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- 저자 : Jaime Jesús Martínez-Anda (검색결과 3 건)
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Fuster Salvador,Martínez-Anda Jaime Jesús,Castillo-Rivera Sergio Antonio,Vargas-Reverón Caribay,Tornero Eduard 대한척추외과학회 2022 Asian Spine Journal Vol.16 No.3
Study Design: Retrospective, controlled study.Purpose: Dynamic fixation (topping-off technique) adjacent to a transforaminal lumbar interbody fusion (TLIF) level was developed to reduce the risk of adjacent segment disease (ASDi). This study was designed to compare the clinical and radiological outcomes between patients who underwent circumferential lumbar fusion (CLF) without the topping-off technique, CLF with dynamic rod constructs (DRC), and CLF with interspinous device (ISD).Overview of Literature: Lumbar fusion can result in the re-distribution of stress, increased mobility, and increased intradiscal pressure at adjacent levels, ultimately leading to adjacent segment degeneration (ASDe) and ASDi. Dynamic fixation techniques (topping-off techniques) adjacent to vertebral fusion have been developed to reduce the risk of ASDe and ASDi because they provide a transitional zone between a caudal rigid fused segment and cephalad-mobile unfused levels.Methods: A single-center, retrospective, controlled study was designed, including all patients who underwent CLF due to degenerative lumbar spinal disease in Hospital Clinic of Barcelona between 2012 and 2018. Three groups of patients were evaluated as per the type of topping-off technique used: CLF alone group, DRC group, and ISD group. Clinical and radiological outcomes were evaluated.Results: A total of 117 patients were enrolled in the study. Sixty patients (51.3%) underwent CLF without dynamic stabilization, 24 (20.5%) were treated with DRC as topping-off technique, and 33 (28.5%) were treated with an ISD. A total of 12 patients (20.0%) in the CLF alone group showed ASDi at the final follow-up, compared to 1 (4.2%) in the DRC group (p=0.097) and 2 (6.1%) in the ISD group (p=0.127). The Cox regression model identified a significantly decreased risk of ASDi when a topping-off technique (DRC or ISD) was used (hazard ratio, 0.154; 95% confidence interval, 0.31–0.77).Conclusions: Dynamic fixation adjacent to CLF was a safe and efficient procedure associated with improved clinical outcomes in patients with lumbar spine degenerative disease.
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Locking Stand-Alone Cage Constructs for the Treatment of Cervical Spine Degenerative Disease
Roberto Alfonso De Leo–Vargas,Ildefonso Muñoz–Romero,Michel Gustavo Mondragón–Soto,Jaime Jesús Martínez–Anda 대한척추외과학회 2019 Asian Spine Journal Vol.13 No.4
Study Design: Prospective case series study. Purpose: Description of the outcome of stand-alone cervical cages for single and multilevel cervical degenerative spine disease. Overview of Literature: The aim of anterior cervical discectomy and fusion (ACDF) for cervical spine disease is to improve patient symptoms and spine stability and restore lordosis. Locking stand-alone cages were developed with the goal of minimizing soft tissue disruption anterior to the vertebrae and reducing the profile of the construct by avoiding an anterior plate, thereby maximizing ACDF benefits. Methods: This study comprises a case series of patients surgically treated between July 2015 and February 2018 who received single or multilevel ACDF with a zero-profile stand-alone cervical cage. Surgical and clinical preoperative evaluation and surgical outcomes were evaluated using pre- and postoperative Nurick, Visual Analog Scale (VAS), Neck Disability Index (NDI), Japanese Orthopedic Association (JOA) score for myelopathy scales, cervical Cobb angles, postoperative surgical complications, and fusion and subsidence rates. Results: Fifty-three patients underwent ACDF; the mean age of these patients was 58.8 years, and their preoperative VAS, NDI, and JOA scores were 8.1, 31.6, and 15.3, respectively. The preoperative Cobb angle was 30.7°. Forty-five percent of patients had one-level, 54.7% had two-level, and 13.2% had three-level procedures. On preoperative magnetic resonance imaging, foraminal stenosis was present in 94.3% of patients, whereas medullar stenosis was present in 41.5%. The rate of complications was 5.7%: two patients had postoperative dysphagia (3.7%), and one patient had a surgical site hematoma. Mean postoperative follow-up time was 6.7 months; postoperative VAS, NDI, and JOA scores were 2.4, 15.9, and 15.8, respectively. Postoperative Cobb angle was 35.9°, fusion rate was 84.9%, and subsidence rate was 11.3%. Conclusions: ACDF with zero-profile stand-alone cervical devices is an excellent option for cervical degenerative disc disease of one, two, and three levels, with similar results reported when using ACDF with either cage or plate.
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Juan Luis Gómez-Amador,Pablo David Guerrero-Suárez,Jaime Jesús Martínez-Anda,Jorge Fernando Aragón-Arreola,Andrea Castillo-Matus,Ricardo Marian-Magaña,Marcos V Sangrador-Deitos,Alan Hernández-Hernánde 대한뇌혈관외과학회 2023 Journal of Cerebrovascular and Endovascular Neuros Vol.25 No.4
Bilateral posterior communicating (pComm) artery aneurysms represent only 2% of mirror intracranial aneurysms. Usually, these are surgically approached through bilateral craniotomies for clipping. We present the case of a 50-year-old female presenting with headache and horizontal diplopia. Neurological examination revealed a left oculomotor palsy, with no other neurological deficits. Imaging studies revealed bilateral aneurysmatic lesions in both internal carotid arteries (ICA). A conventional left pterional approach was planned in order to treat the symptomatic aneurysm, and, if deemed feasible, a contralateral clipping through the same approach. The procedure was performed in a hybrid operating room (HOR), performing an intraoperative digital subtraction angiography (DSA) and roadmapping assistance during dissection and clipping. Transoperatively, a post-fixed optic chiasm was identified, with a wide interoptic space, which allowed us to perform the contralateral clipping through a unilateral approach. This technique for clipping bilateral pComm aneurysms can be performed when the proper anatomical features are met.
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