Morphologic Characteristics and Clinical Significance of Computed Tomography and Magnetic Resonance Imaging Findings of Spinal Epidural Gas.

Objective: To evaluate the morphologic characteristics and clinical significance of epidural gas based on computed tomography (CT) and magnetic resonance imaging (MRI) findings and to determine their relationship with radiculopathy.

Materials And Methods: Between March 2009 and November 2018, 110 epidural gas lesions were identified in 103 patients who underwent both CT and MRI for suspected herniated disc in the authors' institution. Patterns of epidural gas were classified as air pseudocyst, air cyst, air-contained disc herniation, and honeycomb-like air cyst.

A novel preoperative trajectory evaluation method for L5-S1 transforaminal percutaneous endoscopic lumbar discectomy.

Background Context: L5-S1 transforaminal percutaneous endoscopic lumbar discectomy (PELD) is a demanding procedure because of structures such as iliac crest, L5 transverse process, hypertrophic L5-S1 facet joint, and sacral ala. There has been no definite preoperative evaluation method to evaluate the surgical validity of L5-S1 transforaminal PELD.

Purpose: The authors report a new preoperative trajectory evaluation method for L5-S1 transforaminal PELD using magnetic resonance imaging (MRI) or computed tomography (CT) examinations.

Epidural Fluid Collection After Percutaneous Endoscopic Lumbar Discectomy.

Objective: The frequency and extent of epidural fluid collection after percutaneous endoscopic lumbar discectomy (PELD) have not been previously described. The purpose of this study was to evaluate the significance of epidural fluid collection after PELD.

Methods: From March 2008 to November 2015, immediate postoperative magnetic resonance imaging (MRI) of 464 consecutive patients, comprising 284 men and 180 women, were obtained after PELD.

Comparison between the accuracy of percutaneous and open pedicle screw fixations in lumbosacral fusion.

Background Context: In pedicle screw fixation, accurate insertion is essential to avoid neurological injury or weak stability. The percutaneous pedicle screw system was developed for minimally invasive spine surgery, and its safety has already been reported. However, the accuracy of percutaneous pedicle screw fixation (PPF) has not been compared with that of the open system to date.

Spinal meningeal melanocytoma in the S-1 nerve root sheath with paraspinal extension mimicking schwannoma.

Background: Spinal melanocytomas are variants that can be extradural or intradural and are most often located in the intradural extramedullary compartment of the main thecal sac as in schwannomas. However, origin of this variant from the pure peripheral compartment of rootlets is exceedingly rare.

Case Description: The authors present a case of spinal melanocytoma with confusing pathologic and radiologic features.

MRI versus CT for the diagnosis of lumbar spinal stenosis.

Objective: The purpose of the study was to compare the effectiveness of CT and MRI in visualizing soft tissues in lumbar spinal stenosis (LSS), and to correlate the images with preoperative symptoms.

Materials And Methods: A total of 163 patients who had undergone unilateral laminotomy for bilateral decompression to treat LSS at L4-5 were retrospectively analyzed. The narrowed spinal canal area was measured on axial images with CT and MRI, and compared with the acquired dimensions from preoperative Visual Analog Scale (VAS) and Oswestry Disability Index (ODI) scores.

Effect of intervertebral disk degeneration on spinal stenosis during magnetic resonance imaging with axial loading.

Magnetic resonance (MR) imaging with axial loading can simulate the physiological standing state and disclose spinal stenosis undetected or underestimated in the conventional position. Intervertebral disk degeneration may be an important factor in spinal stenosis. This study investigated whether intervertebral disk degeneration increases spinal stenosis during axial loading.

Radiological findings of spinal schwannomas and meningiomas: focus on discrimination of two disease entities.

This study evaluates the effectiveness of CT and MR imaging in differentiating intradural extramedullary spinal schwannomas and meningiomas in a large group of patients. In addition, the study correlates tumour location, morphologic characteristics and enhancement pattern. From January 2000 to June 2007, we retrospectively reviewed 128 consecutive patients (51 male, 77 female; mean age at admission 53.

Transforaminal percutaneous endoscopic lumbar discectomy for upper lumbar disc herniation: clinical outcome, prognostic factors, and technical consideration.

Background: Compared with lower lumbar disc herniations, upper lumbar disc herniations at L1-L2 and L2-L3 have specific characteristics that result in different surgical outcomes after conventional open discectomy. There are no published studies on the feasibility of percutaneous endoscopic lumbar discectomy for upper lumbar disc herniation. The purpose of this study was to assess the clinical outcome, prognostic factors and the technical pitfalls of PELD for upper lumbar disc herniation.

Midterm results of percutaneous CT-guided aspiration of symptomatic lumbar discal cysts.

Objective: Lumbar intervertebral discal cysts are rarely reported. To our knowledge, only 12 cases have been reported in the literature. The symptoms are indistinguishable from those of typical discal herniation.

The balloon dilatation and large profile catheter maintenance method for the management of the bile duct stricture following liver transplantation.

Objective: We wanted to evaluate the therapeutic efficacy of the percutaneous balloon dilatation and large profile catheter maintenance method for the management of patients with anastomotic biliary strictures following liver transplant.

Materials And Methods: From May 1999 to June 2003, 12 patients with symptomatic benign biliary stricture complicated by liver transplantation were treated with the percutaneous balloon dilatation and large profile catheter maintenance method (1-6 months). The patients were eight males and four females, and their ages ranged from 20 to 62 years (mean age: 44 years).

The mid-term efficacy and safety of a permanent nitinol IVC filter(TrapEase).

Objective: 1) To evaluate the mid-term efficacy and safety of a permanent nitinol inferior vena cava (IVC) filter; 2) to evaluate filter effectiveness, filter stability and caval occlusion.

Materials And Methods: A prospective evaluation of the TrapEase IVC filter was performed on 42 patients (eight men, 34 women) ranging in age from 22 to 78 years (mean age 66 years). All patients were ill with a high risk of pulmonary embolism (PE).

Ethanol embolization of arteriovenous malformations: interim results.

Purpose: To assess retrospectively the interim results and the complications of ethanol embolization treatment of arteriovenous malformations (AVMs).

Materials And Methods: Institutional review board approval was obtained for a retrospective review of patient medical and imaging records. Informed consent was not required by the institutional review board.

Selective intra-arterial calcium stimulation with hepatic venous sampling for preoperative localization of insulinomas.

Objective: To determine the value of selective intra-arterial calcium stimulation with hepatic venous sampling using serum insulin and C-peptide gradients for the preoperative localization of insulinomas.

Materials And Methods: Seven consecutive patients (three men and four women aged 15-77 (mean, 42.7) years) with hypoglycemia underwent selective intra-arterial calcium stimulation in conjunction with hepatic venous sampling.

Poor sensitivity of sonography in detection of hepatocellular carcinoma in advanced liver cirrhosis: accuracy of pretransplantation sonography in 118 patients.

The objective of this study was to assess the detectability of hepatocellular carcinoma by sonography in advanced cirrhotic patients undergoing liver transplantation. We retrospectively reviewed pretransplantation sonography in 118 consecutive patients with advanced liver cirrhosis. We assessed the detectability of hepatocellular carcinoma in relation to tumor size, location, total liver volume, and degree of sonographic heterogeneity of the liver parenchyma.