scholarly journals Characteristics of Pain Syndrome in Patients with Lumbosacral Discogenic Pathology in Post- OPERATIVE PERIOD

2017 ◽  
Vol 24 (2) ◽  
pp. 32-39
Author(s):  
A. O Gospod ◽  
A. I Krupatkin ◽  
A. A Kuleshov ◽  
T. V Sokolova
Keyword(s):  
Disc Herniation ◽  
Surgical Intervention ◽  
Pain Syndrome ◽  
Intervertebral Disc Herniation ◽  
Complex Evaluation ◽  
Number Of Patients ◽  
Study Evaluation ◽  
Before And After ◽  
Degree Of Disability ◽  
High Degree

Purpose of study. Evaluation of the pain sources and comparative analysis of chronic pain syndrome peculiarities in patients with various types of disc herniation before and after surgical intervention at lumbosacral level. Patients and methods. The study included 80 patients (20-60 years old) with discogenic pathology at lumbosacral level. The type and size of herniation was assessed by MSU classification. Every patient went through a complex evaluation of low back pain sources, pain syndrome characteristics and personality before and on day 10 after surgery. Results. The most common cause of pain was a musculoskeletal syndrome that was more pronounces in the older (41-60 years) group. Neither correlation between the degree of degenerative dystrophic changes and type and size of discogenic pathology, nor the relation between the disc herniation size and type and neurologic symptoms development was detected. The relation between the intensity and other characteristics of pain syndrome and type of disc herniation was not detected too. Analysis of pain syndrome characteristics and mechanisms in complex with the assessment of pain sources revealed the group of patients with high pain and emotionally affected indices before and after surgical intervention and mild vertebrogenic and other pain sources. That group made up 13% of the total number of patients; the majority of them (75%) were females (mean age 37.8±5.0 years) and in 50% of cases the herniation size and localization corresponded to type 2A. Taking into consideration a high degree of disability and other pain indices in postoperative period we do not recommend surgical intervention in this group of patients. Conclusion. Management of patients with lumbosacral intervertebral disc herniation requires the evaluation of all pain sources and pain syndrome aspects.

scholarly journals Characteristics of Pain Syndrome in Patients with Lumbosacral Discogenic Pathology in Post- OPERATIVE PERIOD

2017 ◽  
pp. 32-39
Author(s):  
A. O. Gospod ◽  
A. I. Krupatkin ◽  
A. A. Kuleshov ◽  
T. V. Sokolova
Keyword(s):  
Disc Herniation ◽  
Surgical Intervention ◽  
Pain Syndrome ◽  
Intervertebral Disc Herniation ◽  
Complex Evaluation ◽  
Number Of Patients ◽  
Before And After ◽  
Degree Of Disability ◽  
High Degree ◽  
Cause Of Pain

Purpose of study. Evaluation of the pain sources and comparative analysis of chronic pain syndrome peculiarities in patients with various types of disc herniation before and after surgical intervention at lumbosacral level.Patients and methods. The study included 80 patients (20-60 years old) with discogenic pathology at lumbosacral level. The type and size of herniation was assessed by MSU classification. Every patient went through a complex evaluation of low back pain sources, pain syndrome characteristics and personality before and on day 10 after surgery.Results.The most common cause of pain was a musculoskeletal syndrome that was more pronounces in the older (41-60 years) group. Neither correlation between the degree of degenerative dystrophic changes and type and size of discogenic pathology, nor the relation between the disc herniation size and type and neurologic symptoms development was detected. The relation between the intensity and other characteristics of pain syndrome and type of disc herniation was not detected too. Analysis of pain syndrome characteristics and mechanisms in complex with the assessment of pain sources revealed the group of patients with high pain and emotionally affected indices before and after surgical intervention and mild vertebrogenic and other pain sources. That group made up 13% of the total number of patients; the majority of them (75%) were females (mean age 37.8±5.0 years) and in 50% of cases the herniation size and localization corresponded to type 2A. Taking into consideration a high degree of disability and other pain indices in postoperative period we do not recommend surgical intervention in this group of patients.Conclusion.Management of patients with lumbosacral intervertebral disc herniation requires the evaluation of all pain sources and pain syndrome aspects.

