SURGICAL TREATMENT OF FRACTURES OF THE ANKYLOSED SPINE

ABSTRACT Objective We aim to identify retrospectively surgically treated patients with an ankylosed spine who sustained a vertebral fracture. Our goal is to evaluate the main outcomes and complications. Methods We selected patients through the database of surgical interventions in the setting of fractures of an ankylosed spine segment between January 1st 2008 and June 30th 2018. We collected data from digital medical records. The parameters analyzed include hospital length of stay, Intensive Care Unit (ICU) admission, perioperative and postoperative complications as well as neurological evolution. Results Fractures occurred in 14 patients with ankylosing spondylitis (82%) and 3 patients with diffuse idiopathic skeletal hyperostosis (18%). All patients were male and the mean age was 69 years. Fourteen fractures occurred after minor trauma (83%), of which 11 were due to falls from standing height or lower (65%). The cervical spine represents the majority of the levels involved (65%). Seven patients were admitted to the ICU (41%) and 11 suffered neurological damage. There was improvement of neurological status in less than 50% and there were high percentages of post-operative complications. Conclusion Patients with ankylosed spine diseases are at higher risk for vertebral fracture, even after minor trauma, and these are located predominantly in the cervical spine. The surgical treatment of these conditions is effective as it allows improvement of the patient’s neurological status. However, they still present higher morbidity and mortality, as well as increased post-op complications. Prevention of falls may drastically change patients’ outcome, neurological function and independence in activities of daily living. Level of evidence IV; A case series therapeutic study.

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Radiographic assessment of AO 44-B1 and -B2 ankle fractures

Journal of the Foot & Ankle ◽

10.30795/jfootankle.2021.v15.1229 ◽

2021 ◽

Vol 15 (1) ◽

pp. 31-36

Author(s):

Pedro Labronici ◽

Fabricio Fogagnolo ◽

William Belangero ◽

Luiz Amorim

Keyword(s):

Surgical Treatment ◽

Case Series ◽

The Other ◽

Ankle Fractures ◽

Radiographic Assessment ◽

Level Of Evidence ◽

Radiographic Images ◽

Other Hand ◽

Lower Frequencies

Objective: To verify if there is a type of image that guides the surgeon in recommending surgical treatment for ankle fractures and assess whether this decision is associated with the evaluator’s age and experience, considering surgeons of different nationalities. Methods: We analyzed 3 different presentations of radiographic images of ankle fractures in 36 patients: anteroposterior and lateral views, true anteroposterior and lateral views, as well as the 3 grouped images. Images were assessed randomly and independently by 89 professionals of different nationalities, ages, and experience. Results: Among professionals from Ecuador, Argentina, Mexico, and Chile, surgery recommendations were more frequent when images were presented in true anteroposterior and lateral views. For professionals from Peru, Venezuela, Bolivia, Paraguay, Brazil, Colombia, Uruguay, and Guatemala, as well as globally, recommendations for surgery were more frequent when grouped images of the 3 positions were presented. In all countries and globally, we verified lower frequencies of surgery recommendations when presenting only anteroposterior and lateral views. Conclusion: In most countries, surgery recommendations were more frequent when grouped images of all 3 views were presented. On the other hand, the highest frequencies of surgery recommendations were observed when images were presented only in true anteroposterior and lateral views. Surgery recommendations were not associated with the experience (years since graduation) of the evaluating physician. Level of Evidence IV; Prognostic Studies; Case Series.

