scholarly journals Scheuermann’s disease surgery. Major problems: non-systematic literature review (part I).

2021 ◽  
Vol 18 (3) ◽  
pp. 6-18
Author(s):  
M. V. Mikhaylovskiy ◽  
V. L. Lukinov
Keyword(s):  
Quality Of Life ◽  
Blood Loss ◽  
Intraoperative Blood Loss ◽  
Two Stage ◽  
Scheuermann’S Disease ◽  
Scheuermann's Disease ◽  
One Stage ◽  
Surgery Duration

Objective. To perform multivariate comparison of two surgical strategies in the treatment of patients with severe Scheuermann’s disease.Material and Methods. The search of sources (in Scopus and Web of Science databases) revealed  56 publications containing the required information. The literature data were analyzed in four directions: the results of one- and two-stage interventions are compared in terms of the magnitude of achieved correction and its preservation, the complication rate, the surgery duration and the volume of intraoperative blood loss, and the quality of life of patients in the postoperative period.Results. The magnitude of the achieved correction of kyphotic deformity and postoperative loss of correction in patients after one- and two-stage operations are almost identical. Implant-associated complications are more often observed after one-stage operations, and purulent, neurological and other complications – after two-stage operations. Surgery duration and intraoperative blood loss volume are greater in two-stage operations. The quality of life assessed by various questionnaires is significantly improved, regardless of the type of surgery.Conclusion. Two-stage surgical correction of Scheuermann’s kyphosis has no noticeable advantages over one-stage surgery, however, new studies with long (more than 15–18 years) postoperative follow-up are needed.

scholarly journals One-stage and two-stage breast reconstruction have no meaningful difference in patient quality of life

2020 ◽  
Vol 6 (2) ◽  
Author(s):  
Amer Mansoor
Keyword(s):  
Quality Of Life ◽  
Breast Reconstruction ◽  
Controlled Trial ◽  
Acellular Dermal Matrix ◽  
Clinical Decision ◽  
Two Stage ◽  
Dermal Matrix ◽  
One Stage ◽  
Randomised Controlled

A clinical decision report appraising Negenborn VL, Young-Afat DA, Dikmans REG, et al. Quality of life and patient satisfaction after one-stage implant-based breast reconstruction with an acellular dermal matrix versus two-stage breast reconstruction (BRIOS): primary outcome of a randomised, controlled trial. Lancet Oncology. 2018;19(9):1205-14. https://doi.org/10.1016/s1470-2045(18)30378-4.

scholarly journals COMPARISON OF THE USE OF PEDICLE SUBTRACTION OSTEOTOMY (PSO) IN PRIMARY AND REVISION OPERATIONS

2018 ◽  
Vol 25 (2) ◽  
pp. 5-12
Author(s):  
A. A. Panteleev ◽  
D. S. Gorbatyuk ◽  
M. L. Sazhnev ◽  
A. I. Kaz’min ◽  
V. S. Pereverzev ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Blood Loss ◽  
Postoperative Period ◽  
Lumbar Lordosis ◽  
Surgical Intervention ◽  
Pedicle Subtraction Osteotomy ◽  
Intraoperative Blood Loss ◽  
Revision Operations ◽  
Late Postoperative Period

Purpose of study: to evaluate clinical and roentgenologic results of the use of pedicle subtraction osteotomy (PSO) in primary and revision operations to determine the feasibility of radical spinal sagittal imbalance correction at primary surgical intervention.Patients and methods. Retrospective review of 42 patients (30 men and 12 women, mean age — 58.5 years) with rigid spinal deformities who underwent PSO was performed. Revision interventions (group R) were performed in 23 cases, primary (group P) — in 19 cases. The comparative analysis of spino-pelvic parameters and global spine balance, demographic indices, volume of intraoperative blood loss, duration of surgical intervention, complications in the late postoperative period and quality-of-life indices by SRS-22 and ODI scores was performed. Results. Minimum follow up period was 12 months. Osteotomy was more often performed at L3 level. No differences in the extent of fixation, duration of surgical intervention and degree of segmental correction were detected. The average blood loss was significantly lower in group P (p0.05). Analysis of the late postoperative period changes in roentgenologic parameters showed statistically significant differences for the lumbar lordosis index as well as inconsistency between the lumbar lordosis and pelvic index that were better in group P. Quality of life increased significantly in both groups with the only statistically significant difference in ODI that was better in group P. Serious complications were observed in 47.8 and 38.6% of cases in group R and group P, respectively (p0.05). Revision interventions were required in 26.1% of cases in group R and in 15.8% — in group P. Conclusion. In primary surgical interventions use of PSO technique enables to correct global spinal sagittal balance more effectively. Its use in primary interventions ensures lower volume of intraoperative blood loss as well as lower risk of pseudarthrosis formation and neurologic disorders development.

