scholarly journals Decompression of lumbar canal stenosis with a bilateral interlaminar versus classic laminectomy technique: a prospective randomized study

2019 ◽  
Vol 46 (5) ◽  
pp. E3 ◽  
Author(s):  
Mohamed A. R. Soliman ◽  
Ahmed Ali
Keyword(s):  
Statistical Significance ◽  
Patient Comfort ◽  
Leg Pain ◽  
Neurogenic Claudication ◽  
Low Back ◽  
Lumbar Canal Stenosis ◽  
Canal Stenosis ◽  
Estimated Blood Loss ◽  
Group 2 ◽  
Group 1

OBJECTIVEThe aim of this study was to compare the radiological and clinical results of bilateral interlaminar canal decompression and classic laminectomy in lumbar canal stenosis (LCS).METHODSTwo hundred eighteen patients with LCS were randomized to surgical treatment with classic laminectomy (group 1) or bilateral interlaminar canal decompression (group 2). Low-back and leg pain were evaluated according to the visual analog scale (VAS) both preoperatively and postoperatively. Disability was evaluated according to the Oswestry Disability Index (ODI) preoperatively and at 1 month, 1 year, and 3 years postoperatively. Neurogenic claudication was evaluated using the Zurich Claudication Questionnaire (ZCQ) preoperatively and 1 year postoperatively. The two treatment groups were compared in terms of neurogenic claudication, estimated blood loss (EBL), and intra- and postoperative complications.RESULTSPostoperative low-back and leg pain declined as compared to the preoperative pain. Both groups had significant improvement in VAS, ODI, and ZCQ scores, and the improvements in ODI and back pain VAS scores were significantly better in group 2. The average EBL was 140 ml in group 2 compared to 260 ml in group 1. Nine patients in the laminectomy group developed postoperative instability requiring fusion compared to only 4 cases in the interlaminar group (p = 0.15). Complications frequency did not show any statistical significance between the two groups.CONCLUSIONSBilateral interlaminar decompression is an effective method that provides sufficient canal decompression with decreased instability in cases of LCS and increases patient comfort in the postoperative period.

scholarly journals 1439 A Change in The Use of Post-Operative Drains in Total Knee Arthroplasty (TKA)

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
P Erdman ◽  
R Ali ◽  
R Bhattacharya
Keyword(s):  
Blood Loss ◽  
Statistical Significance ◽  
Length Of Hospital Stay ◽  
Social Barriers ◽  
Estimated Blood Loss ◽  
Relevant Variables ◽  
Total Knee ◽  
Group 2 ◽  
Haematoma Formation ◽  
Group 1

Abstract Aim Closed suction drains (CSD) are routinely used to reduce the risk of haematoma formation and wound infections in TKA. Our study aims to determine if the use of drains has any impact on estimated blood loss, transfusion rates and length of stay in hospital. Method Elective TKA cases performed under a single consultant between February 2018-March 2020 were identified. Electronic medical records were reviewed, and data collected on relevant variables. Estimated blood loss was calculated using Ward’s formula. Mann-Whitney U test was applied to assess for statistical significance. Results A total of 86 elective TKA cases were included in the study. In 41 cases patients had a CSD insitu post-operatively (group 1), in the other 45 cases a drain was not used (group 2). Both groups had similar distributions of age, BMI, and sex. We found no statistically significant differences in mean change (+/-SD) in haemoglobin post-operatively between group 1 (21.3 (+/- 9.4)) and group 2 (19 (+/- 10)), (p = 0.34). Mean estimated blood loss was 915mls (+/-365) for group 1 and 871mls (+/-455) for group 2, (p = 0.45). Group 1 had a higher rate of transfusion (4.8% vs 2.2%); however, this was not statistically significant (p = 0.51). After accounting for unrelated medical complications or social barriers to discharge, the length of hospital stay was 4.7 (+/- 2.27) and 4.9 (+/- 3.14) for group 1 and 2 respectively, (p = 0.84). There were no reported cases of wound infection in both groups. Conclusions We found the use of drains in TKA confers no benefits in the outcomes evaluated.

