scholarly journals Improvement of sagittal parameters in patients with cervical spondylotic myelopathy is associated with outcome after anterior cervical discectomy and fusion

2020 ◽  
Author(s):  
Yefu Xu ◽  
Sangni Liu ◽  
Feng Wang ◽  
Xiaotao Wu
Keyword(s):  
Risk Factors ◽  
Cobb Angle ◽  
Close Correlation ◽  
Cervical Lordosis ◽  
Cervical Compressive Myelopathy ◽  
Sagittal Parameters ◽  
Highly Correlated ◽  
And Gender ◽  
Compressive Myelopathy

Abstract Purpose: After ACDF, cervical lordosis loss, high C2-7 SVA and postoperative T1S will worsen the surgical prognosis. Therefore, this study evaluated the changes of cervical parameters after surgery and correlation with surgical prognosis. Methods: This study enrolled 212 cervical compressive myelopathy patients who underwent ACDF. We collect gender, age, BMI, NDI scores and cervical parameters. And then, we compare the changes of parameters after surgery, and explore the correlation between parameters and NDI score. Results: C2-7 Cobb Angle, SVA, T1S and TS-CL were all improved after surgery, but T1S at the last follow-up was larger than that before the surgery. T1S is positively correlated with TIA (p=0.018, r=0.081), CL (p<0.01, r=0.150) and SVA (p<0.01, r=0.131), but negatively correlated with SCA (p<0.01, r=-0.166). We also found that TIA was highly correlated with the sum of T1S+NT (p<0.01, r=0.459). Preoperative NDI was negatively correlated with preoperative c2-7 Cobb Angle (r=-0.147, p=0.033), positively correlated with SVA (r=0.157, p=0.022). The last follow-up NDI score was negatively correlated with C2-7 Cobb Angle (r=-0.222 p=0.001), positively correlated with SVA (r=0.498, p<0.001) and TS-CL (r=0.165, p=0.016). The risk factors with poor follow-up NDI score (the last follow-up NDI score greater than 30%) were SVA (B=0.337, P=<0.001), CL (B=-0.147, P=0.029) and gender (B=2.153, P=0.017). Conclusions: After ACDF, most postoperative cervical parameters have improved, but T1S deteriorated over time. There was a close correlation between cervical sagittal parameters. Preoperative NDI score was correlated with c2-7 Cobb Angle and SVA. Follow-up NDI score was correlated with CL, TS-CL and SVA. High SVA, loss of cervical lordosis and male patient were risk factors for the deterioration of postoperative NDI score.

scholarly journals Myofacial Release for the Management of Cervical Compressive Myelopathy – Case Study

2021 ◽  
Vol 1 (2) ◽  
pp. 1-5
Author(s):  
Patitapaban Mohanty ◽  
Keyword(s):  
Soft Tissue ◽  
Disc Herniation ◽  
Cord Compression ◽  
Surgical Decompression ◽  
Cervical Cord ◽  
Myofascial Release ◽  
Cervical Compressive Myelopathy ◽  
Compressive Myelopathy

Cervical compressive myelopathy commonly occurs due to degeneration or disc herniation. The persons with cervical meylopathy are usually advised for surgical decompression. Person with signs of cervical cord compression was treated with myofacial release and found to be improved in signs as well as the symptoms. Total 34 numbers of similar cases (31 males and 3 females) age ranging from 25 to 61 years were treated by myofascial release of periscapular soft tissue structures over last 2 & ½ years (2017 to 2020) and found to return back to their activities after 6 months of follow up.

Non-invasive assessment of endothelial activity in patients with coronary heart disease and cardiovascular risk factors

VASA ◽  
2008 ◽  
Vol 37 (2) ◽  
pp. 137-142 ◽  
Author(s):  
Fronek ◽  
Allison
Keyword(s):  
Risk Factors ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Cvd Risk ◽  
Hypertension Status ◽  
The Difference ◽  
Highly Correlated ◽  
And Gender

