Clinical efficacy of short-term pre-operative halo-pelvic traction in the treatment of severe spinal deformities complicated with respiratory dysfunction

Abstract Background Halo traction has been used as an adjunctive method in the treatment of severe spinal deformities. But there are few reports on the clinical efficacy of halo-pelvic traction (HPT) in the treatment of severe spinal deformities complicated with respiratory dysfunction. This study was to evaluate the clinical efficacy and complications associated with pre-operative HPT in the treatment of severe spinal deformities with respiratory dysfunction.Methods Thirty patients with severe spinal deformities complicated with respiratory dysfunction treated with short-term pre-operative HPT were retrospectively reviewed. Inclusion criteria were: (1) patients with severe kyphoscoliosis (coronal Cobb angle or kyphosis angle ≥100°) and respiratory failure, (2) patients undergoing HPT until posterior fusion surgery. All patients underwent general anesthesia for HPT application, which the pelvic ring used in this study was a half-ring, and the rods were all placed on the anterolateral side of the truck. Results The major coronal curve scoliosis averaged 116.00 ± 16.70° and was reduced to 63.23 ± 14.00° after HPT, 46.33 ± 10.70° after surgery. The major kyphosis was 102.40 ± 27.67° and was reduced to 52.23 ± 14.16° after HPT, 42.0 ± 11.92° after surgery. A signiﬁcantly increased FVC was observed after HPT (p<0.001), with a signiﬁcantly improved FVC% (p<0.001). Similarly, a signiﬁcantly increased FEV1 was also observed (p <0.001), with a signiﬁcantly improved FEV1% (p<0.001).Conclusion This study indicated that the modified HPT could be used to help patients with severe spinal deformities complicated with respiratory dysfunction achieve significant correction in both the coronal and sagittal deformities during the pre-operative treatment period along with improved respiratory function and in the absence of severe complications.

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Clinical efficacy of short-term pre-operative halo-pelvic traction in the treatment of severe spinal deformities complicated with respiratory dysfunction

BMC Musculoskeletal Disorders ◽

10.1186/s12891-020-03700-9 ◽

2020 ◽

Vol 21 (1) ◽

Author(s):

Longtao Qi ◽

Beiyu Xu ◽

Chunde Li ◽

Yu Wang

Keyword(s):

Clinical Efficacy ◽

Pelvic Ring ◽

Spinal Deformities ◽

Inclusion Criteria ◽

Short Term ◽

Respiratory Dysfunction ◽

Fusion Surgery ◽

Halo Traction ◽

Significant Correction ◽

Severe Spinal Deformities

Abstract Background Halo traction has been used as an adjunctive method in the treatment of severe spinal deformities. But there are few reports on the clinical efficacy of halo-pelvic traction (HPT) in the treatment of severe spinal deformities complicated with respiratory dysfunction. This study was to evaluate the clinical efficacy and complications associated with pre-operative HPT in the treatment of severe spinal deformities with respiratory dysfunction. Methods Thirty patients with severe spinal deformities complicated with respiratory dysfunction treated with short-term pre-operative HPT were retrospectively reviewed. Inclusion criteria were: (1) patients with severe kyphoscoliosis (coronal Cobb angle or kyphosis angle ≥100°) and respiratory failure, (2) patients undergoing HPT until posterior fusion surgery. All patients underwent general anesthesia for HPT application, which the pelvic ring used in this study was a half-ring, and the rods were all placed on the anterolateral side of the truck. Results The major coronal curve scoliosis averaged 116.00 ± 16.70° and was reduced to 63.23 ± 14.00° after HPT, 46.33 ± 10.70° after surgery. The major kyphosis was 102.40 ± 27.67° and was reduced to 52.23 ± 14.16° after HPT, 42.0 ± 11.92° after surgery. A significantly increased FVC was observed after HPT (p < 0.001), with a significantly improved FVC% (p < 0.001). Similarly, a significantly increased FEV1 was also observed (p < 0.001), with a significantly improved FEV1% (p < 0.001). Conclusion This study indicated that the modified HPT could be used to help patients with severe spinal deformities complicated with respiratory dysfunction achieve significant correction in both the coronal and sagittal deformities during the pre-operative treatment period along with improved respiratory function and in the absence of severe complications.

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Halo Traction with the Circolectric Bed in the Treatment of Severe Spinal Deformities

Journal of Pediatric Orthopaedics ◽

10.1097/01241398-198212000-00016 ◽

1982 ◽

Vol 2 (5) ◽

pp. 554-559 ◽

Cited By ~ 10

Author(s):

Luiz C. Toledo ◽

Catherine Holt Toledo ◽

G. Dean MacEwen

Keyword(s):

Spinal Deformities ◽

Halo Traction ◽

Severe Spinal Deformities

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Posterior Vertebral Column Resection For Severe Spinal Deformities

Spine ◽

10.1097/00007632-200211010-00012 ◽

2002 ◽

Vol 27 (21) ◽

pp. 2374-2382 ◽

Cited By ~ 301

Author(s):

Se-Il Suk ◽

Jin-Hyok Kim ◽

Won-Joong Kim ◽

Sang-Min Lee ◽

Ewy-Ryong Chung ◽

...

