The Anatomical and Biomechanical Superiority of Novel Posterior En Bloc Elevation Cervical Laminoplasty

2021 ◽  
pp. 155335062098465
Author(s):  
Dong-Lai Wang ◽  
Guo-Qing Zhu ◽  
An-Quan Huang ◽  
Hong Zhang ◽  
Chuan Feng ◽  
...  
Keyword(s):  
Biomechanical Testing ◽  
Cervical Laminoplasty ◽  
Open Door ◽  
Lateral Bending ◽  
En Bloc ◽  
Cross Sectional ◽  
Expansion Pattern ◽  
Intact Condition ◽  
Axial Symptoms ◽  
The Common

Objectives. In this study, we performed a novel type of posterior en bloc elevation cervical laminoplasty (PEEL) to keep the integrity of the posterior structure, aiming to reduce axial symptoms complicated by a conventional cervical laminoplasty procedure. Methods. Twelve human cervical cadaveric spines (C2-T1) were sequentially tested in the following order: intact condition, open-door laminoplasty (ODL) through bilateral intermuscular approach (mini-invasive ODL), PEEL, and laminectomy (LN). After bilateral transecting at the junction of lamina and lateral mass through the tubular retraction system, the PEEL procedure symmetrically elevated all the posterior structure which was further stabilized with bone grafts and titanium plates. Computed tomography (CT) scan and biomechanical testing were performed after each condition. Results. Both mini-invasive ODL and PEEL procedures were accomplished with 2 small incisions on each side. Two types of laminoplasties could enlarge the spinal canal significantly both in cross-sectional area and anteroposterior diameter comparing with intact condition. The PEEL procedure demonstrated a significantly higher enlargement rate on a canal area and a symmetrical expansion pattern. Compared with intact condition, mini-invasive ODL performed from C3-C7 demonstrated significantly decreased motion in all testing directions except the flexion range of motion (ROM); the PEEL procedure showed mild and insignificant decrease on ROM in all directions. Laminectomy resulted in a statistically significant increase in all directions except the lateral bending ROM. Conclusions. Posterior en bloc elevation cervical laminoplasty can enlarge the canal more effectively and preserve better ROM after operation than the ODL procedure. Although technically challenging, the PEEL procedure probably would decrease the common complications associated with ODL laminoplasty.

En bloc laminoplasty without dissection of paraspinal muscles

2005 ◽  
Vol 3 (1) ◽  
pp. 29-33 ◽  
Author(s):  
Noboru Hosono ◽  
Hironobu Sakaura ◽  
Yoshihiro Mukai ◽  
Takahiro Ishii ◽  
Hideki Yoshikawa
Keyword(s):  
Ct Scanning ◽  
Cord Compression ◽  
Neck Muscle ◽  
Open Door ◽  
En Bloc ◽  
Cross Sectional ◽  
Content Type ◽  
Spinous Processes ◽  
Significant Difference ◽  
Fine Print

Object. Although conducting cervical laminoplasty in patients with multisegmental cord compression provides good neurological results, it is not without shortcomings, including C-5 palsy, axial neck pain, and undesirable radiologically detectable changes. Postoperative kyphosis and segmental instability can cause neurological problems and are believed mainly to result from neck muscle disruption. The authors developed a new laminoplasty technique, with the aim of preserving optimal muscle function. Methods. The present technique is a modification of unilateral open-door laminoplasty. By using an ultrasonic osteotome in small gaps of muscle bellies, a gutter is made without disrupting muscles, spinous processes, or their connections on the hinged side. Ceramic spacers are then positioned between elevated laminae and lateral masses at C-3, C-5, and C-7 on the opened side, which is exposed in a conventional manner. This new procedure was used to treat 37 consecutive patients with compression myelopathy. Postoperative computerized tomography (CT) scanning revealed a significant difference in a cross-sectional area of muscles between the hinged and opened side. The mean follow-up period was 40.2 months (range 24–54 months). Changes in alignment were observed in only one patient, and vertebral slippage developed in two. Performed at regular intervals, CT scanning demonstrated that the elevated laminae remained in situ throughout the study period. Conclusions. In using the present unilateral open-door laminoplasty technique, deep extensor muscles are left intact along with their junctions to spinous processes on the hinged side. Radiologically documented changes were minimal because the preserved muscles functioned normally immediately after the operation.

