scholarly journals Clinical Outcomes of Hernia Nucleous Pulposus after Microendodiscectomy

2018 ◽  
Vol 11 (2) ◽  
pp. 985-991
Author(s):  
Ahmad Fauzi ◽  
Asrafi Rizky Gatham ◽  
S. Dohar Al-Tobing ◽  
Luthfi Gatham

There are several options of surgical treatment of Hernia Nucleous Pulposus (HNP) such as discectomy and micro-endodiscectomy (MED). The fundamental differences between these procedures are the size of the incision, the discectomy procedure and the volume of disc taken. However, until now, there has not been any class 1 evidences explaining the efficacy of these procedures, and there is only a few studies about its safety and factors influencing its efficacy in treating HNP, especially in Indonesia. This study is aimed to assess clinical outcomes and safety of MED in HNP patients who underwent this procedure. Patient with HNP who underwent MED were followed prospectively in a period of January 2015 until December 2016. Clinical outcomes were evaluated by using Visual Analog Score (VAS) for assessing back pain and leg, and Oswestry Disability Index (ODI). The mean of pre-treatment score was compared with the mean of post-surgical treatment score by using paired t-test. Sampel were 78 HNP patients treated surgery. The average surgery duration (± SD) was 60 ± 17.1 minutes. The pretreatment score mean on VAS and ODI were 4.88 ± 1.10 and 35.21 ± 8.24. After surgical treatment, the VAS and ODI score obtained were significantly reduced to 1.53 ± 1.14 and 5.16 ± 5.52, respectively (p<0,001). A type of complication was observed, which was 5 (6.4%) cases of dural tear; no deficit in ankle dorsiflexion nor foot paresis were found. MED has been shown to be able to treat HNP with clinical outcomes similar to conventional open discectomy but with better levels of safety and effectiveness. However, this procedure still requires high quality randomized controlled trials studying about its efficacy and cost effectiveness in HNP treatment.

2021 ◽  
pp. 68-68
Author(s):  
Erhan Okay ◽  
Feyza Ozkan ◽  
Zilan Karadag ◽  
Emre Koraman ◽  
Tarik Sari ◽  
...  

Introduction/Objective Sciatica is a disabling pathology with variable etiologies. The most common pathologies arise from discogenic or non-discogenic causes. Mass lesions are a rare cause of extraspinal sciatica, which have been commonly overlooked, leading to unnecessary spinal surgeries, delay in diagnosis or inadequate treatment. There is no standard surgical approach and functional outcomes after surgical treatment of these lesions are not well-known. The aim of this study is to evaluate clinical outcomes after surgical treatment of mass lesions causing sciatica in different locations. Methods Data were obtained by a retrospective review from 2015-2020. The mean duration of symptoms at the time of surgery was 10.3 months (3-48 months). The mean age of patients at the time of surgery was 43.8 years (14-73 years). The mean follow-up was 19.5 months (4-50 months). In total, 14 cases had an extrapelvic localization distal to sciatic notch. The other three cases had lesions in the intrapelvic area, including left sciatic notch (1), right acetabulum (1), sacroiliac and lumbosacral region (1). None of the patients had palpable masses. Transgluteal, infragluteal, lateral, and posteromedial approach were used depending on location and size of the lesion. Results At the final follow-up, all patients recovered pain relief. The median musculoskeletal tumor society score was 90% (70-100). There was no recurrence at the latest follow-up. Conclusion Our study demonstrated that early detection by neurological examination and radiological work-up can avoid unnecessary surgeries, enable early surgical treatment of tumoral mass with satisfactory clinical outcomes. The surgical approach should be individualized according to location and size of the lesion.


2021 ◽  
Vol 15 (10) ◽  
pp. 2756-2758
Author(s):  
Haneen Zahra ◽  
Abdul Bary ◽  
Tahir Nazeer ◽  
Saira Naseem ◽  
Muhammad Abdul Aziz ◽  
...  

Background: Ondansetron is a 5HT3 receptor blocker and has multifaceted action like sodium channel blocker and µ - opioid agonist. Objective: To compare the efficiency of ondansetron pre-treatment in alleviating pain caused by propofol during induction of general anaesthesia with placebo. Material & Method: In this randomized controlled trail 120 patients of ASA grade I & II undergoing elective surgery were included and divided into two equal groups A & B by using lottery method. Each group comprised of 60 patients. In group A two ml 0.9 % normal saline and in group B, 2 ml ondansetron (4mg) given intravenously. In both groups propofol was given in a dose of 2.5 mg / Kg intravenously. Results: The mean age of patients in group A was 29.95 ± 4.79 year and in group B was 30.30 ± 4.87 year. Majority of patients 67(55.83 %) were between 18 to 30 year of age. Out of 120 patients. 63 (52.50 %) were ASA I & 52 (47.50 %) were ASA II. Efficacy of group A (placebo) was seen in 11 (18.33 %) while in group B (ondansetron) was seen in 56 (93.33 %). Conclusion: Ondansetron pre-treatment in alleviating pain cause by propofol is very effective. Keywords: Pain, ondansetron, propofol, general anaesthesia.


