Clinical Efficacy and Imaging Analysis for the Surgical Treatment of Thoracolumbar Infections in Elderly Patients

Abstract BackgroundFew reports have been conducted to comparing surgical results and safety evaluations between the different types of infections in geriatric patients. The aim of this study is to investigate the safety and efficacy of surgical treatment for thoracolumbar infections in elderly patients.Methods21 patients with pyogenic spondylodiscitis (PS) and 26 patients with tuberculous spondylodiscitis (TS) were enrolled in the study. All patients were treated using one-stage posterior debridement, decompression, and pedicle screw fixation. Comparison of operative safety parameters between the two groups. Clinical efficacy was evaluated using visual analog scale (VAS) score, the American Spinal Injury Association (ASIA) grade, the short form (SF)-36 survey and Oswestry disability index (ODI) to determine patient quality of life pre- and post-operatively. Results Hospitalisation and intensive care unit duration in the PS group were significantly shorter than in the TS group (P<0.05). The total incidence of post-operative complications for both groups was 44.7%. More complications occurred in the TS group, but the difference was not significant. The VAS and SF-36 scores (physical component) were significantly better in the PS group six months post-operatively, and the SF-36 (mental component) scores were significantly better in the PS group at the one-year follow-up. Neurological status in both groups improved post-operatively, and 83% of the patients were satisfied with the results of their operation. Imaging results showed that bone graft fusion improved in both groups at six months, one year and at the final follow-up. ConclusionSurgical treatment can provide satisfactory clinical and imaging results for thoracolumbar infection in patients over 65 years old. Although the incidence of peri-operative complications in the elderly is high, it is controllable and surgical treatment remains a safe and effective measure.

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Clinical Efficacy and Imaging Analysis for the Surgical Treatment of Thoracolumbar Infections in Elderly Patients

10.21203/rs.3.rs-269772/v1 ◽

2021 ◽

Author(s):

Yanlong Zhong ◽

Benyu Tang ◽

Qi Lai ◽

Yonghong Sheng ◽

Chao Li ◽

...

Keyword(s):

Surgical Treatment ◽

Elderly Patients ◽

Clinical Efficacy ◽

Short Form ◽

Effective Measure ◽

Imaging Results ◽

Sf 36 ◽

Operative Complications ◽

One Year

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Functional and Quality of Life Outcomes of Surgery for Degenerative Cervical Myelopathy: a Quality Improvement Study

Journal of Orthopedic and Spine Trauma ◽

10.18502/jost.v4i2.2956 ◽

2020 ◽

Author(s):

Babak Mirzashahi ◽

Pejman Mansouri ◽

Arvin Najafi ◽

Saeed Besharati ◽

Mohammad Taha Kouchakinejad ◽

...

Keyword(s):

Quality Of Life ◽

Cervical Myelopathy ◽

Short Form ◽

Sf 36 ◽

Patient Reported ◽

Vas Scores ◽

One Year ◽

Degenerative Cervical Myelopathy

Background: This study aimed to determine the outcome of surgical treatments in patients with degenerative cervical myelopathy (DCM). During one-year follow-up period, we evaluated patient-reported functional and quality of life (QOL) measures. Methods: In a retrospective single-center study, we collected data of patients with DCM who underwent cervical fusion surgeries in Imam Khomeini Hospital, Tehran, Iran, from 2011 to 2015. Patients underwent single or multi-level anterior cervical discectomy and fusion (ACDF), anterior cervical corpectomy and fusion (ACCF), or posterior laminectomy and fusion. We utilized patient-reported assessments including Short Form 36 (SF-36), Visual Analogue Scale (VAS), Neck Disability Index (NDI), and Nurick grade. Follow-up was performed at 6 weeks, 3 months, 6 months, and 12 months post-operatively to assess the outcome of surgery. Results: Ninety patients (56 men, 34 women) with a mean age of 54.1 (27-87) years were included. Comparison of pre- and post-operative scores showed significant improvement in SF-36 parameters, VAS, NDI, and Nurick grade (P < 0.001). Also, women’s VAS scores improved more than men's VAS scores during the follow-up period (P < 0.050). Age and type of surgery did not significantly affect the SF-36 parameters, VAS, NDI, and Nurick grade (P > 0.05). Conclusions: Cervical surgeries in patients with different severity of DCM can improve different aspects of QOL during one-year after surgery

