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Objective: Investigate factors associated with preoperative motor paresis, recovery, ambulatory status, and intraoperative neurophysiological monitoring (IONM) among patients with no preoperative paresis (N group), complete preoperative motor recovery (CR group), and no complete recovery (NCR group) in patients with intramedullary spinal cavernous hemangioma to determine the optimal timing of surgery. Methods: The study evaluated 41 surgical cases in our institute. Disease duration, tumor lesion, manual muscle testing (MMT), and gait at onset, just before surgery, and final follow-up (FU), tumor and lesion volume, IONM, extent of tumor resection, and tumor recurrence were evaluated among N, CR, and NCR groups. Results: Motor paresis at onset was found in 26 patients (63%), with 42% of those in CR group. Disease duration from onset negatively affected stable gait just before surgery and FU as well as lower preoperative MMT (P \u003c .05). Thoracic tumors were associated with patients with unstable gait before surgery (P \u003c .05). Tumor volume was larger in NCR group (P \u003c .05). IONM significantly decreased in NCR and CR groups than in N group (P \u003c .05). The NCR group had residual mild motor paresis at FU (P \u003c .05). Stable gait at FU was similar in N group and CR group, though lower in NCR group (P \u003c .05). Conclusions: Early surgery is generally recommended for thoracic tumors and large tumors during stable gait without motor paresis before long disease duration. Surgery may be postponed until patients recover from preoperative motor paresis to allow optimal surgical outcome. 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  1. C100 医学部/医学系研究科
  2. C100a 雑誌掲載論文
  3. 学術雑誌

Optimal Timing of Surgery for Intramedullary Cavernous Hemangioma of the Spinal Cord in Relation to Preoperative Motor Paresis, Disease Duration, and Tumor Volume and Location

http://hdl.handle.net/2237/27175
http://hdl.handle.net/2237/27175
9ab9a04a-ca17-499b-9096-44f16231b009
名前 / ファイル ライセンス アクション
10_1177_2192568217707938.pdf 10_1177_2192568217707938.pdf (369.4 kB)
Item type 学術雑誌論文 / Journal Article(1)
公開日 2017-12-20
タイトル
タイトル Optimal Timing of Surgery for Intramedullary Cavernous Hemangioma of the Spinal Cord in Relation to Preoperative Motor Paresis, Disease Duration, and Tumor Volume and Location
言語 en
著者 Imagama, Shiro

× Imagama, Shiro

WEKO 74391

en Imagama, Shiro

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Ito, Zenya

× Ito, Zenya

WEKO 74392

en Ito, Zenya

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Ando, Kei

× Ando, Kei

WEKO 74393

en Ando, Kei

Search repository
Kobayashi, Kazuyoshi

× Kobayashi, Kazuyoshi

WEKO 74394

en Kobayashi, Kazuyoshi

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Hida, Tetsuro

× Hida, Tetsuro

WEKO 74395

en Hida, Tetsuro

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Ito, Kenyu

× Ito, Kenyu

WEKO 74396

en Ito, Kenyu

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Tsushima, Mikito

× Tsushima, Mikito

WEKO 74397

en Tsushima, Mikito

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Ishikawa, Yoshimoto

× Ishikawa, Yoshimoto

WEKO 74398

en Ishikawa, Yoshimoto

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Matsumoto, Akiyuki

× Matsumoto, Akiyuki

WEKO 74399

en Matsumoto, Akiyuki

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Morozumi, Masayoshi

× Morozumi, Masayoshi

WEKO 74400

en Morozumi, Masayoshi

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Tanaka, Satoshi

× Tanaka, Satoshi

WEKO 74401

en Tanaka, Satoshi

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Machino, Masaaki

× Machino, Masaaki

WEKO 74402

en Machino, Masaaki

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Ota, Kyotaro

× Ota, Kyotaro

WEKO 74403

en Ota, Kyotaro

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Nakashima, Hiroaki

× Nakashima, Hiroaki

WEKO 74404

en Nakashima, Hiroaki

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Wakao, Norimitsu

× Wakao, Norimitsu

WEKO 74405

en Wakao, Norimitsu

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Sakai, Yoshihito

× Sakai, Yoshihito

WEKO 74406

en Sakai, Yoshihito

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Matsuyama, Yukihiro

× Matsuyama, Yukihiro

WEKO 74407

en Matsuyama, Yukihiro

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Ishiguro, Naoki

× Ishiguro, Naoki

WEKO 74408

en Ishiguro, Naoki

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アクセス権
アクセス権 open access
アクセス権URI http://purl.org/coar/access_right/c_abf2
権利
言語 en
権利情報 This article is distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 License (http://www.creativecommons.org/ licenses/by-nc-nd/4.0/) which permits non-commercial use, reproduction and distribution of the work as published without adaptation or alteration, without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
抄録
内容記述 Study Design: Prospective study. Objective: Investigate factors associated with preoperative motor paresis, recovery, ambulatory status, and intraoperative neurophysiological monitoring (IONM) among patients with no preoperative paresis (N group), complete preoperative motor recovery (CR group), and no complete recovery (NCR group) in patients with intramedullary spinal cavernous hemangioma to determine the optimal timing of surgery. Methods: The study evaluated 41 surgical cases in our institute. Disease duration, tumor lesion, manual muscle testing (MMT), and gait at onset, just before surgery, and final follow-up (FU), tumor and lesion volume, IONM, extent of tumor resection, and tumor recurrence were evaluated among N, CR, and NCR groups. Results: Motor paresis at onset was found in 26 patients (63%), with 42% of those in CR group. Disease duration from onset negatively affected stable gait just before surgery and FU as well as lower preoperative MMT (P < .05). Thoracic tumors were associated with patients with unstable gait before surgery (P < .05). Tumor volume was larger in NCR group (P < .05). IONM significantly decreased in NCR and CR groups than in N group (P < .05). The NCR group had residual mild motor paresis at FU (P < .05). Stable gait at FU was similar in N group and CR group, though lower in NCR group (P < .05). Conclusions: Early surgery is generally recommended for thoracic tumors and large tumors during stable gait without motor paresis before long disease duration. Surgery may be postponed until patients recover from preoperative motor paresis to allow optimal surgical outcome. IONM should be carefully monitored in patients with a history of preoperative paresis even with preoperative complete motor recovery.
言語 en
内容記述タイプ Abstract
出版者
言語 en
出版者 SAGE Publications
言語
言語 eng
資源タイプ
資源タイプresource http://purl.org/coar/resource_type/c_6501
タイプ journal article
出版タイプ
出版タイプ VoR
出版タイプResource http://purl.org/coar/version/c_970fb48d4fbd8a85
DOI
関連タイプ isVersionOf
識別子タイプ DOI
関連識別子 https://doi.org/10.1177/2192568217707938
ISSN
収録物識別子タイプ PISSN
収録物識別子 2192-5682
書誌情報 en : Global Spine Journal

巻 7, 号 3, p. 246-253, 発行日 2017-06
著者版フラグ
値 publisher
URI
識別子 https://doi.org/10.1177/2192568217707938
識別子タイプ DOI
URI
識別子 http://hdl.handle.net/2237/27175
識別子タイプ HDL
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