Background: The aim of this study was first to compare the widely used flow mediated dilation ( FMD ) method with the iontophoretically induced acetylcholine vasodilation (IAV ) procedure. The ultimate goal was to examine the endothelial activity ( EA ) in patients with various cardiovascular risk factors compared with control subjects. Patients and methods: In the upper extremities of 27 subjects, comparisons of EA by FMD and IAV measured with laser Doppler flux method (LDF) were conducted. IAV-EA was then measured using LDF in an additional 93 subjects with various cardiovascular ( CVD ) risk factors and/or a diagnosis of coronary heart disease (CHD). Results: The mean age of the subjects was 56.2 years and 54% were male. There was a robust and significant correlation between FMD vs IAV endothelial activity (r = 0.87, p = 0.025). After adjustment for age, there were significant differences in LDF-measured, acetylcholine-induced EA by diagnosis of CHD (p = 0.02), hyperlipidemia (p = 0.03) and diabetes (p < 0.01), as well as by sex (p < 0.01). The difference by hypertension status was of borderline significance (p = 0.07). LDF EA was higher in non-smokers compared to smokers but this difference was not statistically significant (p = 0.3). After adjustment for age and gender, a 10-unit increase in LDF-measured EA was associated with a 12% lower odds for a diagnosis of CHD (p = 0.07). Conclusions: Measurement of IAV-EA by LDF is a simple, noninvasive methodology which is highly correlated with post-occlusive FMD EA and is also significantly associated with a diagnosis of CHD.

scholarly journals How Sublaminar Bands Affect Postoperative Sagittal Alignment in AIS Patients with Preoperative Hypokyphosis? Results of a Series of 34 Patients with 2-Year Follow-Up

2016 ◽  
Vol 2016 ◽  
pp. 1-5 ◽  
Author(s):  
Sébastien Pesenti ◽  
Antoine Chalopin ◽  
Emilie Peltier ◽  
Elie Choufani ◽  
Matthieu Ollivier ◽  
...  
Keyword(s):  
Idiopathic Scoliosis ◽  
Cobb Angle ◽  
Lumbar Lordosis ◽  
Thoracic Kyphosis ◽  
Radiographic Evaluation ◽  
Cervical Lordosis ◽  
Pelvic Parameters ◽  
Sublaminar Bands ◽  
Thoracic Idiopathic Scoliosis

Hypokyphosis is currently observed in thoracic idiopathic scoliosis. The use of sublaminar bands allows a good restoration of sagittal balance of the spine. The aim of the study was to provide a middle-term radiographic analysis of patients with adolescent idiopathic scoliosis with preoperative hypokyphosis treated by posterior arthrodesis with sublaminar bands. This retrospective study included 34 patients with Lenke 1 scoliosis associated with hypokyphosis (TK < 20°). A radiographic evaluation was performed with a 2-year follow-up. Cobb angle, cervical lordosis, thoracic kyphosis, lumbar lordosis, and pelvic parameters were measured preoperatively, postoperatively, and at 6-month and 2-year follow-up. The mean preoperative thoracic kyphosis was 10.5° versus 24.1° postoperatively (p<0.001), representing a mean gain of 13°. Cobb angle ranged from 59.3° to 17.9° postoperatively (mean correction 69%,p<0.001). Cobb angle increased between the immediate postoperative measurement and the 6-month follow-up (17.9 versus 19.9,p=0.03). Cervical curvature changed from a 5.6° kyphosis to a 3.5° lordosis (p=0.001). Concerning lumbar lordosis, preoperative measurement was 39.7° versus 41.3° postoperatively (p=0.27). At 6-month follow-up, lumbar lordosis significantly increased to 43.6° (p=0.03). All parameters were stable at final follow-up. Correction performed by sublaminar bands is efficient for both fontal and sagittal planes. Moreover, the restoration of normal thoracic kyphosis is followed by an adaptation of the adjacent curvatures with improved cervical lordosis and lumbar lordosis.

scholarly journals Sagittal Alignment After Laminectomy Without Fusion as Treatment for Cervical Spondylotic Myelopathy: Follow-up of Minimum 4 Years Postoperatively

