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Hiroaki Nakamura - One of the best experts on this subject based on the ideXlab platform.
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Spinopelvic Sagittal Alignment after Microendoscopic Laminotomy in Patients with Lumbar Degenerative Spondylolisthesis.
Central European Neurosurgery, 2018Co-Authors: Sho Dohzono, Hiromitsu Toyoda, Akinobu Suzuki, Hidetomi Terai, Yusuke Hori, Shinji Takahashi, Hiroaki NakamuraAbstract:BACKGROUND AND STUDY AIMS Spinopelvic sagittal balance is important in managing lumbar diseases. We evaluated the change in spinal sagittal alignment after microendoscopic Laminotomy in patients with low-grade degenerative spondylolisthesis (DS). MATERIAL AND METHODS We retrospectively reviewed the records of 87 patients who underwent microendoscopic Laminotomy. We enrolled 35 patients with DS and 52 patients without DS. Spinopelvic parameters were evaluated, including the sagittal vertical axis (SVA), lumbar lordosis (LL), sacral slope, pelvic tilt, and pelvic incidence (PI). Primary outcome was a change in spinopelvic alignment between the baseline and latest follow-up values (DS group versus non-DS group). Secondary outcomes were the relationships between improved global sagittal alignment and preoperative spinopelvic parameters. RESULTS Both groups showed significantly alleviated low back pain (LBP), leg pain, and leg numbness. Preoperative SVA and PI were significantly higher in the DS group than in the non-DS group (p
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Spinopelvic Sagittal Alignment after Microendoscopic Laminotomy in Patients with Lumbar Degenerative Spondylolisthesis.
Journal of neurological surgery. Part A Central European neurosurgery, 2018Co-Authors: Sho Dohzono, Hiromitsu Toyoda, Akinobu Suzuki, Hidetomi Terai, Yusuke Hori, Shinji Takahashi, Hiroaki NakamuraAbstract:Spinopelvic sagittal balance is important in managing lumbar diseases. We evaluated the change in spinal sagittal alignment after microendoscopic Laminotomy in patients with low-grade degenerative spondylolisthesis (DS). We retrospectively reviewed the records of 87 patients who underwent microendoscopic Laminotomy. We enrolled 35 patients with DS and 52 patients without DS. Spinopelvic parameters were evaluated, including the sagittal vertical axis (SVA), lumbar lordosis (LL), sacral slope, pelvic tilt, and pelvic incidence (PI). Primary outcome was a change in spinopelvic alignment between the baseline and latest follow-up values (DS group versus non-DS group). Secondary outcomes were the relationships between improved global sagittal alignment and preoperative spinopelvic parameters. Both groups showed significantly alleviated low back pain (LBP), leg pain, and leg numbness. Preoperative SVA and PI were significantly higher in the DS group than in the non-DS group (p < 0.05). SVA significantly decreased and LL significantly increased in the DS group (p < 0.05), whereas those parameters did not differ significantly from before versus after surgery in the non-DS group. In both groups, SVA improvement correlated significantly with preoperative SVA (DS: r = 0.702; non-DS: r = 0.397). There was also a significant intergroup difference in the correlation coefficient (z = 1.98; r = 0.048). SVA and LL significantly improved after microscopic Laminotomy in patients with low-grade DS and neurologic symptoms. SVA improvement in the DS group was correlated with preoperative spinopelvic sagittal imbalance. The strength of those correlations was greater in the DS group than in the non-DS group. Georg Thieme Verlag KG Stuttgart · New York.
