Asian journal of neurosurgery最新文献

{"title":"The Clinical Presentation, Treatment Modalities, and Outcomes Associated with Interhemispheric Subdural Hematomas.","authors":"Muhammad Kashif, Princess Afia Nkrumah-Boateng, Elsayed Mohamed Hammad, Habiba Abdullahi, Wireko Andrew Awuah, Mohammed Q Alibraheemi, Hamza A Abdul-Hafez, Alan Hernández-Hernández, Fadi Al-Tarawni, Mohsen Nabih Shama, Mohammed A Azab, Oday Atallah","doi":"10.1055/s-0044-1801770","DOIUrl":"10.1055/s-0044-1801770","url":null,"abstract":"<p><p>Interhemispheric subdural hematoma (ISH) poses significant challenges in neurosurgical practice owing to its deep localization within the cerebral hemispheres. Despite widespread adoption of advanced neurosurgical technologies, adverse patient outcomes hinder progress in enhancing overall prognosis. This review seeks to evaluate the etiology, clinical manifestations, treatment modalities, and outcomes associated with ISHs, thereby informing clinical decision-making and improving patient care. Databases such as PubMed, Scopus, and Google Scholar were systematically searched from 1964 to 2024. The search was limited to studies involving human subjects and published in English. Keywords such as \"interhemispheric subdural hematoma\" and \"parafalcine subdural hematoma\" were used in various combinations to identify relevant articles. Our search identified 167 individuals (87 females and 80 males) ranging in age from 6 weeks to 93 years. Trauma emerged as the leading risk factor, accounting for 86.8% of cases. Nausea and vomiting were the most frequent symptoms (14.7%), followed by headache (11.8%). Most patients (22.8%) had a Glasgow Coma Scale score of 13 to 16, indicating moderate severity. Radiological analysis showed that subdural hematomas were almost evenly distributed between hemispheres, with 51% located in the right hemisphere and 49% in the left. Quantitative analysis revealed that 65.1% of patients were managed conservatively, particularly those with minimal neurological impairment, while 34% underwent surgery, including burr hole drainage and craniotomy. Of the surgical cases, 18.4% experienced complications. Our findings reveal that the outcome of ISH management depends on several factors, the most important being the etiology and size of the hematoma, the clinical presentation and comorbidities of the patient, and the interval between presentation and treatment.</p>","PeriodicalId":94300,"journal":{"name":"Asian journal of neurosurgery","volume":"20 2","pages":"211-218"},"PeriodicalIF":0.0,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12136967/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144251766","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":"Early versus Delayed Surgical Decompression in Spinal Cord Injury: A Systematic Review and Meta-Analysis.","authors":"Gino Vasquez-Paredes, Carlos Zavaleta-Corvera, José Caballero-Alvarado","doi":"10.1055/s-0044-1801373","DOIUrl":"10.1055/s-0044-1801373","url":null,"abstract":"<p><p>Spinal cord injury is a devastating clinical condition that causes secondary damage, which can be prevented with some treatments. Early surgical decompression may have a beneficial effect and lead to a better neurological outcome. This study aims to demonstrate the effectiveness of early compared with delayed surgical decompression to evaluate neurological improvement in patients with traumatic spinal cord injury. A systematic review and meta-analysis were conducted following the PRISMA-2020 (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Until April 2024, PubMed, Scopus, Web of Science, and Embase were searched for randomized controlled clinical trials. The primary outcome is an improvement of one grade or more on the American Spinal Injury Association Impairment Scale at 12 months' follow-up. Secondary outcomes included hospital stay, postoperative complications, and mortality. Of the 4,101 records identified, 4 studies and 430 patients were included. A statistically significant difference was found in favor of the early surgical decompression group regarding neurological improvement (mean difference 0.88, 95% confidence interval [CI] = -0.03 to 1.73, <i>p</i>  = 0.04). Also, in patients with complete spinal cord injuries (relative risk [RR] 3.65, 95% CI = 1.10-12.17, <i>p</i>  = 0.03) reduction of postoperative complications was observed in the early group (RR 0.42; 95% CI = 0.20-0.88, <i>p</i>  = 0.02). Regarding hospital stay, there were no significant differences between the two groups (RR -7.95, 95% CI = -18.53 to 2.63, <i>p</i>  = 0.14) and mortality (RR = 1.27, 95% CI = 0.30-5.38, <i>p</i>  = 0.75). Our study demonstrates that early surgical decompression within the first 24 hours after spinal cord injury leads to better neurological outcomes with statistical significance. Furthermore, statistically significant results were found in favor of early surgical decompression in patients with complete spinal cord injuries and to statistically reduce the risk of complications in the early group.