scholarly journals Efficacy of Intradiscal Ozone Therapy with or without Periforaminal Steroid Injection on Lumbar Disc Herniation: A Double-Blinded Controlled Study

2020 ◽  
Vol 5;23 (9;5) ◽  
pp. 477-484
Author(s):  
Tulay Ercalik
Keyword(s):  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Steroid Injection ◽  
Lumbar Disc ◽  
Leg Pain ◽  
Low Back ◽  
Ozone Therapy ◽  
Group 2 ◽  
Double Blinded ◽  
Group 1

Background: Intradiscal ozone therapy, a minimally invasive technique, is used in patients that do not respond to standard conservative therapies for low back pain due to degenerative disc-induced lumbar disc herniation (LDH). Many studies on clinical efficacy lack a standardized injection method and are limited by inadequate study design. Objective: This study aimed to determine the efficacy of periforaminal steroid injection together with intradiscal ozone therapy. Study Design: A prospective, double-blinded, randomized controlled trial. Setting: A tertiary care center. Methods: This study was conducted in 65 patients with low back and leg pain caused by LDH. Group 1 received intradiscal ozone therapy (n = 35) and Group 2 received intradiscal ozone therapy with periforaminal steroid injection (n = 30). Patients were evaluated for pain using the visual analogue scale (VAS), for disability using Oswestry Disability Index (ODI), and for quality of life using the short form 36 health survey administered pre-injection and at one and 6 months postinjection. All procedures were performed under sterile conditions using C-arm fluoroscopy. Results: Significant improvements were observed in pain, disability, and quality of life in both groups post-treatment compared to pre-injection. Mean pre-injection VAS was not significantly different between the groups (VAS: 7.8 ± 1.1 for Group 1, 7.8 ± 1.2 for Group 2). VAS values at 6 months for Group 1 and Group 2 were as follows: 3.6 ± 2.4, 4.1 ± 1.6, respectively) (P < 0.001). Mean pre-injection ODI was not significantly different between the groups (ODI: 20.9 ± 9.6 for Group 1, 25.2 ± 10.3 for Group 2). ODI values at 6 months for Group 1 and Group 2 were as follows: 12.8 ± 9.2, 14.3 ± 7.2, respectively) (P < 0.001). However, there were no significant differences between the groups. Similarly, there was no significant difference between the 2 groups on any of these parameters. Limitations: A limited number of patients and limited follow-up time. Conclusion: This study showed that intradiscal ozone injection alone was sufficient to treat low back and leg pain caused by LDH and that periforaminal steroid injection does not provide additional benefit, which is contrary to the literature. Key words: Low back pain, intradiscal ozone, steroid, lumbar disc herniation, lumbar disc degeneration

scholarly journals ANALYSIS OF INTERBODY VERSUS POSTEROLATERAL FUSION FOR LUMBAR SPONDYLOSIS

2015 ◽  
Vol 14 (4) ◽  
pp. 290-294
Author(s):  
Rodrigo Góes Medéa de Mendonça ◽  
Carlos Alberto Assunção Filho ◽  
Nelson Astur ◽  
Alberto Ofenhejm Gotfryd ◽  
Ricardo Shigueaki Galhego Umeta ◽  
...  
Keyword(s):  
Clinical Evaluation ◽  
Interbody Fusion ◽  
Short Form ◽  
Statistical Significance ◽  
Posterolateral Fusion ◽  
Leg Pain ◽  
Lumbar Spondylosis ◽  
Sf 36 ◽  
Group 2 ◽  
Group 1

