scholarly journals Cervical spondylotic myelopathy: surgical decision making

1996 ◽  
Vol 1 (6) ◽  
pp. E3 ◽  
Author(s):  
Sait Naderi ◽  
Edward C. Benzel ◽  
Nevan G. Baldwin
Keyword(s):  
Decision Making ◽  
Surgical Treatment ◽  
Surgical Approach ◽  
Cervical Spondylotic Myelopathy ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Controversial Issue ◽  
Surgical Decision ◽  
Clinical Signs And Symptoms ◽  
Surgical Decision Making

Cervical spondylotic myelopathy can produce a variety of clinical signs and symptoms secondary to neural compromise and biomechanical involvement of the spine. The surgical treatment of cervical spondylotic myelopathy remains a controversial issue after many years of study, evolution, and refinement. Several ventral, dorsal, or combined approaches have been defined. The complications associated with ventral approaches and the concerns about kyphosis following dorsal approaches led to the development of a variety of laminoplasty procedures. This paper reviews the biomechanical basis of cervical spondylotic myelopathy and its effect on choosing the appropriate surgical approach.

scholarly journals Appendicitis in puerpeium: Case report

2011 ◽  
Vol 58 (4) ◽  
pp. 111-112 ◽  
Author(s):  
Milica Berisavac ◽  
Biljana Kastratovic-Kotlica ◽  
V. Tosic ◽  
N. Markovic ◽  
S. Ljustina ◽  
...  
Keyword(s):  
Case Report ◽  
Surgical Treatment ◽  
Early Detection ◽  
Acute Appendicitis ◽  
Abdominal Wall ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Laboratory Infection ◽  
Infection Parameters ◽  
Clinical Signs And Symptoms

Acute appendicitis in puerperium is often diagnosed too late, because clinical signs can be unrelaible. Abdominal wall rigidity is rarely noticed in puerpeium because of weak abdominal wall muscles, laboratory parameters are not enough relaible and atipycal appendix presentation makes difficulties in diagnosis3,4. Knowing clinical signs and symptoms of appendicitis, possible complications and their early detection, make a chance for a good surgical outcome. Measuring of axillar and rectal temperature can take confusion in, and prolong time until surgical treatment. Leucocytosis in puerperium is not valid for diagnosis. We report a case of patient in puerperium with high laboratory infection parameters. Diagnosis of appendicitis is made based on clinical signs and symptoms, that is proved intraoperatively and histologicaly. Appendectomy without perforation carries less risks for mother and fetus.

Is Modified K-line a Powerful Tool of Surgical Decision Making for Patients With Cervical Spondylotic Myelopathy?

2019 ◽  
Vol 32 (9) ◽  
pp. 351-356 ◽  
Author(s):  
Takashi Hirai ◽  
Toshitaka Yoshii ◽  
Hiroyuki Inose ◽  
Masato Yuasa ◽  
Tsuyoshi Yamada ◽  
...  
Keyword(s):  
Decision Making ◽  
Cervical Spondylotic Myelopathy ◽  
Surgical Decision ◽  
Surgical Decision Making

scholarly journals Operative Treatment of Cervical Myelopathy: Cervical Laminoplasty

2012 ◽  
Vol 2012 ◽  
pp. 1-5 ◽  
Author(s):  
Brett A. Braly ◽  
David Lunardini ◽  
Chris Cornett ◽  
William F. Donaldson
Keyword(s):  
Surgical Technique ◽  
Cervical Spondylotic Myelopathy ◽  
Surgical Intervention ◽  
Treatment Options ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Technical Difficulty ◽  
Cervical Laminoplasty ◽  
Open Door ◽  
Clinical Signs And Symptoms

Cervical spondylotic myelopathy (CSM) is a degenerative process which may result in clinical signs and symptoms which require surgical intervention. Many treatment options have been proposed with various degrees of technical difficulty and technique sensitive benefits. We review laminoplasty as a motion-sparing posterior decompressive method. Current literature supports the use of laminoplasty for indicated decompression. We also decribe our surgical technique for an open-door, or “hinged”, laminoplasty.

scholarly journals Currarino Syndrome in a China children’s health institute: on diagnosis and surgical treatment

