The Comparison of Two Surgical Treatments for Lumbar Stenosis with Degenerative Scoliosis in Six-Year Minimum Follow-Up

2014 ◽  
Vol 14 (11) ◽  
pp. S78
Author(s):  
Liang Yan ◽  
Dingjun Hao ◽  
Baorong He
Keyword(s):  
Lumbar Stenosis ◽  
Degenerative Scoliosis ◽  
Surgical Treatments

scholarly journals Diagnosis, treatment, and misdiagnosis analysis of 28 cases of central nervous system echinococcosis

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Guojia Du ◽  
Yandong Li ◽  
Pan Wu ◽  
Xin Wang ◽  
Riqing Su ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Central Nervous System ◽  
Nervous System ◽  
Clinical Features ◽  
Multiple Organ ◽  
Pathological Examination ◽  
Surgical Removal ◽  
Surgical Treatments

Abstract Background To explore central nervous system (CNS) involvement in this disease, from the perspectives of diagnosis, treatment, and misdiagnosis Methods Twenty-eight patients with CNS echinococcosis were included in this retrospective study, including 18 males (64.3%) and 10 (35.7%) females. The average age of all the patients were 23.5 years (ranged 4–60 years). Twenty-three (23) patients (82.1%) received the first surgical resection in our hospital. Five (5) patients (17.9%) gave up surgical treatment for multiple-organ hydatidosis and previous surgery history at other hospitals, and albendazole was applied for a long-term (3–6 months) adjunct therapy for the 5 patients. The average follow-up time was 8 years. Results For the 28 patients, 23 cases received surgical treatments, and the diagnosis was confirmed by pathological examinations. The diagnosis of 4 cases of brain echinococcosis and 2 cases of spinal cord echinococcosis could not be confirmed, resulting in a misdiagnosis rate of 21.4% (6/28). For the pathological examination, a total of 17 cases were infected with Echinococcus granulosus (including 2 cases of spinal cord echinococcosis), and 6 cases were infected with Echinococcus alveolaris. Conclusion The diagnosis should be specifically considered in endemic regions. The clinical features of CNS hydatidosis were intracranial space-occupying lesions. For the treatment, the surgical removal of cysts should be necessary. In addition, the adjuvant therapy with drug and intraoperative prophylaxis is also suggested. The misdiagnosis may have resulted from atypical clinical features and radiographic manifestations, as well as the accuracy of hydatid immunologic test.

A new surgical technique for the treatment of scaphotrapezial arthritis associated with trapeziometacarpal arthritis: the narrow pseudoarthrosis

2016 ◽  
Vol 41 (7) ◽  
pp. 710-718 ◽  
Author(s):  
M. Rubino ◽  
L. Cavagnaro ◽  
V. Sansone
Keyword(s):  
Simple Technique ◽  
Stage Iv ◽  
Pinch Strength ◽  
Dash Score ◽  
Level Of Evidence ◽  
First Ray ◽  
Excision Arthroplasty ◽  
Surgical Treatments ◽  
New Surgical Technique

We describe a technique for treating Eaton stage IV osteoarthritis of the first ray, which is a development of our previously published technique for treating trapeziometacarpal arthritis. This simple technique is based on a limited resection arthroplasty of the first trapeziometacarpal and the scaphotrapezial joints, with the aim of inducing the formation of a narrow pseudoarthrosis at both sites. A total of 26 consecutive patients were treated for Eaton stage IV arthritis at a mean follow-up of 4.7 years (range 3.2–6.6). There were statistically significant improvements in all clinical parameters: mean appositional and oppositional pinch strength, mean DASH score (65 points pre-operatively to 8.7 points at final follow-up), and in mean visual analogue scale score (8.6 to 0.2 points). Although a larger cohort and a longer follow-up will be necessary to evaluate this new technique fully, these results encourage us to believe that the limited excision arthroplasty of the trapeziometacarpal and scaphotrapezial joints is a viable alternative to the existing surgical treatments for stage IV thumb arthritis. Level of evidence: 4

scholarly journals Intentional Fallers with Complex Pelvic and Acetabular Fractures Do Not have Worse Radiological and Functional Outcomes than Accidental Fallers

