Background Since there are a complex anatomic structure and vital function in the high cervical spinal cord, it is difficult to remove the tumors lateroventral and ventral to the high cervical spinal cord. This clinic...Background Since there are a complex anatomic structure and vital function in the high cervical spinal cord, it is difficult to remove the tumors lateroventral and ventral to the high cervical spinal cord. This clinical study was undertaken to analyze surgical approaches, manner of tumor resection and postoperative management. Methods Thirty-four patients underwent microsurgical excision of tumors lateroventral and ventral to the high cervical spinal cord by means of three approaches. The tumors comprised mostly Schwannoma and meningioma (88.24%, 30/34) in this group. Tumor volume varied from 3.0 cm×2.5 cm×2.0 cm to 12 cm×3.0 cm×2.5 cm. Of the 34 patients, 4 had dumbbell-shaped tumors growing outside the spinal canal and 7 tumors growing into the intracranium. Results The tumor was totally removed in 32 patients (94.1%). Follow-up for 7 months to 6.4 years (median 3.6 years) showed a recovery of a normal life or work ability in 30 (83.3%) patients. Conclusion Modified operative approaches and microsurgical techniques can raise the rate of total tumor removal and reduce the disability of patients.展开更多
目的分析高频重复经颅磁刺激(HFrTMS)联合悬吊训练(SET)治疗不完全性脊髓损伤(ISCI)的效果。方法依据随机数字表法将安徽省六安市中医院2021年12月至2022年10月收治的90例ISCI患者分为联合组(45例)及对照组(45例)。对照组予以SET干预,...目的分析高频重复经颅磁刺激(HFrTMS)联合悬吊训练(SET)治疗不完全性脊髓损伤(ISCI)的效果。方法依据随机数字表法将安徽省六安市中医院2021年12月至2022年10月收治的90例ISCI患者分为联合组(45例)及对照组(45例)。对照组予以SET干预,联合组在对照组基础上增加HF r TMS干预,两组均干预4周。评价临床疗效,比较干预前后脊髓功能独立性(FIM)、神经性疼痛程度(SF-MPQ)、独立生活能力(BI)平衡能力(BBS)、下肢功能(ASIA-LEMS)评分及步态参数变化。结果联合组临床疗效优于对照组,差异有统计学意义(P<0.05)。干预后,两组FIM及BI评分高于干预前,且联合组高于对照组,差异有统计学意义(P<0.05);干预后两组SF-MPQ评分低于干预前,且联合组低于对照组,差异有统计学意义(P<0.05)。干预后,两组BBS、ASIA-LEMS评分高于治疗前,且联合组高于对照组,差异有统计学意义(P<0.05)。干预后,两组步长、步速、步频高于干预前,且联合组高于对照组,差异有统计学意义(P<0.05)。结论HF r TMS联合SET治疗ISCI患者效果显著,能够提高脊髓功能独立性、平衡能力和独立生活能力,降低神经性疼痛程度。展开更多
目的探讨低频(low-frequency,LF)与高频(high-frequency,HF)脊髓刺激(spinal cord stimulation,SCS)对腰部手术失败综合征(failed lumbar surgery syndrome,FLSS)疼痛的影响。方法根据计算机产生的随机数字表,将58例FLSS患者分为LF组和H...目的探讨低频(low-frequency,LF)与高频(high-frequency,HF)脊髓刺激(spinal cord stimulation,SCS)对腰部手术失败综合征(failed lumbar surgery syndrome,FLSS)疼痛的影响。方法根据计算机产生的随机数字表,将58例FLSS患者分为LF组和HF组各29例。对照组给予LF-SCS治疗,观察组给予HF-SCS治疗。观察两组患者入组时(T0)、3个月(T1)、6个月(T2)和12个月(T3)时的VAS评分、疼痛检测评分(pain detect questionnaire,PDQ)、Oswestry功能障碍指数(Oswestry disability index,ODI)、健康调查12条简表(short form 12 questionnaire,SF-12)、睡眠量表(medical outcomes study sleep scale,MOSS)和医院焦虑和抑郁量表(hospital anxiety and depression,HAD)。结果T1、T2、T3时,两组患者腰痛VAS、腿痛VAS、PDQ、ODI、HAD-D、HAD-A评分均显著低于T0时(P<0.05),且HF组上述指标均低于同期LF组(P<0.05)。T1、T2、T3时,两组患者SF-12、MOSS评分均高于T0时(P<0.05),且HF组上述指标均高于同期LF组(P<0.05)。结论与LF-SCS相比,HF-SCS治疗FLSS可进一步改善患者疼痛程度,减轻功能障碍,改善生活质量。展开更多
