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RISS 인기검색어
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- 저자 : Kosei Ono (검색결과 4 건)
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Cervical Lordosis Ratio as a Novel Predictor for the Loss of Cervical Lordosis After Laminoplasty
Kosei Ono,Sohei Murata,Mutsumi Matsushita,Hiroshi Murakami 대한척추신경외과학회 2021 Neurospine Vol.18 No.2
Objective: Maintaining cervical lordosis (CL) after laminoplasty is important for indirect decompression of the spinal cord. This study aimed to identify preoperative dynamic radiographic predictors for the loss of CL after laminoplasty. Methods: We retrospectively analyzed 141 consecutive patients who underwent cervical laminoplasty for cervical myelopathy. The following radiographic parameters were measured before surgery and at 1 year of follow-up: CL, C7 slope, C2–7 sagittal vertical axis (SVA), C2–7 range of motion (ROM), CL in flexion, CL in extension, ROM of flexion (Flex ROM), and ROM of extension. The CL ratio (CLR) was defined as 100×Flex ROM/C2–7 ROM. ΔCL was defined as postoperative CL minus preoperative CL. Patients were classified into 2 groups: group K (kyphotic change group, ΔCL ≤-10) and group C (control group, ΔCL >-10). Results: The patient population comprised 94 men and 47 women (mean age, 70.9±9.4 years), with 24 patients (17.0%) classified into group K. CL, C7 slope, and CLR were significantly higher in group K than in group C. The groups did not significantly differ in age, sex, C2–7 SVA, and C2–7 ROM. On multivariable analysis, the CLR was significantly associated with postoperative kyphotic changes. On receiver-operating characteristic curve analysis (area under the curve=0.717, p<0.001), the cutoff value for CLR was 68.9%, with sensitivity and specificity of 87.5% and 57.3%, respectively. Conclusion: The CLR, reflecting the balance between flexion and extension mobility, was identified as a novel predictor for CL loss after laminoplasty, with a cutoff value of 68.9%.
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Kosei Ono,Takayoshi Shimizu,Shunsuke Fujibayashi,Bungo Otsuki,Koichi Murata,Akio Sakamoto,Shuichi Matsuda 대한척추신경외과학회 2021 Neurospine Vol.18 No.1
Objective: Spinal meningioma is mostly benign, but they can exhibit neurological deficit. The relationship between neurological impairment and its radiographic findings, including intratumor magnetic resonance imaging (MRI) gadolinium enhancement and calcification in computed tomography (CT) scan, has not been studied. The purpose of this study was to investigate the association of preoperative image findings with neurological status in spinal meningioma. Methods: Patients histologically diagnosed with spinal meningioma (n=24), with an average age of 65.4 years, were included. The patients were classified into 2 groups, the homogeneous and heterogeneous groups, based on the contrast-enhanced T1-weighted MRI findings. Further, baseline demographics (age, sex, presence of preoperative paralysis [manual muscle testing 3 or worse neurological deficit in upper and/or lower limbs], tumor level, tumor length, and tumor occupation ratio), histological findings (Ki-67 index and histological subtypes), and CT findings (presence of intratumor calcification and Hounsfield unit [HU] value) were examined. Results: Preoperative paralysis was observed in 33.3% (8 of 24) of the patients. These patients exhibited frequent heterogeneous contrast-enhanced MRI findings than those without preoperative paralysis (57.1% vs. 14.3%, p=0.040). Further, preoperative paralysis did not associate with tumor level, tumor length, tumor-occupied ratio, Ki-67 index, and histological subtypes. The heterogeneous group showed 100% intratumor calcification and higher maximum HU than the homogeneous group (1,109.8 vs. 379.2, p=0.001). Conclusion: The heterogeneous contrast-induced MRI findings in the spinal meningioma were significantly associated with preoperative neurological impairment. Moreover, the intratumor contrast-deficient region in the heterogeneously enhanced tumors reflected marked calcification. The tumor hardness due to calcification may be related to preoperative neurological deficit.
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