Objective : To evaluate and compare radiographic and clinical evaluation of patients undergoing interbody fusion versus posterolateral fusion of the lumbar spine. Methods : Retrospective study of patients diagnosed with lumbar spondylosis that were surgically treated in the period from 2012 to 2014. The results were observed by clinical evaluation by the Visual Analogue Scale (VAS) for low back and leg pain. We evaluated functional results and quality of life through the application of the Oswestry Disability Index (ODI) and the Short Form-36 (SF-36) questionnaires, respectively. The pre and postoperative condition were compared in Group 1 (interbody fusion) and Group 2 (posterolateral fusion), in addition to evaluation of fusion by means of post-operative radiograph. Results : A total of 30 patients of 36 were eligible, 12 in Group 1 and 18 in Group 2. The mean follow-up was 10.1 months. Statistical analysis showed similar scores for back and leg pain VAS, SF-36 function scores and Oswestry between groups with interbody and posterolateral fusion, and compared within these groups regarding the pre- and postoperative condition, and found no statistical significance. The successful fusion was similar in both groups, with 11 of 12 patients in Group 1 showing bone fusion and 17 of 18 in Group 2 showing arthrodesis. Conclusion : No clinical or radiographic differences between patients who underwent posterolateral or interbody fusion were observed. Both methods showed improvement in functional outcome and pain reduction.

VAS score assessment for outcome of posterior lumbar inter body fusion in cases of lumbar canal stenosis

2016 ◽  
Vol 2 (3) ◽  
pp. 163
Author(s):  
Harish Murthy ◽  
T V S Reddy
Keyword(s):  
Back Pain ◽  
Statistical Significance ◽  
Tertiary Care ◽  
Posterior Lumbar Interbody Fusion ◽  
Leg Pain ◽  
Lumbosacral Spine ◽  
Lumbar Canal Stenosis ◽  
Vas Score ◽  
Canal Stenosis ◽  
Significant Difference

<p class="abstract"><strong>Background:</strong> One of the major causes for disability in adult working population is degenerative lumbosacral spine disorders are fairly common in middle aged and elderly population. Lumbar canal stenosis remains one of the most frequently encountered clinically important degenerative spinal disorders requiring operative treatment in the aging population. The objective of the present study is to assess the outcome of posterior lumbar inter body fusion in cases of lumbar canal stenosis</p><p class="abstract"><strong>Methods:</strong> The present study, 30 cases of lumbar canal stenosis, who were treated operatively with decompression and posterior lumbar inter body fusion, which was carried out over a period of 6 months in a tertiary care center were included. 16 women and 14 men were included in the study.<strong></strong></p><p><strong>Results:</strong> Most patients were in the age group of 41-50 years (36.7%) followed by 51-60 years (33.3%). In this study it was found that there was significant improvement in VAS score for back pain and leg pain over the 6 month follow-up. There is significant difference between mean improvement in VAS score with respect to number of levels involved for leg pain (p =0.01).  There is no statistical significance difference between number of levels involved and improvement in back pain (p =0.66).</p><strong>Conclusions:</strong>VAS score showed posterior lumbar interbody fusion with interbody cage and local graft with posterior instrumentation gave significantly improved clinical and functional outcome by causing significant reduction in pain and patient disability.<p> </p>

EVALUATION OF THE EFECTS OF EMBEDDING THERAPY AND ELECTRONIC ACUPUNCTURE COMBINED WITH “DOC HOAT TANG KY SINH” REMEDY IN THE TREATMENT OF LOW BACK PAIN BY OSTEOARTHRITIS

2016 ◽  
pp. 33-38
Author(s):  
Thi Ngoc Dung Thai ◽  
Thi Tan Nguyen
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Effective Treatment ◽  
Key Words ◽  
Low Back ◽  
Good Level ◽  
Embedding Therapy ◽  
The World ◽  
Group 2 ◽  
Group 1

Background: Low back pain by osteoarthristis is one of the most common diseases in the world as well as in Vietnam, estimated 70-85% people in the world have low back pain sometime in their lives. Obiectives: To evaluate the effects of embedding therapy and electronic acupuncture combined with “Doc hoat tang ky sinh” remedy in the treatment of low back pain by spondylosis. Materials and methods: 72 patients diagnosed of low back pain by spondylosis, were examined and treated at Phu Yen Traditional Medicine Hospital, divided equally into 2 groups (group 1 and group 2). Results: In group 1: Effective treatment at good and fair good level accounted for 41.7% and 41.7%. In group 2: Good level occupied 33.3% and fair good level occupied 55.6%. Conclusion: The ratios of good and fair good in 2 groups were equal (p >0.05) Key words: Low back pain, spondylosis, embedding therapy, electronic acupuncture

