scholarly journals Multi-stage treatment of non-specific spondylodiscitis of the cervical spine

2021 ◽  
Vol 23 (2) ◽  
pp. 93-102
Author(s):  
A. V. Sytnik ◽  
V. N. Obolenskiy ◽  
I. S. Lvov ◽  
A. Yu. Kordonskiy ◽  
S. A. Rozhanskiy
Keyword(s):  
Cervical Spine ◽  
Antibacterial Therapy ◽  
Clinical Case ◽  
Pain Syndrome ◽  
Bone Block ◽  
Complete Regression ◽  
Titanium Plate ◽  
Spinal Root ◽  
Paravertebral Abscess ◽  
Halo Device

The objective is to present a clinical case of successful treatment of a patient with recurrent spondylitis at the cervical level.Clinical case. A 65-year-old patient was diagnosed with purulent spondylodiscitis at the level of C6-C7 vertebrae with the epidural and paravertebral abscesses and spinal cord compression. Emergency left colotomy, paravertebral abscess dissection, corporectomy of the C6 vertebra, abscess removal, anterior spondylodesis with bone autograft and titanium plate were performed. Massive antibacterial therapy was prescribed. After the operation, the volume of movement in the left limbs was restored, and on the 15th day after the operation, the patient was discharged. On the 36th day after discharge, she was hospitalized again with hematuria. A recurrence of suppuration in the area of the operation and phlegmon of both feet was revealed. Revision of the surgical wound and rehabilitation of the purulent focus on the neck, surgical intervention for phlegmon were performed. In purulent foci, Staphylococcus aureus was verified, which is sensitive to the main antibacterial drugs. Antibacterial therapy was continued, then, after changing the microflora in the wound, other antibiotics were prescribed. There was a pain in the area of the left spinal root C5. The connection of the fistula course with the titanium plate, the increase of pathological kyphosis at the level of the overlying vertebrae was found. The wound was examined, the titanium plate was removed, and the halo device was applied to correct the pathological kyphosis. After the operation, the radicular pain syndrome regressed, and the axis of the cervical spine was restored. After 1 month, the posterior combined fixation of the cervical spine at the C3-Th7 level was performed, and the halo device was dismantled. After 6 months, the patient was stopped wearing the Philadelphia neck collar, no recurrence of suppuration was observed, and a complete regression of neurological disorders was noted. After 1 year, a complete bone block is preserved between the C4-C7 vertebrae.Conclusion. The presented clinical case clearly illustrates the complexity of managing patients with inflammatory diseases of the cervical spine. Currently, there is no single treatment strategy for patients with spondylitis.

scholarly journals The effectiveness of electrophoresis with caripain in the treatment of discogenic radiculopathy in the cervical spine. Clinical case.

2020 ◽  
Vol 19 (1) ◽  
pp. 65-68
Author(s):  
M.Kh. Al-Zamil ◽  
N. G. Kulikova ◽  
E. S. Vasil`eva ◽  
Yu. M. Zhuk
Keyword(s):  
Cervical Spine ◽  
Intervertebral Disc ◽  
Positive Result ◽  
Clinical Case ◽  
Sensory Function ◽  
Complete Regression ◽  
High Efficacy ◽  
Motor Deficiency

In this article, we demonstrate a clinical case with high efficacy of Karipain electrophoresis in the treatment of a patient with discogenic radiculopathy in the cervical spine. The positive result was a complete regression of motor deficiency, restoration of sensory function and a decrease in the size of a hernia of the intervertebral disc at the level of C5C6 by 40%.

Possibilities of correction of the statodynamic stereotype violations in patients with dorsopathy at the cervical-thoracic level

2021 ◽  
pp. 20-33
Author(s):  
V. O. Belash ◽  
A. E. Vorobyova ◽  
D. A. Vasyukovich
Keyword(s):  
Cervical Spine ◽  
Range Of Motion ◽  
Exercise Therapy ◽  
Frontal Plane ◽  
Pain Syndrome ◽  
Main Group ◽  
Medical Community ◽  
Control Group ◽  
Active Movement ◽  
Social Significance

