The Experts below are selected from a list of 2016 Experts worldwide ranked by ideXlab platform

Yoshiharu Kawaguchi - One of the best experts on this subject based on the ideXlab platform.

Xiangyang Guo - One of the best experts on this subject based on the ideXlab platform.

  • preoperative x ray c 2 c 6 ar is applicable for prediction of difficult laryngoscopy in patients with Cervical Spondylosis
    BMC Anesthesiology, 2021
    Co-Authors: Yang Zhou, Jun Wang, Yongzheng Han, Yuqing Zhao, Ning Yang, Taotao Liu, Xiangyang Guo
    Abstract:

    Background Airway management is one of the most important techniques in anesthesia practice and inappropriate airway management is related with airway injury, brain hypoxia, and even death. The patients with Cervical Spondylosis are often confronted with difficult laryngoscopy who are more prone to appear difficult airway, so it is important to figure out valuable predictors of difficult laryngoscopy in these patients. Methods We randomly enrolled 270 patients undergoing elective Cervical spine surgery and analyzed the Cervical mobility data in predicting difficult laryngoscopy. The preoperative X-ray radiological indicators were measured by an attending radiologist. Cormack-Lehane scales were assessed during intubation, and patients with a class III or IV view were assigned to the difficult laryngoscopy group. Results Univariate analysis showed that the hyomental distance (HMD, the distance between the hyoid bone and the tip of the chin) and the hyomental distance ratio (HMDR, the ratio between HMD in the extension position and the one in the neutral position) might not be suitable indicators in patients with Cervical Spondylosis. Binary multivariate logistic regression (backward-Wald) analyses identified two independent correlative factors from the Cervical mobility indicators that correlated best as a predictor of difficult laryngoscopy: modified Mallampati test (MMT) and C2C6AR (the ratio of the angle between a line passing through the bottom of the second Cervical vertebra and a line passing through the bottom of the sixth Cervical vertebra in the extension position and the one in the neutral position). The odds ratio (OR) and 95 % CI were 2.292(1.093-4.803) and 0.493 (0.306-0.793), respectively. C2C6AR exhibited the largest area under the curve (0.714; 95 % CI 0.633-0.794). Conclusions C2C6AR based on preoperative X-ray images may be the most accurate predictor of Cervical mobility indicators for difficult laryngoscopy in patients with Cervical Spondylosis. Trial registration The study was registered at the Chinese Clinical Trial Registry ( http://www.chictr.org.cn ; identifier: ChiCTR-ROC-16,008,598) on June 6, 2016.

  • radiologic indicators for prediction of difficult laryngoscopy in patients with Cervical Spondylosis
    Acta Anaesthesiologica Scandinavica, 2018
    Co-Authors: Yongzheng Han, Yang Tian, H Zhang, Yan Zhao, Xiangyang Guo
    Abstract:

    BACKGROUND We identified the most useful variables for prediction of difficult laryngoscopy in patients with Cervical Spondylosis according to physical indicators and preoperative skeletal X-ray and soft tissue MRI measurements. We hypothesized that there was a closer association between difficult laryngoscopy and radiologic indicators. METHODS We randomly enroled 315 patients undergoing elective Cervical spine surgery and analysed the radiological and physical data in predicting difficult laryngoscopy. RESULTS We identified five variables that were most useful in predicting difficult laryngoscopy: the inter-incisor gap (P = 0.006), modified Mallampati test score (P = 0.004), distance from the highest point of the hyoid bone to the mandibular body (P 0.05) and that of modified Mallampati test (0.602, P < 0.05). CONCLUSION Distance from the highest point of the hyoid bone to the mandibular body appears to be the most accurate indicator for difficult laryngoscopy in patients with Cervical Spondylosis.

  • shikani optical stylet versus macintosh laryngoscope for intubation in patients undergoing surgery for Cervical Spondylosis a randomized controlled trial
    Chinese Medical Journal, 2017
    Co-Authors: Xiangyang Guo, Jun Wang
    Abstract:

    Background: Airway management is critical in patients with Cervical Spondylosis, a population with a high incidence of difficult airway. Intubation with Shikani Optical Stylet (SOS) has become increasingly popular in difficult airway. We compared the effects of intubation with SOS versus Macintosh laryngoscope (MLS) in patients undergoing surgery for Cervical Spondylosis. Methods: A total of 270 patients scheduled for elective surgery for Cervical Spondylosis of spinal cord and nerve root type from August 2012 to January 2016 were enrolled and randomly allocated to the MLS or SOS group by random numbers. Patients were evaluated for difficult airway preoperatively, and Cormack-Lehane laryngoscopy classification was determined during anesthesia induction. Difficult airway was defined as Cormack-Lehane Grades III–IV. Patients were intubated with the randomly assigned intubation device. The success rate, intubation time, required assistance, immediate complications, and postoperative complaints were recorded. Categorical variables were analyzed by Chi-square test, and continuous variables were analyzed by independent samples t-test or rank sum test. Results: The success rate of intubation among normal airways was 100% in both groups. In patients with difficult airway, the success rates in the MLS and SOS groups were 84.2% and 94.1%, respectively (P = 0.605). Intubation with SOS took longer compared with MLS (normal airway: 25.1 ± 5.8 s vs. 24.5 ± 5.7 s, P = 0.426; difficult airway: 38.5 ± 8.5 s vs. 36.1 ± 8.2 s, P = 0.389). Intubation with SOS required less assistance in patients with difficult airway (5.9% vs. 100%, P < 0.001). The frequency of postoperative sore throat was lower in SOS group versus MLS group in patients with normal airway (22.0% vs. 34.5%, P = 0.034). Conclusions: SOS is a safe and effective airway management device in patients undergoing surgery for Cervical Spondylosis. Compared with MLS, SOS appears clinically beneficial for intubation, especially in patients with difficult airway. Trial Registration: Chinese Clinical Trial Registry, ChiCTR-IOR-16007821; http://www.chictr.org.cn/showproj.aspx?proj=13203. Key words: Airway; Cervical Spondylosis; Intubation; Laryngoscope; Optical Stylet

  • application of a new combined model including radiological indicators to predict difficult airway in patients undergoing surgery for Cervical Spondylosis
    Chinese Medical Journal, 2014
    Co-Authors: Jun Wang, Xiangyang Guo
    Abstract:

    Background Airway management is crucial in clinical anesthesia. Many complications associated with airway management result from unexpected difficult airway, but predicting a difficult airway is a major challenge. We investigated the efficacy of a new combined model including radiological indicators to predict difficult airway in patients undergoing surgery for Cervical Spondylosis, a population with a high incidence of difficult airway. Methods We randomly enrolled 303 patients scheduled for elective surgery for Cervical Spondylosis at Peking University Third Hospital between August 2012 and March 2013. Preoperatively, patients were evaluated for difficult airway according to a clinical index and parameters on lateral Cervical radiographs and magnetic resonance images. Difficult airway was defined as Cormack-Lehane grades III-IV. Logistic regression was used to identify a combined (clinical and radiological) model for difficult airway. A receiver operating characteristic (ROC) curve was used to describe the effectiveness of prediction. Results We identified three clinical predictive factors using the ROC curve: mouth opening, sternomental distance, and neck mobility. We created a clinical model using three factors: gender, age, and mouth opening, with odds ratios (OR) of 0.370, 1.034, and 0.358, respectively. Using the clinical and radiological parameters, we formulated a combined model with five risk factors: gender, mouth opening, atlanto-occipital gap, the angle from the second to sixth Cervical vertebraes in the neutral position, and the angle difference of d (the angle between the laryngeal axis and the epiglottic axis) from the neutral position to extension (OR: 0.107, 0.355, 0.846, 1.057, and 0.952, respectively). The sensitivity and specificity of the combined model were 80.0% and 65.7%, respectively, and the ROC curve confirmed that the combined model was better than any single clinical predictor and the clinical model. Conclusion The efficacy of the combined model including both clinical and radiological indicators was better than any single clinical predictor or the clinical model in patients undergoing elective surgery for Cervical Spondylosis.

Hamid Hassanzadeh - One of the best experts on this subject based on the ideXlab platform.

