scholarly journals Long-Segmental Posterior Fusion Combined With Vertebroplasty and Wiring: Alternative Surgical Technique for Kummell’s Disease With Neurologic Deficits-A Retrospective Case Series

2021 ◽  
Vol 12 ◽  
pp. 215145932110270
Author(s):  
Hyung-Youl Park ◽  
Ki-Won Kim ◽  
Ji-Hyun Ryu ◽  
S. Tim Yoon ◽  
In-Hwa Baek ◽  
...  
Keyword(s):  
Surgical Technique ◽  
Posterior Fusion ◽  
Kyphotic Angle ◽  
Neurologic Deficits ◽  
Surgical Methods ◽  
Kummell’S Disease ◽  
The Mean ◽  
Frankel Grade ◽  
Kümmell’S Disease

Purpose: Various surgical methods have been reported for Kummell’s disease with neurologic deficits. The aim of this study was to introduce long-segmental posterior fusion (LPF) combined with vertebroplasty (VP) and wiring as an alternative surgical technique. Material and Methods: We retrospectively analyzed 10 patients undergoing posterior decompression and LPF combined with VP and wiring for Kummell’s disease with neurologic deficits from January 2011 to December 2014. The radiologic outcomes included the local kyphotic angle (LKA) and segmental kyphotic angle (SKA). Clinical outcomes, including the visual analog scale (VAS), the Oswestry Disability Index (ODI) and the Frankel grade were assessed. Surgery-related complications were also evaluated. Results: The mean age of the included patients was 77 ± 8 years with a mean follow-up period of 31.4 ± 4.9 months and a mean bone mineral density of −3.5 ± 0.7 (T-score). The mean operation time was 220 ± 32.3 minutes with a mean blood loss of 555 ± 125.7 mL. The preoperative LKA and SKA were significantly corrected postoperatively (37.9 ± 8.7° vs. 15.3 ± 5.3°, p = 0.005 for LKA; 21.3 ± 5.1° vs. 7.6 ± 2.8°, p = 0.005 for SKA) without a loss of correction at the last follow-up. The VAS and ODI were also significantly improved (7.7 ± 1.1 vs. 3.0 ± 1.6, p = 0.007 for VAS; 90.3 ± 8.9 vs. 49.6 ± 22.7, p = 0.007 for ODI). The Frankel grade of all patients was improved by at least 1 or 2 grades at the last follow-up. Surgery-related complications such as intraoperative cement leakage and implant loosening during the follow-up were not observed. Conclusions: LPF combined with VP and wiring might be an effective surgical option for Kummell’s disease with neurologic deficits, especially for the elderly patients with morbidities. Level of Evidence: level IV.

scholarly journals Comparison between Balloon Kyphoplasty and Short Segmental Fixation Combined with Vertebroplasty in the Treatment of Kümmell’s Disease

2015 ◽  
Vol 18;4 (4;18) ◽  
pp. 373-381 ◽  
Author(s):  
Liang Chen
Keyword(s):  
Pain Score ◽  
Vertebral Body ◽  
Balloon Kyphoplasty ◽  
Vertebral Height ◽  
Kyphotic Angle ◽  
Kummell’S Disease ◽  
Segmental Fixation ◽  
The Mean ◽  
Kümmell’S Disease