CD34 immunostain increases sensitivity of the diagnosis of fetal vascular malperfusion in placentas from ex-utero intrapartum treatment

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Jerzy Stanek
Keyword(s):  
Statistical Significance ◽  
Treatment Procedure ◽  
Fetal Survival ◽  
Ex Utero Intrapartum Treatment ◽  
Life Threatening ◽  
Group 2 ◽  
Cd34 Immunostain ◽  
The Impact ◽  
Diaphragmatic Hernias ◽  
Group 1

AbstractShort CommunicationsEXIT (ex-utero intrapartum treatment) procedure is a fetal survival-increasing modification of cesarean section. Previously we found an increase incidence of fetal vascular malperfusion (FVM) in placentas from EXIT procedures which indicates the underlying stasis of fetal blood flow in such cases. This retrospective analysis analyzes the impact of the recently introduced CD34 immunostain for the FVM diagnosis in placentas from EXIT procedures.Objectives and MethodsA total of 105 placentas from EXIT procedures (48 to airway, 43 to ECMO and 14 to resection) were studied. In 73 older cases, the placental histological diagnosis of segmental FVM was made on H&E stained placental sections only (segmental villous avascularity) (Group 1), while in 32 most recent cases, the CD34 component of a double E-cadherin/CD34 immunostain slides was also routinely used to detect the early FVM (endothelial fragmentation, villous hypovascularity) (Group 2). 23 clinical and 47 independent placental phenotypes were compared by χ2 or ANOVA, where appropriate.ResultsThere was no statistical significance between the groups in rates of segmental villous avascularity (29 vs. 34%), but performing CD34 immunostain resulted in adding and/or upgrading 12 more cases of segmental FVM in Group 2, thus increasing the sensitivity of placental examination for FVM by 37%. There were no other statistically significantly differences in clinical (except for congenital diaphragmatic hernias statistically significantly more common in Group 2, 34 vs 56%, p=0.03) and placental phenotypes, proving the otherwise comparability of the groups.ConclusionsThe use of CD34 immunostain increases the sensitivity of placental examination for FVM by 1/3, which may improve the neonatal management by revealing the increased likelihood of the potentially life-threatening neonatal complications.

scholarly journals POS0888 EPIDEMIOLOGICAL AND CLINICAL DIFFERENCES BETWEEN ANTI-MDA5 PHENOTYPES: DATA FROM A LARGE COHORT (MEDRA5) STUDY

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 700.1-700
Author(s):  
E. Trallero-Araguás ◽  
F. Romero ◽  
I. Castellví ◽  
V. Ortiz-Santamaria ◽  
S. Castañeda ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Statistical Significance ◽  
Disease Onset ◽  
Amyopathic Dermatomyositis ◽  
Clinically Amyopathic Dermatomyositis ◽  
San Sebastian ◽  
Group 3 ◽  
Group 2 ◽  
Hospital General ◽  
Group 1