  • complications and mortality following one to two level anterior Cervical fusion for Cervical Spondylosis in patients above 80 years of age
    Spine, 2017
    Co-Authors: Varun Puvanesarajah, Amit Jain, Adam L Shimer, Anuj Singla, Francis H Shen, Hamid Hassanzadeh
    Abstract:

    STUDY DESIGN A retrospective database review. OBJECTIVE The aim of this study was to determine the complication and mortality rates in patients 80 years of age and older who were treated with anterior Cervical fusion surgery and to compare these rates against those of other elderly patients. SUMMARY OF BACKGROUND DATA Cervical Spondylosis is frequently observed in the elderly and is the most common cause of myelopathy in older adults. With increasing life expectancies, a greater proportion of patients are being treated with spine surgery at a later age. Limited information is available regarding outcomes following anterior Cervical fusion surgery in patients 80 years of age or older. METHODS Medicare data from the PearlDiver Database (2005-2012) were queried for patients who underwent primary one to two-level anterior Cervical spine fusion surgeries for Cervical Spondylosis. After excluding patients with prior spine metastasis, bone cancer, spine trauma, or spine infection, this cohort was divided into two study groups: patients 65 to 79 (51,808) and ≥80 years old (5515) were selected. A cohort of matched control patients was selected from the 65 to 79-year-old and 90-day complication rates and 90-day and 1-year mortality rates were compared between cohorts. RESULTS The proportion of patients experiencing at least one major medical complication was relatively increased by 53.4% in patients aged ≥80 years [odds ratio (OR) 1.63]. Patients 80 years of age or older were more likely to experience dysphagia (OR 2.16), reintubation (OR 2.34), and aspiration pneumonitis (OR 3.17). Both 90-day (OR: 4.34) and 1-year (OR 3.68) mortality were significantly higher in the ≥80 year cohort. CONCLUSION Patients 80 years of age or older are more likely to experience a major medical complication or mortality following anterior Cervical fusion for Cervical Spondylosis than patients 65 to 79 years old. Dysphagia, aspiration pneumonitis, and reintubation rates are also significantly higher in patients 80 years of age or older. Although complication rates may be higher in this patient population, carefully selected patients could potentially derive much benefit from surgery and should not be screened out solely on the basis of age. LEVEL OF EVIDENCE 4.

  • readmission rates reasons and risk factors following anterior Cervical fusion for Cervical Spondylosis in patients above 65 years of age
    The Spine Journal, 2016
    Co-Authors: Varun Puvanesarajah, Adam L Shimer, Francis H Shen, Hamid Hassanzadeh, Anuj Singla
    Abstract:

    Study design A retrospective database review. Objective The aim of this study was to determine readmission reasons and rates following primary, elective anterior Cervical spinal fusion surgery for Cervical Spondylosis and determine risk factors predicting increased risk of 30-day readmission in an exclusively elderly population. Summary of background data In the United States, there were almost 190,000 Cervical spine procedures in 2009. Many Cervical spine surgery patients are elderly, a demographic increasingly requiring surgery for degenerative Cervical spine pathology. Unfortunately, this patient population is poorly studied, particularly concerning readmission rates. Methods Medicare data from 2005 to 2012 were queried for elderly patients (65-84 years) who underwent primary one to two and ≥three-level anterior Cervical spine fusion surgeries for Cervical Spondylosis. Forty-five thousand two hundred eighty-four patients treated with one to two-level and 12,103 patients with ≥three-level anterior Cervical fusion (ACF) were identified and included in two study cohorts. Reasons for and rates of readmission were determined within 30 days, 90 days, and one-year postoperatively. Risk factors for medical, surgical, and all 30-day readmissions were also determined, selecting from various comorbidities, demographics, and surgical variables. Results Readmission rates of 1.0% to 1.4%, 2.7% to 3.6%, and 13.2% to 14.1% were observed within 30 days, 90 days, and one year. Within 30 days, over 30% of patients from both study cohorts were readmitted for surgical reasons. Of surgical reasons for 30-day readmission, hematoma/seroma diagnoses were the most frequent (11.4%-15.4% of all readmissions). Male gender, diabetes mellitus, chronic pulmonary disease, obesity, and smoking history were all found to be predictive of all-cause readmissions. Conclusion Unplanned 30-day readmission rates following primary, elective ACF in elderly patients is low and often due to medical reasons. Frequent surgical reasons for 30-day readmission include hematoma/seroma formation. Male gender and various comorbid diagnoses are significant predictors of all-cause readmissions within 30 days. Level of evidence 3.

Li Cui - One of the best experts on this subject based on the ideXlab platform.

