1.Preliminary clinical report of bilateral decompression under microscope via unilateral approach for the treatment of lumbar stenosis
Fengzeng JIAN ; Zan CHEN ; Feng LING
Chinese Journal of Microsurgery 2009;32(1):6-8,illust 1
Objective To report the surgical technique and preliminary clinical results of bilateral decompression under microscope via unilateral approach for the treatment of lumbar stenosis. Methods Sixteen eases of lumbar stenosis were treated in our institute. For the surgical treatment, only one side paraspinous muscle was dissected. The upper and lower margins of the adjacent laminae were drilled, and the underlying ligament flavum was exposed. By changing the direction of the microscopy, the base of the spinous process and the internal side of the contralateral laminae were also drilled off till the lateral recess. Finally, decompression of the spinal canal was achieved by removing the ligament llavum. Results Follow-up ranged from 6 to 47 months. Intermittent claudication was totally relieved in 14 out of 16 cases, and markedly relieved in 2 cases. Back pain was relieved totally in 6 cases, marked improved in 8 cases, not change in 2 cases. Pain was significantly relieved in all 5 cases with sciatica, among them, diseetomy had to be performed in 3 cases. During follow-up, there was no symptom recurrence, and dynamic X ray did not show lumbar in-stability. Conclusion Bilateral decompression under microscope via unilateral approach for the treatment of lumbar stenosis is minimally invasive surgery, the effect of the operation is good. The technique has little in-fluence on spinal stability.
2.Surgical Treatment of Ten Adults with Spinal Extradural Meningeal Cysts in the Thoracolumbar Spine
Feifan XU ; Fengzeng JIAN ; Liang LI ; Jian GUAN ; Zan CHEN
Journal of Korean Neurosurgical Society 2021;64(2):238-246
Objective:
: To retrospectively analyze the clinical characteristics and surgical experience of 10 adults with spinal extradural meningeal cysts (SEMCs) in the thoracolumbar spine which may further provide evidence for surgical decision-making.
Methods:
: Ten adults with SEMCs in the thoracolumbar spine were surgically treated and enrolled in this study. Clinical manifestations, imaging data, intraoperative findings and postoperative outcome were recorded.
Results:
: Clinical manifestations of SEMCs included motor and sensory dysfunction of the lower limbs and urination and defecation disturbance. The cysts presented as intraspinal occupying lesions dorsal to the spine, ranging from the T8 to L3 level. Defects of eight cases were found on preoperative magnetic resonance imaging (MRI). Selective hemilaminectomy or laminectomy were used to reveal the defect within the cyst, which was further sutured with microscopic technique. The final outcome was excellent or good in seven cases and fair in three cases. No recurrence was observed during follow-up.
Conclusion
: SEMCs are rare intraspinal cystic lesions. Radiography and MRI are clinically practical methods to assess defects within SEMCs. Selective hemilaminectomy or laminectomy may reduce surgical trauma. Detection and microscopic suturing of the defects are the key steps to adequately decompress the nervous tissue and prevent postoperative recurrence.
3.Knockdown of best1 Gene in Zebrafish Caused Abnormal Neuronal and Skeletal Development - A Subtype of Craniovertebral Junction Malformation?
Zhenlei LIU ; Kang LI ; Kai WANG ; Lei ZHANG ; Shanhang JIA ; He WANG ; Fengzeng JIAN ; Hao WU
Neurospine 2024;21(2):555-564
Objective:
To investigate the developmental defects caused by knockdown of best1 gene in zebrafish as a model for a subtype of craniovertebral junction (CVJ) malformation.
Methods:
Two antisense morpholinos (MOs) were designed targeting zebrafish best1 to block translation (ATG-MO) or to disrupt splicing (I3E4-MO). MOs were microinjected into fertilized one-cell embryos. Efficacy of splicing MO was confirmed by reverse transcription-polymerase chain reaction. Phenotypes were analyzed and quantified by microscopy at multiple developmental stages. Neuronal outgrowth was assessed in transgenic zebrafish expressing green fluorescent protein in neurons. Skeletal ossification was visualized by Calcein staining.
Results:
Knockdown of best1 resulted in zebrafish embryos with shorter body length, curved axis, low survival rate, microcephaly, reduced eye size, smaller head and brain, impaired neuronal outgrowth, and reduced ossification of craniofacial and vertebral bone.
