scholarly journals Interlaminar decompression for patients with degenerative lumbar stenosis. Literature review and results of a prospective study

2019 ◽  
Vol 21 (4) ◽  
pp. 57-66 ◽  
Author(s):  
A. A. Grin ◽  
A. S. Nikitin ◽  
A. A. Kalandari ◽  
S. A. Asratyan ◽  
S.‑E. R. Yusupov

The study objective is to assess the effectiveness of interlaminar decompression in patients with degenerative lumbar stenosis.Materials and methods. A prospective study was conducted among 100 patients with degenerative lumbar stenosis. All patients were operated, interlaminar decompression of the symptomatic side was made. Outcomes were assessed by using a visual analogue scale and Oswestry questionnaire 1 and 2 years after surgery. Among patients with an unsatisfactory result, the cause of the unsatisfactory outcome was studied.Results. One year after surgery a satisfactory result was noted in 71 patients, and 2 years after surgery a satisfactory result was noted in 67 patients. The following causes of unsatisfactory outcome were found in 33 patients: 9 – spinal canal restenosis, 2 – herniated disc at the operation level, 4 – the facet syndrome, 4 – development of clinical instability, 3 – pain in the opposite leg (there was no pain before the operation), 2 – development of delayed radiculopathy, 9 – decompensation of concomitant diseases (4 – coxarthrosis, 3 – gonarthrosis, 2 – chronic ischemia of the lower extremities). Among the risk factors for restenosis, statistically significant relationship was found only with the presence of spondylolisthesis.Conclusion. Interlaminar decompression is an effective surgical option in patients with degenerative lumbar stenosis. The presence of spondylolisthesis is a risk factor for the inefficiency of this operation.Conflict of interest. The authors declare no conflict of interest.Informed consent. All patients gave written informed consent to participate in the study

2008 ◽  
Vol 122 (10) ◽  
pp. 1088-1091 ◽  
Author(s):  
N Jayashankar ◽  
K P Morwani ◽  
M J Shaan ◽  
S R Bhatia ◽  
K T Patil

AbstractGold eyelid implantation is widely considered the procedure of choice to reanimate the upper eyelid in paralytic lagophthalmos. Commercially supplied implants are not readily available in all places and are sometimes cumbersome to import.Objective:We aimed to devise a method whereby every surgeon performing gold eyelid implantation could have easy and quick access to the implant. Furthermore, we aimed to develop a means of creating an implant of the exact weight required for complete eyelid closure.Study design and setting:A prospective study was performed from 1997 to 2005 in a tertiary research hospital, involving 50 subjects requiring gold upper eyelid implantation and using the technique in question.Results:Only patients with a minimum follow up of one year were included in the study group. Symptoms improved in 96 per cent of subjects, who were able to dispense with eyedrops and eye ointments. Visual acuity improved in 92 per cent of patients. There were two extrusions amongst the early cases.Conclusion and significance:Customised gold eyelid implantation offers an alternative in regions where commercial implants are not easily obtained.


2021 ◽  
Vol 9 (B) ◽  
pp. 588-592
Author(s):  
Ahmed A. Hafez ◽  
Ahmed Hamdy Ashry ◽  
Ahmed Elsayed ◽  
Amr El Tayeb ◽  
Mohamed Badran Abdel Salam ElShenawy

OBJECTIVE: This thesis aim to report the incidence of iatrogenic spinal instability that occurs after laminectomy, discectomy or facetectomy in Lumbar spine surgery. METHODS: This is a prospective study of 50 cases of degenerative lumbar spondylosis complaining of various symptoms of claudication, sciatica and back pain which were surgically managed by laminectomy according to the level of stenosis in the period between October 2018 and October 2020 in the neurosurgery department at Cairo university hospitals. Mesial facetectomy was added according to the degree of stenosis if needed. Some patients needed discectomy if sciatica was an eminent symptom. RESULTS: Out of 50 patients included: 9 patients (18%) developed postoperative instability. The number of levels operated on and the degree of mesial facetectomy were found to be variables that may affect postoperative stability. CONCLUSION: Iatrogenic instability may result from large laminectomy and extensive facetectomy for lumbar stenosis in patients who do not have obvious pre-existing instability. Key words: Iatrogenic spinal instability - Laminectomy - conventional open discectomy - Mesial facetectomy.


