of CSF duetobloodandproteinblocking thearachnoidgranulations. In any event, the authors astutely recognized that this patient’s pseudomeningocele was a sign of hydrocephalus and treated the hydrocephalus before further morbidity or even death ensued.","PeriodicalId":89675,"journal":{"name":"Evidence-based spine-care journal","volume":"5 2","pages":"139-40"},"PeriodicalIF":0.0,"publicationDate":"2014-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-0034-1387802","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32716964","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical correction of scoliosis in children with spastic quadriplegia: benefits, adverse effects, and patient selection.","authors":"Julian Legg, Evan Davies, Annie L Raich, Joseph R Dettori, Ned Sherry","doi":"10.1055/s-0034-1370898","DOIUrl":"10.1055/s-0034-1370898","url":null,"abstract":"<p><strong>Study rationale: </strong>Cerebral palsy (CP) is a group of nonprogressive syndromes of posture and motor impairment associated with lesions of the immature brain. Spastic quadriplegia is the most severe form with a high incidence of scoliosis, back pain, respiratory compromise, pelvic obliquity, and poor sitting balance. Surgical stabilization of the spine is an effective technique for correcting deformity and restoring sitting posture. The decision to operate in this group of patients is challenging.</p><p><strong>Objectives: </strong>The aim of this study is to determine the benefits of surgical correction of scoliosis in children with spastic quadriplegia, the adverse effects of this treatment, and what preoperative factors affect patient outcome after surgical correction.</p><p><strong>Materials and methods: </strong>A systematic review was undertaken to identify studies describing benefits and adverse effects of surgery in spastic quadriplegia. Factors affecting patient outcome following surgical correction of scoliosis were assessed. Studies involving adults and nonspastic quadriplegia were excluded.</p><p><strong>Results: </strong>A total of 10 case series and 1 prospective and 3 retrospective cohort studies met inclusion criteria. There was significant variation in the overall risk of complications (range, 10.9-70.9%), mortality (range, 2.8-19%), respiratory/pulmonary complications (range, 26.9-57.1%), and infection (range, 2.5-56.8%). Factors associated with a worse outcome were a significant degree of thoracic kyphosis, days in the intensive care unit, and poor nutritional status.</p><p><strong>Conclusion: </strong>Caregivers report a high degree of satisfaction with scoliosis surgery for children with spastic quadriplegia. There is limited evidence of preoperative factors that can predict patient outcome after scoliosis. There is a need for well-designed prospective studies of scoliosis surgery in spastic quadriplegia.</p>","PeriodicalId":89675,"journal":{"name":"Evidence-based spine-care journal","volume":"5 1","pages":"38-51"},"PeriodicalIF":0.0,"publicationDate":"2014-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3969433/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32250337","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lumbar Lateral Interbody Fusion (LLIF): Comparative Effectiveness and Safety versus PLIF/TLIF and Predictive Factors Affecting LLIF Outcome.","authors":"Giuseppe M V Barbagallo, Vincenzo Albanese, Annie L Raich, Joseph R Dettori, Ned Sherry, Massimo Balsano","doi":"10.1055/s-0034-1368670","DOIUrl":"10.1055/s-0034-1368670","url":null,"abstract":"<p><strong>Study design: </strong>Systematic review.</p><p><strong>Study rationale: </strong>The surgical treatment of adult degenerative lumbar conditions remains controversial. Conventional techniques include posterior lumbar interbody fusion (PLIF) or transforaminal lumbar interbody fusion (TLIF). A new direct approach known as lumbar lateral interbody fusion (LLIF), or extreme lateral interbody fusion (XLIF(®)) or direct lateral interbody fusion (DLIF), has been introduced. Objectives The objective of this article is to determine the comparative effectiveness and safety of LLIF, at one or more levels with or without instrumentation, versus PLIF or TLIF surgery in adults with lumbar degenerative conditions, and to determine which preoperative factors affect patient outcomes following LLIF surgery.</p><p><strong>Materials and methods: </strong>A systematic review of the literature was performed using PubMed and bibliographies of key articles. Articles were reviewed by two independent reviewers based on predetermined inclusion and exclusion criteria. Each article was evaluated using a predefined quality rating scheme.