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Article ; Online: Letter to the Editor. Presacral Tarlov cyst in Marfan syndrome: intervention with microsurgical sealing or conservative treatment?

Liu, Ping-Chuan / Chang, Hsuan-Kan / Chang, Chih-Chang / Wu, Jau-Ching

2023 Volume 40, Issue 1, Page(s) 123–124

MeSH term(s)	Humans ; Tarlov Cysts/diagnostic imaging ; Tarlov Cysts/surgery ; Marfan Syndrome/complications ; Conservative Treatment ; Laminectomy ; Microsurgery
Language	English
Publishing date	2023-10-27
Publishing country	United States
Document type	Journal Article ; Letter
ZDB-ID	2158643-3
ISSN	1547-5646 ; 1547-5654
ISSN (online)	1547-5646
ISSN	1547-5654
DOI	10.3171/2023.8.SPINE23861
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Article ; Online: Commentary: Low-Grade Infection and Implant Failure Following Spinal Instrumentation: A Prospective Comparative Study.

Chang, Hsuan-Kan / Huang, Wen-Cheng / Wu, Jau-Ching

Neurosurgery

2020 Volume 87, Issue 5, Page(s) E541–E542

MeSH term(s)	Humans ; Infections ; Prospective Studies ; Spinal Fusion ; Spine
Language	English
Publishing date	2020-05-14
Publishing country	United States
Document type	Journal Article ; Comment
ZDB-ID	135446-2
ISSN	1524-4040 ; 0148-396X
ISSN (online)	1524-4040
ISSN	0148-396X
DOI	10.1093/neuros/nyaa160
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Zs.A 1424: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
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Article ; Online: Cervical disc arthroplasty at C2-3: illustrative case.

Ku, Jason / Ku, Johnson / Chang, Hsuan-Kan / Wu, Jau-Ching

Journal of neurosurgery. Case lessons

2021 Volume 2, Issue 5

Abstract: Background: Since the beginning of the 21st century, cervical disc arthroplasty (CDA) has been accepted as an alternative to anterior cervical discectomy and fusion for surgical management of disc problems. The published clinical trials of CDA have ... ...

Abstract	Background: Since the beginning of the 21st century, cervical disc arthroplasty (CDA) has been accepted as an alternative to anterior cervical discectomy and fusion for surgical management of disc problems. The published clinical trials of CDA have included patients with radiculopathy or myelopathy caused by one- or two-level disc herniation at C3-7. However, it remains uncertain whether CDA is a viable option for C2-3 disc herniation. Observations: In this report, a 52-year-old man presented with hand numbness, arm pain, and myelopathic symptoms that were refractory to medical treatment for more than 6 months. The magnetic resonance images demonstrated herniated discs at C2-3, C3-4, and C4-5, causing stenosis. There was no ossification of posterior longitudinal ligament and the spine was mobile, so he received anterior discectomies with artificial disc replacement at each of the C2-3, C3-4, and C4-5 levels. The surgery went smoothly, and his neurological symptoms were promptly relieved. The postoperative radiographs at 24 months demonstrated a preserved range of motion at each level. Lessons: To date, this was the first report of CDA performed at C2-3, which also involved three consecutive levels of disc replacement. The report suggested that both C2-3 and three-consecutive-level CDA may be a viable option for cervical disc disease.
Language	English
Publishing date	2021-08-02
Publishing country	United States
Document type	Journal Article
ISSN	2694-1902
ISSN (online)	2694-1902
DOI	10.3171/CASE21320
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Article: Comparison of Cortical Bone Trajectory to Pedicle-Based Dynamic Stabilization: An Analysis of 291 Patients.

Chang, Chih-Chang / Chang, Hsuan-Kan / Ko, Chin-Chu / Wu, Ching-Lan / Kuo, Yi-Hsuan / Tu, Tsung-Hsi / Huang, Wen-Cheng / Wu, Jau-Ching

Neurospine

2023 Volume 20, Issue 1, Page(s) 308–316

Abstract: Objective: Pedicle-based dynamic stabilization (DS) has gained popularity outside of America. Although pedicle screw (PS) loosening has always been a concern, it is reportedly innocuous. Cortical bone trajectory (CBT) screw is an emerging option with ... ...

