Surgical management of axis' traumatic spondylolisthesis (Hangman's frature)

OBJECTIVE: To evaluate the results of surgical treatment using pedicle screws going through C2 pedicles for fixating the spondylolisthesis of the axis in patients who presented pseudoarthrosis after clinical treatment, or who have no condition for fixation with "halo vest", due to serious head trauma. METHOD: Ten patients have been operated from June 1998 to April 2002, nine suffering from traumatic spondylolisthesis of the axis caused by car accident and one horse fall. Four of those patients have undergone clinical treatment and presented signs of pseudoarthrosis, suffering intense pain at the movement of the cervical spine. Two of them presented moderate head trauma with multiple fractures of the skull. Another one was submitted to a surgical treatment for an acute extradural hematoma. Three patients presented a serious dislocation of C2 over C3. The patients were submitted to arthrodesis of the fractures with two screws, placed on the C2 pedicles, which allowed a better approximation of the fractures with the alignment of C2-C3. Two other patients required additional fixation with a plate on the lateral masses of C3. RESULTS: Nine patients had a good post surgery evolution with satisfactory consolidation of the fractures and disappearance of the symptoms. One patient had a good evolution but still has cervical pain resulting from strain. CONCLUSION: The fixation of the traumatic spondylolisthesis of the axis using screws in C2 pedicles and through fractures traces is a good option for treating patients who present pseudoarthrosis after clinical treatment or who present contraindication to the "halo vest", such as skull fracture or great lacerations in the scalp.

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Hidden, visceral and traumatic: a dramaturgical approach to men talking about their penis after surgery for penile cancer

10.31234/osf.io/dxnp6 ◽

2018 ◽

Author(s):

Peter Branney ◽

Karl Witty

Keyword(s):

Body Image ◽

Surgical Treatment ◽

Thematic Analysis ◽

Penile Cancer ◽

Stage Of Disease ◽

Self And Other ◽

Post Surgery ◽

Maximum Variation ◽

Sexual Object

Drawing upon concepts of expressive equipment and body image, the aim of this study is to explore how men diagnosed and treated for penile cancer construct their penis and its surgical disfigurement (penectomy). Using maximum variation sampling with the intention to acquire the broadest range of experiences of stage of disease and treatment, 27 cisgender men (aged 48-83, x=63) who had surgical treatment consented for their data to be archived for analysis. From a dramaturgical perspective, the constructionist thematic analysis explored direct and indirect talk about the penis after surgery. The analysis showed that through graphic and sequential narratives of dismemberment revealed, participants constructed a post-surgery period in which they both wanted and did-not-want to see their penis. Additionally, participants constructed themselves managing difficult emotions through others and seeing themselves being rejected by a potentially desiring (female) Other. The findings extend research on male genitals by showing how the post-surgery penis can function as something hidden but visceral and traumatic when revealed. Importantly, this paper illustrates body image as expressive equipment where body and identity are formed in the image of manhood, which is an intersubjective (sexual) object between self and other.

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Psychiatric and psychosocial morbidity 1 year after epilepsy surgery

Irish Journal of Psychological Medicine ◽

10.1017/ipm.2020.114 ◽

2020 ◽

pp. 1-8

Author(s):

S. Patel ◽

M. Clancy ◽

H. Barry ◽

N. Quigley ◽

M. Clarke ◽

...

Keyword(s):

Quality Of Life ◽

Surgical Treatment ◽

Epilepsy Surgery ◽

Refractory Epilepsy ◽

Post Surgery ◽

Axis I ◽

Patients With Epilepsy ◽

The Impact

Abstract Objectives: There is a high rate of psychiatric comorbidity in patients with epilepsy. However, the impact of surgical treatment of refractory epilepsy on psychopathology remains under investigation. We aimed to examine the impact of epilepsy surgery on psychopathology and quality of life at 1-year post-surgery in a population of patients with epilepsy refractory to medication. Methods: This study initially assessed 48 patients with refractory epilepsy using the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I), the Hospital Anxiety and Depression Scale (HADS) and the Quality of Life in Epilepsy Inventory 89 (QOLIE-89) on admission to an Epilepsy Monitoring Unit (EMU) as part of their pre-surgical assessment. These patients were again assessed using the SCID-I, QOLIE-89 and HADS at 1-year follow-up post-surgery. Results: There was a significant reduction in psychopathology, particularly psychosis, following surgery at 1-year follow-up (p < 0.021). There were no new cases of de novo psychosis and surgery was also associated with a significant improvement in the quality of life scores (p < 0.001). Conclusions: This study demonstrates the impact of epilepsy surgery on psychopathology and quality of life in a patient population with refractory surgery. The presence of a psychiatric illness should not be a barrier to access surgical treatment.