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Factors associated with patient-reported outcomes following coccygectomy for chronic coccydynia

Bone & Joint Open ◽

10.1302/2633-1462.27.bjo-2021-0018.r2 ◽

2021 ◽

Vol 2 (7) ◽

pp. 540-544

Author(s):

Mads Moss Jensen ◽

Stefan Milosevic ◽

Gustav Østerheden Andersen ◽

Leah Carreon ◽

Ane Simony ◽

...

Keyword(s):

Patient Reported Outcomes ◽

Smoking Status ◽

Short Form ◽

Duration Of Symptoms ◽

Factors Associated ◽

Poor Outcome ◽

Sf 36 ◽

Patient Reported ◽

One Year

Aims The aim of this study was to identify factors associated with poor outcome following coccygectomy on patients with chronic coccydynia and instability of the coccyx. Methods From the Danish National Spine Registry, DaneSpine, 134 consecutive patients were identified from a single centre who had coccygectomy from 2011 to 2019. Patient demographic data and patient-reported outcomes, including pain measured on a visual analogue scale (VAS), Oswestry Disability Index (ODI), EuroQol five-dimension five-level questionnaire, and 36-Item Short-Form Health Survey questionnaire (SF-36) were obtained at baseline and at one-year follow-up. Patient satisfaction was obtained at follow-up. Regression analysis, including age, sex, smoking status, BMI, duration of symptoms, work status, welfare payment, preoperative VAS, ODI, and SF-36 was performed to identify factors associated with dissatisfaction with results at one-year follow-up. Results A minimum of one year follow-up was available in 112 patients (84%). Mean age was 41.9 years (15 to 78) and 97 of the patients were female (87%). Regression showed no statistically significant association between the investigated prognostic factors and a poor outcome following coccygectomy. The satisfied group showed a statistically significant improvement in patient-reported outcomes at one-year follow-up from baseline, whereas the dissatisfied group did not show a significant improvement. Conclusion We did not identify factors associated with poor outcome following coccygectomy. This suggests that neither of the included parameters should be considered contraindications for coccygectomy in patients with chronic coccydynia and instability of the coccyx. Cite this article: Bone Jt Open 2021;2(7):540–544.

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Chopart amputation with tibiotalocalcaneal arthrodesis and free flap reconstruction for severe foot crush injury

The Bone & Joint Journal ◽

10.1302/0301-620x.100b10.bjj-2018-0118.r1 ◽

2018 ◽

Vol 100-B (10) ◽

pp. 1359-1363 ◽

Cited By ~ 1

Author(s):

Y-C. Chiu ◽

T-C. Chung ◽

C-H. Wu ◽

K-L. Tsai ◽

I-M Jou ◽

...

Keyword(s):

Short Form ◽

Treatment Method ◽

Crush Injury ◽

Soft Tissue Coverage ◽

Walking Ability ◽

Sf 36 ◽

Crush Injuries ◽

The Mean ◽

One Year

AimsThis study reports the outcomes of a technique of soft-tissue coverage and Chopart amputation for severe crush injuries of the forefoot.Patients and MethodsBetween January 2012 to December 2016, 12 patients (nine male; three female, mean age 38.58 years; 26 to 55) with severe foot crush injury underwent treatment in our institute. All patients were followed-up for at least one year. Their medical records, imaging, visual analogue scale score, walking ability, complications, and functional outcomes one year postoperatively based on the American Orthopedic Foot and Ankle Society (AOFAS) and 36-Item Short-Form Health Survey (SF-36) scores were reviewed.ResultsThe mean length of follow-up was 18.6 months (13 to 28). Two patients had a local infection, flap necrosis was seen in one patient, and one patient experienced a skin graft wound healing delay. Of the 12 patients, one had persistent infection and eventually required below-knee amputation, but pain-free walking was achieved in all the other patients. The mean one-year postoperative AOFAS and SF-36 scores were 75.6 (68 to 80) and 82 (74 to 88), respectively.ConclusionAlthough our sample size was small, we believe that this treatment method may be a valuable alternative for treating severe foot crush injuries. Cite this article: Bone Joint J 2018;100-B:1359–63.

