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RISS 인기검색어
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- 저자 : Rashim Kataria (검색결과 2 건)
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Prashant Agarwal,Sanjeev Chopra,Virendra Deo Sinha,Rashim Kataria 대한척추외과학회 2020 Asian Spine Journal Vol.14 No.2
Study Design: Prospective study. Purpose: To evaluate the utility and limitations of using three-dimensional (3D)-printed models for the management of craniovertebral (CV) junction abnormalities. Overview of Literature: In comparison to other bony and vascular anomalies, CV junction abnormalities are difficult to treat. For cases of irreducible atlantoaxial dislocation (AAD), posterior reduction and stabilization have replaced anterior decompression as the standard management protocol. The use of 3D models, such as those described herein, can provide surgeons with in-depth knowledge of the vertebral artery course and bony anomalies associated with CV junction abnormalities. Methods: Clinical and radiological features of 18 patients with CV junction abnormalities were analyzed between March 2017 and February 2019 at Sawai Man Singh Medical College, Jaipur, India. Dynamic computed tomography (CT) of the CV junction and CT angiographies of the neck with respect to the vertebral artery course at the C1–C2 joints were obtained and studied. Customized 3D models of the CV junction were then made based on the CT data, and rehearsal of the surgical procedure was performed using the 3D model one day prior to performing the actual procedure. Results: Seventeen patients had congenital-type AAD, whereas one patient had posttraumatic AAD. Improvements in neck pain and myelopathy were seen in all patients at the follow-up, as analyzed using the Visual Analog Scale and the Japanese Orthopedic Association Scale score, respectively. There were no cases of malpositioning of screws or any direct vertebral artery injury, although in one patient, the distal flow in the dominant vertebral artery was cut off as it got compressed between the bony arch and the screw head. Conclusions: Compared to computer-generated images, 3D-printed models are a more practical approach for dealing with complex CV junction abnormalities. They provide surgeons with deep insights into the complex bony anomalies as well as variations in the vertebral artery courses, thereby improving surgical outcomes.
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Das Anand Kumar,Purohit Devendra Kumar,Gupta Ajay,Kataria Rashim 대한척추외과학회 2023 Asian Spine Journal Vol.17 No.3
Anterior cervical corpectomy and fusion is considered the mainstay of surgical treatment in cervical pathology. Expandable and nonexpandable cages are preferred over autogenous bone graft because of donor-related morbidity. However, the choice of the cage type remains a debatable topic as studies report conflicting results. Thus, we evaluated the outcomes of expandable and non-expandable cages following cervical corpectomy. Studies were searched in various electronic databases (MEDLINE, PubMed, EMBASE, CINAHL, Scopus, and Cochrane) between 2011 and 2021. Forest plot was made to compare the radiological and clinical outcomes between expandable and non-expandable cages following cervical corpectomy. Altogether, 26 studies (1,170 patients) were included in the metaanalysis. The mean change in segmental angle was significantly greater in the expandable cage group than in the non-expandable cage group (6.7° vs. 3.0°, <i>p</i> <0.001). The mean subsidence rate was lower in the expandable cage group (6% vs. 41%, <i>p</i> <0.001). The mean fusion rate was lower (93% vs. 98%, <i>p</i> =0.06) and the mean displacement rate was significantly higher in the expandable cage group (29% vs. 5%, <i>p</i> <0.05). The mean reoperation rate was higher in the expandable cage group (16% vs. 2%, <i>p</i> >0.05). The improvement in segmental angle is better with expandable cages. Higher subsidence is a major problem with non-expandable cages, but it seems to be beneficial as evidenced by the high fusion rate and minimal effect on clinical outcome in patients with this cage.
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