scholarly journals Our Experience in the Treatment of Vertebrobasilar Insufficiency Due to Cervical Spine Disorders

2021 ◽  
Vol 15 ◽  
pp. 318-324
Author(s):  
Beslan S. Dzhilkashiev ◽  
Gennadiy I. Antonov ◽  
Gennadiy E. Chmutin ◽  
Keith Simfukwe ◽  
Edward R. Miklashevich
Keyword(s):  
Cervical Spine ◽  
Surgical Treatment ◽  
Clinical Results ◽  
Early Postoperative Period ◽  
Vertebrobasilar Insufficiency ◽  
Vertebrobasilar System ◽  
Circulatory Insufficiency ◽  
Basilar Arteries ◽  
Spine Disorders

This article defines vertebra-related causes of vertebrobasilar insufficiency in patients with the signs of tortuosity of segment VI of the VA. The aim of this study is to present the results of diagnostics of discirculatory phenomena in the vertebrobasilar system and to show their importance for differentiated surgical treatment of stenotic lesions of segment V1 of VA in pathological disorders of cerebral circulation in the VBS caused by osteochondrosis of the cervical spine. The following traditional methods are used in diagnostics: Doppler ultrasonography, multispiral computed tomography with contrast enhancement. Also using developed by the author method for determining VA reactivity and circulatory insufficiency in the vertebrobasilar system (VBS). Based on our methodology and criteria, patients were selected for different types of surgical treatment with clinical outcome prediction following interventions on the arteries of the VBS. To determine the pathologies of the intracranial segments of the vertebral and basilar arteries, taking into account the pathways of collateral compensation in the VBS, cerebral angiography is recommended before surgery on the arteries of the VBS. Reconstructive techniques used on segment VI of the VA will predictably show the best long-term clinical results. The excision of a tortuous segment VI of the VA may be effective in obtaining reliable results of successful interventions in the early postoperative period. The conservative treatment of the patients with multiple VBD lesions is possible. early outcomes of their use are satisfactory.

Long-term follow up of surgical outcomes in patients with cervical disorders undergoing hemodialysis

2006 ◽  
Vol 5 (4) ◽  
pp. 313-319 ◽  
Author(s):  
Hideki Sudo ◽  
Manabu Ito ◽  
Kuniyoshi Abumi ◽  
Yoshihisa Kotani ◽  
Tatsuto Takeuchi ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Spinal Fusion ◽  
Posterior Instrumentation ◽  
Survival Rates ◽  
Spinal Instability ◽  
Initial Surgery ◽  
Long Term Follow Up ◽  
Spine Disorders

Object As increasing numbers of patients receive long-term hemodialysis, the number of reports regarding hemodialysis-related cervical spine disorders has also increased. However, there have been few reports summarizing the surgical results in patients with these disorders. The objective of this study was to evaluate the long-term follow up and clinical results after surgical treatment of cervical disorders in patients undergoing hemodialysis. Methods Seventeen patients in whom surgery was performed for cervical spine disorders while they received long-term hemodialysis therapy were enrolled in this study. Of these, 15 underwent follow-up review for more than 3 years after surgery, and these represent the study population. The remaining two patients died of postoperative sepsis. The average follow-up period was 120 months. Five patients without spinal instability underwent spinal cord decompression in which bilateral open-door laminoplasty was performed. Ten patients with destructive spondyloarthropathy (DSA) underwent reconstructive surgery involving pedicle screw (PS) fixation. In eight patients in whom posterior instrumentation was placed, anterior strut bone grafting was performed with autologous iliac bone to treat anterior-column destruction. Marked neurological recovery was obtained in all patients after the initial surgery. In the mobile segments adjacent to the site of previous spinal fusion, the authors observed progressive destructive changes with significant instability in four patients (40%) who underwent circumferential spinal fusion. No patients required a second surgery after laminoplasty for spinal canal stenosis without DSA changes. Conclusions Cervical PS-assisted reconstruction provided an excellent fusion rate and good spinal alignment. During the long-term follow-up period, however, some cases required extension of the spinal fusion due to the destructive changes in the adjacent vertebral levels. Guidelines or recommendations to overcome these problems should be produced to further increase the survival rates of patients undergoing hemodialysis.

scholarly journals Diagnosis and treatment of reflex-pain syndromes in patients with herniated intervertebral disc before surgical decompression