Conclusion
Best1 gene plays critical roles in ophthalmologic, neurological and skeletal development in zebrafish. A patient with a premature stop codon in BEST1 gene exhibited similar phenotypes, implying a subtype of CVJ malformation.
4.A Nomogram for Predicting Overall Survival of Patients With Primary Spinal Cord Glioblastoma
Yao WANG ; Qingchun MU ; Minfeng SHENG ; Yanming CHEN ; Fengzeng JIAN ; Rujun LI
Neurospine 2024;21(2):676-689
Objective:
Primary spinal cord glioblastoma (PSCGBM) is a rare malignancy with a poor prognosis. To date, no prognostic nomogram for this rare disease was established. Hence, we aimed to develop a nomogram to predict overall survival (OS) of PSCGBM.
Methods:
Clinical data of patients with PSCGBM was retrospectively collected from the neurosurgery department of Soochow University Affiliated Second Hospital and the Surveillance Epidemiology and End Results database. Information including age, sex, race, tumor extension, extent of resection, adjuvant treatment, marital status, income, year of diagnosis and months from diagnosis to treatment were recorded. Univariate and multivariate Cox regression analyses were used to identify independent prognostic factors for PSCGBM. A nomogram was constructed to predict 1-year, 1.5-year, and 2-year OS of PSCGBM.
Results:
A total of 132 patients were included. The 1-year, 1.5-year, and 2-year OS were 45.5%, 29.5%, and 18.9%, respectively. Four variables: age groups, tumor extension, extent of resection, and adjuvant therapy, were identified as independent prognostic factors. The nomogram showed robust discrimination with a C-index value for the prediction of 1-year OS, 1.5-year OS, and 2-year of 0.71 (95% confidence interval [CI], 0.61–0.70), 0.72 (95% CI, 0.62–0.70), and 0.70 (95% CI, 0.61–0.70), respectively. The calibration curves exhibited high consistencies between the predicted and observed survival probability in this cohort.
Conclusion
We have developed and internally validated a nomogram for predicting the survival outcome of PSCGBM for the first time. The nomogram has the potential to assist clinicians in making individualized predictions of survival outcome of PSCGBM.
5.Knockdown of best1 Gene in Zebrafish Caused Abnormal Neuronal and Skeletal Development - A Subtype of Craniovertebral Junction Malformation?
Zhenlei LIU ; Kang LI ; Kai WANG ; Lei ZHANG ; Shanhang JIA ; He WANG ; Fengzeng JIAN ; Hao WU
Neurospine 2024;21(2):555-564
Objective:
To investigate the developmental defects caused by knockdown of best1 gene in zebrafish as a model for a subtype of craniovertebral junction (CVJ) malformation.
Methods:
Two antisense morpholinos (MOs) were designed targeting zebrafish best1 to block translation (ATG-MO) or to disrupt splicing (I3E4-MO). MOs were microinjected into fertilized one-cell embryos. Efficacy of splicing MO was confirmed by reverse transcription-polymerase chain reaction. Phenotypes were analyzed and quantified by microscopy at multiple developmental stages. Neuronal outgrowth was assessed in transgenic zebrafish expressing green fluorescent protein in neurons. Skeletal ossification was visualized by Calcein staining.
Results:
Knockdown of best1 resulted in zebrafish embryos with shorter body length, curved axis, low survival rate, microcephaly, reduced eye size, smaller head and brain, impaired neuronal outgrowth, and reduced ossification of craniofacial and vertebral bone.
Conclusion
Best1 gene plays critical roles in ophthalmologic, neurological and skeletal development in zebrafish. A patient with a premature stop codon in BEST1 gene exhibited similar phenotypes, implying a subtype of CVJ malformation.
6.A Nomogram for Predicting Overall Survival of Patients With Primary Spinal Cord Glioblastoma
Yao WANG ; Qingchun MU ; Minfeng SHENG ; Yanming CHEN ; Fengzeng JIAN ; Rujun LI
Neurospine 2024;21(2):676-689
Objective:
Primary spinal cord glioblastoma (PSCGBM) is a rare malignancy with a poor prognosis. To date, no prognostic nomogram for this rare disease was established. Hence, we aimed to develop a nomogram to predict overall survival (OS) of PSCGBM.