Axial Symptoms After En Bloc Cervical Laminoplasty

1999 ◽  
Vol 12 (5) ◽  
pp. 392-395 ◽  
Author(s):  
Yoshiharu Kawaguchi ◽  
Hisao Matsui ◽  
Hirokazu Ishihara ◽  
Ryuichi Gejo ◽  
Osamu Yoshino
Keyword(s):  
Cervical Laminoplasty ◽  
En Bloc ◽  
Axial Symptoms

scholarly journals Unilateral C-1 posterior arch screws and C-2 laminar screws combined with a 1-side C1–2 pedicle screw system as salvage fixation for atlantoaxial instability

2016 ◽  
Vol 24 (2) ◽  
pp. 315-320 ◽  
Author(s):  
Jin Guo-Xin ◽  
Wang Huan
Keyword(s):  
Biomechanical Testing ◽  
Pedicle Screws ◽  
Atlantoaxial Instability ◽  
Posterior Arch ◽  
Lateral Bending ◽  
Significant Difference ◽  
Flexion Extension ◽  
Intact Condition ◽  
Atlantoaxial Fixation ◽  
Group B

OBJECT Atlantoaxial instability often requires surgery, and the current methods for fixation pose some risk to vascular and neurological tissues. Thus, new effective and safer methods are needed for salvage operations. This study sought to assess unilateral C-1 posterior arch screws (PASs) and C-2 laminar screws (LSs) combined with 1-side C1–2 pedicle screws (PSs) for posterior C1–2 fixation using biomechanical testing with bilateral C1–2 PSs in a cadaveric model. METHODS Six fresh ligamentous human cervical spines were evaluated for their biomechanics. The cadaveric specimens were tested in their intact condition, stabilization after injury, and after injury at 1.5 Nm of pure moment in 6 directions. The 3 groups tested were bilateral C1–2 PSs (Group A); left side C1–2 PSs with an ipsilateral C-1 PAS + C-2 laminar screw (Group B); and left side C1–2 PSs with a contralateral C-1 PAS + C-2 LS (Group C). During the testing, angular motion was measured using a motion capture platform. Data were recorded, and statistical analyses were performed. RESULTS Biomechanical testing showed that there was no significant difference among the stabilities of these fixation systems in flexion-extension and rotation control. In left lateral bending, the bilateral C1–2 PS group decreased flexibility by 71.9% compared with the intact condition, the unilateral C1–2 PS and ipsilateral PAS+LS group decreased flexibility by 77.6%, and the unilateral C1–2 PS and contralateral PAS+LS group by 70.0%. Each method significantly decreased C1–2 movements in right lateral bending compared with the intact condition, and the bilateral C1–2 PS system was more stable than the C1–2 PS and contralateral PAS+LS system (p = 0.036). CONCLUSIONS A unilateral C-1 PAS + C-2 LS combined with 1-side C-1 PSs provided the same acute stability as the PS, and no statistically significant difference in acute stability was found between the 2 screw techniques. These methods may constitute an alternative method for posterior atlantoaxial fixation.

Axial Symptoms After En Bloc Cervical Laminoplasty

1999 ◽  
Vol 12 (5) ◽  
pp. 392-395 ◽  
Author(s):  
Yoshiharu Kawaguchi ◽  
Hisao Matsui ◽  
Hirokazu Ishihara ◽  
Ryuichi Gejo ◽  
Osamu Yoshino
Keyword(s):  
Cervical Laminoplasty ◽  
En Bloc ◽  
Axial Symptoms

Side Effects of Chemotherapy and Cancer Treatment in Tertiary Care Teaching Hospital

2016 ◽  
Vol 2 (1) ◽  
pp. 62-78
Author(s):  
. Hemraj ◽  
Raj Kumar ◽  
Sourabh Kosey ◽  
Amit Sharma ◽  
Nalini Negi
Keyword(s):  
Side Effects ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Informational Needs ◽  
Cross Sectional ◽  
Clinical Pharmacists ◽  
Medical College ◽  
Related Information ◽  
The Common ◽  
Chemotherapy Patients