2009 ◽  
Vol 8 (1(2)) ◽  
pp. 111-114
Author(s):  
Ye. B. Kolotov ◽  
A. A. Lutsik ◽  
A. V. Mironov ◽  
S. V. Yelagin
Keyword(s):  
Cervical Spine ◽  
Surgical Treatment ◽  
Clinical Outcome ◽  
Intervertebral Disc ◽  
Intervertebral Discs ◽  
Intervertebral Disk ◽  
Surgical Decompression ◽  
Pain Syndromes ◽  
Herniated Intervertebral Disc

To upgrade the results of surgical treatment in patients operated on for gerniated intervertebral disk the reflex-pain syndromes of spondylarthrosis and osteohondrous was studied. Before surgical treatment alcohol-novocain blockades have been used to perform denervation of intervertebral discs and joints. The reflex-pain syndromes was evoked by solution injection and then arrested by alcohol-novocain injection. Clinical outcome in long-term period after surgical treatment became good in 89% (p < 0.05) on cervical spine and in 84% (p < 0.05) lumbar.

Cervical spine disorders

2011 ◽  
Author(s):  
Howard An
Keyword(s):  
Cervical Spine ◽  
Surgical Treatment ◽  
Clinical Symptoms ◽  
Exercise Program ◽  
Cervical Radiculopathy ◽  
Radicular Pain ◽  
Narcotic Analgesics ◽  
Advantages And Disadvantages ◽  
Degenerative Cervical Spine ◽  
Spine Disorders

♦ Degenerative cervical spine disorders may manifest clinically with axial neck pain, radiculopathy, myelopathy, or a combination of these clinical symptoms♦ The findings on radiographs and MRI are pertinent if they correlate with the clinical symptoms♦ The initial treatment for patients with degenerative cervical spine disorders is conservative, including non-narcotic analgesics, anti-inflammatory medications, exercise program, physiotherapy, and occasional injections♦ Surgical indications include significant radicular pain despite conservative treatment, profound neurologic deficits, and presence of significant myelopathy♦ Surgical treatment for cervical radiculopathy includes lamino-foraminotomy, anterior cervical discectomy and fusion (ACDF), and artificial disk replacement, and surgical treatment for myelopathy includes anterior discectomy and/or corpectomy with fusion, posterior laminoplasty, and posterior laminectomy and fusion. The surgeon should be familiar with the specific indications as well as advantages and disadvantages of each procedure.

Long-term results of expansive open-door laminoplasty for ossification of the posterior longitudinal ligament of the cervical spine

2004 ◽  
Vol 1 (2) ◽  
pp. 168-174 ◽  
Author(s):  
Yuto Ogawa ◽  
Yoshiaki Toyama ◽  
Kazuhiro Chiba ◽  
Morio Matsumoto ◽  
Masaya Nakamura ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Cervical Myelopathy ◽  
Posterior Longitudinal Ligament ◽  
Clinical Results ◽  
Long Term Results ◽  
Open Door ◽  
Content Type ◽  
Anterior Posterior ◽  
Fine Print

Object. Numerous surgical procedures have been developed for treatment of ossification of the posterior longitudinal ligament (OPLL) of the cervical spine, and these can be performed via three approaches: anterior, posterior, or combined anterior—posterior. The optimal approach in cases involving OPLL-induced cervical myelopathy, however, remains controversial. To address this issue, the authors assessed the benefits and limitations of expansive open-door laminoplasty for OPLL-related myelopathy by evaluating mid- and long-term clinical results. Methods. Clinical results obtained in 72 patients who underwent expansive open-door laminoplasty between 1983 and 1997 and who were followed for at least 5 years were assessed using the Japanese Orthopaedic Association (JOA) scoring system. The mean preoperative JOA score was 9.2 ± 0.4; at 3 years postoperatively, the JOA score was 14.2 ± 0.3 and the recovery rate (calculated using the Hirabayashi method) was 63.1 ± 4.5%, both having reached their highest level. These favorable results were maintained up to 5 years after surgery. An increase in cervical myelopathy due to progression of the ossified ligament was observed in only two of 30 patients who could be followed for more than 10 years. Severe surgery-related complications were not observed. Preoperative JOA score, age at the time of surgery, and duration between onset of initial symptoms and surgery affected clinical results. Conclusions. Mid-term and long-term results of expansive open-door laminoplasty were satisfactory. Considering factors that affected surgical results, early surgery is recommended for OPLL of the cervical spine.

