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논문 기본 정보

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저자정보
Pingchuan Xia (Department of Neurosurgery, Xuanwu Hospital, Capital Medical University) Houyuan Lv (Department of Neurosurgery, Xuanwu Hospital, Capital Medical University) Chenghua Yuan (Department of Neurosurgery, Xuanwu Hospital, Capital Medical University) Wanru Duan (Department of Neurosurgery, Xuanwu Hospital, Capital Medical University) Jiachen Wang (Xuanwu Hospital) Jian Guan (Department of Neurosurgery, Xuanwu Hospital, Capital Medical University) Yueqi Du (Department of Neurosurgery, Xuanwu Hospital, Capital Medical University) Can Zhang (Department of Neurosurgery, Xuanwu Hospital, Capital Medical University) Zhenlei Liu (Department of Neurosurgery, Xuanwu Hospital, Capital Medical University) Kai Wang (Department of Neurosurgery, Xuanwu Hospital, Capital Medical University) Zuowei Wang (Department of Neurosurgery, Xuanwu Hospital, Capital Medical University) Xingwen Wang (Department of Neurosurgery, Xuanwu Hospital, Capital Medical University) Hao Wu (Department of Neurosurgery, Xuanwu Hospital, Capital Medical University) Zan Chen (Department of Neurosurgery, Xuanwu Hospital, Capital Medical University) Fengzeng Jian (Department of Neurosurgery, Xuanwu Hospital, Capital Medical University)
저널정보
대한척추신경외과학회 Neurospine Neurospine Vol.21 No.1
발행연도
2024.3
수록면
212 - 222 (11page)
DOI
10.14245/ns.2347152.576

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Objective: Surgical procedures for patients with posttraumatic syringomyelia (PTS) remain controversial. Until now, there have been no effective quantitative evaluation methods to assist in selecting appropriate surgical plans before surgery. Methods: We consecutively enrolled PTS patients (arachnoid lysis group, n = 42; shunting group, n = 14) from 2003 to 2023. Additionally, 19 intrathecal anesthesia patients were included in the control group. All patients with PTS underwent physical and neurological examinations and spinal magnetic resonance imaging preoperatively, 3–12 months postoperatively and during the last follow-up. Preoperative lumbar puncture was performed and blood-spinal cord barrier disruption was detected by quotient of albumin (Qalb, cerebrospinal fluid/serum). Results: The ages (p = 0.324) and sex (p = 0.065) of the PTS and control groups did not differ significantly. There were also no significant differences in age (p = 0.216), routine blood data and prognosis (p = 0.399) between the arachnoid lysis and shunting groups. But the QAlb level of PTS patients was significantly higher than that of the control group (p < 0.001), and the shunting group had a significantly higher QAlb (p < 0.001) than the arachnoid lysis group. A high preoperative QAlb (odds ratio, 1.091; 95% confidence interval, 1.004–1.187; p = 0.041) was identified as the predictive factor for the shunting procedure, with the receiver operating characteristic curve showing 100% specificity and 80.95% sensitivity for patients with a QAlb > 12.67. Conclusion: Preoperative QAlb is a significant predictive factor for the types of surgery. For PTS patients with a QAlb > 12.67, shunting represents the final recourse, necessitating the exploration and development of novel treatments for these patients.
#Biomarker #Syringomyelia #Spinal cord injury #Blood-spinal cord barrier

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