scholarly journals OPTIMIZATION OF OPERATIVE DELIVERY OF WOMEN IN LABOR WITH PLACENTA PREVIA

2021 ◽  
pp. 162-165
Author(s):  
D. M. Zhelezov
Keyword(s):  
Blood Loss ◽  
Postoperative Period ◽  
Placenta Previa ◽  
Statistical Processing ◽  
Maternity Hospital ◽  
Main Stage ◽  
Satisfactory Condition ◽  
Ultrasound Monitoring ◽  
Group I ◽  
Group Ii

The aim – to evaluate the effectiveness of preventive ligation of uterine vessels during caesarean section in women with placenta previa. Material and Methods. The study was conducted on the basis of the Regional Perinatal Center and Maternity Hospital № 5 (Odessa) for 2000–2020 and performing the main stage of cesarean section after reducing perfusion in the placenta. Uterine ligation was performed after fetal removal. The volume of blood loss, the condition of the mother and fetus were monitored, and perinatal results were analyzed. Statistical processing was performed by methods of variance and frequency analysis using Statistica 13.0 software (TIBCO, USA). Results. The mean age of pregnant women was 33.4±1.2 years. The clinic of placenta previa during pregnancy was extremely scanty. As a rule, the diagnosis was made during ultrasound monitoring. In 16 (17.7 %) there was repeated bleeding from the genital tract without pain and increased uterine tone, with the development of anemia of moderate severity. Single bleeding was observed in 53 (58.9 %) women. Blood loss was 1380±112 ml in group I, 466±34 ml in group II (p<0.05). The frequency of anemia in the postoperative period was 38.0 % and 17.5 %, respectively (p<0.05). All newborns were discharged on the 5-7th day of the postpartum period in satisfactory condition. There were no cases of distress syndrome. Conclusions: 1. The method of control of blood loss during placenta previa by ligation of the uterine arteries is effective – blood loss was in group I 1380±112 ml, in group II – 466±34 ml (p<0,05). 2. The frequency of anemia in the postoperative period was 38.0 in group I and 17.5 % in group II (p<0.05).

scholarly journals Adjunctive intrauterine Foley’s Catheter Balloon adding to hypogastric artery ligation in the conservative management of morbid adherent placenta previa

2018 ◽  
Vol 7 (6) ◽  
pp. 2093
Author(s):  
Hany F. Sallam ◽  
Nahla W. Shady
Keyword(s):  
Blood Loss ◽  
Placenta Previa ◽  
Hypogastric Artery ◽  
Artery Ligation ◽  
Cesarean Hysterectomy ◽  
Adherent Placenta ◽  
Group I ◽  
Estimated Blood Loss ◽  
Group Ii ◽  
Foley’S Catheter

Background: Objective of present study was to demonstrate the efficacy of Foley’s catheters balloon tamponade as an adjuvant to control blood loss during and after a caesarian section in patient undergone hypogastric artery ligation (HAL) due to morbid adherent placenta previa (MAPP).Methods: A single-center retrospective case-control clinical trial was carried out in a tertiary university hospital between March 2015 and March 2018, 124 women were undergoing cesarean delivery for MAPP, were managed conservatively either with HAL or HAL plus inflated Intrauterine Foley’s Catheter Balloon to control post-partum hemorrhage secondary to MAPP. In the case of conservative treatment protocol failure, cesarean hysterectomy was performed.Results: 124 women were enrolled (n=62 in each group). group of women received HAL plus Intrauterine Foley’s Catheter Balloon (group II)) showed a significant reduction in intraoperative and 4 hours post-operative blood loss compared with (Group I) which received HAL without Intrauterine Foley’s Catheter Balloon. (P = 0.0001,0.0.015), so the overall estimated blood loss in group II showed significant reduction compared with group I (P = 0.0001).Conclusions: Adjunctive intrauterine Foley's catheter balloon adding to HAL ligation in the management of MAPP is a novel combination approach have proved to be effective to control of intraoperative and PPH and to preserve the uterus as possible and change in the concept of MAPP management always mandates hysterectomy. And may become an alternative valid option to planned cesarean-hysterectomy in well-selected cases who have a strong desire for future fertility.

