scholarly journals Could Screw/Hook Insertion at the Apical with Rib Head Dislocation Effectively Retract the Corresponding Rib Head from Spinal Canal in Dystrophic Scoliosis Secondary to Type 1 Neurofibromatosis?

2021 ◽  
Author(s):  
Song Li ◽  
Saihu Mao ◽  
Yanyu Ma ◽  
Ben-long Shi ◽  
Zhen Liu ◽  
...  
Keyword(s):  
Cobb Angle ◽  
Spinal Canal ◽  
Linear Regression Analysis ◽  
Multiple Linear Regression Analysis ◽  
Scoliosis Surgery ◽  
Type 1 Neurofibromatosis ◽  
Whole Spine ◽  
Rib Head ◽  
Surgical Manipulation

Abstract Background. Rib head dislocation (RHD) in dystrophic scoliosis of type 1 neurofibromatosis (DS-NF1) is a unique disorder caused by skeletal dystrophy and scoliotic instability. No particular surgical manipulation is mentioned in the literature to instruct the spine surgeons to effectively obtain more migration of the dislocated rib head without resection. The present study aimed to investigate the effectiveness of screw/hook insertion at vertebrae with RHDs on the retraction of penetrated rib head from spinal canal.Methods. 37 neurologically intact patients with DS-NF1 and concomitant 53 RHDs undergoing scoliosis surgery without rib head excision were retrospectively reviewed. We used pre and postoperative whole-spine radiographs to determine the Cobb angle and the vertebral translation (VT), and the CT scans to evaluate the intraspinal rib length (IRL) and rib-vertebral angle (RVA). The dislocated ribs were stratified into two groups according to the presence of screw/hook insertion at vertebrae with RHD: screw/hook group and non-screw/hook group. Results. 37 dislocated ribs with screws/hooks insertion at corresponding vertebrae were assigned into the screw/hook group and the remaining 16 dislocated ribs consisted of the non-screw/hook group. In the screw/hook group, the correction rates of Cobb angle and VT were significantly higher than the non-screw/hook group after surgery (58.7±16.0% vs. 30.9±12.4%, p=0.003; 61.8±18.8% vs. 35.1±16.6%, p=0.001; respectively). Similarly, more correction rates of IRL and RVA were found in the screw/hook group than the non-screw/hook group (63.1±31.3% vs. 30.1±20.7%, p=0.008; 17.6±9.7% vs. 7.2±3.6%, p=0.006; respectively). Multiple linear regression analysis revealed that the correction rates of Cobb angle, VT and RVA contributed significantly to correction of IRL (β=0.389, 0.939 and 1.869, respectively; p=0.019, 0.001 and 0.002, respectively).Conclusion. Screw/hook insertion at dystrophic vertebrae with RHDs contributed significantly to the degree of retraction of penetrated rib head from spinal canal. This effectiveness is mediated by more corrections of VT and RVA.

scholarly journals Therapeutic Strategy of Percutaneous Transforaminal Endoscopic Decompression for Stenosis Associated With Adult Degenerative Scoliosis

2020 ◽  
pp. 219256822095903
Author(s):  
Lin-Yu Jin ◽  
Kun Wang ◽  
Zhen-Dong Lv ◽  
Xin-Jin Su ◽  
Hai-Ying Liu ◽  
...  
Keyword(s):  
Regression Analysis ◽  
Cobb Angle ◽  
Linear Regression Analysis ◽  
Multiple Linear Regression Analysis ◽  
Lumbar Stenosis ◽  
Degenerative Scoliosis ◽  
Adult Degenerative Scoliosis ◽  
Lateral Subluxation ◽  
The Mean ◽  
Transforaminal Endoscopic Surgery

