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RISS 인기검색어
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- 저자 : Grasso Giovanni (검색결과 2 건)
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Wu Pang Hung,Kim Hyeun Sung,Grasso Giovanni,An Jin Woo,Kim Myeonghun,Lee Inkyung,Park Jong Seon,Lee Jun Hyoung,Kang Sangsoo,Lee Jeongshik,Yi Yeonjin,Lee Jun Hyung,Park Jun Hwan,Lim Jae Hyeon,Jang Il-T 대한척추외과학회 2023 Asian Spine Journal Vol.17 No.1
tudy Design: Retrospective cohort study. Purpose: To evaluate the clinical and radiological effects of epidural fluid hematoma in the medium term after lumbar endoscopic decompression. Overview of Literature: There is limited literature comparing the effect of postoperative epidural fluid hematoma after uniportal endoscopic decompression. Methods: Magnetic resonance imaging (MRI) and clinical evaluation were performed for patients with single-level uniportal endoscopic lumbar decompression with a minimum follow-up of 2 years. Results: A total of 126 patients were recruited with a minimum follow-up of 26 months. The incidence of epidural fluid hematoma was 27%. Postoperative MRI revealed a significant improvement in the postoperative dura sac area at postoperative day 1 and at the upper endplate at 6 months in the hematoma cohort (39.69±15.72 and 26.89±16.58 mm2) as compared with the nonhematoma cohort (48.92±21.36 and 35.1±20.44 mm2), respectively (p<0.05); and at the lower endplate on postoperative 1 day in the hematoma cohort (51.18±24.69 mm2) compared to the nonhematoma cohort (63.91±27.92 mm2) (p<0.05). No significant difference was observed in the dura sac area at postoperative 1 year in both cohorts. The hematoma cohort had statistically significant higher postoperative 1-week Visual Analog Scale (VAS; 3.32±0.68) pain and Oswestry Disability Index (ODI; 32.65±5.56) scores than the nonhematoma cohort (2.99±0.50 and 30.02±4.84, respectively; p<0.05). No significant difference was found at the final follow-up VAS, ODI, and MRI dura sac area. Conclusions: Epidural fluid hematoma is a common early postoperative MRI finding in lumbar endoscopic unilateral laminotomy with bilateral decompression. Conservative management is the preferred treatment option for patients who do not have a neurological deficit. Symptoms last only a few days and are self-limiting. A common endpoint is a remodeled fluid hematoma and the subsequent expansion of the dura sac area.
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Pang Hung Wu,Eugene Tze-Chun Lau,김현성,Giovanni Grasso,장일태 대한척추신경외과학회 2023 Neurospine Vol.20 No.1
Objective: There is a lack of literature on indirect decompression in uniportal endoscopic posterolateral transforaminal lumbar interbody fusion (EPTLIF). Our aim is to evaluate the dimensions of the spinal canal and contralateral foramen before and after EPTLIF. Methods: This is a retrospective study of patients who underwent EPTLIF in a tertiary spine centre over a 2-year period. The cross-sectional area of the spinal canal and the contralateral foramen at the level of fusion were measured on magnetic resonance imaging scan at 1-day postoperation and at the final follow-up. Patients were grouped according to the decompression performed as per the clinician’s judgement. Results: One hundred fifty-two levels of fusion were performed in 120 patients. There was a statistically significant clinical improvement in visual analogue scale and Oswestry Disability Index scores postoperation. The measurements of the spinal canal area were 106.0 mm2 , 138.8 mm2 , and 195.5 mm2 ; while contralateral foraminal area were 73.2 mm2 , 104.4 mm2 , and 120.7 mm2 at preoperation, 1-day postoperation, and at the final follow-up, respectively (p < 0.001). For the subgroup analyses, spinal canal area measurements for the bilateral decompression cohort (n = 35) were 57.0 mm2 , 123.9 mm2 , and 191.8 mm2 ; for the ipsilateral decompression cohort (n = 42) were 89.3 mm2 , 128.9 mm2 , 183.3 mm2 ; and for the cohort without any decompression and only cage inserted (n = 75) were 138.3 mm2 , 151.2 mm2 , and 204.1 mm2 (p < 0.001). Contralateral foraminal area measurements were 73.3 mm2 , 106.4 mm2 and 120.4 mm2 in the bilateral decompression cohort; 69.5 mm2 , 99.0 mm2 , 116.9 mm2 in the ipsilateral decompression cohort; and 75.1 mm2 , 106.5 mm2 , 122.9 mm2 in the cohort without any decompression (p < 0.001). Conclusion: Indirect decompression of both the spinal canal and the contralateral foramen can be achieved via EPTLIF. Decompression on an asymptomatic contralateral side is not necessary.
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