An unusual complication of Cloward's procedure presenting to the otolaryngologist

1998 ◽  
Vol 112 (11) ◽  
pp. 1087-1089 ◽  
Author(s):  
Salil B. Nair ◽  
Liam M. Flood ◽  
Fred Nath
Keyword(s):  
Computed Tomography ◽  
Ct Scan ◽  
Conservative Management ◽  
Cervical Vertebrae ◽  
Csf Leak ◽  
Unusual Complication ◽  
Cervical Surgery ◽  
Anterior Cervical Surgery

AbstractWe present the case of a 51-year-old lady who developed a CSF leak following a Cloward's procedure (anterior cervical surgery with fusion), which settled with conservative management. Two months following the surgery she was assessed by an otolaryngologist for persistent dysphagia and a swelling in the anterior triangle of her neck. A computed tomography (CT) scan identified a fluid-filled mass displacing the trachea and communicating with the anterior cervical vertebrae, thus confirming th e persistence of a CSF leak.

scholarly journals Conservative Management of Segmental Infarction of the Greater Omentum: A Case Report and Review of Literature

2010 ◽  
Vol 2010 ◽  
pp. 1-4 ◽  
Author(s):  
Ramawad Soobrah ◽  
Mohammad Badran ◽  
Simon G. Smith
Keyword(s):  
Computed Tomography ◽  
Abdominal Pain ◽  
Case Report ◽  
Ct Scan ◽  
Conservative Management ◽  
Acute Abdominal Pain ◽  
Correct Diagnosis ◽  
Greater Omentum ◽  
Review Of Literature ◽  
Segmental Infarction

Segmental omental infarction (SOI) is a rare cause of acute abdominal pain. Depending on the site of infarction, it mimics conditions like appendicitis, cholecystitis, and diverticulitis. Before the widespread use of Computed Tomography (CT), the diagnosis was usually made intraoperatively. SOI produces characteristic radiological appearances on CT scan; hence, correct diagnosis using this form of imaging may prevent unnecessary surgery. We present the case of a young woman who was treated conservatively after accurate radiological diagnosis.

scholarly journals Treatment for early postoperative esophageal fistula complicated with anterior cervical surgery

2017 ◽  
Vol 25 (1) ◽  
pp. 230949901668441 ◽  
Author(s):  
Haifeng Yuan ◽  
Huiqiang Ding ◽  
Lihong Hu ◽  
Zorica Buser ◽  
Haoning Zhao ◽  
...  
Keyword(s):  
Cervical Vertebrae ◽  
Cervical Vertebra ◽  
Spinal Injuries ◽  
Therapeutic Effects ◽  
Esophageal Fistula ◽  
Open Drainage ◽  
Cervical Surgery ◽  
Gastric Tubes ◽  
Anterior Cervical Surgery ◽  
Postoperative Feeding

Object: To investigate the efficacy of debridement, open drainage, and early feeding to treat early esophageal fistula complicated with anterior cervical surgery. Methods: Retrospective analysis was conducted on data from 3154 patients who had undergone anterior cervical surgeries for cervical vertebra diseases between January 2006 and January 2013, in which eight patients had esophageal fistula with five males and three females. Four patients had cervical spinal injuries and four patients had cervical spondylosis. All of whom had postoperative esophageal fistulas and underwent debridement and drainage. The wounds were left open for natural drainage. No drainage devices were placed in surgical sites, and no gastric tubes were placed after surgeries. Such normal food as rice balls but not liquid or semiliquid diet was recommended. Local pressurization was conducted with fists during feeding to prevent food overflowing from orificium fistulae. Results: Healed esophageal fistulas were achieved in all of the patients after 1–2 weeks treatment. There weren’t recurrent esophageal fistulas and delayed infection found during 2–5 years follow-up. Good swallowing functions and stable cervical vertebrae were achieved in all of the patients. The satisfactory therapeutic effects were achieved in patients with previous neck diseases. Frankel classifications were increased by 1–2 grades in patients with cervical spinal injuries. JOA scores were increased from 9.5 before surgery to 15.5 after surgery in patients with cervical vertebra diseases. Conclusions: Early postoperative esophageal fistula complication after anterior cervical surgery can successfully be treated by debridement, drainage without gastric tube, and with early oral postoperative feeding but without fluids.