  • EasiCS: the objective and fine-grained classification method of Cervical Spondylosis dysfunction
    2019
    Co-Authors: Wang Nana, Li Cui, Xi Huang, Xiang Yingcong, Xiao Jing, Yi Rao
    Abstract:

    The precise diagnosis is of great significance in developing precise treatment plans to restore neck function and reduce the burden posed by the Cervical Spondylosis (CS). However, the current available neck function assessment method are subjective and coarse-grained. In this paper, based on the relationship among CS, Cervical structure, Cervical vertebra function, and surface electromyography (sEMG), we seek to develop a clustering algorithms on the sEMG data set collected from the clinical environment and implement the division. We proposed and developed the framework EasiCS, which consists of dimension reduction, clustering algorithm EasiSOM, spectral clustering algorithm EasiSC. The EasiCS outperform the commonly used seven algorithms overall

  • a convenient non harm Cervical Spondylosis intelligent identity method based on machine learning
    Scientific Reports, 2018
    Co-Authors: Nana Wang, Xi Huang, Yi Rao, Jing Xiao, Nian Wang, Li Cui
    Abstract:

    Cervical Spondylosis (CS), a most common orthopedic diseases, is mainly identified by the doctor’s judgment from the clinical symptoms and Cervical change provided by expensive instruments in hospital. Owing to the development of the surface electromyography (sEMG) technique and artificial intelligence, we proposed a convenient non-harm CS intelligent identify method EasiCNCSII, including the sEMG data acquisition and the CS identification. Faced with the limit testable muscles, the data acquisition method are proposed to conveniently and effectively collect data based on the tendons theory and CS etiology. Faced with high-dimension and the weak availability of the data, the 3-tier model EasiAI is developed to intelligently identify CS. The common features and new features are extracted from raw sEMG data in first tier. The EasiRF is proposed in second tier to further reduce the data dimension, improving the performance. A classification model based on gradient boosted regression tree is developed in third tier to identify CS. Compared with 4 common machine learning classification models, the EasiCNCSII achieves best performance of 91.02% in mean accuracy, 97.14% in mean sensitivity, 81.43% in mean specificity, 0.95 in mean AUC.

  • a convenient non harm Cervical Spondylosis intelligent identity method based on machine learning
    bioRxiv, 2018
    Co-Authors: Nana Wang, Li Cui, Xi Huang, Yi Rao, Yunyou Huang, Fanda Fan, Jing Xiao
    Abstract:

    Cervical Spondylosis (CS), one of the most common orthopedic diseases, poses a serious financial burden on individuals and society. The early detection is an effective way to reduce the burden, since the earlier the CS is detected, the easier it is to treat, the higher the cure rate is, and the less the patient spend. However, the CS identification is mainly determined by the doctor9s judgment based on the clinical symptoms and the morphological or structural changes of spine depending on expensive medical instruments in hospital, which may have potential harm to the human body, for example radiation. Owing to the development of the surface electromyography (sEMG, in short) technique and artificial intelligence, a convenient non-harm intelligent CS identification method EasiCNCSII is proposed in this paper, which consist of the sEMG data acquisition and CS identification. For the sEMG acquisition, a convenient method based on the relationship between muscle activity and CS is proposed. It spend less than 20 minutes with the simple instructor and can be easily performed in the non-hospital environment. For the CS identification, the EasiAI model based on machine learning is developed to intelligently identify CS and achieve a performance with 91.02% in accuracy, 97.14% in sensitivity, and 81.43% in specificity.

  • EasiCSDeep: A deep learning model for Cervical Spondylosis Identification using surface electromyography signal
    2018
    Co-Authors: Wang Nana, Li Cui, Xi Huang, Xiang Yingcong, Xiao Jing
    Abstract:

    Cervical Spondylosis (CS) is a common chronic disease that affects up to two-thirds of the population and poses a serious burden on individuals and society. The early identification has significant value in improving cure rate and reducing costs. However, the pathology is complex, and the mild symptoms increase the difficulty of the diagnosis, especially in the early stage. Besides, the time-consuming and costliness of hospital medical service reduces the attention to the CS identification. Thus, a convenient, low-cost intelligent CS identification method is imperious demanded. In this paper, we present an intelligent method based on the deep learning to identify CS, using the surface electromyography (sEMG) signal. Faced with the complex, high dimensionality and weak usability of the sEMG signal, we proposed and developed a multi-channel EasiCSDeep algorithm based on the convolutional neural network, which consists of the feature extraction, spatial relationship representation and classification algorithm. To the best of our knowledge, this EasiCSDeep is the first effort to employ the deep learning and the sEMG data to identify CS. Compared with previous state-of-the-art algorithm, our algorithm achieves a significant improvement

Anuj Singla - One of the best experts on this subject based on the ideXlab platform.

