Introduction: Vertebroplasty and kyphoplasty are percutaneous techniques that consist in injecting an acrylic cement into the body of a pathological vertebra. This work aims to report the experience the of Fann’s neu...Introduction: Vertebroplasty and kyphoplasty are percutaneous techniques that consist in injecting an acrylic cement into the body of a pathological vertebra. This work aims to report the experience the of Fann’s neurosurgery department in treating certain spinal pathologies by vertebroplasty and kyphoplasty. Methods: During a 3-year period from July 1, 2019 to July 31, 2022, we conducted a retrospective, descriptive and analytical study, including patients who underwent vertebroplasty or kyphoplasty for dorsolumbar spinal pathology. Results: The mean age of the 13 patients in our study was 51.61 years. Female gender was predominant in 62% (n = 8). The context of spontaneous onset was found in six patients. Nine patients had a VAS (visual analogue scale) ≥ 8 (69.23%). On clinical examination, all patients had a syndrome without neurological deficits. 84.61% of patients had a CT scan (n = 11). The dorsolumbar hinge was most affected with 53.85% of cases. Seven patients had a vertebral compression of between 25% and. The average degree of kyphosis was 8˚ and seven patients had a degree of kyphosis ≥ 10˚. Tumour aetiology accounted for 46.15% of cases. Kyphoplasty was performed in 61.53% (n = 9) of the cases and vertebroplasty was performed in 38.47% (n = 4) of the patients. Kyphoplasty was associated with biopsy in two cases and with osteosynthesis in one patient. Vertebroplasty was always associated with a biopsy. The evolution was favourable with a significant reduction in pain and vertebral kyphosis. The mean VAS decreased from 8.15 to 0.69 three months after treatment and the mean kyphosis decreased from 8˚ to 2˚. Conclusion: Kyphoplasty and vertebroplasty as percutaneous techniques allow consolidation of the vertebral body and pain relief. Kyphoplasty alone not only reduces pain but also restores the height of the compacted vertebral body.展开更多
Objective Arachnoid cysts are non-arachnoid fluid collections that accout for about 1% of all intracranial space-occupying lessions. So far,the optimal method of treatment for symptomatic arachnoid cysts remains contr...Objective Arachnoid cysts are non-arachnoid fluid collections that accout for about 1% of all intracranial space-occupying lessions. So far,the optimal method of treatment for symptomatic arachnoid cysts remains controversial. In this article,we want to find an ideal technique展开更多