Introduction. Back pain is not only a high prevalence, but also a costly health problem. That is why the search for new and the optimization of existing methods of dorsopathies treatment acquire an important clinical and medico-social significance. In recent years, the medical community has increased the interest in non-drug methods of treatment, including osteopathy. Previous studies have substantiated the possibility of effective application of osteopathic correction methods in the treatment of patients with dorsopathies. A specific object of the osteopath′s work is somatic dysfunction (SD). And if earlier SD was perceived from the standpoint of purely biomechanical disorders, then in recent years there have been serious changes in understanding the heterogeneity of this state nature. The biomechanical, rhythmogenic and neurodynamic components are conventionally distinguished in the structure of SD. One of the neurodynamic disorders types is the violation of motor stereotypes, the so-called static-dynamic disorders, revealed through special dynamic tests and manifested in the functional impossibility of building of active movement at various levels. At the same time, the generally accepted biomechanical approaches do not allow to completely eliminate violations of the statodynamic stereotype.The goal of research — the study was to research the effectiveness of the osteopathic approach using in combination with kinesitherapy for correction of the statodynamic stereotype violations in patients with dorsopathy at the cervicothoracic level.Materials and methods. A controlled randomized prospective study was conducted on the basis of a private rehabilitation center «Ezramed-Clinic» in Omsk in the period from February 2019 to December 2019. 52 patients with a diagnosis of dorsopathy at the cervicothoracic level were observed. 12 people were knocked out during the study in accordance with the exclusion criteria. As a result, 40 patients participated in the study. Depending on the applied treatment method, the patients were divided by simple randomization into two groups (main and control), each of which consisted of 20 people. Both groups of patients received osteopathic correction three times with a frequency of receptions 1 time in 7–10 days. The main group of patients additionally independently performed daily for 10 minutes a set of exercises aimed to restore the disturbed motor stereotypes (normal synkinesis). The control group of patients additionally independently performed a set of exercise therapy for the cervical spine every day for 10 minutes. All patients, regardless of the group, underwent an osteopathic examination before and after treatment with the formation of an osteopathic conclusion; the severity of pain syndrome and the volume of active movements in the cervical spine were assessed. The severity of the pain syndrome and the range of active movements were assessed before and immediately after treatment, as well as 3 months after the first session.Results. The use of osteopathic correction in conjunction with kinesitherapy (both special exercises and a complex of exercise therapy) in patients with a diagnosis of dorsopathy at the cervicothoracic level leads to a statistically significant increase in the range of motion in the cervical spine in the sagittal and frontal planes (p<0,05). The combination of osteopathic correction together with exercise therapy in patients of the control group led to a statistically more significant increase (p<0,05) in the range of motion in the cervical spine in the frontal plane after treatment compared with the results of the main group. However, 3 months after treatment, the indicators in patients of both groups did not have statistically significant differences.The combination of osteopathic correction in conjunction with kinesiotherapy in the form of special exercises for the motor stereotype correction in the main group of patients with diagnosed dorsopathy at the cervicothoracic level led to a statistically significant (p<0,05) decrease in the intensity of the pain syndrome at the 2nd session.Conclusion. In order to increase the effectiveness of treatment, osteopathic correction of somatic dysfunctions in patients with dorsopathy at the cervicothoracic level can be supplemented with complex kinesitherapy, both in the form of traditional exercise therapy, and in the form of special exercises for correction of altered motor stereotype.

scholarly journals Antibacterial Therapy of Bronchopulmonary Complicationsin Patients with Cervical Spine Injury

2010 ◽  
pp. 72-76
Author(s):  
Vladimir Ulyanov ◽  
◽  
Igor Norkin ◽  
Elena Makarkina ◽  
Valery Schukovsky ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Antibacterial Therapy ◽  
Cervical Spine Injury ◽  
Spine Injury

scholarly journals C1-C2 Subluxation after Mild Cervical Spine Trauma in a Child

2020 ◽  
pp. 1-3
Author(s):  
Isabel Snee ◽  
Isabel Snee ◽  
Catherine A. Mazzola
Keyword(s):  
Cervical Spine ◽  
Head Tilt ◽  
Spine Injury ◽  
Halo Traction ◽  
Cord Injury ◽  
Magnetic Resonance Imaging Mri ◽  
Cervical Spine Alignment ◽  
Atlanto Axial Joint ◽  
Spine Radiographs ◽  
Halo Device

We report a case of a seven-year-old girl who presented with a “Cock-Robin” head tilt and cervical spine injury after falling from her bed. Initial cervical spine X-ray reported a fractured clavicle. However, almost four weeks later, the torticollis had not resolved. Computerized tomography (CT) of the cervical spine revealed subluxation of the atlanto-axial joint at C1-C2. Cervical spine magnetic resonance imaging (MRI) did not show any spinal cord injury. Manual reduction and hard collar placement were attempted, yet C1- C2 subluxation recurred. The child was placed into halo traction and then into a halo vest. CT scan showed near complete resolution of C1-C2 subluxation. Three months later the halo device was removed, and the patient was placed in a hard cervical collar then transitioned into a soft collar over a four month period. During this time, the patient received physical therapy. Final cervical spine radiographs revealed proper cervical spine alignment and resolution of C1-C2 subluxation.

scholarly journals Chronic infectious lesions of the cervical spine in adults: monocentric cohort analysis and literature review

