Pub Date : 2023-07-01Epub Date: 2023-01-18DOI: 10.25259/JNRP-2022-2-32
Amit Shankar Singh, Jeenendra Prakash Singhvi, Jaslovleen Kaur
{"title":"Para-choreo-ballism due to pinealoma in an elderly lady.","authors":"Amit Shankar Singh, Jeenendra Prakash Singhvi, Jaslovleen Kaur","doi":"10.25259/JNRP-2022-2-32","DOIUrl":"10.25259/JNRP-2022-2-32","url":null,"abstract":"","PeriodicalId":16443,"journal":{"name":"Journal of Neurosciences in Rural Practice","volume":"14 3","pages":"551-553"},"PeriodicalIF":1.4,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10483206/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10570356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Polyuria is urine output exceeding 3 L/d in adults, primarily due to solute and water diuresis. In a hospital setting, mannitol and diuretics commonly lead to polyuria. We have found an interesting association of polyuria with glycopyrrolate; to the best of our knowledge, no case is reported in the literature. Here, we are describing a case of Guillain-Barre Syndrome, which developed polyuria during the hospital stay, which was secondary to glycopyrrolate.
{"title":"Glycopyrrolate-induced polyuria: An unexpected side effect.","authors":"Sunil Kumar Behera, Abhishek Agarwal, Alok Singh, Vinay R Pandit, Pankaj Kumar Kannauje","doi":"10.25259/JNRP_73_2023","DOIUrl":"10.25259/JNRP_73_2023","url":null,"abstract":"<p><p>Polyuria is urine output exceeding 3 L/d in adults, primarily due to solute and water diuresis. In a hospital setting, mannitol and diuretics commonly lead to polyuria. We have found an interesting association of polyuria with glycopyrrolate; to the best of our knowledge, no case is reported in the literature. Here, we are describing a case of Guillain-Barre Syndrome, which developed polyuria during the hospital stay, which was secondary to glycopyrrolate.</p>","PeriodicalId":16443,"journal":{"name":"Journal of Neurosciences in Rural Practice","volume":"14 3","pages":"525-527"},"PeriodicalIF":1.4,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10483195/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10588148","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objectives: The objectives of this study were to share our initial experience with epilepsy surgery and provide an overview on the surgical treatments of epilepsies.
Materials and methods: This was a retrospective analysis of the demographics and clinical and investigative features of patients who underwent epilepsy surgery between January 2016 and August 2021. Postoperative seizure outcome was categorized according to modified Engel's classification, and the minimum period of follow-up was 1 year.
Results: The study group included 30 patients with an age ranging from 6 years to 45 years (mean: 22.28 years, median: 20 years) and a male: female ratio of 20:10. The epilepsy duration before surgery ranged from 3 years to 32 years (median: 7 years). Majority of our patients underwent resective surgeries (28/30 = 93.3%), and disconnection procedures were done in two patients. This included one functional hemispherotomy and one posterior quadrantic disconnection. Temporal lobe resective surgery was the most common procedure (16/30 = 53.3%), followed by eight frontal lobe and two parietal lobe surgeries. Among resective surgeries, majority were lesional surgeries and the pathologies included mesial temporal sclerosis (4), dysembryoplastic neuroepithelial tumor (8), ganglioglioma (6), cavernoma (4), focal cortical dysplasia (2), gliosis (1), and one case of hypothalamic hamartoma. Intraoperative electrocorticography was used in all cases for optimizing surgical resection/disconnection. Nearly two-thirds of our patients (66.6%) had an Engel's Class I outcome, five patients had Engel's Class II outcome, three patients had Class III outcome, and one patient did not have any worthwhile improvement. Temporal lobe surgery patients had a better seizure outcome compared to extratemporal surgeries (84% vs. 74%). Overall, complications were minimal and short lasting, and comprised meningitis in three patients (5.6%) and transient worsening of hemiparesis following hemispherotomy in two patients. There was no mortality or long-lasting major morbidity in our patients.