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Feline head trauma: a CT analysis of skull fractures and their management in 75 cats

Journal of Feline Medicine and Surgery ◽

10.1177/1098612x18819183 ◽

2018 ◽

Vol 21 (12) ◽

pp. 1120-1126 ◽

Cited By ~ 3

Author(s):

Rebekah Knight ◽

Richard L Meeson

Keyword(s):

Risk Factors ◽

Head Trauma ◽

Bone Fractures ◽

Skull Fracture ◽

Dental Occlusion ◽

Skull Fractures ◽

Common Cause ◽

Increased Risk ◽

Multiple Regions ◽

Upper Jaw

Objectives The aim of this study was to describe and evaluate the configurations and management of feline skull fractures and concurrent injuries following head trauma. Methods Medical records and CT images were reviewed for cats with skull fractures confirmed by CT that were managed conservatively or with surgery. Details of signalment, presentation, skull fracture configuration, management, re-examination, and complications or mortality were recorded and analysed. Results Seventy-five cats (53 males, 22 females) with a mean age of 4.8 ± 3 years met the inclusion criteria. Eighty-nine percent of cats had fractures in multiple bones of the skull, with the mandible, upper jaw (maxilla, incisive and nasal bones) and craniofacial regions most commonly affected. Temporomandibular joint injury occurred in 56% of cats. Road traffic accidents (RTAs) were the most common cause of skull fractures, occurring in 89% of cats, and caused fractures of multiple regions of the skull. RTAs were also associated with high levels of concurrent injuries, particularly ophthalmic, neurological and thoracic injuries. A more limited distribution of injuries was seen in non-RTA cats. Equal numbers of cats were managed conservatively or surgically (47%). Mortality rate was 8% and complications were reported in 22% of cats. Increasing age at presentation and presence of internal upper jaw fractures were risk factors for development of complications. No risk factors were identified for mortality. Conclusions and relevance RTAs were the most common cause of feline skull fractures and resulted in fractures in multiple regions of the skull and concurrent injuries occurred frequently. Problems with dental occlusion were uncommon post-treatment. An increased risk of implant loosening and malocclusion was seen with palatine and pterygoid bone fractures and hard palate injuries. This study provides useful additional information regarding feline skull fractures, concurrent injuries and management techniques following head trauma.

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Diagnosis and management of gastroesophageal reflux disease

ABCD Arquivos Brasileiros de Cirurgia Digestiva (São Paulo) ◽

10.1590/s0102-67202014000300013 ◽

2014 ◽

Vol 27 (3) ◽

pp. 210-215 ◽

Cited By ~ 9

Author(s):

Maria Aparecida Coelho de Arruda Henry

Keyword(s):