目的观察小脑出血不同手术治疗方案的临床疗效。方法本研究为回顾性病例对照研究,收集2018年1月至2022年1月住院手术治疗的小脑出血患者60例,采用枕下骨瓣开颅清除血肿的20例患者设为开颅组;采用锁孔小骨窗入路清除血肿的20例患者设为...目的观察小脑出血不同手术治疗方案的临床疗效。方法本研究为回顾性病例对照研究,收集2018年1月至2022年1月住院手术治疗的小脑出血患者60例,采用枕下骨瓣开颅清除血肿的20例患者设为开颅组;采用锁孔小骨窗入路清除血肿的20例患者设为锁孔组,采用软通道穿刺置管引流术清除血肿的20例患者设为穿刺组;观察3组患者手术时间、术中出血量、术后术区残余血肿量、术后术区再出血例数、术后并发症发生例数、住院天数、重症监护病房时间、术前术后7 d格拉斯哥昏迷评分(GCS)、美国国立卫生院卒中量表评分(NIHSS);术后6个月格拉斯哥预后评分(GOS)。结果3组患者术后7 d GCS、NIHSS评分较术前明显改善(P<0.05);开颅组和锁孔组明显优于穿刺组(P<0.05);锁孔组明显优于开颅组(P<0.05);3组患者术后6个月GOS评分差异无统计学意义(P>0.05)。穿刺组手术时间、术中出血量明显小于开颅组和锁孔组(P<0.05),锁孔组手术时间、术中出血量明显小于开颅组(P<0.05)。穿刺组术后术区残余血肿量、术后术区再出血例数明显多于开颅组和锁孔组(P<0.05)。锁孔组术后并发症发生例数明显小于穿刺组和开颅组(P<0.05)。锁孔组住院天数、症监护病房时间明显小于穿刺组和开颅组(P<0.05),开颅组住院天数、症监护病房时间小于穿刺组(P<0.05)。结论临床上要根据小脑出血患者的具体情况选择手术方式,条件允许的情况下优先选择锁孔小骨窗入路显微镜或内镜下清除血肿,近期疗效、住院天数和重症病房时间均优于骨瓣开颅和穿刺置管引流清除血肿。展开更多
目的探讨亲环蛋白B(cyclophilin B,PPIB)在脑胶质瘤中的表达与临床病理特征、患者生存期的关系,以及与肿瘤相关巨噬细胞浸润的相关性。方法基于癌症基因组数据集(The Cancer Genome Atlas,TCGA)数据库资料,比对正常、低级别和高级别脑...目的探讨亲环蛋白B(cyclophilin B,PPIB)在脑胶质瘤中的表达与临床病理特征、患者生存期的关系,以及与肿瘤相关巨噬细胞浸润的相关性。方法基于癌症基因组数据集(The Cancer Genome Atlas,TCGA)数据库资料,比对正常、低级别和高级别脑胶质瘤中PPIB的表达情况,采用免疫组织化学染色方法检测脑胶质瘤病理组织中PPIB的表达;基于TCGA数据库临床病例资料,分析脑胶质瘤PPIB表达与临床病理特征的关系;采用Kaplan-Meier法评估PPIB表达差异对脑胶质瘤患者生存期的影响;免疫荧光法分析脑胶质瘤病理组织中PPIB表达及其与肿瘤相关巨噬细胞浸润的相关性。结果高级别脑胶质瘤中PPIB的表达明显高于正常组织及低级别脑胶质瘤;PPIB与胶质瘤级别、IDH野生型、1p/19q非共缺失等显著相关(P<0.001);PPIB高表达患者的总生存期、无进展间隔期均低于PPIB低表达患者;除高级别脑胶质瘤病理组织中PPIB表达升高外,PPIB高表达区域伴随大量肿瘤相关巨噬细胞浸润。结论相较于低级别胶质瘤,高级别胶质瘤PPIB表达水平更高,且PPIB表达区域存在明显肿瘤相关巨噬细胞浸润。提示PPIB可能作为脑胶质瘤患者独立预后因素,为患者预后判断提供参考。展开更多
目的观察老年基底节区脑出血不同微侵袭手术方式的临床疗效。方法本研究为回顾性病例对照研究,收集2020年1月至2022年12月住院手术治疗的老年基底节区脑出血患者60例,采用神经内镜经额中回入路清除血肿的20例患者为内镜组;采用显微镜经...目的观察老年基底节区脑出血不同微侵袭手术方式的临床疗效。方法本研究为回顾性病例对照研究,收集2020年1月至2022年12月住院手术治疗的老年基底节区脑出血患者60例,采用神经内镜经额中回入路清除血肿的20例患者为内镜组;采用显微镜经侧裂入路清除血肿的20例患者为显微镜组;采用软通道穿刺置管引流术清除血肿的20例患者为穿刺组。观察3组患者手术时间、术中出血量、术后术区残余血肿量、术后术区再出血例数、术后手术并发症发生情况;术前术后7 d格拉斯哥昏迷评分(GCS)、美国国立卫生院卒中量表评分(NIHSS);术后6个月格拉斯哥预后评分(GOS)。结果3组患者术后7 d GCS、NIHSS评分较术前明显改善,3组间比较差异有统计学意义(P<0.05),内镜组和显微镜组明显优于穿刺组(P<0.05);3组患者术后6个月GOS评分差异有统计学意义,内镜组和显微镜组明显优于穿刺组(P<0.05);3组手术时间、术中出血量、术后术区残余血肿量差异有统计学意义(P<0.05),穿刺组手术时间、术中出血量明显小于内镜组和显微镜组(P<0.05),但穿刺组术后术区残余血肿量明显多于内镜组和显微镜组(P<0.05);穿刺组术后术区再出血例数明显多于显微镜组(P<0.05);3组术后肺部感染和泌尿道感染例数比较差异有统计学意义(P<0.05),穿刺组肺部感染、泌尿道感染、手术部位感染明显高于内镜组(P<0.05)。结论临床上要根据老年基底节区脑出血患者的具体情况选择手术方式,条件允许的情况下优先选择神经内镜直视下清除血肿,近期和远期疗效佳,术后并发症发生率低。展开更多
