12 results on '"Ma-Chao Guo"'
Search Results
2. The ratio of C2–C7 Cobb angle to T1 slope is an effective parameter for the selection of posterior surgical approach for patients with multisegmental cervical spondylotic myelopathy
- Author
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Yi-Ming Yang, Chao Kong, Xiangyao Sun, Xiangyu Li, Ma-Chao Guo, Shibao Lu, and Jun-Zhe Ding
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medicine.medical_specialty ,Lordosis ,Visual analogue scale ,Decompression ,medicine.medical_treatment ,Spinal Cord Diseases ,Laminoplasty ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Humans ,Orthopedics and Sports Medicine ,Retrospective Studies ,030222 orthopedics ,Cobb angle ,business.industry ,Laminectomy ,medicine.disease ,Sagittal plane ,medicine.anatomical_structure ,Orthopedic surgery ,Cervical Vertebrae ,Surgery ,business ,Nuclear medicine ,030217 neurology & neurosurgery - Abstract
To our knowledge, laminectomy with fusion (LCF) and laminoplasty alone (LP) are both effective posterior surgical approaches for decompression of cervical spondylotic myelopathy (CSM). However, which one is suitable for patients has no standard answer. This study estimated whether the ratio of C2-C7 Cobb angle to T1 slope (CL/T1S) could be an indication of posterior surgical approach.We retrospectively reviewed 128 patients with at least 6 months of follow-up who underwent LCF or LP. Radiological measurements, including C2-C7 Cobb angle, decompressed Cobb angle, T1 slope, cervical sagittal vertical axis, and curvature index (CI), and clinical outcomes, including Japanese Orthopedic Association score and visual analogue scale were evaluated. ROC curve analysis was used to identify discriminative power of CL/T1S ratio to predict kyphotic deformity and severe lordosis loss. The t-test and Mann-Whitney U-test were used to evaluate the difference between LCF and LP. Kruskal-Wallis H - test and ANOVA were used to evaluate the difference among different ratio CL/T1S groups.The cervical lordosis decreased after LCF or LP (p 0.001, p 0.001, respectively). Based on ROC curve analysis, CL/T1S ratio had a good discriminative power to predict kyphotic deformity and severe lordosis loss (AUC = 0.70, AUC = 0.88, respectively). According to CI value changes, cervical lordosis losses in group LP were larger than that in group LCF (p = 0.006). However, there was no significant difference in CI changes of fair-ratio CL/T1S group between LCF and LP. For patients with low CL/T1S ratio or high CL/T1S ratio, CI changes in group LP were greater than that in group LCF (p = 0.037, p = 0.042, respectively).CL/T1S ratio could be an indication of posterior surgical approach. Compared with LP, LCF reduces postoperative cervical lordosis losses in low-ratio and high-ratio CL/T1S groups.
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- 2020
3. Complications in Elderly Patients Undergoing Lumbar Arthrodesis for Spinal Stenosis
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Xiangyao Sun, Chao Kong, Xiangyu Li, Ma-Chao Guo, Shibao Lu, and Jun-Zhe Ding
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Male ,Reoperation ,medicine.medical_specialty ,Spinal stenosis ,Arthrodesis ,medicine.medical_treatment ,Operative Time ,Blood Loss, Surgical ,Comorbidity ,Logistic regression ,Body Mass Index ,03 medical and health sciences ,Postoperative Complications ,Spinal Stenosis ,0302 clinical medicine ,Lumbar ,Pedicle Screws ,Risk Factors ,Humans ,Surgical Wound Infection ,Medicine ,Risk factor ,Aged ,Aged, 80 and over ,Hypoproteinemia ,Lumbar Vertebrae ,business.industry ,Pneumonia ,Perioperative ,Length of Stay ,medicine.disease ,Surgery ,Logistic Models ,Spinal Fusion ,030220 oncology & carcinogenesis ,Female ,Neurology (clinical) ,business ,Complication ,Body mass index ,030217 neurology & neurosurgery - Abstract
To report the perioperative complication rates in elderly patients undergoing lumbar arthrodesis and to analyze the risk factors.Between September 2015 and June 2018, 215 patients aged ≥70 underwent posterior lumbar arthrodesis with pedicle screw fixation. Demographic data including age, gender, smoking status, body mass index (BMI) and preoperative comorbidities were collected. Operative records as the number of levels fused, estimated blood loss, time of surgery, and the occurrence of perioperative complications were reviewed. Risk factors of perioperative complications were determined by logistic regression analysis.The total perioperative complication rate in all patients was 30.2%, of which major complications occurred in 24 patients (11.2%) and minor complications occurred in 41 patients (19.1%). Two risk factors of perioperative complications (major or minor) were chosen: BMI (cutoff value 24.32) and surgical level (≥3). Lower surgical level (≥3) and smaller BMI were risk factors for perioperative minor complications, and major complication was affected only by surgical level (≥3).The risk factor of perioperative complication in elderly patients after lumbar arthrodesis was fusion segment (≥3), and BMI was a protective factor. Elderly patients with BMI24.32 are more likely to have perioperative complications after lumbar arthrodesis.
