scholarly journals Clinical effectiveness of posterior-only approach using polyetheretherketone cage combined with single-segment instrumentation for lumbar tuberculosis in children

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Zhengquan Xu ◽  
Lanhua Chen ◽  
Changsheng Wang ◽  
Liqun Zhang ◽  
Weihong Xu
Keyword(s):  
Sedimentation Rate ◽  
Medical Records ◽  
Clinical Effectiveness ◽  
Peek Cage ◽  
Single Segment ◽  
Erythrocyte Sedimentation ◽  
Polyetheretherketone Cage ◽  
Tuberculosis In Children ◽  
Postoperative Improvement

AbstractWe sought to investigate the outcomes of posterior-only approach using polyetheretherketone (PEEK) cage combined with single-segment instrumentation (modified-approach) for mono-segment lumbar tuberculosis in children. Between February 2008 and August 2017 in our hospital, 18 children with single-segment lumbar tuberculosis enrolled in this study were treated by modified-approach. Medical records and radiographs were retrospectively analyzed. Mean follow-up time was 54.6 ± 12.1 months. No severe complications were noted to have occurred. Measures indicated there was satisfactory bone fusion for all patients. Mean Cobb angles were significantly decreased from preoperative angle (19.8° ± 13.1°) to those both postoperatively (− 4.9° ± 7.6°) and at final follow-up (− 3.5° ± 7.3°) (both P < 0.05), with a mean angle loss of 1.7° ± 0.9°. The erythrocyte sedimentation rate (ESR) returned to normal levels for all patients within 3 months postoperatively. All patients had significant postoperative improvement in neurological performance. The modified-approach was an effective and feasible treatment option for mono-segment children with lumbar tuberculosis. Such procedures can likely help patients by increasing retainment of lumbar mobility and reducing invasiveness.

scholarly journals Clinical Effectiveness of Treatment of Children Afflicted by Lumbar Tuberculosis With Posterior-only Approach Using Poly-ether-ether-ketone Cage Combined With Single-segment Instrumentation

2021 ◽  
Author(s):  
Zhengquan Xu ◽  
Lanhua Chen ◽  
Changsheng Wang ◽  
Liqun Zhang ◽  
Weihong Xu
Keyword(s):  
Spinal Injury ◽  
Clinical Effectiveness ◽  
Peek Cage ◽  
Single Segment ◽  
Ether Ether Ketone ◽  
Poly Ether Ether Ketone ◽  
Vas Scores ◽  
Ether Ketone ◽  
Tuberculosis In Children

Abstract Background: We sought to investigate the clinical outcomes of posterior-only approach using poly-ether-ether-ketone (PEEK) cage combined with single-segment instrumentation in the treatment of lumbar tuberculosis in children.Methods: Between February 2008 and August 2017 in our hospital, 18 children with single-segment lumbar tuberculosis were enrolled in this study. Children were treated by a posterior-only approach using PEEK cage combined with single-segment instrumentation. Medical records and radiographs were retrospectively analyzed. Visual analogue scores (VAS) were used to evaluate measures of quality of daily life. Criteria defined from the American Spinal Injury Association (ASIA) were used to evaluate measures of neurological function.Results: Mean follow-up time was 54.6 ± 12.1 months (39–84 months). No severe complications were noted to have occurred. Measures indicated there was satisfactory bone fusion for observations for all patients. Mean Cobb angles were significantly decreased from the mean preoperative angle (19.8° ± 13.1°) to those both postoperatively (-4.9° ± 7.6°) and at final follow-up (-3.5° ± 7.3°) (both P < 0.05), with a mean angle loss of 1.7° ± 0.9°. Th erythrocyte sedimentation rate (ESR) returned to normal levels for all patients within 3 months postoperatively. All patients had significant postoperative improvement in respect to neurological performance and VAS scores.Conclusions: The posterior-only approach using PEEK cage combined with single-segment instrumentation was found to be an effective and feasible treatment option for children with lumbar tuberculosis. Such procedures can likely be used to help patients by facilitating reconstruction of spinal stability, and increasing retainment of lumbar mobility in conjunction with reduced invasiveness compared to counterpart treatments.

