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RISS 인기검색어
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- 저자 : Ryoji Ishiguro (검색결과 3 건)
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Postoperative Severe Headache Following Cervical Posterior Surgical Fixation from C2 Distally
Ryoji Tauchi,이상훈,Jin-Young Kim,김용찬,Colleen Peters,Shiro Imagama,Naoki Ishiguro,Jacob Buchowski,K. Daniel Riew 대한척추외과학회 2016 Asian Spine Journal Vol.10 No.4
Study Design: Retrospective study. Purpose: To identify the prevalence of severe headache occurring after cervical posterior surgical fixation (PSF) and to evaluate the clinical and radiological findings associated with severe headache after surgery. Overview of Literature: Several studies have reported on the axial pain after cervical surgery. However, to our knowledge, the incidence of severe headache after cervical PSF has not been elucidated. Methods: The medical records and radiological assessment of patients who underwent surgical treatment from August 2002 to May 2012 were reviewed to identify the prevalence and risk factors for severe headaches occurring following PSF from C2 distally. Neck disability index scores (NDI) (the item for neck pain), the type of C2 screw, number of cervical fused levels (1–6), and smoking habit were calculated preoperatively and postoperatively. In addition, radiological parameters (T1 slope angle, C1/2 angle, C2–7 Cobb angle, C2–7 sagittal vertical axis and C1-implant distance) were assessed for all patients. Severe headache was defined as a high NDI headache score (>4 out of 5). Results: Eighty-two patients met the inclusion criteria. The mean age was 59.2 years (range, 21–78 years), and the mean number of fused levels was 5.1. The mean follow-up period was 2.9 years (range, 1–10.9 years). While only one severe headache occurred de novo postoperatively in a patient in the C3 or C4 distally group (total 30 patients, average age of 50.2 years), 11 patients in the C2 distally group (p =0.04) had severe headache occur postoperatively. The radiological parameters were not significantly different between the postoperative milder headache and severe headache (SH) groups. The SH group had a significantly higher preoperative NDI score (neck pain) (p <0.01). Conclusions: Newly occurring severe headaches can occur in 18% of patients after PSF from C2 distally. The patients with newly occurring severe headaches had significantly higher preoperative NDI score (neck pain).
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Kei Ando,Shiro Imagama,Norimitsu Wakao,Kenichi Hirano,Ryoji Tauchi,Akio Muramoto,Hiroki Matsui,Tomohiro Matsumoto,Yukihiro Matsuyama,Naoki Ishiguro 연세대학교의과대학 2012 Yonsei medical journal Vol.53 No.3
Purpose: Thoracic dumbbell tumors are relatively rare, usually arising from neurogenic elements. Methods for surgical removal thereof remain controversial. The purpose of this study was to evaluate the surgical results of a single-stage posterior approach with laminectomy and costotransversectomy only for the management of thoracic dumbbell tumors. Materials and Methods: Eight cases of thoracic large dumbbell tumor were analyzed retrospectively: seven men and one woman (mean age, 49 years). Pathologic findings included schwannoma in five patients, neurofibroma in two patients (Recklinghausen in one patient), and ganglioneuroma in one patient. All patients underwent single-stage removal of dumbbell tumors by a posterior approach followed by laminectomy and costotransversectomy combined with instrumentation. Clinical and radiologic outcomes were reviewed, thereafter. Results: Operative time ranged from 185 to 420 minutes (mean, 313 minutes), with estimated blood loss ranging from 71 to 1830 mL (mean, 658 mL). Postoperative complications included atelectasis in one case. All patients had tumors successfully removed with no neurological deterioration. Spinal deformities were not observed in any patients at the last follow-up (mean, 52 months), with instrumentation. Conclusion: Single-stage surgery with laminectomy and costotransversectomy may be useful for removing thoracic dumbbell tumors without a combined anterior approach.
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