Abstract	Objective: Pedicle-based dynamic stabilization (DS) has gained popularity outside of America. Although pedicle screw (PS) loosening has always been a concern, it is reportedly innocuous. Cortical bone trajectory (CBT) screw is an emerging option with less invasiveness and similar effectiveness to PS in short-segment lumbar fusion. This study aimed to verify the use of CBT for DS by comparing the outcomes between pedicle- and CBT-based DS. Methods: Consecutive patients with lumbar spondylosis or low-grade spondylolisthesis who underwent 1- or 2-level DS between L3-5 with a minimum follow-up of 24 months were reviewed. Screw loosening was determined by computed tomography and the incidences were compared. Results: A total of 291 patients who underwent Dynesys DS (235 pedicle- and 56 CBT-based, respectively) were compared. The demographics and preoperative conditions were similar. All the clinical outcomes improved at 24-month postoperation, while the CBT-based group had less operation time and blood loss than the pedicle-based group. The rates of screw loosening were lower in the CBT-based (5.4% per screw and 12.5% per patient) than the pedicle-based group (9% per screw and 26.4% per patient). Furthermore, there were no differences in the clinical outcomes and complication profiles. Conclusion: The CBT-based DS for 1- or 2-level lumbar degeneration demonstrated equivalent clinical improvement as the pedicle-based DS. The adaption of CBT-based screws for DS could be a less invasive approach (shorter operation time and less blood loss), with lower chances of screw loosening than the conventional PS-based DS.
Language	English
Publishing date	2023-03-31
Publishing country	Korea (South)
Document type	Journal Article
ZDB-ID	3031654-6
ISSN	2586-6591 ; 2586-6583
ISSN (online)	2586-6591
ISSN	2586-6583
DOI	10.14245/ns.2244888.444
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Article ; Online: Early Discharged Lumbar Spine Fusion Reduced Postoperative Readmissions: A Retrospective Cohort Study.

Huang, Wen-Cheng / Wu, Jau-Ching / Chang, Hsuan-Kan / Chen, Yu-Chun

International journal of environmental research and public health

2020 Volume 17, Issue 4

Abstract: Early discharge (ED) has emerged and gained popularity in spine surgery. However, the benefits of ED in lumbar fusion have not yet been validated by large cohort studies. To evaluate the effects of ED on readmissions and reoperations in lumbar fusion, ... ...

Abstract	Early discharge (ED) has emerged and gained popularity in spine surgery. However, the benefits of ED in lumbar fusion have not yet been validated by large cohort studies. To evaluate the effects of ED on readmissions and reoperations in lumbar fusion, this study utilized a national database to enroll patients who had undergone lumbar fusion surgery at age 50-70 years, and grouped them into an ED group or a comparison group. In the comprehensive follow-up of 180 days post-operation, the two groups were compared. There were 18,008 patients in the cohort, including 2172 in the ED group and 15,836 in the comparison group. The ED group was slightly younger (59.9 vs. 60.7 years,
MeSH term(s)	Aged ; Female ; Humans ; Lumbar Vertebrae/surgery ; Male ; Middle Aged ; Patient Discharge ; Patient Readmission ; Reoperation ; Retrospective Studies ; Risk Factors ; Spinal Fusion ; Time Factors
Language	English
Publishing date	2020-02-19
Publishing country	Switzerland
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ISSN	1660-4601
ISSN (online)	1660-4601
DOI	10.3390/ijerph17041335
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Article ; Online: Iatrogenic cerebrospinal fluid leak after repeated nasal swab tests for COVID-19: illustrative case.

Ku, Johnson / Chen, Chieh-Yi / Ku, Jason / Chang, Hsuan-Kan / Wu, Jau-Ching / Yen, Yu-Shu

Journal of neurosurgery. Case lessons

2021 Volume 2, Issue 17, Page(s) CASE21421

Abstract: Background: Nasal swab tests are one of the most essential tools for screening coronavirus disease 2019 (COVID-19). The authors report a rare case of iatrogenic cerebrospinal fluid (CSF) leak from the anterior skull base after repeated nasal swab tests ... ...

