"Mai kānalua i kahi hui liʻiliʻi o nā kamaʻāina noʻonoʻo a hoʻolaʻa hiki ke hoʻololi i ka honua.ʻOiaʻiʻo, ʻo ia wale nō ma laila.
ʻO ka hana a Cureus ke hoʻololi i ke kumu hoʻohālike lōʻihi o ka paʻi ʻana i ka lāʻau lapaʻau, kahi e uku ai ka hoʻouna noiʻi ʻana, paʻakikī, a hoʻopau manawa.
Neuroradiology, hoʻoili vertebral, cervical vertebroplasty, posterolateral approach, curved needle, interventional neuroradiology, percutaneous vertebroplasty
E haʻi i kēia ʻatikala e like me: Swarnkar A, Zain S, Christie O, et al.(Mei 29, 2022) ʻO Vertebroplasty no nā haʻihaʻi C2 pathological: kahi hihia lapaʻau kūʻokoʻa e hoʻohana ana i ka ʻenehana curved needle.Laau 14(5): e25463.doi:10.7759/cureus.25463
Ua puka mai ka liʻiliʻi invasive vertebroplasty ma ke ʻano he lāʻau lapaʻau ʻē aʻe no nā haʻihaʻi vertebral pathological.Hoʻopaʻa maikaʻi ʻia ka Vertebroplasty ma ka ʻāʻī a me ka lumbar posterolateral approach, akā ʻaʻole i hoʻohana pinepine ʻia i ka spine cervical ma muli o ka nui o nā neural a me nā vascular structures pono e pale ʻia.Pono ka hoʻohana ʻana i ka ʻenehana akahele a me ke kiʻi kiʻi e hoʻoponopono i nā hale koʻikoʻi a hōʻemi i ka pilikia o nā pilikia.Ma kahi hoʻokokoke posterolateral, pono ke kau ʻia ka ʻeha ma kahi alahele o ka nila pololei ma ka ʻaoʻao o ka vertebra C2.Hiki i kēia ala ke kaupalena i ka mālama pono ʻana i nā ʻeha ʻoi aku ma waena.Hōʻike mākou i kahi hihia lapaʻau kūikawā o kahi ala posterolateral kūleʻa a palekana no ka mālama ʻana i nā metastases medial C2 me ka hoʻohana ʻana i kahi nila curved.
Hoʻopili ka Vertebroplasty i ka hoʻololi ʻana i nā mea i loko o ke kino vertebral e hoʻoponopono i nā haʻihaʻi a i ʻole ke kūlana paʻa.Hoʻohana pinepine ʻia ʻo Cement ma ke ʻano he mea hoʻopili, e hoʻonui ai i ka ikaika o ka vertebrae, hōʻemi i ka hopena o ka hāʻule ʻana, a me ka emi ʻana o ka ʻeha, ʻoi aku ka nui o nā maʻi me ka osteoporosis a i ʻole nā ​​​​iwi osteolytic [1].Hoʻohana pinepine ʻia ka percutaneous vertebroplasty (PVP) ma ke ʻano he mea hoʻohui i ka analgesics a me ka radiation therapy e hoʻomaha ai i ka ʻeha i nā poʻe maʻi me nā haʻihaʻi vertebral lua i ka malignancy.Hana ʻia kēia kaʻina hana ma ka ʻāʻī a me ka lumbar spine ma o ka pedicle posterolateral a i ʻole ke ala extrapedicular.ʻAʻole i hana pinepine ʻia ka PVP ma ka spine cervical ma muli o ka liʻiliʻi o ke kino vertebral a me nā pilikia ʻenehana e pili ana i ka hele ʻana o nā hale neurovascular koʻikoʻi i loko o ka spine cervical e like me ka spinal cord, carotid arteries, jugular veins, a me cranial nerves.2].ʻO ka PVP, ʻoi aku ka nui ma ka pae C2, he ʻano kakaʻikahi a ʻoi aku paha ma muli o ka paʻakikī anatomical a me ke komo ʻana o ka maʻi ma ka pae C2.I ka hihia o nā ʻeha osteolytic paʻa ʻole, hiki ke hana ʻia ka vertebroplasty inā manaʻo ʻia ke kaʻina hana paʻakikī loa.I nā lesions PVP o nā kino vertebral C2, hoʻohana pinepine ʻia kahi nila pololei mai ka anterolateral, posterolateral, translational, a i ʻole transoral (pharyngeal) ala e pale i nā hale koʻikoʻi [3].ʻO ka hoʻohana ʻana i kahi nila pololei e hōʻike ana e pono ka lesion e hahai i kēia alahele no ka ho'ōla kūpono.ʻO nā maʻi ma waho o ke ala pololei hiki ke hopena i ka palena, kūpono ʻole a i ʻole ka hoʻopau piha ʻana mai ka lāʻau kūpono.Ua hoʻohana hou ʻia ka ʻenehana PVP curved needle i loko o ka lumbar a me ka thoracic spine me nā hōʻike o ka hoʻonui ʻana i ka maneuverability [4,5].Eia naʻe, ʻaʻole i hōʻike ʻia ka hoʻohana ʻana i nā nila curved i ka spine cervical.Hōʻike mākou i kahi hihia lapaʻau o ka C2 pathologic fracture kiʻekiʻe i ka metastatic pancreatic cancer i mālama ʻia me ka PVP cervical cervical.
