Translaminar Approach for Treatment of Hidden Zone Foraminal Lumbar Disc Herniations: Surgical Technique and Preoperative Selection of Patients with Long-Term Follow-Up

AbstractThe interest of professional medical societies in research about outcomes, mixed with the recent accessibility to management of data on the internet, has moved many societies to create national databases or registries for their specialty. In societies with procedure-based specialties such as surgery, these databases will help with the care of patients by predicting prognosis, defining risk-factors, and aiding with the selection of patients who are the best candidates for these procedures. These databases eventually will also help to establish standards of care. The latter is rapidly growing in importance as governments attempt to create “pay-for-performance” programs in many of the surgical specialties. It is essential to create a database from which a specialty can provide accurate data and standards to its members, its patients, and third parties, such as regulatory bodies and agencies of re-numeration. Unfortunately, surgeons often only care for their patients in the short-term peri-operative period, typically lasting weeks to months; and therefore, the ability of surgeons to create databases with long-term follow-up has been limited. The introduction of “personal health information” into a surgical database, with the intention of linking with other societies or national databases that have long-term follow-up, can remedy this weakness. This article describes the investigation by one surgical society into the available national registries of death and examines their accuracy, accessibility, cost, and their suitability in respect to the goals of that society. The information gathered, the comparisons outlined, and the processes used to determine the best combination of indices of death for this society should be translatable and hopefully useful for other societies and registries who wish to empower their databases with long-term national data about mortality.

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Urinary artificial sphincter

Urologia Journal ◽

10.1177/039156039506200308 ◽

1995 ◽

Vol 62 (3) ◽

pp. 356-361

Author(s):

R. Carone ◽

E. Vestita

Keyword(s):

Artificial Urinary Sphincter ◽

Urinary Continence ◽

Artificial Sphincter ◽

Inflatable Cuff ◽

Urinary Sphincter ◽

Long Term Follow Up ◽

Selection Of Patients ◽

Selection Of

The artificial sphincter is a well-accepted and successful method for restoring urinary continence in selected patients. The patient who will benefit from this device is one who has a poorly or non-functioning urethral sphincter mechanism. The site of inflatable cuff placement is around the bulbous urethral or bladder neck (children, women). The complications currently associated with artificial urinary sphincter are cuff erosion, infection, mechanical malfunction, recurrent or persistent incontinence, retention, hematoma. In order to get the best from the device and to justify the mechanical and infective risks, the accurate selection of patients and the identification of high risk categories is most important. It is essential that ali patients should have regular long-term follow-up after surgery.

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Long-term follow-up results of surgically treated patients with foraminal and far lateral disc herniations

British Journal of Neurosurgery ◽

10.1080/02688697.2021.1874293 ◽

2021 ◽

pp. 1-8

Author(s):

Huseyin Dogu ◽

Nuriye Guzin Ozdemir ◽

Hakan Yilmaz ◽

Ibrahim Burak Atci

Keyword(s):

Long Term Follow Up ◽

Disc Herniations ◽

Far Lateral

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Active surveillance in patients with a PSA >10 ng/mL

Canadian Urological Association Journal ◽

10.5489/cuaj.2121 ◽

2014 ◽

Vol 8 (9-10) ◽

pp. 702 ◽

Cited By ~ 6

Author(s):

Paul Toren ◽

Lih-Ming Wong ◽

Narhari Timilshina ◽

Shabbir Alibhai ◽

John Trachtenberg ◽

...

Keyword(s):

Active Surveillance ◽

Specific Antigen ◽

Sufficient Evidence ◽

Hazard Ratios ◽

Diagnostic Biopsy ◽

Selection Of Patients ◽

Baseline Psa ◽

Selection Of

Introduction: The use of prostate-specific antigen (PSA) in active surveillance (AS) for prostate cancer is controversial. Some consider it an unreliable marker and others as sufficient evidence to exclude patients from AS. We analyzed our cohort of AS patients with a PSA over 10 ng/mL.Methods: We included patients who had clinical T1c–T2a Gleason ≤6 disease, and ≤3 positive cores with ≤50% core involvement at diagnostic biopsy and ≥2 total biopsies. Patients were divided into 3 groups: (1) those with baseline PSA >10 ng/mL, (2) those with a PSA rise >10 ng/mL during follow-up; and (3) those with a PSA <10 ng/mL throughout AS. Adverse histology was defined as biopsy parameters exceeding the entry criteria limits. We further compared this cohort to a concurrent institutional cohort with equal biopsy parameters treated with immediate radical prostatectomy.Results: Our cohort included 698 patients with a median follow-up of 46.2 months. In total, 82 patients had a baseline PSA >10 ng/mL and 157 had a PSA rise >10 ng/mL during surveillance. No difference in adverse histology incidence was detected between groups (p = 0.3). Patients with a PSA greater than 10 were older and had higher prostate volumes. Hazard ratios for groups with a PSA >10 were protective against adverse histology. Larger prostate volume and minimal core involvement appear as factors related to this successful selection of patients to be treated with AS.Conclusion: These results suggest that a strict cut-off PSA value for all AS patients is unwarranted and may result in overtreatment. Though lacking long-term data and validation, AS appears safe in select patients with a PSA >10 ng/mL and low volume Gleason 6 disease.

