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Kagami Y, Nakashima H, Ito K, Satake K, Tsushima M, Ouchida J, Morita Y, Ode Y, Segi N, Imagama S, Kanemura T. The anatomical relationship between the celiac artery and the median arch ligament in degenerative spinal surgery. J Orthop Sci 2024; 29:502-507. [PMID: 36914482 DOI: 10.1016/j.jos.2023.02.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 01/13/2023] [Accepted: 02/20/2023] [Indexed: 03/16/2023]
Abstract
BACKGROUND This study aimed to characterize the anatomical relationship between the spine, the celiac artery (CA), and the median arcuate ligament using preoperative contrast-enhanced computed tomography (CT) images of patients with spinal deformity who underwent surgical correction. METHODS This retrospective study included 81 consecutive patients (34 males, 47 females; average age: 70.2 years). The spinal level at which the CA originated, the diameter, extent of stenosis, and calcification were determined using CT sagittal images. Patients were divided into two groups: CA stenosis group and non-stenosis group. Factors associated with stenosis were examined. RESULTS CA stenosis was observed in 17 (21%) patients. CA stenosis group had significantly higher body mass index (24.9 ± 3.9 vs. 22.7 ± 3.7, p = 0.03). In the CA stenosis group, J-type CA (upward angling of the course by more than 90° immediately after descending) was more frequently observed (64.7% vs. 18.8%, p < 0.001). The CA stenosis group had lower pelvic tilt (18.6 ± 6.7 vs. 25.1 ± 9.9, p = 0.02) than non-stenosis group. CONCLUSIONS High BMI, J-type, and shorter distance between CA and MAL were risk factors for CA stenosis in this study. Patients with high BMI undergoing fixation of multiple intervertebral corrective fusions at the thoracolumbar junction should undergo preoperative CT evaluation of the anatomy of CA to assess the poteitial risk of celiac artery compression syndrome.
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Affiliation(s)
- Yujiro Kagami
- Department of Orthopedic Surgery, Konan Kosei Hospital, Japan; Department of Orthopedic Surgery, Anjo Kosei Hospital, Japan
| | - Hiroaki Nakashima
- Department of Orthopedic Surgery, Konan Kosei Hospital, Japan; Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, Japan.
| | - Kenyu Ito
- Department of Orthopedic Surgery, Konan Kosei Hospital, Japan
| | - Kotaro Satake
- Department of Orthopedic Surgery, Konan Kosei Hospital, Japan
| | - Mikito Tsushima
- Department of Orthopedic Surgery, Konan Kosei Hospital, Japan
| | - Jun Ouchida
- Department of Orthopedic Surgery, Konan Kosei Hospital, Japan; Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, Japan
| | - Yoshinori Morita
- Department of Orthopedic Surgery, Konan Kosei Hospital, Japan; Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, Japan
| | - Yukihito Ode
- Department of Orthopedic Surgery, Konan Kosei Hospital, Japan
| | - Naoki Segi
- Department of Orthopedic Surgery, Konan Kosei Hospital, Japan; Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, Japan
| | - Shiro Imagama
- Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, Japan
| | - Tokumi Kanemura
- Department of Orthopedic Surgery, Konan Kosei Hospital, Japan
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Patel K, Harikar MM, Venkataram T, Chavda V, Montemurro N, Assefi M, Hussain N, Yamamoto V, Kateb B, Lewandrowski KU, Umana GE. Is Minimally Invasive Spinal Surgery Superior to Endoscopic Spine Surgery in Postoperative Radiologic Outcomes of Lumbar Spine Degenerative Disease? A Systematic Review. J Neurol Surg A Cent Eur Neurosurg 2024; 85:182-191. [PMID: 36746397 DOI: 10.1055/a-2029-2694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
BACKGROUND Minimally invasive spinal surgery (ESS) are both well-established surgical techniques for lumbar spinal stenosis; however, there is limited literature comparing the efficacy of the two techniques with respect to radiologic decompression data. METHODS In this review, PubMed, Google Scholar, and Scopus databases were systematically searched from inception until July 2022 for studies that reported the radiologic outcomes of endoscopic and minimally invasive approaches for decompressive spinal surgery, namely, the spinal canal area, neural foraminal area, and neural foraminal heights. RESULTS Of the 378 articles initially retrieved using MeSH and keyword search, 9 studies reporting preoperative and postoperative spinal areas and foraminal areas and heights were finally included in our review. Of the total 581 patients, 391 (67.30%) underwent MISS and 190 (32.70%) underwent ESS. The weighted mean difference between the spinal canal diameter in pre- and postoperative conditions was 56.64 ± 7.11 and 79.52 ± 21.31 mm2 in the MISS and ESS groups, respectively. ESS was also associated with a higher mean difference in the foraminal area postoperatively (72 ± 1 vs. 35.81 ± 11.3 mm2 in the MISS and ESS groups, respectively), but it was comparable to MISS in terms of the foraminal height (0.32 ± 0.037 vs. 0.29 ± 0.03 cm in the MISS and endoscopic groups, respectively). CONCLUSIONS Compared with MISS, ESS was associated with improved radiologic parameters, including spinal canal area and neural foraminal area in the lumbar spinal segments. Both techniques led to the same endpoint of neural decompression when starting with a more severe compression. However, the present data do not allow the correlation of the radiographic results with the related clinical outcomes.
