scholarly journals Approaches to Thoracic and Lumbar Spine: Our 10 Years Review

2019 ◽  
Vol 7 (08) ◽  
Author(s):  
Parthasarahi Datta
Keyword(s):  
Lumbar Spine ◽  
Retrospective Analysis ◽  
Anterior Approach ◽  
Posterior Approach ◽  
Perioperative Complications ◽  
Complete Recovery ◽  
Neurological Deficits ◽  
Posterior Aspect ◽  
Thoracic And Lumbar Spine

Background: Lesions of the Thoracic and lumbar spine (TL) are numerous. These lesions affect one or more columns (anterior, middle and posterior) of the spine and compress the spinal cords either from anterior and posterior, giving rise to the features of radiculo-myelopathy. These lesions can be approached either from the anterior or posterior aspect of the spine. We present our last 10 years experience regarding the comparison between two approaches. Methods: Retrospective analysis of records of all patients with thoracic and lumbar lesion treated in our hospital between January 2005 and June 2014 was performed. Over the last 10 years, we came across 186 patients of thoracic and lumbar lesion lesion who were operated either by anterior or posterior approach and were the focus of this study. Follow up ranged from 6 months to 7 years. Results: All the patients presented with neurological deficits. They were evaluated with investigation protocol of our hospital. Anterior approach was done in 38 cases (n = 38) and posterior approach was done in 148 cases (n = 148). We compared between the two groups in terms of perioperative complications, recovery, persisting symptoms and mortality. Conclusion: Complete recovery is better in the posterior approach (74.3%) v/s 52.6%) and morality is more in the anterior approach (7.9% v/s 1.3%). Keywords: Columns, radiculo-myelopathy, thoracic, lumbar

Simultaneous anterior—posterior approach to the thoracic and lumbar spine for the radical resection of tumors followed by reconstruction and stabilization

2001 ◽  
Vol 94 (2) ◽  
pp. 232-244 ◽  
Author(s):  
Daryl R. Fourney ◽  
Dima Abi-Said ◽  
Laurence D. Rhines ◽  
Garrett L. Walsh ◽  
Frederick F. Lang ◽  
...  
Keyword(s):  
Lumbar Spine ◽  
Posterior Approach ◽  
Malignant Tumors ◽  
Neurological Deficits ◽  
Spinal Tumors ◽  
Rank Test ◽  
Content Type ◽  
Thoracic And Lumbar Spine ◽  
Anterior Posterior ◽  
Fine Print

Object. Thoracic or lumbar spine malignant tumors involving both the anterior and posterior columns represent a complex surgical problem. The authors review the results of treating patients with these lesions in whom surgery was performed via a simultaneous anterior—posterior approach. Methods. The hospital records of 26 patients who underwent surgery via simultaneous combined approach for thoracic and lumbar spinal tumors at our institution from July 1994 to March 2000 were reviewed. Surgery was performed with the patients in the lateral decubitus position for the procedure. The technical details are reported. The mean survival determined by Kaplan—Meier analysis was 43.4 months for the 15 patients with primary malignant tumors and 22.5 months for the 11 patients with metastatic spinal disease. At 1 month after surgery, 23 (96%) of 24 patients who complained of pain preoperatively reported improvements (p < 0.001, Wilcoxon signed-rank test), and eight (62%) of 13 patients with preoperative neurological deficits were functionally improved (p = 0.01). There were nine major complications, five minor complications, and no deaths within 30 days of surgery. Two patients (8%) later underwent surgery for recurrent tumor. Conclusions. The simultaneous anterior—posterior approach is a safe and feasible alternative for the exposure tumors of the thoracic and lumbar spine that involve both the anterior and posterior columns. Advantages of the approach include direct visualization of adjacent neurovascular structures, the ability to achieve complete resection of lesions involving all three columns simultaneously (optimizing hemostasis), and the ability to perform excellent dorsal and ventral stabilization in one operative session.

scholarly journals Lower Dislocation Rate Following Total Hip Arthroplasty via Direct Anterior Approach than via Posterior Approach: Five-Year-Average Follow-Up Results

2015 ◽  
Vol 9 (1) ◽  
pp. 157-162 ◽  
Author(s):  
Sachiyuki Tsukada ◽  
Motohiro Wakui
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Anterior Approach ◽  
Posterior Approach ◽  
Direct Anterior Approach ◽  
Dislocation Rate ◽  
Rank Test ◽  
Consecutive Series ◽  
Total Hip

Objective: The aim of the study was to compare the dislocation rate between total hip arthroplasty (THA) via direct anterior approach (DAA) and via posterior approach (PA). Methods: We compared a consecutive series of 139 THAs via DAA with 177 THAs via PA. All study patients received ceramic-on-ceramic bearing surfaces and similar uncemented prostheses. Dislocation-free survival after THA was estimated using the Kaplan–Meier survival method and compared between groups using the log-rank test. Results: In the DAA group, none of 139 hips experienced dislocations in five-year-average follow-up. In the PA group, seven hips experienced dislocations among 177 hips (4 %). The dislocation was significantly less in the DAA group compared to the PA group (p = 0.033). Conclusion: The dislocation rate of THA via DAA was significantly less than that of THA via PA.