</p>","PeriodicalId":94300,"journal":{"name":"Asian journal of neurosurgery","volume":"20 2","pages":"199-210"},"PeriodicalIF":0.0,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12136963/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144251739","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":"Sparganosis of the Cauda Equina: A Rare Case of Lower Thoracic Cord Edema and Diagnostic Challenges.","authors":"Prasert Iampreechakul, Chonlada Angsusing, Sunisa Hangsapruek, Samasuk Thammachantha, Adisak Tanpun","doi":"10.1055/s-0044-1801377","DOIUrl":"10.1055/s-0044-1801377","url":null,"abstract":"<p><p>Sparganosis is a rare parasitic infection caused by the larvae of <i>Spirometra</i> species, with spinal involvement being exceedingly uncommon. We present the case of a 46-year-old woman with progressive lower limb weakness, sensory deficits, and bowel and bladder dysfunction over a 3-month period. Initial magnetic resonance imaging revealed an abnormal intradural lesion from L2 to S2, along with thoracic spinal cord edema, raising suspicion for a spinal dural arteriovenous fistula (DAVF). After referral to our institution, further imaging ruled out DAVF, and findings suggested arachnoiditis and radiculitis of the lumbosacral nerve roots. The patient underwent a laminectomy, revealing inflamed arachnoid membranes and diffuse yellowish-whitish granulation tissue adherent to the cauda equina, which histopathological analysis confirmed as sparganosis. Postoperatively, the patient showed improved motor strength, although bowel and bladder dysfunction persisted. This case highlights the diagnostic challenges of spinal sparganosis, the need for early surgical intervention, and the importance of considering parasitic infections in endemic regions.</p>","PeriodicalId":94300,"journal":{"name":"Asian journal of neurosurgery","volume":"20 2","pages":"378-382"},"PeriodicalIF":0.0,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12136945/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144251764","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":"Outcomes and Surgical Approaches for Pineal Region Tumors in Adults: A Retrospective Study of a Single-Center Over 12 Years.","authors":"Aidos Moldabekov, Aiman Maidan, Nurzhan Ryskeldiyev, Nurali Ashirov, Nurzhan Borykbaev, Serik Akshulakov","doi":"10.1055/s-0044-1801372","DOIUrl":"10.1055/s-0044-1801372","url":null,"abstract":"<p><p><b>Background</b>  Pineal region tumors are considered rare, deeply located, and very difficult to resect. They can cause various symptoms by compressing and obstructing different structures. Contradictory data have been reported regarding various aspects of surgical outcomes in different patient positioning. <b>Objectives</b>  This retrospective study aimed to describe the variety of pineal region tumors and patient positioning in pineal region surgeries and compare the neurological outcomes during different approaches. <b>Materials and Methods</b>  From January 1, 2010, to December 31, 2022, 61 patients with pineal area tumors were hospitalized at the National Center for Neurosurgery. Thirty-five patients' histology examinations were available. Twenty-nine patients had open surgical excision. Regarding approaches, supracerebellar infratentorial, posterior transfalcine interhemispheric, and occipital transtentorial approaches were employed. <b>Results</b>  Among 35 patients, 17 had hydrocephalus and required ventricular drainage to address third ventricle obstruction. Complete tumor resection was achieved in 55% of patients. The mortality rate was 13.7% in the open surgical group and 15.625% in the endoscopic third ventriculostomy (ETV) group. <b>Conclusion</b>  Proper patient positioning and selecting the optimal approach are crucial for a successful outcome.</p>","PeriodicalId":94300,"journal":{"name":"Asian journal of neurosurgery","volume":"20 2","pages":"241-252"},"PeriodicalIF":0.0,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12136960/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144251758","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":"A Comparative Outcome of Full Endoscopic Lumbar Discectomy for L4/5 Central-Paracentral Disc Herniation: Interlaminar versus Transforaminal Approach: A 2-Year Prospective Randomized Controlled Follow-Up Study.","authors":"Pritsanai Pruttikul, Tinnakorn Pluemvitayaporn, Palapat Ananpipatkij, Kinzang Dorji, Sombat Kunakornsawat, Suttinont Surapuchong, Warot Ratanakoosakul, Kitjapat Tiracharnvut, Chaiwat Piyasakulkaew, Piyabuth Kittithamvongs","doi":"10.1055/s-0044-1801376","DOIUrl":"10.1055/s-0044-1801376","url":null,"abstract":"<p><p><b>Background</b>  The interlaminar and transforaminal approaches are commonly employed in full endoscopic lumbar spine surgery. Both approaches are well-suited for addressing specific types of lumbar disc herniation, particularly at the L4/5 level. <b>Objective</b>  This article compares the clinical outcomes of full endoscopic discectomy for