Wounds, Fractures, Orthopaedics

2011 ◽  
Author(s):  
Pawan Gupta
Keyword(s):  
Physical Examination ◽  
Soft Tissue Injuries ◽  
Basic Knowledge ◽  
X Rays ◽  
Number Of Patients ◽  
Before And After ◽  
Life Threatening ◽  
Minor Injuries ◽  
High Degree ◽  
Type Of Injury

A significant number of patients attending the ED are those who are often referred to as ‘minors’, ‘streamers’, ‘walking wounded’, etc. These include patients with minor injuries, wounds, fractures or other soft tissue injuries. Therefore, a basic knowledge of anatomy and its application in various circumstances is mandatory. The injuries mentioned above are rarely life-threatening, but they may be limb-threatening and severely disabling. So it is extremely important to avoid errors in diagnosis and management, and to know when to ask for help at the appropriate time. By following the key principles listed below, you will be able to avoid many problems with such patients: • In the history, a detailed description of the mechanism of injury and the patient’s complaint will help in predicting the type of injury sustained. • A careful and thorough physical examination can point to the site and type of injury, on the basis of which appropriate radiological images can then be requested. • A neurovascular examination must be completed and documented in every limb injury, before and after any reductions, and before and after immobilization. • Appropriate radiological imaging, accompanied by a thorough physical examination, can pick up injuries with a high degree of accuracy. Inadequate radiographic films should not be accepted. • Immobilize the patient if a fracture is clinically suspected even if the X-rays are negative. • In cases of dislocations or subluxations, X-rays should be done before and after reductions, except when a delay could be potentially harmful to the patient (for example, when a severe traumatic deformity of a joint threatens to jeopardize the viability of the overlying skin). • The patient should be able to mobilize safely before being discharged from the ED. • Patients should be given proper aftercare instructions before leaving the ED, including how to look after themselves and to recognize limb-threatening features, the follow-up arrangement, and to return if things go wrong. • Ask for senior help if you are not sure about an injury or its management.

VOZMOZhNOSTI KOMP'YuTERNOY TOMOGRAFII V KOMPLEKSNOY OTsENKE SKOLIOTIChESKOY DEFORMATsII POZVONOChNIKA

2003 ◽  
Vol 10 (1) ◽  
pp. 11-20
Author(s):  
S T Vetrile ◽  
A K Morozov ◽  
A A Kisel' ◽  
A A Kuleshov ◽  
I A Kosova
Keyword(s):  
Bone Density ◽  
Surgical Intervention ◽  
Apical Vertebra ◽  
Subarachnoidal Space ◽  
Scoliotic Deformity ◽  
Postoperative Changes ◽  
Complex Evaluation ◽  
Before And After ◽  
Spine Fixation ◽  
Oval Shape

Complex evaluation of scoliotic deformity was performed using CT. Fifty patients with displastic scoliosis of III-IV degree were examined before and after surgical intervention - dorsal correction and spine fixation with Cotrel-Dubousset instrumentation. No marked derotation of spine at the deformity apex was noted postoperatively. Changes of thorax in the plane of apical vertebra were studied and quantitatively evaluated: postoperatively thorax became of more correct oval shape in all cases. Density of trabecular bone of apical and neutral vertebrae coincided with the understanding about asymmetry of deformed vertebrae bone density. No marked immediate postoperative changes were noted. Combination of CT and myelography showed the dislocation ofdural sac to the side opposite to the deformity convexity; either partial (up to 60- 70% in patients with deformity of HI and early W degree) or complete (in patients with severe deformity) disturbance of contrast distribution in subarachnoidal space from concave side and compensatory widening of subarachnoidal space from the opposite side with maximum changes at the apex of scoliotic deformity

scholarly journals Cholelithiasis and laparoscopic cholecystectomy: identifying the appropriate time for operative intervention

2021 ◽  
Author(s):  
Ravi Kotecha ◽  
Vishwa Kotecha
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Gold Standard ◽  
Complete Resolution ◽  
Prospective Observational Study ◽  
Surgical Intervention ◽  
Gallstone Disease ◽  
Duration Of Symptoms ◽  
Number Of Patients ◽  
Before And After ◽  
Group B

Background: Cholelithiasis is the most common among hepatobiliary disease and often requires surgical intervention. Laparoscopic cholecystectomy is the gold standard nowadays. This research paper was done to know appropriate time for laparoscopic cholecystectomy and how much improvement will we get after laparoscopic cholecystectomy.Methods: In our prospective observational study, 118 patients of cholelithiasis, 59 with dyspepsia in one group and 59 without dyspepsia in another group were taken. Both groups patients were analysed with Bucklay validated dyspeptic score before and after laparoscopic cholecystectomy till 6 months postoperatively for score improvement.Results: In our study, we confirmed that there was improvement in Buckley validated dyspeptic score in both group of patients with dyspepsia and without dyspepsia 6 month after laparoscopic cholecystectomy but not complete improvement. Improvement in Buckley validated dyspeptic score 6 months after laparoscopic cholecystectomy was more in patients with less duration of symptoms and less frequency of episode preoperatively and in non-dyspeptic patients.Conclusions: We could conclude that even earlier surgery after onset of symptoms didn’t result in complete resolution of symptoms in both groups particularly in group B (patients with dyspepsia). We can say that weather it is dyspeptic or non-dyspeptic gallstone disease, it has benefit from laparoscopic cholecystectomy but we can also say that improvement achieved is not complete as after laparoscopic cholecystectomy there were still number of patients who had Buckley validated score more than 6 in both groups after 6 months of surgery.