2020 ◽  
Author(s):  
Yi-Hsun Yu ◽  
Ying-Chao Chou ◽  
Yung-Heng Hsu ◽  
I-Jung Chen ◽  
Lien-Chung Wei
Keyword(s):  
Functional Outcomes ◽  
Injury Severity ◽  
Adjustment Disorder ◽  
Acetabular Fractures ◽  
Clinical Parameters ◽  
Severe Injuries ◽  
Severity Scores ◽  
Surgical Treatments ◽  
Major Diagnosis

Abstract Background: Individuals who fell from heights of >6 m accidentally or intentionally can suffer from complex pelvic and acetabular fractures. The extent to which an intentional fall correlates with prognosis and outcome after osteosynthesis is unclear. We aimed to investigate the clinical outcomes of fallers with pelvic and acetabular fractures after osteosynthesis and to compare the radiological and functional outcomes between intentional and accidental fallers.Methods: Between 2014 and 2017, individuals who fell from heights of >6 m, developed pelvic and acetabular fractures, survived after resuscitation, and completed surgical treatments were enrolled. The fallers were divided into the intentional and accidental fallers, and their clinical parameters were statistically evaluated and compared.Results: Forty-nine fallers who underwent osteosynthesis for pelvic and acetabular fractures were included. Sixteen patients were intentional fallers, whereas the rest of the patients fell accidentally. All patients who fell intentionally had pre-existing mental disorders, and the major diagnosis was adjustment disorder. The group with intentional fallers had female sex predominance, higher injury and new injury severity scores, and longer hospital stay. However, the early loss of fixation (less than three month) and functional outcomes (6- and 12-month follow-up) did not significantly differ between the intentional and accidental fallers. Conclusions: The intentional fallers with pelvic and acetabular fractures might be accompanied by more severe injuries compared to accidental fallers. However, the radiological and functional outcomes of the intentional fallers after osteosynthesis were not inferior to those of the accidental fallers.

scholarly journals Mid-term Outcome Of Surgical Treatment In Pediatric Patients With Ebstein's Anomaly: A Single-center Cohort Study.

2020 ◽  
Author(s):  
Jia-chen Li ◽  
Xian-chao Jiang ◽  
Si-meng Zhang ◽  
Jin-yang Liu ◽  
Ya-juan Zhang ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Reoperation Rate ◽  
Term Effect ◽  
Ebstein’S Anomaly ◽  
Biventricular Repair ◽  
Ebstein's Anomaly ◽  
Long Term Follow Up ◽  
Surgical Treatments

Abstract Background: Ebstein’s anomaly is a malformation of the tricuspid valve and myopathy of the right ventricle. Surgery is now the main treatment for the defect. To summarize our surgical results and experience based on patients with Ebstein’s anomaly who were under 7 years of age and treated with different surgical treatments.Materials and Methods: From January 2010 to December 2019, 80 patients under 7 years old who were diagnosed of Ebstein’s anomaly and underwent different surgical treatments were consecutively enrolled and followed up in detail. Results: The median age of the 80 patients at the time of surgery was 3.63 years. Sixty-four (80.00%) patients underwent biventricular repair while 13 (16.25%) underwent 1.5-ventricle repair. With the median follow-up 27.50 months, the long-term survival of the total cohort, 1.5-ventricular repair and biventricular repair was 82.35%, 91.67% and 100%, respectively. The long-term freedom from reoperation rate was 97.50%, 92.31% and 98.44%, respectively. Mild, moderate and severe TR before surgery occurred in 6 (7.50%), 18 (22.50%) and 56 (70.00%), respectively. The early outcomes of 78 patients were 65 (83.33%), 11 (14.11%) and 2 (2.56%); the mid-term outcomes of 72 patients were 49 (68.06%), 19 (26.38%) and 4 (5.56%). Both early and long-term valve regurgitation were significantly decreased (p< 0.001) compared with preoperative condition. No more severe regurgitation occurred (p=0.404), though some early mild regurgitation became acceptable moderate regurgitation during long-term follow-up (p=0.036). Compared with Carpentier procedure, cone procedure had better long-term effect, while the effect of whole-valve technique needed more operation and long-term follow-up.Conclusion: The reoperation rate and mid-term mortality of surgical treatment for Ebstein’s anomaly were both low, tricuspid regurgitation was significantly improved during mid-term follow up. Cone procedure had the best mid-term effect among anatomic repair.

