scholarly journals Outcome of surgical treatment by Harrington method different combinations in patients with scoliosis

1996 ◽  
Vol 3 (1) ◽  
pp. 3-6
Author(s):  
S. T. Vetrile ◽  
V. V. Shvets ◽  
A. A. Kuleshov

Authors analysed the outcomes of surgical treatment in 108 patients with scoliosis. Depending on surgical technique the patients were divided into 4 groups. The base of surgical procedures was different combinations of Harrington distractor with Luque rod as well as with segmental angular resection at the deformity apex. The efficacy of segmental angular resection that enabled to mobilize the rigid scoliotic deformity and increase intraoperative correction was detected. The combination of that procedure with the deformity correction by Harrington distractor and lateral traction by Luque rod allowed to achieve more marked correction and to preserve it to a greater degree and for longer time (2 years after operation 67,8% of achieved correction was preserved). It was also shown that fixation of corrective spine by Harrington distractor only did not provide considerable preservation of primary achieved correction in long term postoperative period (2 years after operation 47,3% of the achieved correction was preserved).

1996 ◽  
Vol 3 (1) ◽  
pp. 6-9
Author(s):  
I. Z. Neiman ◽  
N. N. Pavlenko ◽  
Yu. G. Sumin ◽  
A. Ye. Kriger

The results of surgical treatment of 36 patients with scoliosis, aged 18-29, were presented. Correction by Harrington distractor and posterior spondylosyndesis with allografts was performed. The average deformity correction achieved made up 38,8% of the initial value. Long term results (from 2 to 9 years) were studied in 29 patients. In 2 patients, complete loss of the correction was noted. In the rest of patients, the final correction varied from 9,9 to 49%, average 25,7%, of the initial value. The less is the scoliosis degree and age of a patient, the better is outcome of surgical correction. The preoperative pain syndrome being present in 7 patients was eliminated after operation.


2006 ◽  
pp. 033-038
Author(s):  
Ravil Rafailovich Gatiatulin ◽  
Valentina Spiridonovna Lapinskaya ◽  
Vladimir Nikolayevich Shubkin ◽  
Timofey Viktorovich Frolyakin ◽  
Aleksandr Erikovich Kovalenko ◽  
...  

Objectives. To analyze the efficacy of surgery using the original plate endocorrectors for III–IV grade idiopathic progressing scoliosis. Materials and methods. Two-plate endocorrector was used in surgical treatment of 380 patients. Out of them 171 patients at the age of 13–15 years had vertebral body apophysis ossification of stage 2–3 according to Risser’s test. Scoliosis was congenital in 12 patients (3.2 %) and idiopathic in 368 patients (96.8 %). The smallest coronal angle of curve according to Cobb was 40°, the largest one – 145°. Surgery of severe IV grade scoliotic deformity (curve angle of 60–90°) was performed in 178 patients. Results. Patients with non-removable instrumentation show the maintenance of post-surgical correction within 75–80% in long-term follow-up period (up to 9 years). Complications related to the plate endocorrector were observed in 9.8 % of cases: aseptic serous reaction induced by instability of the construct elements – in 3.7 %, plate breakage and release of endocorrector locking – in 5.3 %. Conclusion. Plate endocorrector of the third generation provides effective three-dimensional deformity correction for idiopathic III–IV grade scoliosis. The endocorrector does not prevent further spine growth in children after surgery.


2012 ◽  
Vol 19 (3) ◽  
pp. 14-19
Author(s):  
Ya. R Jalilov ◽  
V. Q Verdiyev ◽  
T. Y Jalilov

Surgical treatment results for 53 patients with III—IV stage of scoliosis are presented. In all patients original endocorrector has been applied. Endocorrector is based on the application of cross-section corrective («translation effect») forces that enable to shift the vertebrae of the main scoliotic arch to the median line of the trunk. Endocorrector was the most effective in curvature arch under 75° and provided 35—45° correction. Mathematic modeling of a situation «endocor- rector—curved spine» was performed as well as the pattern of forces created by endocorrector and participated in the scoliotic deformity correction was studied. Surgical intervention enabled to achieve stable fixation of the spine with its sagittal contours preservation. At long-term follow up (1—6 years) loss of correction did not exceed 8—10°. In scoliosis with arch over 75° step-by- step corrections were performed and loss of correction could make up 15°.