Comparative Analysms of Posterior Interbody Fusion and Transforaminal Interbody Fusion in Combination with Transpedicular Fixation

2012 ◽  
Vol 19 (1) ◽  
pp. 12-21 ◽  
Author(s):  
Aleksandr Vladimirovich Krut'ko ◽  
A V Krutko
Keyword(s):  
Interbody Fusion ◽  
Surgical Intervention ◽  
Treatment Results ◽  
Transpedicular Fixation ◽  
Complex Evaluation ◽  
Number Of Patients ◽  
Spine Pathology ◽  
Transforaminal Interbody Fusion ◽  
Block Formation ◽  
Neurovascular Structures

Results of comparative study of posterior interbody fusion (PLIF) and transforaminal interbody fusion (TLIF) in degenerative lumbar spine pathology are presented. Total number of patients was 101. In 47 patients (1st group) transpedicular fixation, decompression and interbody fusion with one cage (TLIF) was performed. In 54 patients (2nd group) transpedicular fixation via posteromedial approach, decompression of intracanal neurovascular structures and interbody fusion with two interbody implants (PLIF) was applied. Complex evaluation of surgical treatment results was performed in 52 patients in 6-12 months after surgery. It was shown that application of either of the techniques resulted in 95-98% cases of interbody block formation. Differential approach to application of those interbody fusion techniques and the advantages of TLIF over PLIF, i.e. simplicity and higher safety of performance, lower intraoperative blood loss and duration of surgical intervention, were presented.

scholarly journals Efficiency of treatment of patients with muscular and joint dysfunction of the TMJ

2020 ◽  
Vol 24 (4 (96)) ◽  
pp. 41-47
Author(s):  
T. Kostiuk ◽  
A. Kaniura ◽  
N. Lytovchenko
Keyword(s):  
Temporomandibular Joint ◽  
Sagittal Plane ◽  
Muscle Relaxation ◽  
Pain Syndrome ◽  
Psychological Measures ◽  
Occlusal Splints ◽  
Number Of Patients ◽  
Before And After ◽  
Opening And Closing ◽  
Dental Applications

The prevalence of dysfunction of the temporomandibular joint (TMJ), especially in people aged 18-65 years, reached 95-98% among all dental applications. The course of the pathology is usually hidden, with periodic recurrences, and has a long nature, which is accompanied by a decrease in overall quality of life. Treatment of this pathology of the TMJ is a set of complex therapeutic, orthopedic and psychological measures. The literature describes many ways to treat TMJ dysfunction, and one of the modern ones is the use of occlusal splints, which enables to change the position of the mandible, diagnose and eliminate musculoskeletal dysfunction of the TMJ. The aim of the study was to determine the effectiveness of treatment of musculoskeletal dysfunction of the TMJ with occlusal splints according to axiography. Material and methods. 274 patients aged 18 to 65 years were diagnosed with temporomandibular joint (TMJ) pain syndrome before and after treatment.Results. All patients with signs of TMJ dysfunction before treatment had a violation of the trajectory of the mandible (deviation – 68.7%, dyslexia – 31.3%). When opening and closing the mouth, asymmetrical shifts of the lower jaw to the sides of more than 2 mm (deviation from the midline – more than 2 mm) were observed. After treatment with occlusal splints there was an improvement in the trajectory of opening and closing the mouth: the number of patients with a violation of the trajectory decreased by 89.1%, and the displacement of the mandible during opening and closing the mouth in 92.4% of patients decreased on average to 0, 9 mm. When analyzing the movements of the mandible in the sagittal plane in 79 % of cases, deviations of the trajectory of the mandible were detected. After treatment with occlusive muscle relaxation splints, elimination of violations of the trajectory of the mandible in the transverse plane was noted in 93.4% of cases, reduction of displacement to 0.9 mm in 78.1% of patients. Сonclusions. The trajectory of the mandible in the sagittal plane improved in 80.1% of patients, normalization of the position of the mandible relative to the neuromuscular trajectory was achieved in 93.4% of clinical cases. According to the analysis of parameters, such treatment should be considered effective.

scholarly journals Efficiency of treatment of patients with muscular and joint dysfunction of the temporomandibular joints

