scholarly journals Analysis of the results of microsurgical lumbar discectomy, characteristics of complications in the early and remote period: the current state of the issue (review of literature)

TRAUMA ◽  
2021 ◽  
Vol 21 (6) ◽  
pp. 59-64
Author(s):  
L.O. Bublyk
Keyword(s):  
Surgical Treatment ◽  
High Efficiency ◽  
Intraoperative Complications ◽  
Lumbosacral Spine ◽  
Epidural Fibrosis ◽  
Significant Discrepancy ◽  
Surgical Interventions ◽  
Current State ◽  
Herniated Discs ◽  
Late Postoperative Period

The technologies of surgical treatment of herniated discs of the lumbar spine are progressively developing about this, the main direction of improvement is the desire to minimize the invasiveness of the surgical approach, without reducing the radicality of the operation. To date, microdiscectomy is the gold standard in the treatment of discogenic diseases of the lumbosacral spine, and the high efficiency of the method has been proven. However, comparing the results of surgical interventions accor-ding to this technique of various authors, a significant discrepancy in the results of surgical treatment, the ratio of satisfactory and unsatisfactory results, the ratio of complications in the early and late postoperative period was revealed. Epidural fibrosis is a common cause of poorly operated spine syndrome. Our study pre-sents an analysis of 82 literature sources that most fully reflect the frequency and structure of intraoperative complications, possible postoperative complications, and pathogenically substantiated prevention of the formation of epidural fibrosis in the intraoperative and postoperative periods.

Tactics of Surgical Treatment for Degenerative-Dystrophic Diseases of Lumbosacral Spine in Elderly and Senile Patients

2009 ◽  
Vol 16 (2) ◽  
pp. 40-46
Author(s):  
G M Kavalerskiy ◽  
S K Makirov ◽  
M D Chenskiy ◽  
M V Boev ◽  
V G Cherepanov ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Elderly Patients ◽  
Treatment Outcomes ◽  
Daily Activity ◽  
Life Quality ◽  
Lumbosacral Spine ◽  
Analog Scale ◽  
Surgical Interventions ◽  
Pathologic Process ◽  
Different Types

Surgical treatment outcomes on 87 patients aged 60-83 years operated on for degenerative-dystrophic diseases of lumbosacral spine have been presented. Depending on the stage of pathologic process and compressive factor direction, different types of decompressive stabilizing surgical interventions were performed in compliance with the elaborated tactics of surgical treatment. Evaluation of the results showed significant decrease in pain sensations (by Visual Analog Scale) and increase in the indices of daily activity (by Oswestry Disability Index) both in early (under 3 months) and late (up to 36 months) postoperative periods, that led to significant improvement of the life quality in elderly patients. The achieved results confirmed the efficacy of the elaborated differentiated approach to surgical treatment of that group of patients.

scholarly journals RESULTS OF SURGICAL TREATMENT OF NON-PARASITIC SPLENIC CYSTS IN CHILDREN

2018 ◽  
Vol 22 (1) ◽  
pp. 32-35
Author(s):  
A. V. Myzin ◽  
Vasily G. Kuleshov ◽  
A. E. Stepanov ◽  
N. V. Gerasimova ◽  
K. Yu. Ashmanov
Keyword(s):  
Surgical Treatment ◽  
High Efficiency ◽  
Clinical Symptoms ◽  
Abdominal Cavity ◽  
Long Term Results ◽  
Surgical Interventions ◽  
Results Of Treatment ◽  
Splenic Cysts ◽  
Good Cosmetic