Study Design: A retrospective study. Objective: To investigate the effects of percutaneous transforaminal endoscopic decompression (PTED) for lumbar stenosis associated with adult degenerative scoliosis and to analyze the correlation between preoperative radiological parameters and postoperative surgical outcomes. Methods: Two years of retrospective data was collected from 46 patients with lumbar stenosis associated with adult degenerative scoliosis who underwent PTED. The visual analog scale (VAS), Oswestry Disability Index, and modified MacNab criteria were used to evaluate the clinical outcomes. Multiple linear regression analysis was used to analyze the correlation between radiological parameters and surgical outcomes. Results: The mean age of the 33 female and 13 male patients was 73.5 ± 8.1 years. The mean follow-up was 27.6 ± 3.5 months (range from 24 to 36). The average coronal Cobb angle was 24.5 ± 8.2°. There were better outcomes of the VAS for leg pain and Oswestry Disability Index after surgery. Based on the MacNab criteria, excellent or good outcomes were noted in 84.78% of patients. Multiple linear regression analysis showed that Cobb angle and lateral olisthy may be the predictors for low back pain. Conclusion: Transforaminal endoscopic surgery may be an effective and safe method for geriatric patients with lumbar stenosis associated with degenerative scoliosis. The predictive factors of clinical outcomes were severe Cobb angle and high degree lateral subluxation. Transforaminal endoscopic surgery may not be recommended for patients with Cobb angle larger than 30° combined with lateral subluxation.

scholarly journals Diabetes Knowledge and Metabolic Control in Type 1 Diabetes Starting with Continuous Glucose Monitoring: FUTURE-PEAK

2021 ◽  
Author(s):  
Ben Broos ◽  
Sara Charleer ◽  
Nancy Bolsens ◽  
Carolien Moyson ◽  
Chantal Mathieu ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Health Literacy ◽  
Continuous Glucose Monitoring ◽  
Linear Regression Analysis ◽  
Glucose Monitoring ◽  
Multiple Linear Regression Analysis ◽  
Diabetes Knowledge ◽  
Secondary Endpoints ◽  
One Year

Abstract Purpose To investigate whether diabetes knowledge and health literacy impact glycemic control after one year of intermittently scanned continuous glucose monitoring (isCGM) in people with type 1 diabetes (PWD1) ≥16 years. Methods In this prospective real-world cohort study we assessed diabetes knowledge using a new 10-item questionnaire (Patient Education And Knowledge [PEAK]), and health literacy using the validated 6-item Newest-Vital Sign-D (NVS-D) questionnaire. Primary endpoint was association between PEAK score and change in HbA1c. Secondary endpoints were link between NVS-D score and change in HbA1c, and that between time spent in/above/below range and PEAK/NVS-D scores. Results 851 subjects were consecutively recruited between 07/2016 and 07/2018. Median PEAK score was 8 (range:0-10) and median NVS-D score was 6 (range 0-6). HbA1c evolved from 7.9 [7.8-8.0]%, 63 [62-64] mmol/mol at start to 7.7 [7.6-7.7]%, 61 [60-61] mmol/mol (p<0.001) at 6 months and to 7.8 [7.7-7.9]%, 62 [61-63] at 12 months (p<0.001). HbA1c only improved in subgroups with higher scores (PEAK subgroups with score 7-8 [p=0.005] and 9-10 [p<0.001] and NVS-D score 4-6 [p<0.001]). At 12 months, time spent below 70 mg/dl was reduced by 15 % (p<0.001) and time spent below 54 mg/dl was reduced by 14% (p<0.001), irrespective of PEAK/NVS-D score. Multiple linear regression analysis demonstrated an association of PEAK score, scan frequency and baseline HbA1c with evolutions in time in range and time in hyperglycemia. Conclusions isCGM reduced time in hypoglycemia and HbA1c evolved favourably. Our findings suggest that diabetes and health literacy affect glucometrics emphasizing the importance of education.

scholarly journals A far-lateral approach for removal of a C1–2 extradural neurofibroma