</p><p><strong>Results: </strong>The search yielded 258 citations and the following met our inclusion criteria: three retrospective cohort studies (all using historical cohorts) (class of evidence [CoE] III) examining the comparative effectiveness and safety of LLIF/XLIF(®)/DLIF versus PLIF or TLIF surgery, and one prospective cohort study (CoE II) and two retrospective cohort studies (CoE III) assessing factors affecting patient outcome following LLIF. Patients in the LLIF group experienced less estimated blood loss and a lower mortality risk compared with the PLIF group. The number of levels treated and the preoperative diagnosis were significant predictors of perioperative or early complications in two studies.</p><p><strong>Conclusion: </strong>There is insufficient evidence of the comparative effectiveness of LLIF versus PLIF/TLIF surgery. There is low-quality evidence suggesting that LLIF surgery results in fewer complications or reoperations than PLIF/TLIF surgery. And there is insufficient evidence that any preoperative factors exist that predict patient outcome after LLIF surgery.</p>","PeriodicalId":89675,"journal":{"name":"Evidence-based spine-care journal","volume":"5 1","pages":"28-37"},"PeriodicalIF":0.0,"publicationDate":"2014-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3969425/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32248193","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cervical stenosis in a patient with arthrogryposis: case report.","authors":"Jerry Du,&nbsp;Alexander Aichmair,&nbsp;Marios Lykissas,&nbsp;Federico Girardi","doi":"10.1055/s-0034-1368669","DOIUrl":"https://doi.org/10.1055/s-0034-1368669","url":null,"abstract":"<p><p>Study Design Case report. Objective Amyoplasia-type arthrogryposis is a rare congenital disease that presents as multiple contractures involving various areas of the body. To the authors' knowledge, there have been no reports of adults with amyoplasia in the current literature. We report a case of an adult patient with cervical stenosis in the setting of amyoplasia. Patients and Methods A 48-year-old patient with amyoplasia and over 30 previous orthopedic reconstructive surgeries presented with neck pain radiating down his left shoulder and into the fingers, dysesthesia in his fingertips, and left-sided periauricular headache. A diagnosis of central spinal canal stenosis and bilateral foraminal stenosis at C3-C7 with radiculopathy was made based on computed tomography scans. Because of a prior right-side sternocleidomastoid muscle transfer, a left-side C3-C4, C5-C7 anterior cervical discectomy and fusion procedure was performed. Results The patient experienced significant improvement in symptoms that was transient. Symptoms returned to preoperative values after 1 year, despite significant and persistent improvement in stenosis. Conclusions Both amyoplasia and cervical stenosis can manifest in neurologic symptoms. Distinguishing the causing pathology can be challenging. The radiographic improvement of cervical stenosis in a patient with amyoplasia is not always associated with long-standing pain relief. </p>","PeriodicalId":89675,"journal":{"name":"Evidence-based spine-care journal","volume":"5 1","pages":"57-62"},"PeriodicalIF":0.0,"publicationDate":"2014-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-0034-1368669","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32250339","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Occam's Paradox? A Variation of Tapia Syndrome and an Unreported Complication of Guidewire-Assisted Pedicle Screw Insertion","authors":"O. Emohare, Erik Peterson, Nathaniel Slinkard, S. Janus, R. Morgan","doi":"10.1055/s-0034-1371444","DOIUrl":"https://doi.org/10.1055/s-0034-1371444","url":null,"abstract":"1Center for Spine and Spinal Cord Injury, Regions Hospital, St. Paul, Minnesota, United States 2Department of Orthopaedic Surgery, University of Minnesota, Minneapolis, Minnesota, United States 3Department of Orthopaedic Surgery, Henry Ford Health System, Detroit, Michigan, United States 4Department of Otolaryngology, Regions Hospital, St. Paul, Minnesota, United States 5Department of Otolaryngology, University of Minnesota, Minneapolis, Minnesota, United States","PeriodicalId":89675,"journal":{"name":"Evidence-based spine-care journal","volume":"122 1","pages":"70 - 70"},"PeriodicalIF":0.0,"publicationDate":"2014-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73160576","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Credibility matters: mind the gap.","authors":"Andrea C Skelly","doi":"10.1055/s-0034-1371445","DOIUrl":"https://doi.org/10.1055/s-0034-1371445","url":null,"abstract":"The purpose of the Science in Spine articles in EBSJ is to assist surgeons in understanding research, facilitate critical thinking about research beyond “statistical significance,” and to help enhance the quality of research that they report. Decisions by clinicians, patients, and policy makers rest on the quality and integrity of reported research. To avoid biased study reporting: \u0000 \u0000 \u0000It is important to have a framework such as PICOTS/PPOTS for specific primary study features a priori. \u0000 \u0000 \u0000It is important to report on all study results/outcomes regardless of statistical