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spinopelvic sagittal alignment after microendoscopic Laminotomy in patients with lumbar degenerative spondylolisthesis
Central European Neurosurgery, 2018Co-Authors: Sho Dohzono, Hiromitsu Toyoda, Akinobu Suzuki, Hidetomi Terai, Yusuke Hori, Shinji Takahashi, Hiroaki NakamuraAbstract:BACKGROUND AND STUDY AIMS Spinopelvic sagittal balance is important in managing lumbar diseases. We evaluated the change in spinal sagittal alignment after microendoscopic Laminotomy in patients with low-grade degenerative spondylolisthesis (DS). MATERIAL AND METHODS We retrospectively reviewed the records of 87 patients who underwent microendoscopic Laminotomy. We enrolled 35 patients with DS and 52 patients without DS. Spinopelvic parameters were evaluated, including the sagittal vertical axis (SVA), lumbar lordosis (LL), sacral slope, pelvic tilt, and pelvic incidence (PI). Primary outcome was a change in spinopelvic alignment between the baseline and latest follow-up values (DS group versus non-DS group). Secondary outcomes were the relationships between improved global sagittal alignment and preoperative spinopelvic parameters. RESULTS Both groups showed significantly alleviated low back pain (LBP), leg pain, and leg numbness. Preoperative SVA and PI were significantly higher in the DS group than in the non-DS group (p < 0.05). SVA significantly decreased and LL significantly increased in the DS group (p < 0.05), whereas those parameters did not differ significantly from before versus after surgery in the non-DS group. In both groups, SVA improvement correlated significantly with preoperative SVA (DS: r = 0.702; non-DS: r = 0.397). There was also a significant intergroup difference in the correlation coefficient (z = 1.98; r = 0.048). CONCLUSIONS SVA and LL significantly improved after microscopic Laminotomy in patients with low-grade DS and neurologic symptoms. SVA improvement in the DS group was correlated with preoperative spinopelvic sagittal imbalance. The strength of those correlations was greater in the DS group than in the non-DS group.
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the influence of preoperative spinal sagittal balance on clinical outcomes after microendoscopic Laminotomy in patients with lumbar spinal canal stenosis
Journal of Neurosurgery, 2015Co-Authors: Sho Dohzono, Hiromitsu Toyoda, Tomiya Matsumoto, Akinobu Suzuki, Hidetomi Terai, Hiroaki NakamuraAbstract:OBJECT More information about the association between preoperative anterior translation of the C-7 plumb line and clinical outcomes after decompression surgery in patients with lumbar spinal canal stenosis (LSS) would help resolve problems for patients with sagittal imbalance. The authors evaluated whether preoperative sagittal alignment of the spine affects low-back pain and clinical outcomes after microendoscopic Laminotomy. METHODS This study was a retrospective review of prospectively collected surgical data. The study comprised 88 patients with LSS (47 men and 41 women) who ranged in age from 39 to 86 years (mean age 68.7 years). All patients had undergone microendoscopic Laminotomy at Osaka City University Graduate School of Medicine from May 2008 through October 2012. The minimum duration of clinical and radiological follow-up was 6 months. All patients were evaluated by Japanese Orthopaedic Association (JOA) and visual analog scale (VAS) scores for low-back pain, leg pain, and leg numbness before ...
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Objective assessment of reduced invasiveness in MED. Compared with conventional one-level Laminotomy.
European spine journal : official publication of the European Spine Society the European Spinal Deformity Society and the European Section of the Cerv, 2005Co-Authors: Ryuichi Sasaoka, Hidetomi Terai, Hiroaki Nakamura, Sadahiko Konishi, Ryuichi Nagayama, Eisuke Suzuki, Kunio TakaokaAbstract:Microendoscopic discectomy (MED) has been accepted as a minimally invasive procedure for lumbar discectomy because of the small skin incision and short hospital stay required for this surgery. However, there are few objective laboratory data to confirm the reduced systemic responses in the early phase after this procedure. In order to substantiate the reduced invasiveness of MED compared to microdiscectomy (MD) or procedures involved in one-level unilateral Laminotomy, the invasiveness of each surgical procedure was evaluated by measuring serum levels of biochemical parameters reflective of a post-operative inflammatory reaction and damage to the paravertebral muscles. Thirty-three patients who underwent lumbar discectomy or one-level unilateral Laminotomy (MED in 15 cases, MD in 11 cases and one-level unilateral Laminotomy in 7 cases with lumbar spinal canal stenosis) were included in this study. The serum levels of C-reactive protein (CRP) and creatine phosphokinase (CPK) were measured at 24 h after operation. Interleukin-6 (IL-6) and Interleukin-10 (IL-10) were measured at 2, 4, 8 and −24 h following the surgery to monitor the inflammatory response to the respective surgery. The post-operative serum CRP levels from both the MD and MED groups were significantly lower than those from the open Laminotomy group. However, there was no significant difference in these serum levels between the MED and MD groups. The levels of IL-6 and IL-10 in the MED group during0 the first post-operative day were also significantly lower than those in the Laminotomy group. When the MED and MD groups were compared, the IL-6 levels in the MED group were lower than in MD group at 2, 4 and 8 h after surgery, but the differences were not statistically significant. However, the level was significantly lower in the MED group at 24 h after surgery. In terms of IL-10, no significant difference was noted between the MED and MD groups over the study period. The changes in serum levels of post-operative inflammatory: markers (CRP, IL-6 and IL-10) in the early phase indicated reduced inflammatory reactions in MED as well as in MD when compared with classical open unilateral Laminotomy. These data draw a direct link between the lower level of the inflammatory response and reduced invasiveness of MED. However, an indicator for muscle damage (CPK) appeared not to be affected by the type of surgical procedure used to correct disc herniation.
