Clinical neurology and neurosurgery
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Clin Neurol Neurosurg · Mar 2015
Brain metabolism assessed via proton magnetic resonance spectroscopy in patients with amnestic or vascular mild cognitive impairment.
To address the possible role of brain regional metabolic differences between different types of mild cognitive impairment (MCI). ⋯ This study indicated that there are differences in metabolism related to brain regions between A-MCI and V-MCI, thus it may be concluded that 1H MRS may be a useful tool to differentiate A-MCI and V-MCI.
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Clin Neurol Neurosurg · Mar 2015
Anterior stabilization for unstable traumatic thoracolumbar spine burst fractures.
Traumatic injuries to the thoracolumbar spine result in a high incidence of unstable fractures. The goal of the surgical management is to achieve an adequate decompression and stabilization. We have analyzed operative and postoperative features of anterior surgical approaches. ⋯ Based on our findings, anterior surgical approach appears to be a safe and effective technique for managing traumatic thoracic and lumbar unstable burst fractures. This is also evident that anterior decompression and stabilization achieves a significant correction of kyphotic deformity with a lower risk of neurological deterioration and pseudoarthrosis.
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Clin Neurol Neurosurg · Mar 2015
Intraoperative neurophysiological monitoring for intradural extramedullary tumors: why not?
While intraoperative neurophysiological monitoring (IOM) for intramedullary tumors has become a standard in neurosurgical practice, IOM for intradural extramedullary tumors (IDEMs) is still under debate. The aim of this study is to evaluate the role of IOM during surgery for IDEMs. ⋯ In our series significant IOM changes occurred in 5 out of 68 patients with IDEMs (7.35%), and it is conceivable that the modification of the surgical strategy - induced by IOM - prevented or mitigated neurological injury in these cases. Vice versa, in 63 patients (92.65%) IOM invariably predicted a good neurological outcome. Furthermore this technique allowed a safer tumor removal in IDEMs placed in difficult locations as cranio-vertebral junction or in antero/antero-lateral position (where rotation of spinal cord can be monitored) and even in case of tumor adherent to the spinal cord without a clear cleavage plane.
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Clin Neurol Neurosurg · Feb 2015
Randomized Controlled TrialBotulinum Toxin type A injections for patients with painful hallux valgus: a double-blind, randomized controlled study.
Hallux valgus (HV) related pain and disability remains a medical challenge to date. We have evaluated the therapeutic effect of intramuscular Botulinum Toxin type A (BTX-A) injection on painful HV in a double-blind randomized controlled trial. Sixteen patients having painful HV in at least one foot from the Department of Physical Medicine and Rehabilitation at a medical center in northern Taiwan have participated. ⋯ Pain reduction induced by BTX-A injection lasted for at least 6 months while that induced by NS lasted for only 1 month. In addition, patients in the BTX-A group showed greater improvement in pain score (p<0.001), disability score (p<0.05), and HV angle (p<0.05) than patients in the NS group. The results reflected that HV-related muscle injection of BTX-A resulted in a marked reduction in pain for up to 6 months.
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Clin Neurol Neurosurg · Feb 2015
Randomized Controlled TrialIs rehabilitation intervention during hospitalization enough for functional improvements in patients undergoing lumbar decompression surgery? A prospective randomized controlled study.
Rehabilitation has been reported to improve pain and disability for patients after lumbar surgery. However, studies to investigate the rehabilitation intervention for lumbar decompression surgery during hospitalization are scarce. The aim of this study was to examine outcomes of perioperative rehabilitation intervention for patients who underwent lumbar decompression surgery (LDS). ⋯ The findings of this study indicate that the rehabilitation intervention during hospitalization improves pain intensity as well as disability and quality of life, yet has limited effects on the functional performance over time up to six months post-surgery in patients who received LDS. The study suggest that rehabilitation interventions during hospitalization must include regular support for patient adherence to the intervention program and focus on task-oriented programs for lower extremities such as closed-chain exercises in functional postures.