Conclusion: In carefully selected patients with drug-resistant epilepsy, surgery offers an excellent chance of becoming seizure-free with significant improvement in overall quality of life. Majority of the common epilepsy surgery procedures can be performed through a multidisciplinary approach even in centers with limited resources.
{"title":"Surgical treatment of epilepsy - Initial experience from a comprehensive epilepsy program in coastal South India.","authors":"Nisha Shenoy, Siddharth Srinivasan, Girish Menon, Radhakrishnan Kurupath","doi":"10.25259/JNRP_116_2023","DOIUrl":"10.25259/JNRP_116_2023","url":null,"abstract":"<p><strong>Objectives: </strong>The objectives of this study were to share our initial experience with epilepsy surgery and provide an overview on the surgical treatments of epilepsies.</p><p><strong>Materials and methods: </strong>This was a retrospective analysis of the demographics and clinical and investigative features of patients who underwent epilepsy surgery between January 2016 and August 2021. Postoperative seizure outcome was categorized according to modified Engel's classification, and the minimum period of follow-up was 1 year.</p><p><strong>Results: </strong>The study group included 30 patients with an age ranging from 6 years to 45 years (mean: 22.28 years, median: 20 years) and a male: female ratio of 20:10. The epilepsy duration before surgery ranged from 3 years to 32 years (median: 7 years). Majority of our patients underwent resective surgeries (28/30 = 93.3%), and disconnection procedures were done in two patients. This included one functional hemispherotomy and one posterior quadrantic disconnection. Temporal lobe resective surgery was the most common procedure (16/30 = 53.3%), followed by eight frontal lobe and two parietal lobe surgeries. Among resective surgeries, majority were lesional surgeries and the pathologies included mesial temporal sclerosis (4), dysembryoplastic neuroepithelial tumor (8), ganglioglioma (6), cavernoma (4), focal cortical dysplasia (2), gliosis (1), and one case of hypothalamic hamartoma. Intraoperative electrocorticography was used in all cases for optimizing surgical resection/disconnection. Nearly two-thirds of our patients (66.6%) had an Engel's Class I outcome, five patients had Engel's Class II outcome, three patients had Class III outcome, and one patient did not have any worthwhile improvement. Temporal lobe surgery patients had a better seizure outcome compared to extratemporal surgeries (84% vs. 74%). Overall, complications were minimal and short lasting, and comprised meningitis in three patients (5.6%) and transient worsening of hemiparesis following hemispherotomy in two patients. There was no mortality or long-lasting major morbidity in our patients.</p><p><strong>Conclusion: </strong>In carefully selected patients with drug-resistant epilepsy, surgery offers an excellent chance of becoming seizure-free with significant improvement in overall quality of life. Majority of the common epilepsy surgery procedures can be performed through a multidisciplinary approach even in centers with limited resources.</p>","PeriodicalId":16443,"journal":{"name":"Journal of Neurosciences in Rural Practice","volume":"14 3","pages":"488-494"},"PeriodicalIF":1.4,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10483204/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10219154","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objectives: Fatigue is a common symptom occurring in a variety of disorders. Chronic fatigue syndrome (CFS) is characterized by debilitating fatigue as the core symptom. The risk of CFS is nearly 1.5 times higher in migraine while headaches have been reported in 59% of cases with CFS. However, details of its occurrence and severity remain largely unexplored. The primary objective of our study was to determine the occurrence and severity of fatigue and CFS in patients with episodic and chronic migraine. The secondary objectives were to define their relationship with other common comorbidities.