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RESULTS OF TREATMENT OF PLICA SYNDROME OF THE KNEE

Acta Ortopédica Brasileira ◽

10.1590/1413-785220212902241609 ◽

2021 ◽

Vol 29 (2) ◽

pp. 72-75

Author(s):

GILBERTO LUIS CAMANHO ◽

RICCARDO GOMES GOBBI ◽

MARTA HALASZ DE ANDRADE

Keyword(s):

Surgical Treatment ◽

Case Series ◽

Rehabilitation Program ◽

Level Of Evidence ◽

Sports Activity ◽

Results Of Treatment ◽

Rehabilitation Period ◽

Plica Syndrome ◽

Synovial Fold ◽

Non Surgical Treatment

ABSTRACT Objective: The synovial fold is an intra-articular structure found in more than 50% of the knees, which can cause symptoms similar to meniscal injuries. These symptoms are mostly related to hypertrophy of the synovial fold resulting from inadequate physical activity. Conservative treatment with readjustment of sports activity and muscle rebalancing solves most cases. Rare cases require surgical treatment, which is indicated due to the persistence of instability, blockage and pain. We present our experience in the treatment of this pathology. Methods: 58 patients (70 knees), with 62 knees treated conservatively and 8 treated surgically exclusively for the pathological synovial fold. Results: Description of the series and treatment results are reported. Conclusion: The non-surgical treatment of the pathological synovial fold of the knee provided good results within 60 days of rehabilitation program in almost 90% of the patients. Arthroscopic resection of the synovial fold is a surgery that has a longer and laborious rehabilitation period, despite good results in most cases. Level of Evidence IV, Case series.

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LUMBAR SPINAL STENOSIS: EVALUATION OF PAIN AND LIFE QUALITY AFTER SURGICAL TREATMENT

Coluna/Columna ◽

10.1590/s1808-185120191801168174 ◽

2019 ◽

Vol 18 (1) ◽

pp. 37-42

Author(s):

Gustavo Alvarenga ◽

João Otávio Araújo Rotini ◽

Leonardo Yukio Jorge Asano ◽

Vinícius Alves de Andrade ◽

André Evaristo Marcondes Cesar ◽

...

Keyword(s):

Quality Of Life ◽

Surgical Treatment ◽

Life Quality ◽

Case Series ◽

Level Of Evidence ◽

The Mean ◽

One Year ◽

Lumbar Spinal

ABSTRACT Objective: The objective of this study was to present an analysis of progression of the quality of life and pain in patients undergoing surgical treatment of LSS and the potential correlations between individual factors and the clinical outcome observed. Methods: We studied 111 patients undergoing surgical treatment of LSS from January 2009 to December 2011 using the functional capacity (ODI) and pain (VAS) questionnaires. The preoperative data were compared statistically with the results obtained during the postoperative follow-up at one month, six months, one year, and two years. Results: The population consisted of 60 men and 51 women. The mean age was 61.16 years at the time of surgery, 33.33% were 60 years or older. When the questionnaires were applied, we found improvement in the progressive disability assessment with a mean drop of 23.65 ODI points after 6 months of the surgical treatment and 27.47 at the end of one year of surgery compared to preoperative for this scale. There was a decline of 3.84 points (mean) in the VAS at first postoperative month. Conclusion: Surgical treatment of LSS presented favorable postoperative evolution in a 2-year follow-up regarding pain and quality of life through VAS and ODI. Level of Evidence IV; Case series.

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Current Treatment Options for Patulous Eustachian Tube: A Review of the Literature

Ear Nose & Throat Journal ◽

10.1177/0145561320932807 ◽

2020 ◽

pp. 014556132093280

Author(s):

Petros Koltsidopoulos ◽

Charalampos Skoulakis

Keyword(s):