Background:Idiopathic inflammatory myopathies are a heterogenous group of systemic autoimmune diseases. Several phenotypes have been linked to specific autoantibodies. Clinically amyopathic dermatomyositis with rapidly progressive interstitial lung disease, the most severe form of ILD, is associated with the anti-MDA5 antibodies. However not all the patients with dermatomyositis and anti-MDA5 positive antibodies develop this severe condition.Objectives:We aim to define different phenotypes from a large cohort of patients diagnosed with dermatomyositis who were positive to anti-MDA5 antibodies.Methods:We retrospective analyzed the clinical and immunological data of 90 anti-MDA5 patients [50 female, 55.6%, mean (SD) age at diagnosis 47 (15.4) yrs.] with dermatomyositis recruited from a multicenter register in Spain (MEDRA5) including 30 hospitals. All the patients fulfill de International Myositis Classification Criteria (EULAR/ACR) for dermatomyositis (score >90%). Anti-MDA5 were detected by means of commercial immunoblot (EUROIMMUN©). The chi-square test was used to assess the relationships between qualitative variables. The Kruskal-Wallis test was used to compared medians between groups.Results:Sixty-six patients (73.3%) were diagnosed with clinically amyopathic dermatomyositis. Three different phenotypes linked with the anti-MDA5 antibody were identified. Group 1: patients with rapidly-ILD phenotype (28 patients, 31.1%), group 2: antisynthetase-like phenotype (23 patients, 25.5%), and group 3: non-ILD phenotype (39 patients, 43.3%). Clinical and immunological comparison between the groups disclosed that age at disease onset was higher (median, IQR) in patients from group 1 [53 (43-60)] vs. group 2 [46 (40-56)] or group 3 [42(41-51)] (p=0.01); disease onset was more frequent in spring in patients from group 1 (46.5%) than in the rest of the groups (21.7% and 28.9%) (p<0.01). Cancer was detected in 7 patients, only associated with myositis in 3 cases (3 years interval between cancer and dermatomyositis) without significant differences between phenotypes. Vasculitis (one case ANCA positive) was detected in 9 cases (6 limited to skin, 1 renal and 1 intestinal), 6 of them in the group 3 (statistical significance, in comparison with group 1 and 2, p<0.01). Mortality rate was higher in group 1 (51.9%, 16 out of 17 due to refractory respiratory failure) vs group 2 (12.5%) or 3 (0%) (p<0.001). Anti Ro52 positivity was more frequent in group 1 (65.4%) vs. group 2 (25%) or 3 (35.5%) (p<0.017), although it did not reach statistical significance in terms of mortality (p=0.173) or patients admitted in the intensive care unit (p=0.173). Mechanic hands were more frequent in group 2 (40.6%) than in groups 1 (25%) and 3 (34.4%) (p=0.05). Fever was significantly most frequent in group 1(52.6%) than in group 2 (21.1%) and 3 (26.3%) (p=0.001). Other clinical or immunological features such as arthritis, myositis, or the number of characteristic skin lesions among others were not more frequent in one group or another.Conclusion:Three different phenotypes of patients positive to anti-MDA5 were identified. The presence or not of ILD, or the different type (rapidly progressive or not) of ILD were the main feature that allow to differentiate these phenotypes, which are relevant in clinical practice.References:[1]Allenbach Y, Uzunhan Y, Toquet S, et al; French Myositis Network. Different phenotypes in dermatomyositis associated with anti-MDA5 antibody: Study of 121 cases. Neurology. 2020;95: e70-e78.Acknowledgements:List of contributors of MEDRA5 group: Aguilar-García J (Internal Medicine, Hospital Costa del Sol, Marbella), Carrión-Barberá I (Rheumatology, Hospital del Mar, Barcelona), Cobo-Ibañez T (Rheumatology, Hospital Infanta Sofía, San Sebastián de los Reyes), de Escalante-Yangüela B (Internal Medicine, Hospital Clínico Lozano Blesa, Zaragoza), Fonseca-Aizpuru EM (Internal Medicine, Hospital de Cabueñes, Gijón), González-Cubillo L (Intensive Medicine, Hospital Universitario de Cruces, Barakaldo), González-Gay MA (Rheumatology, Hospital Marqués de Valdecilla, Santander), Prieto-González S (Internal Medicine, Hospital Clinic, Barcelona), Ruiz-Román A (Rheumatology, Hospital Universitario Virgen del Rocío, Sevilla), Calero-Paniagua I (Internal Medicine, Hospital Virgen de la Luz, Cuenca), Callejas-Rubio JL (Internal Medicine, Hospital Clínico San Cecilio, Granada), Gil-Vila A (Internal Medicine, Hospital Vall d’Hebron, Barcelona), de Miguel-Campo B (Internal Medicine, Hospital Doce de Octubre, Madrid), García-Sevilla R (Pneumology, Hospital General Universitario de Alicante, Alicante), Iriarte-Fuster A (Internal Medicine, Hospital de Bellvitge, Hospitalet de Llobregat), Jovani-Casano V (Rheumatology, Hospital General Universitario de Alicante, Alicante), Lozano-Rivas N (Rheumatology, Hospital Virgen de la Arritxaca, Murcia), Martín-Gascón M (Internal Medicine, Hospital Morales Meseguer, Murcia), Martinez-González O (Rheumatology, Hospital Universitario de Salamanca, Salamanca), Monteagudo-Jiménez M (Internal Medicine, Hospital Parc Taulí, Sabadell), Mora-Ortega GM (Pneumology, Hospital Universitario Infanta Sofía, San Sebastián de los Reyes), Moral-Moral Pedro (Internal Medicine, Hospital Universitari i Politecnic La Fe, Valencia), Pérez-De Pedro I (Interna Medicine, Hospital Regional Universitario de Málaga, Málaga), Picazo-Talavera MR (Rheumatology, Hospital del Sureste, Madrid), Rubio-Rivas M (Internal Medicine, Hospital de Bellvitge, Hospitalet de Llobregat)Disclosure of Interests:None declared

