scholarly journals Posterior Percutaneous Endoscopic Cervical Diskectomy as a treatment for cervical radiculopathy

2019 ◽  
pp. 1-2
Author(s):  
Hao Wu
Keyword(s):  
Nerve Root ◽  
Gold Standard ◽  
Standard Treatment ◽  
Cervical Radiculopathy ◽  
Endoscopic Technique ◽  
Spinal Instability ◽  
Adjacent Segment ◽  
Less Invasive ◽  
Symptom Relapse

Anterior cervical diskectomy and fusion (ACDF) is the gold standard treatment for patients with cervical radiculopathy. However, the use of ACDF for patients with cervical radiculopathy can result in several disadvantages, such as limitation of motion and accelerating degeneration of adjacent segment. An alternative, less invasive endoscopic technique, posterior percutaneous endoscopic cervical diskectomy (PPECD), was applied to address the above problems associated with ACDF. The patient presented with pain and weakness of the left arm for 2 years. P-PECD was applied and complete decompression of the nerve root was achieved. The symptoms were relieved after surgery. Postoperative MR showed the ruptured disk fragment was successful removed. No spinal instability or symptom relapse was observed in follow-up. PPECD may be an option for patients with cervical radiculopathy.

A new endoscopic technique to decompress lumbar nerve roots affected by spondylolysis

2003 ◽  
Vol 98 (3) ◽  
pp. 290-293 ◽  
Author(s):  
Koichi Sairyo ◽  
Shinsuke Katoh ◽  
Tadanori Sakamaki ◽  
Shinji Komatsubara ◽  
Natsuo Yasui
Keyword(s):  
Clinical Outcome ◽  
Nerve Root ◽  
Clinical Results ◽  
Skin Incision ◽  
Endoscopic Technique ◽  
Spinal Instability ◽  
Nerve Roots ◽  
Content Type ◽  
Proximal Stump

✓ The authors describe a new endoscopic technique to decompress lumbar nerve roots affected by spondylolysis. Short-term clinical outcome was evaluated. Surgery-related indications were: 1) radiculopathy without low-back pain; 2) no spinal instability demonstrated on dynamic radiographs; and 3) age older than 40 years. Seven patients, four men and three women, fulfilled these criteria and underwent endoscopic decompressive surgery. Their mean age was 60.9 years (range 42–70 years). No subluxation was present in four patients, whereas Meyerding Grade I slippage was demonstrated in three. For endoscopic decompression, a skin incision of 16 to 18 mm in length was made, and fenestration was performed to identify the affected nerve root. The proximal stump of the ragged edge of the spondylotic lesion, and the fibrocartilaginous mass compressing the nerve root were removed. The follow-up period ranged from 6 to 22 months (mean 11.7 months). Clinical outcome was evaluated using Gill criteria; in three patients the outcome was excellent, and in four it was good. This new endoscopic technique was useful in the decompression of nerve roots affected by spondylolysis, the technique was minimally invasive, and the clinical results were acceptable.

scholarly journals Whether Hemiarthroplasty Remains a Gold Standard Treatment for Patients With Displaced Femoral Neck Fractures? - A 20-year Sample of 4516 Patients From a Single Institute

2020 ◽  
Author(s):  
Chi-Yung Yeung ◽  
Shang-Wen Tsai ◽  
Po-Kuei Wu ◽  
Cheng-Fong Chen ◽  
Ming-Chau Chang ◽  
...  
Keyword(s):  
Gold Standard ◽  
Standard Treatment ◽  
Revision Rate ◽  
Femoral Stem ◽  
Recurrent Dislocation ◽  
Geriatric Population ◽  
Displaced Femoral Neck Fractures ◽  
Neck Fracture ◽  
Therapeutic Study

Abstract BackgroundFemoral neck fracture (FNF) is among the commonest fractures affecting the geriatric population. Hemiarthroplasty (HA) is a standard treatment procedure and has been performed by hip surgeons for decades. Recently, primary total hip replacement has proved advantageous for the treatment of such fractures. This study analysed the causes of HA failure and reevaluated whether HA remains a gold standard treatment for patients with displaced FNFs.MethodsA total of 4516 patients underwent HA at our centre from 1998 to 2017. The HA implants included unipolar and bipolar prostheses. Patients were enrolled who received the diagnosis of a displaced FNF, underwent primary HA initially, required second revision procedures, and were followed up for a minimum of 36 months. Data were collected and comprehensively analysed.ResultsIn 4516 cases, 99 patients underwent second surgeries. The revision rate was 2.19%. Reasons for failure were acetabular wear (n = 30, 30.3%), femoral stem subsidence (n = 24, 24.2%), periprosthetic fracture (n = 22, 22.2%), infection (n = 16, 16.2%), and recurrent dislocation (n = 7, 7.1%). The mean follow-up period was 78.1 months. The interval between failed HA and revision surgery was 22.8 months.ConclusionHA has an extremely low revision rate and remains a gold standard treatment for patients with displaced FNFs.Levels of Evidence: Level III, Retrospective Cohort Study, Therapeutic Study