Quality Of Life ◽

Surgical Treatment ◽

Gastroesophageal Reflux Disease ◽

Drug Use ◽

Gastroesophageal Reflux ◽

Reflux Disease ◽

Disease Diagnosis ◽

Clinical Treatment ◽

Atypical Symptoms

INTRODUCTION: Gastroesophageal reflux disease (GERD) is probably one of the most prevalent diseases in the world that also compromises the quality of life of the affected significantly. Its incidence in Brazil is 12%, corresponding to 20 million individuals. OBJECTIVE: To update the GERD management and the new trends on diagnosis and treatment, reviewing the international and Brazilian experience on it. METHOD: The literature review was based on papers published on Medline/Pubmed, SciELO, Lilacs, Embase and Cochrane crossing the following headings: gastroesophageal reflux disease, diagnosis, clinical treatment, surgery, fundoplication. RESULTS: Various factors are involved on GERD physiopathology, the most important being the transient lower esophageal sphincter relaxation. Clinical manifestations are heartburn, regurgitation (typical symptoms), cough, chest pain, asthma, hoarseness and throat clearing (atypical symptoms), which may be followed or not by typical symptoms. GERD patients may present complications such as peptic stenosis, hemorrhage, and Barrett's esophagus, which is the most important predisposing factor to adenocarcinoma. The GERD diagnosis must be based on the anamnesis and the symptoms must be evaluated in terms of duration, intensity, frequency, triggering and relief factors, pattern of evolution and impact on the patient's quality of life. The diagnosis requires confirmation with different exams. The goal of the clinical treatment is to relieve the symptoms and surgical treatment is indicated for patients who require continued drug use, with intolerance to prolonged clinical treatment and with GERD complications. CONCLUSION: GERD is a major digestive health problem and affect 12% of Brazilian people. The anamnesis is fundamental for the diagnosis of GERD, with special analysis of the typical and atypical symptoms (duration, intensity, frequency, triggering and relief factors, evolution and impact on the life quality). High digestive endoscopy and esophageal pHmetry are the most sensitive diagnosctic methods. The clinical treatment is useful in controlling the symptoms; however, the great problem is keeping the patients asymptomatic over time. Surgical treatment is indicated for patients who required continued drug use, intolerant to the drugs and with complicated forms of GERD.

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Repeated fracture of the femoral neck. Tactics of treatment. Clinical observation

Pediatric Traumatology Orthopaedics and Reconstructive Surgery ◽

10.17816/ptors3248-51 ◽

2015 ◽

Vol 3 (2) ◽

pp. 48-51

Author(s):

Pavel Igorevich Bortulev ◽

Yaroslav Nikolaevich Proshchenko ◽

Anatoliy Vasilievich Ovsyankin ◽

Alexey Polikarpovich Drozdetskiy ◽

Oksana Vyacheslavovna Bortuleva

Keyword(s):

Case Report ◽

Surgical Treatment ◽

Femoral Neck ◽

Clinical Observation ◽

Multiple Fractures

The article presents a case report of surgical treatment of multiple fractures of the femoral neck in 15-year old child.

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Massive subgaleal hematoma in a 62-year-old man treated with apixaban as a consequence of mild head trauma

Folia Medica ◽

10.3897/folmed.63.e58872 ◽

2021 ◽

Vol 63 (4) ◽

pp. 613-617

Author(s):

Diamantoula Pagkou ◽

Theodosios Papavramidis ◽

Xanthippi Mavropoulou ◽

Moysis Moysidis ◽

Ioannis Patsalas

Keyword(s):

Skull Base ◽

Head Trauma ◽

Therapeutic Strategy ◽

Chronic Atrial Fibrillation ◽

Hair Pulling ◽

The Third ◽

Subgaleal Hematoma ◽

Car Accident ◽

Subgaleal Space ◽

Full Body

Subgaleal hematoma, accumulation of blood in the loose areolar tissue of the subgaleal space of the skull, is considered the most catastrophic complication of instrumental delivery. It is a rare finding in older ages, usually associated with coagulation disorders, severe head trauma leading to skull base fractures and accidental or abusive hair pulling. Complications include periorbital necrotising fasciitis, permanent blindness, infections and, in extreme rare cases, airway obstruction. Most cases of subgaleal hematoma resolve spontaneously, without the need of aspiration or drainage. We present here the case of a 62-year-old male on anticoagulant therapy with apixaban for chronic atrial fibrillation, who came to the emergency department after a car accident suffering from mild head trauma. The patient was complaining of a diffuse headache and physical examination showed a large ecchymosis and edema on the frontal area of the head. His neurological examination was unremarkable. Full-body computed tomography (CT) revealed a fracture of the third right rib. Twelve hours after admission, due to an excessive decrease of hematocrit, a second CT was performed. Although the images didn’t show intracranial hemorrhage or skull base fractures, a large and diffuse hematoma of the subaponeurotic space was observed and the diagnosis of subgaleal hematoma was confirmed. Massive subgaleal hematoma after mild head trauma is rather infrequent. Early diagnosis improves outcomes and can avert serious complications. Therapeutic strategy should be based on the severity of each case. In our case, conservative treatment appeared to be a valid alternative to surgery, as hematoma resolved spontaneously within 10 days. It is noteworthy that the use of anticoagulation is the only evident factor that could have been the precipitating factor for the development of the hematoma in our patient.