2021 ◽  
Vol 18 (3) ◽  
pp. 68-76
Author(s):  
D. G. Naumov ◽  
S. G. Tkach ◽  
A. Yu. Mushkin ◽  
M. E. Makogonova
Keyword(s):  
Cervical Spine ◽  
Surgical Treatment ◽  
Sagittal Balance ◽  
Cohort Analysis ◽  
Pain Syndrome ◽  
Vertical Axis ◽  
Sagittal Vertical Axis ◽  
Comorbidity Index ◽  
Anterior Reconstruction ◽  
Infectious Spondylitis

Objective. To analyze the results of surgical treatment of chronic infectious cervical spondylitis and literature data.Material and Methods. Design: retrospective monocentric cohort study for 2017–2020. The study included medical history and clinical and instrumental data of 25 patients who underwent 28 reconstructive surgeries on the suboccipital (n1 = 3) and subaxial (n2 = 25) spine. The average follow-up period was 1 year 2 months ± 4 months. Statistical analysis was performed using the Statistical Package for the Social Sciences (SPSS), version 22.0.Results. The effect of the duration of the therapeutic pause (p = 0.043) and the T1 slope (T1S) (p = 0.022) on the intensity of vertebrogenic pain syndrome was established. When assessing the parameters of the sagittal balance a direct relationship between the age of patients and the value of cervical sagittal vertical axis (CSVA) (p = 0.035) was revealed, while CSVA (p = 0.514) and neck tilt angle (NTA) (p = 0.617) did not significantly affect the intensity of vertebral pain syndrome. The extent of vertebral destruction did not affect either the intensity of vertebral pain (p = 0.872) or the indices of the sagittal balance: CSVA (p = 0.116), T1S (p = 0.154), and NTA (p = 0.562). A significant predictor of postoperative complications is the level of comorbidity with an index of 7 or more (p = 0.027) according to the Charlson scale.Conclusion. The leading predictors of complications of surgical treatment of cervical infectious spondylitis are the Charlson comorbidity index (7 points or more) and the variant of anterior reconstruction (the use of a blocked extraspinal plate). The factors influencing the intensity of vertebrogenic pain syndrome in this pathology are the duration of the therapeutic pause and the magnitude of T1S compensation. Anterior reconstruction of the cervical spine in the presence of infectious spondylitis provides a correction of the sagittal balance parameters, with the possibility of long-term maintaining the achieved values.

CLINICAL CASE OF SUCCESSFUL MANAGEMENT OF PREGNANCY AND CHILDBIRTH IN A PATIENT WITH PERIPHERAL NERVOUS SYSTEM PATHOLOGY

2021 ◽  
Vol 2 (1) ◽  
pp. 42-47
Keyword(s):  
Nervous System ◽  
Pregnant Woman ◽  
Peripheral Nervous System ◽  
Clinical Case ◽  
Test Preparation ◽  
Pain Syndrome ◽  
Delivery Method ◽  
Successful Management ◽  
Pregnancy And Childbirth ◽  
Joint Management

The purpose of our study was to study the case of successful management of pregnancy and childbirth in patient K., 39 years old with pathology of the peripheral nervous system: spinal stenosis L5 – S1, herniated L5-S1, surgery in 2014 (hemilaminectomy L5-S1, disc resection L5-S1), vertebrogenic pain syndrome. At the stage of pre-test preparation and during pregnancy, she is consulted by a neurologist to determine the tactics of pregnancy and childbirth management. Rational pregnancy planning, joint management of a pregnant woman by an obstetrician-gynecologist and a neurologist allowed choosing the optimal pregnancy management tactics and delivery method.

Corneoscleral xanthogranuloma treated with chemotherapy: The room for nonsurgical management

2019 ◽  
Vol 30 (2) ◽  
pp. NP23-NP26
Author(s):  
Osama M Mustafa ◽  
Yassine J Daoud
Keyword(s):  
Literature Search ◽  
Clinical Case ◽  
Juvenile Xanthogranuloma ◽  
Complete Regression ◽  
Azathioprine Therapy ◽  
Systemic Involvement ◽  
Nonsurgical Management ◽  
Rare Manifestation ◽  
Disseminated Disease ◽  
Xanthoma Disseminatum

Purpose: To describe a clinical case of corneoscleral xanthogranuloma, a rare manifestation of juvenile xanthogranuloma, and xanthoma disseminatum, which responded well to chemotherapy. Methods: Interventional case report and literature search. Results: A 9-year-old female patient with a disseminated disease showed complete regression of her corneoscleral xanthogranuloma with methotrexate and azathioprine therapy. Conclusion: Since they are potentially blinding, corneoscleral xanthogranulomas are commonly surgically excised. While surgical resection has been widely advocated in the literature, immunosuppressive therapy alone may be a pertinent management line of corneoscleral xanthogranuloma, especially with systemic involvement.

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