Background: To evaluate the effect of the 3D radiation field design on normal tissues compared with commonly used appositional fields in patients with lumbar spine metastases.
Methods And Materials: Ten comparative treatment plans for radiation of lumbar spine metastases were compared for posterior and anterior- posterior fields with 3D plans.
Results: The PTV coverage in all comparative plans was similar. V 15 of the bowel in 3D, AP-PA and PA plans was 6.7 Gy (SD 6.47), 39.8 Gy (SD 11.4) and 37.3 Gy (SD15.7), respectively (p < 0.0001). The mean dose to both kidneys was 9.6 Gy (SD 4.8), 4.1 Gy (SD 3.9) and 4.6 Gy (SD 4.4) for appropriate plans (p = 0.002). Maximal dose to the spinal cord was 30.6 Gy (SD 2.1), 33.1 Gy (SD 9.8) and 37.7 Gy (SD 2) for 3D, AP-PA and PA plans.
Conclusion: 3D conformal treatment planning of lumbar vertebral metastases was significantly better in term of bowel and spinal cord exposure compared to AP-PA and PA techniques. The exposure of the kidneys in 3D plans, while greater than in the comparative plans, did not violate accepted dose-volume thresholds.
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http://dx.doi.org/10.1186/1748-717X-8-34 | DOI Listing |
Introduction: The efficacy of postoperative braces for degenerative lumbar disorders has long been debated, with conflicting reports regarding the promotion of bone fusion and pain relief. The current aspects of postoperative brace prescriptions have been previously reported in Western countries but not in Asia. This study aimed to elucidate prescription practices in Japan and identify factors influencing prescription decisions.
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January 2025
Department of Neurosurgery, Ayabe Renaiss Hospital.
Adult spinal deformity(ASD) is a condition in which the spinopelvic alignment changes owing to age-related degeneration, making it difficult to maintain a standing position. The goal of surgery for ASD is to correct the spine and obtain normal alignment. Here, we discuss the pathophysiology of ASD, spinopelvic alignment, surgical methods, and complications.
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January 2025
Department of Neurosurgery, Tokyo General Hospital.
Lateral lumbar interbody fusion(LLIF), including extreme lateral interbody fusion(XLIF) and oblique lateral interbody fusion(OLIF), constitute a treatment option for many lumbar disorders that predominantly cause degenerative disc disease. LLIF is beneficial for managing conditions, such as lumbar spondylolisthesis, degenerative disc disease, and adult spinal deformities. LLIF is preferred for enabling indirect decompression of the spinal canal and nerve root foramen, without inducing immediate postoperative damage to the peri-vertebral tissues.
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January 2025
Department of Neurosurgery, Mie University.
Lumbar posterior fixation is a fundamental spinal technique typically performed in patients with instability, although no absolute criteria exist for diagnosing instability. Interbody fusion procedures, such as posterior lumbar interbody fusion and transforaminal lumbar interbody fusion involve the insertion of cages or grafts between vertebrae to achieve solid bone fusion. These techniques provide strong stabilization of the spine.
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January 2025
Department of Neurosurgery, Yao Tokushukai General Hospital.
Full endoscopic spine surgery is a technique to perform hernia extraction using a single-hole-type endoscope with a coaxial operation system of a sheath, endoscope, and surgical instrument in reflux water. In the lumbar region, the ventral side of the dura mater can be directly approached via the lateral route. Not only is the skin incision small, but damage to muscle tissue is also minimal, which is why it is a minimally invasive surgery.
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