scholarly journals Management of patients in the post-operative period after the hip joint replacement accessed by low-invasive access

2019 ◽  
Vol 1 (4) ◽  
pp. 32-38
Author(s):  
N S Nikolaev ◽  
A V Efimov ◽  
R V Petrova ◽  
D V Kovalev ◽  
M I Ivanov
Keyword(s):  
Quality Of Life ◽  
Blood Loss ◽  
Hip Arthroplasty ◽  
Postoperative Period ◽  
Early Postoperative Period ◽  
Modified Rankin Scale ◽  
Surgical Access ◽  
Group I ◽  
Group Ii

Up to 1.5 million total hip arthroplasty is performed annually in the world. In Russia, at least 300 thousand patients a year need hip replacement surgery. High tissue invasiveness during surgical approaches presents special requirements for the rehabilitation process in the early postoperative period. Accelerating and making it more efficient is possible with the use of the least traumatic operating access. The purpose of the study is a comparative analysis of two models of the organization of rehabilitation in the postoperative period after hip arthroplasty: using standard Harding surgical access and the minimally invasive Rottinger access. Material of the study - patients operated on with standard Harding access (group I, n = 227) and front-external Rottinger access (group II, n = 266). Criteria for inclusion of patients in both groups are primary coxarthrosis without previous surgical interventions, exclusion criteria are connective tissue diseases, severe comorbidity. Group I patients underwent postoperative rehabilitation according to the standard protocol, group II - according to the rehabilitation concept "ERAS, fast-track". To assess the effectiveness of the rehabilitation at all stages in both groups, the rehabilitation potential was assessed on the rehabilitation routing scale (SRM), the dynamics of the pain syndrome on the visual analogue pain scale (VAS), the verticalization period was taken into account, the main assessment scales of the patient's motor functions and psychological status were used in hip arthroplasty: Harris scale, quality of life questionnaire (EQ - 5D), modified Rankin scale. Results and discussion. The proportion of hip arthroplasty using MIS access in the total number of operations increased from 0.7% in 2015 to 10.1% in 2018. The studied groups are comparable in terms of the ratio of men and women, average age, number of observations, BMI and the volume of blood loss. The surgeon duration and the duration of the stationary phase in group I exceeded the similar parameters of the II group. The modified Rankin scale at admission and discharge in all patients showed moderate disability, starting indicators and results after 3 months were more prosperous in group II. Both groups had an equivalent score on the Harris scale before surgery and after 3 months after it, more pronounced positive dynamics of the quality of life on the EQ-5D scale ("thermometer") was noted in group II. A decrease in pain after surgery compared with baseline, with regression to 0.8-1.0 points by 3 months after surgery, was noted in all patients. The assessment on the rehabilitation routing scale did not differ in both groups. At the stationary stage, group I patients walked with additional support on crutches (100%), group II - on a cane (92.5%). On long days 4-6, 82.8% of patients of group I and 91.7% of patients of group II passed long distances. At the end of stage I rehabilitation, 83.7% of group I patients and 92.5% of group II were sent to the outpatient rehabilitation stage, the rest were transferred to stage II of rehabilitation in a 24 - hour hospital. The third stage of rehabilitation, all patients went on an outpatient basis at the place of residence. At the follow-up stage, the data of a telephone survey of group II were analyzed (n = 68, 25.6% of the respondents). By 3 months, the Harris score exceeds 90 points, satisfaction with the operation is 97%. As a result of the use of surgical MIS access for hip arthroplasty, all patients had good rehabilitation indicators. Conclusions. The general approach to managing patients after hip arthroplasty is similar for all types of surgical access, however, MIS-access creates the most favorable conditions for the rehabilitation of patients in the early postoperative period: a positive attitude of the patient, reduced blood loss, reduced surgical incision, the possibility of early activation and transition to the general regime for 6-7 days. The results of the study showed the advantages of a model for the organization of rehabilitation in the postoperative period after hip arthroplasty using mini-invasive access over standard surgical access. Group II patients (MIS access) had a higher level of physical activity and a low level of pain in the early postoperative period.

scholarly journals Effects of the regional nerve blockade at the limb reperfusion in pediatric orthopedics

