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복강경하 자궁적출술 시 기관내튜브 기낭팽창법 중 공기풍선촉진법과 최소기낭용적팽창법이 수술 후 인후통에 미치는 효과 비교
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Cyclic Dipeptides from Lactic Acid Bacteria Inhibit the Proliferation of Pathogenic Fungi
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Clinical Characteristics in Patients with Vancomycin-Resistant Enterococci Colonization or Infection during 5 years in a Private General Hospital
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Highly dispersive substitution box (S-box) design using chaos
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청소년활동이 협동역량에 미치는 영향: 창의성과 자아존중감의 매개효과를 중심으로
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종양의 치료방침에 관한 최근의 화제
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- 저자 : Katsuhisa Yamada (검색결과 1 건)
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Akira Iwata,Kuniyoshi Abumi,Masahiko Takahata,Hideki Sudo,Katsuhisa Yamada,Tsutomu Endo,Norimasa Iwasaki 대한척추외과학회 2019 Asian Spine Journal Vol.13 No.2
Study Design: Retrospective case-control study, level 4. Purpose: To clarify the risk factors for late subaxial lesion after occipitocervical (O-C) reconstruction. We examined cases requiring fusion-segment-extended (FE) reconstruction in addition to/after O-C reconstruction. Overview of Literature: Patients with rheumatoid arthritis (RA) frequently require O-C reconstruction surgery for cranio-cervical lesions. Acceptable outcomes are achieved via indirect decompression using cervical pedicle screws and occipital plate–rod systems. However, late subaxial lesions may develop occasionally following O-C reconstruction. Methods: O-C reconstruction using cervical pedicle screws and occipital plate–rod systems was performed between 1994 and 2007 in 113 patients with RA. Occipito-atlanto-axial (O-C2) reconstruction was performed for 89 patients, and occipito-subaxial cervical (O-under C2) reconstruction was performed for 24 patients. We reviewed the cases of patients requiring FE reconstruction (fusion extended group, FEG) and 26 consecutive patients who did not require FE reconstruction after a follow-up of >5 years (non-fusion extended group, NEG) as controls. Results: FE reconstructions were performed for nine patients at an average of 45 months (range, 24–180 months) after O-C reconstruction. Of the 89 patients, three (3%) underwent FE reconstruction in cases of O-C2 reconstruction. Of the 24 patients, five (21%) underwent FE reconstruction in cases of O-under C2 reconstruction (p =0.003, Fisher exact test). Age, sex, RA type, and neurological impairment stage were not significantly different between FEG and NEG. O-under C2 reconstruction, larger correction angle (4° per number of unfixed segment), and O-C7 angle change after O-C reconstruction were the risk factors for late subaxial lesions on radiographic assessment. Conclusions: Overcorrection of angle at fusion segments requiring O-C7 angle change was a risk factor for late subaxial lesion in patients with RA with fragile bones and joints. Correction should be limited, considering the residual mobility of the cervical unfixed segments.
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