Introduction. Currently, there are different views on the treatment of non-parasitic spleen cysts in children. The choice of method of treatment is under discussion. The aim of our study was to evaluate and analyze the immediate and long-term results of surgical interventions performed on nonparasitic spleen cysts in children. Material and methods. There are presented results of surgical treatment of the 21 patient, who was on treatment at the Department of Abdominal Surgery of the Russian Children Clinical Hospital over the period from 2013 to 2016. Patients were examined by means of ultrasound of the abdominal cavity, CT, MRI. All patients have been operated. 22 surgical interventions were performed by using laparoscopic access, out of which 2 partial resections of the spleen, 1 splenectomy, 19 fenestrations of spleen cysts.Results. During the course of the operation and in the immediate postoperative period there were no complications. Patients were observed for the period of from 1 year to 3 years. Good results of treatment were obtained in 20 (95.2%) children. In a long-term period a relapse occurred in the one patient one year after the operation. The patient was reoperated, splenectomy was performed. Conclusion. The surgical treatment of spleen cysts is the basic one. It is indicated for cysts sized larger than 5 cm and cysts with clinical symptoms. Minimally invasive interventions in children are optimal because of their low traumatism and good cosmetic effect. Our study showed a high efficiency of laparoscopic operations in children suffered from non-parasitic spleen cysts with good long-term results.

scholarly journals Formation of Adhesive Arachnoiditis with Epidural Fibrosis as a Cause of Repeated Surgical Interventions (Clinical Case)

2020 ◽  
Vol 5 (3) ◽  
pp. 54-61
Author(s):  
A. P. Zhivotenko ◽  
V. A. Sorokovikov ◽  
Z. V. Koshkareva
Keyword(s):  
Surgical Treatment ◽  
Epidural Space ◽  
Clinical Case ◽  
Intraoperative Complications ◽  
Failed Back Surgery Syndrome ◽  
Unsatisfactory Result ◽  
Surgical Interventions ◽  
Constant Pain ◽  
Failed Back Surgery ◽  
Conservative And Surgical Treatment

The work presents a rare clinical case of adhesive arachnoiditis, which developed against the background of epidural fibrosis during repeated surgical interventions. The cicatricial adhesion in the epidural space is formed in 100% of cases after surgery and is a frequent cause of intraoperative complications during repeated surgical interventions (bleeding, damage to the spinal cord and the dura mater with subsequent outflow of cerebrospinal fluid) and, therefore, an unsatisfactory result of surgical treatment with the formation of constant pain of various intensity, pseudomeningocele, commissural arachnoiditis, etc. The cicatricial adhesion in the epidural space is the main reason for the development of failed back surgery syndrome (FBSS), which today is an important and unresolved problem in spinal surgery. The epidural, as well as the subdural and subarachnoid space of the operated spinal motor segment of the spinal canal can be involved in the cicatricial adhesion, as it is shown in our clinical example. In this regard, it is important to prevent the development of the cicatricial adhesion in the epidural space during primary spinal surgeries, since with the increase in life expectancy of the population and increase in surgical activity during spinal surgeries, the patient can be operated repeatedly. Consequently, the question arises of preventing the formation of the cicatricial adhesion in 100% of cases with each surgical intervention, since the formed cicatricial adhesion in the epidural space does not have effective methods of conservative and surgical treatment and worsens favorable and satisfactory forecasts of surgical treatment for repeated surgical interventions.

scholarly journals Peculiarities of surgical treatment of lumbosacral disc herniation

2020 ◽  
Vol 24 (3) ◽  
pp. 174-180
Author(s):  
Lyubov S. Gornaeva ◽  
G. N. Rumyantseva
Keyword(s):  
Surgical Treatment ◽  
Spinal Nerve ◽  
Herniated Disc ◽  
Spinal Diseases ◽  
Minimal Risk ◽  
Pediatric Practice ◽  
New Techniques ◽  
Surgical Interventions ◽  
Herniated Discs