2020 ◽  
Vol 86 (1) ◽  
pp. 94-102
Author(s):  
T. Kostiuk ◽  
A. Kaniura
Keyword(s):  
Temporomandibular Joint ◽  
Sagittal Plane ◽  
Muscle Relaxation ◽  
Pain Syndrome ◽  
Temporomandibular Joint Dysfunction ◽  
Occlusal Splints ◽  
Temporomandibular Joints ◽  
Number Of Patients ◽  
Before And After ◽  
Opening And Closing

The prevalence of dysfunction of the temporomandibular joint, especially in people aged 18-60 years, reached 95-98 % among all dental applications. The course of the pathology is usually hidden, with periodic recurrences and has a long nature, which is accompanied by a decrease in overall quality of life. Treatment of this pathology of the temporomandibular joint is a set of complex therapeutic, orthopedic and psychological measures. The literature describes many ways to treat temporomandibular joint dysfunction, one of the modem ones is the use of occlusal splints, which allow to change the position of the mandible, diagnose and eliminate musculoskeletal dysfunction of the temporomandibular joint. The aim of the study was to determine the effectiveness of treatment of musculoskeletal dysfunction of the temporomandibular joint with occlusal splints according to axiography. 274 patients aged 18 to 65 years were diagnosed with temporomandibular joint pain syndrome before and after treatment. All patients with signs of temporomandibular joint dysfunction before treatment had a violation of the trajectory of the mandible (deviation is 68.7 %, dyslexia is 31.3 %). When opening and closing the mouth, asymmetrical shifts of the lower jaw to the sides of more than 2 mm (deviation from the midline is more than 2 mm) were observed. After treatment with occlusal splints there was an improvement in the trajectory of opening and closing the mouth: the number of patients with a violation of the trajectory decreased by 89.1 %, and the displacement of the mandible during opening and closing the mouth in 92.4 % of patients decreased on average to 0.9 mm. When analyzing the movements of the mandible in the sagittal plane in 79 % of cases, deviations of the trajectory of the mandible were detected. After treatment with occlusive muscle relaxation splints, elimination of violations of the trajectory of the mandible in the transverse plane was noted in 93.4 % of cases, reduction of displacement to 0.9 mm in 78.1 % of patients. The trajectory of the mandible in the sagittal plane improved in 80.1 % of patients, normalization of the position of the mandible relative to the neuromuscular trajectory was achieved in 93.4 % of clinical cases. According to the analysis of parameters, such treatment should be considered effective. Keywords: musculoskeletal dysfunction, temporomandibular joint, clinical dysfunction index, axiography, sagittal articular pathway angle, sagittal incisor pathway angle, Bennett’s angle (movement), duration.

scholarly journals PERCUTANEOUS ENDOSCOPIC DISCECTOMY FOR DEGENERATIVE-DYSTROPHIC DISEASE OF THE LUMBAR SPINE

2006 ◽  
pp. 016-021
Author(s):  
Aleksandr Timofeyevich Khudyaev ◽  
Sergey Vladimirovich Lyulin ◽  
Elena Nikolayevna Schurova
Keyword(s):  
Lumbar Spine ◽  
Intervertebral Disc ◽  
Disc Herniation ◽  
Lumbar Disc ◽  
Degenerative Spondylolisthesis ◽  
Pain Syndrome ◽  
Invasive Technique ◽  
Intervertebral Disc Herniation ◽  
Endoscopic Discectomy ◽  
Radicular Syndrome

Objective. To determine a rational surgical strategy and approach to the treatment of patients with degenerativedystrophic disorders of the lumbar spine by percutaneous endoscopic discectomy. Material and Methods. Percutaneous endoscopic nucleotomy was applied in surgical treatment of 60 patients. Out of them 46 patients had L4–L5 intervertebral disc herniation, 7 patients had L3–L4 intervertebral disc herniation, 2 patients – L4–L5 hernia relapse after microdiscectomy, 1 patient – ossificated foraminal hernia at L3–L4, 3 patients – unstable degenerative spondylolisthesis at L4 level, and 1 – the same at L3. Complex examination of patients included acquisition of complaints and anamnestic data, general clinical, neurological, laboratory, and radiologic evaluation. All patients had CT images, in 10 cases they were added by MRI, and in 16 cases – by CT myelography. Pain syndrome intensity was assessed by digital rating and visual-analogue scales allowing the analysis of pain at rest, in motion, and at night. Results. Pain syndrome was arrested in 51 patients. Two patients showed residual radicular syndrome in the early postoperative period, and seven patients – residual reflex pain syndrome. Three months after the operation moderate reflex pain syndrome was observed in 6 cases, radicular syndrome in no one case. No aggravation of neurological deficit occured at the later follow-up period. Conclusion. Percutaneous endoscopic nucleotomy is a minimal invasive technique for lumbar disc hernia removal which reduces hospitalisation terms and risk of postoperative complications.

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