scholarly journals Optimization of Surgical Care and Anesthesia in the Treatment of Multilevel Degenerative Diseases of the Lumbar Spine in Patients with Overweight and Obesity

2018 ◽  
Vol 73 (6) ◽  
pp. 401-410 ◽  
Author(s):  
Vadim A. Byvaltsev ◽  
Andrey A. Kalinin ◽  
Victoria Yu. Goloborodko
Keyword(s):  
Lumbar Spine ◽  
Minimally Invasive ◽  
Surgical Procedures ◽  
Surgical Techniques ◽  
Surgical Care ◽  
Pain Syndrome ◽  
Overweight And Obesity ◽  
Degenerative Diseases ◽  
Minimally Invasive Surgical ◽  
Paravertebral Muscles

Background: The provision of surgical care in the treatment of degenerative diseases of the lumbar spine in patients with obesity and obesity is associated with significant risks of anesthesia and the development of perioperative complications. Aims: to analyze the results of the introduction of a combination of surgical procedures and anesthesia in the treatment of multilevel degenerative diseases of the lumbar spine in patients with excessive body weight and obesity.Materials and methods: The results of surgical treatment of 86 patients were studied, 2 groups were identified. In the study group (SG, n=37), minimally invasive surgical techniques and original surgical approach, paravertebral musculature infiltration with bupivacaine with epinephrine, and multimodal anesthesia with dexmedetomidine were used. The comparison group (CG, n=49) consisted of patients who used the technique of traditional open transpedicular fixation in combination with the posterior interbody fusion without the above combination of surgical procedures and anesthesia. Observation and clinical evaluation was performed in the early (during hospitalization) and in the distant (on average 36 months) postoperative periods.Results: In SG there were no changes in hemodynamics and better results were obtained on the speed of recovery of psychomotor functions. The use of local anesthetics significantly reduced the local pain syndrome (p0.05) and the need for analgesics (p=0.002). Comparative analysis in the main group revealed significantly better results in indices of the duration of the operation [SG 145 (105; 155) min, CG 185 (100; 205) min; p=0.02], the volume of blood loss [SG 110 (90; 140) ml, CG 510 (390; 640) ml; p0.001], the activation time [SG 1 (1; 2) days, CG 3 (3; 4) days; p=0.01], the length of hospitalization [SG 10 (9; 11) days, CG 13 (12; 15) days; p=0,03], remote clinical parameters of the pain syndrome level from the visual analogue scale in the lower extremities [SG 3 (1; 4) mm, CG 9 (6; 14) mm; p=0.006] and the lumbar spine [SG 6 (4; 9) mm, CG 16 (11; 21) mm; p=0.001], functional state according to ODI [SG 8 (6; 10) points, CG 16 (12; 24) points; p=0.008], subjective satisfaction with the operation performed on the Macnab scale (p=0.01). The number of postoperative complications in SG was 8%, in CG ― 18% (p=0.006).Conclusions: Analysis of the results of the introduction of a combination of surgical and anesthetic support methods in the treatment of multilevel degenerative diseases of the lumbar spine in patients with overweight and obesity, including minimally invasive surgical techniques, infiltration of paravertebral muscles with bupivacaine and epinephrine, multimodal anesthesia with dexmedetomidine showed its high perioperative safety, low number of complications, as well as better and clinical outcomes in the early and late postoperative periods.

scholarly journals Surgical Removal of Defects in the Palate with the Use of TiNi Mesh

2017 ◽  
Vol 2 (1) ◽  
pp. 354
Author(s):  
M.N. Shakirov ◽  
R.N. Dzhonibekova ◽  
I.D. Tazin ◽  
X.O. Gafarov ◽  
V.Y. Mitasov
Keyword(s):  
Surgical Technique ◽  
Connective Tissue ◽  
Minimally Invasive ◽  
Surgical Procedures ◽  
Surgical Techniques ◽  
The Body ◽  
Surgical Removal ◽  
Minimally Invasive Surgical ◽  
Body Tissues

Application of a thin- profiled mesh NiTi with filaments thickness of 40 micrometer sand with the cell size of 3x3-5x5 mm for patients allows to improve the quality of the surgical technique in conducting surgical procedures for eliminating different forms and sizes of the palate defects. Due to its biochemical, biophysical compatibility with the body tissues and the peculiar integration properties a connective tissue grows around and through the structure of the implant by forming a durable frame. At the same time this process takes place by type of covering the muco-periosteal cover from the wound periphery to the center of the palate, over the implant material and completes with the full elimination of the existing defect. The developed method should be considered as minimally invasive surgical techniques and is recommended as a method of choice for patients with various background diseases.