Introduction. In pediatric practice, herniated discs that require surgical treatment are quite rare (0.5% of all surgical interventions for degenerative spinal diseases). At the same time, there is a tendency to the increase in the number of diagnosed intervertebral disc extrusions in adolescents. Despite of good effectiveness of the standard microdiscectomy, new techniques for removing a herniated disc are being developed to improve results in the postoperative period. Material and methods. The paper presents outcomes of surgical treatment of 59 patients with herniated discs, including 22 children. A comparative characteristics of two techniques was made: traditional microdiscectomy where a hernial component is removed and advanced microdiscectomy where an additional foraminotomy is made under the control of endoscopic technique. The discussed modified surgical treatment was patented (patent for invention No. 2687020 dated 06.05.2019). The authors have compared the effectiveness of these techniques at immediate and long-term periods in all operated patients. Rezults. The number of excellent and good results for the proposed method was higher than 95%, than for the traditional method - 88,9% . Conclusion. The proposed technique improves outcomes of surgical treatment of a herniated disc by eliminating compression of the spinal nerve root in the initially narrow foraminal opening and by expanding the latter under the control of endoscopy with a minimal risk of postoperative complications.

scholarly journals Surgical Treatment of Osteochondral Lesions of the Talar Dome: Review

2021 ◽  
Vol 27 (3) ◽  
pp. 149-161
Author(s):  
Ekaterina A. Pashkova ◽  
Evgenii P. Sorokin ◽  
Viktor A. Fomichev ◽  
Nikita S. Konovalchuk ◽  
Ksenia A. Demyanova
Keyword(s):  
Surgical Treatment ◽  
Functional Results ◽  
Osteochondral Lesions ◽  
Talar Dome ◽  
Surgical Interventions ◽  
Current State ◽  
Surgical Methods ◽  
Treatment Concepts ◽  
Detailed Assessment ◽  
Number Of Publications

Background. The relevance of the talar dome osteochondral lesions problem is assosiated with the difficulties of diagnosis, the lack of unified treatment algorythm and the great number of unsatisfactory clinical and functional results. In the last decade, there has been increasing interest in this topic in the literature, which is demonstrated by a great number of publications with series of observations or clinical cases. However, attempts to create the universal algorithm for this group of patients treatment are limited by the low level of existing studies evidence, high frequency of the new data publications, as well as the impossibility of using a number of surgical methods in different countries for legislative or other reasons. The aim is to determine the current state of the problem of the talar dome osteochondral lesions surgical treatment and to identify types of surgical interventions in patients with the studied pathology. Material and methods. 120 international articles published from 2000 to 2021, as well as 18 domestic publications for the period from 2007 to 2021 were selected for the literature analysis. The search for publications was carried out in the PubMed/MedLine and eLibrary databases. Results. The most widespread are surgical interventions aimed at stimulation of the bone marrow, and plastic surgery using osteochondral auto - and allografts. Currently, there is no consensus on the indications for different types of surgical methods, and the previously used indications are being questioned. This determines the need to improve diagnostic and treatment concepts. Conclusion. The studied literature cannot fully answer a number of questions related to the methods of surgical treatment of patients with symptomatic osteochondral lesions of the talar dome and indications for them. A more detailed assessment of the medium- and long-term clinical outcomes of various surgical methods and the development of algorithms for this group of patients treatment, specific for different countries, are needed.

scholarly journals ALGORITHM OF DIAGNOSTICS AND SURGICAL TREATMENT OF INTERVERTEBRAL DISK HERNIAS IN LUMBAR AND LUMBOSACRAL SPINE

2018 ◽  
Vol 2 (5) ◽  
pp. 78-86
Author(s):  
Зинаида Кошкарёва ◽  
Zinaida Koshkareva ◽  
Владимир Сороковиков ◽  
Vladimir Sorokovikov ◽  
Вадим Бывальцев ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Intervertebral Disc ◽  
Spinal Canal ◽  
Complete Blood Count ◽  
Weight Bearing ◽  
Surgical Techniques ◽  
Diagnostic Algorithm ◽  
Intervertebral Disk ◽  
Lumbosacral Spine ◽  
Surgical Interventions

