Characteristics of lumbar canal stenosis patient at Koja district hospital year 2011-2021

Background:Since there are too many cases of lumbar canal stenosis in Indonesia. The aim of the study was to discover all the factors that influence the incidence of lumbar canal stenosis.Methods:This study used all cases of lumbar canal stenosis in Koja District Hospital in Jakarta from 2011 to 2021. This was a medical record-based retrospective study in which files of patients with the diagnosis of lumbar canal stenosis were reviewed. A descriptive analytic test was used to analyze results was presented in the form of a table.Results:There were 48 lumbar canal stenosis cases in male patients out of 66 total patients. Incidents of lumbar canal stenosis occurred more frequently in anatomical locations L4-5 than in other locations. There were 48 lumbar canal stenosis cases with anatomical locations L4-5 in 50 patients from 66 patients. Incidents of lumbar canal stenosis occur in people with obesity more frequently than in people without obesity. There were 48 lumbar canal stenosis cases in people with obesity patients out of 66 total patients. The incidence of lumbar canal stenosis with a moderate VAS score was greater than that with a mild or severe VAS score. There were 48 lumbar canal stenosis patients with a moderate vas score out of 66 patients. There were 59 lumbar canal stenosis patients who got surgery out of 66 patients, and 7 of them had no surgery. Lumbar canal stenosis more frequently occurred in men than women, with more frequent anatomical lesions in L4-L5, and more frequently in people with obesity than in people without obesity. Most of them had a moderate VAS score and got surgery.Conclusions:According to this study, males had more lumbar canal stenosis incidents than females.

Morpho-Histological Study of Myocardial Bridges and Their Association with Atherosclerosis

Coronary arteries supply blood to the heart. They run through the epicardial adipose tissue during their course. Occasionally a band of myocardial tissue overlies a segment of the coronary arteries. This band of myocardium overlying the coronary artery is named as Myocardial Bridge (MB). There have been numerous instances of sudden and unexpected cardiac death where the presentation of myocardial bridging was the main clinically pertinent finding post-mortem. We wanted to study the distinct morphological aspects of MBs along with the structural composition of the coronary vessel present beneath, in front of and past the myocardial bridge. METHODSMicroscopy and morphometry were utilized to detail the distinct morphological characteristics of myocardial bridges as well as to take a closer look at the structural composition of the coronary vessel present beneath, in front of and past the myocardial bridge being evaluated. Three segments of the left anterior descending artery (LAD) were utilized to glean testable samples. These samples are as follows: (A) located proximally to the bridge at a distance of 8 mm, (B) alongside the bridge and (C) located distally from the bridge at a distance of 8 mm. RESULTSPrevalence of MB was found to be 40 %. Male to female ratio was 7:1. 87.5 % of the hearts have single MB, 10 % have double MB, 2.5 % have triple MB. Most common vessel affected is LAD. The MBs ranged in length from 4.4 mm to 45 mm with a length of 12.67 mm being the quantifiable mean. Thickness of MB ranged from 0.4 to 1.9 mm with mean thickness of 1.11 mm. The component of the coronary artery that was bridged often showed a diminished tunica intima compared to similar segments taken from proximal and distal sites. It should be noted that the proximal segment is predisposed to atherosclerotic presentation on account of myocardial bridging. CONCLUSIONSA myocardial bridge leads to detrimental changes in the vessel which in turn leads to early presentation of atherosclerosis, arrhythmias, myocardial infarctions and in severe cases, sudden death. Myocardial bridging is frequently localized in the LAD. It can have significant effects on the overall health.

Anatomical Evaluation Of Lumbar Vertebral Canal In Indian Population

Introduction: Low backache is one of the most common symptoms of lumbar canal stenosis and it developed aninterest among anatomists to do osteological analysis of lumbar canal. The aim of the current study was tocreate the morphometric database of lumbar canal dimensions in context of its applied clinical implications.Materials and Methods: A dry bone study was carried out on 47 adult human lumbar vertebral sets obtained fromvarious medical colleges in Pune District of Maharashtra. Anteroposterior (LCAP) and transverse (LCT) diametersof lumbar canal were measured by ‘Digital Vernier Caliper with 0.01 mm precision’. The data analysis was donein SPSS Version 20 and ‘ANOVA’ test was applied to evaluate statistical differences.Results: Lumbar canal antero-posterior (LCAP) diameters decreased from L1 to L5 vertebrae whereas there wasgradual increase in Lumbar canal transverse (LCT) diameter from first to fifth lumbar vertebra.Conclusion: The present study reported statistically significant differences in the dimensions of lumbar canal ofL1 to L5 in Indian population. This morphometric baseline data can be utilized in surgical management of lowback pain as a result of lumbar canal stenosis.

