scholarly journals Skip hemilaminectomy for the treatment of holospinal epidural abscess: A single-center experience

2021 ◽  
Vol 12 ◽  
pp. 625
Author(s):  
Alessandro Di Rienzo ◽  
Riccardo Paracino ◽  
Valentina Liverotti ◽  
Maurizio Gladi ◽  
Mauro Dobran

Background: Holospinal epidural abscesses (HEAs) are rare with potentially devastating consequences. Urgent bony decompression and abscess evacuation with long-term antibiotic therapy are typically the treatment of choice. Methods: We reviewed cases of holospinal HEAs operated on between 2009 and 2018. Variables studied included preoperative laboratories, CT/MR studies plus clinical and radiographic follow-up for between 34 and 60 postoperative months. Results: We utilized skip hemilaminectomies to minimize the risks of segmental instability. Targeted antibiotic therapy was also started immediately and maintained for 6 postoperative weeks. MR/CT studies documented full radiographic and neurological recovery between 6 and 12-months later. Conclusion: HEAs may be treated utilizing multilevel skip hemilaminectomies to help maintain spinal stability while offering adequate abscess decompression/resolution.

Pituitary ◽  
2011 ◽  
Vol 15 (1) ◽  
pp. 25-29 ◽  
Author(s):  
Panagiotis Anagnostis ◽  
Fotini Adamidou ◽  
Stergios A. Polyzos ◽  
Zoe Efstathiadou ◽  
Eleni Karathanassi ◽  
...  

2018 ◽  
Vol 35 (2) ◽  
pp. 227-235 ◽  
Author(s):  
Valentina Di Leo ◽  
Paolo Biban ◽  
Federico Mercolini ◽  
Francesco Martinolli ◽  
Andrea Pettenazzo ◽  
...  

2012 ◽  
Vol 28 (5) ◽  
pp. S311
Author(s):  
R. Ibrahim ◽  
S. Noble ◽  
A. Basmadjian ◽  
M. Jolicoeur ◽  
S. Levesque ◽  
...  

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Gemma Patella ◽  
Alessandro Comi ◽  
Giuseppe Coppolino ◽  
Nicolino Comi ◽  
Giorgio Fuiano ◽  
...  

Abstract Background and Aims Steroid-dependent nephrotic syndrome (SDNS) may require a prolonged multi-drug therapy with risk of drug toxicity and renal failure. Rituximab (RTX) treatment has been found to be helpful in reducing the steroid dosage and the need for immunosuppressants (ISs), but little data are currently available regarding very long-term outcomes in adults. We herein describe a long-term, single-center experience of RTX use in a large series of adults with SDNS. Method We studied 23 adult patients with SDNS (mean age 54.2±17.1 y; 65% male; BMI 28.5±4.7), mostly consequent to membranous (47.8%) or focal glomerulonephritis (30.2 %) who were eligible to start a RTX regimen. Before entering the RTX protocol, proteinuria and eGFR were 7.06±3.87 g/24h and 65.9±28.2 ml/min/1.73 m2, respectively; albumin and CD19/CD20 ratio were 2.9±0.9 g/L and 0.99±0.01 respectively; the mean number of ISs was 2.39±0.89 and the mean annual rate of relapses was 2.2±0.9. Results Patients were followed over a mean follow-up of 64 months (range: 12-144). After RTX (mean dose: 1202.1±372.4 mg) the rate of relapses was virtually nullified (p<0.001). eGFR remained roughly stable (62.1±19.8 ml/min/1.73 m2, p=NS), while proteinuria, albumin, CD19/CD20 and BMI all significantly improved (p ranging from 0.01 to 0.001). The mean number of additional ISs was also reduced (0.44±0.12; p<0.001) and RTX enabled discontinuation of steroids in 13/23 (56.5%) patients. No major adverse events related to therapy were recorded. Conclusion Findings from this large case-series with a remarkable very long follow-up reinforce the role of RTX as an efficient and safe weapon to improve outcomes in adult patients suffering from SDNS.


2014 ◽  
Vol 98 ◽  
pp. 730
Author(s):  
W. Schoening ◽  
N. Buescher ◽  
R. Neuhaus ◽  
A. Pascher ◽  
G. Puhl ◽  
...  

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