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- 2019
4. The Parallelogram Effect of Degenerative Structures Around the Apical Vertebra in Patients with Adult Degenerative Scoliosis: The Influence of Asymmetric Degeneration and Diagonal Degeneration on the Severity of Deformity
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Wei Wang, Yun-Zhong Cheng, Ma-Chao Guo, Chao Kong, Shibao Lu, Siyuan Sun, Jun-Zhe Ding, and Xiangyao Sun
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Male ,musculoskeletal diseases ,Pelvic tilt ,Statistics as Topic ,Posture ,Intervertebral Disc Degeneration ,Lumbar vertebrae ,030204 cardiovascular system & hematology ,Severity of Illness Index ,Pelvis ,Multifidus muscle ,Muscular Atrophy, Spinal ,03 medical and health sciences ,0302 clinical medicine ,Lumbar ,Clinical Research ,Deformity ,medicine ,Humans ,Kyphosis ,Aged ,Retrospective Studies ,Lumbar Vertebrae ,Cobb angle ,business.industry ,Lumbosacral Region ,General Medicine ,Anatomy ,Middle Aged ,Sagittal plane ,Muscular Atrophy ,medicine.anatomical_structure ,Scoliosis ,030220 oncology & carcinogenesis ,Coronal plane ,Linear Models ,Lordosis ,Female ,medicine.symptom ,business - Abstract
BACKGROUND This is the first published study assessing the parallelogram effect of degenerative structures around the apical vertebra. We evaluated the effect of degenerative structures around the apical vertebra and spinopelvic parameters on the severity of ADS. MATERIAL AND METHODS We retrospectively reviewed data on 144 patients with ADS. The coronal (coronal Cobb angle, CA) and sagittal (thoracic kyphosis, TK; sagittal vertical axis, SVA; pelvic incidence, PI; lumbar lordosis, LL; sacral slope, SS; pelvic tilt, PT) parameters, lumbar multifidus muscle atrophy (LMA), and facet joint osteoarthritis (FJOA) were evaluated. Multiple linear regression was used to assess the correlations. RESULTS LL and PT were negatively correlated with CA (P
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- 2019
5. Clinical and magnetic resonance imaging predictors of the surgical outcomes of patients with cervical spondylotic myelopathy
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Shibao Lu, Chao Kong, Siyuan Sun, Xiangyao Sun, Yi-Ming Yang, Xiangyu Li, Ma-Chao Guo, and Jun-Zhe Ding
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Male ,medicine.medical_specialty ,Spinal Cord Diseases ,Cohort Studies ,03 medical and health sciences ,Myelopathy ,0302 clinical medicine ,Predictive Value of Tests ,Spondylotic myelopathy ,medicine ,Humans ,Aged ,Retrospective Studies ,030222 orthopedics ,Surgical approach ,medicine.diagnostic_test ,business.industry ,Magnetic resonance imaging ,General Medicine ,Middle Aged ,Decompression, Surgical ,Spinal cord ,medicine.disease ,Magnetic Resonance Imaging ,Sagittal plane ,Treatment Outcome ,medicine.anatomical_structure ,Cervical decompression ,Cohort ,Cervical Vertebrae ,Female ,Surgery ,Spondylosis ,Neurology (clinical) ,Radiology ,business ,030217 neurology & neurosurgery ,Follow-Up Studies - Abstract
To determine whether clinical characteristics and signal and morphologic changes on magnetic resonance (MR) images of the spinal cord (SC) are associated with surgical outcomes for cervical spondylotic myelopathy (CSM).A total of 113 consecutive patients with cervical myelopathy underwent cervical decompression surgery in our hospital from January 2015 to January 2018. All patients with preoperative MR images available for review were recruited for this study. Research data included patient sex, age, duration of symptoms, surgical approach, compression level, preoperative mJOA (modified Japanese Orthopaedic Association) score, postoperative mJOA recovery rate, and complications. Imaging data included signal changes on T2-weighted MRI images (grade and extension on sagittal images, four types of signal changes on axial images according to the Ax-CCM system), SC compression, transverse area of the SC, and compression ratio. The t-test, Mann-Whitney