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 CLINICAL CASE OF APPLICATION OF AN OBTURIRUYUSHCHY ARTIFICIAL LIMB, AT MAINTENANCE SURGICAL TREATMENT OF DEFECT OF THE LOWER JAW

2018 ◽  
Vol 14 (3) ◽  
pp. 45-48
Author(s):  
Наталья Нуриева ◽  
Natal'ya Nurieva ◽  
Юрий Васильев ◽  
Yuri Vasilev
Keyword(s):  
Surgical Treatment ◽  
Oral Cavity ◽  
Clinical Case ◽  
Surgical Techniques ◽  
Artificial Limb ◽  
Surgical Interventions ◽  
Lower Jaw ◽  
Orthopedic Rehabilitation ◽  
The Moment ◽  
Temporary Closure

Subject. The obturator for dissociation of an oral cavity from a nose cavity, the maxillary of cavities, the post surgeons of defects of maxillary bones. Purpose ― to carry out stomatology rehabilitation of the patient with the acquired defect of the lower jaw with use of the obturator. Methodology. Surgical treatment in maxillofacial area, often doesn't do without appearance of defects of maxillary bones. Elimination of the arising deformations unconditionally perhaps both surgical techniques, and orthopedic designs. Temporary closure of the formed defects and restoration of functions of breath, the speech and food can be the purpose of orthopedic maintenance, at surgical interventions, as division of an oral cavity from cavities of a nose, a bosom, and. We made use of experience of production of various obturator at more than 50 patients needing orthopedic rehabilitation for writing of this article, and in honesty in production of various designs the obturator of artificial limbs, at the moment and after the surgical and combined methods of treatment of new growths of maxillary bones postponed. All of them are at different stages of rehabilitation. Results. On example of a clinical case is shown a possible orthopedic way of closing of temporary defect of the lower jaw, by production of the obturator artificial limb adapted in an oral cavity. The Obturator artificial limb has the small sizes, can independently be established and be taken by the patient, for hygienic leaving, doesn't influence diction and an articulation, helps to avoid of postoperative defect and also to normalize meal. Conclusions. The assessment of results of the carried-out orthopedic treatment is carried out, its efficiency is established, practical recommendations about clinical use and ways of production are made.

scholarly journals NEW APPROACHES IN THE TREATMENT OF ACUTE INFLAMMATION OF THE EPITHELIAL PILONIDAL SINUS

2016 ◽  
Vol 7 (4) ◽  
pp. 49-57
Author(s):  
N K Gigin ◽  
N I Chernyi ◽  
Yu V Ivanov
Keyword(s):  
Surgical Treatment ◽  
Postoperative Period ◽  
Pilonidal Sinus ◽  
Patient Management ◽  
Acute Inflammation ◽  
Wound Closure ◽  
Surgical Interventions ◽  
New Approaches ◽  
Surgical Access ◽  
Conservative And Surgical Treatment

Presents an overview of russian and foreign publications, devoted to contemporary methods of conservative and surgical treatment of acute inflammation of the epithelial pilonidal sinus. Details of surgical interventions, techniques, indications and contraindications. Special attention is paid to pre-operative preparation for surgery, wound closure after surgical access, patient management in the postoperative period.

scholarly journals Surgical treatment of complications of Crohn’s disease

2018 ◽  
Vol 20 (1) ◽  
pp. 111-116
Author(s):  
I A Solovev ◽  
A M Pershko ◽  
D P Kurilo ◽  
M V Vasilchenko ◽  
E S Silchenko ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Surgical Treatment ◽  
Crohn's Disease ◽  
Surgical Intervention ◽  
Intestinal Anastomosis ◽  
Clinical Manifestations ◽  
Intestinal Fistula ◽  
Subtotal Resection ◽  
Surgical Interventions ◽  
Conservative And Surgical Treatment

Possibilities and options of surgical treatment of complications of Crohn’s disease in the general surgical hospital are considered. Patients underwent various surgical interventions: ileum resection with «side-to-side» anastomosis (4 patients), resection of ileocecal department with the formation of ileoascendoanastomosis (2 patients), total coloproctectomy with the formation of ileostomy (2 patients), right-sided hemicolectomy (1 patient), obstructive resection of transverse colon (1 patient), obstructive resection of sigmoid colon (2 patients). Postoperative complications developed in 3 patients (25%), among them: postoperative wound suppuration - 2, dehiscence of anastomosis in 1 patient, which led to the formation of internal intestinal fistula and death. It was found that with limited lesions of colon in Crohn’s disease (less than a third of the colon) can be limited to resection of the affected segment with formation of intestinal anastomosis in the limits of healthy tissues. In the presence of lesions in the ascending department of colon proximal border of resection should be at the level of middle colic vessels with preservation of the latter. In long Crohn’s disease of colon with severe clinical manifestations of the operation of choice is a subtotal resection of colon with the imposition of single-barrel ileostomy. Surgical treatment of complicated forms of Crohn’s disease is in all cases performed in surgical profile hospitals, taking patients by ambulance. Most often, patients have delayed indications for operations, which gives the opportunity to carry out a comprehensive preoperative preparation. In all cases, complications of Crohn’s disease requires an individual approach, which combines conservative and surgical treatment. Surgical intervention is determined by the shape and characteristics of the course of complications of Crohn’s disease.