L4/5 central-paracentral disc herniation between the interlaminar and transforaminal approaches. <b>Materials and Methods</b>  Sixty patients were randomly assigned to either a full endoscopic interlaminar discectomy group or a full endoscopic transforaminal discectomy group, with 30 patients each. The procedures were performed by a single spine surgeon at our institution between 2017 and 2019. Over a 2-year follow-up period, various parameters, including operative time, postoperative hospitalization duration, Visual Analog Scale (VAS) scores for leg and back pain, Oswestry Disability Index (ODI), and modified MacNab criteria, were assessed and compared between the two groups. Additionally, the complication rates were documented. <b>Results</b>  The two full endoscopic approaches resulted in significant improvements in back-leg pain measured by the VAS and in the ODI scores postsurgery. A comparison between the two approaches revealed a significant difference in the ODI score at the 6-week postoperative mark ( <i>p</i>  = 0.02). However, other clinical outcome parameters did not show significant differences at the other follow-up time points. Postoperative dysesthesia was more prevalent in patients who underwent endoscopic transforaminal discectomy ( <i>p</i>  < 0.05). The operative time was notably longer for the interlaminar approach compared with the transforaminal approach (62.6 ± 18.0 vs. 37.0 ± 13.6). Postoperative hospitalization time did not exhibit significant differences between the two groups. <b>Conclusion</b>  Both the interlaminar and transforaminal approaches demonstrate similar clinical outcomes in treating central-paracentral L4/5 disc herniation. Each technique presents distinct advantages and disadvantages regarding operative time and postoperative dysesthesia. The full endoscopic interlaminar and transforaminal approaches have proven to be safe and effective methods for addressing L4/5 central-paracentral disc herniation.</p>","PeriodicalId":94300,"journal":{"name":"Asian journal of neurosurgery","volume":"20 2","pages":"269-277"},"PeriodicalIF":0.0,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12136931/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144251710","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":"Nonfunctioning Ectopic Pituitary Adenoma: A Rare Case Report from Southern Asia.","authors":"Darpanarayan Hazra, Gina Maryann Chandy, Indranil Chakraborty, Amit Ghosh","doi":"10.1055/s-0044-1801282","DOIUrl":"10.1055/s-0044-1801282","url":null,"abstract":"<p><p>Ectopic pituitary adenoma (EPA) is an extraordinarily rare condition characterized by the presence of a pituitary adenoma outside the intrasellar region. Although EPA may share similarities with typical pituitary adenomas in morphology, radiological findings, immunohistochemistry, and hormonal activity, it can present with either nonspecific or specific endocrine symptoms. A 37-year-old female school teacher with persistent and worsening headaches underwent neuroimaging, which revealed a sizable extra-axial solid mass in the right parasellar region, extending into the cavernous sinus, base of the skull, and sphenoid sinus. This mass was initially indicative of a cavernous sinus meningioma. Laboratory investigations, including a pituitary hormone profile, yielded normal results. Despite the lack of typical symptoms, the patient underwent an elective right temporal craniotomy and subtotal tumor resection, which exposed both extra-axial and intra-axial components. Immunohistochemistry analysis confirmed the presence of a pituitary adenoma with atypical features. Postoperatively, the patient recovered well, and adjuvant stereotactic radiosurgery was used to address the residual lesion. During the 1-year follow-up, the patient remained free of symptoms. This case highlights the diagnostic complexities associated with nonfunctioning EPAs and underscores the importance of a comprehensive approach to ensure accurate diagnosis, effective treatment, and sustained patient well-being.</p>","PeriodicalId":94300,"journal":{"name":"Asian journal of neurosurgery","volume":"20 2","pages":"362-366"},"PeriodicalIF":0.0,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12136942/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144251755","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":"Trends of Mortality due to Traumatic Brain Injury in the USA: A Comprehensive Analysis of CDC WONDER Data from 1999 to 2020.","authors":"Muhammad Ashir Shafique, Muhammad Saqlain Mustafa, Aashish Kumar, Javed Iqbal, Abdul Haseeb, Hafsah Alim Ur Rahman, Abdullah Mussarat, Burhanuddin Sohail Rangwala, Hussain Sohail Rangwala, Syed Muhammad Sinaan Ali, Mohammad Ashraf","doi":"10.1055/s-0044-1800952","DOIUrl":"10.1055/s-0044-1800952","url":null,"abstract":"<p><p>Traumatic brain injury (TBI) poses a significant public health challenge in the United States, with diverse causes and outcomes. Understanding the trends in TBI-related mortality is crucial for effective prevention