Ua hōʻike ʻia kahi kanaka 65 makahiki i ka haukapila me ka hoʻomaka hou ʻana i ka ʻeha nui ma kona poʻohiwi ʻākau a me ka ʻāʻī i hoʻomau ʻia no nā lā 10 me ka ʻole o ka hōʻoluʻolu me nā lāʻau lapaʻau.ʻAʻole pili kēia mau hōʻailona me ka helu a nāwaliwali paha.He moʻolelo koʻikoʻi kona o ka metastatic poorly differentiated pancreatic cancer stage IV, arterial hypertension a me ka waiʻona koʻikoʻi.Ua hoʻopau ʻo ia i 6 mau pōkole o FOLFIRINOX (leucovorin/leucovorin, fluorouracil, irinotecan hydrochloride a me oxaliplatin) akā ua hoʻomaka i kahi regimen hou o gemzar a me abraxane i ʻelua pule i hala ma muli o ka piʻi ʻana o ka maʻi.Ma ka hoʻokolokolo kino ʻana, ʻaʻohe ona ʻoluʻolu i ka palpation o ka ʻāʻī o ka ʻāʻī, ka ʻāʻī, a me ka lumbar spine.Eia kekahi, ʻaʻohe pilikia o ka sensory a me ka kaʻa ma ka ʻaoʻao o luna a me lalo.He mea maʻamau kona ʻano hoʻohālikelike bilateral.Ma waho o ka haukapila computed tomography (CT) scan o ka cervical spine i hōʻike i nā ʻeha osteolytic e kūlike me ka maʻi metastatic e pili ana i ka ʻaoʻao ʻākau o ke kino vertebral C2, ka nui C2 ʻākau, ka pā vertebral ʻākau e pili ana, a me ka ʻaoʻao kaumaha o C2 .ʻĀkau ʻāʻī o luna (Fig. 1).Ua kūkākūkā ʻia kahi neurosurgeon, magnetic resonance imaging (MRI) o ka cervical, thoracic a me lumbar spine, me ka noʻonoʻo ʻana i nā ʻeha osteolytic metastatic.Ua hōʻike ʻia nā ʻike MRI i ka T2 hyperintensity, T1 isointense soft tissue mass e pani ana i ka ʻaoʻao ʻākau o ke kino vertebral C2, me ka liʻiliʻi o ka diffusion a me ka hoʻonui post-contrast.Ua loaʻa iā ia ka lāʻau lapaʻau me ka ʻike ʻole ʻia o ka hoʻomaikaʻi ʻana i ka ʻeha.Manaʻo ka lawelawe neurosurgical ʻaʻole e hana i ka ʻokiʻoki pilikia.No laila, ua koi ʻia ka radiology interventional (IR) no ka hoʻomaʻamaʻa hou ʻana ma muli o ka ʻeha nui a me ka pilikia o ka paʻa ʻole a me ka hiki ke hoʻopaʻa ʻia ke kuamoʻo.Ma hope o ka loiloi ʻana, ua hoʻoholo ʻia e hana CT-guided percutaneous C2 spine plastic me ka hoʻohana ʻana i kahi ala posterolateral.
Hōʻike ka Panel A i nā ʻokoʻa like ʻole a me nā cortical irregularities (nā pua) ma ka ʻaoʻao mua ʻākau o ke kino vertebral C2.Asymmetric hoʻonui o ka hui atlantoaxial akau a me ka cortical irregularity ma C2 (mānoanoa pua, B).ʻO kēia, me ka ʻike o ka nui ma ka ʻaoʻao ʻākau o C2, e hōʻike ana i kahi haki pathological.
