scholarly journals Improvement of Spinopelvic Parameters Following the Surgical Treatment of Spondylolisthesis Using Interbody Fusion Cage

2020 ◽  
Vol 7 (4) ◽  
pp. 159-164
Author(s):  
Hasan Ghandhari ◽  
◽  
Farshad Nikouei ◽  
Mohammad Reza Chehrassan ◽  
Mohamadreza Heidarikhoo ◽  
...  
Keyword(s):  
Visual Analog Scale ◽  
Interbody Fusion ◽  
Pelvic Tilt ◽  
Posterolateral Fusion ◽  
Spinopelvic Parameters ◽  
Analog Scale ◽  
Before And After ◽  
The Mean ◽  
Fusion Cage ◽  
Interbody Fusion Cage

Background: There is no consensus regarding the clinical benefit of interbody fusion cage in the treatment of Spondylolisthesis (SL). This study aimed to evaluate the effect of posterolateral fusion combined with interbody fusion cage on the spinopelvic parameters and the pain level of the patients. Objectives: Role of interbody fusion in the treatment of spondylolisthesis Methods: This prospective study included 40 SL patients who underwent surgery following the failure of conservative management. The Meyerding classification was used to grade SL. Also, the visual analog scale was used to measure the level of pain, before and after the operation. Spinopelvic parameters included total kyphosis, sagittal vertebral axis, pelvic tilt, pelvic incidence, and lumbar lordosis. Results: The Mean±SD age of the patients was of 53.4±11.6 years. In four patients (10%), SL occurred at two levels. Besides, the etiology was degenerative in 21 cases (52.5%) and isthmic in 19 cases (47.5%). The grade I, II, and III of SL were detected respectively in 17, 17, and 6 cases (42.5%, 42.5%, and 15%, respectively). The Mean±SD preoperative value of the sagittal vertebral axis was 43.1±33.1 mm, which improved to 24.8±22.3 mm after the surgery (P<0.001). Also, the Mean±SD preoperative value of the pelvic tilt significantly improved from 19.2±10º to 17±9.1º (P=0.049). Moreover, the Mean±SD score of the visual analog scale improved from 9.1±0.8 to 2.8±1.2 (P<0.001). The clinical and spinopelvic parameters greatly improved in patients with degenerative SLs, single-level SLs, and the lower grades of SL. Conclusion: Posterolateral fusion combined with interbody fusion cage improves both the clinical and spinopelvic parameters of SL patients and could be suggested as the treatment of choice for these patients.

Coverage of Painful Peripheral Nerve Neuromas with Vascularized Soft Tissue: Method and Results

2005 ◽  
Vol 56 (suppl_4) ◽  
pp. ONS-369-ONS-378 ◽  
Author(s):  
Kartik G. Krishnan ◽  
Thomas Pinzer ◽  
Gabriele Schackert
Keyword(s):  
Spinal Cord ◽  
Soft Tissue ◽  
Peripheral Nerve ◽  
Visual Analog Scale ◽  
Soft Tissue Coverage ◽  
Spinal Cord Stimulator ◽  
Analog Scale ◽  
Before And After ◽  
The Mean

Abstract OBJECTIVE: Our goals are to describe a method of treating painful peripheral nerve neuromas by means of vascularized tissue coverage, report the results in seven patients, and discuss the indications for this treatment modality. An analysis of pain, functionality of the affected body part, professional activities of the patients, and medications before and after surgery is presented. METHODS: Seven male patients (mean age, 45.1 yr) with posttraumatic nerve injuries, who had developed painful stump neuromas or neuromas-in-continuity, and who had unsuccessfully undergone several treatment procedures, were selected for the surgery described here. The operation included resection of the stump neuroma (four patients) or neurolysis of the neuroma-in-continuity (three patients) and coverage of the nerve with a vascularized fascial, fasciocutaneous, or perforator flap (three pedicled regional flaps and four free flaps). A modified quadruple visual analog scale was used to quantify pain before and after surgical treatment. The mean follow-up was 16.6 months. RESULTS: The mean values of the quadruple visual analog scale (pain now/typically/at its best/at its worst) before surgery were 6.5/6.5/4.7/7.9. These values changed to 0.3/0.4/0/0.9 at a mean follow-up of 16.6 months after surgery. Five patients returned to their original profession, one receives a pension, and one began a less demanding job after undergoing surgery. Six of the seven patients received opioids before surgery (one had a spinal cord stimulator). After surgery, all patients stopped taking regular pain killers and the spinal cord stimulator was deactivated in one; two patients still take nonsteroidal anti-inflammatory drugs occasionally, but not on a regular basis. CONCLUSION: Vascularized soft tissue coverage of painful peripheral nerve neuromas seems to be an effective and attractive, but also complex, method of treatment. This option may be considered and reserved for patients who have already undergone several pain treatment modalities without success.

