scholarly journals Outpatient management of patients with discogenic lumbosacral radiculopathy

2021 ◽  
pp. 420-425
Author(s):  
V. S. Prokopovich
Keyword(s):  
Surgical Treatment ◽  
Conservative Treatment ◽  
Muscle Relaxant ◽  
Conservative Therapy ◽  
Surgical Intervention ◽  
Outpatient Management ◽  
Lumbosacral Radiculopathy ◽  
Intravenous Drip ◽  
Outpatient Practice ◽  
Group B

Disсоgenic lumbosacral radiculopathy (DLSR) is less common than lumbar musculoskeletal pains, but has a worse forecast and is more often accompanied by a long disabilities. Most patients with DLSR can effectively be treated under polyclinic conditions, but it is not clear how effective conservative methods of DLSR therapy are used in real outpatient practice. This study was carried out in order to analyze the outpatient maintenance of patients with DLSR, which were surgical treatment (lumbar microdiskectomy) due to the ineffectiveness of conservative therapy.Materials and methods. 90 patients (33 men, 57 women, average age – 59.78 ± 12) years suffered surgical treatment (microdiskectomy) due to the ineffectiveness of conservative DLSR. The duration of the disease to operation ranged from 2 to 14 weeks and was an average of 6 ± 3 weeks.Results. Patients were not informed about the favorable course of the DLSR, the possibilities of natural (without surgical intervention) of the regression of the disk hernia, as well as expediency to maintain all types of activity, avoid a long bed mode. Only half of the patients were conducted by therapeutic gymnastics. 94.4% of patients received non-steroidal anti-inflammatory funds, 92.2% – muscle relaxant, 79.8% – a complex of vitamins of group B, and epidural blockade with anesthetics and corticosteroids were not used. Relatively widely used ineffective methods of therapy of the DLSR: paravertebral blockade of analgesics (42.2%), intravenous drip administration of actovegin and/or pentoxyfalline (26.7%), magnetotherapy and/or laser and therapy (36.7%).Conclusion. In an outpatient practice, patients with DLSR do not receive effective conservative treatment, which may be a reason for the early (after 6 weeks) directions for surgical treatment. Polyclinic doctors are poorly informed about the effective conservative methods of DLSR therapy.

scholarly journals Prevention and conservative treatment of nasopharyngeal tonsil hypertrophy

2021 ◽  
Vol 20 (1) ◽  
pp. 56-60
Author(s):  
G. I. Markov ◽  
◽  
A. L. Klochikhin ◽  
V. A. Romanov ◽  
M. G. Markov ◽  
...  
Keyword(s):  
Conservative Treatment ◽  
Nasal Cavity ◽  
Mucous Membrane ◽  
Conservative Therapy ◽  
Pediatric Patients ◽  
Surgical Intervention ◽  
Whole Body ◽  
Fungal Flora ◽  
Sparing Effect ◽  
Pharyngeal Tonsil

The aim of this work is to draw the attention of otorhinolaryngologists to the advantages of early conservative treatment of children with hypertrophy of the nasopharyngeal tonsil - adenoids. In childhood, a significant part of the protective and informational functions lies on the pharyngeal tonsil, since it is in the path of inhaled air. Unfavourable environmental conditions exacerbate its functional failure. Pathology of the lymphopharyngeal ring is highly prevalent and occupies a leading place among ENT diseases in children. Each person has a certain own microflora on the nasal mucosa from birth. In most cases, monoflora is determined on the mucous membrane of the nasal cavity, and only 2-3% is due to the combination of two types of microbial and fungal flora. For more than twenty years, we have been using the tactics of a sparing effect on the mucous membrane when using medicinal mixtures on a protective basis. Conservative treatment of 245 children aged 3 to 6 years with grade 1 – 2 adenoiditis was carried out, which made it possible to avoid surgical intervention in this group of children. When choosing a drug mixture, the sensitivity of the microflora of the patient’s nasal cavity was considered according to the results of a smear from the mucous membrane. Adenoidectomy is an operation with potentially undesirable consequences for the whole body, therefore, effective timely conservative therapy can reduce the risks and harms of surgery for pediatric patients.