To determine the most common physical side effects experienced by local chemotherapy patients. Their perceptions of these side effects and informational needs from clinical pharmacists were also evaluated. This was a single center, observational cross-sectional study conducted at department of General Surgery, Guru Gobind Singh Medical College and Hospital, Faridkot, Punjab. A face to face interview was conducted. Information collected included chemotherapy related side effects after last chemotherapy experience, the most worrisome side effects, overlooked by healthcare professionals and the preferred method, amount and source of receiving related information. In this study, hundred patients were enrolled out of them 48 were male and 52 were female. When differential calculations was done, common side effects or adverse effects of chemotherapy in the patients of breast, lung cancer, Ovarian Cancer, Colon cancer, Prostate cancer, Lymphoma Cancer, Cervix cancer where there is much irregular medicine intake 57.4% may be due to common problem of joint pain reported by all the patients under study, with the consecutive problem of nausea and vomiting. The high prevalence of chemotherapy related side effects among local patients is a major concern and findings of their perceptions and informational needs may serve as a valuable guide for clinical pharmacists and physicians to help in side effect management. This study shows the common problems reported by the patients when they are suffering from cancer condition, according to their incidence perceptions as experienced by the patient, this will allow the physician and clinical pharmacist to effectively counsel and manage the common symptoms as reported prior to its occurrence in the patient, so that withdrawal can be checked.

STUDY OF PEDIATRIC INJURIES: PATTERNS AND OUTCOME

2019 ◽  
Vol 3 (8) ◽  
Author(s):  
Yasir. B. Elshambaty
Keyword(s):  
School Level ◽  
Common Mechanism ◽  
Injury Patterns ◽  
Severe Injuries ◽  
Injured Child ◽  
Cross Sectional ◽  
Pediatric Injuries ◽  
Pediatric Injury ◽  
The Common ◽  
Structured Questionnaire

Purpose this study aims to show the patterns and outcome of pediatric injury among those living in Albaha region in Saudi Arabia Methods this is a cross-sectional descriptive household-based study, included children between 0-17 years old both male and female. The data were collected with structured questionnaire between 20 Nov – 20 Dec 2018 and  analyzed with SPSS version 25 Results the total of participants was 257 injured child. 199(77.4%) are male and 58(22.6%) are female. About 44%of them were injured at pre-school level and 56% were traumatized at school age. The least incidence of injury occurred in those less than 2 yrs and higher incidence in those between 3-10 yrs old. The most common mechanism of injury was falling from height. The most affected group age by RTA accidents was 11-17 yrs old. Approximately 83% of the injured children required hospital management. Only one third of the injuries were  associated complications. The most common injured anatomic part was the upper limb and the least affected part was the spine. Only 5% of the injuries were associated with a disability and the common was loss of organ or part of it. Paralysis occurred in less than 1% and head injury resulted in disabilities more than 1%. Conclusion the vast majority of the injuries in our participants are not serious. The severe injuries were associated with RTA-related trauma. Most of injuries due to falling from height are not serious. We recommend not to allow the children to drive cars. Keywords: pediatric injuries; injury patterns; household.

Comparison of Heffner Criteria and Light Criteria in Differentiating Exudative and Transudative Pleural Effusion

2020 ◽  
Vol 22 (3) ◽  
pp. 141-145
Author(s):  
Krishna Chandra Devkota ◽  
S Hamal ◽  
PP Panta
Keyword(s):  
Pleural Effusion ◽  
Cross Sectional Study ◽  
Pleural Space ◽  
Sectional Study ◽  
Inclusion Criteria ◽  
Cross Sectional ◽  
Medical College ◽  
The Common ◽  
The Mean ◽  
Exudative Pleural Effusion

Pleural effusion is present when there is >15ml of fluid is accumulated in the pleural space. It can be divided into two types; exudative and transudative pleural effusion. Tuberculosis and parapneumonic effusion are the common cause of exudative pleural effusion whereas heart failure accounts for most of the cases of transudative pleural effusion. This study was a hospital based cross sectional study performed at Nepal Medical College during the period of January 2016-December 2016. A total of 50 patients who fulfilled the inclusion criteria were enrolled. Pleural effusion was confirmed by clinical examination and radiology. After confirmation of pleural effusion, pleural fluid was aspirated and was analysed for protein, LDH, cholesterol. The Heffner criteria was compared with Light criteria to classify exudative or transudative pleural effusion. Among 50 patients, 30 were male and 20 were female. The mean age of patient was 45.4±21.85 years. The sensitivity and specificity of using Light criteria to detect the two type of pleural effusion was 100% and 90.9%, whereas using Heffner criteria was 94.87%, 100% respectively(P<0.01). There are variety of causes for development of pleural effusion and no one criteria is definite to differentiate between exudative or transudative effusion. In this study Light criteria was more sensitive whereas Heffner criteria was more specific to classify exudative pleural effusion. Hence a combination of criteria might be useful in case where there is difficulty to identify the cause of pleural effusion.

