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  • 1
    Online-Ressource
    Online-Ressource
    Surgical Outcomes and Limitations of Decompression Surgery for Degenerative Spondylolisthesis
    SAGE Publications ; 2018
    In:  Global Spine Journal Vol. 8, No. 7 ( 2018-10), p. 733-738
    Details
    In: Global Spine Journal, SAGE Publications, Vol. 8, No. 7 ( 2018-10), p. 733-738
    Kurzfassung: A retrospective study. Objectives: To investigate surgical outcomes and limitations of decompression surgery for degenerative spondylolisthesis. Methods: One hundred patients with degenerative spondylolisthesis who underwent decompression surgery alone were included in this study. The average follow-up period was 3.7 years. Radiography and magnetic resonance imaging were used for radiological assessment. Patients with a recovery rate of 〉 50% throughout the study period were classified as the control group (Group C), while those with a recovery rate of 〈 50% throughout the study period were classified as the poor group (Group P). Patients that had improved symptoms, and yet later showed neurological deterioration due to foraminal stenosis at the same level were classified as the exiting nerve root radiculopathy group (Group E), while those who showed deterioration due to slip progression at the same level were classified as the traversing nerve root radiculopathy group (Group T). Results: Patient distribution in each group was 73, 12, 7, and 8 in Groups C, P, E, and T, respectively. As for preoperative radiological features, slippage and an upper migrated disc in Group P, disc wedging and an upper migrated disc in Group E, and lamina inclination and posterior opening in Group T were evident. The cutoff value of preoperative slippage with a poor outcome was 13%. Conclusions: Surgical outcomes of decompression surgery for degenerative spondylolisthesis were successful in 73% cases. Preoperative radiological features for poor outcomes were slippage of more than 13%, an upper migrated disc, disc wedging, and lamina inclination.
    Materialart: Online-Ressource
    ISSN: 2192-5682 , 2192-5690
    URL: Article
    DOI: 10.1177/2192568218770793
    Sprache: Englisch
    Verlag: SAGE Publications
    Publikationsdatum: 2018
    ZDB Id: 2648287-3
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 2
    Online-Ressource
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    Effects of Concomitant Decompression Adjacent to a Posterior Lumbar Interbody Fusion Segment on Clinical and Radiologic Outcomes: Comparative Analysis 5 Years After Surgery
    SAGE Publications ; 2019
    In:  Global Spine Journal Vol. 9, No. 5 ( 2019-08), p. 505-511
    Details
    In: Global Spine Journal, SAGE Publications, Vol. 9, No. 5 ( 2019-08), p. 505-511
    Kurzfassung: Retrospective cohort study. Objective: To examine the effects of concomitant decompression adjacent to the posterior lumbar interbody fusion (PLIF) segment on the clinical and radiological outcomes 5 years after surgery. Methods: Forty-five consecutive patients who had undergone L3/4 decompression with L4/5 PLIF for multilevel stenosis with degenerative spondylolisthesis (DS), and were followed for 5 years, were enrolled (group D). As a control group, 45 age-, sex- and preoperative disc height at L3/4–matched patients who had undergone L4/5 PLIF alone for L4/5DS were randomly selected (group A). Disc height, vertebral slippage, range of motion, posterior opening angle, segmental lordotic angle, presence of the intradiscal vacuum phenomenon (IVP) at the L3/4 level were measured on radiographs. Japanese Orthopaedic Association (JOA) score and the requirement for additional L3/4 surgery were evaluated. Results: In terms of pre-/postoperative radiographic changes between the groups, significant differences were detected regarding disc height narrowing of ≥3 mm (group D 31%, group A 9%) and IVP (group D 33%, group A 11%). There were no significant differences in other radiological parameters. The recovery rate of the JOA score (group D 58%, group A 61%) and reoperation rate (group D 2.2%, group A 6.7%) were not significantly different between the groups. Conclusion: Concomitant decompression adjacent to the PLIF segment accelerated adjacent disc degeneration compared to PLIF alone, but it did not predispose to the development of instability 5 years after surgery. Moreover, the JOA score and reoperation rate were not significantly different between groups D and A.
