scholarly journals Preoperative management through modified halo-pelvic distraction assembly in a case of severe thoracic spine kyphosis

2021 ◽  
Vol 12 ◽  
pp. 290
Author(s):  
Muhammad Saad Ilyas ◽  
Abdullah Shah ◽  
Aftab Rahim Afridi ◽  
Uruj Zehra ◽  
Ijaz Ahmad ◽  
...  
Keyword(s):  
Thoracic Spine ◽  
Lower Limbs ◽  
Kyphotic Deformity ◽  
Thoracic Vertebrae ◽  
Kyphotic Angle ◽  
Halo Traction ◽  
Distraction Device ◽  
Traction Device ◽  
Acute Correction ◽  
Definitive Surgery

Background: Halo-traction device has been seen with favorable outcome in managing the patients with severe kyphotic deformities preoperatively, however, associated complications are inevitable. Slight modifications can improve the outcome and clinical efficacy. Case Description: A 14-year-old boy was presented with severe kyphotic deformity of 141° from T1 to T10 thoracic vertebrae with diffuse paraspinal calcification in thoracic spine and complete loss of power of both lower limbs. A modified halo-pelvic distraction device was applied before the definitive surgery. The device comprised halo and pelvic assembly, the halo ring was connected to the head with 06 pins, while pelvic assembly had Ilizarov half pins connected to the arches. The assembly construct had four threaded rods, two of them were placed anterolateral and the other two were posterolateral. Distraction at the rate of 3 mm/day was started from 1st postoperative day for 35 days. The neurology improved in both lower limbs and kyphotic angle reduced to 56° from 141°. Surgery at this stage was done and a standalone solid titanium cage was placed from T1 to T10 vertebral body after debridement. No peri- or post-operative complications were observed. Conclusion: The application of halo-pelvic distraction before corrective surgeries can not only reduce the severity of the kyphotic deformity making the definitive surgery easy but neurology can also be improved. The high-risk complications associated with acute correction of deformities can be minimized using our modified halo-pelvic distraction device.

scholarly journals Natural Orifice Translumenal Endoscopic Surgery for Anterior Spinal Procedures

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Priscilla Magno ◽  
Mouen A. Khashab ◽  
Manuel Mas ◽  
Samuel A. Giday ◽  
Jonathan M. Buscaglia ◽  
...  
Keyword(s):  
Thoracic Spine ◽  
Endoscopic Surgery ◽  
Vertebral Column ◽  
Bone Biopsy ◽  
Posterior Mediastinum ◽  
Direct Access ◽  
Thoracic Vertebrae ◽  
Natural Orifice ◽  
Vertebral Bone ◽  
Vertebral Bodies

Background. NOTES techniques allow transesophageal access to the mediastinum. The aim of this study was to assess the feasibility of transesophageal biopsy of thoracic vertebrae.Methods. Nonsurvival experiments on four 50-kg porcine animals were performed. Transesophageal access to the mediastinum was attained using submucosal tunneling technique.Results. The posterior mediastinum was successfully accessed and navigated in all animals. Vertebral bodies and intervertebral spaces were easily approached while avoiding damage to adjacent vessels. Bone biopsy was successfully performed without complications, but the hardness of bone tissue resulted in small and fragmented samples.Conclusions. Peroral transesophageal access into the posterior mediastinum and thoracic vertebral bone biopsy was feasible and safe. The proximity of the esophagus to the vertebral column provides close and direct access to the thoracic spine and opens up new ground for the performance of multilevel anterior spine procedures using NOTES techniques.

Retrograde Tracheal Intubation in a Patient with a Halo Traction Device

2006 ◽  
Vol 103 (6) ◽  
pp. 1628-1629 ◽  
Author(s):  
Neerja Bhardwaj ◽  
Sandhya Yaddanapudi ◽  
Surinder Makkar
Keyword(s):  
Tracheal Intubation ◽  
Halo Traction ◽  
Traction Device

scholarly journals FEATURES OF THE DIAGNOSIS OF UNCOMPLICATED COMPRESSION FRACTURE OF THE THORACIC SPINE IN CHILDREN

2019 ◽  
Vol 20 (5) ◽  
pp. 307-311
Author(s):  
Yakhya M. Yakhyaev ◽  
M. I. Izrailov ◽  
V. N. Merkulov ◽  
A. M. Aliskandiev ◽  
T. Ya. Yakhyaeva
Keyword(s):  
Thoracic Spine ◽  
Compression Fracture ◽  
Diagnostic Process ◽  
Vertebral Compression Fractures ◽  
Thoracic Vertebrae ◽  
Healthy Children ◽  
X Ray ◽  
Compression Fractures ◽  
Fractures In Children ◽  
Ct And Mri

