scholarly journals Pathophysiology and surgical treatment of spinal adhesive arachnoid pathology: patient series

2021 ◽  
Vol 2 (16) ◽  
Author(s):  
Izumi Koyanagi ◽  
Yasuhiro Chiba ◽  
Genki Uemori ◽  
Hiroyuki Imamura ◽  
Masami Yoshino ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Spinal Surgery ◽  
Cyst Formation ◽  
Anterior Decompression ◽  
Venous Circulation ◽  
Thoracic Level ◽  
Hemorrhagic Events ◽  
Secondary Pathology ◽  
Patient Series

BACKGROUND Spinal adhesive arachnoid pathology is a rare cause of myelopathy. Because of rarity and variability, mechanisms of myelopathy are unknown. The authors retrospectively analyzed patients to understand pathophysiology and provide implications for surgical treatment. OBSERVATIONS Nineteen consecutive patients were studied. Thirteen patients had a secondary pathology due to etiological disorders such as spinal surgery or hemorrhagic events. They received arachnoid lysis (4 patients), syringo-subarachnoid (S-S) shunt (8 patients) with or without lysis, or anterior decompression. Three of them developed motor deterioration after lysis, and 6 patients needed further 8 surgeries. Another 6 patients had idiopathic pathology showing dorsal arachnoid cyst formation at the thoracic level that was surgically resected. With mean follow-up of 44.3 months, only 4 patients with the secondary pathology showed improved neurological grade, whereas all patients with idiopathic pathology showed improvement. LESSONS The idiopathic pathology was the localized dorsal arachnoid adhesion that responded to surgical treatment. The secondary pathology produced disturbed venous circulation of the spinal cord by extensive adhesions. Lysis of the thickened fibrous membrane with preservation of thin arachnoid over the spinal veins may provide safe decompression. S-S shunt was effective if the syrinx extended to the level of normal subarachnoid space.

scholarly journals NONCOMPLICATED UNSTABLE SPINE INJURIES IN CHILDREN

2005 ◽  
pp. 008-012 ◽  
Author(s):  
Eduard Vladimirovich Ulrikh ◽  
Sergey Valentinivich Vissarionov ◽  
Aleksandr Yuryevich Mushkin
Keyword(s):  
Surgical Treatment ◽  
Posterior Instrumentation ◽  
Spinal Injuries ◽  
Anterior Decompression ◽  
Two Stage ◽  
Spinal Stabilization ◽  
Spine Injuries ◽  
Group A ◽  
Bone Autograft

Thirty-four patients aged from 3 to 17 years were operated on for noncomplicated unstable injuries of the spine. The operation was performed within the next few hours or days after trauma in 15 cases and significantly later (in 2 to 6 months) in 19 cases. In the first group the surgery included indirect posterior instrumental reduction and stabilization of the spine. In the second group a two-stage surgery was performed simultaneously. The first stage included anterior decompression and stabilization, and the second – posterior instrumentation. In both groups the posterior fusion with bone autograft was done. The post-op follow-up was 5 years. The correction of deformity, spinal stabilization and pain arrest were achieved in all cases. The surgical treatment of unstable noncomplicated spinal injuries in children must be conducted by emergency indications within the first hours and days after trauma.

La RM nelle sequele dei traumi spinali

1997 ◽  
Vol 10 (2_suppl) ◽  
pp. 192-195 ◽  
Author(s):  
G. Pellicanò ◽  
G. Caracchini ◽  
M. D'Andrea ◽  
M. Bartolucci ◽  
I. Del Seppia ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Surgical Treatment ◽  
Acute Phase ◽  
Vertebral Body ◽  
Neurological Symptoms ◽  
Spinal Cord Lesions ◽  
Guided Surgery ◽  
Thoracic Level ◽  
Post Traumatic

From January 1990 to April 1997 we retrospectively evaluated 90 patients with MR examinations at our Spine Unit. The following post-traumatic spinal cord lesions were diagnosed: atrophy (47 pts), myelomalacia (40 pts), cysts (14), syrinx (14) and medullary transection with adhesion(4 pts). MR was very useful to identify atrophy more frequently found at the cervical-thoracic level (C6-D3). Myelomalcia was found in a patient with severe vertebral body trauma with chronic compression of the spinal cord. Intramedullary cysts were found in patients with hematomyelia in acute phase and were stable lesions. Post-traumatic syringomyelia is the most important sequela due to the fact that is often correlated with symptoms. MR not only detected the lesion but also identified intramedullary cavities without new neurological symptoms and guided surgery and follow-up. MR is the examination of choice not only for diagnosis of chronic spinal cord lesions but also to evaluate the possibility of surgical treatment.