scholarly journals Management strategies for prosthetic joint infection: long-term infection control rates, overall survival rates, functional and quality of life outcomes

2021 ◽  
Vol 6 (9) ◽  
pp. 727-734
Author(s):  
Theofilos Karachalios ◽  
George A. Komnos
Keyword(s):  
Quality Of Life ◽  
Joint Infection ◽  
Management Strategies ◽  
Survival Rates ◽  
Outcome Data ◽  
Life Outcomes ◽  
Two Stage ◽  
One Stage ◽  
Prosthetic Joint

DAIR (debridement, antibiotics, and implant retention), one-stage and two-stage revision surgery are the most common management strategies for prosthetic joint infection (PJI) management. Our knowledge concerning their efficacy is based on short to medium-term low-quality studies. Most studies report infection recurrence rates or infection-free time intervals. However, long-term survival rates of the infection-free joints, functional and quality of life outcome data are of paramount importance. DAIR, one-stage and two-stage revision strategies are not unique surgical techniques, presenting several variables. Infection control rates for the above strategies vary from 75% to 90%, but comparisons are difficult because different indications and patient selection criteria are used in each strategy. Recent outcome data show that DAIR and one-stage revision in selected patients (based on host, bacteriological, soft tissue and type of infection criteria) may present improved functional and quality of life outcomes and reduced costs for health systems as compared to those of two-stage revision. It is expected that health system administrators and providers will apply pressure on surgeons and departments towards the wider use of DAIR and one-stage revision strategies. It is the orthopaedic surgeon’s responsibility to conduct quality studies in order to fully clarify the indications and outcomes of the different revision strategies. Cite this article: EFORT Open Rev 2021;6:727-734. DOI: 10.1302/2058-5241.6.210008

scholarly journals SURGICAL CORRECTION OF KYPHOSIS ASSOCIATED WITH SCHEUERMANN’S DISEASE

2005 ◽  
pp. 050-055
Author(s):  
Mikhail Vitalyevich Mikhailovsky ◽  
Vyacheslav Viktorovich Novikov ◽  
Aleksandr Sergeyevich Vasyura ◽  
Maya Nikolayevna Lebedeva
Keyword(s):  
Interbody Fusion ◽  
Surgical Intervention ◽  
Two Stage ◽  
Scheuermann’S Disease ◽  
Scheuermann's Disease ◽  
Loss Of Correction ◽  
Kyphosis Correction ◽  
Thoracic And Lumbar Spine ◽  
Surgery Department

Objective. To analyze the results of two-stage surgical treatment of progressive kyphosis associated with Scheuermann’s disease performed in the Spine Surgery Department for Children and Adolescents from 1996 till 2004. Material and Methods. Fourteen patients were surgically treated. Surgical intervention included segmental vertebrectomy, interbody fusion, and kyphosis correction with Cotrel – Dubousset Instrumentation (CDI). Results. Kyphosis was reduced from 78.1° to 43.4°; the loss of correction during the follow-up period (minimum 2 years) was 4.4°. Sagittal contour of the lower thoracic and lumbar spine was also normalized. Conclusion. Two-stage surgical intervention permits to achieve significant cosmetic and pain-reducing effect in patients with major kyphosis associated with Scheuermann’s disease.

scholarly journals Total en bloc spondylectomy combined with the satellite rod technique for spinal tumors

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Hongyu Wei ◽  
Chunke Dong ◽  
Jun Wu ◽  
Yuting Zhu ◽  
Haoning Ma
Keyword(s):  
Quality Of Life ◽  
Blood Loss ◽  
Spinal Tumors ◽  
Vertebral Height ◽  
En Bloc ◽  
Total En Bloc Spondylectomy ◽  
En Bloc Spondylectomy ◽  
Bloc Spondylectomy