Materials and methods: 60 migraine patients (30 each, episodic [EM] and chronic migraine [CM]) were recruited from Neurology Outpatient Department, GIPMER a tertiary referral center in New Delhi, India. Patients' headache severity was analyzed using the Headache impact test-6 (HIT-6) score while fatigue and other migraine accompaniments were assessed using Fatigue severity scale (FSS), Chalder fatigue scale, CDC diagnostic criteria for CFS, American College of Rheumatology Diagnostic Criteria for fibromyalgia, Hamilton Depression Scale, the Generalized Anxiety Disorder 7-Item Scale, and Epworth sleepiness Scale (ESS). Comparative analysis was further done among migraine patients with and without fatigue and CFS.
Results: The mean HIT-6 score was significantly higher in CM versus EM. The CM group had a higher mean FSS score (47.87 vs. 37.3 in EM; P = 0.004), a percentage of patients with severe fatigue (60% vs. 20% in EM; P = 0.004), and a higher percentage of patients with pathological fatigue (83.3% vs. 63.3% in EM; P = 0.04). Around 23.33% of CM patients fulfilled the criteria of CFS. Fatigue correlated positively with severity, frequency, attack duration and chronicity of the migraine episodes, along with depression, anxiety, and excessive daytime sleepiness.
Conclusion: Fatigue and related comorbid disorders are significantly more common in CM than in EM, expanding the morbidity of the condition and underscores the need to address these accompanying symptoms for devising a holistic treatment plan.
{"title":"Fatigue, chronic fatigue syndrome and migraine: Intersecting the lines through a cross-sectional study in patients with episodic and chronic migraine.","authors":"Hemant Kumar, Kamakshi Dhamija, Ashish Duggal, Geeta Anjum Khwaja, Sujata Roshan","doi":"10.25259/JNRP_63_2022","DOIUrl":"10.25259/JNRP_63_2022","url":null,"abstract":"<p><strong>Objectives: </strong>Fatigue is a common symptom occurring in a variety of disorders. Chronic fatigue syndrome (CFS) is characterized by debilitating fatigue as the core symptom. The risk of CFS is nearly 1.5 times higher in migraine while headaches have been reported in 59% of cases with CFS. However, details of its occurrence and severity remain largely unexplored. The primary objective of our study was to determine the occurrence and severity of fatigue and CFS in patients with episodic and chronic migraine. The secondary objectives were to define their relationship with other common comorbidities.</p><p><strong>Materials and methods: </strong>60 migraine patients (30 each, episodic [EM] and chronic migraine [CM]) were recruited from Neurology Outpatient Department, GIPMER a tertiary referral center in New Delhi, India. Patients' headache severity was analyzed using the Headache impact test-6 (HIT-6) score while fatigue and other migraine accompaniments were assessed using Fatigue severity scale (FSS), Chalder fatigue scale, CDC diagnostic criteria for CFS, American College of Rheumatology Diagnostic Criteria for fibromyalgia, Hamilton Depression Scale, the Generalized Anxiety Disorder 7-Item Scale, and Epworth sleepiness Scale (ESS). Comparative analysis was further done among migraine patients with and without fatigue and CFS.</p><p><strong>Results: </strong>The mean HIT-6 score was significantly higher in CM versus EM. The CM group had a higher mean FSS score (47.87 vs. 37.3 in EM; <i>P</i> = 0.004), a percentage of patients with severe fatigue (60% vs. 20% in EM; <i>P</i> = 0.004), and a higher percentage of patients with pathological fatigue (83.3% vs. 63.3% in EM; <i>P</i> = 0.04). Around 23.33% of CM patients fulfilled the criteria of CFS. Fatigue correlated positively with severity, frequency, attack duration and chronicity of the migraine episodes, along with depression, anxiety, and excessive daytime sleepiness.</p><p><strong>Conclusion: </strong>Fatigue and related comorbid disorders are significantly more common in CM than in EM, expanding the morbidity of the condition and underscores the need to address these accompanying symptoms for devising a holistic treatment plan.</p>","PeriodicalId":16443,"journal":{"name":"Journal of Neurosciences in Rural Practice","volume":"14 3","pages":"424-431"},"PeriodicalIF":1.4,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10483198/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10212650","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-07-01Epub Date: 2023-08-16DOI: 10.25259/JNRP_27_2023
Rajdeep Ojha, Abhinav Singh, Jacob George, Bobeena Rachel Chandy
Objectives: Suprasacral spinal cord lesions are prone to have neurogenic detrusor overactivity leading to urinary incontinence. Current medical management has known side-effects and often surgical managements are irreversible. Electrical stimulation to modulate spinal reflex pathway having same nerve root as urinary bladder is reported in the literature. This study aimed to reduce detrusor overactivity in patients with spinal cord injury (SCI) using surface electrical stimulation of medial plantar nerve at the sole of foot.