Lateral Collateral Ligament Repair for Hallux Metatarsophalangeal Joint Instability in a Collegiate Sumo Wrestler: A Case Report

2021 ◽  
Vol 111 (1) ◽  
Author(s):  
Sadanori Shimizu ◽  
Tetsuya Sato ◽  
Tomohiko Tateishi ◽  
Tsuyoshi Nagase ◽  
Teruhiko Nakagawa ◽  
...  
Keyword(s):  
Athletic Performance ◽  
Joint Instability ◽  
Lateral Collateral Ligament ◽  
Metatarsophalangeal Joint ◽  
Metatarsal Bone ◽  
Burr Hole ◽  
Ligament Repair ◽  
Collateral Ligament ◽  
Surgical Treatments

Although sprains of the hallux metatarsophalangeal (MTP) joint ligaments occur in barefooted martial arts athletes, few studies discuss the surgical treatments for lateral collateral ligament damage. We report herein a case of lateral collateral ligament repair for chronic hallux MTP joint instability. A 21-year-old male collegiate sumo wrestler injured his left hallux by snagging it on a sumo straw bale at 14 years of age. After entering university (4 years after the injury), he could no longer put weight on his foot at the left hallux; his athletic performance deteriorated, and he was referred to our department by his doctor. He had instability in the MTP joint of the left hallux, and magnetic resonance imaging revealed a tear in the attachment of the lateral collateral ligament to the metatarsal bone. Conservative treatment, such as taping, did not improve the symptoms; thus, surgery was performed, which consisted of passing a strong suture attached to the capsular ligament through a burr hole made in the metatarsal bone and fixing it to the burr-hole wall using an anchor. Postoperatively, the patient's joint instability improved, and he returned to competitive wrestling 4 months after surgery. He was able to put weight on his left hallux, and his athletic performance improved. The follow-up period after surgery was 2 years. In competitive sumo wrestling, hallux weakness and joint instability lead to a significant reduction in performance. Thus, ligament repair is an effective treatment for hallux MTP joint instability that cannot be treated by conservative means.

scholarly journals Chondrosarcoma of bone in children and adolescents

2020 ◽  
Vol 14 (4) ◽  
pp. 330-334
Author(s):  
Yoichi Kaneuchi ◽  
Tomohiro Fujiwara ◽  
Yusuke Tsuda ◽  
Shinichirou Yoshida ◽  
Jonathan D. Stevenson ◽  
...  
Keyword(s):  
Children And Adolescents ◽  
Young Patients ◽  
Good Prognosis ◽  
Level Of Evidence ◽  
Biological Behaviour ◽  
Children And Adolescent ◽  
Grade Ii ◽  
Surgical Treatments ◽  
Ray Amputation

Purpose Chondrosarcomas typically present in adults during the fifth to seventh decades and are rare in young patients. The biological behaviour and oncological outcomes may be different in children and adolescents. Methods We retrospectively evaluated the outcomes of all patients with chondrosarcoma of bone who were younger than 18 years of age at the time of diagnosis and were treated at our centre between 1995 and 2018. Results The 15 consecutive patients studied included nine male and six female cases, with a mean age at diagnosis of 13 years (7 to 17). The median follow-up was 117 months (30 to 277). The tumours were primary and secondary in ten and five patients, respectively. The tumours were central in 13 and surface in two patients. The tumour locations were the humerus in five, digits in five, femur in three, radius in one and pelvis in one patient. The histological grades were grade I in seven, grade II in seven and grade III in one patient. The surgical treatments were limb salvage in ten patients and ray amputation in five patients. The surgical margins were wide in eight, marginal in two and intralesional in five patients. All the patients were alive and continuously free of disease at the time of the last follow-up. No patient developed metastases or local recurrence. Conclusion Chondrosarcoma of bone in children and adolescent patients has a very good prognosis and is less aggressive compared with published outcomes in older patients. Level of evidence IV

scholarly journals Therapeutic Strategy of Percutaneous Transforaminal Endoscopic Decompression for Stenosis Associated With Adult Degenerative Scoliosis