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Clinical Study of Surgical Combination Chemotherapy in the Treatment of Borderline Ovarian Tumors

Journal of Clinical and Nursing Research ◽

10.26689/jcnr.v1i1.108 ◽

1970 ◽

Vol 1 (1) ◽

Author(s):

Chen Ming

Keyword(s):

Clinical Study ◽

Surgical Treatment ◽

Combination Chemotherapy ◽

Clinical Manifestations ◽

Research Process ◽

Clinical Treatment ◽

Ovarian Tumors ◽

Borderline Ovarian Tumors

Borderline ovarian tumors belong to a kind of epithelial ovarian tumors, nature between benign and malignant, the incidence of ovarian tumors accounted for 4.0% to 14.0%, clinical manifestations and malignant have a greater similarity,will be transferred, and can recurrence[1]. For the disease,most of the clinical treatment will be given, in recent years,after the completion of surgical treatment, our hospital also onÂ such patients with chemotherapy[2]. In this study, 32 patientsÂ were divided into two groups, one group received surgery,chemotherapy, a group of patients undergoing surgery alone,the research process and the results reported in the study ofÂ the results of the combination of surgery and chemotherapy inÂ the treatment of borderline ovarian tumors as follows.

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Case report of the successful removal of a haemangioma of the left ventricle in a paediatric patient

Patologiya krovoobrashcheniya i kardiokhirurgiya ◽

10.21688/1681-3472-2020-3-132-137 ◽

2020 ◽

Vol 24 (3) ◽

pp. 132

Author(s):

U. G. Kolbik ◽

A. V. Gorustovich ◽

Yu. I. Linnik ◽

M. M. Shved ◽

V. V. Drozdovskaya ◽

...

Keyword(s):

Surgical Treatment ◽

Paediatric Patient ◽

Conflict Of Interest ◽

Recovery Period ◽

Final Diagnosis ◽

Surgical Removal ◽

Capillary Haemangioma ◽

Cardiac Tumours ◽

Post Surgery ◽

Choice Of Treatment

This publication presents the clinical observation in a paediatric patient with haemangioma of the left stomach. The effectiveness of surgical treatment of this disease is also noted. We assess the challenges in diagnosis and the choice of treatment of this pathology in children and the effectiveness of surgical treatment disease. Primary cardiac tumours are rare; vascular tumours and haemangiomas are rarer. The clinical picture of heart haemangioma is non-specific and varies as per its location and size. Echocardiography is the main diagnostic method for this disease. However, in most cases of preoperative diagnostic examination, the pre-surgery diagnosis is not confirmed. The final diagnosis of capillary haemangioma is established following immunohistochemical staining of the surgical material. Thus far, owing to the rare occurrence, a generally accepted tactic for the treatment of such patients with vascular heart tumours has not been developed. This clinical case describes our experience of treating a rare pathology in children with unusual localisation as well as the rapid successful surgical removal of the tumour without complications and with a favourable post-surgery recovery period.Received 14 May 2020. Revised 15 June 2020. Accepted 26 June 2020.Funding: The study did not have sponsorship.Conflict of interest: Authors declare no conflict of interest.Author contributions Literature review: U.G. Kolbik, A.V. Gorustovich, Y.I. Linnik Illustrations: U.G. Kolbik, I.V. Sakharov, V.V. Drozdovskaya Drafting the article: U.G. Kolbik, A.V. Gorustovich, I.V. Sakharov Critical revision of the article: I.V. Sakharov, M.M. Shved, Yu.I. Linnik Surgical treatment: A.V. Gorustovich, M.M. Shved, U.G. Kolbik Final approval of the version to be published: U.G. Kolbik, A.V. Gorustovich, Yu.I. Linnik, M.M. Shved, V.V. Drozdovskaya, I.V. Sakharov, K.V. Drozdovski

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Diagnostic and Clinical Management of Skull Fractures in Children

Journal of Clinical Imaging Science ◽

10.4103/2156-7514.194261 ◽

2016 ◽

Vol 6 ◽

pp. 47

Author(s):

Christoph Arneitz ◽

Maria Sinzig ◽

Günter Fasching

Keyword(s):