Research progress in minimally invasive treatment of cervical nerve root canal stenosis under total endoscope / 中国修复重建外科杂志

Objective: To review the research progress of total endoscopic minimally invasive technique in treating cervical nerve root canal stenosis (CNRCS). Methods: The related literature at home and abroad was extensively reviewed. The research history, current situation, research progress, advantages and disadvantages of minimally invasive treatment of CNRCS under total endoscope were summarized. Results: In recent years, with the continuous development of minimally invasive technique of total endoscope in spine surgery, the surgical treatment methods are also constantly innovated. Compared with the traditional open surgery, minimally invasive treatment of CNRCS under total endoscope can obtain better effectiveness, keep the stability of the cervical segment to the maximum extent, reduce the impact on the activity of the cervical spine and the occurrence of related surgical complications, which is an effective minimally invasive technology. Conclusion: The minimally invasive treatment of CNRCS under total endoscope has achieved some results, which is expected to be one of the indispensable means to treat CNRCS, but it still needs to be improved.

Estenosis congénita aislada del conducto auditivo interno como causa de hipoacusia neurosensorial unilateral y paresia del nervio facial / Congenital internal auditory canal stenosis presenting with unilateral sensorineural hearing loss and facial nerve dysfunction

RESUMEN La estenosis del conducto auditivo interno con aplasia/hipoplasia del nervio cocleovestibular es una patología muy infrecuente. Suele ser unilateral y puede acompañarse de aplasia/hipoplasia del nervio facial y otras malformaciones del oído interno. Se presentan aquí dos casos clínicos de pacientes pediátricos con estenosis del conducto auditivo interno unilateral con compromiso del séptimo y octavo par craneal ipsilateral. Se describen las historias y evaluaciones clínicas, hallazgos audiovestibulares, hallazgos imagenológicos, tratamientos indicados y sus resultados.

ABSTRACT Congenital internal auditory canal stenosis associated with aplasia/hypoplasia of the cochleovestibular nerve is a very infrequent pathology. It is usually unilateral and may be accompanied by aplasia/hypoplasia of the facial nerve and other malformations of the inner ear. We hereby present two clinical cases of pediatric patients with congenital internal auditory canal stenosis, with involvement of the seventh and eighth ipsilateral cranial nerve. The medical histories and clinical evaluations, audiovestibular findings, imaging findings, treatments and their results are described.

Study of inter pedicular distance of lumbar spinal canal in perspective of lumbar canal stenosis using plain antero-posterior radiographs in western population of Rajasthan, India

Background: Various causes have been attributed to low backache, but lumbar canal stenosis is turned out to be a major causative factor. It has been suggested that reduced IPD is one among the major cause of narrowing of the spinal canal. The objective of this study was to evaluate the inter pedicular distances in lumbar vertebral column in both sexes of western Rajasthan, India.Methods: The present descriptive type study was conducted in Department of Anatomy and Neurosurgery Sawai Man Singh Medical College, Jaipur, Rajasthan, India. Antero-posterior plain radiographs of lumbar spine in 1000 subjects aged between 20 to 60 years and those who were born and brought up in Rajasthan state were used for the study. All measurements were made by using electronic digital Vernier caliper. Student t-test was used for analysis.                           Results: Mean transverse diameter of lumbar vertebral canal (I.P.D) is minimum at L1 vertebra in both sexes. The maximum values of I.P.D were recorded for vertebra L5 for both sexes.Conclusions: The values of IPD are higher in male population in comparison to female counterparts.