Background: Kümmell’s disease is a clinical syndrome characterized by a minor spinal trauma with a symptom-free period from months to years, followed by progressive painful kyphosis. Kyphoplasty and vertebroplasty have been introduced to treat Kümmell’s disease, and obtained good clinical results. Recently, delayed cement displacement was reported for Kümmell’s disease treated by cement augmentation alone. Some authors recommended internal fixation combined with cement injection for this particular condition. Objective: To evaluate and compare the clinical efficacy, especially the pain reduction, of 2 procedures (kyphoplasty alone versus short segmental fixation combined with vertebroplasty) in the treatment of Kümmell’s disease. Study Design: Retrospective evaluation and comparison of postoperative VAS scores and radiographic outcomes. Setting: Single center inpatient population. Methods: Two procedures, including conventional balloon kyphoplasty and short segmental fixation combined with vertebroplasty, were utilized for 54 patients with Kümmell’s disease. All patients were followed-up for 8 – 42 months. Visual analog scale (VAS), vertebral height, and local kyphotic angle were evaluated and compared for 2 groups before surgery, after surgery, and at final follow-up. Pearson correlation coefficients were calculated to assess the relationship between the decreased values of pain scores (VAS) and improvement of anterior vertebral height and local kyphotic angle. Results: For the KP group, the VAS pain score decreased significantly from 7.8 ± 0.9 before surgery to 3.3 ± 1.0 after surgery (P < 0.01), and 2.9 ± 0.9 at final follow-up (P < 0.01). The mean height of the anterior vertebral body increased from 14.8 ± 2.4 mm before surgery to 19.3 ± 2.1 mm after surgery (P < 0.01). The mean local kyphotic angle decreased from 22.7 ± 6.9° before surgery to 14.5 ± 5.3° after surgery (P < 0.01). For SSF + VP group, the VAS pain score decreased significantly from 7.2 ± 1.6 before surgery to 4.7 ± 1.3 after surgery (P < 0.01), and 3.5 ± 1.2 at final follow-up (P < 0.01). The mean height of the anterior vertebral body increased from 13.6 ± 2.5mm before surgery to 17.3 ± 2.7 mm after surgery (P < 0.01). The mean local kyphotic angle decreased from 24.7 ± 9.2° before surgery to 15.5 ± 6.2° after surgery (P < 0.01). No significant loss of correction of vertebral height and kyphosis was observed at follow-up. Improvement of VAS score had no correlation with improvement of vertebral height or local kyphotic angle. Asymptomatic cement leakage occurred in both groups. Limitations: Retrospective study with a relatively small sample size. Conclusions: This study showed that both balloon kyphoplasty alone and short segmental fixation combined with vertebroplasty for Kümmell’s disease were safe and effective. Improvement of VAS score had no correlation with improvement of vertebral height or local kyphotic angle. Comparatively, balloon kyphoplasty resulted in same the clinical outcomes with less complications. Key words: Kümmell’s disease, kyphoplasty, vertebroplasty, short segmental fixation, pain

scholarly journals Comparison of Unipedicular and Bipedicular Percutaneous Kyphoplasty for Kummell's Disease

2020 ◽  
Author(s):  
Dan Pan ◽  
Xiaojie Ouyang ◽  
Qinghua Huang ◽  
Dayong Chen
Keyword(s):  
Bone Cement ◽  
Operative Time ◽  
Cement Leakage ◽  
Vertebral Height ◽  
Kyphotic Angle ◽  
Injection Volume ◽  
Kummell’S Disease ◽  
Kümmell’S Disease ◽  
Better Than

Abstract Background: Percutaneous kyphoplasty (PKP) is effective for the treatment of Kummell's disease. However, controversy remains regarding whether a unipedicular or bipedicular PKP is superior.Methods: A retrospective study was performed to review 40 patients with stage I and II Kummell's disease who underwent PKP in our hospital from January 2015 to June 2018. Based on the transpedicular approach of PKP, those patients were randomly divided into unipedicular group (n = 19) and bipedicular group (n = 21) . Operative time, bone cement injection volume and cement leakage rate were compared in the two groups. Pre- and post-operative visual analogue score (VAS), local kyphotic angle and average vertebral height were also evaluated.Results: All patients underwent surgery successfully. Compared with preoperative condition, VAS was significantly decreased at 1 day after operation and the last follow-up in both groups (P < 0.05) , and local kyphotic angle and average vertebral height were restored markedly (P < 0.05). Operative time of both groups had no significant difference (P > 0.05). Bone cement injection volume was larger in bipedicular group (P < 0.05). At 1 day after operation and the last follow-up , the local kyphotic angle and average vertebral height in bipedicular group were restored better than those in unipedicular group (P < 0.05). There were 4 cases of cement leakage in both groups, with leakage rates of 21.1% and 19.0%, respectively, and the difference was not significant (P > 0.05).Conclusion: Both unipedicular and bipedicular PKP are effective for treating patients with stage I and II Kummell's disease, while postoperative pain relief and imaging results in bipedicular group were better than those in unipedicular group.