Efficacy of high voltage stimulation for healing of venous leg ulcers in surgically and conservatively treated patients

Phlebologie ◽  
2006 ◽  
Vol 35 (03) ◽  
pp. 127-133 ◽  
Author(s):  
J. Taradaj ◽  
A. Polak ◽  
L. Cierpka ◽  
E. Blaszczak ◽  
A. Franek
Keyword(s):  
Drug Therapy ◽  
Surgical Treatment ◽  
Conservative Treatment ◽  
High Voltage ◽  
Treatment Efficacy ◽  
Leg Ulcers ◽  
Treatment Progress ◽  
Venous Leg Ulcers ◽  
Linear Dimensions ◽  
Group B

Summary Aim: Examination of the efficacy of high voltage stimulation (HVS) on healing (in various phases: decontamination, granulation, epidermization) of venous leg ulcers. Patients, material, methods: 110 persons with venous leg ulcers were included in the study. Patients in groups A and B were treated conservatively (compression and drug therapy). Patients in groups C and D were treated surgically (modified Babcock’s method). Patients in groups A and C were additionally treated with the HVS (100 μs, 100 Hz, 100 V) for 50 minutes daily, six times a week for seven weeks. Treatment progress was evaluated by observation of the number of healed wounds and measurement of the linear dimensions, area and isolated areas (covered with pus or granulation) and the volume of the leg ulcers. Results: Treatment was effective in all comparative groups. Comparison of the treatment efficacy (number of completely healed wounds) indicated statistically significant differences between groups A and B (p = 0.03), B and C (p = 0.03), B and D (p = 0.03) in favour of groups A, C and D. Comparison of other parameters supported a better therapeutic effect in groups A, C and D than in group B. There were no statistical differences in these parameters between groups A, C and D. Conclusion: The results demonstrated that HVS is an efficient method of enhancing healing in conservative treatment of venous leg ulcers. However, it appeared that HVS does not enhance healing of venous leg ulcers in patients after causal surgical treatment.

Surgical Treatment Strategies for Pyogenic Spondylodiscitis of the Thoracolumbar Spine

2021 ◽  
Author(s):  
Max J. Scheyerer ◽  
Christian Herren ◽  
Christian Kühne ◽  
Jörg Neufang ◽  
Philipp Pieroh ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Conservative Therapy ◽  
Surgical Intervention ◽  
Standard Procedure ◽  
Thoracolumbar Spine ◽  
Trauma Surgery ◽  
Treatment Strategies ◽  
German Society ◽  
Surgical Indications ◽  
Pyogenic Spondylodiscitis

Abstract Background Despite advances, the morbidity and mortality rates of patients with spondylodiscitis remains high, with an increasing incidence worldwide. Although conservative therapy has progressed, several cases require surgical intervention. However, the indication and opportunities for surgical treatment are still disputable. Methods In a joint consensus, the members of the ‘Spondylodiscitis’ working group of the Spine Section of the German Society for Orthopaedics and Trauma Surgery considered current literature, particularly the newly published S2k guideline of the AWMF, and examined the surgical indications and treatment strategies for thoracolumbar spondylodiscitis. Results Surgical intervention for spondylodiscitis is only required in a small percentage of patients. In studies comparing conservative and surgical therapies, most patients benefitted from surgery, regardless of the surgical technique selected. Presently, the standard procedure is a combined dorsoventral approach, in which a monolateral attempt should always be made. The choice of material (PEEK, titanium) for ventral support does not influence the clinical result.

scholarly journals A comparative study on outcome of conservative and surgical treatment of type III supracondylar fracture of humerus in children

2020 ◽  
Vol 6 (4) ◽  
pp. 817
Author(s):  
Vinay N. ◽  
Manjunatha A. ◽  
Anand Kumar B. S.
Keyword(s):  
Surgical Treatment ◽  
Conservative Treatment ◽  
Supracondylar Fracture ◽  
Type Iii ◽  
Wire Fixation ◽  
Group A ◽  
Group B ◽  
Cross Wire ◽  
Conservative And Surgical Treatment ◽  
Better Than

<p class="abstract"><strong>Background:</strong> Supracondylar fracture of humerus is most common of all the fractures around the elbow in children. They occur most commonly in children more so in male child with the peak around 5-8 years. Objective of this study was to compare the outcome of 3 different modalities of treatment for supracondylar fracture of humerus.</p><p class="abstract"><strong>Methods:</strong> Children with type III supracondylar fracture of humerus were categorized into group A, group B, group C based on conservative, closed reduction and percutaneous K wire fixation and open reduction and K wire fixation modalities of treatment given. All the children were followed for 6 months and the outcome of treatment was evaluated using Flynn’s criteria.<strong></strong></p><p class="abstract"><strong>Results:</strong> 40 children were treated with 3 different modalities of treatment. The rate of complications was less in children who were operated on first day of admission (p=0.02). Group B and group C had 80% and 61.11% excellent results and group A had 47.05% poor results. The outcome was better with cross K wire pinning than lateral pinning (p=0.015).</p><p class="abstract"><strong>Conclusions:</strong> Supracondylar fracture of humerus should be operated as early as possible to reduce the rate of complications. The outcome of surgical treatment was better than conservative treatment evaluated in terms of Flynn’s criteria. Cross wire pinning was better than lateral pinning in terms of outcome, but the rate of neuropraxias was more with cross wire pinning.</p>