2020 ◽  
Author(s):  
Wenbo Pang ◽  
Yajun Chen ◽  
Chunhui Peng ◽  
Kai Wang ◽  
Xiang Qi ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Operative Treatment ◽  
Multidisciplinary Approach ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Bowel Function ◽  
Currarino Syndrome ◽  
Clinical Signs And Symptoms ◽  
Prompt Diagnosis

Abstract Background Currarino syndrome is a rare disease which needs multidisciplinary management. Misdiagnosis with mal-management is common in children. This study was to summarize the clinical features of children diagnosed with Currarino syndrome in a China institute, with an emphasis on diagnosis and surgical treatment, in order to aid in the diagnosis and determination of the optimal operative treatment. Results From 2016 to 2018, seven patients were diagnosed with Currarino syndrome in our department. One patient was male and six were female, with an admission age of 27.00(16.00, 44.00) months. In four patients, diagnosis of the presacral masses had been missed. Ultrasonography, plain sacral radiographs, contrast enemas and magnetic resonance imaging are necessary for the prompt diagnosis of this syndrome. The initial treatment involved a sagittal anorectoplasty and resection of the mass, followed by a defunctioning ostomy and closure of the stoma in a staged multidisciplinary approach. A limited sagittal route was chosen for the surgical treatment in this group. After closure of the ileostomy or colostomy, bowel function was satisfactory in all children. Conclusion Improved knowledge of the different clinical signs and symptoms of Currarino syndrome will result in appropriate imaging and prompt diagnosis. A protocol with rational timing of multidisciplinary surgical procedures may help to avoid undesirable outcomes. The limited sagittal route is available for effective operative treatment.

CHILDHOOD HYPERTHYROIDISM

1966 ◽  
Vol 51 (3) ◽  
pp. 321-336 ◽  
Author(s):  
J. Mäenpää ◽  
H. Hiekkala ◽  
B.-A. Lamberg
Keyword(s):  
Surgical Approach ◽  
Thyroid Nodules ◽  
Radioactive Iodine ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Nodular Goitre ◽  
Close Observation ◽  
Conservative Attitude ◽  
Clinical Signs And Symptoms

ABSTRACT Thirty-nine patients with childhood hyperthyroidism were treated during the period 1950-1964, most of them after 1955. The youngest patient was 3 years old. Thyroid nodules occurred in 55 per cent of the cases. In 25 patients long-term anti-thyroid treatment was instituted. This therapy was considered as successful in 7 instances (29 per cent). Four patients (17 per cent) are still under treatment, while in 13 (54 per cent) operation was later regarded as advisable owing to unsuccessful anti-thyroid treatment. The failure of thyrostatic therapy may have had some connection with the presence or appearance of thyroid nodules. In eight instances operation was carried out, primarily owing to compressive and/or nodular goitre. The results of operation (21 cases in all) are that 10 patients are euthyroid (48%) and 4 hypothyroid (19%) whilst 7 had a relapse or persistence of the disease (33%) of whom 5 are still under treatment and two have subsequently been rendered euthyroid by reoperation in one case and radioactive iodine (at the age of 19) in another case. There also seems to be a small group of patients (6 cases in this series) in whom, in spite of evident »biochemical disease« although with slight clinical signs and symptoms, the condition seems to resolve spontaneously and nothing but close observation appears to be needed. A primarily conservative attitude seems advisable. The presence of nodules in the thyroid initially, however, seems to indicate that a surgical approach will be required later on.

Surgical Decision Making in Cervical Spondylotic Myelopathy

2016 ◽  
Vol 17 (8) ◽  
pp. 1-5
Author(s):  
Dustin H. Massel ◽  
Varun Puvanesarajah ◽  
Benjamin C. Mayo ◽  
Hamid Hassanzadeh ◽  
Steven M. Presciutti ◽  
...  
Keyword(s):  
Decision Making ◽  
Cervical Spondylotic Myelopathy ◽  
Surgical Decision ◽  
Surgical Decision Making

scholarly journals Carpel ligament release for carpel tunnel syndrome (CTS) under local anesthesia: our experience with 277 cases