Hoʻonoho ʻia ka mea maʻi ma ka ʻaoʻao ʻākau e moe ana a me 2.5 mg o Versed a me 125 μg o fentanyl i hoʻokaʻawale ʻia.I ka hoʻomaka ʻana, ua hoʻonohonoho ʻia ke kino vertebral C2 a ua hoʻokomo ʻia ka 50 ml o ka intravenous contrast e hoʻokaʻawale i ke ʻano o ka vertebral a me ka hoʻolālā ʻana i ka trajectory.A laila, ua hoʻonui ʻia kahi kui hoʻokomo 11-gauge i ka ʻaoʻao hope-medial o ke kino vertebral mai ke ala posterolateral kūpono (Fig. 2a).Ua hoʻokomo ʻia kahi nila Stryker TroFlex® curved (Fig. 3) a waiho ʻia ma ka ʻaoʻao medial haʻahaʻa o ka C2 osteolytic lesion (Fig. 2b).Ua hoʻomākaukau ʻia ka sima iwi polymethyl methacrylate (PMMA) e like me nā ʻōlelo kuhikuhi maʻamau.I kēia manawa, ma lalo o ka mana CT-fluoroscopic intermittent, ua hoʻokomo ʻia ka sima iwi ma o ka nila curved (Fig. 2c).Ke hoʻokō pono ʻia ka hoʻopiha piha ʻana o ka ʻāpana haʻahaʻa o ka liona, ua wehe ʻia ka nila a hoʻohuli ʻia e komo i ke kūlana waena waena (Fig. 2d).ʻAʻohe mea kūʻē i ka hoʻonohonoho hou ʻana i ka nila no ka mea he ʻeha osteolytic koʻikoʻi kēia lesion.E hoʻokomo i ka sima PMMA hou ma luna o ka ʻeha.Ua mālama ʻia e pale aku i ka leaka ʻana o ka iwi sima i loko o ke kuamoʻo a i ʻole nā ​​ʻiʻo palupalu paravertebral.Ma hope o ka loaʻa ʻana o ka hoʻopiha piha ʻana me ka sima, ua wehe ʻia ka nila curved.Ua hōʻike ʻia ke kiʻi kiʻi postoperative kūleʻa i ka vertebroplasty iwi sima PMMA (Nā Kiʻi 2e, 2f).ʻAʻole i hōʻike ʻia nā hemahema ma hope o ka hana ʻana i ka neurological.I kekahi mau lā ma hope mai ua hoʻokuʻu ʻia ka mea maʻi me kahi kola cervical.ʻO kona ʻeha, ʻoiai ʻaʻole i hoʻopau loa ʻia, ua ʻoi aku ka maikaʻi o ka mālama ʻana.Ua make ʻino ka mea maʻi i kekahi mau mahina ma hope o ka hoʻokuʻu ʻia ʻana mai ka haukapila ma muli o nā pilikia o ka maʻi maʻi pancreatic invasive.
Nā kiʻi computed tomography (CT) e hōʻike ana i nā kikoʻī o ke kaʻina hana.A) I ka hoʻomaka ʻana, ua hoʻokomo ʻia kahi cannula waho 11 mai ke ala ʻaoʻao posterolateral i hoʻolālā ʻia.B) Ka hoʻokomo ʻana i kahi nila curved (pua pālua) ma o ka cannula (pua hoʻokahi) i loko o ka lesion.Hoʻokomo ʻia ka piko o ka nila i lalo a ʻoi aku ka waena.C) Ua hoʻokomo ʻia ka sima Polymethyl methacrylate (PMMA) i lalo o ka ʻeha.D) Hoʻihoʻi ʻia ka nila i kulou a hoʻokomo hou ʻia i loko o ka ʻaoʻao medial kiʻekiʻe, a laila hoʻokomo ʻia ka sima PMMA.E) a me F) hōʻike i ka māhele ʻana o ka PMMA cement ma hope o ka mālama ʻana i nā mokulele coronal a sagittal.