scholarly journals MRI Spectrum of Japanese Encephalitis in Northeast India: A Cross-Sectional Study

2021 ◽  
Vol 12 (02) ◽  
pp. 281-289
Author(s):  
Pranjal Phukan ◽  
Kalyan Sarma ◽  
Barun Kumar Sharma ◽  
Deb K. Boruah ◽  
Bidyut Bikash Gogoi ◽  
...  
Keyword(s):  
Japanese Encephalitis ◽  
Statistical Significance ◽  
Tertiary Care ◽  
Care Hospital ◽  
Mri Findings ◽  
Mri Scan ◽  
Cross Sectional ◽  
Adc Value ◽  
Group 2 ◽  
Group 1

Abstract Objective Japanese encephalitis (JE) is an arthropod-borne flavivirus infection having high mortality and morbidity. This study was performed to evaluate the conventional magnetic resonance imaging (MRI) findings in JE and to find out any difference between pediatric and adult JE. Materials and Methods This retrospective study was performed on serologically positive 54 JE patients presented to a tertiary care hospital with acute encephalitic symptoms between April 2016 and October 2019. Relevant neurological examination, cerebrospinal fluid analysis, and MRI scan of the brain were performed. Results Fifty-four JE patients (n = 31 males and n = 23 females) having 32 pediatric and 22 adult JE were included in the study sample. Group 1 JE (n = 16) patients had encephalitic symptoms with duration less than 15 days up to the day of MRI scan and group 2 JE (n = 38) had symptoms more than 15 days. Group 1 JE had mean apparent diffusion coefficient (ADC) value of 0.563 ± 0.109 (standard deviation [SD]) × 10–3 mm2/sec and group 2 JE had 1.095 ± 0.206 (SD) × 10–3 mm2/sec. The mean ADC value of pediatric JE was 0.907 ± 0.336 (SD) × 10–3 mm2/sec and adult JE was 0.982 ± 0.253 (SD) × 10–3 mm2/sec. Conclusion The majority of the JE patient shows abnormal signal alterations in bilateral thalami and substantia nigra. Diffusion-weighted imaging with ADC mapping helps in evaluating the stage of the JE. No statistical significance of the various conventional MRI findings was found between the pediatric JE and adult JE.

scholarly journals Impact of percutaneous embolization versus subinguinal microsurgical ligation on semen parameters in primary varicocele patients: comparative study

2020 ◽  
Vol 51 (1) ◽  
Author(s):  
Haytham M. Nasser ◽  
Ahmed Hussein ◽  
Gad M. Behairy ◽  
Mostafa Abdo
Keyword(s):  
Sperm Count ◽  
Semen Analysis ◽  
Statistical Significance ◽  
Semen Parameters ◽  
Male Factor ◽  
Percutaneous Embolization ◽  
Significant Difference ◽  
Group 2 ◽  
Group 1