Methods:
Clinical data of patients with PSCGBM was retrospectively collected from the neurosurgery department of Soochow University Affiliated Second Hospital and the Surveillance Epidemiology and End Results database. Information including age, sex, race, tumor extension, extent of resection, adjuvant treatment, marital status, income, year of diagnosis and months from diagnosis to treatment were recorded. Univariate and multivariate Cox regression analyses were used to identify independent prognostic factors for PSCGBM. A nomogram was constructed to predict 1-year, 1.5-year, and 2-year OS of PSCGBM.
Results:
A total of 132 patients were included. The 1-year, 1.5-year, and 2-year OS were 45.5%, 29.5%, and 18.9%, respectively. Four variables: age groups, tumor extension, extent of resection, and adjuvant therapy, were identified as independent prognostic factors. The nomogram showed robust discrimination with a C-index value for the prediction of 1-year OS, 1.5-year OS, and 2-year of 0.71 (95% confidence interval [CI], 0.61–0.70), 0.72 (95% CI, 0.62–0.70), and 0.70 (95% CI, 0.61–0.70), respectively. The calibration curves exhibited high consistencies between the predicted and observed survival probability in this cohort.
Conclusion
We have developed and internally validated a nomogram for predicting the survival outcome of PSCGBM for the first time. The nomogram has the potential to assist clinicians in making individualized predictions of survival outcome of PSCGBM.
7.Knockdown of best1 Gene in Zebrafish Caused Abnormal Neuronal and Skeletal Development - A Subtype of Craniovertebral Junction Malformation?
Zhenlei LIU ; Kang LI ; Kai WANG ; Lei ZHANG ; Shanhang JIA ; He WANG ; Fengzeng JIAN ; Hao WU
Neurospine 2024;21(2):555-564
Objective:
To investigate the developmental defects caused by knockdown of best1 gene in zebrafish as a model for a subtype of craniovertebral junction (CVJ) malformation.
Methods:
Two antisense morpholinos (MOs) were designed targeting zebrafish best1 to block translation (ATG-MO) or to disrupt splicing (I3E4-MO). MOs were microinjected into fertilized one-cell embryos. Efficacy of splicing MO was confirmed by reverse transcription-polymerase chain reaction. Phenotypes were analyzed and quantified by microscopy at multiple developmental stages. Neuronal outgrowth was assessed in transgenic zebrafish expressing green fluorescent protein in neurons. Skeletal ossification was visualized by Calcein staining.
Results:
Knockdown of best1 resulted in zebrafish embryos with shorter body length, curved axis, low survival rate, microcephaly, reduced eye size, smaller head and brain, impaired neuronal outgrowth, and reduced ossification of craniofacial and vertebral bone.
Conclusion
Best1 gene plays critical roles in ophthalmologic, neurological and skeletal development in zebrafish. A patient with a premature stop codon in BEST1 gene exhibited similar phenotypes, implying a subtype of CVJ malformation.
8.A Nomogram for Predicting Overall Survival of Patients With Primary Spinal Cord Glioblastoma
Yao WANG ; Qingchun MU ; Minfeng SHENG ; Yanming CHEN ; Fengzeng JIAN ; Rujun LI
Neurospine 2024;21(2):676-689
Objective:
Primary spinal cord glioblastoma (PSCGBM) is a rare malignancy with a poor prognosis. To date, no prognostic nomogram for this rare disease was established. Hence, we aimed to develop a nomogram to predict overall survival (OS) of PSCGBM.
Methods:
Clinical data of patients with PSCGBM was retrospectively collected from the neurosurgery department of Soochow University Affiliated Second Hospital and the Surveillance Epidemiology and End Results database. Information including age, sex, race, tumor extension, extent of resection, adjuvant treatment, marital status, income, year of diagnosis and months from diagnosis to treatment were recorded. Univariate and multivariate Cox regression analyses were used to identify independent prognostic factors for PSCGBM. A nomogram was constructed to predict 1-year, 1.5-year, and 2-year OS of PSCGBM.