RENAL TUBERCULOSIS IN CHILDREN

PEDIATRICS ◽  
1958 ◽  
Vol 22 (6) ◽  
pp. 1193-1200 ◽  
Author(s):  
John K. Lattimer ◽  
Truman Boyes
Keyword(s):  
Erythrocyte Sedimentation Rate ◽  
Sedimentation Rate ◽  
Multiple Drug ◽  
Genitourinary Tuberculosis ◽  
Bilateral Disease ◽  
Erythrocyte Sedimentation ◽  
Renal Tuberculosis ◽  
Tuberculosis Chemotherapy ◽  
Tuberculosis In Children

Genitourinary tuberculosis in children is not easily detected because symptoms are usually minimal, the erythrocyte sedimentation rate is not elevated and the number of leukocytes in the urine may be very few even when the renal destruction is far advanced. The disease is serious because it tends to invade and destroy both kidneys if untreated. Nephrectomy alone failed to arrest the disease in two of six children with cavitary tuberculosis. Chemotherapy with three drugs arrested the disease in all of the five patients with cavitary lesions treated to date. The follow-up of the cases treated by chemotherapy is shorter than that of the nephrectomy cases. Ten patients with noncavitary kidney tuberculosis have all had negative urine cultures since multiple-drug chemotherapy. Tuberculosis showed a tendency to lie dormant in the kidneys for long periods (up to 12 years) and then become active again. Although this series is small and the follow-up is short, the results to date parallel those found in our larger experience with chemotherapy in adults with genitourinary tuberculosis. In general, as in adults, modern triple-drug chemotherapy appears to be about as effective, if not more effective, then nephrectomy, as treatment for this potentially bilateral disease. As a consequence, at the authors' clinic, nephrectomies are currently being deferred indefinitely, due to the apparent success of chemotherapy. Whether chemotherapy will entirely replace excisional therapy for genitourinary tuberculosis is still problematical, but it has certainly greatly enhanced the outlook for patients with this once lethal disease.

scholarly journals One-Stage Anterolateral Debridement, Bone Grafting, and Internal Fixation for Treating Lumbosacral Tuberculosis

2017 ◽  
Vol 11 (2) ◽  
pp. 305-313 ◽  
Author(s):  
Tao Zhang ◽  
Lihua Ma ◽  
Xu Lan ◽  
Ping Zhen ◽  
Shiyong Wang ◽  
...  
Keyword(s):  
Internal Fixation ◽  
Erythrocyte Sedimentation Rate ◽  
Sedimentation Rate ◽  
Bone Grafting ◽  
Oswestry Disability Index ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
One Stage ◽  
Erythrocyte Sedimentation