Abstract Background Instrumentation failure (IF) is a common complication after total en bloc spondylectomy (TES) in spinal tumors. This study aims to evaluate the clinical outcomes of TES combined with the satellite rod technique for the treatment of primary and metastatic spinal tumors. Methods The clinical data of 15 consecutively treated patients with spinal tumors who underwent TES combined with the satellite rod technique by a single posterior approach from June 2015 to September 2018 were analyzed retrospectively. Radiographic parameters including the local kyphotic angle (LKA), anterior vertebral height (AVH), posterior vertebral height (PVH), and intervertebral titanium mesh cage height (ITMCH) were assessed preoperatively, postoperatively, and at the final follow-up. The visual analog scale (VAS), Oswestry Disability Index (ODI), and American Spinal Injury Association (ASIA) scale were used to assess quality of life and neurological function. The operative duration, volume of blood loss, and complications were also recorded. Results The mean operation time and volume of blood loss were 361.7 min and 2816.7 mL, respectively. During an average follow-up of 31.1 months, 2 patients died of tumor recurrence and multiple organ metastases, while recurrence was not found in any other patients. Solid fusion was achieved in all but one patient, and no implant-related complications occurred during the follow-up. The VAS, ODI, and ASIA scores significantly improved from before to after surgery (P < 0.05). The LKA, AVH, and PVH significantly improved from before to immediately after surgery and to the final follow-up (P < 0.05), and the postoperative and final follow-up values did not significantly differ (P > 0.05). Conclusions TES combined with the satellite rod technique can yield strong three-dimensional fixation and reduce the occurrence of rod breakage, thereby improving the long-term quality of life of patients with spinal tumors.

scholarly journals One-stage versus two-stage revision of the infected knee arthroplasty - a randomized multicenter clinical trial study protocol

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Martin Lindberg-Larsen ◽  
◽  
Anders Odgaard ◽  
Charlotte Fredborg ◽  
Henrik Morville Schrøder
Keyword(s):  
Quality Of Life ◽  
Clinical Trial ◽  
Cohort Study ◽  
Randomized Trial ◽  
Functional Status ◽  
Knee Arthroplasty ◽  
Stage Versus ◽  
Two Stage ◽  
One Stage

Abstract Background A two-stage prosthesis exchange procedure has been the gold standard in surgical treatment of the chronically infected knee arthroplasty so far. This includes 2 surgeries/hospitalizations and an interim period of 2–3 months between surgeries with impaired health, functional status and quality of life of the patients. A one-stage exchange procedure holds many obvious advantages compared to the two-stage approach, but outcomes of a one-stage versus two-stage procedures have never been investigated in a randomized clinical trial. The purpose of this study is primarily to investigate time-adjusted differences in functional status of patients after one-stage versus two-stage revision. Secondary, to report time-adjusted differences in quality of life, complications (including re-revisions due to infection) and mortality. Methods This study is a pragmatic, multi-center, randomized, non-inferiority trial comparing one-stage versus two-stage revision of the infected knee arthroplasty. Seven Danish hospitals are currently participating in the study, but additional hospitals can enter the study if adhering to protocol. Ninety-six patients will be included prospectively. Follow-up will be with PROM-questionnaires and clinical controls up to 10 years. The patients who are not able to participate in the randomized trial are followed in a parallel cohort study. PROM’s Oxford Knee Score and EQ5D + EQ5D VAS questionnaires are completed preoperatively and sent out to the study participants at 6 weeks, 3, 6, 9, 12, 18 and 24 months as well as 5 and 10 years postoperatively. In addition a tailor made cost questionnaire on the non-treating hospital resource use, community health and social service use, travel costs, time off work and informal care are sent out. Discussion If one of the two treatment alternatives is found superior in both domains of quality of life (both knee-specific and generic) and health economics, that treatment should be promoted. Other outcomes will open informed discussions about treatment strategies for periprosthetic knee infections. Trial registration The randomized trial is registered on ClinicalTrials.gov with ID NCT03435679, initial release date January 31, 2018 and the cohort study is registered with ID NCT04427943, submitted January 8, 2020 and posted June 11, 2020.

scholarly journals Laparoscopic transperitoneal renal cyst decortication

2014 ◽  
Vol 61 (1) ◽  
pp. 35-40
Author(s):  
Alexander Hinev ◽  
Deyan Anakievski
Keyword(s):  
Quality Of Life ◽  
Postoperative Complications ◽  
Blood Loss ◽  
Clinical Symptoms ◽  
Renal Cysts ◽  
Perioperative Blood Loss ◽  
Short Period ◽  
Laparoscopic Transperitoneal