Multiple Cervical Vertebral Malformations in a 21-Week-Old Kitten

2019 ◽  
Vol 55 (5) ◽  
pp. 256-260
Author(s):  
Barnaby Luke Dean ◽  
Caroline Smith ◽  
Francois-Xavier Liebel ◽  
Christopher Warren-Smith
Keyword(s):  
Computed Tomography ◽  
Conservative Management ◽  
Vertebral Column ◽  
Cervical Vertebrae ◽  
Acute Onset ◽  
Neurologic Examination ◽  
First Report ◽  
History Of

ABSTRACT A 21 wk old, 2 kg neutered male domestic shorthair presented with a 24 hr history of acute-onset severe nonambulatory tetraparesis with no known inciting cause. Neurologic examination revealed a C1–C5 myelopathy. Computed tomography of the vertebral column and thorax revealed incomplete ossification of the C2 and C3 vertebrae and lung bullae. After 4 wk of conservative management, the client reported a return to normal ambulation with reluctance to jump up. To the authors' knowledge, this is the first report of a feline case of incomplete ossification of cervical vertebrae. The cervical malformations outlined in this report are differentials to consider in cases of acute-onset tetraparesis in cats.

scholarly journals Is Obtaining a Computed Tomography Prior to Offering Anterior Cervical Disc Arthroplasty (ACDA) Necessary? The Results of Surgeons Predicting ACDA Candidacy From Magnetic Resonance Imagings and X-Rays Alone

Neurosurgery ◽  
2019 ◽  
Vol 66 (Supplement_1) ◽  
Author(s):  
Joseph A Osorio ◽  
Griffin R Baum ◽  
Simon Morr ◽  
Richard P Menger ◽  
Patrick Reid ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Magnetic Resonance ◽  
Ct Scan ◽  
Ct Scans ◽  
Cervical Disc ◽  
Cervical Disc Arthroplasty ◽  
X Rays ◽  
Disc Arthroplasty ◽  
X Ray ◽  
Cervical Surgery

Abstract INTRODUCTION Moderate/severe cervical spondylosis, and the presence of ossification of the posterior longitudinal ligament (OPLL) are contraindications to anterior cervical disc arthroplasty (ACDA). Although computed tomography (CT) is the gold standard for identifying these conditions, some surgeons proceed with ACDA surgery with only an magnetic resonance imaging (MRI) and plain radiographs. We sought to determine if an X-ray and MRI alone were adequate for assessing bridging osteophytes and OPLL, when considering ACDA candidates. METHODS A total of 121 cervical levels in 86 consecutive anterior cervical surgery candidates were included. None had prior cervical surgery, all were being considered for ADCA prior to obtaining a CT scan, and all were being considered for 1 to 2 levels of pathology. A total of 10 spine surgeons rated X-rays and MRIs to determine if the patients were suitable candidates for ACDA. Analysis was performed using Fleiss’ Kappa and sensitivity and specificity. RESULTS A total of 86 patients were included, CT scans changed the initial planned arthroplasty (ACDA) to fusion (ACDF) in 17% of cases (15 of 86) because of contraindications that included significant bridging osteophytes and/or OPLL. A total of 10 surgeons rated scans from 86 patients over 2 separate sessions using X-ray and MRIs. Intrarater reliability (k = 0.44), and inter-rater reliability (k = 0.24) demonstrated weak predictability in identifying which patients would be found on CT to have significant bridging osteophytes and/or OPLL. Raters were found to have diagnostic sensitivity and specificity of 69.59% and 52.51% respectively. An ACDA candidate was rated by a majority of surgeon raters for ACDA, although the CT scan found OPLL vs retrovertebral osteophyte, making this a contraindication to ACDA. CONCLUSION CT scans changed operative management in 17% of ACDA-planned cases. Spine surgeon assessments of X-ray and MRIs alone for ACDA were highly unreliable with significantly weak intra-rater and inter-rater reliability, further emphasizing the need for obtaining CT scans on all ACDA candidates.