2020 ◽  
Vol 24 (5) ◽  
pp. 317-322
Author(s):  
Olga G. Chekhova ◽  
V. A. Ostanina ◽  
A. H. Shmakov
Keyword(s):  
Regional Anesthesia ◽  
Lactate Level ◽  
Lactate Concentration ◽  
Main Stage ◽  
Topical Anesthetic ◽  
Nerve Blockade ◽  
Arterial Blood ◽  
Group I ◽  
Group Ii ◽  
Arterial Blood Glucose

Introduction. Arterial tourniquets are widely used to improve visualization of the surgical field and to reduce blood loss . However, the resulting ischemia and subsequent reperfusion make doctors seek for better options to reduce these complications. Objective. To find out how the regional nerve blockade impacts the reperfusion of ischemized limb when arterial tourniquets are removed during orthopedic surgeries in children. Material and methods. In 16 patients, who were operated on at the department of trauma and orthopedics of the Novosibirsk Children ‘s Clinical Hospital of Emergency Medical Care (CCHEMC) , surgical intervention required the application of an arterial tourniquet. These patients became participants in an observational pilot study. Patients with tourniquets were divided into two groups: Group I - had the regional nerve blockade ( 9 patients) and Group II - had no regional nerve blockade (7 patients). Parameters of acid-base homeostasis, lactate and arterial blood glucose were assessed in all patients at all stages: before surgery (stage 1), main stage (stage 2), 5 minutes after the tourniquet removal (stage 3). The following parameters were compared in this work: mean arterial pressure (MAP), mm Hg; heart rate (min-1); concentration of lactate in the arterial blood (mmol/l), glycemia (mmol/l). The obtained findings are presented as median (Me) of lower and upper quartiles [Q25; Q75]. Results. The found dynamics of lactate concentration in participants’ blood was the most significant result of the study. In Group I, where regional anesthesia was used, lactate level decreased at the stage 2 and returned to its baseline at the stage 3. In Group II (without regional anesthesia, but with a powerful central analgesic preparation) , lactate level did not change at stage 2, but significantly increased at stage 3. Conclusion. Topical anesthetic (Ropivakaine), used in the regional nerve blockade during orthopedic surgeries in children when arterial tourniquets are put, has less harmful effects in surgical aggression.

scholarly journals Results of observation of the postoperative period in patients with surgical aortic pathology after surgical intervention using cardiopulmonary bypass

2019 ◽  
Vol 23 (2) ◽  
pp. 267-276
Author(s):  
K. A. Khyzhniak ◽  
Y. V. Volkova ◽  
K. Y. Sharlai ◽  
M. V. Khartanovych
Keyword(s):  
Cardiopulmonary Bypass ◽  
Hospital Stay ◽  
Postoperative Period ◽  
Surgical Intervention ◽  
Infusion Therapy ◽  
The Third ◽  
Group I ◽  
Aortic Pathology ◽  
Number Of Patients ◽  
Group Ii

