Mini Open Foraminotomy for Cervical Radiculopathy: A Comparison of Large Tubular and TrimLine Retractors

STUDY DESIGN: Retrospective chart review. PURPOSE: A comparison of mini open foraminotomy (MOF) for cervical radiculopathy using either large tubular (LT) or TrimLine (TL) retractors. OVERVIEW OF LITERATURE: Posterior foraminotomy relieves compression of the cervical nerve root in radiculopathy patients. However, invasion of the paravertebral muscle may cause major problems in these patients. To address these problems, we performed MOF. METHODS: Twenty cervical radiculopathy patients (16 male and 4 female) who underwent MOF between May 2004 and August 2011 were assigned to LT and TL groups. Each group contained 10 subjects. Surgical and clinical outcomes were compared. RESULTS: The average operating time in the TL group was significantly shorter than that in the LT group. The final follow-up mean neck disability indices significantly improved compared to the preoperative values (LT group, 12.0+/-7.8 vs. 28.0+/-9.4; TL group, 6.0+/-5.9 vs. 21.9+/-10). The final follow-up neck pain visual analog scale (VAS) scores also decreased significantly from the preoperative of 8.0+/-1.5 and 2.5+/-2.5 to the final follow-up values of 2.2+/-2.2 and 1.0+/-2.5 in the LT and TL groups, respectively. The recovery rate for the neck pain VAS score was 70.0+/-31.9 in the LT group and 87.0+/-32.0 in the TL group, thus suggesting no significant difference between the two groups. CONCLUSIONS: MOF with the TL retractor is an easy and safe procedure. Furthermore, the use of the TL retractor allows for a minimally invasive and effective surgical treatment of cervical radiculopathy patients.

Urinary Incontinence Among the Middle-Aged and Senior Members of a Rural Community / 日本農村医学会雑誌

We investigated the prevalence of, and factors in, urinary incontinence among the people of middle to advanced age, using a yes/no questionnaire. The total number of respondents was 4, 020 (1, 520 males and 2, 500 females). Seventy-five percent of them were over 65 years old (median age: 67 years). The prevalence of urinary incontinence was 14% for the males and 30% for the females. The data were analyzed by standard statistical tests, such as χ<SUP>2</SUP> tests. The factors closely associated with urinary incontinence were aging, the high urinary frequency in a day, a history of cerebrovascular accidents, difficulty of urination in the males and UTI in the females. Urinary incontinence of the urge type account for 64% of the males and that of the stress type 81% of the females. Fifteen percent of the males and 6% of the females had consulted with physicians or urologists about urinary incontinence. These percentages were lower than those in European countries. However, we suspect that there may be much more latent patients who suffer from urinary incontinence in their daily community life.