and intervention strategies. This comprehensive analysis utilized data from the <i>Centers for Disease Control and Prevention's Wide-ranging Online Data for Epidemiologic Research</i> (CDC WONDER) database, covering the period from 1999 to 2020. Cause-of-death records were examined using the 10th Edition of the International Classification of Diseases and Related Health Problems diagnostic code S06 for TBI-related fatalities. Mortality rates were calculated per 100,000 individuals, adjusted for age and urban/rural status. Joinpoint Regression analysis was employed to identify significant trends over time. Between 1999 and 2020, 1,218,667 TBI-related deaths occurred, with varying mortality rates across demographic groups and geographic regions. Within the overall population, the highest annual average mortality rates were observed in the non-Hispanic (NH) American Indian or Alaska Native cohort, followed by NH white, NH black or African American, Hispanic or Latino, and NH Asian or Pacific Islander groups. Overall, there was an initial decrease in mortality rate from 1999 to 2012, followed by a subsequent significant increase. Males consistently exhibited higher mortality rates than females across all age groups. Disparities were also observed based on race/ethnicity, with NH American Indian or Alaska Native populations showing the highest mortality rates. Regional variations were evident, with the southern region consistently exhibiting the highest mortality rates. Evolving trends in TBI-related mortality in the United States highlight the need for targeted interventions, particularly in high-risk demographic groups and regions.</p>","PeriodicalId":94300,"journal":{"name":"Asian journal of neurosurgery","volume":"20 1","pages":"20-33"},"PeriodicalIF":0.0,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11875712/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143559445","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":"Clinical and Radiological Criteria for Surgery in Posttraumatic Extradural Hematoma: An Update from Central India.","authors":"Ela Haider Rizvi, Snehil Sharma, Mohammad Kashif, Suramya Maheshwari, Ravi Pratap Singh, Atul Kumar Khare","doi":"10.1055/s-0044-1795164","DOIUrl":"10.1055/s-0044-1795164","url":null,"abstract":"<p><p><b>Background</b>  The surgical management guidelines for any intracranial hemorrhage were objectively defined by the Brain Trauma Foundation (BTF) in 2006 for patients who should be treated surgically or conservatively. Since then, not much work has been done toward the identification of patients who are at high risk and may have progression of the hematoma who may ultimately require surgery. This study aimed to apply the said criteria to all patients coming to the hospital with extradural hematoma (EDH) and analyze the outcome of the patient whether treated conservatively or surgically on the basis of the Glasgow Outcome Scale (GOS) and to observe the factors and variables that are associated with EDH that will help in furthering the demographic design of the entity in central India. <b>Materials and Methods</b>  A prospective and retrospective, ambivalent cohort study was performed at a hospital in central India involving all cases of computed tomography (CT) diagnosed EDH that were reported to the center from October 2016 to March 2018. A total of 78 patients were included in the study. Patients were selected and managed conservatively or surgically as per the criteria and were followed up until the outcome. In retrospective analysis, we evaluated the current criteria for surgery in all patients of posttraumatic EDH in the past 5 years and whose records were available. Condition on discharge or the outcome along with GOS was taken as the endpoint for retrospective analysis. <b>Results</b>  Temporoparietal and frontal regions were the most common sites of EDH and also presented higher mortality rates as compared with other sites. The majority of patients had EDH of length of greater than 5 cm and the mortality rate for the same group also increased with lesser survival chances with length of greater than 10 cm. Patients who presented with an EDH of greater than 1-cm width were higher in numbers, with survival rates decreasing with an increase in width, especially with an EDH greater than 2 cm. <b>Conclusion</b> We conclude that the criteria laid out by the BTF, namely, CT findings of an EDH volume greater than 30 mL, width greater than 15 mm, and mildline shift of greater than 5 mm, hold good in cases of EDH. This study reviewed the previous criteria in the Indian setting and found them to hold good so far.