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RISS 인기검색어
- 검색키워드
- 저자 : Lau Eugene Tze Chun (검색결과 2 건)
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Pang Hung Wu,Eugene Tze-Chun Lau,김현성,Giovanni Grasso,장일태 대한척추신경외과학회 2023 Neurospine Vol.20 No.1
Objective: There is a lack of literature on indirect decompression in uniportal endoscopic posterolateral transforaminal lumbar interbody fusion (EPTLIF). Our aim is to evaluate the dimensions of the spinal canal and contralateral foramen before and after EPTLIF. Methods: This is a retrospective study of patients who underwent EPTLIF in a tertiary spine centre over a 2-year period. The cross-sectional area of the spinal canal and the contralateral foramen at the level of fusion were measured on magnetic resonance imaging scan at 1-day postoperation and at the final follow-up. Patients were grouped according to the decompression performed as per the clinician’s judgement. Results: One hundred fifty-two levels of fusion were performed in 120 patients. There was a statistically significant clinical improvement in visual analogue scale and Oswestry Disability Index scores postoperation. The measurements of the spinal canal area were 106.0 mm2 , 138.8 mm2 , and 195.5 mm2 ; while contralateral foraminal area were 73.2 mm2 , 104.4 mm2 , and 120.7 mm2 at preoperation, 1-day postoperation, and at the final follow-up, respectively (p < 0.001). For the subgroup analyses, spinal canal area measurements for the bilateral decompression cohort (n = 35) were 57.0 mm2 , 123.9 mm2 , and 191.8 mm2 ; for the ipsilateral decompression cohort (n = 42) were 89.3 mm2 , 128.9 mm2 , 183.3 mm2 ; and for the cohort without any decompression and only cage inserted (n = 75) were 138.3 mm2 , 151.2 mm2 , and 204.1 mm2 (p < 0.001). Contralateral foraminal area measurements were 73.3 mm2 , 106.4 mm2 and 120.4 mm2 in the bilateral decompression cohort; 69.5 mm2 , 99.0 mm2 , 116.9 mm2 in the ipsilateral decompression cohort; and 75.1 mm2 , 106.5 mm2 , 122.9 mm2 in the cohort without any decompression (p < 0.001). Conclusion: Indirect decompression of both the spinal canal and the contralateral foramen can be achieved via EPTLIF. Decompression on an asymptomatic contralateral side is not necessary.
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Hey Hwee Weng Dennis,Ng Nathaniel Li-Wen,Loh Khin Yee Sammy,Tan Yong Hong,Tan Kimberly-Anne,Moorthy Vikaesh,Lau Eugene Tze Chun,Liu Gabriel Ka-Po,Wong Hee-Kit 대한척추외과학회 2021 Asian Spine Journal Vol.15 No.1
Study Design: Prospective radiographic comparative study.Purpose: To compare and understand the load-bearing properties of each functional spinal unit (FSU) using three commonly assumed, physiological, spinal postures, namely, the flexed (slump sitting), erect (standing) and extended (backward bending) postures. Overview of Literature: Sagittal spinal alignment is posture-dependent and influences the load-bearing properties of the spine. The routine placement of intervertebral cages “as anterior as possible” to correct deformity may compromise the load-bearing capabilities of the spine, leading to complications.Methods: We recruited young patients with nonspecific low back pain for <3 months, who were otherwise healthy. Each patient had EOS images taken in the flexed, erect and extended positions, in random order, as well as magnetic resonance imaging to assess for disk degeneration. Angular and disk height measurements were performed and compared in all three postures using paired t-tests. Changes in disk height relative to the erect posture were caclulated to determine the alignment-specific load-bearing area of each FSU.Results: Eighty-three patients (415 lumbar intervertebral disks) were studied. Significant alignment changes were found between all three postures at L1/2, and only between erect and flexion at the other FSUs. Disk height measurements showed that the neutral axis of the spine, marked by zones where disk heights did not change, varied between postures and was level specific. The load-bearing areas were also found to be more anterior in flexion and more posterior in extension, with the erect spine resembling the extended spine to a greater extent.Conclusions: Load-bearing areas of the lumbar spine are sagittal alignment-specific and level-specific. This may imply that, depending on the surgical realignment strategy, attention should be paid not just to placing an intervertebral cage “as anterior as possible” for generating lordosis, but also on optimizing load-bearing in the lumbar spine.
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