Surgical treatment of terrible triad of the elbow: retrospective continuous 50-patient series at 2 years’ follow-up

2021 ◽  
pp. 103057
Author(s):  
Clémentine Corbet ◽  
Mehdi Boudissa ◽  
Séverine Dao Lena ◽  
Sébastien Ruatti ◽  
Denis Corcella ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Terrible Triad ◽  
Patient Series

Epicardial cryoablation as surgical treatment for atrial fibrillation: One year follow up in 84 patients

2008 ◽  
Vol 56 (S 1) ◽  
Author(s):  
R Uhl ◽  
I Marcolino ◽  
E Zimmer ◽  
F Beyersdorf ◽  
E Eschenbruch
Keyword(s):  
Atrial Fibrillation ◽  
Surgical Treatment ◽  
One Year

Case of follow-up and successful surgical treatment rare form of subaortic membrane in infant

2017 ◽  
Vol 14 (3) ◽  
pp. 161-165
Author(s):  
A.I. Kim ◽  
Т.V. Rogova ◽  
R.М. Кurganov ◽  
Е.V. Kholmanskaya
Keyword(s):  
Surgical Treatment ◽  
Rare Form ◽  
Subaortic Membrane

Delayed Pancreatic Metastasis of Renal Clear Cell Carcinoma

2013 ◽  
Vol 13 (2) ◽  
pp. 79-80
Author(s):  
Zane Simtniece ◽  
Gatis Kirsakmens ◽  
Ilze Strumfa ◽  
Andrejs Vanags ◽  
Maris Pavars ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Surgical Treatment ◽  
Cell Carcinoma ◽  
Clear Cell ◽  
Clear Cell Carcinoma ◽  
Primary Tumour ◽  
Renal Clear Cell Carcinoma ◽  
Pancreatic Metastasis ◽  
Distal Pancreatic Resection

Abstract Here, we report surgical treatment of a patient presenting with pancreatic metastasis (MTS) of renal clear cell carcinoma (RCC) 11 years after nephrectomy. RCC is one of few cancers that metastasise in pancreas. Jaundice, abdominal pain or gastrointestinal bleeding can develop; however, asymptomatic MTS can be discovered by follow-up after removal of the primary tumour. The patient, 67-year-old female was radiologically diagnosed with a clinically silent mass in the pancreatic body and underwent distal pancreatic resection. The postoperative period was smooth. Four months after the surgery, there were no signs of disease progression.

Patients with “benign” Chiari I malformations require surgical decompression at a low rate

2019 ◽  
Vol 23 (4) ◽  
pp. 498-506 ◽  
Author(s):  
Tofey J. Leon ◽  
Elizabeth N. Kuhn ◽  
Anastasia A. Arynchyna ◽  
Burkely P. Smith ◽  
R. Shane Tubbs ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Posterior Fossa ◽  
Multivariate Logistic Regression Analysis ◽  
Large Cohort ◽  
Initial Evaluation ◽  
Published Data ◽  
Posterior Fossa Decompression ◽  
Signal Abnormality ◽  
Chiari I

OBJECTIVEThere are sparse published data on the natural history of “benign” Chiari I malformation (CM-I)—i.e., Chiari with minimal or no symptoms at presentation and no imaging evidence of syrinx, hydrocephalus, or spinal cord signal abnormality. The purpose of this study was to review a large cohort of children with benign CM-I and to determine whether these children become symptomatic and require surgical treatment.METHODSPatients were identified from institutional outpatient records using International Classification of Diseases, 9th Revision, diagnosis codes for CM-I from 1996 to 2016. After review of the medical records, patients were excluded if they 1) did not have a diagnosis of CM-I, 2) were not evaluated by a neurosurgeon, 3) had previously undergone posterior fossa decompression, or 4) had imaging evidence of syringomyelia at their first appointment. To include only patients with benign Chiari (without syrinx or classic Chiari symptoms that could prompt immediate intervention), any patient who underwent decompression within 9 months of initial evaluation was excluded. After a detailed chart review, patients were excluded if they had classical Chiari malformation symptoms at presentation. The authors then determined what changes in the clinical picture prompted surgical treatment. Patients were excluded from the multivariate logistic regression analysis if they had missing data such as race and insurance; however, these patients were included in the overall survival analysis.RESULTSA total of 427 patients were included for analysis with a median follow-up duration of 25.5 months (range 0.17–179.1 months) after initial evaluation. Fifteen patients had surgery at a median time of 21.0 months (range 11.3–139.3 months) after initial evaluation. The most common indications for surgery were tussive headache in 5 (33.3%), syringomyelia in 5 (33.3%), and nontussive headache in 5 (33.3%). Using the Kaplan-Meier method, rate of freedom from posterior fossa decompression was 95.8%, 94.1%, and 93.1% at 3, 5, and 10 years, respectively.CONCLUSIONSAmong a large cohort of patients with benign CM-I, progression of imaging abnormalities or symptoms that warrant surgical treatment is infrequent. Therefore, these patients should be managed conservatively. However, clinical follow-up of such individuals is justified, as there is a low, but nonzero, rate of new symptom or syringomyelia development. Future analyses will determine whether imaging or clinical features present at initial evaluation are associated with progression and future need for treatment.