文摘Background Since there are a complex anatomic structure and vital function in the high cervical spinal cord, it is difficult to remove the tumors lateroventral and ventral to the high cervical spinal cord. This clinical study was undertaken to analyze surgical approaches, manner of tumor resection and postoperative management. Methods Thirty-four patients underwent microsurgical excision of tumors lateroventral and ventral to the high cervical spinal cord by means of three approaches. The tumors comprised mostly Schwannoma and meningioma (88.24%, 30/34) in this group. Tumor volume varied from 3.0 cm×2.5 cm×2.0 cm to 12 cm×3.0 cm×2.5 cm. Of the 34 patients, 4 had dumbbell-shaped tumors growing outside the spinal canal and 7 tumors growing into the intracranium. Results The tumor was totally removed in 32 patients (94.1%). Follow-up for 7 months to 6.4 years (median 3.6 years) showed a recovery of a normal life or work ability in 30 (83.3%) patients. Conclusion Modified operative approaches and microsurgical techniques can raise the rate of total tumor removal and reduce the disability of patients.
文摘目的分析高频重复经颅磁刺激(HFrTMS)联合悬吊训练(SET)治疗不完全性脊髓损伤(ISCI)的效果。方法依据随机数字表法将安徽省六安市中医院2021年12月至2022年10月收治的90例ISCI患者分为联合组(45例)及对照组(45例)。对照组予以SET干预,联合组在对照组基础上增加HF r TMS干预,两组均干预4周。评价临床疗效,比较干预前后脊髓功能独立性(FIM)、神经性疼痛程度(SF-MPQ)、独立生活能力(BI)平衡能力(BBS)、下肢功能(ASIA-LEMS)评分及步态参数变化。结果联合组临床疗效优于对照组,差异有统计学意义(P<0.05)。干预后,两组FIM及BI评分高于干预前,且联合组高于对照组,差异有统计学意义(P<0.05);干预后两组SF-MPQ评分低于干预前,且联合组低于对照组,差异有统计学意义(P<0.05)。干预后,两组BBS、ASIA-LEMS评分高于治疗前,且联合组高于对照组,差异有统计学意义(P<0.05)。干预后,两组步长、步速、步频高于干预前,且联合组高于对照组,差异有统计学意义(P<0.05)。结论HF r TMS联合SET治疗ISCI患者效果显著,能够提高脊髓功能独立性、平衡能力和独立生活能力,降低神经性疼痛程度。
文摘目的探讨低频(low-frequency,LF)与高频(high-frequency,HF)脊髓刺激(spinal cord stimulation,SCS)对腰部手术失败综合征(failed lumbar surgery syndrome,FLSS)疼痛的影响。方法根据计算机产生的随机数字表,将58例FLSS患者分为LF组和HF组各29例。对照组给予LF-SCS治疗,观察组给予HF-SCS治疗。观察两组患者入组时(T0)、3个月(T1)、6个月(T2)和12个月(T3)时的VAS评分、疼痛检测评分(pain detect questionnaire,PDQ)、Oswestry功能障碍指数(Oswestry disability index,ODI)、健康调查12条简表(short form 12 questionnaire,SF-12)、睡眠量表(medical outcomes study sleep scale,MOSS)和医院焦虑和抑郁量表(hospital anxiety and depression,HAD)。结果T1、T2、T3时,两组患者腰痛VAS、腿痛VAS、PDQ、ODI、HAD-D、HAD-A评分均显著低于T0时(P<0.05),且HF组上述指标均低于同期LF组(P<0.05)。T1、T2、T3时,两组患者SF-12、MOSS评分均高于T0时(P<0.05),且HF组上述指标均高于同期LF组(P<0.05)。结论与LF-SCS相比,HF-SCS治疗FLSS可进一步改善患者疼痛程度,减轻功能障碍,改善生活质量。