U-test, Kruskal-Wallis H - test, analysis of variance, and regression analysis were used to evaluate the effects of individual predictors on surgical outcomes.The study cohort included 85 males and 27 females with a mean age of 60.92 ± 8.93 years. The mean mJOA score improved from 10.24 ± 1.69 preoperatively to 15.11 ± 2.05 at the final follow-up (p 0.001). Patients in the poor outcome group were more likely to present with a longer duration of symptoms (p 0.001) and smaller transverse area of the SC (p 0.001). Bright T2-weighted high signal changes (T2HSCs), multisegmental high signal changes on sagittal MR images, and fuzzy focal T2HSCs on axial MR images were associated with a poor outcome (p0.001, p = 0.005, p 0.001, respectively). The maximum SC compression and compression ratio were not reliable predictors of surgical outcomes (p = 0.375, p = 0.055, respectively). The result of multivariate stepwise logistic regression showed that a longer duration of symptoms, multisegmental T2HSCs on sagittal MR images and fuzzy focal T2HSCs on axial MR images were significant risk factors of poor outcomes (p0.001, p = 0.049, p = 0.016, respectively).A longer duration of symptom, multisegmental T2HSCs on sagittal MR images, and fuzzy focal T2HSCs on axial MR images were highly predictive of a poor surgical outcome for CSM. Smaller transverse area of the SC and bright T2HSCs were also associated with the prognosis of CSM.
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- 2018
6. Survival outcomes and prognostic factors of patients with intramedullary Grade II ependymomas after surgical treatments
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Xiangyao Sun, Ma-Chao Guo, Chao Kong, Shibao Lu, Siyuan Sun, and Jun-Zhe Ding
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Adult ,Male ,Ependymoma ,Oncology ,medicine.medical_specialty ,Adolescent ,Papillary Ependymoma ,Disease-Free Survival ,Neurosurgical Procedures ,law.invention ,Intramedullary rod ,03 medical and health sciences ,Postoperative Complications ,0302 clinical medicine ,law ,Physiology (medical) ,Internal medicine ,medicine ,Adjuvant therapy ,Humans ,Spinal Cord Neoplasms ,Survival analysis ,Aged ,Clinical Trials as Topic ,Proportional hazards model ,business.industry ,Hazard ratio ,General Medicine ,Middle Aged ,medicine.disease ,Confidence interval ,Neurology ,030220 oncology & carcinogenesis ,Female ,Surgery ,Neurology (clinical) ,business ,030217 neurology & neurosurgery - Abstract
This study evaluated survival outcomes of patients with intramedullary Grade II ependymomas and identify prognostic factors. Electronic searches of PubMed, EMBASE, OVID, the Cochrane Central Register of Controlled Trials were performed to identify trials according to the Cochrane Collaboration guidelines. The objects were intramedullary Grade II ependymoma according to 2007 WHO classification. Kaplan-Meier survival analysis with log-rank test was used to analyze progressive free survival (PFS) and overall survival (OS). Cox proportional hazard model was utilized for multivariate analysis with hazard ratio (HR) and 95% confidence interval (CI) calculated. P values
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- 2018
7. Predictors of L4-L5 Degenerative Lumbar Spondylolisthesis: L4 Inclination Angle and Facet Joint Angle
- Author
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Shibao Lu, Siyuan Sun, Ma-Chao Guo, Chao Kong, Xiangyao Sun, and Xiangyu Li
- Subjects
Male ,Spinal stenosis ,Intervertebral Disc Degeneration ,Zygapophyseal Joint ,Facet joint ,Multifidus muscle ,03 medical and health sciences ,0302 clinical medicine ,Spinal Stenosis ,Predictive Value of Tests ,Inclination angle ,medicine ,Humans ,Grading (tumors) ,Lumbar spondylolisthesis ,Aged ,Retrospective Studies ,Orthodontics ,Lumbar Vertebrae ,business.industry ,technology, industry, and agriculture ,Intervertebral disc ,Middle Aged ,medicine.disease ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,Surgery ,Female ,Neurology (clinical) ,Lumbar disc herniation ,Spondylolisthesis ,business ,030217 neurology & neurosurgery ,Intervertebral Disc Displacement - Abstract