Results:
A total of 132 patients were included. The 1-year, 1.5-year, and 2-year OS were 45.5%, 29.5%, and 18.9%, respectively. Four variables: age groups, tumor extension, extent of resection, and adjuvant therapy, were identified as independent prognostic factors. The nomogram showed robust discrimination with a C-index value for the prediction of 1-year OS, 1.5-year OS, and 2-year of 0.71 (95% confidence interval [CI], 0.61–0.70), 0.72 (95% CI, 0.62–0.70), and 0.70 (95% CI, 0.61–0.70), respectively. The calibration curves exhibited high consistencies between the predicted and observed survival probability in this cohort.
Conclusion
We have developed and internally validated a nomogram for predicting the survival outcome of PSCGBM for the first time. The nomogram has the potential to assist clinicians in making individualized predictions of survival outcome of PSCGBM.
9.Knockdown of best1 Gene in Zebrafish Caused Abnormal Neuronal and Skeletal Development - A Subtype of Craniovertebral Junction Malformation?
Zhenlei LIU ; Kang LI ; Kai WANG ; Lei ZHANG ; Shanhang JIA ; He WANG ; Fengzeng JIAN ; Hao WU
Neurospine 2024;21(2):555-564
Objective:
To investigate the developmental defects caused by knockdown of best1 gene in zebrafish as a model for a subtype of craniovertebral junction (CVJ) malformation.
Methods:
Two antisense morpholinos (MOs) were designed targeting zebrafish best1 to block translation (ATG-MO) or to disrupt splicing (I3E4-MO). MOs were microinjected into fertilized one-cell embryos. Efficacy of splicing MO was confirmed by reverse transcription-polymerase chain reaction. Phenotypes were analyzed and quantified by microscopy at multiple developmental stages. Neuronal outgrowth was assessed in transgenic zebrafish expressing green fluorescent protein in neurons. Skeletal ossification was visualized by Calcein staining.
Results:
Knockdown of best1 resulted in zebrafish embryos with shorter body length, curved axis, low survival rate, microcephaly, reduced eye size, smaller head and brain, impaired neuronal outgrowth, and reduced ossification of craniofacial and vertebral bone.
Conclusion
Best1 gene plays critical roles in ophthalmologic, neurological and skeletal development in zebrafish. A patient with a premature stop codon in BEST1 gene exhibited similar phenotypes, implying a subtype of CVJ malformation.
10.A Nomogram for Predicting Overall Survival of Patients With Primary Spinal Cord Glioblastoma
Yao WANG ; Qingchun MU ; Minfeng SHENG ; Yanming CHEN ; Fengzeng JIAN ; Rujun LI
Neurospine 2024;21(2):676-689
Objective:
Primary spinal cord glioblastoma (PSCGBM) is a rare malignancy with a poor prognosis. To date, no prognostic nomogram for this rare disease was established. Hence, we aimed to develop a nomogram to predict overall survival (OS) of PSCGBM.
Methods:
Clinical data of patients with PSCGBM was retrospectively collected from the neurosurgery department of Soochow University Affiliated Second Hospital and the Surveillance Epidemiology and End Results database. Information including age, sex, race, tumor extension, extent of resection, adjuvant treatment, marital status, income, year of diagnosis and months from diagnosis to treatment were recorded. Univariate and multivariate Cox regression analyses were used to identify independent prognostic factors for PSCGBM. A nomogram was constructed to predict 1-year, 1.5-year, and 2-year OS of PSCGBM.
Results:
A total of 132 patients were included. The 1-year, 1.5-year, and 2-year OS were 45.5%, 29.5%, and 18.9%, respectively. Four variables: age groups, tumor extension, extent of resection, and adjuvant therapy, were identified as independent prognostic factors. The nomogram showed robust discrimination with a C-index value for the prediction of 1-year OS, 1.5-year OS, and 2-year of 0.71 (95% confidence interval [CI], 0.61–0.70), 0.72 (95% CI, 0.62–0.70), and 0.70 (95% CI, 0.61–0.70), respectively. The calibration curves exhibited high consistencies between the predicted and observed survival probability in this cohort.
Conclusion
We have developed and internally validated a nomogram for predicting the survival outcome of PSCGBM for the first time. The nomogram has the potential to assist clinicians in making individualized predictions of survival outcome of PSCGBM.