    Materialart: Online-Ressource
    ISSN: 2192-5682 , 2192-5690
    URL: Article
    DOI: 10.1177/2192568218803324
    Sprache: Englisch
    Verlag: SAGE Publications
    Publikationsdatum: 2019
    ZDB Id: 2648287-3
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 3
    Online-Ressource
    Online-Ressource
    Neurogenic Shock Immediately following Posterior Lumbar Interbody Fusion: Report of Two Cases
    SAGE Publications ; 2015
    In:  Global Spine Journal Vol. 5, No. 4 ( 2015-08), p. 13-16
    Details
    In: Global Spine Journal, SAGE Publications, Vol. 5, No. 4 ( 2015-08), p. 13-16
    Kurzfassung: Case report. Objective To present two cases of neurogenic shock that occurred immediately following posterior lumbar interbody fusion (PLIF) and that appeared to have been caused by the vasovagal reflex after dural injury and incarceration of the cauda equina. Case Report We present two cases of neurogenic shock that occurred immediately following PLIF. One patient had bradycardia, and the other developed cardiac arrest just after closing the surgical incision and opening the drainage tube. Cardiopulmonary resuscitation was performed immediately, and the patients recovered successfully, but they showed severe motor loss after awakening. The results of laboratory data, chest X-ray, electrocardiogram, computed tomography, and echocardiography ruled out pulmonary embolism, hemorrhagic shock, and cardiogenic shock. Although the reasons for the postoperative shock were obscure, reoperation was performed to explore the cause of paralysis. At reoperation, a cerebrospinal fluid collection and the incarceration of multiple cauda equina rootlets through a small dural tear were observed. The incarcerated cauda equina rootlets were reduced, and the dural defect was closed. In both cases, the reoperation was uneventful. From the intraoperative findings at reoperation, it was thought that the pathology was neurogenic shock via the vasovagal reflex. Conclusion Incarceration of multiple cauda equina rootlets following the accidental dural tear by suction drainage caused a sudden decrease of cerebrospinal fluid pressure and traction of the cauda equina, which may have led to the vasovagal reflex.
    Materialart: Online-Ressource
    ISSN: 2192-5682 , 2192-5690
    URL: Article
    DOI: 10.1055/s-0034-1395422
    Sprache: Englisch
    Verlag: SAGE Publications
    Publikationsdatum: 2015
    ZDB Id: 2648287-3
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 4
    Online-Ressource
    Online-Ressource
    Adjacent Segment Disease After Posterior Lumbar Interbody Fusion: A Case Series of 1000 Patients
    SAGE Publications ; 2018
    In:  Global Spine Journal Vol. 8, No. 7 ( 2018-10), p. 722-727
    Details
    In: Global Spine Journal, SAGE Publications, Vol. 8, No. 7 ( 2018-10), p. 722-727
    Kurzfassung: Retrospective study. Objective: There have been few reports of adjacent segment disease (ASD) after posterior lumbar interbody fusion (PLIF) with large numbers and long follow-up. The purpose of this study was to investigate (1) ASD incidence and time periods after primary PLIF, (2) repeat ASD incidence and time periods, and (3) ASD incidence and time periods by fusion length, age, and preoperative pathologies. Methods: A total of 1000 patients (average age 67 years, average follow-up 8.3 years) who underwent PLIF for degenerative lumbar disorders were reviewed. ASD was defined as a symptomatic condition in which revision surgery was required. Results: The overall ASD rate was 9.0%, and the average ASD period was 4.7 years after primary surgery. With respect to clinical features of ASD, degenerative spondylolisthesis at the cranial fusion segment was the most frequent. In terms of repeat ASD, second and third ASD incidences were 1.1% and 0.4%, respectively. As for ASD by fusion length, age, and preoperative pathologies, ASD incidence was increased by fusion length, while the time period to ASD was significantly shorter in elderly patients and those with degenerative lumbar scoliosis. Conclusions: In the present study, the overall ASD incidence was 9.0%, and the average ASD period was 4.7 years after primary operation. Second and third ASD incidences were 1.1% and 0.4%, respectively. Fusion length affected the ASD incidence, while aging factor and preoperative pathology affected the ASD time period.