To evaluate the relationship between degenerative lumbar spondylolisthesis (DLS) and the L4 inclination angle (IA) and evaluate the risk factors of DLS.Ninety patients with L4-L5 DLS and 90 with L4-L5 lumbar disc herniation or spinal stenosis (control group) were compared. Parameters including L4 IA, facet joint angle (FJA), cross-sectional area of paraspinal muscle, Pfirrmann grading of intervertebral disc, and degeneration grading of facet joint (FJ) were evaluated. The Student t tests and logistic regression analysis were used to analyze the risk factors of DLS.Statistical differences were found in L4 IA, cross-sectional area of multifidus muscle, FJA, and degeneration grading of FJ between 2 groups (P0.001, P = 0.07, P0.001, and P0.001, respectively). The logistic regression analysis demonstrated that greater L4 IA (β: -0.186, P0.001), more sagittal FJ (β: -0.117, P0.001), and more severe degeneration of FJ (β: -1.033, P0.001) were both significant predictors of DLS.Patients with L4 IA greater than 11.15° and FJA greater than 60.19° are more likely to occur DLS.
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- 2019
8. Comparison of the French and CARDS classifications for lumbar degenerative spondylolisthesis: reliability and validity
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Jun-Zhe Ding, Xiangyu Li, Xiangyao Sun, Shibao Lu, Ma-Chao Guo, and Chao Kong
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Male ,lcsh:Diseases of the musculoskeletal system ,Sports medicine ,Radiography ,medicine.medical_treatment ,Severity of Illness Index ,Disability Evaluation ,0302 clinical medicine ,Musculoskeletal Pain ,Back pain ,Orthopedics and Sports Medicine ,Postoperative Period ,Pain Measurement ,Aged, 80 and over ,030222 orthopedics ,Rehabilitation ,Lumbar Vertebrae ,Clinical outcome ,Middle Aged ,Reliability ,Oswestry Disability Index ,Treatment Outcome ,Preoperative Period ,Female ,CARDS classification ,medicine.symptom ,Research Article ,French classification ,Adult ,medicine.medical_specialty ,Visual analogue scale ,03 medical and health sciences ,Lumbar ,Rheumatology ,medicine ,Humans ,Aged ,030203 arthritis & rheumatology ,Lumbar degenerative spondylolisthesis ,Leg ,business.industry ,Reproducibility of Results ,Spinal Fusion ,Orthopedic surgery ,Physical therapy ,lcsh:RC925-935 ,Spondylolisthesis ,business ,Low Back Pain ,Follow-Up Studies - Abstract
Background The aim of this study was to compare the reliability and validity of the CARDS and French classification systems for lumbar DS. Methods Between May 2013 and December 2016, 158 consecutive patients diagnosed with single-level lumbar DS were included in this study, and all underwent lumbar fusion. All patients underwent long-cassette standing anterioposterior and lateral radiographs of the spine preoperatively and postoperatively. The images were graded according to the CARDS and French classification systems by two orthopedic spinal surgeons and two orthopedic spinal fellows, independently. Clinical outcome measures used were the visual analog scale, Oswestry Disability Index, and the 36-Item Short Form Health Survey. Clinical data were collected before surgery and 1 year after surgery. Results A total of 146 patients were finally included in this study and followed up for at least 1 year. When grading using the CARDS system, the κ values for inter- and intraobserver reliability were 0.837 and 0.869, respectively, representing perfect agreement. The interobserver κ value for the French classification was 0.693 and the intraobserver κ value was 0.743, both representing substantial agreement. CARDS Type D patients have higher preoperative back pain scores and better improvement after surgery compared with non-Type D patients. Mean back and leg pain was worse in French Type 5 patients, while the most significant improvement was also seen in Type 5 patients after surgery. Conclusions Both CARDS and French classification systems have acceptable reliability and validity. The CARDS system is easier to utilize and has better reliability. Level of evidence IV