2021 ◽  
Vol 9 (2) ◽  
pp. 153-162
Author(s):  
Dmitry N. Kokushin ◽  
Michael A. Khardikov ◽  
Sergey V. Vissarionov ◽  
Vera V. Sokolova ◽  
Nikita O. Khusainov ◽  
...  

BACKGROUND: Congenital scoliosis with disorders of the formation of the vertebrae is the most common cause of pronounced deformities of the spine in early childhood. This pathology can be treated surgically using various techniques that differ in invasiveness, severity of the condition in the postoperative period, achieved result of deformity correction, and nature of the long-term prognosis. Numerous studies have assessed the quality of life of patients who underwent surgery for acquired deformities, trauma, and degenerative and neoplastic diseases of the spine in adults. However, features of the childs quality of life following surgical technique for congenital scoliosis have not been sufficiently studied. AIM: This study aimed to compare the quality of life of children with congenital scoliosis of the thoracolumbar localization after extirpation of the hemivertebra from the dorsal and combined approaches. MATERIALS AND METHODS: An intergroup prospective analysis of the results of a survey of 60 patients with congenital deformity of the spine against the background of an isolated violation of the formation of the thoracic or lumbar vertebra was carried out. Patients underwent standard surgical treatment. Patients were divided into two groups according to the surgical approach to the abnormal vertebral body: dorsal group (n = 28) and combined group (n = 32). The average age of the patients was 75 (minmax, 26196) months. The follow-up period was 18 months after surgery. To assess the quality of life, a specialized Russian version of the PedsQL v4.0 questionnaire and a modified visual analog scale were used. RESULTS: After surgical treatment of congenital spinal deformity, quality of life indicators decreased more than two times than the results of a preoperative survey. At 18 months postoperatively, the physical activity and psychoemotional state were restored to the preoperative level, while patients of the combined group had a higher satisfaction score on the quality of life (p 0.05). CONCLUSIONS: The combined approach provides the best correction of congenital deformity of the spine and allows maintaining of the achieved result throughout the observation period. In the early postoperative period, the combined group demonstrated a significant decrease in the level of satisfaction with the quality of life, while the pain syndrome was higher than that in the dorsal group. Dynamic observation revealed the leveling of these differences and a subsequent increase in the level of satisfaction with the quality of life of these patients.


2020 ◽  
pp. 167-175
Author(s):  
O. M. Babii ◽  
S. A. Tarabarov ◽  
N. V. Prolom ◽  
B. F. Shevchenko ◽  
A. A. Galinsky

Summary. Purpose: to improve the results of surgical treatment of stenosis of the pyloroduodenal zone of ulcerative origin through the use of minimally invasive laparoendoscopic interventions. Material and methods. In the Department of Surgery of the Digestive Organs of the State Institution “Institute of Gastroenterology of the NAMS of Ukraine” for 2014-2019, 114 patients with stenosis of the pyloroduodenal zone of ulcerative origin were examined. Of these, 35 — with compensated stenosis, 57 — with subcompensated, 22 — with decompensated stenosis. The average age (45.3±5.2) years. The control group consisted of 20 healthy individuals. All patients underwent surgical treatment using minimally invasive and traditional surgical interventions. Results and discussion. During the study, known indications were clarified and new indications for performing endoscopic balloon pyloroduodenoplasty and combined laparoendoscopic intervention were clarified. Complications in the immediate postoperative period occurred in 1 patient (1.04%) in the form of perforation of the dilated zone. In patients after the traditional laparotomy surgery, the average postoperative period was (15 ± 2) days. Complications in the immediate postoperative period occurred in 2 patients (11.1 %) in the form of bleeding and leaks in the pyloroplasty zone, which required repeated surgical treatment. Тhere were no fatal cases. The remote observation period was 7-22 months. Endoscopic, radiological and clinical signs of recurrence of peptic ulcer and stenosis were not detected. Conclusions. The method of minimally invasive endoscopic and combined laparoendoscopic interventions in the treatment of stenosis of the pyloroduodenal zone of ulcerative genesis is characterized by a minimal number of complications, has good efficacy indicators and the absence of disease recurrence in the long-term period.