2012 ◽  
Vol 33 (Suppl1) ◽  
pp. 1
Author(s):  
Jon H. Robertson ◽  
Jeffrey M. Sorenson
Keyword(s):  
Spinal Cord ◽  
Spinal Canal ◽  
Lateral Approach ◽  
Stereoscopic Video ◽  
Progressive Myelopathy ◽  
Link Type ◽  
Far Lateral Approach ◽  
Type 1 Neurofibromatosis ◽  
Far Lateral

A young man with type 1 neurofibromatosis presented with progressive myelopathy. Imaging revealed an anterolateral mass within the spinal canal at C1–2, with severe compression of the spinal cord. A far-lateral approach was used to remove the mass, which proved to be an extradural neurofibroma. This narrated stereoscopic video details the important steps of the operation. The video can be found here: http://youtu.be/td4MjLtiMbk.

scholarly journals The Importance of Apex Location and Proximal Hemi-Curve Morphology for the Surgical Tactic of Significant Convex Coronal Imbalance in Patients with Dystrophic Scoliosis Secondary to Type I Neurofibromatosis: Classification and Management

2021 ◽  
Author(s):  
Saihu Mao ◽  
Song Li ◽  
Yanyu Ma ◽  
Ben-long Shi ◽  
Zhen Liu ◽  
...  
Keyword(s):  
Linear Regression Analysis ◽  
Multiple Linear Regression Analysis ◽  
Fine Tuning ◽  
Type I ◽  
Coronal Imbalance ◽  
Valid Information

Abstract Background. There was a paucity of valid information on how to discriminate between different patterns of convex coronal imbalance (CCI>3cm) in dystrophic scoliosis secondary to Type I neurofibromatosis (DS-NF1), while aggravated postoperative CCI occurred regularly with the causes being insufficiently investigated. We aimed to develop a new classification of CCI in DS-NF1, and to optimize the coronal rebalancing strategies.Methods. NF1-related scoliosis database was reviewed and different types of CCI were identified, and the outcomes of coronal rebalance were analyzed. Results. Two main CCI patterns were defined: thoracic CCI (Type 1) and thoracolumbar/lumbar CCI (Type 2), and were further subtyped by the compensatory behavior of the upper hemi-curve (straight or curved morphology). The incidence of immediate post-op CCI was 0.0% and 63.6% for Type1 and Type 2 groups, respectively. Mismatch of both translation and inclination correction between the upper and lower hemi-curve was significant in the post-op coronal imbalanced group (△Upper Arc Translation/△Lower Arc Translation: 109.6±60.0% vs. 31.8±34.4%, p=0.008; △Upper Arc Inclination/△Lower Arc Inclination: 89.8±36.6% vs. 33.5±37.3%, p=0.012). Multiple linear regression analysis revealed that △UAT/△LAT significantly correlated with the correction of coronal balance distance (β=-21.567; p=0.018). A surgical rebalancing algorithm was proposed to treat each subtype.Conclusion. Thoracolumbar/lumbar CCI in dystrophic scoliosis was prone to suffer high risk of persistent post-op CCI. Satisfying coronal rebalance should rely on maximal translational correction of lower hemi-curve, while the upper hemi-curve played the role of fine-tuning for coronal realignment rather than radical Cobb correction, straight morphology in particular.

scholarly journals Surgical Treatment of the Intraspinal Rib Head Dislocation in Children With Dystrophic Scoliosis Secondary to Type 1 Neurofibromatosis

2022 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Rongxuan Gao ◽  
Dong Guo ◽  
Xuejun Zhang ◽  
Baosheng Sun ◽  
Ziming Yao ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Type 1 Neurofibromatosis ◽  
Rib Head

scholarly journals Pediatric Scoliosis Surgery—A Comprehensive Analysis of Treatment-Specific Variables and Trends in Latvia