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- 2018
9. Correlation between multifidus muscle atrophy, spinopelvic parameters, and severity of deformity in patients with adult degenerative scoliosis: the parallelogram effect of LMA on the diagonal through the apical vertebra
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Siyuan Sun, Chao Kong, Shibao Lu, Jun-Zhe Ding, Wei Wang, Xiangyao Sun, Ma-Chao Guo, and Tongtong Zhang
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Pelvic tilt ,musculoskeletal diseases ,Male ,lcsh:Diseases of the musculoskeletal system ,Lumbar multifidus muscle atrophy ,Paraspinal Muscles ,Scoliosis ,Severity of Illness Index ,Multifidus muscle ,03 medical and health sciences ,Spinopelvic parameters ,0302 clinical medicine ,Lumbar ,lcsh:Orthopedic surgery ,medicine ,Humans ,Orthopedics and Sports Medicine ,Pelvic Bones ,Aged ,Retrospective Studies ,030203 arthritis & rheumatology ,030222 orthopedics ,Lumbar Vertebrae ,Cobb angle ,business.industry ,Middle Aged ,medicine.disease ,musculoskeletal system ,Sagittal plane ,Vertebra ,Correlation ,lcsh:RD701-811 ,Muscular Atrophy ,Adult degenerative scoliosis ,medicine.anatomical_structure ,Cross-Sectional Studies ,Coronal plane ,Sagittal imbalance ,Surgery ,Female ,lcsh:RC925-935 ,business ,Nuclear medicine ,Research Article - Abstract
Background There were several reports describing the biomechanics and microstructure of multifidus muscles in patients with lumbar disc herniation. However, correlations between lumbar multifidus muscle atrophy (LMA), spinopelvic parameters, and severity of adult degenerative scoliosis (ADS) have not been investigated. The study evaluated the impact of LMA and spinopelvic parameters on the severity of ADS. Methods One hundred and thirty-two patients with ADS were retrospectively reviewed. Standing whole-spine X-ray was used to evaluate the coronal (coronal Cobb angle, CA; coronal vertical axis, CVA) and sagittal (sagittal vertical axis, SVA; thoracic kyphosis, TK; lumbar lordosis, LL; pelvic incidence, PI; pelvic tilt, PT; sacral slope, SS) parameters. LMA was evaluated on axial T2-weighted magnetic resonance imaging (MRI) at intervertebral levels above and below the vertebra at the apex of the scoliotic curve. Clinical symptoms were evaluated by the Oswestry Disability Index (ODI) and the Japanese Orthopaedic Association (JOA) score. Multiple linear regression was used to assess correlations between LMA, spinopelvic parameters, and severity of scoliosis. Results LL and PT were negatively correlated with CA (P
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- 2018
10. Influence of the Ratio of C2-C7 Cobb Angle to T1 Slope on Cervical Alignment After Laminoplasty
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Xiangyao Sun, Jun-Zhe Ding, Chao Kong, Ma-Chao Guo, Shibao Lu, Yi-Ming Yang, and Xiangyu Li
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medicine.medical_specialty ,Cobb angle ,business.industry ,medicine.medical_treatment ,Kyphosis ,medicine.disease ,Laminoplasty ,Imaging data ,Sagittal plane ,03 medical and health sciences ,Myelopathy ,0302 clinical medicine ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,Orthopedic surgery ,medicine ,Surgery ,Neurology (clinical) ,High ratio ,business ,Nuclear medicine ,030217 neurology & neurosurgery - Abstract
