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Maduri Rodolfo,Cossu Giulia,Aureli Viviana,Wüthrich Sonia Plaza,Bobinski Lukas,Duf John Michael 대한척추외과학회 2021 Asian Spine Journal Vol.15 No.5
Study Design: This was a retrospective review of patients with compressive cervical radiculopathy treated with a minimally invasive anterior cervical foraminotomy (ACF). Purpose: This study aimed to evaluate the results and complication rates of ACF in a consecutive series of patients and to report our clinical results of ACF as a minimally invasive technique in a series of 45 consecutive patients treated for compressive cervical radiculopathy. Overview of Literature: ACF is a motion-sparing procedure and an alternative to anterior cervical discectomy and fusion (ACDF) and posterior cervical foraminotomy for direct nerve root decompression in patients with compressive cervical radiculopathy. Methods: The chart review recorded clinical and radiological features preoperatively and postoperatively and at follow-up (FU). The effect of prognostic factors was analyzed in relation to the clinical outcome. Results: Between January 2004 and October 2019, 45 patients (15 females and 30 males) with a mean age of 55.9 years (range, 28–78 years) underwent ACF for unilateral cervical radiculopathy. The global clinical outcome according to the MacNab scale was evaluated as excellent in 64.5% of patients (n=29), good in 28.9% (n=13), fair in 4.4% (n=2), and poor in 2.2% (n=1). The radiological FU was available for 73.3% (n=33). The statistical analysis revealed no influence of age, sex, operated level, and side on the clinical outcome. Only one patient (2.2%) exhibited spontaneous bone fusion at the operated level on FU after a right-sided C6–7 ACF with no clinical consequences. No patient presented with signs of delayed segmental instability. The overall reoperation rate of this series was 4.4%. Conclusions: ACF is a feasible and low-cost alternative to ACDF in selected patients with cervical radiculopathy. The use of tubular retractors in ACF may confer an added advantage that creates a safe corridor for direct cervical root decompression yet minimizing surrounding soft tissue retraction and avoiding unnecessary bone removal.
The Burden of Agoraphobia in Worsening Quality of Life in a Community Survey in Italy
Antonio Preti,Martina Piras,Giulia Cossu,Elisa Pintus,Mirra Pintus,Goce Kalcev,Federico Cabras,Maria Francesca Moro,Ferdinando Romano,Matteo Balestrieri,Filippo Caraci,Liliana Dell’Osso,Guido Di Scias 대한신경정신의학회 2021 PSYCHIATRY INVESTIGATION Vol.18 No.4
Objective Current nosology redefined agoraphobia as an autonomous diagnosis distinct from panic disorder. We investigated the life-time prevalence of agoraphobia, its association with other mental disorders, and its impact on the health-related quality of life (HR-QoL). Methods Community survey in 2,338 randomly selected adult subjects. Participants were interviewed with the Advanced Neuropsy-chiatric Tools and Assessment Schedule (ANTAS), administered by clinicians. The diagnoses were based on the ICD-10 criteria. The Short-Form Health Survey (SF-12) was used to quantify HR-QoL. Results In the sample, 35 subjects met the criteria for agoraphobia (1.5%), with greater prevalence among women (2.0%) than men (0.9%): odds ratio (OR) 2.23; 95% CI: 1.0-5–2. Agoraphobia was more often seen among those with (n=26; 1.1%) than without (n=9; 0.4%) panic disorder: OR=8.3; 2.9–24.4. Co-morbidity with other mental disorders was substantial. The mean score of SF-12 in people with agoraphobia was 35.2±7.8, with similar levels of HR-QoL in people with (35.3±7.9) or without (34.8±7.3) panic disorder: ANOVA: F(1;33)=0.0; p=1.00. Conclusion One out of seventy people may suffer from agoraphobia in their lifetime. The attributable burden in terms of HR-QoL is substantial and comparable to the one observed for chronic mental disorders such as major depression, post-traumatic stress disorder, or obsessive-compulsive disorder. Psychiatry Investig 2021;18(4):277-283