The aim of this study was to report our experience with the llaparoscopic transperitoneal treatment of simple renal cysts, to analyze the immediate and long-term clinical outcomes, and to evaluate the efficacy and safety of this miniinvasive surgical technique. Between 2009 and 2014 we diagnosed and treated a total of 48 patients with symptomatic simple renal cysts. The diagnosis was set up by ultrasound (US) and/or computed tomography (CT) examination. All cases were managed by transperitoneal laparoscopic cyst decortication. Demographic data, perioperative blood loss, duration of operative procedure, length of hospital stay and peri- and postoperative complications were analyzed. Follow-up included clinical examination and renal US, performed at 3-monthly intervals during the first year and yearly thereafter. Patient age ranged from 32 to 68 years (mean age 52.4 years). 27(56.2%) of the patients were males and 21(43.8%) - females. 42(87.5%) of the cysts were peripheral, and 6(12.5%)-peripelvic; 28(58.3%) were localized to the left and 20 (41.7%) - to the right; and they ranged by size from 5 to 30 cm (mean 9.8 cm). 45 (93.8%) of the cysts were identified as category I, and only 3 (6.2%) - as category II, according to the Bosniak classification. None of the cases required conversion to open surgery. There were no peri- and postoperative complications. The average duration of the laparoscopic procedure was 55min, and the average perioperative blood loss - 50 mL. All patients had negative cytological and histological findings indicative for malignancy. The follow-up period ranged from 5 to 52ain months (average - 25.4 months). In 47cases (97.9%) exellent therapeutic results were reported: complete relief of clinical symptoms, fast recovery of physical activity and patient quality of life. There were three recurrences (6,2%) met in patients with multiple cysts, but only one of them required repeated surgery. Laparoscopic transperitoneal decortication is a miniinvasive, highly effective and safe method of treatment of symptomatic renal cysts. The immediate relief of clinical symptoms, the short period of reconvalescence, the excellent quality of life after surgery, and the low relapse rate confidently define it as the surgical method of choice.

scholarly journals Total en bloc spondylectomy combined with the satellite rod technique for spinal tumors

2020 ◽  
Author(s):  
Hongyu Wei ◽  
Chunke Dong ◽  
Jun Wu ◽  
Yuting Zhu ◽  
Haoning Ma
Keyword(s):  
Quality Of Life ◽  
Blood Loss ◽  
Spinal Tumors ◽  
Vertebral Height ◽  
En Bloc ◽  
Total En Bloc Spondylectomy ◽  
En Bloc Spondylectomy ◽  
Bloc Spondylectomy

Abstract Background: Instrumentation failure (IF) is a common complication after total en bloc spondylectomy (TES) in spinal tumors. This study aims to evaluate the clinical outcomes of TES combined with the satellite rod technique for the treatment of primary and metastatic spinal tumors.Methods: The clinical data of 15 consecutively treated patients with spinal tumors who underwent TES combined with satellite rod technique by a single posterior approach from June 2015 to September 2018 were analyzed retrospectively. Radiographic parameters including the local kyphotic angle (LKA), anterior vertebral height (AVH), posterior vertebral height (PVH) and intervertebral titanium mesh cage height (ITMCH) were assessed preoperatively, postoperatively and at the final follow-up. The visual analog scale (VAS), Oswestry Disability Index (ODI) and American Spinal Injury Association (ASIA) scale were used to assess quality of life and neurological function. The operative duration, volume of blood loss, and complications were also recorded.Results: The mean operation time and volume of blood loss were 361.7 min and 2816.7 mL, respectively. During an average follow-up of 31.1 months, 2 patients died of tumor recurrence and multiple organ metastases, while recurrence was not found in any other patients. Solid fusion was achieved in all but one patient, and no implant-related complications occurred during the follow-up. The VAS, ODI and ASIA scores significantly improved from before to after surgery (P<0.05). The LKA, AVH and PVH significantly improved from before to immediately after surgery and to the final follow-up (P<0.05), and the postoperative and final follow-up values did not significantly differ (P>0.05).Conclusions: TES combined with the satellite rod technique can yield strong three-dimensional fixation and reduce the occurrence of rod breakage, thereby improving the long-term quality of life of patients with spinal tumors.

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