scholarly journals Physical Therapy Following Anterior Cervical Discectomy and Fusion: A Study of Current Clinical Practice and Therapist Beliefs

2015 ◽  
Vol 2 (2) ◽  
pp. 399 ◽  
Author(s):  
Brian T. Swanson ◽  
Robin R. Leger
2015 ◽  
Vol 84 (1) ◽  
Author(s):  
Tilen Žele ◽  
Borut Prestor

Background:One of the most common surgical operations for treatment of cervical spondylosis is anterior cervical discectomy with fusion (ACDF). In order to achieve stable fusion after discectomy and avoid dysphagia the artificial stand-alone zero-profile cages with integrated screws were developed and introduced into clinical practice. Outcome and complications after ACDF with such cages were not adequately assessed yet.Methods:We analyzed 20 consecutive patients with cervical spondylosis treated in our institution with ACDF with stand-alone zero-profile cage Zero-P. Before and after surgery and then 6, 12 and 24 months after surgery we assessed the level of pain with VAS scale, severity of myelopathy with mJOA scale and dysphagia with four level scale. Treatment outcome was assessed after 2 years according to Odom's criteria.Results:No complications occurred during surgery or recovery after surgery. The VAS score after surgery and then after 6, 12 and 24 months was statistically significantly lower than before surgery (p<0.05). The mJOA scores were 6, 12 and 24 months after surgery statistically significantly higher than before surgery (p<0.05). Transient and mild dysphagia was present after surgery in 15% (3/20) of patients and 6, 12 or 24 months after surgery in none. Outcome after 2 years was excellent in 9 patients and good in 11 patients.Conclusions:Operative treatment of symptomatic cervical spondylosis with ACDF using stand-alone zero-profile cage with integrated screws is safe and efficient. Incidence of dysphagia after surgery is low and generally transient.


2019 ◽  
Vol 27 (2) ◽  
pp. 74-77
Author(s):  
Victoria Team ◽  
Georgina Gethin ◽  
John D Ivory ◽  
Kimberley Crawford ◽  
Ayoub Bouguettaya ◽  
...  

Venous leg ulcers (VLUs) are a significant complication amongst persons with chronic venous insufficiency (CVI) that frequently follow a cycle of healing and recurrence. Current clinical practice guidelines (CPGs) recommend applying below knee compression to improve VLU healing. Compression could be applied if the Ankle Brachial Pressure Index (ABPI) rules out significant arterial disease, as sufficient peripheral arterial circulation is necessary to ensure safe compression use. We conducted a content analysis of 13 global CPGs on the accuracy of recommendations related to ABPI and compression application. Eight CPGs indicated that compression is recommended when the ABPI is between 0.8 and 1.2 mmHg. However, this review found there is disagreement between 13 global VLU CPGs, with a lack of clarity on whether or not compression is indicated for patients with ABPIs between 0.6 and 0.8 mmHg. Some CPGs recommend reduced compression for treatment of VLUs, while others do not recommend any type of compression at all. This has implications for when it is safe to apply compression, and the inconsistency in evidence indicates that specialist advice may be required at levels beyond the ABPI “safe” range listed above.


2019 ◽  
Vol 110 (1) ◽  
Author(s):  
Abhishek Sharma ◽  
Nidhi Madan

2016 ◽  
Vol 22 (13) ◽  
pp. 1888-1895 ◽  
Author(s):  
Nikolaos A. Magkoutis ◽  
Sabi Fradi ◽  
Alexandre Azmoun ◽  
Ramsi Ramadan ◽  
Sami Ben Ouanes ◽  
...  

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