Requesting physicians’ knowledge of X-radiation exposure from computed tomography scan examinations: A case study of two Nigerian tertiary hospitals

2020 ◽  
Vol 3 ◽  
pp. 36-39
Author(s):  
Samson O. Paulinus ◽  
Benjamin E. Udoh ◽  
Bassey E. Archibong ◽  
Akpama E. Egong ◽  
Akwa E. Erim ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Ionizing Radiation ◽  
Ct Scan ◽  
Radiation Exposure ◽  
Work Experience ◽  
Radiation Risk ◽  
Radiological Protection ◽  
X Ray ◽  
Tertiary Hospitals ◽  
Medical Exposure

Objective: Physicians who often request for computed tomography (CT) scan examinations are expected to have sound knowledge of radiation exposure (risks) to patients in line with the basic radiation protection principles according to the International Commission on Radiological Protection (ICRP), the Protection of Persons Undergoing Medical Exposure or Treatment (POPUMET), and the Ionizing Radiation (Medical Exposure) Regulations (IR(ME)R). The aim is to assess the level of requesting physicians’ knowledge of ionizing radiation from CT scan examinations in two Nigerian tertiary hospitals. Materials and Methods: An 18-item-based questionnaire was distributed to 141 practicing medical doctors, excluding radiologists with work experience from 0 to >16 years in two major teaching hospitals in Nigeria with a return rate of 69%, using a voluntary sampling technique. Results: The results showed that 25% of the respondents identified CT thorax, abdomen, and pelvis examination as having the highest radiation risk, while 22% said that it was a conventional chest X-ray. Furthermore, 14% concluded that CT head had the highest risk while 9% gave their answer to be conventional abdominal X-ray. In addition, 17% inferred that magnetic resonance imaging had the highest radiation risk while 11% had no idea. Furthermore, 25.5% of the respondents have had training on ionizing radiation from CT scan examinations while 74.5% had no training. Majority (90%) of the respondents were not aware of the ICRP guidelines for requesting investigations with very little (<3%) or no knowledge (0%) on the POPUMET and the IR(ME)R respectively. Conclusion: There is low level of knowledge of ionizing radiation from CT scan examinations among requesting physicians in the study locations.

Long-term outcomes of lumbar microdiscectomy in the pediatric population: a large single-institution case series

2019 ◽  
Vol 24 (5) ◽  
pp. 549-557
Author(s):  
Malia McAvoy ◽  
Heather J. McCrea ◽  
Vamsidhar Chavakula ◽  
Hoon Choi ◽  
Wenya Linda Bi ◽  
...  
Keyword(s):  
Conservative Management ◽  
Functional Outcomes ◽  
Pediatric Patients ◽  
Clinical Presentation ◽  
Case Series ◽  
Csf Leak ◽  
Single Institution ◽  
The Mean

OBJECTIVEFew studies describe long-term functional outcomes of pediatric patients who have undergone lumbar microdiscectomy (LMD) because of the rarity of pediatric disc herniation and the short follow-up periods. The authors analyzed risk factors, clinical presentation, complications, and functional outcomes of a single-institution series of LMD patients over a 19-year period.METHODSA retrospective case series was conducted of pediatric LMD patients at a large pediatric academic hospital from 1998 to 2017. The authors examined premorbid risk factors, clinical presentation, physical examination findings, type and duration of conservative management, indications for surgical intervention, complications, and postoperative outcomes.RESULTSOver the 19-year study period, 199 patients underwent LMD at the authors’ institution. The mean age at presentation was 16.0 years (range 12–18 years), and 55.8% were female. Of these patients, 70.9% participated in competitive sports, and among those who did not play sports, 65.0% had a body mass index greater than 25 kg/m2. Prior to surgery, conservative management had failed in 98.0% of the patients. Only 3 patients (1.5%) presented with cauda equina syndrome requiring emergent microdiscectomy. Complications included 4 cases of postoperative CSF leak (2.0%), 1 case of a noted intraoperative CSF leak, and 3 cases of wound infection (1.5%). At the first postoperative follow-up appointment, minimal or no pain was reported by 93.3% of patients. The mean time to return to sports was 9.8 weeks. During a mean follow-up duration of 8.2 years, 72.9% of patients did not present again after routine postoperative appointments. The total risk of reoperation was a rate of 7.5% (3.5% of patients underwent reoperation for the same level; 4.5% underwent adjacent-level decompression, and one patient [0.5%] ultimately underwent a fusion).CONCLUSIONSMicrodiscectomy is a safe and effective treatment for long-term relief of pain and return to daily activities among pediatric patients with symptomatic lumbar disc disease in whom conservative management has failed.