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Internal Valvuloplasty: Surgical Technique, Valve Location, Indication, Quantitative Assessment, and Long-Term Follow-Up

Textbook of Angiology ◽

10.1007/978-1-4612-1190-7_84 ◽

2000 ◽

pp. 1073-1081

Author(s):

V. S. Sottiurai

Keyword(s):

Surgical Technique ◽

Quantitative Assessment ◽

Long Term Follow Up

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Adductor Spastic Dysphonia: 1 1/2 Years after Recurrent Laryngeal Nerve Resection

Annals of Otology Rhinology & Laryngology ◽

10.1177/000348948109000102 ◽

1981 ◽

Vol 90 (1) ◽

pp. 2-6 ◽

Cited By ~ 18

Author(s):

Arnold E. Aronson ◽

Lawrence W. DeSanto

Keyword(s):

Recurrent Laryngeal Nerve ◽

Laryngeal Nerve ◽

Physical Effort ◽

Patients Âgés ◽

Reduced Volume ◽

Follow Up Studies ◽

Long Term Follow Up ◽

Selection Of

After recurrent laryngeal nerve resection for adductor spastic dysphonia, the voices of 37 patients (ages 39 to 79 years) were assessed 24 hours, 1 month, 6 months, and 1 year after surgery, and those of 33 patients up to 1 1/2 years after surgery. By 24 hours after surgery, 97% of patients had improved and 3% had failed; by 1 month, 97% were still improved while 3% had failed; by 6 months, 92% had maintained improvement while 8% had failed; by 1 year, 68% were still improved but 32% had failed; and by 1 1/2 years, 61% were still improved while 39% had failed. The patients whose voices improved varied from one another in both type and degree of residual dysphonia. The typical postsurgical voice was free of spasm, with some breathiness, hoarseness, and reduced volume being present. The voices of some patients approached normalcy. To most patients, relief from the physical effort to phonate was as important as the improved voice. Continued long-term follow-up studies and careful, collaborative selection of surgical candidates are needed.

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Surgical management of recurrent disc herniations with microdiscectomy and long-term results on life quality: Detailed analysis of 70 cases

Journal of Neurosciences in Rural Practice ◽

10.4103/0976-3147.165426 ◽

2016 ◽

Vol 7 (01) ◽

pp. 87-90 ◽

Cited By ~ 3

Author(s):

Serdal Albayrak ◽

Sait Ozturk ◽

Emre Durdag ◽

Ömer Ayden

Keyword(s):

Quality Of Life ◽

Facet Joint ◽

Lumbar Disc ◽

Life Quality ◽

Early Period ◽

Long Term Results ◽

Disc Herniations

ABSTRACT Background: Aim of this paper is to recall the surgical technique used in the recurrent lumbar disc herniations (LDHs) and to share our experiences. Materials and Methods: Out of series of 1115 patients who underwent operations for LDH between 2006 and 2013, 70 patients underwent re-operations, which were included in this study. During surgery, lateral decompression performed over the medial facet joint to the superior facet joint border was seen after widening the laminectomy defect, and microdiscectomy was performed. The demographic findings of the patients, their complaints in admission to hospital, the level of operation, the condition of dural injury, the first admission in the prospective analysis, and their quality of life were evaluated through the Oswestry scoring during their postoperative 1st, 3rd, 6th-month and 1st, 3rd, 5th and 7th-year follow-up. In the statical analysis, Friedman test was performed for the comparison of the Oswestry scores and Siegel Castellan test was used for the paired nonparametrical data. A P < 0.05 was considered statistically significant. Results: Considering the Oswestry Index during the follow-ups, the values in the postoperative early period and follow-ups were seen to be significantly lower than those at the time of admission to hospital (P < 0.05). None of the patients, who re-operated by microdiscectomy, presented with iatrogenic instability in 7 years follow-up period. Conclusion: Microdiscectomy performed through a proper technique in the re-operation of recurrent disc herniations eases complaints and improves the quality of life. Long-term follow-ups are required for more accurate results.

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