The aim of the work was to analyze the results of the observation of the postoperative period in patients with surgical aortic pathology after surgical intervention using cardiopulmonary bypass. 118 patients with surgical aortic pathology (SAP) were examined. Patients were divided into 2 groups. Group I included 46 patients who were additionally prescribed a solution of meglumin sodium succinate (reamberin), group II included 46 patients who were additionally assigned a solution of D-fructose-1,6-diphosphate sodium hydrate salt (esophosphine). The control group (K) consisted of 26 patients who had surgical pathology of the aorta, all the criteria coincided with patients of groups I and II, but did not have additional substances as part of intensive care (IT) in order to prevent postoperative cognitive dysfunction (PСD). Analyzed the patient's condition on a scale of postoperative mortality prediction EuroSCORE II, the depth of anesthesia with a BIS monitor, the qualitative composition of the leukocyte formula, nasal and rectal temperature, blood gas composition, electrolyte level, glucose, lactate, coagulogram indices, hemolysis and phosphates; levels of autoantibodies to brain antigens (MBP, calcium binding protein S-100, NSE and GBA) were determined in the serum by ELISA a day before the operation and on the first, third, seventh and fourteenth day after surgery. The morphometric and functional properties of erythrocytes were investigated the day before the operation (starting level), 12:00 after the operation, and on the third day of hospital stay. The initial assessment of the cognitive abilities of the patients was made the day before the operation, on the third, seventh and fourteenth day of hospital stay. Used to determine the magnitude of the coefficient of linear Pearson correlation. In the analysis, no significant differences were found between the preliminary data on the phosphorus content in the patients' blood, however, the recovery dynamics of its numbers differed in the K, I and II patients. So, in group K and in group I, after 12:00 after surgery, the level of phosphatemia was 0.86 ± 0.21 mmol/l and 0.85 ± 0.18 mmol / l, on the 3rd day of hospital stay — 0,94 ± 0.08 mmol/l and 0.97 ± 0.04 mmol/l, on the 7th day — 1.04 ± 0.16 mmol/l and 1.07 ± 0.21 mmol/l and on The 14th day — 1.08 ± 0.12 mmol/l and 1.1 ± 0.14 mmol/l. It can be noted that the dynamics of blood phosphatemia in patients of groups K and I was identical, its figures almost coincided in terms of the level of phosphorus in the blood and the corresponding number of patients in the variation rows of patients in both groups. It may be noted that there is an unconditional positive effect on the course of the perioperative period of the option of infusion therapy in the IT complex in patients of group II.  

scholarly journals Surgical treatment of patients with sagittal imbalance of degenerative etiology: a comparison of two methods

2020 ◽  
Vol 27 (3) ◽  
pp. 16-26
Author(s):  
Evgenii S. Baykov ◽  
Alexey V. Peleganchuk ◽  
Abdugafur J. Sanginov ◽  
Olga N. Leonova ◽  
Aleksandr V. Krutko
Keyword(s):  
Surgical Treatment ◽  
Blood Loss ◽  
Perioperative Complications ◽  
Sagittal Imbalance ◽  
Radiological Parameters ◽  
Results Of Treatment ◽  
Group I ◽  
Surgical Methods ◽  
Group Ii ◽  
Clinical And Radiological Results

Purpose. Compare the clinical and radiological results of treatment of patients with spinal deformities operated on using the PSO method and corrective fusion in the lumbar spine. Materials and methods. Retrospective monocenter cohort study. The data of 42 patients were analyzed. PSO (group I) was performed in 12 patients; 30 patients had a combination of surgical methods (group II) with mandatory ventral corrective spinal fusion at levels L4-L5, L5-S1. Clinical and radiological parameters were evaluated during hospitalization and at least 1 year later. Results. Postoperative hospitalization in group I 32.5 7.4 days, 27.1 7.4 in group II (p = 0.558758). The duration of the operation in group I was 402.5 55.6 minutes, in group II 526.0 116.2 minutes (p = 0.001124); blood loss 1862.5 454.3 ml versus 1096.0 543.3 ml (p = 0.000171). In both groups, significantly improved clinical and radiological parameters after surgery and after 1 year (p 0.05). In group II, as compared with group I after surgery and more than 1 year: lower back pain according to VAS (p = 0.015424 and p = 0.015424); below ODI after 1 year was (p = 0.000001). In group I, compared with group II after surgery and after 1 year, SVA is less (p = 0.029879 and p = 0.000014), lumbar lordosis is higher (p = 0.045002 and p = 0.024120), LDI is restored more optimally (p = 0.000001 and p = 0.000002), the GAP is lower (p = 0.005845 and p = 0.002639). The ideal Russoly type is restored more often in patients of group II (p = 0,00032). Complications in group I were noted in 12 (100%) patients, in group II in 13 (43.3%) patients (p = 0.001). Conclusions. In multistep surgical treatment compared with PSO, the anterior corrective interbody fusion L4-L5, L5-S1 reliably better and more harmoniously restores the sagittal balance parameters, has significantly lower volume of intraoperative blood loss, fewer perioperative complications and significantly improves the quality of life of patients.

scholarly journals Does an increased number of cesarean sections result in greater risk for mother and baby in low-risk, late preterm and term deliveries?