scholarly journals Effectiveness of the Cox Maze-IV Procedure in Cardiac Surgery Patients With Atrial Fibrillation

Kardiologiia ◽  
2020 ◽  
Vol 60 (5) ◽  
pp. 83-89
Author(s):  
N. A. Trofimov ◽  
A. P. Medvedev ◽  
V. E. Babokin ◽  
A. V. Nikolsky ◽  
I. P. Efimova ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Surgical Treatment ◽  
Heart Defects ◽  
Left Ventricular ◽  
Early Postoperative Period ◽  
Left Ventricular Dilatation ◽  
Repeated Surgery ◽  
History Of ◽  
Antiarrhythmic Medication

Aim Analyzing a 5-year experience of surgical treatment of cardiosurgical patients with atrial fibrillation (AF).Material and methods The study analyzed results of surgical treatment with extracorporeal circulation in 132 patients with AF who underwent the Maze-IV procedure using a radiofrequency ablator with transmurality feedback from 2013 through 2018.Results Two fatal outcomes were observed in the study group. These outcomes took place in the early postoperative period and were associated with progressive acute heart failure in patients with repeated surgery for mitral valve restenosis. 61.2% of the patients had no AF. Recurrent AF was observed during the first three years after surgery in association with withdrawal of the antiarrhythmic medication, which confirmed a need for long-term antiarrhythmic therapy. Analysis of risk factors for AF relapse identified significant predictors, including left ventricular dilatation larger than 5.5 cm at baseline and more than two-year duration of a history of arrhythmias.Conclusion The Maze-IV procedure proved an effective and safe method of surgical treatment in AF patients with acquired heart defects and ischemic heart disease, which allowed maintaining sinus rhythm in 61.2% of patients for 5 years. Preventive amiodarone saturation reduced the risk of AF relapse by 24.2 % (p=0.038) and incidence of postoperative arrhythmic complications by 34.9 % (p=0.008) in cardiosurgical patients.

Analysis of Reoperations after Surgical Treatment of Degenerative Cervical Spine Disorders: A Report on 900 Cases

2009 ◽  
Vol 70 (01) ◽  
pp. 3-8 ◽  
Author(s):  
R. Greiner-Perth ◽  
Y. Allam ◽  
H. El-Saghir ◽  
F. Röhl ◽  
J. Franke ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Surgical Treatment ◽  
Degenerative Cervical Spine ◽  
Spine Disorders

Long-term results after expansive open-door laminoplasty for the segmental-type of ossification of the posterior longitudinal ligament of the cervical spine: a comparison with nonsegmental-type lesions

2005 ◽  
Vol 3 (3) ◽  
pp. 198-204 ◽  
Author(s):  
Yuto Ogawa ◽  
Kazuhiro Chiba ◽  
Morio Matsumoto ◽  
Masaya Nakamura ◽  
Hironari Takaishi ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Posterior Longitudinal Ligament ◽  
Clinical Results ◽  
Long Term Results ◽  
Open Door ◽  
Intergroup Difference ◽  
Content Type ◽  
Fine Print ◽  
Group 1

Object. The segmental-type of ossification of the posterior longitudinal ligament (OPLL) of the cervical spine is distinct from other types in its morphological features. Whether the results of expansive open-door laminoplasty for the segmental-type are different from those for other types remains unclear. To clarify this issue, the long-term results after surgical treatment of segmental-type OPLL were compared with those of other types. Methods. Clinical results were documented in 57 patients who underwent expansive open-door laminoplasty and were followed for a minimum of 7 years, results were quantified using the Japanese Orthopaedic Association (JOA) scoring system to determine function. Segmental-type OPLL was observed in 10 patients (Group 1) and other types in 47 patients (Group 2). Preoperative JOA scores were not significantly different between the two groups. As many as 5 years after surgery, clinical results were favorable and maintained in both groups, and no significant intergroup difference in postoperative JOA scores was observed; however, after 5 years postoperatively, JOA scores decreased in both groups. The decrease was greater in Group 1, and a significant intergroup difference in JOA scores was demonstrated when analyzing final follow-up data. In Group 1, the authors found that the degree of late-onset deterioration relating to cervical myelopathy positively correlated with the cervical range of motion. Conclusions. The long-term results of expansive open-door laminoplasty in the treatment of segmental-type OPLL were inferior to those for other types. Cervical mobility may contribute to the development of late deterioration of cervical myelopathy.

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