Morphometric Analysis Of Lumbar Vertebrae And Its Applied Clinical Importance

Introduction: The lumbosacral spine is the region of transition from the appendicular to the axial skeleton.Accidents, degenerative conditions, congenital defects and neoplastic metastases often affect the lumbar region.Low back pain resulting from lumbar canal stenosis is one of the major complaints in young to adult population.Apart from that lumbar vertebrae morphometry is required in many surgical as well as anaesthetic procedures.Aims and objectives: The present study was undertaken to determine the morphometry of human cadavericlumbar vertebrae and to compare findings with other authors and forming a baseline data in relation to variouslumbar canal pathologies that can be of help to the medical and surgical experts.Materials and methods: Dried lumbar vertebrae were obtained from the Department of Anatomy of RegionalInstitute of Medical Sciences, Imphal, India. Vertebrae belonging to same set and without any external deformitywere chosen and separated into typical and atypical ones. Measurement of Midsaggital diameter, Interpediculardistance, and Anteroposterior diameter of lateral recess was done using digital vernier calliper.Observations and Results: The study showed increase in all the diameters from L1 to L5 with a narrowing in allcases at L3 level. Therefore, L3 remains the transition point in all the measurements and thus one of the possiblesites for nerve root compression due to canal stenosis, which is one of the major causes of low back pain.Conclusion: The present data forms a baseline of adult lumbar vertebral morphology and is useful source ofinformation to surgeons, physicians and anatomists. It is also helpful for the screw and implant manufacturers.Further study with sex and ethnic consideration can generate forensic and anthropological data.KEY WORDS: Lumbar vertebrae, Lumbar canal stenosis, Morphometry, Midsaggital diameter, Interpediculardistance, Lateral recess diameter.

Reconsideration of lumbar spinal stenosis / 中国修复重建外科杂志

People's understanding of lumbar spinal stenosis has become more and more comprehensive and reasonable, however, there are still many controversies about the concepts of "central lumbar canal" and "lateral lumbar spinal canal", and there is no unified standard at present. In this paper, we redefine and differentiate the two concepts. We believe that some kinds of central canal stenosis caused by bilateral recess stenosis can be completely solved by bilateral percutaneous endoscopic transforaminal discectomy. At the same time, the concept of "lumbar lateral recess" is ambiguous. We redefine it as "lateral lumbar spinal canal" and propose "West China Hospital classification" to guide surgical decision-making, which has been widely recognized and applied.

Lumbar Spinal Canal Measurements By Magnetic Resonance Imaging (MRI) In Indian Population

Introduction: Lumbar spinal canal stenosis is the progressive narrowing of spinal canal that causes compression of nerve roots. Magnetic resonance imaging (MRI) is commonly used to assess patients with lumbar spinal canal stenosis. The aim of the study is to determine the normal sagittal and transverse diameter of the lumbar spinal canal and depth of the lateral recess in asymptomatic population by using MR imaging of the lumbosacral spine and to arrive at a reference lower limit of normal values at each level. Materials and Methods: This study was conducted on one hundred and five patients. MRI scan was performed on 1.5 T scanner. Measurements were performed on T1- weighted and T2-weighted fast spin echo sequences in axial and sagittal planes. Results: In our study narrowest mid sagittal diameter was at L4-L5 (10.9 mm) in males and L5-S1 (10.8 mm) females. There is no significant difference noted in the mid sagittal diameter and transverse diameter between males and females. Lateral recess depths showed a significant difference between the two groups at L2-L3 on right side and L4-L5 on left side. Conclusion: The mean values for the normal spinal canal diameters (SCD) and lateral rescess depth in our population are similar to data from other literature.

