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  • 1
    In: Translational Neuroscience and Clinics, SAGE Publications, Vol. 3, No. 3 ( 2017), p. 123-134
    Type of Medium: Online Resource
    ISSN: 2096-0441
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2017
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  • 2
    In: Translational Neuroscience and Clinics, SAGE Publications, Vol. 3, No. 3 ( 2017), p. 135-146
    Type of Medium: Online Resource
    ISSN: 2096-0441
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2017
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  • 3
    In: Translational Neuroscience and Clinics, SAGE Publications, Vol. 3, No. 3 ( 2017-09), p. 123-134
    Abstract: Spinal ependymomas (SEs) are common adult intramedullary tumors; however, determining the absolute boundary between the tumor and the tumor residual may be difficult. We assessed outcomes following the use of fluorescein sodium (FS) during surgical removal of SEs. We performed a retrospective analysis of 112 patients with SEs who were treated at Beijing Tsinghua Changgung Hospital between December 2014 and December 2016. Each patient received intravenous FS (3–4 mg/kg) to determine the SE boundaries during surgery. Tumor removal efficiencies and tumor residuals were assessed using magnetic resonance imaging (MRI) at 10 days and 3 months after surgical recovery; McCormick's spinal function classification was also performed at the 3-month follow-up. The complete tumor removal rate was 92% (103/112). Ninety-four patients underwent tumor removal under fluorescent light, which provided distinctive tumor fluorescence. Tumor removal under white light was performed in 18 patients; fluorescent images were invisible or indistinctive in these 18 patients. At the 3-month follow-up, sensory function (85.8% (91/106)) and movement (84.3% (86/102)) were improved in patients with pre-surgical dysfunction; urination and defecation functions were improved in 66.7% (16/24). The McCormick spinal cord functional classifications, at the 3-month follow-up, showed significant differences in the percentages of patients with disease classified to each grade (I–IV), compared with preoperative classifications (each, P 〈 0.05). There was no MRI evidence of tumor relapse or residuals at the 3-month follow-up. FS use during the surgical treatment of SE enables complete tumor removal and detection of tumor residuals.
    Type of Medium: Online Resource
    ISSN: 2096-0441
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2017
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  • 4
    In: Translational Neuroscience and Clinics, SAGE Publications, Vol. 3, No. 3 ( 2017-09), p. 135-146
    Abstract: This study explored the combined use of the O-arm and real-time navigation during spinal fixation. The clinical data for 60 patients undergoing spinal fixation, at Beijing Tsinghua Chang Gung Hospital between May 5, 2015 and May 1, 2017, were retrospectively analyzed. Pre-, intra-, and postoperative imaging findings were assessed. The patients were classified into the occipitocervical fusion (32 cases) and thoracic/lumbar/sacral spine fixation (28 cases, including 6 cases of percutaneous pedicle screw) groups. Lesion resections were performed microscopically. An O-arm, combined with real-time navigation, was used to assess spinal fixation. Efficacy was evaluated using operative times, Xray times, screw positioning, and complications. Within the occipitocervical fusion group, 182 screws were placed in the cervical spine and 96 in the occipital bone. However, 6 screws penetrated the bone cortex and were adjacent to the vertebral arteries, based on O-arm three-dimensional imaging; therefore, the precision rate was 96.7%. Within the thoracic/lumbar/sacral spine fixation group, 148 pedicle screws were implanted, with 4 initially outside the vertebral body, yielding a precision rate of 97.3%. Ten percutaneous pedicle screws were implanted and well positioned. O-arm scans were performed 3 times/patient, with an average of 20–30 min/time. Screw implantation times were 5–7 min (cervical spine), 8–10 min (thoracic spine), and 6–8 min (lumbar spine). Intraoperative O-arm scans, combined with real-time navigation technology, allow real-time observation of screw angles and depths, improving the accuracy and safety of posterior screw fixations and reducing the radiation dose and frequency experienced by patients and surgeons.