HISTOPATHOLOGY OF THE PIGMENTED TUMORAL-LIKE LESIONS OF THE SKIN AT HUE HOSPITAL OF MEDICINE AND PHARMACY UNIVERSITY

2018 ◽  
Vol 8 (4) ◽  
pp. 65-69
Author(s):  
Mao Nguyen Van ◽  
Dong Tran Nam
Keyword(s):  
Key Words ◽  
Definitive Diagnosis ◽  
The Other ◽  
Cell Tumour ◽  
Cross Sectional ◽  
Skin Tumour ◽  
Clinical Appearance ◽  
The Face ◽  
The Common ◽  
Difficult Cases

Background: Pigmented tumour of the skin is one of the common tumour in human including the benign pigmented tumours (more common) called Nevi tumours and the malignant one called melanoma which was less frequent but the most poor in prognosis. In addition, the others not belonging to these group had the same clinical appearance, so the application of histopathology and immunohistochemistry for the definitive diagnosis was indespensible. Objectives: 1. To describe the macroscopic features of the pigmented tumoral-like lesions; 2. To classify the histopathologic types of the pigmented cell tumours and the other pigmented tumours of the skin. Materials and Method: Cross-sectional research on 55 patients diagnosed as pigmented tumoral lesions by clinician, then all definitively diagnosed by histopathology combining the immunohistochemistry in difficult cases. Results: There was no difference in gender, the disease was discovered most common in adult, especially with the age over 51 years old (58.1%). the most region located was in the face accounting for 60%, following the trunk and limbs (14.6%, 12.8% respectively). All 3 malignant melanomas happened in foot. The most common color of the lesions was black (65.4%), the other ones were rose, grey and blue. Histopathology and immunohisthochemistry showed that the true pigmented cell tumours were 52.6% encompassing benign ones (Nevi tumour) (41.8%), melanoma (5.4%) and lentigo (5.4%). 47.4% was not the true pigmented cell tumour including pigmented basocellular carcinoma (36.4%) and the others less common as histiofibromas, acanthoma and papilloma. Conclusion: the pigmented tumoral-like lesions of the skin could be the true pigmented cell tumours and the others, so the application of the histopathology and the immunohistochemistry after the clinical discovery helps to determine and classify the disease definitely and for the best orientation of treatment as well. Key words: skin tumour, benign pigmented tumour (Nevi), malignant pigmented tumour (melanoma), pigmented basocellular carcinoma

EVALUATING THE RESULTS OF SEPTOPLASTY AND PARTIAL INFERIOR TURBINOPLASTY

2017 ◽  
pp. 46-52
Author(s):  
Thanh Thai Le ◽  
Phuong Nam Tran ◽  
Thi Ngan An Nguyen
Keyword(s):  
Key Words ◽  
Nasal Obstruction ◽  
Inferior Turbinate ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Grade Ii ◽  
The Common

Aims: To study outcomes of septoplasty and partial inferior turbinectomy (PIT) method, expecting leastsurgical equipment, good result, price rationalization. Methods: Prospective, cross-sectional study. Including 40 patients treated by septoplasty and PIT method. Assessment had been made after 3 months post-op. Results: The common symptoms were nasal obstruction (100%), headache (40%). The deformities of nasal septalwere deviation (42.5%), crest (30%). There were 67.5% of patients with severe bilateral hypertrophic inferior turbinate, mostly over grade II, enlargement both soft and bone parts (60%). After 3 months, the nasal obstruction and headache presented good or great results in 90% of patients, 93.7% of patients had straight nasal septaland 90% hadsmall inferior turbinate.VAS: patients’s contentment was 100%. Conclusions: The study showed that septoplasty and partial inferior turbinectomy presented good results with 87.5% after surgery and 90% after 3 months. Key words: septal deformity, hypertrophy inferior turbinate, septoplasty, partial inferior turbinectomy

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