Eustachian Tube ◽

Therapeutic Option ◽

Treatment Options ◽

Case Series ◽

Current Treatment ◽

Case Control Studies ◽

Retrospective Case ◽

Level Of Evidence ◽

Surgical Interventions ◽

Patulous Eustachian Tube

Objective: Patulous Eustachian tube (PET) is a clinical condition that is associated with troublesome aural symptoms and is difficult to be treated successfully. The purpose of this review is to examine the published literature regarding the therapeutic value of the current treatment options for PET. Methods: We searched Web of Science, PubMed and Medline from 1999 to 2019. The search focused on papers concerning the clinical evaluation of treatment methods in PET patients. Statistical techniques were not used. Results: Prospective and retrospective case series were the types of trials available for review. We included 28 articles that evaluated the efficacy of various conservative and surgical therapeutic options. The recovery rates ranged from 50% to 100%. In most studies the assessment of efficacy was based on the subjective improvement of patient symptoms as there is no validated outcome tool available. No severe adverse events were observed in any study. Conclusion: On the basis of the available literature, it seems that conservative treatments can be considered as a primary therapeutic option for PET. Concerning the surgical interventions they seem to be a safe and valuable solution in patients with refractory disease. Finally, given the low level of evidence, prospective case–control studies with long follow-up and robust setting looking into the therapeutic approach of PET are required. The need for establishment of standard criteria of PET recovery should be underlined.

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Significance of Perinatal Anamnesis for Determination of Treatment Plan and Subsequent Neurological Prognosis for Children with Anomaly Chiari 1

Journal of New Medical Technologies ◽

10.12737/4998 ◽

2014 ◽

Vol 21 (2) ◽

pp. 54-57

Author(s):

Козлитина ◽

T. Kozlitina ◽

Глаголев ◽

Nikolay Glagolev

Keyword(s):

Cervical Spine ◽

Surgical Treatment ◽

Soft Tissues ◽

Treatment Plan ◽

Neurological Status ◽

Pathological Process ◽

Spine Injury ◽

Normal Birth ◽

And Function ◽

Conservative And Surgical Treatment

The injuries of the cervical spine injury craniovertebral transition, involving in pathological process of vertebral arteries or the spinal cord can cause obstetric benefits as pathological and normal birth. In this article the authors evaluate the effects generic posttraumatic changes soft tissues of the cervical spine in the development of vascular disorders in the field craniovertebral transition. For this study, 112 patients with Chiari anomaly 1, received conservative and surgical treatment, were ex-amined. Children from 2 to 18 years were divided into two groups: the 1st group - children (55 patients) without surgical treatment, and the 2nd group of children after decompressive trepanation about Chiari anomaly 1. Common neurological status, anatomy and function of blood vessels at the level craniovertebral transition were assessed in all children. Perinatal anamnesis, including: cesarean section, rapid delivery, entanglement neck child´s umbilical cord, and use of obstetric benefits in the form of application of forceps and receive «squeezing», was studied. Changes in the normal course of delivery, pointing to birth trauma level craniovertebral transition were noted in 96 patients (85,7%). This fact may have prognostic value in the treatment and follow-up care of children with Chiari anomaly 1.

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Cranial thoracic vertebral canal stenosis in three juvenile large-breed brachycephalic dogs treated by unilateral hemilaminectomy

Veterinary and Comparative Orthopaedics and Traumatology ◽

10.3415/vcot-16-10-0147 ◽

2017 ◽

Vol 30 (03) ◽

pp. 223-229 ◽

Cited By ~ 4

Author(s):

Andrew Marchevsky ◽

Amanda Miller

Keyword(s):

Spinal Cord ◽

Surgical Treatment ◽

Case Series ◽

Neurological Status ◽

Cord Compression ◽

Vertebral Canal ◽

Neurological Signs ◽

Canal Stenosis ◽

Spinal Cord Segment ◽

Independent Ambulation

SummaryObjective: To describe the surgical treatment and outcome for juvenile dogs with cranial thoracic vertebral canal stenosis treated by unilateral hemilaminectomy.Study design: Case series.Animals: Three large-breed brachycephalic dogs of various breeds (Dogue de Bordeaux, Australian Bulldog, Boerboel) with neurological signs consistent with a myelopathy of the third thoracic (T) to third lumbar (L) spinal cord segment.Methods: Information on clinical presentation, diagnostic imaging, surgical procedures, postoperative complications, recovery and outcome is described.Results: Neurological signs were present and progressive for two to four weeks prior to surgery and ranged from mild ataxia to paralysis. Cranial thoracic vertebral canal stenosis was diagnosed with computed tomography imaging. Lateral and dorsolateral spinal cord compression was present at multiple sites between T2 and T6. Alternating left and right-sided compressions were common. Surgical treatment was by unilateral, continuous hemilaminectomy over three to six vertebral spaces. Postoperative morbidity was minimal and return of independent ambulation was rapid (median: 13.5 days, range: 2–29 days). Neurological status in one dog worsened four months after surgery due to reoccurrence of osseous compression; unilateral hemilaminectomy was repeated in this dog. Long-term follow-up ranged from six to 10 months; neurological signs had completely resolved in one dog and substantially improved in the other two dogs.Clinical significance: Unilateral hemilaminectomy was associated with rapid return of independent ambulation and substantial improvement in neurological scores.