2019 ◽  
Vol 35 (1) ◽  
Author(s):  
Necati Hancerliogullari ◽  
Selen Yaman ◽  
Rifat Taner Aksoy ◽  
Aytekin Tokmak
Keyword(s):  
Placenta Previa ◽  
Low Risk ◽  
Neonatal Outcomes ◽  
Late Preterm ◽  
Cesarean Sections ◽  
Intraperitoneal Adhesions ◽  
Group I ◽  
Significant Difference ◽  
Maternal And Neonatal Outcomes ◽  
Group Ii

Objective: To compare surgical complications and maternal and neonatal outcomes of low-risk, late preterm and term pregnant women who have had one or two previous cesarean sections (CSs) with those who have had three or more CSs. Methods: We conducted a retrospective study of 850 patients undergoing repeat CS at a tertiary level maternity hospital in Ankara, Turkey. Of those, 380 had previously undergone one or two CSs (Group-I: second or third CS) and 470 had previously undergone three or four CSs (Group-II: fourth or fifth CS). Outcomes and complications were compared between the groups. Results: The two groups were statistically significantly different in terms of maternal age, parity, body mass index, maternal weight gain during pregnancy, and length of hospital stay (all p<0.001). Although the prevalence of intraperitoneal adhesions and placenta previa was higher in Group-II than in Group-I (p<0.001), there was no statistically significant difference in terms of cesarean hysterectomy and adjacent organ injuries (p>0.05). There were also no significant differences between the groups in terms of neonatal outcomes (p>0.05). Conclusion: Although the increase in the number of CSs appears to be associated with intraperitoneal adhesions and placenta previa, adverse maternal and neonatal outcomes were not observed in those women with low-risk pregnancies who underwent CS for the fourth or fifth time. Therefore, fourth and fifth CSs may be considered relatively safe surgical procedures in this cohort. How to cite this:Hancerliogullari N, Yaman S, Aksoy RT, Tokmak A. Does an increased number of cesarean sections result in greater risk for mother and baby in low-risk, late preterm and term deliveries? Pak J Med Sci. 2019;35(1):---------. doi: https://doi.org/10.12669/pjms.35.1.364 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals Comprehensive Treatment of Patients with Constricted Hernias and Metabolic Syndrome Signs

2016 ◽  
Vol 23 (3) ◽  
Author(s):  
I. V. Melnyk
Keyword(s):  
Metabolic Syndrome ◽  
Postoperative Period ◽  
Abdominal Hernia ◽  
Wound Complications ◽  
Comprehensive Treatment ◽  
Clinical Group ◽  
Hernia Defect ◽  
Group I ◽  
Group Ii ◽  
Methods Of Treatment

57 patients with constricted abdominal hernia and diagnosed metabolic syndrome were examined. They were performed the urgent hernia defect plastics with polypropylene mesh Linteks-Esfil (St. Petersburg). Patients were divided into two clinical groups: clinical group I (20) included patients in the postoperative period treated with conventional comprehensive conservative treatment. Clinical group II (37) consisted of patients treated with 2.5% solution of 2 ml tiotriazolini in muscle and metformin in a dose of 500 mg / day for metabolic syndrome correction in addition to above mentioned conventional treatment. Lipid metabolism indices improved on the 7th day in 59.2% of patients in clinical group II and only in 15% of patients in clinical group I.Postoperative wound complications such as seromas and infiltrations developed in 6.3% of patients and were eliminated by conservative methods of treatment. Patients of group II tolerated postoperative period better. Average duration of hospital stay decreased by 2.03±0.2 bed days. Thus, the treatment of patients with constricted hernia of anterior abdominal wall and metabolic syndrome should be in complex with hernia defect plastics by propylene mesh and medicamentous correction of metabolism disorders.  

scholarly journals Placenta accreta and emergency cesarean delivery correlates to cervical length and transcervical placental thickness measurement

2017 ◽  
Vol 6 (11) ◽  
pp. 4808 ◽  
Author(s):  
Nahla W. Shady ◽  
Hany F. Sallam ◽  
Ahmed M. Abbas
Keyword(s):  
Placenta Accreta ◽  
Placenta Previa ◽  
Transvaginal Ultrasound ◽  
Thickness Measurement ◽  
Cervical Length ◽  
Group Iii ◽  
Emergency Cesarean ◽  
Group I ◽  
Group Ii ◽  
Placental Thickness