Partial internal hemipelvectomy as rescue therapy in obstipation in four dogs: case report / Hemipelvectomia caudal parcial interna como terapia de salvamento na obstipação em quatro cães: relato de caso

Multiple pelvic fractures can lead to narrowing of the pelvic canal and loss of life quality. Hemipelvectomy, characterized by removal of bone fragments from the pelvis, is considered a rescue therapy. This report describes the technique of caudal partial hemipelvectomy in four cases of obstipation secondary to traumatic pelvic canal narrowing in four dogs, with promising results. All patients had tenesmus and fecal retention. After the procedure, the patients presented immediate normochezia and support of the ipsilateral limb after 10 to 20 days, showing the feasibility of the technique in small animals, providing clinical improvement without walking alterations.(AU)

Múltiplas fraturas da pelve podem gerar angústia pélvica. A hemipelvectomia, caracterizada pela remoção de fragmentos ósseos da pelve, é considerada terapia de salvamento. O presente relato descreve a técnica de hemipelvectomia interna parcial em quatro casos de obstipação por angústia pélvica traumática em cães, com resultados alvissareiros. Todos os pacientes apresentavam tenesmo e retenção fecal. Após a realização do procedimento, os pacientes apresentaram normoquesia imediata e apoio do membro ipsilateral ao procedimento após 10 a 20 dias, mostrando a exequibilidade da técnica em animais leves, uma vez que houve melhora clínica sem alterações na deambulação.(AU)

The impact of sarcopenia on the results of lumbar spinal surgery

OBJECTIVES: As the population ages, the number of lumbar spinal surgeries performed on sarcopenic patients will increase. The purpose of this study was to investigate the prevalence of sarcopenia and evaluated its impact on the results of lumbar spinal surgery. METHODS: This study included 2 groups: One group consisted of patients who underwent whole-body dual-energy X-ray absorptiometry (DXA) scanning before the option of undergoing surgery for lumbar spinal disease (LSD group) and a second group consisted of patients underwent DXA scanning for osteoporosis screening under hospital watch at the geriatric medicine department (control group). In order to evaluate the impact of sarcopenia on the clinical outcome of lumbar spinal surgery, the Japanese Orthopedic Association (JOA) score, the recovery rate based on the JOA score, and visual analogue scale (VAS) scores for lower back pain, lower extremity pain, and lower extremity numbness were compared within the LSD group. RESULTS: The prevalence of sarcopenia showed no statistical difference between groups (control group, 50.7%; LSD group, 46.5%). In the LSD group, while the changes in VAS scores showed no statistical difference between the nonsarcopenia subgroup and sarcopenia subgroup, the sarcopenia subgroup demonstrated inferior JOA scores and recovery rates at the final follow-up when compared with the nonsarcopenia subgroup (P < 0.05). CONCLUSIONS: This study demonstrated a high prevalence of sarcopenia among the elderly populations in Japan and a negative impact of sarcopenia on clinical outcomes after lumbar spinal surgery.

Prophylactic surgery is invalid intreatment of spinal injury without fracture and dislocationcomplicated by cervical spinal canal stenosis / 实用医学杂志

Objective In this study,we aim to evaluate the risk and incidence of traumatic cervical spinal cord injury (CSCI) in patients with traumatic cervical spinal canal stenosis (CSCS) without major fracture or dislocation,and evaluate the feasibility of preventive decompression surgery. Methods This study included eighty?seven patients with traumatic CSCI without major fracture or dislocation treated in our department between 2005 and 2012. Mann?Whitney U test was used for statistical analyses. Analysis of variance (ANOVA) was used to calculate the relative and absolute risks for the incidence of traumatic CSCI without major fracture or dislocation related with CSCS. Results The relative risk for the incidence of traumatic CSCI with CSCS was 145.7 times higher than that for the incidence without CSCS. However ,only 0.000026% of patients with CSCS may be able to avoid developing traumatic CSCI if they underwent decompression surgery before trauma. Conclusions Prophylactic surgical management for CSCS might not significantly affect the incidence of traumatic CSCI.

Unilateral pedicle screws on the side of the transarticular screw fixation combined with interbody fusion and traditional operation in the treatment of lumbar tube stenosis of the efficacy and safety of comparison / 中国综合临床