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Epicardial cryoablation as surgical treatment for atrial fibrillation: One year follow up in 84 patients

The Thoracic and Cardiovascular Surgeon ◽

10.1055/s-2008-1037863 ◽

2008 ◽

Vol 56 (S 1) ◽

Author(s):

R Uhl ◽

I Marcolino ◽

E Zimmer ◽

F Beyersdorf ◽

E Eschenbruch

Keyword(s):

Atrial Fibrillation ◽

Surgical Treatment ◽

One Year

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Comparing durability of water- and land-based exercise benefits among older adults in South Korea: A randomized controlled trial with 1-year follow-up

Journal of Back and Musculoskeletal Rehabilitation ◽

10.3233/bmr-200109 ◽

2021 ◽

pp. 1-11

Author(s):

Se Jun Oh ◽

Sang Heon Lee

Keyword(s):

Exercise Intervention ◽

External Rotation ◽

Short Form ◽

Controlled Trial ◽

Weight Bearing ◽

Aquatic Exercise ◽

Step Test ◽

Sf 36 ◽

Partial Weight

BACKGROUND: Aquatic exercise can improve strength, flexibility, and aerobic function while safely providing partial weight-bearing support through viscosity and buoyancy. OBJECTIVE: The aim of the present study was to compare the effects of water-based exercise with land-based exercise before and after a 10-week exercise intervention and again at one-year follow-up. METHODS: Eighty participants aged 65 years and older were randomly assigned to either a water- or a land-based 10-week exercise program. Assessment included the Senior Fitness Test (SFT), the Modified Falls-Efficacy Scale, and the 36-Item Short-Form Health Survey (SF-36). Hip and knee strength was also measured. All assessments were completed at three time points: pre- (T1), post- (T2), and at 1-year follow-up (T3). RESULTS: Significant differences were observed between the two groups on three parameters: the SFT timed up-and-go test; lower hip muscle strength in extension, adduction, and external rotation; and quality of life (QoL) measured by the SF-36 (p< 0.05). No significant differences were observed in the SFT chair stand test, dominant arm curl test, two-minute step test, chair sit-and-reach test, back scratch test, and Modified Falls-Efficacy Scale. CONCLUSION: Aquatic exercise provided greater improvement of physical health and QoL among older people than land-based exercise.

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Chronic Achilles Tendinopathy

The American Journal of Sports Medicine ◽

10.1177/0363546507303558 ◽

2007 ◽

Vol 35 (10) ◽

pp. 1659-1667 ◽

Cited By ~ 65

Author(s):

Wolf Petersen ◽

Robert Welp ◽

Dieter Rosenbaum

Keyword(s):

Synergistic Effect ◽

Short Form ◽

Achilles Tendinopathy ◽

Eccentric Training ◽

Treatment Groups ◽

Alternative Treatment Option ◽

Sf 36 ◽

Significant Difference ◽

Chronic Achilles Tendinopathy

Background Previous studies have shown that eccentric training has a positive effect on chronic Achilles tendinopathy. A new strategy for the treatment of chronic Achilles tendinopathy is the AirHeel brace. Hypothesis AirHeel brace treatment improves the clinical outcome of patients with chronic Achilles tendinopathy. The combination of the AirHeel brace and an eccentric training program has a synergistic effect. Study Design Randomized controlled clinical trial; Level of evidence, 1. Methods One hundred patients were randomly assigned to 1 of 3 treatment groups: (1) eccentric training, (2) AirHeel brace, and (3) combination of eccentric training and AirHeel brace. Patients were evaluated at 6, 12, and 54 weeks after the beginning of the treatment protocol with ultrasonography, visual analog scale (VAS) for pain, American Orthopaedic Foot and Ankle Society (AOFAS) ankle score, and Short Form-36 (SF-36). Results The VAS score for pain, AOFAS score, and SF-36 improved significantly in all 3 groups at all 3 follow-up examinations. At the 3 time points (6 weeks, 12 weeks, and 54 weeks) of follow-up, there was no significant difference between all 3 treatment groups. In all 3 groups, there was no significant difference in tendon thickness after treatment. Conclusions The AirHeel brace is as effective as eccentric training in the treatment of chronic Achilles tendinopathy. There is no synergistic effect when both treatment strategies are combined. Clinical Relevance The AirHeel brace is an alternative treatment option for chronic Achilles tendinopathy.