Abstract Background Varicocele is an abnormally dilated pampiniform plexus of the veins within the spermatic cord and is considered the most common correctable cause of male factor infertility. Many approaches are described for treatment either surgical (tradition inguinal, subinguinal, and laparoscopic) or non-surgical percutaneous embolization. During the period from August 2017 to December 2018, we prospectively analyzed the preoperative and post-operative alteration of semen parameters (at 3 and 9 months) of the data collected from 63 patients with clinically evident varicocele referred to our tertiary hospital. Patients were divided into two groups: group 1, thirty-three patients who underwent subinguinal microsurgical ligation, and group 2, thirty patients who underwent percutaneous embolization. Results Sixty-three patients enrolled in this study were divided in two groups: group 1, patients who underwent surgery, and group 2, patients who underwent embolization; the mean age is 24.6 ± 1.27 years in group 1 and 23.7 ± 2 years in group 2; there was no statistically significant difference between the two groups as regards BMI, diabetes, hypertension, and smoking. Bilaterality was present in 15.2% of group 1 patients and 10% in group 2 patients (P value 0.06). Most of the patients were classified as grades 2 and 3 with no statistical significance regarding severity of the disease. Preoperative semen parameters for patients including sperm count, motility, and abnormal forms showed no statistically significant difference between the two groups. Post-intervention semen analysis was done twice during follow-up after 3 months and 9 months from the date of intervention. After 3 months, the semen parameters were improved in both groups in spite of the higher sperm count in group 2 but with no statistical significance. After 9 months follow-up, semen analysis showed persistent increase in sperm mobility in group 1 patients in comparison to group 2 patients. Both groups had better improvement in count of normal form with no statistical significant change. Conclusion Improvement of semen parameters while treating primary varicocele by either subinguinal microsurgery approach or percutaneous embolization shows equivalent outcomes.

Alloplastic or Autologous? Bone Chips versus PEEK Cage for Lumbar Interbody Fusion in Degenerative Spondylolisthesis

2021 ◽  
Author(s):  
Stefan Koehler ◽  
Christopher Held ◽  
Christian Stetter ◽  
Thomas Westermaier
Keyword(s):  
Interbody Fusion ◽  
Posterior Instrumentation ◽  
Degenerative Spondylolisthesis ◽  
Leg Pain ◽  
Lumbar Interbody Fusion ◽  
Peek Cage ◽  
Cheap Alternative ◽  
Autologous Bone ◽  
Group 2 ◽  
Group 1

Abstract Introduction This study was conducted to compare bone-filled intervertebral cages with autologous bone chips for instrumented lumbar interbody fusion in patients with spinal stenosis and degenerative spondylolisthesis. Methods Surgery consisted of posterior instrumentation and decompression, diskectomy, and intervertebral fusion using a polyetheretherketone (PEEK) cage surrounded and filled with spongious bone chips (group 1, n = 57) or spongious bone chips alone (group 2, n = 37). The choice of method was left to the discretion of the surgeon. Postoperative results were prospectively evaluated using a standardized protocol. Radiological assessment included fusion rates and vertebral height, while clinical assessment included the visual analog scale (VAS) and Oswestry Disability Index (ODI). Results In group 1, a mean of 1.38 ± 0.64 segments were fused. In group 2, a mean of 1.58 ± 0.65 segments were fused. In both groups, the VAS for back pain and leg pain and the ODI improved without significant differences between the two groups. Osseous fusion was documented by computerized tomography in 73% in group 1 and 89% in group 2 after a mean of 18 months. The loss of height was 2.8 ± 4.0% in group 1 and 2.4 ± 5.2% in group 2. Conclusion Regardless of whether a PEEK cage filled with spongious bone chips or spongious bone chips alone were used for lumbar interbody fusion, clinical parameters improved significantly after surgery. There were no significant differences in the rate of bony fusion and loss of height between the two groups. The results of this nonrandomized cohort study indicate that the implantation of autologous spongious bone chips harvested during the decompression procedure is a useful and cheap alternative to an intervertebral cage in patients with degenerative pseudospondylolisthesis.

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