    Materialart: Online-Ressource
    ISSN: 2192-5682 , 2192-5690
    URL: Article
    DOI: 10.1177/2192568218766488
    Sprache: Englisch
    Verlag: SAGE Publications
    Publikationsdatum: 2018
    ZDB Id: 2648287-3
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 5
    Online-Ressource
    Online-Ressource
    Extraneural Metastasis of Ependymoma in the Cauda Equina
    SAGE Publications ; 2013
    In:  Global Spine Journal Vol. 3, No. 1 ( 2013-03), p. 33-39
    Details
    In: Global Spine Journal, SAGE Publications, Vol. 3, No. 1 ( 2013-03), p. 33-39
    Kurzfassung: We report a rare case of extraneural metastasis of spinal ependymoma that developed over a very long period. A 28-year-old man underwent surgery for ependymoma in the cauda equina. After he experienced three local recurrences and had undergone five operations, a lung metastasis occurred 46 years after the first operation. Although the tumor did not show the typical morphological malignancy, the maximum standard uptake value obtained by positron-emission tomography and the antigen K i -67 labeling index demonstrated the tumor's active proliferative ability. One year after the last operation, the patient died of respiratory failure due to progressing lung metastases. The malignant behavior of spinal ependymomas is demonstrated in a case with long-term follow-up.
    Materialart: Online-Ressource
    ISSN: 2192-5682 , 2192-5690
    URL: Article
    DOI: 10.1055/s-0032-1329888
    Sprache: Englisch
    Verlag: SAGE Publications
    Publikationsdatum: 2013
    ZDB Id: 2648287-3
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 6
    Online-Ressource
    Online-Ressource
    Preoperative Risk Factors Affecting Outcome in Surgically Treated Pyogenic Spondylodiscitis
    SAGE Publications ; 2023
    In:  Global Spine Journal Vol. 13, No. 8 ( 2023-10), p. 2201-2209
    Details
    In: Global Spine Journal, SAGE Publications, Vol. 13, No. 8 ( 2023-10), p. 2201-2209
    Kurzfassung: Retrospective study Objective The primary aim of this study was to investigate the predictors of severe complications in patients following surgery for pyogenic spondylodiscitis (PS) using a surgeon-maintained database. The secondary aim was to investigate the predictors of early recovery. Methods We introduced a surgeon-maintained database of prospectively collected multicenter data that mainly focused on perioperative complications in 2012. Our surgeon-maintained database allows the retrospective collection of detailed data. We analyzed 143 patients who underwent surgery for PS from the 19,056 patients in the prospective surgeon-maintained database at 27 affiliated institutions between 2013 and 2017. Data relating to preoperative patient factors, infection factors, surgical factors, and pre- and postoperative blood tests was retrospectively collected. We performed multivariate regression analysis to evaluate the predictors of postoperative severe complications and early recovery in patients with PS. Results High updated Charlson comorbidity index (uCCI), chronic pulmonary disease, diabetes, Gram-negative bacteria, pyogenic osteoarthritis, high preoperative white blood cell count, and low preoperative platelet count were significantly associated with severe complications in patients undergoing surgery for PS. A high uCCI was the sole independent negative predictor on early recovery. Conclusion Careful perioperative management is necessary if surgery is performed on patients who are at a high risk of life-threatening events.