Keyword(s):

Vertebral Column ◽

Spinal Deformities ◽

Vertebral Column Resection ◽

Posterior Vertebral Column Resection ◽

Severe Spinal Deformities

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Comparison of clinical efficacy and safety between dexmedetomidine and propofol among patients undergoing gastrointestinal endoscopy: a meta-analysis

Journal of International Medical Research ◽

10.1177/03000605211032786 ◽

2021 ◽

Vol 49 (7) ◽

pp. 030006052110327

Author(s):

Weihua Liu ◽

Wenli Yu ◽

Hongli Yu ◽

Mingwei Sheng

Keyword(s):

Clinical Efficacy ◽

Lower Risk ◽

Gastrointestinal Endoscopy ◽

Weighted Mean Difference ◽

Meta Analysis ◽

Similar Efficacy ◽

Cochrane Library ◽

Efficacy And Safety ◽

Inclusion Criteria ◽

Weighted Mean

Objective To compare the clinical efficacy and safety of dexmedetomidine and propofol in patients who underwent gastrointestinal endoscopy. Methods Relevant studies comparing dexmedetomidine and propofol among patients who underwent gastrointestinal endoscopy were retrieved from databases such as PubMed, Embase, and Cochrane Library. Results Seven relevant studies (dexmedetomidine group, n = 238; propofol group, n = 239) met the inclusion criteria. There were no significant differences in the induction time (weighted mean difference [WMD] = 3.46, 95% confidence interval [CI] = −0.95–7.88, I2 = 99%) and recovery time (WMD = 2.74, 95% CI = −2.72–8.19, I2 = 98%). Subgroup analysis revealed no significant differences in the risks of hypotension (risk ratio [RR] = 0.56, 95% CI = 0.25–1.22) and nausea and vomiting (RR = 1.00, 95% CI = 0.46–2.22) between the drugs, whereas dexmedetomidine carried a lower risk of hypoxia (RR = 0.26, 95% CI = 0.11–0.63) and higher risk of bradycardia (RR = 3.01, 95% CI = 1.38–6.54). Conclusions Dexmedetomidine had similar efficacy and safety profiles as propofol in patients undergoing gastrointestinal endoscopy.

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Two-stage posterior-only procedures for correction of severe spinal deformities

Archives of Orthopaedic and Trauma Surgery ◽

10.1007/s00402-011-1415-1 ◽

2011 ◽

Vol 132 (2) ◽

pp. 193-201 ◽

Cited By ~ 4

Author(s):

Xiaofei Cheng ◽

Huasong Ma ◽

Rong Tan ◽

Jigong Wu ◽

Jianwei Zhou ◽

...

Keyword(s):

Spinal Deformities ◽

Two Stage ◽

Severe Spinal Deformities

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Abstract P563: Prognosis Driven Definition of Carotid Near-Occlusion With Full Collapse

Stroke ◽

10.1161/str.52.suppl_1.p563 ◽

2021 ◽

Vol 52 (Suppl_1) ◽

Author(s):

Charith Cooray ◽

Thomas Gu ◽

Allan J Fox ◽

Elias Johansson

Keyword(s):

Ischemic Stroke ◽

Carotid Stenosis ◽

Risk Markers ◽

Inclusion Criteria ◽

Short Term ◽

Residual Stenosis ◽

Kaplan Meier ◽

Near Occlusion ◽

Definition Of ◽

Distal Artery

Introduction: Carotid near-occlusion is a severe carotid stenosis causing distal artery collapse of varying degree. Near-occlusion is often divided into a “full collapse” group with a threadlike distal lumen, and the often overlooked “without full collapse” group with a normal-appearing, albeit small, distal lumen. By this division by appearance, symptomatic near-occlusion with full collapse has been reported to have worse short-term prognosis than those without full collapse, no other division has been assessed for prognosis. The aim of this study was to assess if a measurement based definition of full collapse might improve prognostic discrimination. Methods: 99 consecutive patients with symptomatic near-occlusion diagnosed on CT-angiography were included. The risk of preoperative recurrent ipsilateral ischemic stroke within 28 days of presenting event was assessed with Kaplan-Meier analysis, censoring at revascularization. We assessed residual stenosis diameter, distal ICA diameter, ICA-ratio (side-to-side), and ICA-ECA ratio as risk markers. Results: By appearance, the 28-day risk of stroke tended to be higher for full collapse (27%, 11/42) than without full collapse (11%, 6/57), p=0.054 (figure). The best new definition of full collapse was distal ICA diameter ≤2.0 mm and/or ICA ratio ≤0.47. 10 patients were reclassified by this new definition compared to appearance definition, 5 in each direction. By the new definition, 28-day risk of stroke was higher in full collapse (34%, 14/42) than without full collapse (5%, 3/57), p<0.001 (fig 1B). Conclusions: Compared to the appearance based definition, our new definition of separating near-occlusions into with and without full collapse yields similar groups sizes but better prognostic discrimination. This new definition could be used as inclusion criteria in future treatment trials.