Effect of Chlorophyllin on Urinary Odor in Incontinent Geriatric Patients

1983 ◽  
Vol 17 (10) ◽  
pp. 732-734 ◽  
Author(s):  
Milap C. Nahata ◽  
Carole A. Slencsak ◽  
Judith Kamp
Keyword(s):  
Visual Analog Scale ◽  
Washout Period ◽  
Geriatric Patients ◽  
Odor Intensity ◽  
Controlled Study ◽  
Analog Scale ◽  
Double Blind ◽  
Mean Intensity ◽  
The Mean ◽  
Percent Decrease

This randomized, double-blind, crossover, placebo-controlled study involved 20 incontinent geriatric patients; all had indwelling Foley catheters. Each patient received chlorophyllin 100 mg/d for two weeks and placebo daily for two weeks, separated by a washout period of one week. For each subject, the intensity of urinary odor was measured ten times during both the treatment and placebo regimen and three times during the washout period, using a visual analog scale. A decrease in urinary odor was associated with chlorophyllin in 12 patients and with placebo in 6 patients at the end of two weeks on each regimen. Chlorophyllin treatment was associated with about a 21-percent decrease in mean urinary odor intensity, whereas placebo increased the odor by about 9 percent. The mean intensity of urinary odor was lowest during the second week of chlorophyllin treatment. Despite the decrease in urinary odor in many patients receiving chlorophyllin, its effect was not significantly greater than that of placebo. Our data suggest that chlorophyllin 100 mg/d for two weeks may not be effective in incontinent geriatric patients with mild to moderate urinary odor.

Biomechanical comparison of transdiscal fixation and posterior fixation with and without transforaminal lumbar interbody fusion in the treatment of L5–S1 lumbosacral joint

2018 ◽  
Vol 232 (4) ◽  
pp. 371-377 ◽  
Author(s):  
Hakan Özalp ◽  
Mustafa Özkaya ◽  
Onur Yaman ◽  
Teyfik Demir
Keyword(s):  
Pedicle Screw ◽  
Axial Compression ◽  
Interbody Fusion ◽  
Screw Fixation ◽  
Transforaminal Lumbar Interbody Fusion ◽  
Pedicle Screw Fixation ◽  
Posterior Fixation ◽  
Lumbar Interbody Fusion ◽  
Fusion Cage ◽  
Interbody Fusion Cage

Transdiscal screw fixation is generally performed in the treatment of high-grade L5–S1 spondylolisthesis. The main thought of the study is that the biomechanical performances of the transdiscal pedicle screw fixation can be identical to standard posterior pedicle screw fixations with or without transforaminal lumbar interbody fusion cage insertion. Lumbosacral portions and pelvises of 45 healthy lambs’ vertebrae were dissected. Animal cadavers were randomly and equally divided into three groups for instrumentation. Three fixation systems, L5–S1 posterior pedicle screw fixation, L5–S1 posterior pedicle screw fixation with transforaminal lumbar interbody fusion cage insertion, and L5–S1 transdiscal pedicle screw fixation, were generated. Axial compression, flexion, and torsion tests were conducted on test samples of each system. In axial compression, L5–S1 transdiscal fixation was less stiff than L5–S1 posterior pedicle screw fixation with transforaminal lumbar interbody fusion cage insertion. There were no significant differences between groups in flexion. Furthermore, L5–S1 posterior fixation was stiffest under torsional loads. When axial compression and flexion loads are taken into consideration, transdiscal fixation can be alternatively used instead of posterior pedicle screw fixation in the treatment of L5–S1 spondylolisthesis because it satisfies enough stability. However, in torsion, posterior fixation is shown as a better option due to its higher stiffness.