To assess the relationship between the ratio of C2-C7 Cobb angle to T1 slope (CL/T1S) and cervical alignment changes after laminoplasty.78 consecutive patients with cervical myelopathy who underwent laminoplasty were enrolled. All patients with preoperative and follow-up cervical spine lateral x-ray images available for review were recruited in this study. Imaging data included C2-C7 Cobb angle, T1 slope, and cervical sagittal vertical axis (cSVA). All patients were classified into low-ratio group (bottom 25% of CL/T1S), fair-ratio group (middle 50% of CL/T1S), and high ratio group (top 25% of CL/T1S) according to CL/T1S ratio. The recovery rate was calculated based on the Japanese Orthopedic Association score.The preoperative C2-C7 Cobb angle had significant correlations with the T1 slope (r = 0.528). Kyphotic alignment changes in the group with a high ratio of CL/T1S was greater than that of the other 2 groups (P0.001). The incidence of postoperative kyphosis in the group with a low ratio of CL/T1S was higher than that of the other 2 groups (P0.001). There was no postoperative kyphosis in the fair-ratio group. The surgical outcome in the low-ratio CL/T1S group and the high-ratio CL/T1S group was poorer than that in the fair-ratio CL/T1S group (P = 0.005).The cervical alignment was kept well in the mid-range CL/T1S ratio group after laminoplasty. Patients with a high CL/T1S ratio were more likely to present with kyphotic alignment changes. Patients with a low CL/T1S ratio were more likely to have postoperative kyphosis.
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- 2018
11. Factors associated with postoperative outcomes in patients with intramedullary Grade II ependymomas
- Author
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Ma-Chao Guo, Wei Wang, Tongtong Zhang, Shibao Lu, Jun-Zhe Ding, Siyuan Sun, Xiangyao Sun, and Chao Kong
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Ependymoma ,medicine.medical_specialty ,Chemotherapy ,business.industry ,medicine.medical_treatment ,General Medicine ,Scoliosis ,medicine.disease ,Surgery ,law.invention ,Radiation therapy ,Intramedullary rod ,03 medical and health sciences ,0302 clinical medicine ,law ,030220 oncology & carcinogenesis ,Meta-analysis ,Adjuvant therapy ,medicine ,030212 general & internal medicine ,business ,Survival analysis - Abstract
Background Most of the previous studies combined all types of intramedullary ependymomas without providing accurate pathological subtypes. In addition, it was very difficult to evaluate the factors associated with postoperative outcomes of patients with different pathological subtypes of intramedullary Grade II ependymomas by traditional meta-analysis. This study evaluated the factors related with postoperative outcomes of patients with intramedullary Grade II ependymomas. Methods Individual patient data analysis was performed using PubMed, Embase, and the Cochrane Central Register of Controlled Trials. The search included articles published up to April 2018 with no lower date limit on the search results. The topics were intramedullary Grade II ependymomas. Progression-free survival (PFS) and overall survival (OS) were analyzed by Kaplan-Meier survival analysis (log-rank test). The level of significance was set at P Results A total of 21 studies with 70 patients were included in this article. PFS of patients who underwent total resection was much longer than the PFS of those who received subtotal resection (P Conclusions PFS of patients who received total resection was much longer than those who received subtotal resection. Patients treated with adjuvant therapy or radiotherapy and chemotherapy appeared to have shorter PFS than others; PFS of patients with cerebrospinal fluid disease dissemination or scoliosis were significantly shorter than others. Cellular ependymomas would have better OS than giant cell ependymoma. However, giant cell ependymoma patients might have the worst OS.
- Published
- 2019
12. The Parallelogram Effect of Degenerative Structures Around the Apical Vertebra in Patients with Adult Degenerative Scoliosis: The Influence of Asymmetric Degeneration and Diagonal Degeneration on the Severity of Deformity.
- Author
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Xiang-Yao Sun, Chao Kong, Shi-Bao Lu, Wei Wang, Yun-Zhong Cheng, Si-Yuan Sun, Ma-Chao Guo, and Jun-Zhe Ding
- Published
- 2019
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