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Surgical treatment of diffuse idiopathic skeletal hyperostosis of cervical spine with dysphagia – Case report

Annals of Medicine and Surgery ◽

10.1016/j.amsu.2020.07.009 ◽

2020 ◽

Vol 57 ◽

pp. 37-40

Author(s):

Mikołaj Dąbrowski ◽

Adam Sulewski ◽

Jacek Kaczmarczyk ◽

Łukasz Kubaszewski

Keyword(s):

Case Report ◽

Cervical Spine ◽

Surgical Treatment ◽

Diffuse Idiopathic Skeletal Hyperostosis

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Surgical Treatment of Chronic Hand Ischemia: A Systematic Review and Case Series

The Journal of Hand Surgery (Asian-Pacific Volume) ◽

10.1142/s2424835519500462 ◽

2019 ◽

Vol 24 (03) ◽

pp. 359-370

Author(s):

David L. Colen ◽

Oded Ben-Amotz ◽

Thibaudeau Stephanie ◽

Arman Serebrakian ◽

Martin J. Carney ◽

...

Keyword(s):

Systematic Review ◽

Surgical Treatment ◽

Surgical Intervention ◽

Case Series ◽

Ulnar Artery ◽

Pharmacologic Therapy ◽

Cold Intolerance ◽

Algorithmic Approach ◽

Surgical Interventions ◽

Hand Ischemia

Background: Chronic hand ischemia refers to progressive, non-acute ischemic symptoms such as cold intolerance, rest pain, ulceration, tissue necrosis, and digit loss and poses a significant challenge in management. Conservative treatment begins with medical optimization and pharmacologic therapy, but when symptoms persist, surgical intervention may be required. Various operations exist to improve circulation including sympathectomy, arterial bypass, or venous arterialization. The purpose of this study is to systematically review published outcomes and present our experience with each surgical technique. Methods: A systematic review of literature regarding surgical treatment of chronic hand ischemia published between 1990 and 2016 was conducted using PRISMA guidelines. A retrospective-review of surgical interventions for chronic hand ischemia from 2010 to 2016 was then conducted. Primary outcomes included improvement in pain, wound-healing, and development of new ulcerations. Results: The review included 38 eight studies, showing all three techniques were effective in treating chronic hand ischemia. Sympathectomy had the lowest rate of new ulcerations (0.8%); bypass had the highest rate of healing existing ulcerations (89%). Arterialization was associated with consistent pain improvement pain (100%) but more complications (30.8%). Our series included 18 patients with 21 affected hands, 18 sympathectomies, 6 ulnar artery bypasses, and 1 arterialization. Most hands had improvement of wounds (89.5%) and pain (78.9%). No patients developed new ulcerations, but one required secondary amputation. Conclusions: When conservative measures fail to improve chronic hand ischemia, surgical intervention is an effective last line treatment. An algorithmic approach can determine the best operation for patients with chronic hand ischemia.

