scholarly journals The role of reflex-pain syndrome of osteochondrosis and spondyloarthrosis in the results of surgical treatment compressive syndrome offers by disc gerniation (diagnostics and neuron-surgical treatment)

2011 ◽  
Vol 10 (2) ◽  
pp. 73-76
Author(s):  
Ye. B. Kolotov ◽  
R. R. Aminov ◽  
S. V. Yelagin ◽  
V. V. Kelmakov ◽  
Ye. V. Kolotova
Keyword(s):  
Surgical Treatment ◽  
Postoperative Period ◽  
Pain Syndrome ◽  
Facet Joints ◽  
In Series

To improve the results of surgical treatment the patients with discogenic compressive syndromes. Using the denervation of interbody discs and facet joints in series allow us, first off all, to induce, and then to discontinue the reflex-pain syndrome in 41 patients in preoperational period, and in 39 patients in long-term postoperative period. Good results come to 82,8 и 89,8% (р < 0,05) accordingly.

scholarly journals Evaluation of the role of ventral interventions in the surgery of idiopathic scoliosis in patients with active bone growth

2021 ◽  
Vol 9 (1) ◽  
pp. 17-28
Author(s):  
Marija A. Chernyadjeva ◽  
Aleksandr S. Vasyura ◽  
Vyacheslav V. Novikov
Keyword(s):  
Surgical Treatment ◽  
Idiopathic Scoliosis ◽  
Postoperative Period ◽  
Bone Growth ◽  
Long Term Results ◽  
Transpedicular Fixation ◽  
Deformity Progression

BACKGROUND: Today, the question of the tactics of surgical treatment of patients with idiopathic scoliosis during active bone growth, namely, the need for ventral interventions due to the emergence of modern dorsal instruments, remains open. AIM: This study aims to evaluate the role of ventral interventions in the surgical treatment of patients with progressive idiopathic scoliosis Lenke type 1, 2, 3 during the period of active bone growth. MATERIALS AND METHODS: The long-term results of operational correction 352 patients with thoracic idiopathic scoliosis aged from 10 to 14 years old operated in Novosibirsk Research Institute of Traumatology and Orthopedics n.a. Ya.L. Tsivyan from 1998 to 2018 using various methods and different instrumentation types. RESULTS: Among patients (352 people) aged 10 to 14 years with idiopathic thoracic scoliosis (Lenke type 1, 2, 3), statistically significant postoperative progression was observed in patients who underwent surgical deformity correction using laminar (hook) fixation. At the same time, additional ventral stage conduction could not prevent deformity progression in the postoperative period. In those groups where hybrid fixation was used combined with the ventral stage and total transpedicular fixation, no significant progression was observed in the postoperative period. CONCLUSION: Modern dorsal systems for transpedicular fixation narrow the indications for using additional mobilizing and stabilizing ventral interventions in the surgical treatment of progressive idiopathic scoliosis in patients with active bone growth. Total transpedicular fixation provides excellent main curve and anti-curvature arch correction in the absence of scoliotic deformity progression in the postoperative long-term follow-up.

Regression of Enlarged Lumbar Zygapophyseal Inclusions after Manipulative Therapy

1998 ◽  
Vol 11 (1) ◽  
pp. 113-116
Author(s):  
V. Rucco ◽  
P.-T. Basadonna ◽  
D. Gasparini
Keyword(s):  
Magnetic Resonance ◽  
Magnetic Resonance Image ◽  
Pain Syndrome ◽  
Spontaneous Pain ◽  
Low Back ◽  
Facet Joints ◽  
Manipulative Therapy ◽  
Facet Syndrome ◽  
Lumbar Facet

We describe a case of low back pain (LBP) secondary to a facet syndrome, with a magnetic resonance image of enlarged zygapophyseal inclusions, which both regressed with manipulative therapy. The role of the lumbar zygapophyseal inclusion in the pain syndrome remains uncertain, because there are no studies on these inclusions in the lumbar facet syndrome. The explanation of the role of manual therapy is also uncertain (adjusting joint subluxations, restoring bony alignment, reducing nuclear protrusion, reducing meniscoid entrapment or extrapment, decompressing facet joints, etc). The diagnosis of classical facet syndrome LBP was made by history-taking and physical examination. The diagnosis of intra-articular enlargements was made by magnetic resonance imaging. The manipulative therapy consisted of manipulations in rotation with the spine placed in kyphosis. Before every manipulation session, spontaneous pain, pain with pressure on the zygapophyseal joint and the range of thoracic and lumbar spine motions were evaluated. After the fourth manipulation session, the patient's pain was alleviated and the enlarged zygapophyseal inclusions were no longer visible. The clinical improvement continued at the controls one and two months after the end of the manipulative therapy. This is the first report of facet syndrome LBP with a magnetic resonance image of enlarged zygapophyseal inclusions which both regressed with manipulative therapy. It is interesting to speculate on the possible mechanisms to explain this outcome, but further studies are needed.