2020 ◽  
pp. 219256822095903
Author(s):  
Lin-Yu Jin ◽  
Kun Wang ◽  
Zhen-Dong Lv ◽  
Xin-Jin Su ◽  
Hai-Ying Liu ◽  
...  
Keyword(s):  
Regression Analysis ◽  
Cobb Angle ◽  
Linear Regression Analysis ◽  
Multiple Linear Regression Analysis ◽  
Lumbar Stenosis ◽  
Degenerative Scoliosis ◽  
Adult Degenerative Scoliosis ◽  
Lateral Subluxation ◽  
The Mean ◽  
Transforaminal Endoscopic Surgery

Study Design: A retrospective study. Objective: To investigate the effects of percutaneous transforaminal endoscopic decompression (PTED) for lumbar stenosis associated with adult degenerative scoliosis and to analyze the correlation between preoperative radiological parameters and postoperative surgical outcomes. Methods: Two years of retrospective data was collected from 46 patients with lumbar stenosis associated with adult degenerative scoliosis who underwent PTED. The visual analog scale (VAS), Oswestry Disability Index, and modified MacNab criteria were used to evaluate the clinical outcomes. Multiple linear regression analysis was used to analyze the correlation between radiological parameters and surgical outcomes. Results: The mean age of the 33 female and 13 male patients was 73.5 ± 8.1 years. The mean follow-up was 27.6 ± 3.5 months (range from 24 to 36). The average coronal Cobb angle was 24.5 ± 8.2°. There were better outcomes of the VAS for leg pain and Oswestry Disability Index after surgery. Based on the MacNab criteria, excellent or good outcomes were noted in 84.78% of patients. Multiple linear regression analysis showed that Cobb angle and lateral olisthy may be the predictors for low back pain. Conclusion: Transforaminal endoscopic surgery may be an effective and safe method for geriatric patients with lumbar stenosis associated with degenerative scoliosis. The predictive factors of clinical outcomes were severe Cobb angle and high degree lateral subluxation. Transforaminal endoscopic surgery may not be recommended for patients with Cobb angle larger than 30° combined with lateral subluxation.

Partial trapeziectomy and pyrocarbon interpositional arthroplasty for trapeziometacarpal osteoarthritis: minimum 8-year follow-up

2020 ◽  
Vol 45 (5) ◽  
pp. 472-476 ◽  
Author(s):  
Francesco Smeraglia ◽  
Sergi Barrera-Ochoa ◽  
Gerardo Mendez-Sanchez ◽  
Morena A. Basso ◽  
Giovanni Balato ◽  
...  
Keyword(s):  
Young Patients ◽  
Hand Surgery ◽  
Dash Score ◽  
Level Of Evidence ◽  
Interpositional Arthroplasty ◽  
Trapeziometacarpal Osteoarthritis ◽  
Select Group ◽  
Trapeziometacarpal Joint Osteoarthritis ◽  
Surgical Treatments

We undertook a retrospective study to evaluate minimal 8-year outcomes of 46 trapeziometacarpal joints (46 patients) treated with pyrocarbon implant arthroplasty after partial trapeziectomy for trapeziometacarpal joint osteoarthritis in two different hand surgery units. The mean follow-up interval was 9.5 years (average 113 months with a range 97–144 months). The study showed that pyrocarbon interpositional arthroplasty provided pain relief and high patient satisfaction. All patients experienced a reduction in the DASH score, with an average change of 30 points. The visual analogue scale score, the Kapandji score, and key pinch also showed remarkable improvement. The PyroDisk implant exhibited good longevity, with good implant survival. A review of the literature revealed that the functional outcomes after implant surgery are not superior to more common techniques, such as trapeziectomy with or without ligamentoplasty. Therefore, this is a reliable surgery but may not have added benefits over simpler surgical treatments. This implant could have a role, perhaps in a select group of young patients, as a time-procuring procedure. Level of evidence: IV

Sign in / Sign up

Export Citation Format

Share Document