ʻIke pinepine ʻia nā metastases Vertebral i ka umauma, prostate, lung, thyroid, kidney cells, bladder, a me melanoma, me ka haʻahaʻa haʻahaʻa o nā metastases skeletal mai 5 a 20% i ka maʻi pancreatic [6,7].ʻOi aku ka liʻiliʻi o ke komo ʻana o ka cervical i ka maʻi maʻi pancreatic, me ʻehā mau hihia i hōʻike ʻia ma ka palapala, ʻoi aku ka pili me C2 [8-11].ʻO ke komo ʻana o ka spinal he asymptomatic, akā i ka hui pū ʻana me nā haʻihaʻi, hiki iā ia ke alakaʻi i ka ʻeha ʻole a me ka paʻakikī e paʻakikī ke hoʻokele me nā hana conservative a hiki ke predispose i ka mea maʻi i ka hoʻopili ʻana i ka spinal cord.No laila, he koho ka vertebroplasty no ka hoʻokūpaʻa ʻana o ka spinal a pili pū me ka hoʻomaha ʻeha ma mua o 80% o nā maʻi e hana nei i kēia kaʻina hana [12].
ʻOiai hiki ke hoʻokō maikaʻi ʻia ke kaʻina hana ma ka pae C2, hoʻokumu ka anatomy paʻakikī i nā pilikia ʻenehana a hiki ke alakaʻi i nā pilikia.Nui nā hale neurovascular e pili ana i ka C2, no ka mea, aia i mua o ka pharynx a me ka larynx, ma ka ʻaoʻao o ka carotid space, posterolateral i ke aʻalolo vertebral a me ke aʻalolo cervical, a ma hope o ka sac [13].I kēia manawa, hoʻohana ʻia nā ʻano ʻehā i PVP: anterolateral, posterolateral, transoral, a me ka unuhi.Hoʻohana pinepine ʻia ka anterolateral ma ke kūlana kupapaʻu a koi aku i ka hyperextension o ke poʻo e hoʻokiʻekiʻe i ka maʻi a hoʻomaʻamaʻa i ke komo ʻana iā C2.No laila, ʻaʻole kūpono kēia ʻenehana i nā poʻe maʻi ʻaʻole hiki ke mālama i ka hyperextension poʻo.Holo ka nila i loko o ka parapharyngeal, retropharyngeal a me prevertebral space a me ka hoʻolālā ʻana o ka ʻaoʻao posterolateral o ka sheath carotid artery e hoʻohana pono ʻia me ka lima.Me kēia ʻenehana, hiki ke hōʻino i ke aʻa vertebral, carotid artery, jugular vein, submandibular gland, oropharyngeal a me IX, X a me XI cranial nerves [13].ʻO Cerebellar infarction a me C2 neuralgia lua i ka leaka sima ke manaʻo ʻia he mau pilikia [14].ʻAʻole pono ke ala posterolateral i ka anesthesia maʻamau, hiki ke hoʻohana ʻia i nā poʻe maʻi ʻaʻole hiki ke hoʻonui i ka ʻāʻī, a hana maʻamau i ke kūlana supine.Hoʻohele ʻia ka nila ma ka ʻaoʻao o ka cervical hope ma ka ʻaoʻao o mua, cranial a me waena, e hoʻāʻo ana e hoʻopā ʻole i ke aʻaʻa vertebral a me kona ʻōpū.No laila, pili nā hoʻopiʻi me ka hōʻino ʻana i ke aʻa vertebral a me ka spinal cord [15].ʻAʻole paʻakikī loa ke komo ʻana i ka transoral a pili i ka hoʻokomo ʻana i kahi nila i loko o ka paia pharyngeal a me ka hakahaka pharyngeal.Ma waho aʻe o ka pōʻino kūpono i nā aʻa vertebral, pili kēia ʻano me ka nui o ka pilikia o ka maʻi a me nā pilikia e like me ka pharyngeal abscesses a me ka maningitis.Pono pū kēia ala i ka anesthesia āpau a me ka intubation [13,15].Me ke komo ʻana i ka ʻaoʻao, hoʻokomo ʻia ka nila i loko o ka wahi kūpono ma waena o nā sheaths o ke aʻa carotid a me ka ʻāʻī vertebral lateral i ke kiʻekiʻe o C1-C3, ʻoiai ke kiʻekiʻe o ka pōʻino o nā moku nui [13].ʻO ka hoʻopiʻi ʻana o kēlā me kēia ala ʻo ia ka leakage o ka sima iwi, hiki ke alakaʻi i ka paʻi ʻana o ke kuamoʻo a i ʻole nā ​​aʻa aʻalolo [16].