Objective To investigate the contralateral transarticular screw fixation combined with interbody fusion and traditional operation in the treatment of lumbar tube stenosis of the efficacy and safety of unilateral pedicle screw.Methods A retrospective analysis was made in General Hospital of Lanzhou Petrochemical Company from February 2012 to April 2015.Forty cases of lumbar spinal stenosis patients were analyzed respectively,using unilateral pedicle screws on the side of transarticular screw fixation(observation group,20 cases) and bilateral pedicle screw fixation (control group,20 cases) and interbody fusion for the treatment.Between the two groups in the amount of bleeding,operation time,incision length,postoperative drainage were compared.Regular follow-up after operation,the fusion effect was observed,the JOA score was used to evaluate spinal function and observe adverse reaction incidence.Results Intraoperative bleeding volume,operation time and postoperative drainage in the observation group were (321.60±12.35) ml,(101.18±4.11) min,(212.14±18.78) ml,lower than that in control group((377.24±18.11) ml,(134.49±5.25) min,(256.27±15.19) ml,t=2.80,4.11,-3.88,P0.05).The fusion rate and JOA score in the observation group after 3 months of observation group was (100±0)% and (87.5±2.4) points,there was no statistically significant difference compared with the control group((100±0)% and (86.3±2.2) points,t=0,0.20,P>0.05).The fusion rate and JOA score in the observation group after 1 year was (100±0)% and (91.9±1.7) points,there was no statistically significant difference compared with the control group((100±0)% and (92.1±1.5) points,t=0,0.35,P>0.05).The height of intervertebral space in the last follow-up group in the observation group was (8.25±0.13) mm,higher than that of the control group((6.97±0.16) mm,t=3.90,P<0.001).In adverse reactions,the observation group did not appear to be related to complications,while 2 cases in the control group dural leakage,3 cases of nerve injury,rate was 25%(P=0.03).Conclusion Unilateral pedicle screws on the side of the transarticular screw fixation combined with interbody fusion for the treatment of lumbar tube stenosis surgical trauma,postoperative recovery,spinal stability is good in the near future,it is worth clinical promotion.

Improved bone knife spinous lamina osteotomy replantation complex treatment of lumbar spinal stenosis / 临床外科杂志

Objective To improve bone knife spinous lamina osteotomy replantation complex treatment of lumbar spinal stenosis patients.Methods Retrospective analysis from January 2014 to January 2015,the clinical data of 56 patients with lumbar spinal stenosis disease,all patients were taken modified osteotome bone cutting composite lamina spinous process and implant treatment,through follow-up,the CT,preoperatie and follow-up sessions at the end of the measurement of vertebral canal sagittal diameter,spinal canal diameter,to observe the prognosis and complications,and according to the Japanese orthopaedic society of low back pain score standard(Japanese orthopaedics asso ciation,JOA),the rate of good evaluation of clinical curative effect.Results This group of 56 patients with lumbar spinal stenosis disease,the last follow-up,vertebral canal sagittal diameter,spinal canal diameter,than preoperative significantly increased;JOA score was obviously improve the preoperative;The t test,statistically significant difference(P<0.05);The rate of good clinical curative effect was 96.43%;Follow-up period,all patients by CT review that lamina in situ fusion rate was 100%,no lumbar spinal instability,secondary lumbar spinal stenosis,composite lamina spinous complications such as shift,subsidence,fall off;6 months basic achieve bony healing.Conclusion The modified bone knife spinous lamina osteotomy replantation complex therapeutic effect of lumbar spinal stenosis precise,effective reconstruction of posterior structure stability,integrity,reduce complications,the prognosis is good,worthy of clinical use.

Expression of inflammatory factors are increased by sorbitol in lumbar spinal stenosis of diabetic patients / 基础医学与临床