Abstract	Background: Nasal swab tests are one of the most essential tools for screening coronavirus disease 2019 (COVID-19). The authors report a rare case of iatrogenic cerebrospinal fluid (CSF) leak from the anterior skull base after repeated nasal swab tests for COVID-19, which was treated with endoscopic endonasal repair. Observations: A 41-year-old man presented with clear continuous rhinorrhea through his left nostril for 5 days after repeated nasal swabbing for COVID-19. There were no obvious risk factors for spontaneous CSF leak. Computed tomography cisternography showed contrast accumulation in the left olfactory fossa and along the left nasal cavity. Such findings aligned with a preliminary diagnosis of CSF leakage through the left cribriform plate. Magnetic resonance imaging confirmed the presence of a CSF fistula between his left cribriform plate and superior nasal concha. The patient underwent endoscopic endonasal repair. CSF rhinorrhea ceased after the surgery, and no recurrence was noted during the 12-week postoperative follow-up period. Lessons: Although rare, iatrogenic CSF leakage can be a serious complication following COVID-19 nasal swab tests, especially when infection may cause significant neurological sequelae. Healthcare providers should become familiar with nasal cavity anatomy and be well trained in performing nasal swab tests.
Language	English
Publishing date	2021-10-25
Publishing country	United States
Document type	Case Reports
ISSN	2694-1902
ISSN (online)	2694-1902
DOI	10.3171/CASE21421
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Article ; Online: Measuring Optic Nerve Sheath Diameter as a Proxy for Intracranial Pressure.

Chang, Hsuan-Kan / Wu, Jau-Ching / Liu, Laura

JAMA ophthalmology

2018 Volume 136, Issue 11, Page(s) 1310–1311

MeSH term(s)	Brain ; Humans ; Intracranial Hypertension ; Intracranial Pressure ; Optic Nerve ; Ultrasonography
Language	English
Publishing date	2018-08-31
Publishing country	United States
Document type	Letter ; Comment
ZDB-ID	2701705-9
ISSN	2168-6173 ; 2168-6165
ISSN (online)	2168-6173
ISSN	2168-6165
DOI	10.1001/jamaophthalmol.2018.3435
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Article ; Online: Early Discharge for Anterior Cervical Fusion Surgery: Prediction of Readmission and Special Considerations for Older Adults.

Chen, Yu-Chun / Wu, Jau-Ching / Chang, Hsuan-Kan / Huang, Wen-Cheng

International journal of environmental research and public health

2019 Volume 16, Issue 4

Abstract: Anterior cervical discectomy and fusion (ACDF) is the standard surgical management for disc herniation and spondylosis worldwide and reportedly performed with short hospitalization and early discharge (ED). However, it is unknown if ED improves the ... ...

Abstract	Anterior cervical discectomy and fusion (ACDF) is the standard surgical management for disc herniation and spondylosis worldwide and reportedly performed with short hospitalization and early discharge (ED). However, it is unknown if ED improves the outcomes of ACDF including among older adults. This cohort study included patients who underwent ACDF surgery in Taiwan over two years analyzed in two groups: the ED group (discharged within 48 hours), and the comparison group (hospitalized for more than 48 h). Both groups were followed-up for at least 180 days. Pre- and post-operative comorbidities, re-admissions and re-operations were analyzed using a multivariate cox-regression model, with bootstrapping, and Kaplan⁻Meier analysis. Among 5565 ACDF patients, the ED group (
MeSH term(s)	Aged ; Cervical Vertebrae/surgery ; Cohort Studies ; Female ; Humans ; Male ; Middle Aged ; Patient Discharge ; Patient Readmission ; Reoperation ; Spinal Fusion ; Taiwan ; Treatment Outcome
Language	English
Publishing date	2019-02-21
Publishing country	Switzerland
Document type	Journal Article
ISSN	1660-4601
ISSN (online)	1660-4601
DOI	10.3390/ijerph16040641
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Article ; Online: Risk factors of second surgery for adjacent segment disease following anterior cervical discectomy and fusion: A 16-year cohort study.

Wu, Jau-Ching / Chang, Hsuan-Kan / Huang, Wen-Cheng / Chen, Yu-Chun

International journal of surgery (London, England)

2019 Volume 68, Page(s) 48–55

Abstract: Background: Although the incidence of second surgery for adjacent segment disease (ASD) after anterior cervical discectomy and fusion (ACDF) has been reported, its risk factors remain elusive. Few studies have had a sufficiently large number of patients, ...