scholarly journals ТREATMENT OF STENOSIS OF THE PYLORIC BULBAR ZONE OF ULCERATIVE GENESIS USING MINIMALLY INVASIVE SURGERY

2020 ◽  
pp. 167-175
Author(s):  
O. M. Babii ◽  
S. A. Tarabarov ◽  
N. V. Prolom ◽  
B. F. Shevchenko ◽  
A. A. Galinsky
Keyword(s):  
Surgical Treatment ◽  
Minimally Invasive ◽  
Postoperative Period ◽  
Clinical Signs ◽  
State Institution ◽  
Disease Recurrence ◽  
Control Group ◽  
Surgical Interventions ◽  
Remote Observation

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.

scholarly journals Long-term results after surgical treatment of subacromial pain syndrome with or without rotator cuff tear

2018 ◽  
Vol 15 (3) ◽  
pp. 757-760 ◽  
Author(s):  
Eivind Inderhaug ◽  
Maiken Kalsvik ◽  
Kristin H. Kollevold ◽  
Janne Hegna ◽  
Eirik Solheim
Keyword(s):  
Surgical Treatment ◽  
Rotator Cuff ◽  
Rotator Cuff Tear ◽  
Pain Syndrome ◽  
Long Term Results ◽  
Cuff Tear ◽  
Subacromial Pain Syndrome

scholarly journals Interrelation of tropism and angulation parameters of facet joints and results of stabilization surgeries for degenerative diseases of the lumbar spine

2018 ◽  
Vol 15 (4) ◽  
pp. 70-79
Author(s):  
V. A. Byvaltsev ◽  
A. K. Okoneshnikova ◽  
A. A. Kalinin ◽  
S. S. Rabinovich
Keyword(s):  
Surgical Treatment ◽  
Lumbar Spine ◽  
Clinical Outcomes ◽  
Interbody Fusion ◽  
Degenerative Diseases ◽  
Facet Joints ◽  
Group Iii ◽  
Group I ◽  
Transpedicular Stabilization

Objective. To clarify indications for dynamic and rigid stabilization based on the analysis of correlation between neuroimaging parameters of facet joints (FJ) and clinical outcomes of surgical treatment of patients with degenerative diseases of the lumbar spine. Material and Methods. A total of 141 patients with degenerative diseases of the lumbar spine were surgically treated. Patients were divided into three groups: patients of Group I (n = 48) underwent surgical intervention with artificial intervertebral disc prosthesis; those of Group II (n = 42) – with interbody fusion and combined transpedicular and transfacetal stabilization; and those of Group III (n = 51) – with interbody fusion and bilateral transpedicular stabilization. The correlation between long-term clinical outcomes (pain syndrome according to VAS, functional state according to ODI, and satisfaction with surgical result according to MacNab scale) and preoperative neuroimaging parameters of FJ (degenerative changes according to Fujiwara, facet angle magnitudes, and the presence of tropism) was analyzed. Results. A direct significant nonparametric correlation of neuroimaging parameters of facet angles and FJ tropism with long-term clinical outcomes of surgical treatment according to VAS and ODI was revealed. It was established that good clinical outcomes were achieved with the following preoperative parameters: in Group I, the facet angle was less than 60°, while the presence of tropism had no correlation dependence; in Group II, the facet angle – more than 60°, in the absence of FJ tropism; and in Group III, the facet angle – more than 60°, in the presence of FJ tropism. Conclusion. Objective neuroimaging parameters of the facet angle magnitude of less than 60°, regardless of the presence of tropism, allow performing total arthroplasty. If the facet angle is more than 60°, the rigid stabilization of the operated segment is indicated; in the absence of tropism, a contralateral transfacetal fixation is possible, and in its presence – a bilateral transpedicular stabilization is reasonable.

scholarly journals Perioperative Ketamine Administration for Thoracotomy Pain

2017 ◽  
Vol 3 (20;3) ◽  
pp. 173-184 ◽  
Author(s):  
Srinivas Pyati
Keyword(s):  
Neuropathic Pain ◽  
Randomized Controlled Trials ◽  
Pain Syndrome ◽  
Route Of Administration ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Postthoracotomy Pain