scholarly journals Anterior versus posterior surgical approach for lumbosacral tuberculosis

2018 ◽  
Vol 46 (7) ◽  
pp. 2569-2577 ◽  
Author(s):  
Bolong Zheng ◽  
Dingjun Hao ◽  
Hua Guo ◽  
Baorong He
Keyword(s):  
Cobb Angle ◽  
Anterior Approach ◽  
Posterior Approach ◽  
Operation Time ◽  
Analog Scale ◽  
Loss Of Correction ◽  
Pain Scores ◽  
Angle Correction ◽  
Before And After

Objective To compare two different approaches for the treatment of lumbosacral tuberculosis. Patients and Methods In total, 115 patients who were surgically treated in our department from July 2010 to July 2014 were included in this retrospective study. They were divided into the anterior and posterior approach groups. Intraoperative hemorrhage; the surgery time; the Cobb angle preoperatively, postoperatively, and at the follow-up visit (2 years postoperatively); visual analog scale (VAS) pain scores before and after surgery; and Oswestry Disability Index (ODI) scores before and after surgery were compared between the two groups. Results The Cobb angle and VAS and ODI scores were significantly improved in both groups after surgery. Significant differences were found in the operation time, intraoperative hemorrhage, Cobb angle correction, and loss of correction at the last follow-up. No significant differences were found in the VAS and ODI scores between the groups. Conclusions The posterior approach is superior to the anterior approach with respect to the surgery time, intraoperative hemorrhage, and Cobb angle postoperatively and at the last follow-up. When both approaches can be carried out for a patient with lumbosacral tuberculosis, the posterior approach should be favored over the anterior approach.

Minimum 5-Year Follow-up of Anterior Column Structural Allografts in the Thoracic and Lumbar Spine

Spine ◽  
1999 ◽  
Vol 24 (10) ◽  
pp. 967-972 ◽  
Author(s):  
Robert W. Molinari ◽  
Keith H. Bridwell ◽  
Steven J. Klepps ◽  
Christy Baldus
Keyword(s):  
Lumbar Spine ◽  
Anterior Column ◽  
Thoracic And Lumbar Spine ◽  
Structural Allografts

Risk factors for delayed extubation in thoracic and lumbar spine surgery: a retrospective analysis of 135 patients

2013 ◽  
Vol 28 (2) ◽  
pp. 161-166 ◽  
Author(s):  
Fenghua Li ◽  
Reza Gorji ◽  
Richard Tallarico ◽  
Charles Dodds ◽  
Katharina Modes ◽  
...  
Keyword(s):  
Risk Factors ◽  
Lumbar Spine ◽  
Retrospective Analysis ◽  
Spine Surgery ◽  
Lumbar Spine Surgery ◽  
Thoracic And Lumbar Spine ◽  
Delayed Extubation

scholarly journals Cervical ossification of the posterior longitudinal ligament and its post surgical outcome analysis

2020 ◽  
Vol 8 (3) ◽  
pp. 816
Author(s):  
Vipul Kumar Gupta ◽  
T. Narsimha Rao
Keyword(s):  
Anterior Approach ◽  
Posterior Approach ◽  
Tertiary Care ◽  
Disease Process ◽  
Posterior Longitudinal Ligament ◽  
Functional Improvement ◽  
Outcome Analysis ◽  
Biomechanical Factors ◽  
Surgical Group

Background: Ossification of the posterior longitudinal ligament (OPLL) is a complex multi-factorial disease process having both metabolic and biomechanical factors. The objective of this study was to assess the surgical out come and post operative functional improvement in patients with cervical OPLL at a tertiary care centre.Methods: This prospective observational study included 35 patients undergoing surgery for cervical OPLL in the department of neurosurgery, Care hospitals Hyderabad from October 2015 to October 2016 with follow up at 3months and 6 months.Results: Total 35 patients who underwent surgery, majority (77.15%) were males and (22.85%) were female. The age of the patients was between 30 to 70 years. The most common type of OPLL was found to be segmental and mixed type. Nurick grade improved by 1.12 in anterior approach vs 0.66 in posterior approach. Recovery rates observed in anterior approach is 57.72% while in posterior surgical approach it is 48.87%. No complication was observed in this study.Conclusions: OPLL is more common in males as compared to females. The average age of presentation is sixth decade. Younger patients have better outcomes. The most common variant of OPLL is segmental.  The recovery rate achieved from anterior approach are better than those from the posterior approach. Improvement in NURICKS score is more in anterior surgical group than in posterior surgical group. No complications seen in this study. No mortality seen in this study.