Ua ʻike ʻia ʻo ka hoʻohana ʻana i ka nila curved i kēia kūlana he mau mea maikaʻi loa, me ka hoʻonui ʻana i ka hiki ke komo a me ka maneuverability o ka nila.Hāʻawi ka nila curved i: ka hiki ke koho i nā ʻāpana like ʻole o ke kino vertebral, ʻoi aku ka hilinaʻi o ka waena waena, hoʻemi ʻia ka manawa kaʻina hana, hoʻemi ʻia ka nui o ka leakage cement, a hoʻemi i ka manawa fluoroscopy [4,5].Ma muli o kā mākou loiloi o ka palapala, ʻaʻole i hōʻike ʻia ka hoʻohana ʻana i nā nila curved i ka spine cervical, a ma nā hihia ma luna, ua hoʻohana ʻia nā nila pololei no ka vertebroplasty posterolateral ma ka pae C2 [15,17-19].Hāʻawi ʻia i ke anatomy paʻakikī o ka ʻāpana ʻāʻī, ʻoi aku ka maikaʻi o ka hoʻonui ʻia ʻana o ka neʻe ʻana o ka nila curved.E like me ka mea i hōʻike ʻia i kā mākou hihia, ua hana ʻia ka hana ma kahi kūlana ʻaoʻao ʻoluʻolu a hoʻololi mākou i ke kūlana o ka nila e hoʻopiha i kekahi mau ʻāpana o ka lesion.Ma kahi hōʻike hihia hou, Shah et al.Ua ʻike maoli ʻia ka nila curved i waiho ʻia ma hope o ka balloon kyphoplasty, e hōʻike ana i kahi pilikia o ka nila curved: hiki i ke ʻano o ka nila ke hoʻomaʻamaʻa i kona wehe ʻana [20].
Ma kēia pōʻaiapili, hōʻike mākou i ka maikaʻi o ka mālama ʻana i nā haʻihaʻi pathological paʻa ʻole o ke kino vertebral C2 me ka hoʻohana ʻana i ka PVP posterolateral me ka nila curved a me ka intermittent CT fluoroscopy, ka hopena i ka hoʻopaʻa ʻana a me ka hoʻomaikaʻi ʻana i ka ʻeha.He mea maika'i ka 'enehana curved needle: hiki iā mākou ke hō'ea i ka lesion mai kahi ala posterolateral palekana a hiki iā mākou ke ho'ohuli hou i ka nila i nā mea a pau o ka lesion a ho'opiha pono i ka lesion me PMMA cement.Manaʻo mākou hiki i kēia ʻenehana ke kaupalena i ka hoʻohana ʻana i ka anesthesia i koi ʻia no ke komo ʻana i ka transoropharyngeal a pale i nā hoʻopiʻi neurovascular e pili ana me nā ala mua a me ka ʻaoʻao.
Nā Kumuhana Kanaka: Ua hāʻawi a ʻaʻole i hāʻawi ʻae nā mea a pau i komo i kēia haʻawina.Nā Kū'ē o ka hoihoi: E like me ka ICMJE Uniform Disclosure Form, hōʻike nā mea kākau a pau i kēia mau mea: Uku / ʻIke lawelawe: Hōʻike nā mea kākau a pau ʻaʻole lākou i loaʻa ke kākoʻo kālā mai kekahi hui no ka hana i waiho ʻia.Nā Pili Waiwai: Hōʻike nā mea kākau a pau ʻaʻole lākou i kēia manawa a i ʻole i loko o nā makahiki ʻekolu i hala aku nei i loaʻa nā pilina kālā me kekahi hui e makemake paha i ka hana i waiho ʻia.Nā Pili ʻē aʻe: Hōʻike nā mea kākau āpau ʻaʻohe pilina a i ʻole nā ​​​​hana ʻē aʻe e pili ana i ka hana i waiho ʻia.
Swarnkar A, Zane S, Christie O, et al.(Mei 29, 2022) ʻO Vertebroplasty no nā haʻihaʻi C2 pathological: kahi hihia lapaʻau kūʻokoʻa e hoʻohana ana i ka ʻenehana curved needle.Laau 14(5): e25463.doi:10.7759/cureus.25463
© Kuleana kope 2022 Svarnkar et al.He ʻatikala wehe ʻia kēia i hāʻawi ʻia ma lalo o nā ʻōlelo o ka Creative Commons Attribution License CC-BY 4.0.Ua ʻae ʻia ka hoʻohana palena ʻole, ka hāʻawi ʻana, a me ka hana hou ʻana ma kekahi ʻano, inā ʻae ʻia ka mea kākau kumu a me ke kumu.