scholarly journals Laser for the treatment of twin to twin transfusion syndrome

2005 ◽  
Vol 20 (6) ◽  
pp. 478-481 ◽  
Author(s):  
Denise Araújo Lapa Pedreira ◽  
Gregório Lorenzo Acácio ◽  
Carolina Leite Drummond ◽  
Rita de Cássia Sanchez e Oliveira ◽  
Alice D'Agostini Deustch ◽  
...  
Keyword(s):  
Gold Standard ◽  
Standard Treatment ◽  
Neonatal Period ◽  
Uterine Cavity ◽  
Initial Experience ◽  
Therapeutic Technique ◽  
Surface Vessels ◽  
Proper Training ◽  
A New Technique

PURPOSE: To report the initial experience in our country with a new technique for twin to twin transfusion syndrome (TTTS) treatment, using laser to coagulate the placental vessels responsible for the twin transfusion during gestation. METHODS: Prospective study of eight cases diagnosed with TTTS evaluated in our service from january 2001 to june 2005. Through percutaneous introduction of a 2,0mm diameter fetoscope in the uterine cavity, placental surface vessels where directly visualized. Those identified as responsible for the transfusion were laser coagulated. The procedure combines ultrasonography and fetoscopy, in a so-called sonoendoscopic technique (FETENDO). RESULTS: Among the eight pregnancies evaluated, five cases were submitted to the procedure (10 fetuses). All fetuses survived for at least five weeks after surgery. A total of eight fetuses were born alive and five survived the neonatal period. In a 18 months follow-up after birth, all five are still alive and well and their mean age is now 10,6 months. The total survival rate was 50% and in three pregnancies, at least one fetus survived. CONCLUSIONS: Laser fetoscopy is actually the "gold-standard" treatment of TTTS. Nevertheless is a sophisticated technique that epends of proper training. Our service is the first in our country to offer this therapeutic technique. Our success rate is comparable with the international literature.

scholarly journals Clinical Outcomes of Posterior Percutaneous Endoscopic Cervical Foraminotomy and Discectomy Assisted with SNRB in Treating Cervical Radiculopathy with Diagnostic Uncertainty

2021 ◽  
pp. E483-E492
Keyword(s):  
Clinical Outcomes ◽  
Nerve Root ◽  
Cervical Radiculopathy ◽  
Radicular Pain ◽  
Diagnostic Uncertainty ◽  
Retrospective Design ◽  
The Mean ◽  
Selective Nerve Root Block ◽  
Cervical Foraminotomy

BACKGROUND: Selective nerve root block (SNRB) has been used to facilitate the diagnostic process when radiologic abnormalities are not correlated with clinical symptomatology in patients with cervical radiculopathy. Meanwhile, minimally invasive posterior percutaneous endoscopic cervical foraminotomy and discectomy (PPECFD) has been widely used to treat cervical radiculopathy because of its advantages. However, combination of these 2 procedures in the treatment of cervical radiculopathy with diagnostic uncertainty has not been reported. OBJECTIVES: To examine the clinical outcomes of PPECFD assisted with SNRB in patients who had cervical radiculopathy with diagnostic uncertainty. STUDY DESIGN: A retrospective design was used. SETTING: This study was conducted in a university-affiliated tertiary hospital in Shanghai, China. METHODS: Thirty consecutive patients with cervical radicular pain who had diagnostic uncertainty were included (January 2018 to January 2019). Diagnostic SNRB was performed to identify the responsible nerve root(s). PPECFD was selected as the treatment when the SNRB result was positive. Clinical outcomes were assessed by the Visual Analog Scale (VAS), Neck Disability Index (NDI), and modified Macnab criteria. Pre- and post-operative radiologic and clinical parameters were evaluated. Other information was retrieved from the electronic records. RESULTS: All patients had successful SNRB procedures. Four were excluded from the analysis because of the negative results of the SNRB. Among the remaining 26 patients who underwent the subsequent PPECFD surgery, the mean follow-up was 14 months. Compared with preoperative values, the mean VAS scores for radicular arm pain and neck pain, as well as the NDI score, improved significantly. According to the Macnab criteria, 22 patients (84.6%) had excellent or good results. No major peri- and postoperative complications were observed. LIMITATIONS: This study used a retrospective design with relatively small sample size and medium follow-up duration. CONCLUSIONS: Diagnostic SNRB may be a helpful tool to identify the origin of cervical radicular pain for patients with diagnostic uncertainty. With the guidance of SNRB, PPECFD is likely to be an effective and safe option for the treatment of cervical radiculopathy with diagnostic uncertainty. KEY WORDS: Cervical radiculopathy, selective nerve root block, percutaneous endoscopic cervical foraminotomy and discectomy, diagnostic, uncertainty

scholarly journals Carpal tunnel release by mini palmar incision

2011 ◽  
Vol 5 (1) ◽  
pp. 139-142 ◽  
Author(s):  
Kawee Pataradool ◽  
Pravit Kitidumrongsook ◽  
Adisorn Patradul
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Gold Standard ◽  
Standard Treatment ◽  
Carpal Tunnel Release ◽  
Small Series ◽  
Tunnel Syndrome ◽  
Open Carpal Tunnel Release ◽  
Mini Incision