Design and Research of Interspinous Lumbar Non-Fusion Device

2010 ◽  
Author(s):  
Lei Li ◽  
Zhaohua Chang ◽  
Xuelian Gu ◽  
Chengli Song
Keyword(s):  
Stress Concentration ◽  
Vertebral Body ◽  
Interbody Fusion ◽  
Lumbar Fusion ◽  
Pedicle Screws ◽  
Adjacent Level ◽  
Flexion Extension ◽  
Fusion Cage ◽  
Adjacent Level Degeneration ◽  
Interbody Fusion Cage

Objective: Long term clinical data showed that lumbar fusion for Lumbar spinal stenosis (LSS) and lumbar disc degeneration (LDD) therapy could change the loads of disc and articular facet and increase the motion of adjacent segments which lead to facet arthropathy and adjacent level degeneration. This study is to design and analyze an interspinous process device (IPD) that could prevent adjacent level degeneration in the LSS and LDD therapy. Method: The IPD was designed based on anatomical parameters measured from 3D CT images directly. The IPD was inserted at the validated finite element model of the mono-segmental L3/L4. The biomechanical performance of a pair of interbody fusion cages and a paired pedicel screws were studied to compare with the IPD. The model was loaded with the upper body weight and muscle forces to simulate five loading cases including standing, compression, flexion, extension, lateral bending and axial rotation. Results: The interbody fusion cage induced serious stress concentration on the surface of vertebral body, has the worst biomechanical performance among the three systems. Pedicle screws and interbody fusion cage could induce stress concentration within vertebral body which leads to vertebral compression fracture or screw loosening. Regarding to disc protection, the IPD had higher percentage to share the load of posterior lumbar structure than the pedicel screws and interbody fusion cage. Conclusion: IPD has the same loads as pedicle screw-rod which suggests it has a good function in the posterior stability. While the IPD had much less influence on vertebral body. Furthermore, IPD could share the load of intervertebral discs and facet joints to maintain the stability of lumbar spine.

Evaluation of Lumbar Spine Stabilization Using Anterior Interbody Fusion Cage

2002 ◽  
Author(s):  
Robert X. Gao ◽  
Mathew E. Mitchell ◽  
R. Scott Cowan
Keyword(s):  
Lumbar Spine ◽  
Interbody Fusion ◽  
Lumbar Fusion ◽  
Healing Process ◽  
Spine Stabilization ◽  
Anterior Interbody Fusion ◽  
Wide Range ◽  
Flexion Extension ◽  
Fusion Cage ◽  
Interbody Fusion Cage

Spinal surgery uses a wide range of instrumentation devices to provide comfort to the patient, stabilize the spine, and enhance the bony healing process after surgery. In order to improve upon the effectiveness of these devices, the interaction between the spine and the implant devices needs to be studied from both medical and engineering perspectives. This paper investigates the effect of an anterior interbody fusion cage on lumbar spine stabilization, by means of numerical analysis using the finite element technique and experimental testing. Specifically, the relative displacement within an intact L4-L5 motion segment has been simulated and measured, under a range of compression, flexion, extension, torsion, and lateral bending loads. Subsequently, the effect of a single anterior lumbar fusion cage implanted into the segment was simulated and experimentally validated, under similar loading conditions. Comparison between the intact and cage-implanted segments indicated varying stabilizing ability of the fusion cage, which is highly dependent upon the cage position and the type of loading.

scholarly journals The Effect of 1,8-Cineole Inhalation on Preoperative Anxiety: A Randomized Clinical Trial

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Ka Young Kim ◽  
Hyo Jin Seo ◽  
Sun Seek Min ◽  
Mira Park ◽  
Geun Hee Seol
Keyword(s):  
Visual Analog Scale ◽  
Controlled Trial ◽  
Major Constituent ◽  
Control Group ◽  
Analog Scale ◽  
Almond Oil ◽  
Eucalyptus Oil ◽  
Significant Difference ◽  
Before And After ◽  
Selective Nerve Root Block

The aim of this study was to investigate the effect of inhalation of eucalyptus oil and its constituents on anxiety in patients before selective nerve root block (SNRB). This study was a randomized controlled trial carried out in 62 patients before SNRB. The patients were randomized to inhale limonene, 1,8-cineole, or eucalyptus oil, each at concentrations of 1% vol/vol in almond oil or almond oil (control). Anxiety-visual analog scale (A-VAS), state-trait anxiety inventory (STAI), profile of mood states (POMS), pain-visual analog scale (P-VAS), blood pressure, and pulse rate were measured before and after inhalation prior to SNRB. Measures of anxiety, including A-VAS (P<0.001), STAI (P=0.005), and POMS (P<0.001), were significantly lower in 1,8-cineole than in the control group and significantly greater in 1,8-cineole than in the eucalyptus group in A-VAS. P-VAS was significantly lower after than before inhalation of limonene, 1,8-cineole, and eucalyptus, despite having no significant difference in the four groups compared with control group. 1,8-Cineole, a major constituent of eucalyptus, was effective in decreasing anxiety before SNRB. The present findings suggest that inhalation of 1,8-cineole may be used to relieve anxiety before, during, and after various operations, in addition to SNRB.

Sign in / Sign up

Export Citation Format

Share Document