Objectives: This study aimed to investigate the long-term risk of stroke in adult patients with spinal deformity. Specifically, the study addressed the possible protective effect of surgery for spinal deformity against stroke.
Methods: Using the National Health Insurance Research Database (NHIRD), a monopolistic national database in Taiwan, this retrospective cohort study analyzed the incidence of stroke in patients with adult spinal deformity (ASD) in a 11-year period. A total of 13,503 patients, between 55 and 75 years old, were identified for the diagnosis of ASD. The patients were grouped into two: the surgical group (n = 10,439) who received spinal fusion surgery, and the control group (n = 2124) who received other medical treatment. The incidence rates of all subsequent cerebrovascular accidents, including ischemic and hemorrhagic strokes, were calculated. Hazard ratios for stroke were calculated use a full cohort and a propensity score matched cohort. Adjustments for co-morbidities that may predispose to stroke, including hypertension, diabetes mellitus, arrhythmia and coronary heart disease were conducted. Kaplan-Meier and Cox regression analyses were performed to compare the risk of stroke between the two groups.
Results: During the total observation period of 50,450 person-years, the incidence rate of stroke in the surgical group (15.55 per 1000 person-years) was significantly lower than that of the control group (20.89 per 1000 person-years, p < 0.001). Stroke was more likely to occur in the control group than in the surgical group (crude hazard ratio 1.34, p < 0.001; adjusted HR 1.28, p < 0.001, by a propensity score matched model).
Conclusions: In this national cohort of more than 13,000 ASD patients covering 10 years, stroke was approximately 25% less likely to happen in patients who underwent spinal fusion surgery than those who received medical management. Therefore, spinal fusion surgery may provide a protective effect against stroke in adult patients with spinal deformity.
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http://dx.doi.org/10.3390/ijerph121012618 | DOI Listing |
Nagoya J Med Sci
November 2024
Department of Orthopaedic Surgery, Hamamatsu University School of Medicine, Hamamatsu, Japan.
Ganglioneuromas are rare benign tumors that arise from the sympathetic nervous system. The presentation of tumors is variable and associated with adolescent thoracic scoliosis. Herein, we present two case reports and a review of literature.
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Copy number variations (CNVs) contribute to various disorders including intellectual disability, developmental disorders, and cancer. This study identifies a de novo 2.62 Mb deletion at 6q22.
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January 2025
Department of Bioengineering, The Grainger College of Engineering, University of Illinois Urbana-Champaign, Urbana, IL, USA.
An abnormal expansion of a GGGGCC (GC) hexanucleotide repeat in the C9ORF72 gene is the most common genetic cause of amyotrophic lateral sclerosis (ALS) and frontotemporal dementia (FTD), two debilitating neurodegenerative disorders driven in part by gain-of-function mechanisms involving transcribed forms of the repeat expansion. By utilizing a Cas13 variant with reduced collateral effects, we develop here a high-fidelity RNA-targeting CRISPR-based system for C9ORF72-linked ALS/FTD. When delivered to the brain of a transgenic rodent model, this Cas13-based platform curbed the expression of the GC repeat-containing RNA without affecting normal C9ORF72 levels, which in turn decreased the formation of RNA foci, reduced the production of a dipeptide repeat protein, and reversed transcriptional deficits.
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January 2025
Department of Orthopaedics, Peking University Third Hospital, Beijing, China.
The combination of congenital C1 occipitalization and C2-3 non-segmentation (i.e. "sandwich fusion") results in early development of atlantoaxial dislocation (AAD).
View Article and Find Full Text PDFNeurosurg Rev
January 2025
Neurosurgery department Strasbourg University Hospital, Hautepierre University Hospital, 2 Avenue de Molière, Strasbourg, France.
The urgent etiological diagnosis represents the main management objective of cervical spondylodiscitis (CSD) to start as soon as possible antibiotic treatment to prevent neurological deterioration. The present study aimed to evaluate a multicenter experience implementing a minimally invasive surgical approach (MISA) to manage CSD such pathology vs the most complex and aggressive surgical strategies currently used.This retrospective multicenter study used a database of 70 patients from five European neurosurgical centers.
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