Materials and methods: Twenty adults with SCI having episode of at least 1 leak/day due to detrusor overactivity as diagnosed by cystometrogram (CMG), were on clean intermittent catheterization and ankle jerk was present consented for the study. Participants were asked to maintain bladder diary a week before and during 2 weeks of treatment. CMG was done on day-0 and day-14. cmcUroModul@tor®, an inhouse developed electrical stimulator was used for ½ h daily for period of 2 weeks. Patient satisfaction feedback questionnaire was taken on completion of treatment. CMG data were analyzed using Wilcoxon signed-ranked test while bladder diary was analyzed using binomial distribution. P < 0.05 was considered as statistically significant. Institutional Review Board (IRB) and ethics committee of Christian Medical College, Vellore, approved the study (CMC/IRB/11061).
Results: Statistical significant improvement in maximum detrusor pressure (P = 0.03) and cystometric capacity (P = 0.04) was observed. Of 20 subjects, 18 showed improvement in bladder diary.
Conclusion: Neuromodulation of medial plantar nerve at sole of foot by surface electrical stimulation is non-invasive, cost-effective, and alternative simple treatment modality for urinary incontinence due to detrusor overactivity.
{"title":"Neuromodulation of spinal reflex pathway for the treatment of detrusor overactivity by medial plantar nerve stimulation at surface of sole of foot in patients with spinal cord injury.","authors":"Rajdeep Ojha, Abhinav Singh, Jacob George, Bobeena Rachel Chandy","doi":"10.25259/JNRP_27_2023","DOIUrl":"10.25259/JNRP_27_2023","url":null,"abstract":"<p><strong>Objectives: </strong>Suprasacral spinal cord lesions are prone to have neurogenic detrusor overactivity leading to urinary incontinence. Current medical management has known side-effects and often surgical managements are irreversible. Electrical stimulation to modulate spinal reflex pathway having same nerve root as urinary bladder is reported in the literature. This study aimed to reduce detrusor overactivity in patients with spinal cord injury (SCI) using surface electrical stimulation of medial plantar nerve at the sole of foot.</p><p><strong>Materials and methods: </strong>Twenty adults with SCI having episode of at least 1 leak/day due to detrusor overactivity as diagnosed by cystometrogram (CMG), were on clean intermittent catheterization and ankle jerk was present consented for the study. Participants were asked to maintain bladder diary a week before and during 2 weeks of treatment. CMG was done on day-0 and day-14. cmcUroModul@tor<sup>®</sup>, an inhouse developed electrical stimulator was used for ½ h daily for period of 2 weeks. Patient satisfaction feedback questionnaire was taken on completion of treatment. CMG data were analyzed using Wilcoxon signed-ranked test while bladder diary was analyzed using binomial distribution. <i>P</i> < 0.05 was considered as statistically significant. Institutional Review Board (IRB) and ethics committee of Christian Medical College, Vellore, approved the study (CMC/IRB/11061).</p><p><strong>Results: </strong>Statistical significant improvement in maximum detrusor pressure (<i>P</i> = 0.03) and cystometric capacity (<i>P</i> = 0.04) was observed. Of 20 subjects, 18 showed improvement in bladder diary.</p><p><strong>Conclusion: </strong>Neuromodulation of medial plantar nerve at sole of foot by surface electrical stimulation is non-invasive, cost-effective, and alternative simple treatment modality for urinary incontinence due to detrusor overactivity.</p>","PeriodicalId":16443,"journal":{"name":"Journal of Neurosciences in Rural Practice","volume":"14 3","pages":"495-500"},"PeriodicalIF":1.4,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10483192/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10570355","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-07-01Epub Date: 2023-05-25DOI: 10.25259/JNRP_107_2023
Ade Pambayu Suharto, Anggraini Dwi Sensusiati, Muhammad Hamdan, Dewi Setyaning Bastiana
Objective: This review aims to the existing structural neuroimaging literature in Parkinson disease presenting with freezing of gait. The summary of this article provides an opportunity for a better understanding of the structural findings of freezing of gait in Parkinson disease based on MRI.