The purpose of the research is substantiation of the choice of optimal surgical treatment for intervertebral disc hernias basing on the complex examination of patients. The authors worked out and introduced into practical healthcare the diagnostic algorithm for intervertebral disc raptures and constrictive processes of the spinal canal and dural sack. The algorithm includes clinical neurologic examination, complete blood count and biochemical blood test, electroneuro- myography, densitometry, standard and functional spinal radiography, weight-bearing radiography, MSCT, MRI, and multisection CT myelography. The analysis of the obtained data has given the authors the opportunity to establish precise indications for surgical treatment of intervertebral hernias depending on the localization of the rupture, its size, degree of compression of neural structures, and the volume of osteo-neural involvement. The work presents three methods of surgical treatment of intervertebral hernias, optimizing the outcomes of surgical interventions based on the conducted diagnostic algorithm. 425 patients with intervertebral hernias were operated in different ways: 149 people – by laser-mediated vaporization; 131 people – with the use of video-assisted endoneurosurgery; and 145 pa- tients were treated by surgical decompression with minimally invasive reconstruction of spinal canal and dural sack. The suggested methods of surgical treatment of intervertebral raptures are substantiated and confirmed by the patents, innovative surgical techniques and proved to be highly efficient. The use of said methods allowed to achieve good and satisfactory outcomes in 89.5 % of cases.

scholarly journals Choice of surgical treatment for slipped capital femoral epiphysis with severe chronic displacement of the epiphysis

2021 ◽  
Vol 8 (4) ◽  
pp. 383-394
Author(s):  
Dmitry B. Barsukov ◽  
Alexei G. Baindurashvili ◽  
Pavel I. Bortulev ◽  
Vladimir E. Baskov ◽  
Ivan Y. Pozdnikin ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Femoral Component ◽  
Femoroacetabular Impingement ◽  
High Efficiency ◽  
Slipped Capital Femoral Epiphysis ◽  
Hip Dislocation ◽  
Surgical Interventions ◽  
Group 2 ◽  
Low Efficiency ◽  
Group 1

Background. The spatial relationship between the epiphysis and the acetabulum in slipped capital femoral epiphysis (SCFE) with severe chronic epiphysis displacement is restored by different corrective extra-articular femoral osteotomies and a standard Dunn procedure. Severe residual deformity of the femoral component of the joint with symptoms of femoroacetabular impingement and a large number of severe ischemic complications forced the surgeons to improve the technique of these surgical interventions. In particular, a modified Dunn procedure was proposed using a low traumatic surgical hip dislocation. However, the selection of surgical treatment in these patients remains a subject of discussion. Aim. This study aimed to improve the results of treatment in children with SCFE with severe chronic epiphysis displacement. Materials and methods. Data of preoperative and postoperative clinical and radiological studies of 40 patients (24 male and 16 female) aged 1215 years who were suffering from SCFE with severe chronic epiphysis displacement were analyzed. In all cases, on the lesion side, displacement was found in typical directions (posterior-downward or only posterior), and in the contralateral joint, the disease was still at its initial stage (pre-slip). In group 1 (n = 20 children), a corrective extra-articular femoral (anterior-rotational or rotational-valgus) osteotomy was performed according to the method we have proposed in 2011 [22], and in group 2 (n = 20 children), the modified Dunn procedure that strictly followed our technique was performed. The follow-up period after surgery in both groups ranged from 1 month to 2.5 years. Results. At 2.5 years after surgery, good anatomical and functional outcomes were observed only in 1 (12.5%) of 8 patients in group 1, while they were observed in 7 (87.5%) of 8 patients in group 2. Poor results were determined by residual epiphyseal displacement (from 22 to 28) and/or step-like transition of the anterior femoral neck surface to the head in 5 (62.5%) children in group 1 and by femoral head avascular necrosis (diagnosed in 6 months after surgery) in 1 (12.5%) child in group 2. Conclusion. The results allow us to make a preliminary conclusion about the high efficiency of the modified Dunn procedure and the low efficiency of the corrective extra-articular femoral osteotomy in SCFE with severe chronic displacement of the epiphysis. The modified Dunn procedure corrects the pronounced deformity of the femoral component of the affected joint and femoroacetabular impingement in the above-mentioned anatomical situations.