Background: Of all the postsurgical pain conditions, thoracotomy pain poses a particular therapeutic challenge in terms of its prevalence, severity, and ensuing postoperative morbidity. Multiple pain generators contribute to the severity of post-thoracotomy pain, and therefore a multimodal analgesic therapy is considered to be a necessary strategy. Along with opioids, thoracic epidural analgesia, and paravertebral blocks, N-Methyl-D-Aspartate (NMDA) receptor antagonists such as ketamine have been used as adjuvants to improve analgesia. Objective: We reviewed the evidence for the efficacy of intravenous and epidural administration of ketamine in acute post-thoracotomy pain management, and its effectiveness in reducing chronic postthoracotomy pain. Study Design: Systematic literature review and an analytic study of a data subset were performed. Methods: We searched PubMed, Embase, and Cochrane reviews using the key terms “ketamine,” “neuropathic pain,” “postoperative,” and “post-thoracotomy pain syndrome.” The search was limited to human trials and included all studies published before January 2015. Data from animal studies, abstracts, and letters were excluded. All studies not available in the English language were excluded. The manuscript bibliographies were reviewed for additional related articles. We included randomized controlled trials and retrospective studies, while excluding individual case reports. Results: This systematic literature search yielded 15 randomized control trials evaluating the efficacy of ketamine in the treatment of acute post-thoracotomy pain; fewer studies assessed its effect on attenuating chronic post-thoracotomy pain. The majority of reviewed studies demonstrated that ketamine has efficacy in reduction of acute pain, but the evidence is limited on the long-term benefits of ketamine to prevent post-thoracotomy pain syndrome, regardless of the route of administration. A nested analytical study found there is a statistically significant reduction in acute post-thoracotomy pain with IV or epidural ketamine. However currently, the evidence for a role of ketamine as a preventative agent for chronic postthoracotomy pain is insufficient due to the heterogeneity of the studies reviewed with regard to the route of administration, dosage, and outcome measures. Limitations: The evidence for a role of ketamine as a preventative agent for chronic post-thoracotomy pain is insufficient due to the heterogeneity of the studies reviewed. Conclusion: The majority of randomized controlled trials reviewed show no role for ketamine in attenuating or preventing post-thoracotomy pain syndrome at variable follow-up lengths. Therefore, additional research is warranted with consideration of risk factors and long-term follow-up for chronic post-thoracotomy pain though the evidence for benefit appears clear for acute post-thoracotomy pain. Key words: Ketamine, postoperative, thoracotomy pain, post thoracotomy pain syndrome, neuropathic pain

scholarly journals Optimization of management of patients with coloproctological profile in outpatient surgical treatment of hemorrhoids

2020 ◽  
Vol 37 (2) ◽  
pp. 93-100
Author(s):  
A. L. Lisichkin ◽  
Yu. B. Busyrev ◽  
T. I. Karpunina
Keyword(s):  
Surgical Treatment ◽  
Postoperative Period ◽  
Postoperative Bleeding ◽  
Pain Syndrome ◽  
Test System ◽  
Interleukin 4 ◽  
Enzyme Linked Immunosorbent Assay ◽  
Outpatient Basis ◽  
Local Inflammation ◽  
Hemorrhoidal Artery Ligation

Objective. Various aspects of the organization and optimization of diagnosis and treatment, including surgical, in patients with hemorrhoids one of the most common diseases in coloproctology are still the subject of discussion. Problems of the postoperative period can be prolonged spasm of anal sphincter, severe pain syndrome and delayed postoperative bleeding. Materials and methods. We conducted a one-center prospective study in 214 patients, undergoing surgical treatment for stage 34 chronic hemorrhoids. The most common surgery for hemorrhoids was a different combination of hemorrhoidal artery ligation (HAL), rectomucopexy (RAR) and excision of one to three external hemorrhoids in one and the same patient. In all the observations, we used a specially developed questionnaire, including a visual-analog scale (VAS) and registration of taking anesthetiсs per day, so as to objectify the assessment of the level of pain after surgery. Identification of local inflammation included taking a blood sample in an amount of 0.1 ml when punctured with a GU insulin syringe during anoscopy and enzyme-linked immunosorbent assay in accordance with test system instructions and determining interleukin 1 (IL-1), interleukin 4 (IL-4), tumor necrosis factor (FNO-) and interleukin 8 (IL-8). Results. According to the results obtained (severity of pain syndrome and amount of anesthetics, absence of complications), patients were conditionally divided into three groups with mild reaction to surgery 44 (20.5 %), moderate 100 (46.5 %) and severe 70 (32.5 %). In the group with mild reaction, the level of the analyzed indices was almost consistent with the norm; in group II, there was an elevation of two of them; in group III, the level of at least three tests was higher than the norm. Conclusions. More favorably, the postoperative period proceeds against the background of initially unexpressed local inflammation. The proposed additional examination method, which allows identifying subclinical local inflammation and assessing its severity, should help to optimize the selection and, as a result, increase the efficiency and safety of surgical treatment of hemorrhoids on an outpatient basis.

scholarly journals Treatment of Chronic and Complicated Ruptures of the Rotator Cuff of the Shoulder