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PROGNOSTIC FACTORS OF LUMBAR DISCECTOMY RECOVERY.A PROSPECTIVE ANALYSIS

Coluna/Columna ◽

10.1590/s1808-185120171604147556 ◽

2017 ◽

Vol 16 (4) ◽

pp. 283-287

Author(s):

Thiago Kolachinski Brandão ◽

André Nunes Machado ◽

Bruno Vieira Moter ◽

Adriano Masayuki Yonezaki ◽

Fabrício Hidetoshi Ueno ◽

...

Keyword(s):

Prognostic Factors ◽

Short Form ◽

Lumbar Discectomy ◽

Social Aspect ◽

Prospective Analysis ◽

Domain Functional ◽

One Year ◽

Short Form Health

ABSTRACT Objective: To perform a prospective analysis of the quality of life prognostic factors in patients undergoing lumbar discectomy after two years of the procedure, relating the tools Short Form Health Survey, Roland Morris, Oswestry Disability Index, and VAS. Methods: Seventy-two patients were evaluated through the questionnaires in the preoperative, and one month, six months, one year and two years in the postoperative period, being performed lumbar discectomy after failure of conservative treatment. Results: We observed an improvement in comparative analysis during follow-up regarding baseline values. Conclusion: The domains social aspect, pain, general state, emotional aspect, mental health and vitality presented an improvement from the first month after the surgery; however, the domain functional capacity only showed significant improvement after 6 months and the physical aspects only after one year. Roland-Morris and VAS scales improved after one month after surgery, but Oswestry scale showed that for the measured aspects there was only improvement after six months of surgery.

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Efficacy Analysis of One-stage Posterior-only Surgical Treatment for Thoracic Spinal Tuberculosis in the T4-6 Segments with Minimum 5-year Follow-up

10.21203/rs.3.rs-769455/v1 ◽

2021 ◽

Author(s):

Yi Zhan ◽

Xin Kang ◽

Wenjie Gao ◽

Xinliang Zhang ◽

Lingbo Kong ◽

...

Keyword(s):

Surgical Treatment ◽

Cobb Angle ◽

Clinical Efficacy ◽

Spinal Tuberculosis ◽

Surgical Trauma ◽

Posterior Surgery ◽

One Stage ◽

Thoracic Spinal ◽

Thoracic Spinal Tuberculosis

Abstract In recent years, with the in-depth research on spinal tuberculosis, posterior surgery alone has been praised highly by more and more surgeons due to the better correction of kyphosis, better maintenance of spinal physiological curvature, smaller surgical trauma and fewer surgical complications. However, there is currently lack of relevant reports about the efficacy of posterior surgery alone in the treatment of tuberculosis in the T4-6 segments. This study aimed to evaluate the clinical study efficacy and feasibility of one-stage posterior-only surgical treatment for thoracic spinal tuberculosis in the T4-6 segments. 67 patients with tuberculosis in T4-6 segments who underwent one-stage posterior-only surgery were included in this study. The clinical efficacy was evaluated using statistical analysis based on the data about erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), Oswestry Dability Index (ODI) score, Visual Analogue Scale (VAS) score and Cobb angle before surgery, after surgery and at the last follow-up. All patients completed fusion during the follow-up period of 6–9 months. ESR and CRP were returned to normal for all patients at 6 months follow-up. In the meanwhile, among the 27 patients combined with neurological impairment, neurological functions of 22 cases (81.48%) recovered completely at the last follow-up (P < 0.05). Cobb angle of the kyphosis was improved from preoperative 34.8 ± 10.9° to postoperative 9.6 ± 2.8°, maintaining at 11.3 ± 3.2° at the last follow-up, The ODI and VAS scores were improved by 77.10% and 81.70%, respectively. This 5-year follow-up study shows that better clinical efficacy can be achieved for tuberculosis in T4-6 segments using one-stage posterior-only approach by costotransverse debridement in combination with bone graft and internal fixation. The posterior surgical method cannot only effectively accomplish debridement, obtain satisfactory clinical results, but also well correct kyphotic deformity and maintain it.