Republished: Monorail microsnare retrieval of cardiac microcatheter tip embolised to the middle cerebral artery after attempted cardiac ablation procedure

2020 ◽  
Vol 12 (7) ◽  
pp. e6-e6
Author(s):  
Michael Young ◽  
Ryan Johnson ◽  
Hamad Farhat
Keyword(s):  
Atrial Fibrillation ◽  
Mitral Valve ◽  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Complete Recovery ◽  
Neurological Deficits ◽  
Ablation Procedure ◽  
Cardiac Ablation ◽  
The Right

We present a case of a 52-year-old man with previous mitral valve replacement who presented to an outside hospital for planned cardiac ablation for atrial fibrillation. During the procedure, while advancing the microcatheter across the mitral valve, the microcatheter was sheared embolising into the right middle cerebral artery. This retained cardiac microcatheter tip was successfully retrieved with the monorail microsnare technique. The patient made a complete recovery without any neurological deficits or evidence of infarct on follow-up imaging.

Notfallmäßige Carotis Endarterektomie im Stadium progredienter neurologischer Defizite

VASA ◽  
2001 ◽  
Vol 30 (2) ◽  
pp. 115-121 ◽  
Author(s):  
R. Brandl ◽  
R.B. Brauer ◽  
P.C. Maurer
Keyword(s):  
Complete Recovery ◽  
Acute Onset ◽  
Neurological Deficits ◽  
Symptomatic Carotid ◽  
Urgent Surgery ◽  
Post Surgery ◽  
Elective Treatment ◽  
Carotid Stenoses ◽  
History Of

Background: Carotid endarterectomy (CEA) is well established as the elective treatment for moderate or severe carotid stenoses with a history of neurologic symptoms. In contrast, the merits of carotid revascularisation performed in emergency in patients with acute stroke or fluctuating neurological deficit remain controversial. Patients and methods: A total of 445 CEAs were performed on 424 patients for 212 (48%) asymptomatic and 233 (52%) symptomatic carotid stenoses within a 5 years period between January, 1995, and December, 1999. Of the latter, CEA was performed in emergency on 16 patients (3.8%) within 4 to 24 hours after the onset of symptoms. Patients selected for urgent surgery fulfilled the following criteria: acute onset of fluctuating hemispheric neurological symptoms, significant carotid pathology, absence of cerebral hemorrhage, uncompromised vigilance and stable cardiopulmonary conditions. Selected patients presented with a crescendo-TIA (n = 7) or fluctuating neurological deficits (n = 9) corresponding to a contralateral carotid stenosis. Results: Following CEA, the neurological deficits improved instantaneously to complete recovery in 9 patients. The symptoms of 4 patients improved to non-disabling deficits, remained unchanged in one and worsened in 2 patients from hemihypaesthesia to hemiparesis. 14/16 patients were discharged within 8 days after admission. The neurologic status after discharge did not deteriorate in any of the patients during follow up of 19.3 ± 13 months, but improved in 4 of the patients. Conclusion: Our retrospective study suggests that rescue CEA may be beneficial for selected patients with stroke in evolution and fluctuating neurological deficits. Careful adherence to selection criteria, intraoperative shunting, intensive care post surgery surveillance and an experienced team are recommended.

Peculiarities of Treatment of Patients with Complicated Compression Fractures of Thoracic and Lumbar Spine Vertebral Bodies on the Background of Osteoporosis

2009 ◽  
Vol 16 (2) ◽  
pp. 34-39
Author(s):  
S T Vetrile ◽  
Aleksandr Alekseevich Kuleshov ◽  
L Yu Darchiya ◽  
S T Vetrile ◽  
A A Kuleshov ◽  
...  
Keyword(s):  
Lumbar Spine ◽  
Term Treatment ◽  
Mineral Density ◽  
Compression Fractures ◽  
Long Term Treatment ◽  
Thoracic And Lumbar Spine ◽  
Vertebral Bodies ◽  
Adequate Decompression

Experience in surgical treatment of 11 patients (1998-2008) with complicated compression fractures of the thoracic and lumbar spine vertebral bodies on the background of osteoporosis has been presented. Mean age of patients was 58 years (from 37 to 74 years). The treatment consisted of the adequate decompression of spinal canal followed by correction and multilevel fixation of the spine with CDI system. Decision on the fixation extent was made with regard for the degree of bone mineral density and vertebral body injury. Follow up period made up 1-10 years. Long term treatment results were assessed clinically and roentgenologically. Correction of kyphosis was noted in all cases. In the late period slight loss of the achieved correction (within 12°) was observed but the patients did not complained of spinal pains. In patients operated on in early terms (up to 2 months) after neurologic complications development the more rapid regress of neurologic symptoms was noted. It was shown that differentiated approach to the choice of surgical technique enabled to achieve favorable results.

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