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Mobile Schwannoma of the Cauda Equina for Which Intraoperative Myelography Was Useful in Locating

Surgical Science 2017年第4期8卷 184-190页

作者： Hiroki Kasama eiren toh Joji Mochida Masahiko Watanabe Department of Orthopaedic Surgery Tokai University Hachioji Hospital Tokyo Japan Yamato Orthopaedic Clinic Kanagawa Japan Department of Orthopaedic Surgery Ebina General Hospital Kanagawa Japan Department of Orthopaedic Surgery Tokai University School of Medicine Kanagawa Japan

We report on a case of a mobile schwannoma of the cauda equina. The patient was a 24-year-old woman who visited our hospital with the chief complaints of low back pain and numbness of the right leg. A tumor was noted from the L2 midbody level to the L3 upper endplate on preoperative MRI and myelogram. During the surgery, a right L2 hemilaminectomy was performed, and the dura was incised, but no tumor was founded in the surgical field, and this was noted as a missing tumor. Intraoperative myelography showed that the tumor had moved to the adjacent vertebra on the caudal side. Myelography applied again to the caudal side of the mobile tumor. Then, the tumor had moved upward, and could be excised without an additional laminectomy.

关键词： Mobile Tumor Schwannoma Intraoperative Myelography Cauda Equina

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Efficacy of Modified Expansive Open-Door Laminoplasty for Cervical Myelopathy

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Surgical Science 2012年第12期3卷 568-571页

作者： eiren toh Yukihiro Yamamoto Daisuke Sakai Masato Sato Masahiko Watanabe Joji Mochida Department of Orthopaedic Surgery Tokai University Hachioji Hospital Tokyo Japan Department of Orthopaedic Surgery Tokai University School of Medicine Kanagawa Japan

Objectives: Expansive open-door laminoplasty is used widely for the treatment of cervical spondylosis and Ossification of the Posterior Longitudinal Ligament (OPLL). We have developed a unique modification of the surgical procedure to keep the lamina expanded, with the aim of preventing reclosure of the vertebral arch. To examine the effectiveness of and problems associated with the modified expansive open-door laminoplasty technique developed at our institution by evaluating the surgical outcomes. Methods and Materials: Fifty-six patients (46 men and 10 women) underwent the modified expansive open-door laminoplasty and were followed up for at least 1 year. Thirty-eight had Cervical Spondylotic Myelopathy (CSM) and 18 had OPLL. The patients were 34 to 89 years of age (mean: 60.9 years). The severity of myelopathy was evaluated according to the Japanese Orthopaedic Association’s scoring system. Surgical outcomes were evaluated using Hirabayashi’s system for determining recovery rate. In the radiographic analysis, the following angles were measured before and after surgery: lordosis angle and Range of Motion (ROM) at C2 - C7 on lateral radiographs, and opening angle on computerized tomography (CT). The presence and absence of axial pain and postoperative C5 palsy were also evaluated. Results: The rate of JOA score improvement was about 60%, the lordosis angle observed on lateral radiographs was maintained. ROM decreased after surgery in both the CSM and OPLL groups, and the extent of the decrease was similar to that in previous reports. The opening angle of the lamina was 62°- 65° on post-operative CT. Axial pain was reported by 34% of patients. Conclusions: Our modified procedure produced satisfactory postoperative outcomes based on the clinical data and imaging findings for both CSM and OPLL. The advantage of this procedure is that it avoids potential complications associated with bone grafts or implants.

关键词： Cervical Myelopathy Surgical Treatment Middle and Lower Cervical Spine

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