Hospital Stay ◽

Head Trauma ◽

Clinical Management ◽

Skull Fracture ◽

Neurological Symptoms ◽

Ct Scans ◽

Skull Fractures ◽

X Rays ◽

Minor Head Trauma ◽

The Mean

Objective: The indications of routine skull X-rays after mild head trauma are still in discussion, and the clinical management of a child with a skull fracture remains controversial. The aim of our retrospective study was to evaluate our diagnostic and clinical management of children with skull fractures following minor head trauma. Methods: We worked up the medical history of all consecutive patients with a skull fracture treated in our hospital from January 2009 to October 2014 and investigated all skull X-rays in our hospital during this period. Results: In 5217 skull radiographies, 66 skull fractures (1.3%) were detected. The mean age of all our patients was 5.9 years (median age: 4.0 years); the mean age of patients with a diagnosed skull fracture was 2.3 years (median age: 0.8 years). A total of 1658 children (32%) were <2 years old. A typical boggy swelling was present in 61% of all skull fractures. The majority of injuries were caused by falls (77%). Nine patients (14%) required a computed tomography (CT) scan during their hospital stay due to neurological symptoms, and four patients had a brain magnetic resonance imaging. Nine patients (14%) showed an intracranial hemorrhage (ICH; mean age: 7.3 years); one patient had a neurosurgery because of a depressed skull fracture. Nine patients (14%) were observed at our pediatric intensive care unit for a mean time of 2.9 days. The mean hospital stay was 4.2 days. Conclusions: Our findings support previous evidence against the routine use of skull X-rays for evaluation of children with minor head injury. The rate of diagnosed skull fractures in radiographs following minor head trauma is low, and additional CT scans are not indicated in asymptomatic patient with a linear skull fracture. All detected ICHs could be treated conservatively. Children under the age of 2 years have the highest risk of skull fractures after minor head trauma, but do not have a higher incidence of intracranial bleeding. Neuroobservation without initial CT scans is safe in infants and children following minor head trauma and CT scans should be reserved for patients with neurological symptoms.

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THE USE OF NITINOL RODS IN SURGICAL TREATMENT OF DEGENERATIVE SCOLIOSIS. 2.5-YEAR FOLLOW-UP

Coluna/Columna ◽

10.1590/s1808-185120161501156149 ◽

2016 ◽

Vol 15 (1) ◽

pp. 22-25

Author(s):

Natalia Sergeyevna Morozova ◽

Dmitriy Aleksandrovich Kolbovsky ◽

Arkadiy Ivanovich Kazmin ◽

Sergey Vasilievich Kolesov

Keyword(s):

Surgical Treatment ◽

Interbody Fusion ◽

Deformity Correction ◽

Pedicle Screws ◽

Control Group ◽

Rigid Fixation ◽

Degenerative Lumbar Scoliosis ◽

Lumbosacral Region ◽

Pedicle Fixation

ABSTRACT Objectives: To compare the outcomes of surgical treatment with lumbar fixation using nitinol rods without fusion and with standard lumbar fixation with titanium rods and interbody fusion. Methods: Treatment results of 70 patients with degenerative lumbar scoliosis aged 40 to 82 were analyzed. In all cases pedicle screws and nitinol rods with a diameter of 5.5 mm were used. Thirty patients underwent fixation at L1-S1 and 40 patients underwent fixation at L1-L5. Spinal fusion was not performed. All patients had radiography, CT and MRI performed. The results were assessed according to the Oswestry scale, SRS 22, SF 36 and VAS. The minimum follow-up period for all patients was 2.5 years. For the control group, consisting of 72 patients, pedicle fixation with titanium rods and interbody fusion in the lumbosacral region were performed. Results: The average level of deformity correction equaled 25° (10° - 38°). The analysis of X-ray and CT-scans revealed a single patient with implant instability, two patients with bone resorption around the screws and one patient with rod fractures. Functional radiography 2.5 years after surgery showed an average mobility of the lumbar spine of 21° (15° - 30°). There were no problems at the adjacent levels. Conclusions: The use of nitinol rods in spinal deformity surgery is promising. This technology is an alternative to rigid fixation. Continued gathering of clinical data and its further evaluation is necessary.

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