Abstract	Background: Although the incidence of second surgery for adjacent segment disease (ASD) after anterior cervical discectomy and fusion (ACDF) has been reported, its risk factors remain elusive. Few studies have had a sufficiently large number of patients, long follow-up time, and high follow-up rate for investigation. To identify non-surgical risk factors of second surgery for ASD following ACDF, the study used a national cohort with comprehensive follow-up. Materials and methods: All second ACDF surgery after one year from the first ACDF were identified as a consequence of ASD that required another surgery. A multivariate competing risk survival model, Kaplan-Meier survivorship, and average time to events were calculated. Results: Among 38,149 patients who had the first ACDF, 1,092 (2.9%) later (mean 4.66 years) received a second ACDF surgery, during the nearly-perfect follow-up of 16 years. Young age and psychiatric disorders were independent risk factors. Patients who were aged under 40, 50, 60 and 70 years were, respectively, 4.56, 4.09, 3.09 and 2.17 times more likely than those older than 70 years. Also, patients with depression or psychoses were, respectively, 1.42 and 1.45 times more likely to have second surgery for ASD. (all p < 0.05). Conclusion: Young age and psychiatric disorders are independent risk factors of second ACDF surgery for ASD. Personalized strategies to ameliorate or postpone the development of ASD are therefore warranted for patients who need ACDF surgery.
MeSH term(s)	Adult ; Age Factors ; Aged ; Cervical Vertebrae/surgery ; Cohort Studies ; Diskectomy/adverse effects ; Female ; Follow-Up Studies ; Humans ; Incidence ; Male ; Mental Disorders/complications ; Middle Aged ; Postoperative Complications/epidemiology ; Postoperative Complications/etiology ; Postoperative Complications/surgery ; Reoperation/statistics & numerical data ; Retrospective Studies ; Risk Factors ; Spinal Diseases/surgery ; Spinal Fusion/adverse effects
Language	English
Publishing date	2019-06-15
Publishing country	England
Document type	Journal Article
ZDB-ID	2212038-5
ISSN	1743-9159 ; 1743-9191
ISSN (online)	1743-9159
ISSN	1743-9191
DOI	10.1016/j.ijsu.2019.06.002
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Zs.A 6502: Show issues

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Article: Less Opioid Consumption With Enhanced Recovery After Surgery Transforaminal Lumbar Interbody Fusion (TLIF): A Comparison to Standard Minimally-Invasive TLIF.

Chang, Hsuan-Kan / Huang, Meng / Wu, Jau-Ching / Huang, Wen-Cheng / Wang, Michael Y

Neurospine

2020 Volume 17, Issue 1, Page(s) 228–236

Abstract: Objective: The concept of enhanced recovery after surgery (ERAS) is relatively new to the neurosurgical field. The introduction of an ERAS protocol in lumbar fusion surgery has aimed to accelerate patient recovery from surgery by reducing in-hospital ... ...

Abstract	Objective: The concept of enhanced recovery after surgery (ERAS) is relatively new to the neurosurgical field. The introduction of an ERAS protocol in lumbar fusion surgery has aimed to accelerate patient recovery from surgery by reducing in-hospital opioid consumption. Methods: Patients with 1- or 2-level degenerative lumbar spine disease and who underwent ERAS transforaminal lumbar interbody fusion (TLIF) were retrospectively reviewed. Patients' general demographic data, in-hospital opioid dosage (converted to morphine equivalents), and hospital stay were compared to those who underwent standard minimally-invasive (MIS)-TLIF. Results: Twenty-four patients who received ERAS TLIF (the ERAS group) were compared to a series of 24 patients who received standard MIS-TLIF (the MIS group). The demographic data were similar. The operation time and blood loss significantly favored ERAS TLIF. The average daily opioid consumption was remarkably lower in the ERAS group than the MIS group. Average opioid dosage throughout the entire in-hospital period was also significantly reduced in the ERAS group compared to the MIS group. The average length of hospital stay was substantially shorter in the ERAS group (1.4 ± 1.13 days vs. 4.0±1.98 days, p<0.001). Conclusion: The present study demonstrated a significant decline in the consumption of opioids and in the hospital length of stay for patients undergoing ERAS TLIF for 1- or 2-level degenerative lumbar spine disease.
Language	English
Publishing date	2020-03-31
Publishing country	Korea (South)
Document type	Journal Article
ZDB-ID	3031654-6
ISSN	2586-6591 ; 2586-6583
ISSN (online)	2586-6591
ISSN	2586-6583
DOI	10.14245/ns.1938422.211
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