2019 ◽  
Vol 16 (2) ◽  
pp. 3-7
Author(s):  
Aashish Basnet ◽  
Maya Bhattachan ◽  
Sumit Joshi ◽  
Pawan Bhandari ◽  
Ram Chandra Shrestha ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Surgical Treatment ◽  
Median Nerve ◽  
Local Anesthesia ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Surgical Decompression ◽  
Tunnel Syndrome ◽  
The Common ◽  
Clinical Signs And Symptoms

Carpel tunnel syndrome (CTS) is one of the common neurological condition where median nerve is compressed by transverse carpel ligament at wrist. About 5% of general population suffer from this problem and most commonly occurred in young and middle-aged women. 30% of patients suffering from CTS can be managed by medications and physiotherapy and 70% may require surgical decompression at some stage. Surgical treatment is to decompress median nerve by releasing transverse carpel ligament either by open or endoscopic procedure. Both procedures have shown similar results. This is a retrospective study of 277 patients who underwent 349 decompressive surgical procedures under local anesthesia for CTS between May 2007 and April 2017 in our institute. Diagnosis was made from clinical signs and symptoms and confirmed by either NCV or EMG. All patients were operated in day care basis. Data were retrieved from OPD and OT records. Followed up duration ranged from 6 months to 10 years. There were 257 female and 20 male. 74% had unilateral and 26% had bilateral CTS. 93% CTS were idiopathic. 10% suffered postoperative complications.26% achieved immediate pain relief after decompression, 73% after three weeks and 98.5% after three months. Open decompression of CTS is a quick and simple OPD based surgical procedure.

scholarly journals Confidence and willingness among laypersons in the UK to act in a head injury situation: a qualitative focus group study

BMJ Open ◽  
2019 ◽  
Vol 9 (11) ◽  
pp. e033531
Author(s):  
Stefan Tino Kulnik ◽  
Mary Halter ◽  
Ann Hilton ◽  
Aidan Baron ◽  
Stuart Garner ◽  
...  
Keyword(s):  
Decision Making ◽  
Head Injury ◽  
Focus Group ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
First Aid ◽  
Snowball Sampling ◽  
Focus Group Study ◽  
Clinical Signs And Symptoms ◽  
The Uk

ObjectivesTo explore factors influencing confidence and willingness among laypersons in the UK to act in a head injury situation, in order to inform first aid education offered by the British Red Cross.DesignQualitative focus group study.SettingSouth East England.ParticipantsForty-four laypersons (37 women, 7 men) were purposively recruited from the general public using snowball sampling, into one focus group each for six population groups: parents of young children (n=8), informal carers of older adults (n=7), school staff (n=7), sports coaches (n=2), young adults (n=9) and ‘other’ adults (n=11). The median (range) age group across the sample was 25–34 years (18–24, 84–95). Participants were from Asian (n=6), Black (n=6), Mixed (n=2) and White (n=30) ethnic backgrounds.ResultsThe majority of participants described being confident and willing to act in a head injury scenario if that meant calling for assistance, but did not feel sufficiently confident or knowledgeable to assist or make decisions in a more involved way. Individuals’ confidence and willingness presented as fluid and dependent on an interplay of situational and contextual considerations, which strongly impacted decision-making: prior knowledge and experience, characteristics of the injured person, un/observed head injury, and location and environment. These considerations may be framed as enablers or barriers to helping behaviour, impacting decision-making to the same extent as—or even more so than—the clinical signs and symptoms of head injury. An individual conceptual model is proposed to illustrate inter-relationships between these factors.ConclusionsOur findings show that confidence and willingness to act in a head injury scenario are dependent on several contextual and situational factors. It is important to address such factors, in addition to knowledge of clinical signs and symptoms, in first aid education and training to improve confidence and willingness to act.

Is a surgical approach justified for octogenarians with pancreatic carcinoma? Projecting surgical decision making for octogenarian patients

2016 ◽  
Vol 212 (5) ◽  
pp. 896-902 ◽  
Author(s):  
Takehiro Okabayashi ◽  
Yasuo Shima ◽  
Jun Iwata ◽  
Sojiro Morita ◽  
Tatsuaki Sumiyoshi ◽  
...  
Keyword(s):  
Decision Making ◽  
Pancreatic Carcinoma ◽  
Surgical Approach ◽  
Surgical Decision ◽  
Surgical Decision Making
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