2017 ◽  
Vol 4 (2) ◽  
pp. 14
Author(s):  
Putri Megasari

Hepatitis has become a health problem in the world. The hepatitis virus infected many people. According to the teacher of MTsN 02 Bondowoso more than 20 students have hepatitis A viral infection. The purpose of this research was to know the differences of students' knowledge about hepatitis A before and after counseling in MTsN 02 Bondowoso 2015. This study used pre-experimental (pre-post test design). This study used stratified random sampling technique, 127 students from 270 sample involved this research,and 143 students was excluded. We used questionnaires to collect data. The results showed that the mean value of the students 'knowledge about hepatitis A before counseling in MTsN 02 Bondowoso 2015 was 83.96 with the lowest value of 37.5 and the highest value was 100. The mean value of the students' knowledge about hepatitis A after counseling in MTsN 02 Bondowoso 2015 was 93.21 with the lowest value waf 62.5 and the highest value was 100. Paired t test showed that t (-9.07) > t table (1.98), the null hypothesis (H0) was rejected. There was a difference between students' knowledge about hepatitis A before and after counseling in MTsN 02 Bondowoso 2015. This study showed that routine counseling by healthcare provider was important to prevent hepatitis A infection.; Keywords: counseling, knowledge of students, hepatitis


2017 ◽  
Vol 16 (1) ◽  
Author(s):  
Jesús Alberto Luengo - Fereira

Objective: To compare two fluorinated varnishes for the control of white spot lesions.Material and Methods: A randomized controlled clinical trial was conducted. A total of 103 active whitespot lesions on permanent upper anterior teeth from 24 patients, aged 7 to 9 years were randomly assigned totwo groups, G1: Duraphat® (n=52) and G2: DuraShield® (n=51). Weekly applications were perform for fourconsecutive weeks. Fifth week the dimension, regression and activity of the lesions were evaluated. Student’sT test, Wilcoxon Ranks and Chi square were used at 5% significance. Results: At the end of the study, the lesion reduction was observed in 69.7%, finding significant differences(p<0.05) in the mean of the initial and final dimensions in general (2.74 mm to 1.91 mm) and in each group, G1(2.84 mm to 2.03 mm), G2 (2.64 mm to 1.78 mm). In the activity of the lesions, it was found in the G1, 12 active and6 inactive lesions; while in G2, there were 14 active and 29 inactive; these differences were significant (p<0.05). Conclusions: The two evaluated products showed similar clinical efficacy in the remineralization of activewhite spot lesions after 4 weeks of therapy.


2019 ◽  
Author(s):  
Daniel Schiltz ◽  
Natalie Kiermeier ◽  
Dominik Eibl ◽  
Christoph Koch ◽  
Karolina Müller ◽  
...  

BACKGROUND Exact quantification of volumetric changes of the extremities is difficult. There are several direct and indirect methods to assess extremity volume. As water displacement volumetry is rarely viable in a clinical setting and circumference measurements are prone to errors due to poor reproducibility and high inter- and intra-observer variability, an objective and easily reproducible method is indispensable. OBJECTIVE The aim of this study was to establish a standardized method based on 3D scans with defined caudal and cranial landmarks of the lower leg which allows for measurements of exactly the same body area. Furthermore, this study tests the method in terms of reproducibility and evaluates volume changes after surgical therapy in patients suffering from lymphedema. METHODS 3D-scans of the lower limb were performed with a mobile 3D-scanner. Volumetric calculation was done digitally. “Repeatability“ and “Inter-observer reliability” of digital volumetry were tested. Furthermore, the method was applied on 31 patients suffering from chronic lymphedema. ANOVA (analyses of variance) was conducted to compare the digital volumetric measurements. To assess the sensitivity to changes in digital volumetry, the mean volume of 31 patients before and 3 months after therapy were compared by a paired t-Test. RESULTS Calculations of repeatability of the volume based on 20 3D-scans of the same lower leg showed a mean volume of 2,488 ± 0,011 liters (range: 2,470 – 2,510). The mean volume of the 7 measurements of the 3 examiners did not differ significantly (F(2,18) = 1,579, p = .233). The paired t-Test showed a significant mean volume decrease of 375ml (95% CI = 245/505ml) between pre and post treatment (t (30) =5,892, p < .001). CONCLUSIONS 3D-Volumetry is a noninvasive, easy and quick method to assess volume changes of the lower leg. Other than the costs, it is reproducible and precise and therefore ideal for evolution of therapy in lymphedema.


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