INTRODUCTION Great changes have taken place in modern neurosurgery in the past decades.Contrasting models of management for complex neurosurgical patients have been developed in China as the specialty evolving,thus ar...INTRODUCTION Great changes have taken place in modern neurosurgery in the past decades.Contrasting models of management for complex neurosurgical patients have been developed in China as the specialty evolving,thus arise many controversies.Clinical demand calls for an expert consensus on neurosurgical inpatients management,especially for the subspecialty of neurosciences critical care （NCC）.展开更多
文摘Introduction: Vertebroplasty and kyphoplasty are percutaneous techniques that consist in injecting an acrylic cement into the body of a pathological vertebra. This work aims to report the experience the of Fann’s neurosurgery department in treating certain spinal pathologies by vertebroplasty and kyphoplasty. Methods: During a 3-year period from July 1, 2019 to July 31, 2022, we conducted a retrospective, descriptive and analytical study, including patients who underwent vertebroplasty or kyphoplasty for dorsolumbar spinal pathology. Results: The mean age of the 13 patients in our study was 51.61 years. Female gender was predominant in 62% (n = 8). The context of spontaneous onset was found in six patients. Nine patients had a VAS (visual analogue scale) ≥ 8 (69.23%). On clinical examination, all patients had a syndrome without neurological deficits. 84.61% of patients had a CT scan (n = 11). The dorsolumbar hinge was most affected with 53.85% of cases. Seven patients had a vertebral compression of between 25% and. The average degree of kyphosis was 8˚ and seven patients had a degree of kyphosis ≥ 10˚. Tumour aetiology accounted for 46.15% of cases. Kyphoplasty was performed in 61.53% (n = 9) of the cases and vertebroplasty was performed in 38.47% (n = 4) of the patients. Kyphoplasty was associated with biopsy in two cases and with osteosynthesis in one patient. Vertebroplasty was always associated with a biopsy. The evolution was favourable with a significant reduction in pain and vertebral kyphosis. The mean VAS decreased from 8.15 to 0.69 three months after treatment and the mean kyphosis decreased from 8˚ to 2˚. Conclusion: Kyphoplasty and vertebroplasty as percutaneous techniques allow consolidation of the vertebral body and pain relief. Kyphoplasty alone not only reduces pain but also restores the height of the compacted vertebral body.