2021 ◽  
pp. 51-57
Author(s):  
O.S. Strafun ◽  
O.Yu. Sukhin ◽  
A.S. Lysak ◽  
S.V. Bohdan
Keyword(s):  
Surgical Treatment ◽  
Rotator Cuff ◽  
Postoperative Period ◽  
Latissimus Dorsi ◽  
Reverse Shoulder Arthroplasty ◽  
High Energy ◽  
Anterior Dislocation ◽  
Loss Of Function ◽  
Age Related

Relevance. The etiology of ruptures of the rotator cuff of the shoulder (RC) is represented by a variety of diseases, including age-related degeneration, low- and high-energy trauma. Most often, a rupture of the RC, combined with trauma, occurs with anterior dislocation of the shoulder – in 56% of patients. The “terrible triad” of the shoulder, which leads to a loss of function and disability in patients, is diagnosed in 9-18% of patients. RC ruptures of <1-1.5 cm throughout the entire thickness of the tendon have a high risk of progression and formation of a massive rupture of the RC. According to various authors, massive ruptures occur in 40% of all RC ruptures. Objective: to evaluate the results of surgical treatment of patients with old and complicated ruptures of the RC. Materials and Methods. From 2016 to 2021, in the SI “Institute of Traumatology and Orthopedics of NAMS of Ukraine”, Department of Microsurgery and Surgery of the Upper Limb, 140 patients with a ruptured RC were treated. The patients underwent: suture of the RC under arthroscopic control, open RC suture, transposition of the latissimus dorsi tendon into the RC defect, implantation of biodegradable InSpace balloon, or implantation of a biomatrix into the RC defect and reverse shoulder arthroplasty. Results. The function was assessed before surgery and in the long-term postoperative period using the Constant-Murley Score. In 5 patients with an implanted balloon, the score increased from 34-38 to 56-61 in 8-12 months. In 7 patients with reinforced biomatrix implantation, the score increased from 34-38 to 65-69 in 9-12 months. In 7 patients with transposition of the latissimus dorsi tendon, the score increased from 35-37 to 68-75 in 9-12 months. In 10 patients with reverse arthroplasty, the score increased from 30-34 to 58-65 in 12-18 months. In 82 patients, after the suture of the RC under arthroscopic control of the shoulder, the score increased from 36-40 to 78-82 in 12-18 months. In 29 patients with an open suture of the RC, the score increased from 34-38 to 68-75 in 12-18 months. Conclusions. Early diagnosis and timely surgical treatment for the pathology of the RC make it possible to obtain the best results in the long-term postoperative period. Massive and old ruptures of the RC require a complete instrumental examination in the preoperative period. The degree of adipose degeneration and rotator arthropathy is of key importance for determining the operative tactics of surgical treatment.

Features of the course of postoperative period during surgical treatment laparotomic and laparoscopic access to gynecological diseases in women with extragenital pathology

2017 ◽  
pp. 111-115
Author(s):  
V.V. Kostikov ◽  
Keyword(s):  
Surgical Treatment ◽  
Postoperative Period ◽  
Clinical Laboratory ◽  
Pain Syndrome ◽  
Abdominal Pressure ◽  
Laboratory Assessment ◽  
Gynecological Diseases ◽  
Case Rate ◽  
A Current ◽  
Gynecologic Patients

The objective: tactics definition postoperative period at surgical treatment of gynecologic patients with extragenital pathology. Patients and methods. Research included 240 patients who stayed on treatment in a hospital and were operative concerning diseases of internal genitals laparotomical and laparoscopic accesses. All patients had an extragenital pathology. Depending on operation access all patients were divided into two groups. The main group was made by 120 patients who were operated by laparoscopic access. The group of comparison was made by 120 patients whom was operative laparotomical access. Everything patients carried out a clinical-laboratory assessment of a current of the postoperative period. Results. Results of the conducted researches testify that at the compensated accompanying cardiovascular and pulmonary diseases, a diabetes mellitus and an obesity at gynecologic patients at identical gynecologic and extragenital pathology laparoscopic access is more preferable since takes less time, is less travmatical and morbid, is accompanied by a smaller hemorrhage in comparison with the laparotomical. Aftertreatment after laparoscopic operations takes less time that is bound to existence of less expressed pain syndrome, lack of disturbance of function of an intestine, faster restoration of a physical activity and thereof in the smaller postoperative afternoon. At the same time rising of intra abdominal pressure and the provision of Trendelenburg negatively affect hemodynamic indicators at patients with cardiovascular diseases though it doesn’t lead to a decompensation of activity of cardiovascular system. Conclusion. Tactics of maintaining the postoperative period at gynecologic patients with extragenital pathology depends on character of a somatic case rate, option quick to access, a hemorrhage and results of clinical-laboratory inspection. Key words: gynecologic operations, laparotomy, laparoscopy, postpoerative period.

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