David D. Kim - One of the best experts on this subject based on the ideXlab platform.
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Rates of Lead Migration and Stimulation Loss in Spinal Cord Stimulation: A Retrospective Comparison of Laminotomy Versus Percutaneous Implantation
Pain Physician, 2011Co-Authors: David D. KimAbstract:Background: Neuromodulation has been used to treat neuropathic pain. Leads have been implanted using Laminotomy or percutaneous approaches. Laminotomy implantation has been shown to be superior in terms of lead migration when compared to percutaneous implantation. Lead migration has been reported as high as 68% with the percutaneous approach. Because of this, newer anchors have been developed but not tested in vivo. Objectives: This study tests the hypothesis that newer anchoring systems have improved lead migration rates for percutaneous leads relative to Laminotomy leads to the point of parity. This study also analyzed if factors such as laterality of symptoms, lead type, level of implant and diagnosis affect migration rates. Study Design: Neurostimulators implanted in the thoracolumbar spine at Henry Ford Hospital between 2006 and 2008 were reviewed for the following: age, sex, diagnosis, lead type, and implant level. Implants were reviewed for the following: age, sex, diagnosis, lead type, implant level, implant method, symptom laterality, loss of stimulation, radiographic lead migration, and time to loss. Loss of capture and lead migration in the Laminotomy and percutaneous groups were compared using Fisher’s exact test. Variables within each group included: lead type, level of implantation, location of symptoms, and diagnosis. They were compared using Fisher’s exact test. Time to loss of stimulation was compared using the Wilcoxon 2-sample test. Setting: Pain Clinic, Henry Ford Hospital, Detroit, MI. Results: Laminotomies were performed by a single neurosurgeon and percutaneous implants were performed by a single pain medicine specialist. Percutaneous leads were anchored using Titan (Medtronic Corporation, Minneapolis, MN) anchors. Loss of capture was 24% Laminotomy and 23% percutaneous with no significant difference between the 2 groups (P = 0.787). Radiographic evidence of migration was 13.63% percutaneous and 12.67% Laminotomy with no significant difference (P = 0.999). The average days to loss of stimulation for the Laminotomy versus percutaneous were as follows: 124.82 and 323.6 which were not statistically significant. There was no statistical difference in the days to loss of capture between the groups (P = 0.060). There was no significant difference between unilateral or bilateral symptoms in loss of capture within either group (P = 0.263, P = 0.326). There was not enough data to do comparisons by diagnosis. Comparisons of loss of capture based on electrode type was not significant in either group (P = 0.687, P = 0.371). The effect of the spinal level on the lack of recapture rates was not able to be calculated due to the number of levels. Limitations: Retrospective study. Conclusion: Rates of stimulation loss and radiographic lead migration are similar for both Laminotomy and percutaneous implantation. Time to loss of stimulation was not statistically different in either group, although there was a trend toward Laminotomy leads migrating earlier. Lead type and laterality of symptoms do not affect lead migration rates. The effect of the level of implant and diagnosis was indeterminate. Key words: Neuromodulation, spine, stimulation, complication, migration, pain
Adam Shuster - One of the best experts on this subject based on the ideXlab platform.
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Rates of lead migration and stimulation loss in spinal cord stimulation: a retrospective comparison of Laminotomy versus percutaneous implantation.