scholarly journals Unilateral lateral rectus recession is an effective surgery for intermittent exotropia in young children

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Oriel Spierer ◽  
Abraham Spierer
Keyword(s):  
Young Children ◽  
Success Rate ◽  
Lateral Rectus ◽  
Intermittent Exotropia ◽  
Age At Surgery ◽  
Surgical Methods ◽  
Before And After ◽  
The Mean ◽  
Consecutive Esotropia

Abstract Background Different surgical methods have been suggested for the correction of intermittent exotropia. Unilateral lateral rectus recession has been described as a surgical alternative for small and moderate-angle exotropia. In general, previous studies did not focus on the outcomes of unilateral lateral rectus recession in young children with intermittent exotropia. The purpose of this study is to evaluate the surgical outcomes of unilateral lateral rectus recession in the treatment of moderate-angle exotropia (≤ 25 PD (prism diopters)) in children. Methods The charts of all patients younger than 12 years of age with moderate-angle exotropia (up to 25 PD) who were operated during the years 2006–2018 were retrospectively reviewed. Fifty-eight patients underwent unilateral lateral rectus recession and had a minimum follow up of 6 months. The angle of exotropia (PD) before and after surgery and the success rate were documented. Results Mean age at surgery was 6.4 ± 1.9 (range 3.5–11.0) years. Exotropia improved from a preoperative angle of 21.4 ± 4.0 PD to 3.5 ± 5.9 PD postoperatively (p < 0.001). Success rate, defined as deviation of ≤ 10 PD, was achieved in 86.2%. There were 2 (3.4%) cases of overcorrection (consecutive esotropia). There were no intra- or postoperative complications. The mean follow-up duration after surgery was 2.3 ± 1.7 years. Conclusions In children with moderate angle exotropia, good postoperative success rate was achieved by performing unilateral lateral rectus recession.

scholarly journals Kümmell's Disease Treated with Percutaneous Vertebroplasty: Minimum 1 Year Follow-Up

2017 ◽  
Vol 13 (2) ◽  
pp. 119 ◽  
Author(s):  
Jae Won Park ◽  
Jong-Hwa Park ◽  
Hong Jun Jeon ◽  
Jong Young Lee ◽  
Byung Moon Cho ◽  
...  
Keyword(s):  
Percutaneous Vertebroplasty ◽  
Kummell’S Disease ◽  
Kümmell’S Disease

Radiographic and Clinical Outcomes of Surgical Treatment of Kümmell’s Disease With Thoracolumbar Kyphosis: A Minimal Two-Year Follow-Up

2021 ◽  
Author(s):  
Hao Cheng ◽  
Guo-dong Wang ◽  
Tao Li ◽  
Xiao-yang Liu ◽  
Jian-min Sun
Keyword(s):  
Surgical Treatment ◽  
Clinical Outcomes ◽  
Sagittal Balance ◽  
Rating Scale ◽  
Clinical Results ◽  
Spinal Alignment ◽  
Thoracolumbar Kyphosis ◽  
Kummell’S Disease ◽  
Kümmell’S Disease

Abstract Background: To evaluate the short to mid-term radiographic and clinical outcomes of the restoration of normal spinal alignment and sagittal balance in the treatment of Kümmell’s disease with thoracolumbar kyphosis. Methods: Between February 2016 and May 2018,30 cases of Kümmell’s disease with thoracolumbar kyphosis were divided into two groups (A and B) according to whether the kyphosis was combined with neurological deficits.All of the cases underwent surgical treatment to regain the normal spinal alignment and sagittal balance.And the radiographic outcomes and clinical results of these 30 patients were retrospectively evaluated.The sagittal imaging parameters including sagittal vertebral axis (SVA),thoracic kyphosis (TK),thoracolumbar kyphosis (TLK),lumbar lordosis (LL),pelvic incidence (PI),pelvic tilt (PT),and sacral slope (SS)of the whole spine before operation,immediately after operation,and the last follow-up of each group were measured and evaluated.The clinical results included the Oswestry Disability Index (ODI) and the Numerical Rating Scale (NRS) of the two groups .Results: The average follow-up period of group A and B were 34.2 and 38.7 months respectively.The parameters of both groups such as SVA,TLK,and thoracolumbar Cobb angle after surgery and at the last follow-up were significantly improved compared with those before surgery.The ODI and the NRS of the two groups at the last follow-up were also significantly improved. Conclusion: In the treatment of Kümmell’s disease with thoracolumbar kyphosis,to restore the normal alignment and sagittal balance can obtain a satisfactory radiographic and clinical short and medium-term effects.