2020 ◽  
Vol 8 (2) ◽  
pp. 73-77

Neonatal sepsis is one of the commonest causes of morbidity and mortality in neonates in India compared to the developed countries. Aim: To evaluate the Procalcitonin level this is an early marker in the diagnosis of neonatal sepsis and to assess the suitability of this test in the diagnosis of early-onset sepsis. Method: The prospective study was conducted in the Neonatal Division of Department of Pediatrics, Prathima Institute of Medical Sciences over a period of one year. The blood samples from 100 babies meeting the inclusion and exclusion criteria constituted the material for study. Result: Among the n=100 cases n=39 were procalcitonin positive, compared with gestational age 10 (43.5%) cases were positive with a gestation of <37 weeks and 24 (31.2%) cases positive of cases >37 weeks and there was no statistical significance concerning gestational age the association of material characteristics with procalcitonin positive and CRP positive levels. Blood culture was positive in n=9 (9%) of babies with (90% CI, 5.3-14.9) and negative in n=91 (91%) of babies with (90% CI, 85.2-94.7). Conclusion: A positive blood culture is the only definitive and gold standard for confirming a case of sepsis. Since the culture and sensitivity test requires a minimum period of 48 hours which is a precious time in deciding on the treatment of sepsis in the newborn. Rapid diagnosis by using Procalcitonin and CRP gives a reasonable degree of accuracy in diagnosing neonatal sepsis and will also guide antibiotic therapy. Procalcitonin in comparison with CRP has better sensitivity and hence can detect most cases of neonatal sepsis and better negative predictive value.


2020 ◽  
Vol 10 (3) ◽  
Author(s):  
Vanuza Rosa ◽  
Gabriela Kuzma ◽  
Luana Hornung ◽  
Márcia Bandeira

OBJECTIVE: Benign acute childhood myositis is characterized by acute musculoskeletal involvement leading to transient limitations on deambulation followed by a viral illness. Our study objective to evaluate clinical and laboratory features of patients in a pediatric emergency department. METHODOS: We conducted a prospective study in patients with symptoms and laboratory findings compatible with viral myositis in the period of August 2017 to August 2018. RESULTS: We assessed 20 patients in the period of twelve months. The mean age was 8,25 years. Of these, 83,3% had infectious symptoms in the week before the musculoskeletal involvement. By the time of the diagnosis, the symptoms were: calf pain, reluctance to walk, gait abnormality, diffuse myalgia and calf weakness. The most relevant laboratory finding was the elevation of CPK (mean 3359,556U/L) level, followed by AST (mean 131U/L) and ALT (mean 64,66U/L) elevation. The mean time for symptom relief was 3 days and in 7 days all exams were normal. CONCLUSION: Though the exact incidence of this condition remains undetermined, the lower extremity pain and the gait abnormality is of concern of both parents and health care providers. We emphasize the importance of knowing this condition to avoid unnecessary exams and the delay in the diagnosis of severe conditions.


2013 ◽  
Vol 52 (6) ◽  
pp. 1102-1109 ◽  
Author(s):  
Anja Mehnert ◽  
Uwe Koch ◽  
Christin Sundermann ◽  
Andreas Dinkel

1987 ◽  
Vol 12 (1) ◽  
pp. 1-3
Author(s):  
N. A. SHENOUDA ◽  
J. P. S. ENGLAND

A prospective study of the possibilty of confirming clinically suspected scaphoid fractures was carried out over one year. Analysis of the results suggest that ultrasound scanning of suspect scaphoid fractures is a reliable method of assessing this condition. It has one weakness in that the diagnosis is based on subjective sensation and this may at times be faulty. Our results, however, suggest that once practice in the technique has been achieved, then mistakes are rarely made.


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