X-ray diagnostics of compression fractures of bodies of the thoracic vertebrae in children not seldom causes great difficulties due to the fact that even in healthy children vertebrae have a number of features, particularly, the wedge shape. For the purpose of differential diagnosis there was performed chest X-ray examination of the thoracic vertebrae in healthy children and cases after the compression damage. The wedge index and the disk coefficient for various segments of the thoracic spine were calculated. The diagnostic efficiency of radionuclide studies was estimated to reaches 79%. The useof highly informative modern medical techniques (CT and MRI) in the diagnosis of vertebral compression fractures in children allows accurately and timely make the diagnosis and determine the condition of the surrounding tissues. Based on the analysis of medical records, radiographs, identification of options of radionuclide, CT and MRI studies, there was elaborated an algorithm for the diagnosis of compression fractures of vertebrae, which allowed optimize the diagnostic process. There are determined advantages of this algorithm.

scholarly journals Surgery for Metastatic Epidural Spinal Cord Compression in Thoracic Spine, Anterior or Posterior Approach?

2019 ◽  
Author(s):  
Jen Chung Liao
Keyword(s):  
Spinal Cord ◽  
Blood Loss ◽  
Spinal Cord Compression ◽  
Thoracic Spine ◽  
Posterior Approach ◽  
Cord Compression ◽  
Thoracic Vertebrae ◽  
Neurologic Status ◽  
Significant Difference ◽  
Group A

Abstract Background: The most commonly encounter tumor of the spine is metastasis, and thoracic spine is the most commonly metastatic spine. Controversy exists regarding the optimal surgical approach for this kind of patient. The author conducted a study to assess the differences between anterior thoracotomy and posterior approach in patients with malignant epidural cord compression in the thoracic spine. Methods: Between January 2003 and December 2015, patients with metastatic thoracic lesion underwent surgery at our department were stratified into two groups according to different approach method to the lesion site. Group A mean anterior thoracotomy, decompression and fixation. Group P represented posterior decompression and fixation. Survival was defined as months since surgery to last tractable times. American Spinal Injury Association grade was used to assess preoperative and postoperative neurologic status. Days at intensive care unit (ICU) were compared. Every complication by surgery or during admission was documented. Results: Group A had 25 patients and Group P had 67 patients. Lung cancer was ther most commonly origin cancer in both groups. The most commonly surgical level was the 9th thoracic vertebrae in Group A and the 10th thoracic vertbrae in Group P. Both gropus had a similar preoperative neurologic (p=0.959). One patients in Group A and two in the Group P sustained neurologic deterioation immediately after surgery. Group A took more operation time (213.0 vs 199.2 minutes, p=0.380) and had more blood loss (912.5 vs 834.4 ml, p=0.571). 6 patients in Group A (24%) and 10 patients in Group P (13.9%) developed complications immediately or postoperatively. Patients in Group A need more days of care at ICU (2.36 vs 0.19 days, p<0.001). The longer survival was seen in the goup P (15.4 vs 11.2 months) but without significant differnce. Conclusion: Patients in Group P required significantly less days of care at ICU. Besides, posterior approach also took a shorter surgical time, and had a less blood loss during surgery, although without statistically significant difference. According to the results, the author would prefer posterior approach by decompression and fixation for those with thoracic metastatic tumor with epidural compression. Keywords: Thoracic spine; metastatic epidural spinal cord compression; anterior thoracotomy; posterior approach; survivorship; neurologic status; complications.

scholarly journals Primary Myxoid Liposarcoma of the Upper Thoracic Spine in an Elderly Patient

2017 ◽  
Vol 08 (S 01) ◽  
pp. S120-S122 ◽  
Author(s):  
Aristedis Rovlias ◽  
Alexia Balanika ◽  
Alexandros Nomikos ◽  
Savas Melissaris
Keyword(s):  
Thoracic Spine ◽  
Posterior Instrumentation ◽  
Tumor Resection ◽  
Soft Tissue Sarcomas ◽  
Myxoid Liposarcoma ◽  
Lower Limbs ◽  
Primary Tumors ◽  
History Of ◽  
Spinal Cord Decompression ◽  
Upper Thoracic

ABSTRACTLiposarcoma, one of the most common soft-tissue sarcomas, originates from primitive mesenchymal cells, and its diagnostic criteria have been well established. Myxoid liposarcoma is the second most common histological subtype, occurring more frequently during the fourth and fifth decades of life. There are only a few sporadic published cases of spinal liposarcomas, whatever primary or metastatic. We describe an unusual case of primary myxoid liposarcoma of the thoracic spine in a 79-year-old male, presented with a 2-month history of intractable dorsal pain and progressive weakness of lower limbs. Surgical treatment was performed with wide tumor resection, spinal cord decompression, and posterior instrumentation complemented by radiotherapy. Only one other case has been reported with this spinal localization in the literature. Despite its rarity, myxoid liposarcoma should be considered in the differential diagnosis of primary tumors of the thoracic spine.