scholarly journals INDICATIONS FOR INJECTION OF BULKING AGENTS FOR THE TREATMENT OF ANAL INCONTINENCE

2017 ◽  
pp. 43-48
Author(s):  
A. I. Nedozymovany ◽  
E. A. Dementeva ◽  
D. E. Popov ◽  
S. V. Vasiliev
Keyword(s):  
Comparative Analysis ◽  
Anal Canal ◽  
Anal Incontinence ◽  
Bulking Agents ◽  
Study Objective ◽  
Relevant Today ◽  
Surgical Methods ◽  
The Mean ◽  
Methods Of Treatment

Despite of lots conservative and surgical methods of treatment, the problem of anal incontinence is relevant today and remains unresolved. Since the beginning of the 1990s attempts ofimplantation of bulking agents in order to increase the basal pressure in the anal canal were begun. Domestic product “ДАМ+” used in the study. OBJECTIVE. To determine the indications for injection of bulking agents for the treatment of anal incontinence. Research the possibility of using the drug “ДАМ+,” with assessment of treatment outcomes. During a period of 2014 to 2016 there were 30 patients with anal incontinence of various etiologies involved in research. The mean age was 47,5 ± 6,5 years. Injection of bulking agent “ДАМ+” were performed by the punction of submucosa of the anal canal in 3 points, andfollowed by a comparative analysis of the survey after treatment. Average follow-up was 12,1 ± 0,97 months. The study we have identified indications for the implementation of bulking agents for correction of anal incontinence, and the estimation results.

Ten- to 14-Year Follow-up of the Nirschl Surgical Technique for Lateral Epicondylitis

2007 ◽  
Vol 36 (2) ◽  
pp. 261-266 ◽  
Author(s):  
Jonathan H. Dunn ◽  
John J. Kim ◽  
Lonnie Davis ◽  
Robert P. Nirschl
Keyword(s):  
Surgical Treatment ◽  
Surgical Technique ◽  
Tennis Elbow ◽  
Lateral Epicondylitis ◽  
Scoring Systems ◽  
Intensity Scale ◽  
The Mean ◽  
Mini Open

Background Good to excellent short-term results have been reported for the surgical treatment of lateral epicondylitis using various surgical techniques. Hypothesis Surgical treatment for lateral epicondylitis using the mini-open Nirschl surgical technique will lead to durable results at long-term follow-up. Study Design Case series; Level of evidence, 4. Methods Records from 139 consecutive surgical procedures (130 patients) for lateral epicondylitis performed by 1 surgeon between 1991 and 1994 were retrospectively reviewed. Eighty-three patients (92 elbows) were available by telephone for a mean follow-up of 12.6 years (range, 10–14 years). Outcome measures included the Numeric Pain Intensity Scale, Nirschl and Verhaar tennis elbow–specific scoring systems, and American Shoulder and Elbow Surgeons elbow form. Preoperative data were collected retrospectively. Results The mean age of the study group was 46 years (range, 23–70 years) with 45 men and 38 women. Eighty-seven of the procedures were primary, and 5 were revision tennis elbow surgeries. Concomitant procedures were performed in 30 patients including ulnar nerve release in 24 patients, medial tennis elbow procedures in 23 patients, shoulder arthroscopy in 2 patients, carpal tunnel release in 1 patient, and triceps debridement and osteophyte excision in 1 patient. The mean duration of preoperative symptoms was 2.2 years (range, 2 months to 10 years). The mean Nirschl tennis elbow score improved from 23.0 to 71.0, and the mean American Shoulder and Elbow Surgeons score improved from 34.3 to 87.7 at a minimum of 10-year follow-up ( P < .05). The Numeric Pain Intensity Scale pain score improved from 8.4 preoperatively to 2.1 ( P < .05). Results were rated as excellent in 71 elbows, good in 6 elbows, fair in 9 elbows, and poor in 6 elbows by the Nirschl tennis elbow score. By the criteria of Verhaar et al, the results were excellent in 45 elbows, good in 32 elbows, fair in 8 elbows, and poor in 7 elbows. Eighty-four percent good to excellent results were achieved using both scoring systems. Ninety-two percent of the patients reported normal elbow range of motion. The overall improvement rate was 97%. Patient satisfaction averaged 8.9 of 10. Ninety-three percent of those available at a minimum of 10-year follow-up reported returning to their sports. Conclusion The mini-open Nirschl surgical technique with accurate resection of the tendinosis tissue remains highly successful in the long term.