Methods: This systematic review of literature follows the procedures as described by the guideline of Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA).
Results: Initial searches yielded 545 documents. After exclusions, 11 articles were included into our study. Current findings of structural MRI on freezing of gait in Parkinson disease are associated with structural damage between sensorimotor-related cortical grey matter structures and thalamus, but not cerebellum and smaller systems, as well as extensive injuries on white matter connecting between those structures.
Conclusion: Current findings of structural MRI on freezing of gait in Parkinson disease are associated with structural damage between sensorimotor-related cortical grey matter structures and thalamus, but not cerebellum and smaller systems, as well as extensive injuries on white matter connecting between those structures.
{"title":"Structural magnetic resonance imaging in Parkinson disease with freezing of gait: A systematic review of literature.","authors":"Ade Pambayu Suharto, Anggraini Dwi Sensusiati, Muhammad Hamdan, Dewi Setyaning Bastiana","doi":"10.25259/JNRP_107_2023","DOIUrl":"10.25259/JNRP_107_2023","url":null,"abstract":"<p><strong>Objective: </strong>This review aims to the existing structural neuroimaging literature in Parkinson disease presenting with freezing of gait. The summary of this article provides an opportunity for a better understanding of the structural findings of freezing of gait in Parkinson disease based on MRI.</p><p><strong>Methods: </strong>This systematic review of literature follows the procedures as described by the guideline of Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA).</p><p><strong>Results: </strong>Initial searches yielded 545 documents. After exclusions, 11 articles were included into our study. Current findings of structural MRI on freezing of gait in Parkinson disease are associated with structural damage between sensorimotor-related cortical grey matter structures and thalamus, but not cerebellum and smaller systems, as well as extensive injuries on white matter connecting between those structures.</p><p><strong>Conclusion: </strong>Current findings of structural MRI on freezing of gait in Parkinson disease are associated with structural damage between sensorimotor-related cortical grey matter structures and thalamus, but not cerebellum and smaller systems, as well as extensive injuries on white matter connecting between those structures.</p>","PeriodicalId":16443,"journal":{"name":"Journal of Neurosciences in Rural Practice","volume":"14 3","pages":"399-405"},"PeriodicalIF":1.4,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10483193/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10220972","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objectives: The objectives of this study are to elicit sociodemographic details, assess the level of psychological distress, and measure the quality of community life (QoCL) of migratory construction workers.
Materials and methods: A cross-sectional research design and survey method of sampling was followed. The semi-structured interview schedule, self-reporting questionnaire, and QoCL scale were used as measures for the study.
Results: Out of 75 respondents, 37 (49.3%) did not have formal education, 38 (50.7%) have migrated for less than a month duration, 33 (44.0%) respondents migrated with their families. The mean age of respondents was 32.03 ± 9.82 years. About 48 (64.0%) were identified as potential respondents for psychosocial care and female respondents (M = 12.90 ± 4.03, t = -3.03, P < 0.003) have higher distress than males (M = 9.50 ± 4.56, t = -3.03, P < 0.003) ones. Overall, QoCL indicated a below moderate (59.08 ± 8.31) level.