Pain physician, 2011Co-Authors: David Kim, Rakesh Vakharyia, Henry R Kroll, Adam ShusterAbstract:BACKGROUND Neuromodulation has been used to treat neuropathic pain. Leads have been implanted using Laminotomy or percutaneous approaches. Laminotomy implantation has been shown to be superior in terms of lead migration when compared to percutaneous implantation. Lead migration has been reported as high as 68% with the percutaneous approach. Because of this, newer anchors have been developed but not tested in vivo. OBJECTIVES This study tests the hypothesis that newer anchoring systems have improved lead migration rates for percutaneous leads relative to Laminotomy leads to the point of parity. This study also analyzed if factors such as laterality of symptoms, lead type, level of implant and diagnosis affect migration rates. STUDY DESIGN Neurostimulators implanted in the thoracolumbar spine at Henry Ford Hospital between 2006 and 2008 were reviewed for the following: age, sex, diagnosis, lead type, and implant level. Implants were reviewed for the following: age, sex, diagnosis, lead type, implant level, implant method, symptom laterality, loss of stimulation, radiographic lead migration, and time to loss. Loss of capture and lead migration in the Laminotomy and percutaneous groups were compared using Fisher's exact test. Variables within each group included: lead type, level of implantation, location of symptoms, and diagnosis. They were compared using Fisher's exact test. Time to loss of stimulation was compared using the Wilcoxon 2-sample test. SETTING Pain Clinic, Henry Ford Hospital, Detroit, MI. RESULTS Laminotomies were performed by a single neurosurgeon and percutaneous implants were performed by a single pain medicine specialist. Percutaneous leads were anchored using Titan (Medtronic Corporation, Minneapolis, MN) anchors. Loss of capture was 24% Laminotomy and 23% percutaneous with no significant difference between the 2 groups (P = 0.787). Radiographic evidence of migration was 13.63% percutaneous and 12.67% Laminotomy with no significant difference (P = 0.999). The average days to loss of stimulation for the Laminotomy versus percutaneous were as follows: 124.82 and 323.6 which were not statistically significant. There was no statistical difference in the days to loss of capture between the groups (P = 0.060). There was no significant difference between unilateral or bilateral symptoms in loss of capture within either group (P = 0.263, P = 0.326). There was not enough data to do comparisons by diagnosis. Comparisons of loss of capture based on electrode type was not significant in either group (P = 0.687, P = 0.371). The effect of the spinal level on the lack of recapture rates was not able to be calculated due to the number of levels. LIMITATIONS Retrospective study. CONCLUSION Rates of stimulation loss and radiographic lead migration are similar for both Laminotomy and percutaneous implantation. Time to loss of stimulation was not statistically different in either group, although there was a trend toward Laminotomy leads migrating earlier. Lead type and laterality of symptoms do not affect lead migration rates. The effect of the level of implant and diagnosis was indeterminate.
I-ming Jou - One of the best experts on this subject based on the ideXlab platform.
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efficacy of topical cross linked hyaluronic acid hydrogel in preventing post laminectomy Laminotomy fibrosis in a rat model
Journal of Orthopaedic Research, 2016Co-Authors: Yi-hung Huang, Jung-shun Lee, Ta-wei Tai, I-ming JouAbstract:Post-laminectomy/Laminotomy epidural fibrosis (EF) has been implicated as an important cause of failed back syndrome (FBS). The various clinical approaches used to control EF yield mixed outcomes. Cross-linked hyaluronic acid hydrogel (cHA) was synthesized to increase mechanical stability and residence time. We evaluated the therapeutic attenuation of proliferative EF in laminectomy/Laminotomy groups treated and not treated with cHA. A bilateral T11-L1 total laminectomy or unilateral T12 Laminotomy was done on four groups (n = 10 each) of Sprague-Dawley rats and then histologically examined 2 months post-surgery: (I) laminectomy group treated with and (II) not treated with cHA, (III) Laminotomy group treated with and (IV) not treated with cHA. The grade of EF, the diameters within the spinal canal, dura mater thickness, and the area of the epidural space, subarachnoid space, and conus medullaris space were assessed. The cHA-treated subgroups (I, III) had a significantly lower grade of EF, thinner dura mater, and larger epidural and subarachnoid spaces than did the control subgroups (II, IV) (p < 0.05). The cHA formed a solid interpositional membrane barrier that prevented invasive fibrosis, and also helped reduce pathological changes to the adjacent structures. In conclusion, topically applied cHA is effective for reducing EF.