Background: The study aims to evaluate the effect of cervical length and the transcervical placental thickness measurement at 28-30 weeks gestation in predicting the risk of antepartum haemorrhage (APH) and emergency preterm caesarean delivery (CD) in women with placenta previa accreta.Methods: A prospective cohort study conducted at Aswan university hospital from June 2015 to April 2017 included one hundred and five cases diagnosed as placenta previa accreta by transvaginal ultrasound (TVS) between 28-30 weeks gestation were divided into three groups according to their cervical length which measured by TVS: group I (cervical length >30 mm), group II (cervical length 20-30 mm) and group III (cervical length <20 mm). Also, placental thickness measurement was done. Cervical length and placental thickness and correlated with the clinical outcome regarding to gestational age at delivery, APH, emergency CD due to massive haemorrhage, the need for blood transfusion and caesarean hysterectomy.Results: APH and emergency CD due to massive bleeding were significantly higher in cases with short cervical length and thick placenta. APH occurred in 6 cases (15%) in group I, 14 cases (40%) in group II and 24 cases (80%) in group III, (p=0.0001). Emergency CD in group I was performed in 5 cases (12.5 %), 12 cases (34.3 %) in group II and 24 cases (80%) in group III, (p =0.0001). The incidence of APH was higher in thick placenta [6 cases (42.9 %) compared to none with thin placenta in group I (p=0.001), 13 cases (68.4%) compared to one case (6.2%) in group II (p=0.0001) and 21 cases (100%) compared to 3 cases (33.3%) in group III (p=0.0001)].Conclusions: Short cervical length and increased placental thickness may predict the risk of APH and emergency preterm CD in patients with placenta accreta.

scholarly journals Percutaneous endoscopic treatment of benign and malignant renal pelvis carcinoma: A single-center experience

2020 ◽  
Author(s):  
Xin Zhang ◽  
Wu Xiu Han ◽  
Sheng Yan Li ◽  
Hao Yuan Chen ◽  
Zhe Yu Tang ◽  
...  
Keyword(s):  
Blood Loss ◽  
Hospital Stay ◽  
Renal Pelvis ◽  
Operation Time ◽  
Laser Evaporation ◽  
Pathological Grade ◽  
Group I ◽  
Grade Ii ◽  
The Mean ◽  
Group Ii

Abstract Background Percutaneous nephrolithotomy (PCNL) is a safe and efficient treatment for intro-renal diseases, most of which are calculus disease. In this study, we carried out percutaneous endoscopic nephron-sparing ablation for renal carcinoma in carefully selected patients. Our aim was to evaluate whether percutaneous endoscopic nephron-sparing operation was feasible for patients with renal cell carcinoma.Methods A total of 15 patients with renal pelvis carcinoma were treated with laser evaporation under percutaneous endoscopy between January 2015 and September 2019 ( group I ). Another 13 patients who received standard radical nephroureterectomy were recruited as the control group (group II). We recorded demographic data of the patients, the indication for surgery, tumor pathological grade, size and side of tumor, and the intraoperative and postoperative outcome, including the duration of surgery, length of hospital stay, and complication rate, as well as progression-free survival (PFS).Results In both groups, all of the patients received flexible ureteroscopy. In group I, 14 patients had transitional renal cell carcinoma (UCC), four had pathological grade I, nine had grade II, and one had hemangiopericytoma. In group II, all patients had UCC, five had pathological grade I, and eight had grade II. In group I, the mean operation time was 118 min (65–236 min), the mean blood loss was 110 ml (55–220 ml), and the mean hospital stay was 9 days (7–12 days). During follow-up, two patients died and two had recurrence; among them, one had systematic bone metastasis. The PFS rate was 66.7% (10/15). In group II, the mean operation time was 265 min (185–436 min), the mean blood loss was 133 ml (85–240 ml), and the mean hospital stay was 13 days (9–16 days). During the follow-up, two patients died and there was no local or systematic metastasis. The PFS rate was 84.6% (11/13). There was no significant difference in blood loss between the groups. However, the operation time and mean hospital stay were significantly shorter in group I compared with that in group II ( P < 0.05). But the PFS rate was significantly higher in group II than in group I (P < 0.05).Conclusions This study shows that laser evaporation under percutaneous endoscopy for renal pelvis carcinoma is a safe, effective, and technically feasible procedure for treating benign and malignant renal pelvis carcinoma.

