Deep flexor sarcopenia as a predictor of poor functional outcome after anterior cervical discectomy in patients with myelopathy
AbstractBackgroundParaspinal muscle morphometry has been recognized to be a prognostic factor across various surgical conditions, but its utility in predicting disease-specific outcomes in spine surgery remains under-explored.MethodsA prospective cohort study was performed on 45 consecutive patients undergoing anterior cervical discectomy (ACD) for single-level, symptomatic cervical degenerative disc disease causing radiculomyelopathy or myelopathy. Previously described predictors of outcome such as age, gender, smoking, comorbidities, duration of symptoms, preoperative Nurick grade, extent of cord compression, and signal intensity change in the cord were recorded. Additionally, MRI-based morphometrics of the superficial and deep paraspinal muscles were recorded. Logistic regression (LR) analysis was performed using a purposeful variable selection process to identify variables that independently predicted Nurick grade improvement (NGI).ResultsAt a mean follow-up of 20.02 ± 8.63 months after ACD, 37 (82.22%) patients demonstrated NGI. LR analysis yielded three predictors of NGI of which two were related to the deep flexor muscles. While a worse preoperative Nurick grade negatively predicted NGI, a deep flexor area and deep flexor/deep extensor area ratio posit ively predicted NGI. The regression model demonstrated a good fit and was statistically significant (χ2(3) = 22.18,p
In this study, patients with early-stage cervical cancer who underwent radical and modified radical hysterectomy without retroperitoneal lymph node involvement were evaluated, and recurrence development and factors affecting disease-free survival were investigated. A nomogram consisting of factors influencing disease-free survival was constructed. The total score was determined according to the status of all risk factors. This allowed clear definition of the risk for each patient. A nomogram predicting recurrence in patients with stages IA2-IIA cervical cancer with radical hysterectomy without lymph node involvement has no...
ConclusionWhen comparing patients with patients, frozen biopsy approach is significantly better than MRI and PET-CT to evaluate sensitivity, specificity, and accuracy. Frozen biopsy of all lymph nodes retrieved during surgery is still the best method to evaluate lymph node status before fertility-sparing radical trachelectomy.
We performed a radical hysterectomy, bilateral salpingo-oophorectomy plus pelvic lymph node dissection for early stage cervical through laparoendoscopic single-site (LESS) approach, and demonstrated the effective suspension could achieve different exposed purposes and space extension.
ConclusionOCI, an important factor to maintain horizontal gaze, was demonstrated to be associated with radiological ASD, suggesting that the occipito-cervical angle influences accelerated cervical degeneration. Since OCI did not change after surgery, degeneration of the cervical spine may be predicted by the value of OCI.NECK trialDutch Trial Register Number NTR1289.PROCON trialTrial Register Number ISRCTN41681847.Graphic abstractThese slides can be retrieved under Electronic Supplementary Material.
We report two young men who presented with submental nodal metastasis from PCT. Both underwent total thyroidectomy with central compartment neck dissection and modified radical neck dissection (MRND). Probable factors which might influence submental nodal metastasis are analyzed. We conclude that physicians should be aware of the possibility of submental nodal metastasis from PCT. A selective approach for neck dissection can be an alternative to MRND, reducing the morbidity in management of such cases.
Publication date: Available online 7 October 2019Source: International Journal of Surgery Case ReportsAuthor(s): Y. Annalisa Ng, June Lee, X.J. Zheng, J.C. Nagaputra, S.H. Tan, S.A. WongAbstractIntroduction and presentation of caseLiposarcomas are rare causes of oesophageal tumours, accounting for
Abstract INTRODUCTION: There is currently no standard of care for women with cervical cancer stage IB2 (FIGO 2018, ≥2 cm and
ConclusionsIn this series, compartment-oriented lymph node resection of recurrent papillary thyroid carcinoma leads to a final clinical and biochemical disease-free status of 59.3% with 6.9% of major complications.
Authors: Jain NK, Mostoufi-Moab S, Hawkes CP, Nelson ND, Surrey LF, Jones ZS, Adzick NS, Kazahaya K, Bauer AJ Abstract Introduction: The American Joint Committee Cancer (AJCC) TNM system predicts survival in patients with differentiated thyroid cancer (DTC). In the eighth edition of the AJCC TNM, microscopic extrathyroidal extension (microETE) was removed and tumor size>4 cm was maintained in the definition of T3 disease to reduce unnecessarily aggressive therapy for adults at low risk of death from DTC. In pediatric patients where DTC survival rates are high, the AJCC TNM is used to identify patients at ...
Standard treatment of early cervical cancer involves a radical hysterectomy and retroperitoneal lymph node dissection. The existing evidence on the incidence of adverse events following minimally invasive versus open radical hysterectomy for early cervical cancer is either non-randomized or retrospective.