  • complications and mortality following one to two level anterior Cervical fusion for Cervical Spondylosis in patients above 80 years of age
    Spine, 2017
    Co-Authors: Varun Puvanesarajah, Amit Jain, Adam L Shimer, Anuj Singla, Francis H Shen, Hamid Hassanzadeh
    Abstract:

    STUDY DESIGN A retrospective database review. OBJECTIVE The aim of this study was to determine the complication and mortality rates in patients 80 years of age and older who were treated with anterior Cervical fusion surgery and to compare these rates against those of other elderly patients. SUMMARY OF BACKGROUND DATA Cervical Spondylosis is frequently observed in the elderly and is the most common cause of myelopathy in older adults. With increasing life expectancies, a greater proportion of patients are being treated with spine surgery at a later age. Limited information is available regarding outcomes following anterior Cervical fusion surgery in patients 80 years of age or older. METHODS Medicare data from the PearlDiver Database (2005-2012) were queried for patients who underwent primary one to two-level anterior Cervical spine fusion surgeries for Cervical Spondylosis. After excluding patients with prior spine metastasis, bone cancer, spine trauma, or spine infection, this cohort was divided into two study groups: patients 65 to 79 (51,808) and ≥80 years old (5515) were selected. A cohort of matched control patients was selected from the 65 to 79-year-old and 90-day complication rates and 90-day and 1-year mortality rates were compared between cohorts. RESULTS The proportion of patients experiencing at least one major medical complication was relatively increased by 53.4% in patients aged ≥80 years [odds ratio (OR) 1.63]. Patients 80 years of age or older were more likely to experience dysphagia (OR 2.16), reintubation (OR 2.34), and aspiration pneumonitis (OR 3.17). Both 90-day (OR: 4.34) and 1-year (OR 3.68) mortality were significantly higher in the ≥80 year cohort. CONCLUSION Patients 80 years of age or older are more likely to experience a major medical complication or mortality following anterior Cervical fusion for Cervical Spondylosis than patients 65 to 79 years old. Dysphagia, aspiration pneumonitis, and reintubation rates are also significantly higher in patients 80 years of age or older. Although complication rates may be higher in this patient population, carefully selected patients could potentially derive much benefit from surgery and should not be screened out solely on the basis of age. LEVEL OF EVIDENCE 4.

  • readmission rates reasons and risk factors following anterior Cervical fusion for Cervical Spondylosis in patients above 65 years of age
    The Spine Journal, 2016
    Co-Authors: Varun Puvanesarajah, Adam L Shimer, Francis H Shen, Hamid Hassanzadeh, Anuj Singla
    Abstract:

    Study design A retrospective database review. Objective The aim of this study was to determine readmission reasons and rates following primary, elective anterior Cervical spinal fusion surgery for Cervical Spondylosis and determine risk factors predicting increased risk of 30-day readmission in an exclusively elderly population. Summary of background data In the United States, there were almost 190,000 Cervical spine procedures in 2009. Many Cervical spine surgery patients are elderly, a demographic increasingly requiring surgery for degenerative Cervical spine pathology. Unfortunately, this patient population is poorly studied, particularly concerning readmission rates. Methods Medicare data from 2005 to 2012 were queried for elderly patients (65-84 years) who underwent primary one to two and ≥three-level anterior Cervical spine fusion surgeries for Cervical Spondylosis. Forty-five thousand two hundred eighty-four patients treated with one to two-level and 12,103 patients with ≥three-level anterior Cervical fusion (ACF) were identified and included in two study cohorts. Reasons for and rates of readmission were determined within 30 days, 90 days, and one-year postoperatively. Risk factors for medical, surgical, and all 30-day readmissions were also determined, selecting from various comorbidities, demographics, and surgical variables. Results Readmission rates of 1.0% to 1.4%, 2.7% to 3.6%, and 13.2% to 14.1% were observed within 30 days, 90 days, and one year. Within 30 days, over 30% of patients from both study cohorts were readmitted for surgical reasons. Of surgical reasons for 30-day readmission, hematoma/seroma diagnoses were the most frequent (11.4%-15.4% of all readmissions). Male gender, diabetes mellitus, chronic pulmonary disease, obesity, and smoking history were all found to be predictive of all-cause readmissions. Conclusion Unplanned 30-day readmission rates following primary, elective ACF in elderly patients is low and often due to medical reasons. Frequent surgical reasons for 30-day readmission include hematoma/seroma formation. Male gender and various comorbid diagnoses are significant predictors of all-cause readmissions within 30 days. Level of evidence 3.