Objective To investigate the related mechanism of ligamentum flavum (LF) hypertrophy in diabetic pa-tients with lumbar spinal canal stenosis ( LSCS ) .Methods Twenty-four diabetes mellitus patients [ DM (+) ] and twenty normoglycemic patients [ DM (-) ] with LSCS were enrolled in this study .Sorbitol in LF was analyzed using D-Sorbitol/Xylitol test kit .The thickness of LF was measured by CT .The structure of LF was observed after HE and Masson's trichrome staining .The cell cycle and proliferation of fibroblastic cell NIH 3T3 line cultured in high glucose were analyzed .Sorbitol of NIH3T3 was detected under different backgrounds in vitro, normal glucose , high glucose and high glucose burdened with aldose reductase inhibitor ( ARI) , Epalrestat .The expression of inflammatory factors was detected by qPCR and Western blot under above different backgrounds .Results LF of diabetic patients exhibi-ted significantly higher level of sorbitol and pro-inflammatory cytokines , TGF-βand of CD68-positive staining than that of the normoglycemic subjects ( P<0.01 ) .The diabetic LF was significantly thicker than that of the controls , and showed evidence of degeneration .The high glucose-cultured fibroblasts exhibited significantly higher levels of sorbitol , pro-inflammatory factors , and TGF-βcompared to the low glucose-cultured cells , and these levels were dose-dependently reduced by treatment with the aldose reductase inhibitor (P<0.05).Conclusions Sorbitol level of the LF is significantly increased in the DM patients with LSCS .Increased sorbitol recruites inflammatory factors and fibrogenic-related factor TGF-βin LF of DM patients with LSCS which may contributes to the LF hypertrophy .

MRI is the modality of choice for evaluation of spinal lesions

Introduction: Spine is a longitudinal structure, and precise location of the level of a lesion from clinical examination can be difficult. MRI of spine shows the anatomy of the vertebrae that makes up the spine, as well as the discs, spinal cord and the intervertebral foramina through which the nerves pass. It also allows us to differentiate between healthy tissue and diseased tissue. Materials and methods: This study aimed at diagnosing and following up cases of spinal lesions in the department of Radio diagnosis of SBKS Medical Institute and Research Centre and Dhiraj General Hospital. The study is performed using conventional X-rays and MRI. Results: Maximum numbers of patients were between 41–50 years age group followed by 21-30 and 31-40 years of age group, whereas patients of paediatric (00-10 years) and geriatric (>70 years) age group constituted only 8% patients. Average age of patients was 42.5 years. Lumbar spine was the most commonly affected spine region. Maximum numbers of patients were of degenerative and disc lesions (49%). Conclusion: MRI by virtue of non-invasiveness, lack of radiation hazard and by ability to demonstrate structural changes is investigation of choice for spine and spinal cord pathologies. The ability to image the cord directly rather than indirectly as in myelography, the absence of bone artifact as in computed tomography, and the multiplanar capabilities indicate that MRI is the procedure of choice in the examination of the spinal cord.

Preliminary Results of Relationship between Preoperative Walking Ability and Magnetic Resonance Imaging Morphology in Patients with Lumbar Canal Stenosis: Comparison between Trefoil and Triangle Types of Spinal Stenosis

STUDY DESIGN: Cross-sectional. PURPOSE: To examine the relationship between magnetic resonance imaging (MRI) morphology stenosis grades and preoperative walking ability in patients with lumbar canal stenosis (LCS). OVERVIEW OF LITERATURE: No previous study has analyzed the correlation between MRI morphology stenosis grades and walking ability in patients with LCS. METHODS: This prospective study included 98 consecutive patients with LCS who were candidates for surgery. Using features identified in T2-weighted axial magnetic, stenosis type was determined at the maximal stenosis level, and only trefoil and triangle stenosis grade types were considered because of sufficient sample size. Intraobserver and interobserver reliability were assessed by calculating weighted kappa coefficients. Symptom severity was evaluated via the Japanese Orthopedic Association Back Pain Evaluation Questionnaire (JOABPEQ). Walking ability was assessed using the Self-Paced Walking Test (SPWT) and JOABPEQ subscales. Demographic characteristics, SPWT scores, and JOABPEQ scores were compared between patients with trefoil and triangle stenosis types. RESULTS: The mean patient age was 58.1 (standard deviation, 8.4) years. The kappa values of the MRI morphology stenosis grade types showed a perfect agreement between the stenosis grade types. The trefoil group (n=53) and triangle group (n=45) showed similar preoperative JOABPEQ subscale scores (e.g., low back pain, lumbar function, and mental health) and were not significantly different in age, BMI, duration of symptoms, or lumbar stenosis levels (all p>0.05); however, trefoil stenosis grade type was associated with a decreased walking ability according to the SPWT and JOABPEQ subscale scores. CONCLUSIONS: These findings suggest preoperative walking ability is more profoundly affected in patients with trefoil type stenosis than in those with triangle type stenosis.