FINITE ELEMENT MODELING OF HUMAN THORACIC SPINE

2004 ◽  
Vol 08 (04) ◽  
pp. 133-144 ◽  
Author(s):  
Tian-Xia Qiu ◽  
Ee-Chon Teo
Keyword(s):  
Finite Element ◽  
Thoracic Spine ◽  
Three Dimensional ◽  
Axial Rotation ◽  
Torsional Stiffness ◽  
Fe Model ◽  
Thoracic Vertebrae ◽  
Fundamental Information ◽  
Flexion Extension ◽  
Scoliosis Correction

Mathematical models, which can accurately represent the geometric, material and physical characteristics of the human spine structure, are useful in predicting biomechanical behaviors of the spine. In this study, a three-dimensional finite element (FE) model of thoracic spine (T1–T12) was developed, based on geometrical data of embalmed thoracic vertebrae (T1–T12) obtained from a precise flexible digitizer, and validated against published thoracolumbar experimental results in terms of the torsional stiffness of the whole thoracic spine (T1–T12) under axial torque alone and combined with distraction and compression loads. The torsional stiffness was increased by over 60% with application of a 425 N distraction force. A trend in increasing torsional stiffness with increasing distraction forces was detected. The validated model was then loaded under moment rotation in three anatomical planes to determine the ranges of motion (ROMs). The ROMs were approximately 37°, 31°, 32°, 51° for flexion, extension, lateral bending and axial rotation, respectively. These results may offer an insight to better understanding the kinematics of the human thoracic spine and provide clinically relevant fundamental information for the evaluation of spinal stability and instrumented devices functionality for optimal scoliosis correction.

Postpartum Paraplegia Due to Spinal Tuberculosis

1988 ◽  
Vol 18 (2) ◽  
pp. 52-53 ◽  
Author(s):  
B I Nsofor ◽  
O N Trivedi
Keyword(s):  
Thoracic Spine ◽  
Postpartum Haemorrhage ◽  
Spinal Tuberculosis ◽  
Lower Limbs ◽  
Tuberculous Lesion

A case of postpartum paraplegia due to tuberculosis of the spine is reported. The patient presented with postpartum haemorrhage and paraplegia on the 8th postpartum day. She had weakness of both lower limbs on the 4th postpartum day and was unable to walk on the 7th day. Investigations revealed a tuberculous lesion of the thoracic spine. She was treated with chemotherapy and physiotherapy and recovered fully within seven months.

Microsurgical resection of ossification of the posterior longitudinal ligament in the thoracic spine via the transthoracic approach without spinal fusion: case series and technical note

2019 ◽  
Vol 31 (3) ◽  
pp. 326-333
Author(s):  
Ryo Kanematsu ◽  
Junya Hanakita ◽  
Toshiyuki Takahashi ◽  
Yosuke Tomita ◽  
Manabu Minami
Keyword(s):  
Spinal Cord ◽  
Spinal Fusion ◽  
Thoracic Spine ◽  
Posterior Longitudinal Ligament ◽  
Anterolateral Approach ◽  
Thoracic Myelopathy ◽  
Kyphotic Angle ◽  
Thoracic Spinal Cord ◽  
Csf Leakage ◽  
The Mean

OBJECTIVESurgical management of thoracic ossification of the posterior longitudinal ligament (OPLL) remains challenging because of the anatomical complexity of the thoracic spine and the fragility of the thoracic spinal cord. Several surgical approaches have been described, but it remains unclear which of these is the most effective. The present study describes the microsurgical removal of OPLL in the middle thoracic level via the transthoracic anterolateral approach without spinal fusion, including the surgical outcome and operative tips.METHODSBetween 2002 and 2017, a total of 8 patients with thoracic myelopathy due to OPLL were surgically treated via the transthoracic anterolateral approach without spinal fusion. The surgical techniques are described in detail. Clinical outcome, surgical complications, and the pre- and postoperative thoracic kyphotic angle were assessed.RESULTSThe mean patient age at the time of surgery was 55 years (range 47–77 years). There were 5 women and 3 men. The surgically treated levels were within T3–9. The clinical symptoms and Japanese Orthopaedic Association (JOA) score improved postoperatively in 7 cases, but did not change in 1 case. The mean JOA score increased from 6.4 preoperatively to 7.5 postoperatively (recovery rate 26%). Intraoperative CSF leakage occurred in 4 cases, and was successfully treated with fibrin glue sealing and spinal drainage. The mean follow-up period was 82.6 months (range 15.3–169 months). None of the patients had deterioration of the thoracic kyphotic angle.CONCLUSIONSAnterior decompression is the logical and ideal procedure to treat thoracic myelopathy caused by OPLL on the concave side of the spinal cord; however, this procedure is technically demanding. Microsurgery via the transthoracic anterolateral approach enables direct visualization of the thoracic ventral ossified lesion. The use of microscopic procedures might negate the need for bone grafting or spinal instrumentation.

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