scholarly journals A rare case of right-sided varicocele in right renal tumor in the absence of venous thrombosis and IVC compression

2020 ◽  
Vol 26 (1) ◽  
Author(s):  
Priyabrata Adhikari ◽  
Siddalingeshwar I. Neeli ◽  
Shyam Mohan
Keyword(s):  
Computed Tomography ◽  
Ct Scan ◽  
Renal Vein ◽  
Renal Tumor ◽  
Vena Cava ◽  
Signs And Symptoms ◽  
Spermatic Vein ◽  
Careful Study ◽  
Rare Presentation ◽  
Grade 3

Abstract Background The presence of unilateral right-sided varicocele hints at a serious retroperitoneal disease such as renal cell neoplasm. Such tumors are usually associated with a thrombus in renal vein or spermatic vein. We report a rare presentation of right-sided renal tumor causing right-sided varicocele in the absence of thrombus in renal vein and spermatic vein but due to an anomalous vein draining from the tumor into the spermatic vein as demonstrated by computed tomography angiogram. Case presentation A 54-yr-old hypertensive male presented with unilateral grade 3 right-sided varicocele and no other signs and symptoms. Ultrasound examination of his abdomen showed the presence of a mass lesion in the lower pole of right kidney. Computed tomography confirmed the presence of right renal mass, absence of thrombus in right renal vein or inferior vena cava. The angiographic phase of CT scan showed an anomalous vein from the tumor draining into the pampiniform plexus causing varicocele. Conclusion The presence of right-sided varicocele should raise a suspicion hidden serious pathological retroperitoneal condition, renal malignancy in particular, and should prompt the treating physician to carry out imaging studies of the retroperitoneum and careful study of the angiographic phase of the CT scan can ascertain the pathogenesis of the varicocele.

scholarly journals Intraoperative O-arm Navigation Guided Anterior Cervical Surgery; A technical note and case series

2021 ◽  
pp. 101288
Author(s):  
Masato Tanaka ◽  
Hardik Suthar ◽  
Yoshihiro Fujiwara ◽  
Yoshiaki Oda ◽  
Koji Uotani ◽  
...  
Keyword(s):  
Case Series ◽  
Technical Note ◽  
Cervical Surgery ◽  
Anterior Cervical Surgery

scholarly journals Delayed Extradural Hematoma after Evacuation of Contralateral Acute Extradural Hematoma

2020 ◽  
Author(s):  
Majid Anwer ◽  
Atique Ur Rehman ◽  
Farheen Ahmed ◽  
Satyendra Kumar ◽  
Md Masleh Uddin
Keyword(s):  
Computed Tomography ◽  
Ct Scan ◽  
Postoperative Period ◽  
Road Traffic ◽  
Case Reports ◽  
Mass Effect ◽  
Extradural Hematoma ◽  
Traumatic Head Injury ◽  
Neurologic Deterioration ◽  
The Right

Abstract Introduction Traumatic head injury with extradural hematoma (EDH) is seen in 2% of patients. Development of EDH on the contralateral side is an uncommon complication that has been reported in various case reports. Case Report We report here a case of an 18-year-old male who had a road traffic injury. He was diagnosed as a case of left-sided large frontotemporoparietal acute extradural bleed with a mass effect toward the right side. He was managed with urgent craniotomy and evacuation of hematoma. A noncontrast computed tomography (NCCT) scan performed 8 hours after postoperative period showed a large frontotemporoparietal bleed on the right side with a mass effect toward the left side. He was again taken to the operating room and right-sided craniotomy and evacuation of hematoma were performed. A postoperative NCCT scan revealed a resolved hematoma. The patient made a complete recovery in the postoperative period and is doing well. Conclusion Delayed onset epidural hematoma is diagnosed when the initial computed tomography (CT) scan is negative or is performed early and when late CT scan performed to assess clinical or ICP deterioration shows an EDH. The diagnosis of such a condition requires a high index of suspicion based on the mechanism of injury along with fracture patterns. Additionally, change in pupillary size, raised intracranial pressure, and bulging of the brain intraoperatively are additional clues for contralateral bleeding. Neurologic deterioration may or may not be associated with delayed EDH presentation. An early postoperative NCCT scan within 24 hours is recommended to detect this complication with or without any neurologic deterioration.

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