Conclusion: The distress was high and QoCL indicated a below moderate level. Intersectoral and community mental health services were required to enhance QoCL and reduce distress among migratory construction workers.
{"title":"Psychological distress and quality of community life among migratory construction workers in India.","authors":"Sudhir Babu Sriramalu, Aravind Raj Elangovan, Sadananda Reddy Annapally, Raju Birudu, Govindappa Lakshmana","doi":"10.25259/JNRP_42_2022","DOIUrl":"10.25259/JNRP_42_2022","url":null,"abstract":"<p><strong>Objectives: </strong>The objectives of this study are to elicit sociodemographic details, assess the level of psychological distress, and measure the quality of community life (QoCL) of migratory construction workers.</p><p><strong>Materials and methods: </strong>A cross-sectional research design and survey method of sampling was followed. The semi-structured interview schedule, self-reporting questionnaire, and QoCL scale were used as measures for the study.</p><p><strong>Results: </strong>Out of 75 respondents, 37 (49.3%) did not have formal education, 38 (50.7%) have migrated for less than a month duration, 33 (44.0%) respondents migrated with their families. The mean age of respondents was 32.03 ± 9.82 years. About 48 (64.0%) were identified as potential respondents for psychosocial care and female respondents (M = 12.90 ± 4.03, <i>t</i> = -3.03, <i>P</i> < 0.003) have higher distress than males (M = 9.50 ± 4.56, <i>t</i> = -3.03, <i>P</i> < 0.003) ones. Overall, QoCL indicated a below moderate (59.08 ± 8.31) level.</p><p><strong>Conclusion: </strong>The distress was high and QoCL indicated a below moderate level. Intersectoral and community mental health services were required to enhance QoCL and reduce distress among migratory construction workers.</p>","PeriodicalId":16443,"journal":{"name":"Journal of Neurosciences in Rural Practice","volume":"14 3","pages":"533-540"},"PeriodicalIF":1.4,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10483212/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10219156","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-07-01Epub Date: 2023-07-27DOI: 10.25259/JNRP_147_2023
Andrea Perna, Calogero Velluto, Amarildo Smakaj, Francesco Tamburrelli, Maria Ilaria Borruto, Domenico Alessandro Santagada, Franco Lucio Gorgoglione, Francesco Liuzza, Luca Proietti
Introduction: Minimally invasive spine surgery became the gold standard for the treatment of many spinal diseases. Only a few comparative studies were performed regarding the superiority of robotic-assisted (RA) surgery over fluoroscopic guidance (FG) surgery during percutaneous pedicle screws placement. Therefore, the aim of the present study was to conduct a systematic literature review and meta-analysis to evaluate the accuracy and potential advantages of RA compared with FG.
Material and methods: This study is a systematic literature review conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. The review questions were formulated following the PICO scheme. Measured outcomes were presented using Forest plots. Heterogeneity among the included studies was assessed using the χ2 test, and the I2 statistic was utilized to estimate the proportion of total variation among the studies. A value exceeding 50% was considered indicative of substantial heterogeneity.
Results: Seven studies that met inclusion criteria were finally included in this meta-analysis. These seven studies include: 447 patients, 228 patients (931 screws) treated with robotic guide, and 219 patients (767 pedicle screws) using fluoroscopic guide, with a mean age of 55.2. The percentages of clinically acceptable screws were 94.3% in the robot-assisted group and 89% in the fluoroscopic guided group. The percentages of non-acceptable screws were 5.7% in the robot-assisted group and 11% in the fluoroscopic-guided group.
Discussion: Significant differences were observed between the two groups in terms of radiographic and clinical outcomes, with the robotic-assisted pedicle screw group exhibiting longer operative times. Robot technology serves as a valuable tool for assisting surgeons in challenging scenarios such as anatomical variants or patients with spinal deformities, ensuring accurate screw placement.