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Novel Physical Therapy Protocol Targeting Insertional Achilles Tendinopathy Improves Patient Reported Outcomes that Persist For 1 Year

Foot & Ankle Orthopaedics ◽

10.1177/2473011418s00284 ◽

2018 ◽

Vol 3 (3) ◽

pp. 2473011418S0028

Author(s):

Meghan Kelly ◽

Ashlee MacDonald ◽

Rachel Olson ◽

Grace Weyand ◽

Ruth Chimenti ◽

...

Keyword(s):

Physical Therapy ◽

Achilles Tendon ◽

Exercise Program ◽

Achilles Tendinopathy ◽

Home Exercise ◽

Sf 36 ◽

Patient Reported ◽

One Year ◽

Therapy Protocol

Category: Sports Introduction/Purpose: Insertional Achilles Tendinopathy (IAT) affects 5% of the general population and up to 20% of the athletic population. Despite trials of non-surgical management such as physical therapy and heels lifts, more than 50% of patients ultimately pursue surgery. One hypothesis regarding the development of IAT pain and stiffness is that ankle dorsiflexion and associated calcaneal impingement causes transverse compression of the tendon insertion, inducing metaplastic changes within the Achilles tendon, and bursa, contributing to inflammation. Thus the aim of the current study is to examine the effect of a home exercise program designed to minimize compression of insertional tissues for patients with IAT on patient reported outcomes (PRO) measures at 3 months and one year. Methods: Thirty-five patients with IAT were enrolled in the study from May 2014 until June 2015 as two separate cohorts (21 and 14 patients, respectively) of whom 26 completed the study (mean age: 56.7 + 10.1 years, BMI: 29.5 + 6.0 kg/m2, 58% women). One patient elected for surgery prior to completing the physical therapy protocol. Physical therapy exercises were progressive eccentric loading of the Achilles tendon and seated isometric plantar flexion that were performed 4 times a week for 3 months. The Victorian Institute of Sport Assessment – Achilles (VISA-A), the Foot and Ankle Ability Measure (FAAM) and the SF-36 questionnaires were completed at baseline and at the completion of the 3-month physical therapy protocol. Six of the 14 patients in the second cohort returned for a 1 year follow up visit; four patients were lost to follow up and 4 had undergone surgical intervention prior to 1-year follow up. Results: Completion of the 3 month protocol resulted in statistically significant improvements in VISA-A, FAAM ADL and sports scores as well as multiple subcategories of the SF-36 (physical function, role limiting physical function, energy/vitality, social functioning and general pain). Twenty-two of the 26 patients (~85%) that completed the study had clinically significant, greater than MCID, improvements in their VISA-A and/or FAAM scores. In the second cohort, all six patients that returned for a one year follow up assessment maintained their improved VISA-A and FAAM scores observed at the end of the initial physical therapy protocol. Of the four patients that underwent surgical intervention prior to follow up, two did not demonstrate improvement in any of their outcomes following the initial study period. Conclusion: The results of the present study suggest that a physical therapy home exercise program utilizing eccentric and isometric Achilles exercises may result in a greater improvement in functional outcomes compared to other exercise programs that do not progressively increase both ankle dorsiflexion and Achilles tendon loading. Furthermore, improvements in pain and function result in increased energy and social wellbeing. Finally, symptomatic improvement that occurs after 3 months is likely to persist for at least one year following initial treatment.

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