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        Frequency of Vertebral Endplate Modic Changes in Patients with Unstable Lumbar Spine and Its Effect on Surgical Outcome

        Seyyed Mohammad Ghodsi,Reza Rouhani,Sina Abdollahzade,Masoud Khadivi,Morteza Faghih Jouibari 대한척추외과학회 2015 Asian Spine Journal Vol.9 No.5

        Study Design: Prospective cohort study. Purpose: In this study, we investigated the frequency of vertebral endplate Modic changes (MCs) and their effects on surgical outcomes in patients with unstable lumbar spines. Overview of Literature: Signal changes in endplates have been classified into three types by Modic. The prognostic role of MCs has been investigated in various spinal disorders. Methods: A series of 70 patients with clinical and radiographic unstable lumbar spine were included in the study. Endplate signal intensity was determined according to Modic classification. All patients underwent instrumented posterolateral fusion. Functional evaluation was made using the visual analog scale (VAS) and Oswestry disability index (ODI). Results: Eighteen patients (26%) had normal endplate intensity, 31 patients (44%) had MC type I, 20 patients (28%) had MC type II, and one patient (1.4%) had MC type III. Pain level VAS and ODI decreased significantly from the preoperative evaluation to the sixmonth and one-year postoperative evaluations. The surgical outcome (VAS and ODI) was not significantly different between the various types of MC. Conclusions: Posterolateral fusion is an effective treatment in patients with unstable lumbar spines. MC do not have a significant effect on the surgical outcome of these patients.

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        Pial Arteriovenous Fistula with Giant Varices: Report of Two Cases with Good Surgical Outcome

        Morteza Faghih Jouibari,Mehdi Zeinali Zadeh,Masoud Khadivi,Alireza Khoshnevisan,Keisan Moazzeni,Sina Abdollahzade 대한뇌혈관외과학회 2014 Journal of Cerebrovascular and Endovascular Neuros Vol.16 No.2

        Pial arteriovenous fistulas (pAVF) are rare vascular lesions consisting ofone or more arterial connections to a single venous channel without anyintervening nidus of vessels or capillaries. Case 1 : A 65-year-old woman with a complaint of headache and lefthand paresthesia was referred to us. Magnetic resonance imagingshowed a large saccular lesion with signal void in the posterior part ofthe right sylvian fissure and catheter angiography showed a giant venousaneurysm fed by one branch of the middle cerebral artery (MCA) anddraining into the vein of Trolard. Case 2 : A 12-year-old boy was transferred to our hospital with a historyof sudden loss of consciousness and hemiplegia. Brain computed tomographyrevealed a massive hemorrhagic mass in the right hemisphere andcerebral angiography showed a pAVF with a large aneurysmal varix,which was fed by multiple branches of the right MCA and draining intothe superior sagittal sinus. Both patients underwent craniotomy and after ligation of vascular connections,aneurysmal varices were removed completely. Surgical resectioncan be a safe method for treatment of pAVFs, particularly in those withlarge varices.

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