scholarly journals Comparative Assessment of Original vs. Standard Surgery Techniques in Treatment for Purulent Pyelonephritis

2021 ◽  
Vol 11 (4) ◽  
pp. 288-292
Author(s):  
V. A. Ananev ◽  
V. N. Pavlov ◽  
A. M. Pushkarev
Keyword(s):  
Minimally Invasive ◽  
Surgical Techniques ◽  
Pain Syndrome ◽  
Cortical Layer ◽  
Minimally Invasive Technique ◽  
Invasive Technique ◽  
Intraarterial Infusion ◽  
Minimally Invasive Surgical ◽  
Destructive Processes ◽  
Laparoscopic Techniques

Background. Modern minimally invasive surgical techniques reduce traumatism of operative interventions and aggressive anaesthesia, which accordingly shortens the patient’s hospital stay and rehabilitation period.Aim. An improvement of surgical outcomes in patients with purulent pyelonephritis via introduction of laparoscopic techniques.Materials and methods. Th e study included 80 purulent pyelonephritis patients operated at the Territorial Clinical Hospital during 2006—2018. Th e patients were divided between two cohorts. Cohort 1 included 40 (50 %) patients operated with standard techniques (ST), cohort 2 — 40 (50 %) patients having surgery by an original minimally invasive technique (OT). Kidney decapsulation was found to outcome in parenchymal decompression and blood circulation restore in cortical layer. Intraarterial infusion of alprostadil prevents further spread of purulent-destructive processes in kidney.Results and discussion. In patients with the minimally invasive technique, postoperative period proceeded at no complications. On day 1, the patients reported reduced pain syndrome in the surgical area. Contrasted renal MSCT before and aft er surgery showed the recovery of renal blood flow and significant diminishing of destruction foci in short term. Nephrectomy was not performed as no-indication.Conclusion. The treatment outcomes in 40 patients having the new surgical technique demonstrate its efficacy and applicability in clinical practice.

Minimally Invasive Surgical Techniques to Treat Spine Infection S

1996 ◽  
Vol 27 (1) ◽  
pp. 183-199 ◽  
Author(s):  
Larry M. Parker ◽  
Paul C. McAfee ◽  
Ira L. Fedder ◽  
James C. Weis ◽  
W. Peter Geis
Keyword(s):  
Minimally Invasive ◽  
Surgical Techniques ◽  
Spine Infection ◽  
Minimally Invasive Surgical

scholarly journals Minimum Invasive Stabilizing and Decompressive-Stabilizing Methods of Surgical Treatment for Degenerative-Dystrophic Lesions of Spine

2011 ◽  
Vol 18 (4) ◽  
pp. 3-10
Author(s):  
A V Krut'ko ◽  
Shamil' Al'firovich Akhmet'yanov ◽  
D M Kozlov ◽  
A V Peleganchuk ◽  
A V Bulatov ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Lumbar Spine ◽  
Surgical Techniques ◽  
Pain Syndrome ◽  
Early Postoperative Period ◽  
Main Group ◽  
Control Group ◽  
Surgical Interventions ◽  
Comparative Group ◽  
Operative Wound

Results of randomized prospective study with participation of 94 patients aged from 20 to 70 years with monosegmental lumbar spine lesions are presented. Minimum invasive surgical interventions were performed in 55 patients from the main group. Control group consisted of 39 patients in whom decompressive-stabilizing operations via conventional posteromedian approach with skeletization of posterior segments of vertebral column were performed. Average size of operative wound in open interventions more than 10 times exceeded that size in minimum invasive interventions and made up 484 ± 56 and 36 ± 12 sq.cm, respectively. Mean blood loss was 326.6 ± 278.0 ml in the main group and 855.1 ± 512.0 ml in the comparative one. In the main group no one patient required substitution hemotransfusion, while in 13 patients from the comparative group donor erythrocytic mass and/or fresh-frozen plasma were used to eliminate the deficit of blood components. Intensity of pain syndrome in the zone of surgical intervention by visual analog scale in the main group was lower than in comparative group. In the main and comparative groups the duration of hospitalization made up 6.1 ± 2.7 and 9.7 ± 3.7 bed days, respectively. In no one patient from the main group complications in the zone of operative wound were noted. Three patients from the comparative group required secondary debridement and in 1 patient early deep operative wound suppuration was observed. Application of low invasive surgical techniques for the treatment of patients with degenerative lumbar spine lesions enabled to perform radical surgical treatment with minimal iatrogenic injury. The method possessed indubitable advantages over the conventional open operations especially intraoperatively and in early postoperative period.

Sign in / Sign up

Export Citation Format

Share Document