    Materialart: Online-Ressource
    ISSN: 2192-5682 , 2192-5690
    URL: Article
    DOI: 10.1177/21925682221077918
    Sprache: Englisch
    Verlag: SAGE Publications
    Publikationsdatum: 2023
    ZDB Id: 2648287-3
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 7
    Online-Ressource
    Online-Ressource
    C3–6 Laminoplasty for Cervical Spondylotic Myelopathy Maintains Satisfactory Long-Term Surgical Outcomes
    SAGE Publications ; 2014
    In:  Global Spine Journal Vol. 4, No. 3 ( 2014-08), p. 169-173
    Details
    In: Global Spine Journal, SAGE Publications, Vol. 4, No. 3 ( 2014-08), p. 169-173
    Kurzfassung: Prospective cohort study. Objective To clarify long-term surgical outcomes of C3–6 laminoplasty preserving muscles attached to the C2 and C7 spinous processes in patients with cervical spondylotic myelopathy (CSM). Methods Twenty patients who underwent C3–6 open-door laminoplasty for CSM and who were followed for 8 to 10 years were included in this study. Myelopathic symptoms were assessed using Japanese Orthopaedic Association (JOA) score. Axial neck pain was graded as severe, moderate, or mild. C2–7 angle was measured using lateral radiographs of the cervical spine before surgery and at final follow-up. Results Mean JOA score before surgery (11.7) was significantly improved to 15.2 at the time of maximum recovery (1 year after surgery), declining slightly to 14.9 by the latest follow-up. Late deterioration of JOA score developed in eight patients, but was unrelated to the cervical spine lesions in each case. No patient suffered from prolonged postoperative axial neck pain at final follow-up. The mean C2–7 angle before surgery (13.8 degrees) significantly increased to 19.2 degrees at final follow-up. Conclusions C3–6 laminoplasty preserving muscles attached to the C2 and C7 spinous processes in patients with CSM maintained satisfactory long-term neurologic improvement with significantly reduced frequencies of prolonged postoperative axial neck pain and loss of C2–7 angle after surgery.
    Materialart: Online-Ressource
    ISSN: 2192-5682 , 2192-5690
    URL: Article
    DOI: 10.1055/s-0034-1381727
    Sprache: Englisch
    Verlag: SAGE Publications
    Publikationsdatum: 2014
    ZDB Id: 2648287-3
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 8
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    Online-Ressource
    Age-Related Surgical Outcomes of Laminoplasty for Cervical Spondylotic Myelopathy
    SAGE Publications ; 2015
    In:  Global Spine Journal Vol. 5, No. 2 ( 2015-04), p. 118-123
    Details
    In: Global Spine Journal, SAGE Publications, Vol. 5, No. 2 ( 2015-04), p. 118-123
    Kurzfassung: Retrospective clinical study. Objective To investigate the age-related surgical outcomes of laminoplasty. Methods One hundred patients who underwent an en bloc laminoplasty for cervical spondylotic myelopathy from 2004 to 2008 and were followed for at least 1 year were included in this study. The clinical outcomes were assessed with the Japanese Orthopaedic Association (JOA) score. Acquired points (postoperative JOA score minus preoperative JOA score) were also calculated. To investigate the age-related effect for laminoplasty, two analyses were conducted: (1) the correlation between age and clinical outcome; and (2) the clinical outcomes by decade. Patients were divided into four groups according to their age at the time of operation as follows: group 50s, 50 to 59 years old; group 60s, 60 to 69 years; group 70s, 70 to 79 years; and group 80s, 80 to 89 years. The pre- and postoperative JOA scores, acquired points, preoperative comorbidities, and postoperative complications were then compared among the groups. Results Significant correlations were detected between age and JOA scores at the preoperative ( p = 0.03), postoperative maximum ( p  〈  0.0001), and final assessments ( p  〈  0.0001). An age-related decline of JOA scores was observed over all periods. The analysis by decades showed the same results. On the other hand, the significant differences were not found for acquired points over all periods by either method. The preoperative comorbidities of hypertension and diabetes mellitus increased with age. Delirium was more common postoperatively in elderly patients. Conclusions Although an age-related decline of JOA scores was found over all periods, there were no severe sequelae and no differences in the acquired points that were age-related.