2016 ◽  
Vol 2016 ◽  
pp. 1-12 ◽  
Author(s):  
Lea Juul Nielsen ◽  
Caroline Holkmann Olsen ◽  
Jørgen Lock-Andersen

Chondrodermatitis Nodularis Helicis is a benign inflammatory process affecting the skin and cartilage of the ear. It typically presents as a painful nodule surrounded by an area of erythema and often prevents the patient from sleeping on the affected side. Many treatments have been described in the literature, but the condition is prone to recurrence. A literature search was performed in order to identify the best possible treatment. Fifty-eight articles were included, describing and investigating nonsurgical as well as surgical treatment modalities. Large prospective, controlled, and randomised long-term studies are lacking, but based on the available literature, we recommend starting with a conservative approach using decompression devices. Simple surgical procedures should only be used if conservative measures fail.


2005 ◽  
Vol 95 (1) ◽  
pp. 18-25 ◽  
Author(s):  
Bradley M. Lamm ◽  
Dror Paley ◽  
John E. Herzenberg

Multiple surgical procedures have been described for the correction of equinus deformity. We present a review of the anatomy, biomechanics, and clinical assessment of equinus. In addition, we provide a detailed surgical technique for gastrocnemius soleus recession and introduce an anatomical guide for surgical treatment. (J Am Podiatr Med Assoc 95(1): 18–25, 2005)


2007 ◽  
Vol 36 (2) ◽  
pp. 261-266 ◽  
Author(s):  
Jonathan H. Dunn ◽  
John J. Kim ◽  
Lonnie Davis ◽  
Robert P. Nirschl

Background Good to excellent short-term results have been reported for the surgical treatment of lateral epicondylitis using various surgical techniques. Hypothesis Surgical treatment for lateral epicondylitis using the mini-open Nirschl surgical technique will lead to durable results at long-term follow-up. Study Design Case series; Level of evidence, 4. Methods Records from 139 consecutive surgical procedures (130 patients) for lateral epicondylitis performed by 1 surgeon between 1991 and 1994 were retrospectively reviewed. Eighty-three patients (92 elbows) were available by telephone for a mean follow-up of 12.6 years (range, 10–14 years). Outcome measures included the Numeric Pain Intensity Scale, Nirschl and Verhaar tennis elbow–specific scoring systems, and American Shoulder and Elbow Surgeons elbow form. Preoperative data were collected retrospectively. Results The mean age of the study group was 46 years (range, 23–70 years) with 45 men and 38 women. Eighty-seven of the procedures were primary, and 5 were revision tennis elbow surgeries. Concomitant procedures were performed in 30 patients including ulnar nerve release in 24 patients, medial tennis elbow procedures in 23 patients, shoulder arthroscopy in 2 patients, carpal tunnel release in 1 patient, and triceps debridement and osteophyte excision in 1 patient. The mean duration of preoperative symptoms was 2.2 years (range, 2 months to 10 years). The mean Nirschl tennis elbow score improved from 23.0 to 71.0, and the mean American Shoulder and Elbow Surgeons score improved from 34.3 to 87.7 at a minimum of 10-year follow-up ( P < .05). The Numeric Pain Intensity Scale pain score improved from 8.4 preoperatively to 2.1 ( P < .05). Results were rated as excellent in 71 elbows, good in 6 elbows, fair in 9 elbows, and poor in 6 elbows by the Nirschl tennis elbow score. By the criteria of Verhaar et al, the results were excellent in 45 elbows, good in 32 elbows, fair in 8 elbows, and poor in 7 elbows. Eighty-four percent good to excellent results were achieved using both scoring systems. Ninety-two percent of the patients reported normal elbow range of motion. The overall improvement rate was 97%. Patient satisfaction averaged 8.9 of 10. Ninety-three percent of those available at a minimum of 10-year follow-up reported returning to their sports. Conclusion The mini-open Nirschl surgical technique with accurate resection of the tendinosis tissue remains highly successful in the long term.


