Other
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Scientific MembershipsNorth America Spine Society
American Association of Neurological Surgeons
Congress of Neurological Surgeons -
Journal RefereesClinical neurology and neurosurgery, BMC Musculoskeletal Disorders
Publications (56) View all
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Dataset: peds.2011-3008.full
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Article: Intracranial subdural hematoma coexisting with improvement in spontaneous intracranial hypotension after an epidural blood patch.
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ABSTRACT: A 36-year-old male had spontaneous intracranial hypotension (SIH) presenting with refractory headache for 4 months. Multiple epidural blood patches (EBPs) yielded relief of symptoms, but the course was complicated, with asymptomatic intracranial subdural hematoma (SDH). Except for SDH, other radiological diagnostic signs of SIH were resolved and the patient's headaches improved after EBP. Owing to a mass effect and persistent cerebrospinal fluid (CSF) leakage, surgical repair of the spinal leakage was performed, but no cranial procedures were carried out. Postoperatively, the SDH completely resolved, but there was still CSF leakage at the level where surgery was performed. The patient has remained free of headache or other events for 3 years. It was reduction rather than elimination of the spinal CSF leak that yielded remission of SIH. In summary, intracranial SDH can be a complication of inadequately treated SIH (i.e. persistent minor CSF leakage). Management of SDH should focus on correction of the underlying SIH rather than craniotomy for hematoma evacuation.Journal of the Chinese Medical Association 11/2012; 75(11):610-3. · 0.79 Impact Factor -
Article: Hospitalized osteoporotic vertebral fracture increases the risk of stroke: A population-based cohort study.
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ABSTRACT: The association between osteoporosis and cardiovascular diseases has been demonstrated. Higher cardiovascular risk has also been correlated with vertebral fractures. However, the association between osteoporotic vertebral fracture and the possibly higher risk of stroke remains uncertain. This study aimed to evaluate the incidence, risk, and type of stroke in patients with osteoporotic vertebral fracture. Patients with osteoporotic vertebral fracture were identified (n = 380) and ten age- and sex-matched controls per case (comparison group, n = 3795) were chosen from a nationwide representative cohort of 999,997 people from 1998 to 2005. Both groups were followed-up for stroke events for three years, matched by propensity scores with adjustments for covariates such as co-morbidities (i.e., hypertension, diabetes, arrhythmia, and coronary heart diseases) and exposure to medications (i.e., aspirin, lipid lowering drug and nitrates), and assessed by Kaplan-Meier and Cox regression analyses. The incidence rate of stroke in the osteoporotic vertebral fracture group (37.5 per 1000 person-years, 95% confidence interval, 27.5-51.2) was significantly higher than in the comparison group (14.0 per 1,000 person-years, 95% C.I., 12.0-16.4, p < 0.001). Stroke was more likely to occur in the osteoporotic vertebral fracture patients than in the normal controls (crude hazard ratio 2.68, 95% C.I., 1.89-3.79; p < 0.001; adjusted HR = 2.71, 95% C.I., 1.90-3.86; p < 0.001). In conclusion, patients with osteoporotic vertebral fracture have a higher risk of stroke (i.e. both ischemic and hemorrhagic) and require stroke prevention strategies. © 2012 American Society for Bone and Mineral Research.Journal of bone and mineral research: the official journal of the American Society for Bone and Mineral Research 07/2012; · 6.04 Impact Factor -
Article: Comments.
Neurosurgery 07/2012; 71(1):56-7. · 2.79 Impact Factor -
Article: Multilevel Arthroplasty for Cervical Spondylosis: More Heterotopic Ossification at 3 Years of Follow-up.
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ABSTRACT: STUDY DESIGN.: Retrospective cohort study. OBJECTIVE.: To investigate the differences between single- and multilevel degenerative disc diseases (DDDs) treated with cervical arthroplasty. SUMMARY OF BACKGROUND DATA.: The US Food and Drug Administration clinical trials compared arthroplasty with anterior cervical discectomy and fusion for single-level DDD. However, cervical arthroplasty for multilevel DDD is rarely addressed in the literature. METHODS.: A total of 102 consecutive patients who underwent Bryan arthroplasty were divided into either a single- or multilevel group. Clinical outcomes were measured by the visual analogue scale (VAS) of neck and arm, and by the neck disability index with a minimum follow-up of 25 months. Every patient had radiographical evaluations, and computed tomography. RESULTS.: Eighty-six patients (84.3%) completed the follow-up with a mean time of 38.3 ± 8.7 months. Postoperatively, there were significant improvements in clinical outcomes (i.e., VAS neck, VAS arm, and neck disability index) at each time point of evaluation (i.e., 3-, 6-, 12-, and 24 mo postoperation). The sex composition and clinical outcome improvements between the single- and multilevel groups were not significantly different. The multilevel group was older (51.3 ± 8.6 vs. 46.3 ± 11.2 yr; P = 0.02), had more intraoperative blood loss (218.0 ± 182.4 vs. 102.8 ± 79.2 mL; P = 0.001), and demonstrated a higher rate of heterotopic ossification (HO) than the single-level group (66.0% vs. 25.0%; P < 0.001). The majority (97.7%) of the artificial discs in this series remained mobile despite HO. CONCLUSION.: Clinical outcomes of cervical arthroplasty in multilevel spondylosis are similar to single-level outcomes. However, the significantly higher rate of HO found in multilevel arthroplasty and its long-term effect warrant further investigation.Spine 06/2012; 37(20):E1251-E1259. · 2.08 Impact Factor