<sec><title>Study Design</title><p>Retrospective case series.</p></sec><sec><title>Purpose</title><p>To investigate the clinical efficacy and feasibility of one-stage anterolateral debridement, bone grafting, and internal fixation for treating lumbosacral tuberculosis.</p></sec><sec><title>Overview of Literature</title><p>There has been no consensus regarding the optimal means of treating lumbosacral tuberculosis. The one-stage anterolateral extraperitoneal approach for radical debridement, bone grafting, and internal fixation for treating lumbosacral tuberculosis is rare in literature.</p></sec><sec><title>Methods</title><p>Twenty-one patients with lumbosacral tuberculosis were retrospectively analyzed. All patients underwent the surgery of anterolateral debridement after regularly antituberculous drugs therapy. We evaluated the erythrocyte sedimentation rate, C-reactive protein, radiography, computed tomography, magnetic resonance imaging, visual analogue score, and Oswestry disability index before and after surgery.</p></sec><sec><title>Results</title><p>All patients completed a follow-up survey 9–48 months after surgery. All patients' wounds healed well without chronic infection or sinus formation, and all patients with low-back pain reported relief after surgery. All cases had no tuberculosis recurrence. Solid bony fusion was achieved within 6–12 months. At final follow-up, evaluated the erythrocyte sedimentation rate decreased from 38.1±12.5 to 11.3±7.1 mm/hr, C-reactive protein decreased from 6.2±4.2 to 1.6±1.3 mg/dL, the visual analog scale score decreased from 4.6±1.1 to 1.4±1.0, the Oswestry disability index score decreased from 50.2%±11.9% to 13.0%±6.6%, and the lumbosacral angle increased from 20.0°±4.8° to 29.0°±3.9° (<italic>p</italic>&lt;0.05).</p></sec><sec><title>Conclusions</title><p>One-stage anterolateral debridement, bone grafting, and internal instrument fixation for treating lumbosacral tuberculosis is safe and effective.</p></sec>

scholarly journals An assessment of the C-reactive protein, erythrocyte sedimentation rate and white blood cell count, values during the post-operative period of infected tibial nonunions treated with antibiotic- loaded PMMA-coated nails

2021 ◽  
Vol 7 (3) ◽  
pp. 644
Author(s):  
Ferdi Dırvar ◽  
Raşit Özcafer ◽  
Kubilay Beng
Keyword(s):  
Blood Cell ◽  
Cell Count ◽  
Sedimentation Rate ◽  
Postoperative Period ◽  
C Reactive Protein ◽  
Blood Cell Count ◽  
Reactive Protein ◽  
Erythrocyte Sedimentation ◽  
Significant Difference

<p>In this study, our aim was to assess the changes in the serum C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and white blood cell count (WBC) values during the follow-up period of infected tibial pseudoarthrosis treated using antibiotic-loaded nails. Three patients with infected femoral nonunions and 11 patients with infected tibial nonunions were included in the study. All patients were treated with intramedullary nails coated with antibiotic-loaded PMMA after local extensive debridement. Postoperatively, parenteral antibiotic therapy was administered. The CRP, ESR and WBC values were noted preoperatively and on the first day, and then on the second, sixth, and 12<sup>th</sup> weeks postoperatively. The changes in these values over time were analyzed comparatively. The preoperative CRP level was found to be significantly lower than the early postoperative period (1<sup>st</sup> day), while no significant differences were detected during the follow-up period. The CRP level constantly decreased between the first postoperative control (1<sup>st</sup> day) and the final follow-up time (12<sup>th</sup> week). The postoperative ESR showed a significant difference when compared to the preoperative value, and also showed a decreasing trend in the postoperative period, having its highest value on the first day. The WBC did not exhibit a significant difference when comparing the preoperative and postoperative values. C-reactive protein level and ESR can be used to monitor the adequacy of the treatment after antibiotic-loaded nail application, whereas WBC may be insufficient in the diagnosis and follow-up of osteomyelitis treated with antibiotic-loaded nails.</p>

scholarly journals Predictors of anaemia and iron deficiency in HIV-infected pregnant women in Tanzania: a potential role for vitamin D and parasitic infections

2011 ◽  
Vol 15 (5) ◽  
pp. 928-937 ◽  
Author(s):  
Julia L Finkelstein ◽  
Saurabh Mehta ◽  
Christopher P Duggan ◽  
Donna Spiegelman ◽  
Said Aboud ◽  
...  
Keyword(s):  
Vitamin D ◽  
T Cell ◽  
Pregnant Women ◽  
Erythrocyte Sedimentation Rate ◽  
Sedimentation Rate ◽  
Severe Anaemia ◽  
Cd4 T Cell ◽  
Parasitic Infections ◽  
Erythrocyte Sedimentation