2015 ◽  
Vol 3 (1) ◽  
pp. 5-14
Author(s):  
Sergei Valentinovich Vissarionov ◽  
Dmitriy Nikolaevich Kokushin ◽  
Sergei Mikhailovich Belyanchikov ◽  
Vladislav Valerievich Murashko

The purpose of the study is to describe features of the surgical technique for correction of kyphotic deformity of the spine and to analyze the results of surgical treatment of juvenile kyphosis in children with the use of 3D-CT navigation.— Materials and methods. We observed 11 patientsaged 14-17 years old (2 girls and 9 boys) with kyphoticdeformity of the spine, developed on the backgroundof Scheuermann’s disease. The deformity amount aver-aged 73,9° (60 to 90°). Surgery was performed fromthe combined access, carring out discapophysectomyand corporodesis on top of kyphosis and fixing mul-tibasic corrective metal construction. For the insertionof pedicle screws we used 3D-CT navigation.— The results. After surgery kyphosis value decreasedto 32,6° (20 to 45°), the deformity correction averaged41,3° (30 to 50°). Hybrid systems were placed in 5 pa-tients, total transpedicular fixation - in 6 children.Number of fixed vertebrae with hybrid metal construc-tions averaged 14 (13 to 15), in patients with total pediclefixation - 13 (12 to 14). In all cases we observed the correct position of pedicle support elements. Postopera- tive follow-up period was from 1 year and 5 months to5 years and 4 months, on average - 3 years 5 months. The loss of the result achieved in the long-term follow- up period was observed in patients with hybrid metal constructions and averaged 7,2° (4 to 9°).— Conclusion. The use of pedicle screws for thecorrection of juvenile kyphosis in children allows forthe effective correction of the deformity, restoring thephysiological profiles of the spine, eliminating post-operative progression of curvature, and reducing thelength of metal fixation and save the result achievedin the long-term follow-up. The use of active optical3D-CT navigation allows carring out a correct inser-tion of pedicle screws in the vertebral bodies in chil-dren with juvenile kyphosis.— Keywords: Scheuermann’s disease, juvenile ky-phosis, transpedicular fixation, navigation, children,surgical treatment.


Author(s):  
LUIGI CARLO DA SILVA COSTA ◽  
JOÃO GABRIEL ROMERO BRAGA ◽  
VALDIR TERCIOTI JUNIOR ◽  
JOÃO DE SOUZA COELHO NETO ◽  
JOSÉ ANTÔNIO POSSATTO FERRER ◽  
...  

ABSTRACT Objective: to analyze the surgical treatment of patients with recurrent megaesophagus followed at the esophageal-stomach-duodenal outpatient clinic of the Hospital de Clínicas - UNICAMP. Methods: a retrospective study, from 2011 to 2017, with 26 patients with Chagas or idiopathic megaesophagus, surgically treated, and who recurred with dysphagia. Clinical, endoscopic and radiographic aspects were assessed and correlated with the performed surgical procedures. Results: 50% had dysphagia for liquids, 69% regurgitation, 65.3% heartburn, 69.2% weight loss and 69.2% had Chagas disease. In addition, 38.4% had megaesophagus stage 1 and 2 and 61.5% stage 3 and 4. Regarding the reoperations, 53% of them underwent Heller-Pinotti surgery by laparoscopy, Serra-Dória in 30.7% and esophageal mucosectomy in 7.9%. In 72% of the reoperations there were no postoperative complications, and 80% of the patients had a good outcome, with reduction or elimination of dysphagia. Among the reoperated patients undergoing the laparoscopic Heller-Pinotti technique, three reported little improvement of dysphagia in the postoperative period and among those who underwent Serra-Dória surgery, 100% had no dysphagia. It was observed that, when the time between the first procedure and the reoperation was longer, the better the surgical result was, with statistical significant decreased dysphagia (p=0.0013, p<0.05). Conclusions: there was a preference to perform laparoscopic re-miotomy and, as a second option, Serra-Dória surgery, for patients with recurrent megaesophagus. Esophagectomy or esophageal mucosectomy were reserved for more severe patients.


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