scholarly journals RECURRENT PERINEAL HERNIA — LAPAROSCOPIC SURGICAL TREATMENT: CLINICAL CASE

2020 ◽  
pp. 59-64
Author(s):  
E. A. Galliamov ◽  
M. A. Agapov ◽  
D. R. Markaryan ◽  
V. V. Kakotkin ◽  
E. A. Kazachenko ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Clinical Case ◽  
Randomized Clinical Trials ◽  
Rare Complication ◽  
Perineal Hernia ◽  
Permanent Colostomy ◽  
Surgical Interventions ◽  
Number Of Patients ◽  
Wide Range ◽  
Mesh Implant

Background: Recurrent postoperative perineal hernia is a rare complication of such operation as posterior pelvic evisceration. This condition can reduce the quality of life in the postoperative period and requires surgical restoration of the impaired pelvic anatomy.Clinical case: A 54-year old female patient applied to the MSU University clinic in July 2020 with the protrusion in the perineal area. She was diagnosed with recurrent perineal postoperative hernia. She was diagnosed with rectal cancer T4N1M0 and uterine dysplasia in 2017, 6 courses of neoadjuvant polychemoradiation therapy were performed; she underwent extralevator abdominal-perineal resection with uterine extirpation and the permanent colostomy formation in 2018. A perineal postoperative hernia was diagnosed in March 2020, perineal transabdominal plastic surgery was performed with a mesh implant. A recurrent perineal hernia was diagnosed in April 2020, the patient underwent laparoscopic alloplasty with a composite mesh implant. On the 9th postoperative day, she was discharged in a satisfactory condition without any complaints.Conclusion: Postoperative perineal hernia is a fairly rare complication in surgical practice. The recurrent rate is quite high. The insufficient number of patients, the short follow-up period and the wide range of surgical treatment methods do not allow evaluating the results adequately. It is necessary to conduct large randomized clinical trials to assess the efficacy of surgical interventions and to determine the indications for certain procedures.

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.

Clinical outcome of surgical treatment of failed back surgery syndrome

2005 ◽  
Vol 64 (6) ◽  
pp. 483-488 ◽  
Author(s):  
Ghassan Skaf ◽  
Carmel Bouclaous ◽  
Ali Alaraj ◽  
Roukoz Chamoun
Keyword(s):  
Surgical Treatment ◽  
Clinical Outcome ◽  
Failed Back Surgery Syndrome ◽  
Failed Back Surgery ◽  
Back Surgery

scholarly journals Retinal Hemorrhage after Epiduroscopy in a Patient using Dexamethasone: A Case Report

2019 ◽  
pp. 33-36
Author(s):  
JanWillem Kallewaard
Keyword(s):  
Case Report ◽  
Epidural Space ◽  
Retinal Hemorrhage ◽  
Failed Back Surgery Syndrome ◽  
Epidural Fibrosis ◽  
Retinal Hemorrhages ◽  
First Case ◽  
Short Period ◽  
Failed Back Surgery ◽  
Back Surgery

Epiduroscopy is a minimally invasive procedure used to diagnose epidural fibrosis and to release this fibrosis; epiduroscopy is also used to precisely deposit medication into the epidural space. It is commonly used in patients who are diagnosed with failed back surgery syndrome (FBSS) after more conservative treatment has failed to provide sufficient relief of symptoms. A rare complication of epiduroscopy is retinal hemorrhaging, which is likely caused by overpressurization of the epidural space during the procedure. Patient-related risk factors for developing retinal hemorrhage after epiduroscopy remain largely unknown. This is the first case report of retinal hemorrhage in a patient using chronic dexamethasone. We describe a 73-year-old man diagnosed with FBSS who underwent epiduroscopy to diagnose and relieve epidural fibrosis. The procedure was uneventful and he was discharged from our clinic the same day, but upon routine check-up he mentioned blurry vision. Immediately he was referred to an ophthalmologist who diagnosed retinal hemorrhages in both eyes upon fundoscopic examination. Our patient was using dexamethasone for the treatment of allergies. Three months after the procedure, his vision was restored fully in the right eye and 95% in the left eye. Chronic corticosteroid use may weaken retinal veins, making them prone to rupture when there is increased pressure, even for a short period of time. Chronic use of corticosteroids must be considered a risk factor for developing retinal hemorrhages in patients undergoing epiduroscopy. Long-term use of corticosteroid can be considered as a relative contraindication for epiduroscopy. Key words: Epiduroscopy, complications, interventional pain, corticosteroids, retinal hemmorhage, failed back surgery syndrome

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