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Early versus Delayed Extracranial-Intracranial Bypass Surgery in Symptomatic Atherosclerotic Occlusion

Neurosurgery ◽

10.1093/neuros/nyy411 ◽

2018 ◽

Vol 85 (5) ◽

pp. 656-663 ◽

Cited By ~ 5

Author(s):

Cory J Rice ◽

Sung-Min Cho ◽

Ather Taqui ◽

Nina Z Moore ◽

Alex M Witek ◽

...

Keyword(s):

Bypass Surgery ◽

Hemorrhagic Stroke ◽

Artery Occlusion ◽

Carotid Artery Occlusion ◽

Inclusion Criteria ◽

Short Term ◽

Ischemic Event ◽

Perioperative Stroke ◽

Tertiary Referral Center ◽

Bypass Group

Abstract Background Clinical trials of extracranial-intracranial (EC-IC) bypass surgery studied patients in subacute and chronic stage after ischemic event. OBJECTIVE To investigate the short-term outcomes of EC-IC bypass in progressive acute ischemic stroke or recent transient ischemic attacks. Methods The study was a retrospective review at a single tertiary referral center from 2008 to 2015. Inclusion criteria consisted of EC-IC bypass within 1 yr of last ischemic symptoms ipsilateral to atherosclerotic occlusion of internal carotid or middle cerebral artery. Early bypass group who underwent surgery within 7 d of last ischemic symptoms were compared to late bypass group who underwent surgery >7 d from last ischemic symptom. The primary endpoint was perioperative ischemic or hemorrhagic stroke or intracranial hemorrhage within 7 d of surgery. Results Of 126 patients who underwent EC-IC bypass during the period, 81 patients met inclusion criteria, 69 (85%) persons had carotid artery occlusion, 7 (9%) had proximal MCA occlusion, and 5 (6%) had both. Early surgery had a 31% (9/29) perioperative stroke rate compared to 11.5% (6/52) of patients undergoing late bypass (P = .04). Of patients with acute stroke within 7 d of surgery, 41% (7/17) had perioperative stroke within 7 d (P = .07). Six of nine patients (67%) with blood pressure dependent fluctuation of neurologic symptoms had perioperative stroke (P = .049). Conclusion EC-IC bypass in setting of acute symptomatic stroke within 1 wk may confer higher risk of perioperative stroke. Patients undergoing expedited or urgent bypass for unstable or fluctuating stroke symptoms might be at highest risk for perioperative stroke.

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High and low doses of clarithromycin treatment are associated with different clinical efficacies and immunomodulatory properties in chronic rhinosinusitis

The Journal of Laryngology & Otology ◽

10.1017/s0022215114000279 ◽

2014 ◽

Vol 128 (3) ◽

pp. 236-241 ◽

Cited By ~ 11

Author(s):

Y Fan ◽

R Xu ◽

H Hong ◽

Q Luo ◽

W Xia ◽

...

Keyword(s):

Chronic Rhinosinusitis ◽

Clinical Efficacy ◽

Low Dose ◽

Symptom Assessment ◽

Nasal Symptom ◽

High Dose ◽

Life Questionnaire ◽

Short Term ◽

Interleukin 5 ◽

Cytokine Levels

AbstractBackground:Low-dose clarithromycin has been recommended for the treatment of chronic rhinosinusitis without nasal polyps. However, it is uncertain whether a high dose of clarithromycin is more effective than a low dose.Methods:Forty-three chronic rhinosinusitis patients were randomised to low-dose or high-dose clarithromycin groups, and clinical efficacy was evaluated. Pre- and post-treatment measures included: nasal symptom assessment, endoscopic inspection (Lund–Kennedy system), a quality of life questionnaire (the Sino-Nasal Outcome Test 20) and examination of cytokine levels (interleukin-5 and -8) in nasal secretions.Results:The high dose of clarithromycin was significantly better in terms of clinical efficacy than the low dose for the treatment of chronic rhinosinusitis (p < 0.025). Significant differences in nasal cytokine levels (interleukin-5 and -8) were also observed between the low-dose and high-dose groups after short-term clarithromycin treatment (p < 0.025).Conclusion:Short-term, high-dose clarithromycin appears to be more effective for the treatment of chronic rhinosinusitis than low-dose clarithromycin.

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