He ʻatikala hiki ke wehe ʻia kēia ma lalo o ka Creative Commons Attribution License, e ʻae ana i ka hoʻohana ʻole ʻia, ka hāʻawi ʻana, a me ka hana hou ʻana ma kekahi ʻano, ke hāʻawi ʻia ka mea kākau a me ke kumu.
Hōʻike ka Panel A i nā ʻokoʻa like ʻole a me nā cortical irregularities (nā pua) ma ka ʻaoʻao mua ʻākau o ke kino vertebral C2.Asymmetric hoʻonui o ka hui atlantoaxial akau a me ka cortical irregularity ma C2 (mānoanoa pua, B).ʻO kēia, me ka ʻike o ka nui ma ka ʻaoʻao ʻākau o C2, e hōʻike ana i kahi haki pathological.
Nā kiʻi computed tomography (CT) e hōʻike ana i nā kikoʻī o ke kaʻina hana.A) I ka hoʻomaka ʻana, ua hoʻokomo ʻia kahi cannula waho 11 mai ke ala ʻaoʻao posterolateral i hoʻolālā ʻia.B) Ka hoʻokomo ʻana i kahi nila curved (pua pālua) ma o ka cannula (pua hoʻokahi) i loko o ka lesion.Hoʻokomo ʻia ka piko o ka nila i lalo a ʻoi aku ka waena.C) Ua hoʻokomo ʻia ka sima Polymethyl methacrylate (PMMA) i lalo o ka ʻeha.D) Hoʻihoʻi ʻia ka nila i kulou a hoʻokomo hou ʻia i loko o ka ʻaoʻao medial kiʻekiʻe, a laila hoʻokomo ʻia ka sima PMMA.E) a me F) hōʻike i ka māhele ʻana o ka PMMA cement ma hope o ka mālama ʻana i nā mokulele coronal a sagittal.
ʻO Scholarly Impact Quotient™ (SIQ™) kā mākou kaʻina loiloi loiloi loiloi ma hope o ka paʻi ʻana.E ʻike hou aku ma aneʻi.
Na kēia loulou e lawe iā ʻoe i kahi pūnaewele ʻaoʻao ʻekolu ʻaʻole pili me Cureus, Inc. E ʻoluʻolu e hoʻomaopopo ʻaʻole kuleana ʻo Cureus no nā ʻike a i ʻole nā ​​​​hana i loaʻa i kā mākou hoa a i ʻole nā ​​​​wahi pili.
ʻO Scholarly Impact Quotient™ (SIQ™) kā mākou kaʻina loiloi loiloi loiloi ma hope o ka paʻi ʻana.Loiloi ʻo SIQ™ i ke koʻikoʻi a me ka maikaʻi o nā ʻatikala e hoʻohana ana i ka naʻauao hui o ke kaiāulu Cureus holoʻokoʻa.Paipai ʻia nā mea hoʻohana a pau e hāʻawi i ka SIQ™ o kekahi ʻatikala i paʻi ʻia.(ʻAʻole hiki i nā mea kākau ke helu i kā lākou mau ʻatikala.)
Pono e mālama ʻia nā helu kiʻekiʻe no nā hana hou maoli i kā lākou mau kula.Pono e noʻonoʻo ʻia kekahi waiwai ma luna o 5 ma luna o ka awelika.ʻOiai hiki i nā mea hoʻohana a pau i hoʻopaʻa inoa ʻia o Cureus ke helu i kekahi ʻatikala i paʻi ʻia, ʻoi aku ke kaumaha o nā manaʻo o ka poʻe loea kumuhana ma mua o nā manaʻo o ka poʻe ʻike ʻole.E hōʻike ʻia ka SIQ™ o kahi ʻatikala ma hope o ka helu ʻana i ʻelua manawa, a e helu hou ʻia me kēlā me kēia helu hou.
ʻO Scholarly Impact Quotient™ (SIQ™) kā mākou kaʻina loiloi loiloi loiloi ma hope o ka paʻi ʻana.Loiloi ʻo SIQ™ i ke koʻikoʻi a me ka maikaʻi o nā ʻatikala e hoʻohana ana i ka naʻauao hui o ke kaiāulu Cureus holoʻokoʻa.Paipai ʻia nā mea hoʻohana a pau e hāʻawi i ka SIQ™ o kekahi ʻatikala i paʻi ʻia.(ʻAʻole hiki i nā mea kākau ke helu i kā lākou mau ʻatikala.)
E ʻoluʻolu, ma ka hana ʻana pēlā ʻae ʻoe e hoʻohui ʻia i kā mākou leka uila leka uila leka uila.