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Efficacy of topical cross-linked hyaluronic acid hydrogel in preventing post laminectomy/Laminotomy fibrosis in a rat model.
Journal of orthopaedic research : official publication of the Orthopaedic Research Society, 2015Co-Authors: Yi-hung Huang, Jung-shun Lee, Ta-wei Tai, I-ming JouAbstract:Post-laminectomy/Laminotomy epidural fibrosis (EF) has been implicated as an important cause of failed back syndrome (FBS). The various clinical approaches used to control EF yield mixed outcomes. Cross-linked hyaluronic acid hydrogel (cHA) was synthesized to increase mechanical stability and residence time. We evaluated the therapeutic attenuation of proliferative EF in laminectomy/Laminotomy groups treated and not treated with cHA. A bilateral T11-L1 total laminectomy or unilateral T12 Laminotomy was done on four groups (n = 10 each) of Sprague-Dawley rats and then histologically examined 2 months post-surgery: (I) laminectomy group treated with and (II) not treated with cHA, (III) Laminotomy group treated with and (IV) not treated with cHA. The grade of EF, the diameters within the spinal canal, dura mater thickness, and the area of the epidural space, subarachnoid space, and conus medullaris space were assessed. The cHA-treated subgroups (I, III) had a significantly lower grade of EF, thinner dura mater, and larger epidural and subarachnoid spaces than did the control subgroups (II, IV) (p
Sho Dohzono - One of the best experts on this subject based on the ideXlab platform.
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Spinopelvic Sagittal Alignment after Microendoscopic Laminotomy in Patients with Lumbar Degenerative Spondylolisthesis.
Journal of neurological surgery. Part A Central European neurosurgery, 2018Co-Authors: Sho Dohzono, Hiromitsu Toyoda, Akinobu Suzuki, Hidetomi Terai, Yusuke Hori, Shinji Takahashi, Hiroaki NakamuraAbstract:Spinopelvic sagittal balance is important in managing lumbar diseases. We evaluated the change in spinal sagittal alignment after microendoscopic Laminotomy in patients with low-grade degenerative spondylolisthesis (DS). We retrospectively reviewed the records of 87 patients who underwent microendoscopic Laminotomy. We enrolled 35 patients with DS and 52 patients without DS. Spinopelvic parameters were evaluated, including the sagittal vertical axis (SVA), lumbar lordosis (LL), sacral slope, pelvic tilt, and pelvic incidence (PI). Primary outcome was a change in spinopelvic alignment between the baseline and latest follow-up values (DS group versus non-DS group). Secondary outcomes were the relationships between improved global sagittal alignment and preoperative spinopelvic parameters. Both groups showed significantly alleviated low back pain (LBP), leg pain, and leg numbness. Preoperative SVA and PI were significantly higher in the DS group than in the non-DS group (p < 0.05). SVA significantly decreased and LL significantly increased in the DS group (p < 0.05), whereas those parameters did not differ significantly from before versus after surgery in the non-DS group. In both groups, SVA improvement correlated significantly with preoperative SVA (DS: r = 0.702; non-DS: r = 0.397). There was also a significant intergroup difference in the correlation coefficient (z = 1.98; r = 0.048). SVA and LL significantly improved after microscopic Laminotomy in patients with low-grade DS and neurologic symptoms. SVA improvement in the DS group was correlated with preoperative spinopelvic sagittal imbalance. The strength of those correlations was greater in the DS group than in the non-DS group. Georg Thieme Verlag KG Stuttgart · New York.
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Spinopelvic Sagittal Alignment after Microendoscopic Laminotomy in Patients with Lumbar Degenerative Spondylolisthesis.