Abstract Background: Open carpal tunnel release is the gold standard treatment for carpal tunnel syndrome. However, there are complications related to the long incision. Method: We report the results from a mini-incision open carpal tunnel release with simple instruments. Results: There were no complications in our small series, improvement of scores was shown at four-week follow-up, and cosmetic results were satisfactory. Conclusions: Mini-incision carpal tunnel release is one option to treat carpal tunnel syndrome.

scholarly journals Paraganglioma of the Thyroid Gland: A Case Report and a Review of the Literature

2021 ◽  
pp. 014556132110345
Author(s):  
Massimo Campagnoli ◽  
Michele Cerasuolo ◽  
Giorgio Arena ◽  
Valeria Dell’Era ◽  
Annalisa Andorno ◽  
...  
Keyword(s):  
Case Report ◽  
Thyroid Gland ◽  
Gold Standard ◽  
Standard Treatment ◽  
Incidental Finding ◽  
Definitive Diagnosis ◽  
Review Of The Literature ◽  
Staining Techniques ◽  
Histological Staining

Paragangliomas of the thyroid gland are rare and usually they originate from the inferior laryngeal paraganglia. In this case report, we describe the case of a 78-year-old woman who presented with an incidental finding of thyroid nodule dislocating the trachea. After a systemic and radiological evaluation, right lobo-isthmectomy was performed, and the definitive diagnosis of paraganglioma was reached. Diagnosis of these thyroidal lesions could be difficult due to their rarity, to their specific radiological aspects and the need of employing specific histological staining techniques. Once the definitive diagnosis is reached, patients should undergo a systemic and genetic evaluation. Surgery is the gold standard treatment; radiotherapy should be considered when aggressive behavior is suspected. Regular long-lasting follow-up should be proposed to these patients considering the unpredictable behavior of these lesions.

scholarly journals Endoscopic treatment of intraluminal ureteral suture with holmium laser

2021 ◽  
Vol 93 (2) ◽  
pp. 248-249
Author(s):  
Jorge Panach-Navarrete ◽  
María Negueroles-García ◽  
José María Martínez-Jabaloyas
Keyword(s):  
Gold Standard ◽  
Standard Treatment ◽  
Ureteral Injury ◽  
Holmium Laser ◽  
Central Position ◽  
Promising Technique ◽  
Intense Pain ◽  
Ureteral Trauma ◽  
Open Reconstruction

Although reconstructive surgery is the most accepted treatment for ureteral injury, there are reports of cases where endourologic treatment led to correct resolution of the problem. We present the case of a female patient aged 72-year-old who was previously underwent sacralcolpopexy because of anterior vaginal compartment prolapse. The patient underwent surgery to remove the mesh, due to the pain she had had since it was placed. A mid-line laparotomy was performed removing completely the mesh. At 48 hours after intervention, the patient started feeling an intense pain in the left renal fossa that was not relieved with anti-inflammatories and morphic drugs. In the diagnostic ureteroscopy, it was found iatrogenic suture of the ureter. Due to the availability of holmium laser, an endoureterotomy was performed in the 12h central position on the tip, with laser parameters of 1J-10Hz. A 6F ureteral stent was maintained for one month. During follow-up, the patient remained asymptomatic and without dilation of the left system on imaging tests. Although we accept that open reconstruction is the gold standard treatment for ureteral trauma, we describe holmium laser endoureterotomy as a promising technique to consider in the event of ureteral intraluminal ligation.

Multislice imaging of gastrointestinal stromal tumors

2018 ◽  
pp. 3-14
Keyword(s):  
Computed Tomography ◽  
Key Words ◽  
Gold Standard ◽  
Gastrointestinal Stromal Tumors ◽  
Mesenchymal Tumors ◽  
Stromal Tumors ◽  
Preferential Localization ◽  
Multislice Imaging ◽  
Computed Tomography Diagnosis

Gastrointestinal stromal tumors (GIST) are the most common mesenchymal tumors of the digestive tract (1%). These tumors express the CD 117 in 95% of cases. The stomach is the preferential localization (70%). Diagnosis is difficult and sometimes late. Progress of imaging has greatly improved the management and the prognosis. Computed tomography (CT) is the gold standard for diagnosis, staging, and treatment follow-up. The increasing recognition of GIST’s histopathology and the prolonged survival revealed some suggestive imaging aspects. Key words: gastro-intestinal stromal tumors; computed tomography; diagnosis

Sign in / Sign up

Export Citation Format

Share Document