significance. \u0000 \u0000 \u0000It is important to consider the potential for various types of reporting and publication bias when critically appraising studies and systematic reviews. \u0000 \u0000 \u0000 \u0000It is in the best interest of all to “mind the gap” and actively take steps to improve the value and reporting of research (regardless of study design or funding source) by following basic research steps to ensure quality.","PeriodicalId":89675,"journal":{"name":"Evidence-based spine-care journal","volume":"5 1","pages":"2-5"},"PeriodicalIF":0.0,"publicationDate":"2014-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-0034-1371445","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32248189","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The concomitance of cervical spondylosis and adult thoracolumbar spinal deformity.","authors":"Michael H Weber,&nbsp;C H Hong,&nbsp;William W Schairer,&nbsp;Steven Takemoto,&nbsp;Serena S Hu","doi":"10.1055/s-0034-1368668","DOIUrl":"https://doi.org/10.1055/s-0034-1368668","url":null,"abstract":"<p><p>Study Design Retrospective cross-sectional study. Clinical Question What is the prevalence of cervical spondylosis (CS) and thoracolumbar (TL) spinal deformity in an administrative database during a 4-year study period? Is the prevalence of CS or TL deformity higher in patients who have the other spine diagnosis compared with the overall study population? Are patients with both diagnoses more likely to have undergone spine surgery? Patients and Methods An administrative claims database containing 53 million patients with either Medicare (2005-2008) or private payer (2007-2010) insurance was used to identify patients with diagnoses of CS and/or TL deformity. Disease prevalence between groups was compared using a χ (2) test and reported using prevalence ratios (PR). Results The prevalence of CS was higher in patients with TL deformity than without TL deformity, for both Medicare (PR = 2.81) and private payer (PR = 1.79). Similarly, the prevalence of TL deformity was higher in patients with CS than without CS for both Medicare (PR = 3.19) and private payer (PR = 2.05). Patients with both diagnoses were more likely to have undergone both cervical (Medicare, PR = 1.44; private payer, PR = 2.03) and TL (Medicare, PR = 1.68; private payer, PR = 1.74) spine fusion. All comparisons were significant with p < 0.0001. Conclusions Patients with either CS or TL deformity had a higher prevalence of the other spinal diagnosis compared with the overall disease prevalence in the study population. Patients with both diagnoses had a higher prevalence of having spine surgery compared with patients with only one diagnosis. More studies to identify a causal mechanism for this relationship are warranted. </p>","PeriodicalId":89675,"journal":{"name":"Evidence-based spine-care journal","volume":"5 1","pages":"6-11"},"PeriodicalIF":0.0,"publicationDate":"2014-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-0034-1368668","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32248190","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vertebral artery anomaly and injury in spinal surgery.","authors":"Robert Molinari, Matthew Bessette, Annie L Raich, Joseph R Dettori, Christine Molinari","doi":"10.1055/s-0034-1366980","DOIUrl":"10.1055/s-0034-1366980","url":null,"abstract":"<p><strong>Study design: </strong>Systematic review.</p><p><strong>Study rationale: </strong>The purpose of this review is to further define the published literature with respect to vertebral artery (VA) anomaly and injury in patients with degenerative cervical spinal conditions.</p><p><strong>Objectives: </strong>In adult patients with cervical spine or degenerative cervical spine disorders receiving cervical spine surgery, what is the incidence of VA injury, and among resulting VA injuries, which treatments result in a successful outcome and what percent are successfully repaired?</p><p><strong>Materials and methods: </strong>A systematic review of pertinent articles published up to April 2013. Studies involving traumatic onset, fracture, infection, deformity or congenital abnormality, instability, inflammatory spinal diseases, or neoplasms were excluded. Two independent reviewers assessed the level of evidence quality using the Grades of Recommendation Assessment, Development and Evaluation criteria; disagreements were resolved by consensus.</p><p><strong>Results: </strong>From a total of 72 possible citations, the following met our inclusion criteria and formed the basis for this report. Incidence of VA injuries ranged from 0.20 to 1.96%. None of the studies reported using preoperative imaging to identify anomalous or tortuous VA. Primary repair and ligation were the most effective in treating VA injuries.