Medicina ◽  
2020 ◽  
Vol 56 (4) ◽  
pp. 201
Author(s):  
Julian M. Rüwald ◽  
Janis Upenieks ◽  
Janis Ositis ◽  
Alexander Pycha ◽  
Yuval Avidan ◽  
...  
Keyword(s):  
Linear Regression ◽  
Hospital Stay ◽  
Cobb Angle ◽  
Linear Regression Analysis ◽  
Operation Time ◽  
Scoliosis Surgery ◽  
Time Period ◽  
Scoliosis Correction ◽  
Operative Complications ◽  
Insight Into

Background and Objectives: There are currently no data available regarding pediatric scoliosis surgery in Latvia. The aim of this article is to present treatment specific variables, investigate their interrelation, and identify predictors for the length of stay after surgical pediatric scoliosis correction. Materials and Methods: This retrospective study included all surgical pediatric scoliosis corrections in Latvia for the years 2012 to 2016. Analyzed parameters were chosen to portray the patients’ demographics, pathology, as well as treatment specific variables. Descriptive, inferential, and linear regression statistics were calculated. Results: A total of 69 cases, 74% female and 26% male, were identified. The diagnostic subgroups consisted of 62% idiopathic (IDI) and 38% non-idiopathic (non-IDI) scoliosis cases. Non-IDI cases had significantly increased operation time, hospital stay, Cobb angle before surgery, and instrumented levels, while IDI cases showed significantly higher Cobb angle percentage correction. For all operated cases, the operation time and the hospital stay decreased significantly over the investigated time period. Early post-operative complications (PCs) occurred in 15.9% of the cases and were associated with increased hospital stay, instrumented levels, and Cobb angle before surgery. The linear regression analysis revealed that operation time and the presence of PCs were significant predictors for the length of the hospital stay. Conclusions: This is the first study to provide comprehensive insight into pediatric scoliosis surgery since its establishment in Latvia. Our regression model offers clinically applicable predictors and further underlines the significance of the operation length on the hospital stay. These results build the foundation for international comparison and facilitate improvement in the field.

scholarly journals Association of Triglyceride-Glucose Index with the Incidence of Ketoacidosis in Chinese Children with Type 1 Diabetes

2021 ◽  
Author(s):  
Long Gao ◽  
Xinhui Wang ◽  
Jianbo Shu ◽  
Mingying Zhang ◽  
Xiufang Zhi ◽  
...  
Keyword(s):  
Positive Impact ◽  
Linear Regression Analysis ◽  
Multiple Linear Regression Analysis ◽  
Clinical Prognosis ◽  
Tyg Index ◽  
Index Group ◽  
Triglyceride Glucose Index ◽  
The Relationship

Abstract Objective: The relationship between triglyceride-glucose index (TyG index) and the prevalence of type 2 diabetes mellitus (T2DM) has been confirmed by former studies. However, it remains uncertain whether TyG index has a predictive value in T1DM patients with diabetic ketoacidosis (DKA).Methods: The study retrospectively enrolled 143 patients ((boys/girls = 60/83) with T1DM in the Endocrine inpatient wards of Tianjin Children’s Hospital from June 2017 to May 2019.TyG index was calculated as follows: ln[fasting triglycerides (mg/dL)×fasting plasma glucose (mg/dL)/2]. These patients stratifed by the optimal cut-off point of TyG index were divided into the lower TyG index group (n=73) and higher TyG index group (n=70).Results: TyG index and related lipid parameters were significantly higher in patients with DKA compared with those without. Compared with patients in lower TyG index group, those with higher TyG index seemed to be younger. Multiple linear regression analysis showed that increase of TC (95%CI: 0.018~0.568, p=0.037) level and decrease of T3(95%CI:-2.314~-0.668,p=0.001) level were associated with the risk of higher TyG index. A linear equation was obtained between TC, T3 and TyG index (TyG index=10.226+0.299*TC-1.384*T3, R2=0.481). Conclusions: Increased TyG index is a significant predictor of DKA in children with T1DM. Higher TC and lower T3 levels were associated with higher TyG index. Further studies need to be conducted to determine whether interventions for TyG index have a positive impact on improving clinical prognosis.

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