Methods of prevention and elimination of the most frequent intraoperative and postoperative complications in the surgical treatment of pulmonary and pleural tuberculosis using video-assisted surgical interventions

2021 ◽  
pp. 51-59
Author(s):  
M.S. Opanasenko ◽  
V.I. Lysenko ◽  
O.V. Tereshkovych ◽  
B.M. Konik ◽  
M.I. Kalenichenko ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Postoperative Complications ◽  
Postoperative Period ◽  
Intraoperative Complications ◽  
Diagnostic Methods ◽  
Surgical Interventions ◽  
Pleural Tuberculosis ◽  
Preoperative Stage ◽  
Operation And Management ◽  
Selection Of

Objective — to identify and analyze methods of prevention and elimination of the most common intraoperative and postoperative complications in the surgical treatment of pulmonary tuberculosis and pleura using VATS. Materials and methods. In the Department of Thoracic Surgery and Invasive Diagnostic Methods of the National Institute of Phthisiology and Pulmonology named after F.G. Yanovsky NAMS of Ukraine for the period from 2008 to 2019 performed 169 VATS operations on patients with tuberculosis surgery, of which: 130 (79.3 ± 3.2) % VATS lung resections; 35 (20.7 ± 3.1) % VATS pleurectomy with decortication (PE with DC) of the lung; 4 (2.4 ± 1.2) % of patients underwent other VATS interventions. Results and discussions. The level of intraoperative complications among all 169 operated patients was recorded in 9 (5.3 %) cases. Postoperative complications were detected in 29 (17.1 %) patients.Methods of prevention of complications in VATS are the selection of patients at the preoperative stage, correction of hemostasis, safe areas of thoracoport and minitracotomy, lymph dissection, separate treatment of lung root elements, conversion to thoracotomy. Conclusions. VATS interventions are minimally invasive, effective and convenient methods of surgical treatment of patients with pulmonary and pleural tuberculosis. Adequate assessment of the possibility of performing VATS, methods of prevention of complications and their timely application provides a predictable course of the postoperative period and reduces the number of complications. Diagnosis of complications and timely use of various methods of their elimination allows you to effectively and reliably apply medical manipulations to resolve both intra­ and postoperative complications in this type of surgery. Understanding and using methods of prevention and elimination of complications, allows to determine the correct tactics of operation and management of the postoperative period.

scholarly journals Estimation of variants of the pancreatic gland pathology in patients, suffering complicated forms of chronic pancreatitis in late postoperative period

2019 ◽  
Vol 86 (7) ◽  
pp. 18-22
Author(s):  
V. M. Ratchyk ◽  
D. V. Orlovsky ◽  
A. V. Tuzko ◽  
O. P. Petishko
Keyword(s):  
Chronic Pancreatitis ◽  
Surgical Treatment ◽  
Postoperative Period ◽  
Surgical Interventions ◽  
Group I ◽  
Group Ii ◽  
Surgical Tactics ◽  
Pancreatic Pathology ◽  
Late Postoperative Period ◽  
Pancreatic Gland

Objective. Estimation of variants of the pancreatic gland pathology and rate of the unfavorable results occurrence in late postoperative period in patients, suffering  complicated forms of chronic pancreatitis, depending on the procedures of surgical treatment. Materials and methods. Results of surgical treatment of complicated forms of chronic pancreatitis in department of the gut surgery in 2007 - 2017 yrs were studied in 107 patients, who were divided into two groups: the Group I – 67 (62.7%) patients, in whom pancreato- and virsungodigestive operations were performed, and the Group II – 40 (37.4%) patients, in whom duodenum—preserving resection-drainage surgical interventions were done. Results. Unfavorable variants of pancreatic pathology were observed significantly more frequently in patients of the Group I – in 34/67 (50.7%) in comparison with patients of the Group II – in 6/40 (15.0%) (χ2=9.49, p=0.002). Conclusion. Analysis of rate of the unfavorable results occurrence in late postoperative period, depending on surgical tactics appled, have shown a trustworthy advantage of the resection-drainage operations.

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