scholarly journals Short term results of percutaneous vertebroplasty in patients with isolated traumatic vertebral compression fractures

2019 ◽  
Vol 23 (3) ◽  
pp. 401-409
Author(s):  
О.S. Voloshchuk ◽  
O.P. Krasylenko
Keyword(s):  
Motor Activity ◽  
Postoperative Period ◽  
Percutaneous Vertebroplasty ◽  
Age Groups ◽  
Vertebral Compression Fractures ◽  
Short Term ◽  
General Group ◽  
Compression Fractures ◽  
Group I ◽  
Group Ii

Objective — to analyze the effectiveness of percutaneous vertebroplasty (PV) in the short term postoperative period in patients with isolated traumatic vertebral compression fractures (IT VCF). The analysis of short term results of PV for IT VCF in patients (n=160) of two age groups: I — up to 60 years (n=106) and II — 60 years and older (n=54). The criteria for inclusion in the study were: high-energy spinal injury resulting a road accident or a high level fall; absence of signs of osteoporosis. The average pain intensity (M ± σ) before PV matched a severe pain (8.21±1.41 points according VAS in the general group). At 3 days after surgery, the pain radically decreased to insignificant (0.91±0.98 points), gradually decreased to 0.76±0.82 points during the first 3 months; there was a further tendency for its decreasing within the insignificant (up to 0.71±0.76 points after six months). At the same time, before the operation and during the nearest postoperative period, patients of group I had a somewhat lower intensity of pain than in group II. Dependence on painkillers observed in 100% of patients before surgery, in the first 3 days after PV 78.1% of all patients have lost it (80.2% — in group I, 74.0% — in group II); in 3 months — 95,6%, 96,2%, 94,5%, respectively; after 6 months — 96.2%, 97.2%, 94.5%, respectively. Motor activity before surgery was reduced in all patients (45.0% of them to the degree of bedbound). In 3 days after PVP, 60.6% of all patients returned to usual motor activity at home (65.1% in group I, 51.8% in group II), 93.7%, 3 months later, respectively, 2%, 87.0%; in 6 months — 96,3%, 99,1%, 90,7%. The persons of physical work who were employed at the time of injury, remained disabled 3 days after the PVP. Within 3 months, they all returned to work: to their usual work 83.7% in the former group, 90.7% in the first group and 52.9% in the second group; 16,3%, 9,3% and 47,1% of the patients, respectively, for work with facilitated conditions. After 6 months, the number of patients with full physical recovery in these groups reached 94.6%, 97.3% and 82.4%, respectively. Oswestry disability index (ODI), which before the operation was (57.7±20.1)% in the whole group, (55.7±20.85)% — in the first group and (59.6±18.54)% — in group II, and responded to severe disability, 3 days after surgery significantly (p<0.001) decreased and amounted to (31,2±15,89)%, (30,3±16,62)% and (31, 9±14,46)%, respectively, indicating moderate disability. After 3 months, ODI decreased to (18.8±17.45)% (p<0.05) in the general group and to (18.2±18.56)% and (19.1±15.18)% — in the relevant age groups, indicating a minimal disability. After 6 months, there was a tendency for further decrease of ODI (to (18.5±17.1)%) and (17.9±18.08)% and (19.0±15.24)%, respectively). So, in the short term after PV, the degree of disability of patients of both age groups decreased significantly. Thus, PV in patients with IT VCF provides rapid pain regression and improvement in the functional status of patients of both age groups — up to 60 years and 60 years and older. The most radical changes occur within the first 3 days after surgery. Further improvement of most options during the first 6 month is progressing gradually. The rates and completeness of the functional recovery are slightly higher in patients of the age group up to 60 years, compared with the group of 60 years and older.

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