Conclusion: The accuracy of pedicle screw placement with robotic technology is higher than with FG. In fact, the robotic approach allows significantly lower complication rates, fewer cases of violation of the proximal articular facet, less intraoperative exposure to radiation, even if it requires longer surgical times than the FG technique.
{"title":"Positioning accuracy and facet joints violation after percutaneous pedicle screws placement with robot-assisted versus fluoroscopy-guided technique: Systematic review and meta-analysis.","authors":"Andrea Perna, Calogero Velluto, Amarildo Smakaj, Francesco Tamburrelli, Maria Ilaria Borruto, Domenico Alessandro Santagada, Franco Lucio Gorgoglione, Francesco Liuzza, Luca Proietti","doi":"10.25259/JNRP_147_2023","DOIUrl":"10.25259/JNRP_147_2023","url":null,"abstract":"<p><strong>Introduction: </strong>Minimally invasive spine surgery became the gold standard for the treatment of many spinal diseases. Only a few comparative studies were performed regarding the superiority of robotic-assisted (RA) surgery over fluoroscopic guidance (FG) surgery during percutaneous pedicle screws placement. Therefore, the aim of the present study was to conduct a systematic literature review and meta-analysis to evaluate the accuracy and potential advantages of RA compared with FG.</p><p><strong>Material and methods: </strong>This study is a systematic literature review conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. The review questions were formulated following the PICO scheme. Measured outcomes were presented using Forest plots. Heterogeneity among the included studies was assessed using the χ<sup>2</sup> test, and the I<sup>2</sup> statistic was utilized to estimate the proportion of total variation among the studies. A value exceeding 50% was considered indicative of substantial heterogeneity.</p><p><strong>Results: </strong>Seven studies that met inclusion criteria were finally included in this meta-analysis. These seven studies include: 447 patients, 228 patients (931 screws) treated with robotic guide, and 219 patients (767 pedicle screws) using fluoroscopic guide, with a mean age of 55.2. The percentages of clinically acceptable screws were 94.3% in the robot-assisted group and 89% in the fluoroscopic guided group. The percentages of non-acceptable screws were 5.7% in the robot-assisted group and 11% in the fluoroscopic-guided group.</p><p><strong>Discussion: </strong>Significant differences were observed between the two groups in terms of radiographic and clinical outcomes, with the robotic-assisted pedicle screw group exhibiting longer operative times. Robot technology serves as a valuable tool for assisting surgeons in challenging scenarios such as anatomical variants or patients with spinal deformities, ensuring accurate screw placement.</p><p><strong>Conclusion: </strong>The accuracy of pedicle screw placement with robotic technology is higher than with FG. In fact, the robotic approach allows significantly lower complication rates, fewer cases of violation of the proximal articular facet, less intraoperative exposure to radiation, even if it requires longer surgical times than the FG technique.</p>","PeriodicalId":16443,"journal":{"name":"Journal of Neurosciences in Rural Practice","volume":"14 3","pages":"406-412"},"PeriodicalIF":1.4,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10483214/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10220964","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-07-01Epub Date: 2023-08-16DOI: 10.25259/JNRP_223_2023
R Meghana, Shubham Jain, Palash Kumar Malo, Albert Stezin, Thomas Gregor Issac
{"title":"Potential modifications on verbal-language/orientation-memory ratio from Addenbrooke's cognitive examination III to predict mild cognitive impairment from healthy controls.","authors":"R Meghana, Shubham Jain, Palash Kumar Malo, Albert Stezin, Thomas Gregor Issac","doi":"10.25259/JNRP_223_2023","DOIUrl":"10.25259/JNRP_223_2023","url":null,"abstract":"","PeriodicalId":16443,"journal":{"name":"Journal of Neurosciences in Rural Practice","volume":"14 3","pages":"531-532"},"PeriodicalIF":1.4,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10483186/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10220975","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}