2019 ◽  
Vol 10 (4) ◽  
pp. 425-432
Author(s):  
Håkan Löfgren ◽  
Aras Osman ◽  
Anders Blomqvist ◽  
Ludek Vavruch
Keyword(s):  
Clinical Outcome ◽  
Cobb Angle ◽  
Cervical Spondylotic Myelopathy ◽  
Sagittal Alignment ◽  
Neck Disability Index ◽  
Clear Correlation ◽  
Cervical Lordosis ◽  
Radiographic Measurements ◽  
C7 Slope

Objectives: The aims of this study were to evaluate the incidence of sagittal malalignment including kyphosis following cervical laminectomy without fusion as treatment for cervical spondylotic myelopathy and to assess any correlation between malalignment and clinical outcome. Study Design: Retrospective cohort study. Methods: In all, 60 patients were followed up with conventional radiography at an average of 8 years postoperatively. The cervical lordosis (C2-C7 Cobb angle), C2-C7 sagittal vertical axis (cSVA) and C7 slope were measured on both preoperative and postoperative images. Patients completed a questionnaire covering Neck Disability Index (NDI), visual analogue scale for neck pain, and general health (EQ-5D). Results: Mean C2-C7 Cobb angle was 8.6° (SD 9.0) preoperatively, 3.4° (10.7) postoperatively and 9.6° (14.5) at follow-up. Ultimately, 3 patients showed >20° cervical kyphosis. Mean cSVA was 16.3 mm (SD 10.2) preoperatively, 20.6 mm (11.8) postoperatively, and 31.6 mm (11.8) at follow-up. Mean C7 slope was 20.4° (SD 8.9) preoperatively, 18.4° (9.4) postoperatively, and 32.6° (10.2) at follow-up. The preoperative to follow-up increase in cSVA and C7 slope was statistically significant (both P < .0001), but not for cervical lordosis. The preoperative to follow-up change in cSVA correlated moderately with preoperative cSVA ( r = 0.43, P = .002), as did the corresponding findings regarding C7 slope ( r = 0.52, P = .0001). A comparison of radiographic measurements with clinical outcome showed no strong correlations. Conclusions: No preoperative to follow-up change in cervical lordosis was found in this group; 5.0% developed >20° kyphosis. No clear correlation between sagittal alignment and clinical outcome was shown.

scholarly journals Role of Decompressive Laminectomy without Instrumentation in the Management of Nurick Grade 4 and 5 Cervical Compressive Myelopathy

2019 ◽  
Vol 10 (01) ◽  
pp. 21-27 ◽  
Author(s):  
Sunil Malagi ◽  
Subhas Konar ◽  
Dhaval P. Shukla ◽  
Dhananjaya I. Bhat ◽  
Nishanth Sadashiva ◽  
...  
Keyword(s):  
Posterior Longitudinal Ligament ◽  
Female Ratio ◽  
Decompressive Laminectomy ◽  
Japanese Orthopedic Association ◽  
Poor Grade ◽  
Cervical Compressive Myelopathy ◽  
The Mean ◽  
Ossified Posterior Longitudinal Ligament ◽  
Compressive Myelopathy

ABSTRACT Introduction: Cervical laminectomy is a very well-known posterior decompressive procedure for cervical compressive myelopathy (CCM). Our objective is to evaluate the functional effect of posterior decompressive laminectomy for poor grade CCM. Methods: This study was an observational retrospective study carried out on patients with poor-grade CCM who underwent decompressive laminectomy from January 2010 to December 2015. Patients with Nurick Grades 4 and 5 (walking with support or bedbound) were included in the study. Clinical data and radiological information were collected from medical records, and objective scales were applied to compare the surgical outcome between preoperative score and postoperative score. Results: A total of 69 patients who underwent decompressive laminectomy for poor grade CCM were included. The mean age was 54.9 years, and the male-to-female ratio was 5.3:1. Ossified posterior longitudinal ligament comprised 52.6% cases. The follow-up data of at least 6 months' duration after surgery was available for 57 (82.6%) cases. On comparing with preoperative Nurick grade at follow-up, 40 of the 57 patients (70.2%) were found to have improvement following surgery by at least one grade. The remaining 17 (29.8%) had either remained the same or had deteriorated further. The mean preoperative modified Japanese Orthopedic Association score was 8.4 ± 2.8, and the mean follow-up score was 11.8±0.3 (P = 0.0001). On multivariate analysis, the number of levels of laminectomy, postoperative deterioration, and anesthesia grade were predictors of outcome. Conclusion: Decompressive laminectomy for poor grade myelopathy is effective in improving functional outcome.