    Type of Medium: Online Resource
    ISSN: 2096-0441
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2017
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  • 5
    In: Journal of Neurosurgery: Spine, Journal of Neurosurgery Publishing Group (JNSPG), Vol. 30, No. 5 ( 2019-05), p. 655-663
    Abstract: Laminoplasty has been used in recent years as an alternative approach to laminectomy for preventing spinal deformity after resection of intramedullary spinal cord tumors (IMSCTs). However, controversies exist with regard to its real role in maintaining postoperative spinal alignment. The purpose of this study was to examine the incidence of progressive spinal deformity in patients who underwent laminoplasty for resection of IMSCT and identify risk factors for progressive spinal deformity. METHODS Data from IMSCT patients who had undergone laminoplasty at Beijing Tsinghua Changgung Hospital between January 2014 and December 2016 were retrospectively reviewed. Univariate tests and multivariate logistic regression analysis were used to assess the statistical relationship between postoperative spinal deformity and radiographic, clinical, and surgical variables. RESULTS One hundred five patients (mean age 37.0 ± 14.5 years) met the criteria for inclusion in the study. Gross-total resection ( 〉 95%) was obtained in 79 cases (75.2%). Twenty-seven (25.7%) of the 105 patients were found to have spinal deformity preoperatively, and 10 (9.5%) new cases of postoperative progressive deformity were detected. The mean duration of follow-up was 27.6 months (SD 14.5 months, median 26.3 months, range 6.2–40.7 months). At last follow-up, the median functional scores of the patients who did develop progressive spinal deformity were worse than those of the patients who did not (modified McCormick Scale: 3 vs 2, and p = 0.04). In the univariate analysis, age (p = 0.01), preoperative spinal deformity (p 〈 0.01), extent of tumor involvement (p 〈 0.01), extent of abnormal tumor signal (p = 0.02), and extent of laminoplasty (p 〈 0.01) were identified as factors associated with postoperative progressive spinal deformity. However, in subsequent multivariate logistic regression analysis, only age ≤ 25 years and preoperative spinal deformity emerged as independent risk factors (p 〈 0.05), increasing the odds of postoperative progressive deformity by 4.1- and 12.4-fold, respectively (p 〈 0.05). CONCLUSIONS Progressive spinal deformity was identified in 25.7% patients who had undergone laminoplasty for IMSCT resection and was related to decreased functional status. Younger age (≤ 25 years) and preoperative spinal deformity increased the risk of postoperative progressive spinal deformity. The risk of postoperative deformity warrants serious reconsideration of providing concurrent fusion during IMSCT resection or close follow-up after laminoplasty.
    Type of Medium: Online Resource
    ISSN: 1547-5654
    RVK:
    Language: Unknown
    Publisher: Journal of Neurosurgery Publishing Group (JNSPG)
    Publication Date: 2019
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  • 6
    In: Healthcare, MDPI AG, Vol. 11, No. 8 ( 2023-04-14), p. 1135-
    Abstract: Chordomas are very rare malignant bone tumors. Following surgery, their effects on neurological, physical, psychological, social, and emotional functioning are substantial and can have a major impact on a patients’ quality of life (QOL). In this survey, we aimed to characterize the postoperation health-related QOL and emotional problem in patients with chordoma using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire 30 (EORTC QLQ-C30) and Hamilton Depression Rating Scale (HAMD). The cohort included 100 patients who underwent resection surgery between 2014 and 2020. Being single or divorced, living in a rural area, receiving a diagnosis of sacrococcygeal chordoma, Karnofsky performance status (KPS) ≤ 70, and weight loss were associated with increased likelihood of depression (p 〈 0.05). Patients who were single or divorced, with KPS ≤ 70, and experiencing weight loss had a higher likelihood of a worse QOL (p 〈 0.05). The uni- and multivariate logistic regression analyses indicated that the KPS level (p = 0.000) and postoperative radiation therapy (p = 0.009) were related to depression; marital status (p = 0.029), KPS level (p = 0.006), and tumor location (p = 0.033) were related to worse QOL. Certain characteristics placed patients with chordoma at increased risk of emotional problems, which are associated with a lowered QOL and a higher symptom burden. Further knowledge regarding emotional problems is key to improving the QOL for patients with chordoma.
    Type of Medium: Online Resource
    ISSN: 2227-9032
    Language: English
    Publisher: MDPI AG
    Publication Date: 2023
    detail.hit.zdb_id: 2721009-1
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