</p><p><strong>Conclusion: </strong>The incidence of VA injuries in degenerative cervical spinal surgery might be as high as 1.96% and is likely underreported. Direct surgical repair is the most effective treatment option. The most important preventative technique for VA injuries is preoperative magnetic resonance imaging or computed tomography angiographic imaging to detect VA anomalies. The overall strength of evidence for the conclusions is low.</p>","PeriodicalId":89675,"journal":{"name":"Evidence-based spine-care journal","volume":"5 1","pages":"16-27"},"PeriodicalIF":0.0,"publicationDate":"2014-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3969432/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32248192","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retro-odontoid calcium pyrophosphate dehydrate deposition: surgical management and review of the literature.","authors":"Eric Klineberg,&nbsp;Tuan Bui,&nbsp;Richard Schlenk,&nbsp;Isador Lieberman","doi":"10.1055/s-0034-1370897","DOIUrl":"https://doi.org/10.1055/s-0034-1370897","url":null,"abstract":"<p><p>Study Design Case report and review of the literature. Objective A retro-odontoid mass is a rare cause of cervical compression and myelopathy. The differential diagnosis includes the following: metastatic disease, primary tumor, collagen disorder, or inflammatory disease. Calcium pyrophosphate dihydrate (CPPD) deposition has been referred to as \"crowned dens syndrome\" when there are periodontoideal calcifications. There are only a few reported cases where CPPD presents as a cystic retro-odontoid mass in the atlanto-dens interval. In previous descriptions of surgical intervention, transoral resection of the mass is associated with significant morbidity and usually requires stabilization. The objective of this article is to report a case of an unusual presentation of CPPD disease of C1/C2, where we used a novel, minimally invasive surgical technique for decompression without fusion. Patients and Methods An 83-year-old female patient presented with progressive cervical myelopathy over a 3-month period. Computed tomography and magnetic resonance imaging demonstrated a cystic odontoid mass with a separate retro-odontoid compressive mass. A novel, minimally invasive transoral aspiration was performed. Histologic confirmation of CPPD was obtained. Results Postop imaging showed satisfactory decompression, which was maintained at the 6-month follow-up. This correlated with clinical improvement postop and 6-month follow-up. Conclusion CPPD in the atlanto-dens interval may present as a cystic retro-odontoideal mass and should be included in the differential. We used a transoral minimally invasive approach to aspirate the cyst. This novel technique avoided the need for a stabilization procedure or morbid transoral resection and provided excellent results immediately and at 6 months. </p>","PeriodicalId":89675,"journal":{"name":"Evidence-based spine-care journal","volume":"5 1","pages":"63-9"},"PeriodicalIF":0.0,"publicationDate":"2014-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-0034-1370897","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32250340","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Definition of Classes of Evidence (CoE) and Overall Strength of Evidence (SoE).","authors":"","doi":"10.1055/s-0034-1373841","DOIUrl":"https://doi.org/10.1055/s-0034-1373841","url":null,"abstract":"Cohort studies follow individuals with the exposure of interest over time and monitor for occurrence of the outcome of interest. Applies to cohort studies only. Authors must consider other factors that might influence patient outcomes and should control for them if appropriate. A good case-control study must have the all of the following: all incident cases from the defined population over a specified time period, controls that represent the population from which the cases come, exposure that precedes an outcome of interest, and accounting for other prognostic factors. A good cross-sectional studymust have all of the following: a representative sample of the population of interest, an exposure that precedes an outcome of interest (e.g., sex, genetic factor), an accounting for other prognostic factors, and for surveys, at least a 80% return rate. A case-series design for prognosis is one where all the patients in the study have the exposure of interest. Since all the patients have the exposure, risks of an outcome can be calculated only for those with the exposure, but cannot be compared with those who do not have the exposure. For example, a case-series evaluating the effect of smoking on spine fusion that only recruits patients who smoke can simply provide the risk of patients who smoke that result in pseudarthrosis but cannot compare this risk to those that do not smoke.","PeriodicalId":89675,"journal":{"name":"Evidence-based spine-care journal","volume":"5 1","pages":"71"},"PeriodicalIF":0.0,"publicationDate":"2014-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-0034-1373841","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32250341","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}