scholarly journals The change of cervical sagittal parameters plays an important role in clinical outcomes of cervical spondylotic myelopathy after multi-level anterior cervical discectomy and fusion

2019 ◽  
Vol 14 (1) ◽  
Author(s):  
Xi-Wen Fan ◽  
Zhi-Wei Wang ◽  
Xian-Da Gao ◽  
Wen-Yuan Ding ◽  
Da-Long Yang
Keyword(s):  
Risk Factors ◽  
Cobb Angle ◽  
Clinical Outcomes ◽  
Symptom Duration ◽  
Long Duration ◽  
Poor Outcome Group ◽  
Outcome Group ◽  
Sagittal Parameters ◽  
Multi Level ◽  
Poor Outcomes

Abstract Background Cervical sagittal parameters were closely related with clinical outcomes after multi-level ACDF. Our purpose was to evaluate the clinical outcomes and cervical sagittal parameters in patients with MCSM after ACDF and to identify the risk factors of poor clinical outcomes. Material and methods ACDF was performed in 89 patients with MCSM. Based on average JOA recovery rate, patients were divided good-outcome group (group GO) and poor-outcome group (group PO). The cervical sagittal parameters including Cobb angle, SVA, T1S, cranial tilt and cervical tilt were measured. Multivariate logistic regression was used to identify risk factors. Results Fifty-four patients (60.67%) were divided into group GO, while 35 patients (39.33%) were divided into group PO. Cobb angle, SVA and T1S was corrected from preoperative average 11.80° ± 9.63°, 23.69 mm ± 11.69 mm and 24.43° ± 11.78° to postoperative average 15.08° ± 9.05°, 18.79 mm ± 10.78 mm and 26.92° ± 11.94° respectively (p < 0.001). △Cobb angle (p = 0.008) and △SVA (p = 0.009) showed significantly statistical differences between two groups. Longer symptom duration, lower preoperative JOA score, smaller △Cobb angle and larger △SVA were identified as risk factors of poor clinical outcomes. Conclusion Multi-level ACDF is an effective surgical method to treat patients with MCSM. However, long duration of preoperative symptoms, lower preoperative JOA score, smaller △Cobb angle and larger △SVA are risk factors for poor outcomes in patients with MCSM after ACDF. Sagittal parameters should be paid attention to in surgery.

scholarly journals RISK FACTORS FOR HUMERAL HEAD OSTEONECROSIS IN PATIENTS WITH PROXIMAL HUMERAL FRACTURES TREATED OPERATIVELY

2021 ◽  
Vol 27 (4) ◽  
pp. 4072-4076
Author(s):  
Konstantin Totev ◽  
◽  
Georgi Dimitrov ◽  
Lyubomira Toteva ◽  
Svilen Todorov ◽  
...  
Keyword(s):  
Risk Factors ◽  
Humeral Head ◽  
Constant Score ◽  
Functional Results ◽  
Proximal Humeral Fractures ◽  
Humeral Fractures ◽  
Frequent Site ◽  
The Mean ◽  
And Gender

Proximal humerus presents the second most frequent site of posttraumatic osteonecrosis. This complication is usually related to poor functional outcomes. The aim of this study is to identify and analyze the risk factors for posttraumatic humeral head osteonecrosis in surgically treated patients. Ninety-one patients with 92 acute proximal humeral fractures were operated on for a period of 39 months. Operative methods include open reduction and internal fixation and closed reduction and percutaneous fixation. Fractures were classified according to Neer, AO and LEGO classifications. The mean age of patients was 60.9 years. From 91 operated patients for follow-up were available 82. The mean follow-up period was 15 months. Patient data was collected prospectively. Functional results are present using age and gender adjusted Constant score. In 41 patients, the result is excellent, in 28-good, in 11-fair and in 3 poor. Bone union was evident in all cases. No deep wound infections, nerve injuries, vascular injuries and implant failure were observed. Osteonecrosis was seen in 5 (6.1%) patients. Patients with posttraumatic osteonecrosis had significant lower Constant results. Analyzing the pre- and intraoperative factors in patients with osteonecrosis, we find that the most significant factors for this complication are increasing fracture severity and а combination of short medial metaphyseal extension and disrupted medial hinge.