文摘Objective Arachnoid cysts are non-arachnoid fluid collections that accout for about 1% of all intracranial space-occupying lessions. So far,the optimal method of treatment for symptomatic arachnoid cysts remains controversial. In this article,we want to find an ideal technique
文摘目的观察小脑出血不同手术治疗方案的临床疗效。方法本研究为回顾性病例对照研究,收集2018年1月至2022年1月住院手术治疗的小脑出血患者60例,采用枕下骨瓣开颅清除血肿的20例患者设为开颅组;采用锁孔小骨窗入路清除血肿的20例患者设为锁孔组,采用软通道穿刺置管引流术清除血肿的20例患者设为穿刺组;观察3组患者手术时间、术中出血量、术后术区残余血肿量、术后术区再出血例数、术后并发症发生例数、住院天数、重症监护病房时间、术前术后7 d格拉斯哥昏迷评分(GCS)、美国国立卫生院卒中量表评分(NIHSS);术后6个月格拉斯哥预后评分(GOS)。结果3组患者术后7 d GCS、NIHSS评分较术前明显改善(P<0.05);开颅组和锁孔组明显优于穿刺组(P<0.05);锁孔组明显优于开颅组(P<0.05);3组患者术后6个月GOS评分差异无统计学意义(P>0.05)。穿刺组手术时间、术中出血量明显小于开颅组和锁孔组(P<0.05),锁孔组手术时间、术中出血量明显小于开颅组(P<0.05)。穿刺组术后术区残余血肿量、术后术区再出血例数明显多于开颅组和锁孔组(P<0.05)。锁孔组术后并发症发生例数明显小于穿刺组和开颅组(P<0.05)。锁孔组住院天数、症监护病房时间明显小于穿刺组和开颅组(P<0.05),开颅组住院天数、症监护病房时间小于穿刺组(P<0.05)。结论临床上要根据小脑出血患者的具体情况选择手术方式,条件允许的情况下优先选择锁孔小骨窗入路显微镜或内镜下清除血肿,近期疗效、住院天数和重症病房时间均优于骨瓣开颅和穿刺置管引流清除血肿。
文摘目的探讨亲环蛋白B(cyclophilin B,PPIB)在脑胶质瘤中的表达与临床病理特征、患者生存期的关系,以及与肿瘤相关巨噬细胞浸润的相关性。方法基于癌症基因组数据集(The Cancer Genome Atlas,TCGA)数据库资料,比对正常、低级别和高级别脑胶质瘤中PPIB的表达情况,采用免疫组织化学染色方法检测脑胶质瘤病理组织中PPIB的表达;基于TCGA数据库临床病例资料,分析脑胶质瘤PPIB表达与临床病理特征的关系;采用Kaplan-Meier法评估PPIB表达差异对脑胶质瘤患者生存期的影响;免疫荧光法分析脑胶质瘤病理组织中PPIB表达及其与肿瘤相关巨噬细胞浸润的相关性。结果高级别脑胶质瘤中PPIB的表达明显高于正常组织及低级别脑胶质瘤;PPIB与胶质瘤级别、IDH野生型、1p/19q非共缺失等显著相关(P<0.001);PPIB高表达患者的总生存期、无进展间隔期均低于PPIB低表达患者;除高级别脑胶质瘤病理组织中PPIB表达升高外,PPIB高表达区域伴随大量肿瘤相关巨噬细胞浸润。结论相较于低级别胶质瘤,高级别胶质瘤PPIB表达水平更高,且PPIB表达区域存在明显肿瘤相关巨噬细胞浸润。提示PPIB可能作为脑胶质瘤患者独立预后因素,为患者预后判断提供参考。
文摘目的观察老年基底节区脑出血不同微侵袭手术方式的临床疗效。方法本研究为回顾性病例对照研究,收集2020年1月至2022年12月住院手术治疗的老年基底节区脑出血患者60例,采用神经内镜经额中回入路清除血肿的20例患者为内镜组;采用显微镜经侧裂入路清除血肿的20例患者为显微镜组;采用软通道穿刺置管引流术清除血肿的20例患者为穿刺组。观察3组患者手术时间、术中出血量、术后术区残余血肿量、术后术区再出血例数、术后手术并发症发生情况;术前术后7 d格拉斯哥昏迷评分(GCS)、美国国立卫生院卒中量表评分(NIHSS);术后6个月格拉斯哥预后评分(GOS)。结果3组患者术后7 d GCS、NIHSS评分较术前明显改善,3组间比较差异有统计学意义(P<0.05),内镜组和显微镜组明显优于穿刺组(P<0.05);3组患者术后6个月GOS评分差异有统计学意义,内镜组和显微镜组明显优于穿刺组(P<0.05);3组手术时间、术中出血量、术后术区残余血肿量差异有统计学意义(P<0.05),穿刺组手术时间、术中出血量明显小于内镜组和显微镜组(P<0.05),但穿刺组术后术区残余血肿量明显多于内镜组和显微镜组(P<0.05);穿刺组术后术区再出血例数明显多于显微镜组(P<0.05);3组术后肺部感染和泌尿道感染例数比较差异有统计学意义(P<0.05),穿刺组肺部感染、泌尿道感染、手术部位感染明显高于内镜组(P<0.05)。结论临床上要根据老年基底节区脑出血患者的具体情况选择手术方式,条件允许的情况下优先选择神经内镜直视下清除血肿,近期和远期疗效佳,术后并发症发生率低。
文摘INTRODUCTION Great changes have taken place in modern neurosurgery in the past decades.Contrasting models of management for complex neurosurgical patients have been developed in China as the specialty evolving,thus arise many controversies.Clinical demand calls for an expert consensus on neurosurgical inpatients management,especially for the subspecialty of neurosciences critical care （NCC）.