AbstractObjectiveAnaemia is common during pregnancy, and prenatal Fe supplementation is the standard of care. However, the persistence of anaemia despite Fe supplementation, particularly in HIV infection, suggests that its aetiology may be more complex and warrants further investigation. The present study was conducted to examine predictors of incident haematological outcomes in HIV-infected pregnant women in Tanzania.DesignProspective cohort study. Cox proportional hazards and binomial regression models were used to identify predictors of incident haematological outcomes: anaemia (Hb < 110 g/l), severe anaemia (Hb < 85 g/l) and hypochromic microcytosis, during the follow-up period.SettingAntenatal clinics in Dar es Salaam, Tanzania.SubjectsParticipants were 904 HIV-infected pregnant women enrolled in a randomized trial of vitamins (1995–1997).ResultsMalaria, pathogenic protozoan and hookworm infections at baseline were associated with a two-fold increase in the risk of anaemia and hypochromic microcytosis during follow-up. Higher baseline erythrocyte sedimentation rate and CD8 T-cell concentrations, and lower Hb concentrations and CD4 T-cell counts, were independent predictors of incident anaemia and Fe deficiency. Low baseline vitamin D (<32 ng/ml) concentrations predicted a 1·4 and 2·3 times greater risk of severe anaemia and hypochromic microcytosis, respectively, during the follow-up period.ConclusionsParasitic infections, vitamin D insufficiency, low CD4 T-cell count and high erythrocyte sedimentation rate were the main predictors of anaemia and Fe deficiency in pregnancy and the postpartum period in this population. A comprehensive approach to prevent and manage anaemia, including micronutrient supplementation and infectious disease control, is warranted in HIV-infected women in resource-limited settings – particularly during the pre- and postpartum periods.

A comparison of changes over time in cervical foraminal height after tricortical iliac graft or polyetheretherketone cage placement following anterior discectomy

2007 ◽  
Vol 6 (1) ◽  
pp. 10-16 ◽  
Author(s):  
Suat E. Çelik ◽  
Ayhan Kara ◽  
Sevinç Çelik
Keyword(s):  
Cobb Angle ◽  
Peek Cage ◽  
Cage Group ◽  
The Mean ◽  
The Right ◽  
Polyetheretherketone Cage ◽  
Foraminal Height ◽  
Changes Over Time ◽  
Over Time

Object The authors prospectively evaluated cervical foraminal height changes after anterior cervical discectomy and fusion. To their knowledge, this prospective study is the first in which foraminal height changes over time are compared following the placement of a tricortical graft or a polyetheretherketone (PEEK) cage. Methods The patients were randomly divided in two groups. In one group, 30 patients underwent anterior cervical microdiscectomy and free bone graft (FBG) insertion at 46 levels via the Smith–Robinson technique. The FBG was harvested from the right iliac crest. Another 35 patients underwent the same operation, but fusion was provided by the insertion of PEEK intervertebral cages at 41 levels. Fusion status and the C2–7 Cobb angle, interspace height, and foraminal height changes were observed on anterior, lateral, and oblique radiographs obtained at the 18-month follow-up examination. There were no differences between the groups with regard to clinical recovery, fusion status, and Cobb angle. A significant interspace height reduction was observed in the FBG group during the 1st postoperative month. In the FBG group, the mean heights (± standard deviation) of the foramina were 8.2 ± 2.7 mm preoperatively, 10.8 ± 2.6 mm on postoperative Day 2, and 8.1 ± 1.5 mm after 18 months of follow up. In the PEEK cage group, the mean heights were 8.4 ± 2.8 mm preoperatively, 10.3 ± 1.1 mm on postoperative Day 2, and 9.6 ± 1.2 mm after 18 months of follow up. The increase in foraminal height was significantly preserved at the 6th, 12th, and 18th months in the cage group. Conclusions In both groups the foraminal height increased sufficiently and the nerve root was decompressed postoperatively. The PEEK cages may provide sufficient preservation of foraminal height even 1.5 years after the operation.

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