</p>","PeriodicalId":94300,"journal":{"name":"Asian journal of neurosurgery","volume":"20 1","pages":"105-111"},"PeriodicalIF":0.0,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11875698/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143560545","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":"Exploring Nontraumatic Brain Hemorrhage in Sudden and Unexpected Deaths: A Novel Autopsy-Based Investigation.","authors":"Jayeshkumar Kanani, Mohammed Iliyas Sheikh","doi":"10.1055/s-0044-1800811","DOIUrl":"10.1055/s-0044-1800811","url":null,"abstract":"<p><p><b>Background</b>  There has been a surge in sudden and unexpected deaths, presenting a significant challenge for health policymakers and researchers. These individuals showed no signs of recent or past illnesses and died suddenly during routine activities like walking, standing, or working. <b>Objective</b>  This study focuses on exploring nontraumatic brain hemorrhage as a cause of death in autopsies of individuals without prior illnesses. The research aims to explore patterns, prevalence, and risk factors associated with nontraumatic brain hemorrhage, specifically obesity in sudden and unexpected deaths. <b>Materials and Methods</b>  This retrospective, observational study was conducted using autopsy cases with nontraumatic brain hemorrhage as the identified cause of sudden and unexpected deaths. Information on demographic details, medical history, and circumstances surrounding the deaths was collected. The cases were classified based on the body mass index according to the classification of the World Health Organization. <b>Results</b>  From April 2023 to January 2024, 10 cases of sudden and unexpected deaths due to nontraumatic brain hemorrhage were identified. Key findings included predominantly cases of obesity or overweight, deaths occurring predominantly between 8 p.m. and midnight, and all cases being males. <b>Conclusion</b>  The study sheds light on the surge in sudden deaths, specifically attributed to nontraumatic brain hemorrhage. The findings reveal a significant association between obesity and brain hemorrhage in sudden deaths, especially among males. The study's temporal analysis adds depth to understanding these patterns.</p>","PeriodicalId":94300,"journal":{"name":"Asian journal of neurosurgery","volume":"20 1","pages":"126-131"},"PeriodicalIF":0.0,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11875705/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143560518","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":"Pedicle Morphology Analysis in Adolescents with Lenke Type 5 Idiopathic Scoliosis in Thai Population.","authors":"Tinnakorn Pluemvitayaporn, Tassana Kaewmano, Sombat Kunakornsawat, Suttinont Surapuchong, Warot Ratanakoosakul, Kitjapat Tiracharnvut, Pritsanai Pruttikul, Chaiwat Piyasakulkaew, Piyabuth Kittithamvongs","doi":"10.1055/s-0044-1800812","DOIUrl":"10.1055/s-0044-1800812","url":null,"abstract":"<p><p><b>Background</b>  The surgical management of adolescent idiopathic scoliosis (AIS) often incorporates the utilization of pedicle screws, which are three-column construct devices. A comprehensive understanding of the pedicle morphology is essential for determining the appropriate pedicle screw diameter. While previous studies have examined pedicle morphology in Lenke type 1 AIS, there is a scarcity of information about the pedicle morphology in Lenke type 5 AIS, especially in the Thai population. <b>Objective</b>  The aim of this study is to analyze the morphology of the thoracolumbar pedicle, specifically the pedicle width and trajectory length on both the concave and convex sides within a sample of the Thai population diagnosed with Lenke type 5 AIS. <b>Materials and Methods</b>  In this study, we used computed tomography (CT) measurements to examine the thoracolumbar pedicle morphology in Lenke type 5 AIS patients in the Thai population. We also analyzed the pedicle width and trajectory length on both concave and convex sides in 112 AIS patients with Lenke type 5 curvature. <b>Results</b>  A total of 3,808 pedicles from 112 consecutive AIS patients of Lenke type 5 were enrolled in the study. It was observed that the transverse pedicle width was notably smaller on the concave side compared with the convex side in the apical region of the thoracolumbar spine (T12 to L2). Additionally, the pedicle width of T3 was also found to be significantly smaller on the concave side. Moreover, it was noted that the pedicle trajectory length is significantly longer on the concave side, indicating that the concave side in the apical region may have the capacity to accommodate a slightly longer pedicle screw at T3, T6, L2, L3, and L4. <b>Conclusion</b>  Our analysis of measurements indicates that the thoracolumbar pedicle morphology in Lenke type 5 AIS among the Thai population typically shows smaller widths and longer trajectory lengths on the concave side. This information enhances our understanding of the appropriate selection of pedicle screw diameter and length for treating Lenke type 5 AIS in the Thai population.</p>","PeriodicalId":94300,"journal":{"name":"Asian journal of neurosurgery","volume":"20 1","pages":"132-137"},"PeriodicalIF":0.0,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11875695/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143560561","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}