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Affiliation(s)
- Kashyap Patel
- Baroda Medical College, India, Vadodara, Gujarat, India
- Society for Brain Mapping & Therapeutics (SBMT), Los Angeles, California, United States
| | | | - Tejas Venkataram
- Society for Brain Mapping & Therapeutics (SBMT), Los Angeles, California, United States
- Department of Neurosurgery, Cannizzaro Hospital, Trauma Center, Gamma Knife Center, Catania, Italy
| | - Vishal Chavda
- Department of Pathology, Stanford School of Medicine, Stanford University Medical Center, San Francisco, California, United States
- Department of Medicine, Multispeciality, Trauma and ICCU Center, Sardar Hospital, Ahmedabad, Gujarat, India
| | - Nicola Montemurro
- Department of Neurosurgery, Azienda Ospedaliera Universitaria Pisana (AOUP), University of Pisa, Pisa, Italy
| | - Marjan Assefi
- University of North Carolina at Greensboro, Greensboro, North Carolina, United States
| | - Namath Hussain
- Department of Neurosurgery, Loma Linda University, Loma Linda, California, United States
| | - Vicky Yamamoto
- University of Southern California Keck School of Medicine, The University of Southern California Caruso Department of Otolaryngology-Head and Neck Surgery, Los Angeles, California, United States
- University of Southern California-Norris Comprehensive Cancer Center, Los Angeles, California, United States
- Brain Mapping Foundation (BMF), Los Angeles, California, United States
| | - Babak Kateb
- Brain Mapping Foundation (BMF), Los Angeles, California, United States
- Brain Technology and Innovation Park, Los Angeles, California, United States
| | - Kai-Uwe Lewandrowski
- Center for Advanced Spine Care of Southern Arizona and Surgical Institute of Tucson, Tucson, Arizona, United States
| | - Giuseppe E Umana
- Department of Neurosurgery, Cannizzaro Hospital, Trauma Center, Gamma Knife Center, Catania, Italy
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Kagami Y, Nakashima H, Satake K, Ito K, Tanaka S, Segi N, Ouchida J, Morita M, Ando K, Kobayashi K, Machino M, Imagama S, Kanemura T. Assessment of Ureters at Dangerous Locations in Lateral Lumbar Interbody Fusion. Spine Surg Relat Res 2022; 6:38-44. [PMID: 35224245 PMCID: PMC8842351 DOI: 10.22603/ssrr.2021-0013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Accepted: 03/28/2021] [Indexed: 11/05/2022] Open
Affiliation(s)
- Yujiro Kagami
- Department of Orthopedic Surgery, Konan Kosei Hospital
| | | | - Kotaro Satake
- Department of Orthopedic Surgery, Konan Kosei Hospital
| | - Kenyu Ito
- Department of Orthopedic Surgery, Konan Kosei Hospital
| | | | - Naoki Segi
- Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine
| | - Jun Ouchida
- Department of Orthopedic Surgery, Konan Kosei Hospital
| | | | - Kei Ando
- Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine
| | - Kazuyoshi Kobayashi
- Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine
| | - Masaaki Machino
- Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine
| | - Shiro Imagama
- Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine
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Wang H, Li K, Wang Q, Liu X, Zhao X, Zhong Z, Gu C, Li R. Magnetic Resonance Neurography for Evaluation of Dorsal Root Ganglion Morphology. World Neurosurg 2021; 154:e54-e60. [PMID: 34224889 DOI: 10.1016/j.wneu.2021.06.123] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2021] [Revised: 06/23/2021] [Accepted: 06/24/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND In this study, the morphologic characteristics and anatomic position of the dorsal root ganglion (DRG) were measured and analyzed in healthy people using magnetic resonance neurography (MRN), which provided an anatomical reference for minimally invasive spinal surgery. METHODS From January 2018 to December 2019, 20 healthy adult volunteers (10 male and 10 female volunteers between 20 and 65 years old) were scanned and imaged by 3.0 T magnetic resonance imaging combined with neuroimaging technology. Here, the position of the DRG was located, and the shape and size of the DRG, as well as its distance to the upper pedicle, were measured. RESULTS All volunteers provided satisfactory MRN scans of the L1-S1 lumbar DRG. According to the spatial position of the DRG, the morphology of the DRG can be divided into the intervertebral foramen type (81.01%), intraspinal type (16.01%), extraforaminal type (0.8%), and mixed type (2.0%). CONCLUSIONS The intervertebral foramen type and Intraspinal type were observed to be the main distribution forms of lumbar DRG. Due to the downward movement of lumbar segments, the position of the DRG was noted to gradually move to the spinal canal while its volume gradually increased. In addition, the distance from the upper pedicle was found to decrease gradually. MRN imaging can clearly show the shape, location, and adjacent relationship of the DRG, providing effective imaging guidance for the minimally invasive lumbar techniques.
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Affiliation(s)
- Hongwei Wang
- Department of Spine Surgery, Dongguan Tungwah Hospital, Dongguan, China.
| | - Kaixiang Li
- Department of Spine Surgery, Dongguan Tungwah Hospital, Dongguan, China
| | - Qingyun Wang
- Department of Radiology, Dongguan Tungwah Hospital, Dongguan, China
| | - Xiaoqiang Liu
- Department of Spine Surgery, Dongguan Tungwah Hospital, Dongguan, China
| | - Xiangjun Zhao
- Department of Spine Surgery, Dongguan Tungwah Hospital, Dongguan, China
| | - Zhanghua Zhong
- Department of Spine Surgery, Dongguan Tungwah Hospital, Dongguan, China
| | - Changwei Gu
- Department of Spine Surgery, Dongguan Tungwah Hospital, Dongguan, China
| | - Ruibing Li
- Department of Spine Surgery, Dongguan Tungwah Hospital, Dongguan, China
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