Nonoperative versus operative treatment of patients with degenerative spondylolisthesis / Tratamento conservador versus cirúrgico de pacientes com espondilolistese degenerativa / Tratamiento conservador contra quirúrgico de pacientes con espondilolistesis degenerativa

ABSTRACT Objective: To evaluate clinical and functional results of patients with lumbar degenerative spondylolisthesis treated with operatively or nonoperatively. Methods: Patients with degenerative spondylolisthesis treated either nonoperatively or operatively from 2004 to 2014 were selected from databases and a cross-sectional evaluation was performed. Outcome measures included back and leg visual analogue scales (VAS), Fischgrund criteria, Short Form-36 (SF-36) function score, and the modified Oswestry Disability Index (ODI). Results: 43 patients were evaluated: 20 with nonoperative treatment and 23 with operative treatment. Baseline characteristics were similar without significant differences between groups. Mean follow-up time was 43 months (range 10 - 72) for the nonoperative group and 36 months (range 6-80) for the operative group. Significant statistical difference in favor of operative group were found in back VAS (mean 4 versus 8, p = 0.000), leg VAS (mean 3 versus 6, p = 0.0015), SF-36 function score (mean 77 versus 35, p = 0.000), and ODI (mean 17 versus 46, p = 0.000). On the basis of the Fischgrund criteria, only 10 % of patients reported excellent or good health post nonoperative treatment versus 83% for those treated operatively (p = 0.000). Conclusion: In this cross-sectional study, we observed that symptomatic patients with degenerative spondylolisthesis who underwent operative treatment have superior clinical and functional scores compared to those that underwent nonoperative treatment.

RESUMO Objetivo: Avaliar os resultados clínicos e funcionais dos pacientes com espondilolistese degenerativa lombar tratados de maneira conservadora ou cirúrgica. Métodos: Foram selecionados pacientes com espondilolistese degenerativa tratados conservadoramente ou submetidos à cirurgia, durante 2004-2014, à partir da coleta de dados que possibilitou a realização da avaliação transversal. As medidas de avaliação da dor lombar e das pernas foram escalas analógicas visuais (VAS), critérios Fischgrund, Short Form-36 (SF-36) pontuação funcional, e o Índice de Incapacidade Oswestry modificado (ODI). Resultados: 43 pacientes foram avaliados: 20 do tratamento conservador e 23 do tratamento cirúrgico. As características de base foram similares, sem diferenças significativas entre os grupos. O tempo médio de acompanhamento foi de 43 meses (intervalo 10-72) para o grupo não-cirúrgico e 36 meses (intervalo 6-80) para o grupo cirúrgico. Diferenças estatísticas significativas em favor do grupo cirúrgico foram encontrados no VAS lombar (média de 4 versus 8, p = 0,000), VAS pernas (média 3 contra 6, p = 0,0015), SF-36 pontuação funcional (média 77 versus 35, p = 0,000), e ODI (média 17 versus 46, p = 0,000). Com base nos critérios Fischgrund, apenas 10% dos pacientes relataram excelente ou boa saúde de após o tratamento conservador contra 83% para aqueles tratados no cirúrgico (p = 0,000). Conclusão: Neste estudo transversal, observou-se que os pacientes sintomáticos com espondilolistese degenerativa que se submeteram ao tratamento cirúrgico têm escores clínicos e funcionais superiores em comparação àqueles que foram submetidos a tratamento conservador.