Central European Neurosurgery, 2018Co-Authors: Sho Dohzono, Hiromitsu Toyoda, Akinobu Suzuki, Hidetomi Terai, Yusuke Hori, Shinji Takahashi, Hiroaki NakamuraAbstract:BACKGROUND AND STUDY AIMS Spinopelvic sagittal balance is important in managing lumbar diseases. We evaluated the change in spinal sagittal alignment after microendoscopic Laminotomy in patients with low-grade degenerative spondylolisthesis (DS). MATERIAL AND METHODS We retrospectively reviewed the records of 87 patients who underwent microendoscopic Laminotomy. We enrolled 35 patients with DS and 52 patients without DS. Spinopelvic parameters were evaluated, including the sagittal vertical axis (SVA), lumbar lordosis (LL), sacral slope, pelvic tilt, and pelvic incidence (PI). Primary outcome was a change in spinopelvic alignment between the baseline and latest follow-up values (DS group versus non-DS group). Secondary outcomes were the relationships between improved global sagittal alignment and preoperative spinopelvic parameters. RESULTS Both groups showed significantly alleviated low back pain (LBP), leg pain, and leg numbness. Preoperative SVA and PI were significantly higher in the DS group than in the non-DS group (p
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spinopelvic sagittal alignment after microendoscopic Laminotomy in patients with lumbar degenerative spondylolisthesis
Central European Neurosurgery, 2018Co-Authors: Sho Dohzono, Hiromitsu Toyoda, Akinobu Suzuki, Hidetomi Terai, Yusuke Hori, Shinji Takahashi, Hiroaki NakamuraAbstract:BACKGROUND AND STUDY AIMS Spinopelvic sagittal balance is important in managing lumbar diseases. We evaluated the change in spinal sagittal alignment after microendoscopic Laminotomy in patients with low-grade degenerative spondylolisthesis (DS). MATERIAL AND METHODS We retrospectively reviewed the records of 87 patients who underwent microendoscopic Laminotomy. We enrolled 35 patients with DS and 52 patients without DS. Spinopelvic parameters were evaluated, including the sagittal vertical axis (SVA), lumbar lordosis (LL), sacral slope, pelvic tilt, and pelvic incidence (PI). Primary outcome was a change in spinopelvic alignment between the baseline and latest follow-up values (DS group versus non-DS group). Secondary outcomes were the relationships between improved global sagittal alignment and preoperative spinopelvic parameters. RESULTS Both groups showed significantly alleviated low back pain (LBP), leg pain, and leg numbness. Preoperative SVA and PI were significantly higher in the DS group than in the non-DS group (p < 0.05). SVA significantly decreased and LL significantly increased in the DS group (p < 0.05), whereas those parameters did not differ significantly from before versus after surgery in the non-DS group. In both groups, SVA improvement correlated significantly with preoperative SVA (DS: r = 0.702; non-DS: r = 0.397). There was also a significant intergroup difference in the correlation coefficient (z = 1.98; r = 0.048). CONCLUSIONS SVA and LL significantly improved after microscopic Laminotomy in patients with low-grade DS and neurologic symptoms. SVA improvement in the DS group was correlated with preoperative spinopelvic sagittal imbalance. The strength of those correlations was greater in the DS group than in the non-DS group.
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the influence of preoperative spinal sagittal balance on clinical outcomes after microendoscopic Laminotomy in patients with lumbar spinal canal stenosis
Journal of Neurosurgery, 2015Co-Authors: Sho Dohzono, Hiromitsu Toyoda, Tomiya Matsumoto, Akinobu Suzuki, Hidetomi Terai, Hiroaki NakamuraAbstract:OBJECT More information about the association between preoperative anterior translation of the C-7 plumb line and clinical outcomes after decompression surgery in patients with lumbar spinal canal stenosis (LSS) would help resolve problems for patients with sagittal imbalance. The authors evaluated whether preoperative sagittal alignment of the spine affects low-back pain and clinical outcomes after microendoscopic Laminotomy. METHODS This study was a retrospective review of prospectively collected surgical data. The study comprised 88 patients with LSS (47 men and 41 women) who ranged in age from 39 to 86 years (mean age 68.7 years). All patients had undergone microendoscopic Laminotomy at Osaka City University Graduate School of Medicine from May 2008 through October 2012. The minimum duration of clinical and radiological follow-up was 6 months. All patients were evaluated by Japanese Orthopaedic Association (JOA) and visual analog scale (VAS) scores for low-back pain, leg pain, and leg numbness before ...