External Fixation for Surgical Treatment of a Mallet Finger

2003 ◽  
Vol 28 (3) ◽  
pp. 228-230 ◽  
Author(s):  
T. KALELI ◽  
C. OZTURK ◽  
S. ERSOZLU
Keyword(s):  
Surgical Treatment ◽  
Surgical Technique ◽  
Interphalangeal Joint ◽  
Mallet Finger ◽  
Distal Interphalangeal Joint ◽  
Distal Interphalangeal ◽  
The Mean ◽  
Extensor Lag ◽  
New Surgical Technique

A new surgical technique is described for the treatment of mallet finger deformity which involves the application of a mini external fixator across the distal interphalangeal joint and resection of a portion of the extensor mechanism. We reviewed 19 patients who were treated with this technique, at a mean follow-up period of 36 (range, 24–48) months. The mean extensor lag was 2° (range, −7° to 13°) and the mean flexion range was 70° (range, 20°–90°).

scholarly journals Percutaneous Kyphoplasty for Kummell Disease with Severe Spinal Canal Stenosis

2015 ◽  
Vol 6;18 (6;11) ◽  
pp. E1021-E1028
Author(s):  
Yan Yang
Keyword(s):  
Spinal Canal ◽  
Invasive Procedure ◽  
Cement Leakage ◽  
Spinal Canal Stenosis ◽  
Stage Iii ◽  
Canal Stenosis ◽  
Institutional Review ◽  
Kummell’S Disease ◽  
Kümmell’S Disease

Background: Percutaneous kyphoplasty (PKP) has been proven as an effective, minimally invasive procedure for the treatment of Kummell’s disease in the early stages. However, a risk of cement leakage and further neurological damage remains during and after PKP, especially in chronic osteoporotic stage III Kummell’s disease with severe spinal canal stenosis. Objective: To evaluate the feasibility and efficacy of PKP for the treatment of chronic osteoporotic stage III Kummell’s disease with severe spinal canal stenosis. Study Design: A retrospective evaluation of postoperative radiographs. Setting: Pain management clinic. Methods: A retrospective study was performed on 9 patients with 11 levels managed with PKP for chronic osteoporotic stage III Kummell’s disease with severe spinal canal stenosis. Clinical and radiological outcomes were assessed. Results: Substantial pain relief was attained in all the patients. Both visual analogue scale (VAS) and Oswestry Disability Index (ODI) scores improved significantly from pre- to post-operation (P < 0.05), and remained unchanged at every follow-up. No neurological deterioration was found. Postoperatively, the anterior and midline vertebral body heights were significantly corrected (P < 0.05), and were sustained at the final follow-up. Similar results were seen in the correction of kyphotic angle. Neither cement leakage into the spinal canal nor further dislodging of the posterior vertebral fragments occurred. Two cases experienced subsequent fractures with one having a second PKP and the other being treated conservatively. Limitations: Retrospective study of 9 cases with 11 levels due partly to the rarity of the disorder. Conclusions: PKP is an effective, minimally invasive procedure for the treatment of chronic osteoporotic stage III Kummell’s disease with severe spinal stenosis, leading to a significant relief of symptoms and improvement of functional status. Institutional Review: This study was approved by the Institutional Review Board. Key words: Kummell’s disease, kyphoplasty, spine, osteoporosis, cement leakage, polymethylmethacrylate, neurological deficits, burst fractures

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