RESUMEN Objetivo: Evaluar los resultados clínicos y funcionales de los pacientes con espondilolistesis degenerativa lumbar tratados quirúrgicamente o sin cirugía. Métodos: Se realizó una evaluación transversal de los pacientes con espondilolistesis degenerativa, registrados en la base de datos, tratados conservador o quirúrgicamente desde 2004 hasta 2014. Las medidas de desenlace incluyeron: Escala Visual Análoga (EVA) de dolor lumbar y las piernas, criterios de Fischgrund, Short Form-36 (SF-36) e Índice de Discapacidad Oswestry modificado (IDO). Resultados: Se evaluaron 43 pacientes: 20 con tratamiento no quirúrgico y 23 con tratamiento quirúrgico. Las características de base fueron similares, sin diferencias significativas entre los grupos. El tiempo medio de seguimiento fue de 43 meses (rango 10-72) para el grupo no quirúrgico y 36 meses (rango 6-80) para el grupo quirúrgico. Diferencias estadísticamente significativas a favor del grupo quirúrgico fueron encontrados en EVA lumbar (media 4 contra 8, p=0,000), EVA pierna (media 3 contra 6, p=0,0015), SF-36 función (media 77 contra 35, p=0,000), e IDO (media 17 contra 46, p=0,000). Con respecto a los criterios de Fischgrund, sólo el 10% de los pacientes del grupo que recibió tratamiento no quirúrgico informo excelente o buen estado de salud en comparación con 83% de los que recibieron manejo quirúrgico (p = 0,000) Conclusión: En este estudio de corte transversal, se observó que los pacientes sintomáticos con espondilolistesis degenerativa que se sometieron a tratamiento quirúrgico tienen puntuaciones clínicas y funcionales superiores en comparación con los que se sometieron a tratamiento no quirúrgico.

Analysis of Auditory Rehabilitation Outcomes of the Cochlear Neural Canal Stenosis Patients after Cochlea Implantation / 听力学及言语疾病杂志

Objective To study the analysis of auditory rehabilitation outcomes of patients with cochlear nerve canal stenosis after cochlear implantation(CI).Methods A cohort of 30 patients with bilateral profound senso-rineural hearing loss who were diagnosed with cochlear neural canal stenosis by high-resolution CT were tested with evoked compound action potential (ECAP)and evoked auditory brainstem response (EABR)during and 3 ,6 , 9 months after CI.Audiometry in sound field was also assessed before and 3 ,6 ,9 months after CI.Among the co-hort,1 7 patients over 3 years old underwent postoperative speech recognition rate test.All the auditory rehabilita-tion outcomes were analyzed.Results ① For all 30 patients,there were no obvious differences of ECAP and EABR waveforms tested in 3,6 and 9 months after CI.②The thresholds in sound field in 3,6,9 months after CI were 65 ±8 dB HL,62 ±4 dB HL and 61 ±7 dB HL,respectively.The thresholds in sound field were significantly im-proved after than before CI (100 ±5 dB HL).③ The single vowel recognition rates of 17 patients in 3 ,6 and 9 months after CI were 55%±7%,56%±8% and 80%±4%,respectively.The single vowel recognition rate was significantly improved in 9 months after than before CI(52%±8%).The single consonant recognition rates of 17 pa-tients in 3 ,6 and 9 months after CI were 9%±3%,8%±4% and 9%±2%,respectively.The single consonant recognition rates were not significantly improved after than before CI (8%±2%).Conclusion ① For patients with bi-lateral cochlear neural canal stenosis,neither ECAP nor EABR waves were produced during or after CI.The language com-munication of patients is limited as a result of their poor subjective thresholds in sound field and speech recognition rates.

MRI study of relationship between secondary spinal canal stenosis and subacute combined degeneration / 实用放射学杂志

Objective To investigate MRI characteristics of subacute combined degeneration(SCD)with secondary spinal canal stenosis.Methods The clinical and MRI imaging data of 56 patients with SCD were collected to analyze the performance characteristics between spinal cord lesions and spinal canal stenosis,which depended on the synergism of lumbar disc bluge or herniation,degenerative thickening of the ligament flavum and posterior longitudinal ligament.Results Among 56 SCD cases underwent MRI scan,45 cases were combined with spinal cord lesions which showed typical signs of SCD.37 patients were secondary spinal canal stenosis with typical signs,but 2 showed no typical signs.8 patients were no secondary spinal canal stenosis and showed typical.9 cases showed neither spinal cord lesions nor secondary spinal canal stenosis.There was significant difference (P <0.05)between relative secondary spinal canal stenosis and spinal anomaly signal.The course of 1 5 cases were shortened after treated by physical in 37 cases of SCD with secondary spinal canal. Conclusion The secondary spinal canal stenosis can cause microcirculation dysfunction of the spinal cord,which is a key factor contributing to the imaging manifestation.