scholarly journals CHOLELITHIASIS IN INFANTS – CONSERVATIVE OR SURGICAL TREATMENT?

2018 ◽  
Vol 63 (4) ◽  
pp. 63-68
Author(s):  
N. G. Lupash ◽  
K. A. Shakaryan ◽  
S. Yu. Matalayeva ◽  
L. A. Kharitonova
Keyword(s):  
Surgical Treatment ◽  
Conservative Treatment ◽  
Conservative Therapy ◽  
Treatment Effectiveness ◽  
Contractile Function ◽  
Morphological Changes ◽  
Gallbladder Wall ◽  
Priority Method ◽  
Second Year ◽  
Dissolution Of Gallstones

The aim of the research: to optimize the treatment strategy of cholelithiasis in infants by studying the conservative therapy and surgical treatment effectiveness.Children with cholelithiasis were divided into three groups: 60 children received conservative treatment; 14 children were not treated; 22 children underwent cholecystectomy. Conservative treatment was carried out by administration of Ursofalk suspension (Dr. Falk Farma, Germany) on the daily dose basis – 20 mg/kg of body weight per day once a day – at bedtime. Duration of litholysis ranged from 6 to 24 months. The therapeutic effect was controlled every 3 months by ultrasound examination of the bile ducts and biochemical analysis of blood serum.Results. Contractile function of the gallbladder normalized after 6 months, biochemical markers of cholestasis after 3 weeks, lipidogram by the end of  the second year of conservative treatment. All children tolerated therapy well. No side effects were found. No spontaneous dissolution of gallstones was observed in 14 children who did not receive litholytic therapy. In 22 children, who underwent surgery, morphological changes in the gallbladder wall were reversible, but most of them formed post-cholecystectomy syndrome. In view of the aforesaid, conservative therapy should be considered the priority method of cholelithiasis treatment in children under 3 years of age. Surgical treatment should be performed only according to vital indications. 

scholarly journals Conservative treatment for patients with discogenic lumbosacral radiculopathy: results of a prospective follow-up

2018 ◽  
Vol 10 (3) ◽  
pp. 59-65 ◽  
Author(s):  
M. A. Ivanova ◽  
V. A. Parfenov ◽  
A. I. Isaikin
Keyword(s):  
Surgical Treatment ◽  
Conservative Treatment ◽  
Pain Intensity ◽  
Rating Scale ◽  
Short Form ◽  
Depression Scale ◽  
Leg Pain ◽  
Antiinflammatory Drugs ◽  
Lumbosacral Radiculopathy

Surgical treatment as accelerated functional recovery for discogenic radiculopathy has been proven to have advantages over medical treatment, the efficiency of which remains debatable. Objective: to investigate the efficiency of combination conservative treatment in patients with discogenic lumbosacral radiculopathy. Patients and methods. Thirty patients (12 men and 18 women; mean age, 39.5±2.2 years) with discogenic lumbosacral radiculopathy confirmed by magnetic resonance imaging were followed up. All the patients underwent combination conservative treatment (epidural glucocorticoid administration, analgesic therapy, and motor mode correction). They were surveyed using questionnaires (numeric pain rating scale (NPRS), Oswestry disability index, Hospital Anxiety and Depression Scale, the 12-Item Short Form (SF-12) of Quality of Life (QoL) Questionnaire on admission to the clinic, at 7-14 days after treatment (pain intensity and functional status), and in the long-term period (at 3, 6 and 12 months) after discharge. At baseline, the patients were severely disabled due to pain syndrome. The average Oswestry index was 57.9±3.7%, the back and leg pain intensity scores were 6.5±0.6 and 6.9±0.5, respectively, as evidenced by NPRC. The majority of patients were found to have the combined musculoskeletal sources of pain, such as a myofascial component in 56.7% and sacroiliac joint dysfunction in 43.3%. In these cases, nonsteroidal antiinflammatory drugs and muscle relaxants were additionally used. Results. The conservative treatment resulted in a statistically significant clinical improvement with a preserved positive effect in the long term: at 1 year, the average Oswestry index was equal to 16.6±3.9%, the back and leg pain intensity scores were 1.7±0.5 and 1.6±0.5, respectively, as shown by NPRC (p<0.001 vs baseline). Within a year, only one female patient required surgical treatment; regression of large extrusions and sequesters, the average initial size of which reached 11.1 mm, was observed in 9 cases. Conclusion. The findings reflect the efficiency of conservative treatment and the expediency of detecting mixed musculoskeletal disorders and their correction in discogenic radiculopathy.