    Materialart: Online-Ressource
    ISSN: 2192-5682 , 2192-5690
    URL: Article
    DOI: 10.1055/s-0034-1396759
    Sprache: Englisch
    Verlag: SAGE Publications
    Publikationsdatum: 2015
    ZDB Id: 2648287-3
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 9
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    Online-Ressource
    Postoperative Deep Surgical-Site Infection after Instrumented Spinal Surgery: A Multicenter Study
    SAGE Publications ; 2013
    In:  Global Spine Journal Vol. 3, No. 2 ( 2013-06), p. 95-101
    Details
    In: Global Spine Journal, SAGE Publications, Vol. 3, No. 2 ( 2013-06), p. 95-101
    Kurzfassung: A retrospective survey revealed 37 cases (1.1%) of deep surgical-site infection (SSI) among 3,462 instrumented spinal surgeries between 2004 and 2008. Excluding 8 patients who were unclassifiable, we categorized 29 patients into 3 groups of similar backgrounds—thoracolumbar degenerative disease (the DEG group; n = 15), osteoporotic vertebral collapse (the OVC group; n = 10), and cervical disorders (the cervical group; n = 4)—and investigated the key to implant salvage. Final respective implant retention rates for the groups were 40, 0, and 100%, with the OVC group having the worst rate (p  〈  0.01). In the DEG group with early infection, those whose implants were retained had lower body temperatures, lower white blood cell counts, and a lower rate of discharge at the time of SSI diagnosis (p  〈  0.05). Implant retention may be affected by initial spinal pathology. In the DEG group, debridement before drainage may be advantageous to implant salvage.
    Materialart: Online-Ressource
    ISSN: 2192-5682 , 2192-5690
    URL: Article
    DOI: 10.1055/s-0033-1343072
    Sprache: Englisch
    Verlag: SAGE Publications
    Publikationsdatum: 2013
    ZDB Id: 2648287-3
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 10
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    Online-Ressource
    Critical Values of Facet Joint Angulation and Tropism in the Development of Lumbar Degenerative Spondylolisthesis: An International, Large-Scale Multicenter Study by the AOSpine Asia Pacific Research Collaboration Consortium
    SAGE Publications ; 2016
    In:  Global Spine Journal Vol. 6, No. 5 ( 2016-08), p. 414-421
    Details
    In: Global Spine Journal, SAGE Publications, Vol. 6, No. 5 ( 2016-08), p. 414-421
    Kurzfassung: An international, multicenter cross-sectional image-based study performed in 33 institutions in the Asia Pacific region. Objective The study addressed the role of facet joint angulation and tropism in relation to L4–L5 degenerative spondylolisthesis (DS). Methods The study included 349 patients (63% females; mean age: 61.8 years) with single-level DS; 82 had no L4–L5 DS (group A) and 267 had L4–L5 DS (group B). Axial computed tomography and magnetic resonance imaging were utilized to assess facet joint angulations and tropism (i.e., asymmetry between facet joint angulations) between groups. Results There was a statistically significant difference between group A (left mean: 46.1 degrees; right mean: 48.2 degrees) and group B (left mean: 55.4 degrees; right mean: 57.5 degrees) in relation to bilateral L4–L5 facet joint angulations ( p  〈  0.001). The mean bilateral angulation difference was 7.4 and 9.6 degrees in groups A and B, respectively ( p = 0.025). A critical value of 58 degrees or greater significantly increased the likelihood of DS if unilateral (adjusted OR: 2.5; 95% CI: 1.2 to 5.5; p = 0.021) or bilateral facets (adjusted OR: 5.9; 95% CI: 2.7 to 13.2; p  〈  0.001) were involved. Facet joint tropism was found to be relevant between 16 and 24 degrees angulation difference (adjusted OR: 5.6; 95% CI: 1.2 to 26.1; p = 0.027). Conclusions In one of the largest studies assessing facet joint orientation in patients with DS, greater sagittal facet joint angulation was associated with L4-L5 DS, with a critical value of 58 degrees or greater increasing the likelihood of the condition for unilateral and bilateral facet joint involvement. Specific facet joint tropism categories were noted to be associated with DS.
    Materialart: Online-Ressource
    ISSN: 2192-5682 , 2192-5690
    URL: Article
    DOI: 10.1055/s-0035-1564417
    Sprache: Englisch
    Verlag: SAGE Publications
    Publikationsdatum: 2016
    ZDB Id: 2648287-3
    Standort Signatur Einschränkungen Verfügbarkeit
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    Online-Ressource
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