Examining Gender-Specific and Gender-Neutral Risk Factors in Women Who Sexually Offend

2018 ◽  
Vol 46 (4) ◽  
pp. 511-527 ◽  
Author(s):  
Ethan A. Marshall ◽  
Holly A. Miller
Keyword(s):  
Risk Factors ◽  
Future Research ◽  
Specific Information ◽  
Gender Neutral ◽  
Specific Factors ◽  
And Gender ◽  
Sexually Offended ◽  
Victimization History ◽  
Gender Specific

Research on justice-involved women has provided evidence for the importance of using gender-specific information in the assessment, treatment, and understanding of criminal pathways and risk of recidivism in women who have committed offenses. Although research on women who have sexually offended suggests there are differences between men and women who sexually offend, no studies have compared gender-specific and gender-neutral factors to predict recidivism with this group. The current study provided an examination of gender-specific and gender-neutral recidivism risk factors in a sample of 225 women who had sexually offended and were subsequently released from custody with an average follow-up time of about 5 years. Results of the study indicate gender-specific factors, such as mental illness symptoms and victimization history, are demonstrative of risk of reoffense in women who sexually offend. These findings provide implications for future research regarding risk assessment and more effective application of treatment for this understudied population.

scholarly journals Sex- and Gender-specific Risk Factors of Post-COVID-19 Syndrome: A Population-based Cohort Study in Switzerland

2021 ◽  
Author(s):  
Caroline E Gebhard ◽  
Claudia Suetsch ◽  
Susan Bengs ◽  
Manja Deforth ◽  
Karl Philipp Buehler ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Sex And Gender ◽  
Long Term Effects ◽  
Feminine Gender ◽  
Specific Risk ◽  
And Gender ◽  
Gender Specific

Background: Evidence to date indicates that mortality of acute coronavirus disease (COVID-19) is higher in men than in women. Conversely, women seem more likely to suffer from long-term consequences of the disease and pronounced negative social and economic impacts. Sex- and gender-specific risk factors of COVID-19-related long-term effects are unknown. Methods: We conducted a multicentre prospective observational cohort study of 5838 (44.6% women) individuals in Switzerland who were tested positive for SARS-CoV-2 RNA between February and December 2020. Of all surviving individuals who met the inclusion criteria, 2799 (1285 [45.9%] women) completed a follow-up questionnaire. Findings: After a mean follow-up time of 197±77 days, women more often reported at least one persistent symptom (43.0% vs 31.5%, p<0.001) with reduced exercise tolerance and reduced resilience being the most frequently reported symptom in both sexes. Critical illness (intermediate or intensive care unit admission) during acute SARS-CoV-2 infection (odds ratio[95%CI]: 4.00[2.66-6.02], p<0.0001 was a risk factor of post-COVID-19 syndrome in both women and men. Women with pre-existing mental illness (1.81[1.00-3.26], p=0.049), cardiovascular risk factors (1.39[1.03-1.89], p=0.033), higher self-reported domestic stress levels (1.15[1.08-1.22], p<0.0001), and feminine gender identity (1.12[1.02-1.24], p=0.02) increased the odds of experiencing post-COVID syndrome. Conversely, obesity (1.44[1.03-2.02], p=0.034) increased the odds of post-COVID-19 syndrome in men, but not in women. Being responsible for household work (men, OR 0.82[0.69-0.97], p=0.021), taking care of children/relatives (women, 0.90[0.84-0.96], p=0.002) or being pregnant at the time of acute COVID-19 illness (OR 0.48[0.23-1.01], p=0.054) was associated with lower odds of post-COVID syndrome. Interpretation: Predictors of post-COVID syndrome differ between men and women. Our data reinforce the importance to include sex and gender to identify patients at risk for post-COVID syndrome so that access to care and early intervention can be tailored to their different needs.

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