scholarly journals Lumbar disc herniation: Early surgery versus prolonged conservative treatment.

2020 ◽  
Vol 27 (09) ◽  
pp. 1784-1789
Author(s):  
Urooj Fatimah Siddiqui ◽  
Muhammad Faiq Ali ◽  
Muhammad Asim Khan Rehmani ◽  
Atiq Ahmed Khan ◽  
Sheeraz ◽  
...  
Keyword(s):  
Conservative Treatment ◽  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Surgical Intervention ◽  
Lumbar Disc ◽  
Outcome Variable ◽  
P Value ◽  
Group A ◽  
Group B ◽  
Early Surgical Intervention

We seek to compare pain sensation after surgical and conservative treatment in patients having sciatica with lumbar disc herniation in a routine clinical setting. Objectives: To compare the outcome of early surgical intervention versus prolonged conservative treatment in patients with sciatica due to herniated lumbar intervertebral discs. Study Design: Randomized Control Trial. Setting: Department of Neurosurgery, Dow University of Health Sciences, Civil Hospital Karachi. Period: Aug 1, 2017 till May 31, 2018. Material & Methods: Data was prospectively collected from patients after taking a consent. A total of 70 patients, with 35 patients in each Group A (early surgical intervention) and Group B (prolonged conservative treatment) were included. Demographic data was presented as simple descriptive statistics giving mean and standard deviation and qualitative variables were presented as frequency and percentages. P-value of ≤ 0.05 was taken significant. Effect modifiers were controlled through stratification to see the effect of these on the outcome variable. Post stratification independent t-test was applied taking p-value of ≤0.05 as significant. Results: Mean age in group A and B was 45.18±7.64 and 42.78±5.87 years respectively. 30 (85.7%) were male and 05 (14.3%) were female in group A. 28 (80%) were male and 07 (20%) were female in group B. Mean pre and post VAS score in group A was (7.18±0.71 and 2.18±0.55) and group B was (7.78±0.34 and 3.26±0.21). Mean pre and post SF36 BP score in group A was (24.18±3.81 and 65.54±6.14) and group B was (34.29±4.91 and 68.21±5.87). Conclusion: Many patients continue to refer conservative treatment of sciatica, despite of pain but given the results of this study, early surgical intervention appears to be superior to medical management for the treatment of Sciatica with respect to patient outcome.

scholarly journals ESTIMATION OF RESERVES FOR IMPROVING THE RESULTS OF PATIENTS WITH MULTIPRESISTANT PULMONARY TUBERCULOSIS IN THE APPLICATION OF SURGICAL METHODS BASED ON ANALYSIS OF THE EFFICIENCY OF CONSERVATIVE TREATMENT OF A SPECIFIED COHORT

2018 ◽  
Vol 5 ◽  
pp. 33-39
Author(s):  
Oleg Khmel ◽  
Igor Kalabukha ◽  
Vladimir Ivashchenko
Keyword(s):  
Surgical Treatment ◽  
Conservative Treatment ◽  
Pulmonary Tuberculosis ◽  
Surgical Intervention ◽  
Cohort Analysis ◽  
Multidrug Resistant ◽  
Complete Cure ◽  
Results Of Treatment ◽  
Number Of Patients ◽  
Surgical Methods