Thyroidectomy in a patient with a giant multinodular nontoxic cervical retrosternal goiter

2020 ◽  
pp. 97-99
Author(s):  
U. V. Kukhtenko ◽  
O. A. Kosivtsov ◽  
L. A. Ryaskov ◽  
E. I. Abramian
Keyword(s):  
Surgical Treatment ◽  
Clinical Case ◽  
Clinical Signs ◽  
Disease Relapse ◽  
Cardiac Pathology ◽  
Nontoxic Goiter ◽  
Retrosternal Goiter

A clinical case of successful surgical treatment of a patient with a giant cervical retrosternal nontoxic goiter with severe cardiac pathology is presented. Thyroidectomy from cervical access without sternotomy was performed. At the follow-up examination 5 months after the operation, instrumental and clinical signs of disease relapse were not detected.

TRATAMENTO CIRÚRGICO DE CANINO INCLUSO EM REGIÃO MENTUAL: RELATO DE CASO

2019 ◽  
Author(s):  
Rodrigo Figueiredo de Brito Resende
Keyword(s):  
Surgical Treatment ◽  
Key Words ◽  
Oral Surgery ◽  
Tooth Eruption ◽  
Points Of View ◽  
The Aesthetic ◽  
Relationship Of ◽  
Transverse Position

RESUMOO dente denominado incluso nada mais é que um dente retido ou impactado dentro do alvéolo dentário de maneira parcial ou completa que não conseguiu erupcionar por motivos patológicos ou simplesmente anatômicos após o período de rizogênese. O canino, em especial, é de suma importância sob os pontos de vista estético e funcional. O deslocamento do canino incluso ultrapassando, ou se aproximando da linha média antes da erupção dentária do mesmo, é mais frequente na mandíbula do que na maxila.  Este trabalho tem por objetivo descrever o caso de um paciente de 21 anos que apresentava um canino incluso na região mentual, em posição transversal, inicialmente visualizado em uma radiografia periapical e posteriormente submetido a radiografia com a técnica de Donavan. Através de uma radiografia oclusal, foi possível observar o posicionamento do dente para a vestibular mentoniana e íntima relação do dente retido com as raízes dos incisivos centrais decíduos do paciente. Foi realizada a extração do dente retido no mento, removendo o mesmo por completo sendo feitas osteotomias e odontossecções. O paciente está em acompanhamento clínico à 1 ano após o tratamento cirúrgico.Palavras – chave: Dente incluso; Cirurgia Oral; Imaginologia. ABSTRACTThe tooth inserted  is nothing more than a tooth retained or impacted within the dental socket partially or completely that failed to erupt for pathological or simply anatomical reasons after the period of rhizogenesis. The canine, in particular, is of the utmost importance from the aesthetic and functional points of view. The displacement of the canine, even surpassing or approaching the midline before tooth eruption, is more frequent in the mandible than in the maxilla. This work aims to describe the case of a 21 - year - old patient who had a canine included in the mental region, in a transverse position, which was initially visualized on a periapical radiograph and later submitted to radiography with the Donavan technique. An occlusal radiograph showed the positioning of the tooth for the mental vestibular and the intima relationship of the retained tooth with the roots of the patient's central deciduous incisors. Removal of the tooth retained in the denture was performed, removing the tooth completely and osteotomies and odontosections were performed. The patient is in clinical follow-up at 1 year after the surgical treatment. key words: Tooth included; Oral surgery; Imaginology.  

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