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Radiological Changes in the Cervical Spine in Freshman Collegiate Sumo Wrestlers

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967117744210 ◽

2017 ◽

Vol 5 (12) ◽

pp. 232596711774421 ◽

Cited By ~ 1

Author(s):

Yasuaki Nakagawa ◽

Shogo Mukai ◽

Kazufumi Minami ◽

Yuji Hattori ◽

Takashi Nakamura

Keyword(s):

Cervical Spine ◽

Nerve Root ◽

Case Series ◽

Radiographic Examination ◽

Disc Space Narrowing ◽

Cervical Nerve Root ◽

Cervical Nerve ◽

Level Of Evidence ◽

Osteophyte Formation ◽

Radiological Changes

Background: Sumo has long been a traditional sport in Japan and is rapidly attracting enthusiasts abroad. Sumo wrestling entails a risk of impact to the cervical spine during an initial charge. Few reports are available in the English-language literature regarding radiological changes in the cervical spine in sumo wrestlers. Purpose: To examine radiological changes in the cervical spine in freshmen collegiate sumo wrestlers. Study Design: Case series; Level of evidence, 4. Methods: A total of 53 freshmen sumo wrestlers (age, 18-19 years) who belonged to the Japan Sumo Federation underwent routine radiographic examination of the cervical spine and completed questionnaires on cervical symptoms. Results: Of the 53 wrestlers, 81% showed loss of lordosis, 45% showed osteophyte formation (mainly at C3-C4), 11% showed disc space narrowing (mainly at C5-C6), and 51% showed narrowing of the cervical nerve root foramina (mainly at C3-C4). Fifty-one percent had some cervical symptoms. A correlation was found between deformity of the cervical bodies (such as intervertebral disc ballooning) and cervical symptoms, but no correlation was found between cervical degenerative changes and cervical symptoms. Conclusion: Our data suggest that loss of lordosis, osteophyte formation, and narrowing of the cervical nerve root foramina at C3-C4 were frequently present in freshmen wrestlers and may be due to the axial load incurred prior to their collegiate careers.

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Interprosthetic Femoral Fractures Surgical Treatment in Geriatric Patients

Geriatric Orthopaedic Surgery & Rehabilitation ◽

10.1177/21514593211013790 ◽

2021 ◽

Vol 12 ◽

pp. 215145932110137

Author(s):

Marios Loucas ◽

Rafael Loucas ◽

Nico Safa Akhavan ◽

Patrick Fries ◽

Michael Dietrich

Keyword(s):

Surgical Treatment ◽

Geriatric Patients ◽

Standard Procedure ◽

Weight Bearing ◽

Case Series ◽

Femoral Fractures ◽

Full Weight Bearing ◽

Level Of Evidence ◽

Type Iv ◽

Case Series Study

Background: Total hip (THA) and total knee arthroplasty (TKA) are becoming an increasingly standard procedure in the whole world. In conjunction with an aging population and increased prevalence of osteoporosis, proper management of periprosthetic, and interprosthetic fractures is of great interest to orthopedic surgeons. This study aims to report the clinical and radiographic outcomes, complications and reoperations of IFFs in geriatric patients. Methods: A retrospective single-institution case series study was conducted. Between 2011 and 2019, 83 patients underwent surgical treatment for periprosthetic femoral fractures. Thirteen fractures were identified as IFFs. Patient demographics and comorbidities were collected preoperatively, and fractures were classified with the Vancouver and AO unified classification system (AO-UCS). Results: We included 12 patients (13 hips) with IFFs (AO-UCS type IV.3 B (2/13) type IV.3 C (3/13), type IV.3 D (8/13)). The average patient age was 86.54 (range, 79-89) years. There were 10 females and 2 males. Perioperative morbidity has been identified in 10 of the 12 patients, and the 3-month and 1-year mortality were reported in 2 and 3 patients, respectively. Cerclage cables were used in 9 of 12 patients. One of 12 patients showed a local complication, with no documented implant failure or revision. Patients achieved complete union and returned to their preoperative ambulatory status, and full weight-bearing at an average of 5 (range, 2 to 7) months later. Conclusion: Management of IFF can be challenging because these fractures require extensive surgical expertise. Locking plate seems to be a valuable treatment option for geriatric patients with IFFs. Despite the complexity of this type of fracture, the overall complication and revision rate, as well as the radiographic outcome are good to excellent. Level of Evidence: Level III, Therapeutic study.

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