In order to improve the results of treatment of patients with multi-resistant pulmonary tuberculosis with the use of surgical methods, the effectiveness estimation of conservative treatment of 176 patients with this form of tuberculosis according to cohort analysis data in two districts of Kyiv were done. In the list were included following parameters: type of the tuberculosis, its clinical-radiological form and the prevalence of the process, the results of conservative treatment in patients who completely finished the course of anti-TB chemotherapy and the results of conservative treatment of 81 patients who had indications for surgical treatment but had not been operated. Processing of the materials of the study was carried out with the use of licensed software products included in the Microsoft Office Professional 2007 package. The predicted results of treatment were calculated on the condition of surgical intervention. Out of the total sample of patients, 31.3 % of the patients completed treatment. Mortality was 16.5 %, transferred to palliative care 11.9 %. More than one in three patients (35.2 %) stopped treatment at different times from the start. According to the clinic of thoracic surgery SU "National Institute of Phthisiology and Pulmonology named after F.G. Yanovsky NAMS of Ukraine ", the overall effectiveness of treatment for patients with limited multidrug-resistant tuberculosis with the use of surgical intervention is about 95 % in the absence of mortality. We have modelled the potential results of treatment of the selected cohort in case of the surgical stage is fully and timely applied in a complex of therapeutic treatment. If all 81 patients with indications for surgical treatment used that way, then, with the above efficiency, a complete cure could be predicted in 77 patients (44.5 % of the total number of observations), which in turn would allow predicting the achievement completion of treatment at 64.2 % with complete cure for 60.6 % of patients. Thus, it is established that the positive result of surgical treatment in the general complex of treatment measures in patients with multidrug-resistant pulmonary tuberculosis is able to improve the results of treatment of this contingent more than twice, reduce the mortality almost by three times, reduce the need for repeated courses of treatment from 7.4 % to 1.7 %, as well as to reduce the epidemiological reservoir of infection due to a significant decrease in the number of patients with failure to treat tuberculosis, interrupted and palliative treatment.

scholarly journals Degenerative scoliosis of the ventricle: diagnosis, classification and surgical approach in older patients

2021 ◽  
Author(s):  
Anton Yarikov
Keyword(s):  
Surgical Treatment ◽  
Physical Therapy ◽  
Conservative Therapy ◽  
Surgical Intervention ◽  
Clinical Symptoms ◽  
Surgical Techniques ◽  
Neurological Status ◽  
Point Of View ◽  
Degenerative Scoliosis ◽  
Instrumental Methods

Adult scoliosis is a deformity of the spine with an angle of more than 10 (according to Cobb) in people with a fully formed bone system. Due to the aging of the population, the improvement of surgical techniques, the appearance of new implants and the improvement of anesthetic aids, the problem of degenerative scoliosis is increasingly being considered from the point of view of the possibilities of surgery. There are many theories that contribute to the formation of degenerative scoliosis. Conservative therapy of degenerative scoliosis includes non-steroidal anti-inflammatory drugs, corset therapy, epidural and paravertebral injections with glucocorticosteroids, physical therapy, and physical therapy. With complete ineffectiveness of conservative therapy and with a significant decrease in the quality of life of the patient, the question of performing surgical intervention is individually decided. Currently, the question of the role and scope of surgical intervention in individuals with this pathology remains debatable. The choice of surgical intervention depends on a thorough assessment of clinical symptoms, neurological status, data of instrumental methods of examination and mandatory consideration of the parameters of the global vertebral-pelvic balance. Therefore, in this article, special attention is paid to the algorithms of surgical treatment based on the choice of the type of decompression and the length of the fusion. The paper describes the generally accepted criteria for selecting the level of spondylosynthesis. Special attention is paid to the risk factors for surgical treatment. As well as the complications associated with surgical treatment are described.

scholarly journals Surgical intervention in the complex treatment of patients with nonunion of the tibia

2018 ◽  
Vol 27 (3) ◽  
pp. 33-38
Author(s):  
O. Bebykh
Keyword(s):  
Surgical Treatment ◽  
Conservative Treatment ◽  
Surgical Intervention ◽  
Plastic Material ◽  
Complex Treatment ◽  
Fibrin Matrix ◽  
Results Of Treatment ◽  
Vitamin Therapy

The work presents the results of treatment of 47 patients with nonunion of the tibia. Applied surgical treatment of the hearth, plastic, fixation of the fragments with a spin-rod core ring, and conservative treatment was performed. Promised results are obtained. The purpose – to improve the results of treatment of patients with neoplasm of the tibia based on the introduction of literary data and properties of existing methods of surgical and conservative treatment based on analysis. Surgical intervention in patients with tenderness of the tibia included treatment of the hearth, the use of as a plastic material a mixture of autopsigenic, hydroxyapatite, fibrin matrix PRF, hemostatic sponge;  fixation by knitting needles and rod machines.  The conservative component of the rehabilitation complex consisted of multimodal anesthesia, vitamin therapy, the use of antioxidants, kinesitherapy and physiotherapy.

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