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Kei Ando,Shiro Imagama,Norimitsu Wakao,Kenichi Hirano,Ryoji Tauchi,Akio Muramoto,Hiroki Matsui,Tomohiro Matsumoto,Yukihiro Matsuyama,Naoki Ishiguro 연세대학교의과대학 2012 Yonsei medical journal Vol.53 No.3
Purpose: Thoracic dumbbell tumors are relatively rare, usually arising from neurogenic elements. Methods for surgical removal thereof remain controversial. The purpose of this study was to evaluate the surgical results of a single-stage posterior approach with laminectomy and costotransversectomy only for the management of thoracic dumbbell tumors. Materials and Methods: Eight cases of thoracic large dumbbell tumor were analyzed retrospectively: seven men and one woman (mean age, 49 years). Pathologic findings included schwannoma in five patients, neurofibroma in two patients (Recklinghausen in one patient), and ganglioneuroma in one patient. All patients underwent single-stage removal of dumbbell tumors by a posterior approach followed by laminectomy and costotransversectomy combined with instrumentation. Clinical and radiologic outcomes were reviewed, thereafter. Results: Operative time ranged from 185 to 420 minutes (mean, 313 minutes), with estimated blood loss ranging from 71 to 1830 mL (mean, 658 mL). Postoperative complications included atelectasis in one case. All patients had tumors successfully removed with no neurological deterioration. Spinal deformities were not observed in any patients at the last follow-up (mean, 52 months), with instrumentation. Conclusion: Single-stage surgery with laminectomy and costotransversectomy may be useful for removing thoracic dumbbell tumors without a combined anterior approach.
Hirofumi Bekki,Katsumi Harimaya,Yoshihiro Matsumoto,Kenichi Kawaguchi,Mitsumasa Hayashida,Seiji Okada,Toshio Doi,Yasuharu Nakashima 대한척추외과학회 2018 Asian Spine Journal Vol.12 No.4
Study Design: Prospective cohort study. Purpose: The present study aimed to evaluate the difference in the preoperative curve fl exibility between the supine and prone positions in patients with adolescent idiopathic scoliosis (AIS). Overview of Literature: In AIS, a side-bending view is necessary to differentiate a structural curve from a nonstructural curve using the Lenke classifi cation system. However, there are no published studies about which position, supine or prone, is more effective when evaluating preoperative curve fl exibility using side-bending X-ray images in AIS patients. Methods: Radiographs were analyzed for 32 AIS patients (26 females, six males) who underwent posterior correction and fusion of their main thoracic (MT) curves. Cobb angles of MT, proximal thoracic (PT), and thoracolumbar/lumbar (TL/L) curves were measured preoperatively using upright, supine (anteroposterior and side-bending), and prone (posteroanterior and side-bending) X-rays. Results: The average Cobb angles of PT, MT, and TL/L curves on preoperative upright/supine/prone X-rays were 29.1°/26.7°/26.6°, 60.7°/48.5°/48.2°, and 41.0°/32.6°/33.1°, respectively. The average Cobb angles of PT, MT, and TL/L curves on supine/prone sidebending X-rays were 19.2°/20.3°, 36.3°/36.4°, and 13.9°/15.7°, respectively. The fl exibility rates of PT, MT, and TL/L curves in supine/ prone positions were 35.3%/32.5%, 40.6%/40.2%, and 71.7%/68.2%, respectively. Comparing fl exibility rates in the prone position with those in the supine position in each case, the average ratios of PT, MT, and TL/L curves were found to be 1.0, 1.0, and 0.9, respectively. There were no statistically signifi cant differences between supine and prone side-bending X-ray measurements. However, the Lenke classifi cation in six of 32 patients (18.8%) differed between supine and prone positions because the TL/L curve in the supine position was slightly more fl exible than in the prone position. Conclusions: Supine side-bending fi lms may be suitable for the evaluation of preoperative curve fl exibility in AIS, especially for lumbar modifi er C.