scholarly journals Kraniovertebral Bileşke Kemiklerinin Morfometrik Özellikleri

2021 ◽  
pp. 67-75
Author(s):  
Merve Sevgi İNCE ◽  
Güneş AYTAÇ ◽  
Esma Deniz BARÇ ◽  
Yener BEKTAŞ ◽  
Ahmet Cem ERKMAN ◽  
...  
Keyword(s):  
Morphometric Analysis ◽  
Surgical Techniques ◽  
Craniovertebral Junction ◽  
Occipital Bone ◽  
Transverse Foramen ◽  
Surgical Interventions ◽  
Vertebral Canal ◽  
Articular Facet ◽  
Morphometric Features ◽  
Human Skulls

Introduction: The craniovertebral junction comprises the occipital bone, atlas, axis and supporting ligaments. Surgical interventions for treatment of instability, require knowledge of morphometric properties of this area. Therefore, the aim of the present study was to evaluate adult dried human skulls to analyze morphometric features of the bones that joined the craniovertebral junction. Materials and Methods: Morphometric analysis was performed on dry bones which found in the excavations. 9 occipital bone, 18 atlas and 16 axis were measured. Differences between measurements were determined using t-tests and were considered significant at p<0.05. Results: The distance between both tips of the transverse processes (p<0.001), the distance between both outermost edges of the transverse foramen (p=0.011), the distance between both innermost edges of the transverse foramen (p=0.013), the maximum transverse diamater of the vertebral canal (p=0.014), the maximum anteroposterior diameter of the vertebral canal (p=0.014) and the width of the inferior articular facet (left p<0.001 and right p=0.005) were found significantly shorter in females atlases. The width of the dens axis (p<0.001), the height of the corpus axis (p=0.034), the distance from lateral most edge of the transvers process to midline (left p=0.049), the length of the inferior articular facet (left p=0.004, right p=0.005), the width of the superior articular facet (right p=0.007) were found significantly shorter in females axises. Conclusion: Morphometric analysis is very important in the development and improvement of surgical techniques. In this context, the results of our study can contribute to developments in this area. Keywords: Atlas, axis, occipital bone, craniovertebral junction

scholarly journals Trends in surgical and catheter interventions for isolated congenital shunt lesions in the UK and Ireland

Heart ◽  
2019 ◽  
Vol 105 (14) ◽  
pp. 1103-1108 ◽  
Author(s):  
Mehreen Farooqi ◽  
John Stickley ◽  
Rami Dhillon ◽  
David J Barron ◽  
Oliver Stumper ◽  
...  
Keyword(s):  
Ventricular Septal Defect ◽  
Patent Foramen Ovale ◽  
Septal Defect ◽  
Surgical Techniques ◽  
Foramen Ovale ◽  
Patient Age ◽  
Surgical Interventions ◽  
Patient Âgé ◽  
Duct Ligation ◽  
The Uk

ObjectiveTo evaluate time trends in the use of catheter and surgical procedures, and associated survival in isolated congenital shunt lesions.MethodsNationwide, retrospective observational study of the UK National Congenital Heart Disease Audit database from 2000 to 2016. Patients undergoing surgical or catheter procedures for atrial septal defect (including sinus venosus defect), patent foramen ovale, ventricular septal defect and patent arterial duct were included. Temporal changes in the frequency of procedures, and survival at 30 days and 1 year were determined.Results40 911 procedures were performed, 16 604 surgical operations and 24 307 catheter-based interventions. Transcatheter procedures increased over time, overtaking surgical repair in 2003–2004, while the number of operations remained stable. Trends in interventions differed according to defect type and patient age. Catheter closure of atrial septal defects is now more common in children and adults, although surgical interventions have also increased. Patent foramen ovale closure in adults peaked in 2009–2010 before falling significantly since. Surgery remains the mainstay for ventricular septal defect in infants and children. Duct ligation is most common in neonates and infants, while transcatheter intervention is predominant in older children. Excluding duct ligation, survival following surgery was 99.4% and ≈98.7%, and following catheter interventions was 99.7% and ≈99.2%, at 30 days and 1 year, respectively.ConclusionsTrends in catheter and surgical techniques for isolated congenital shunt lesions plot the evolution of the specialty over the last 16 years, reflecting changes in clinical guidelines, technology, expertise and reimbursement, with distinct patterns according to lesion and patient age.

scholarly journals Minimum Invasive Stabilizing and Decompressive-Stabilizing Methods of Surgical Treatment for Degenerative-Dystrophic Lesions of Spine

2011 ◽  
Vol 18 (4) ◽  
pp. 3-10
Author(s):  
A V Krut'ko ◽  
Shamil' Al'firovich Akhmet'yanov ◽  
D M Kozlov ◽  
A V Peleganchuk ◽  
A V Bulatov ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Lumbar Spine ◽  
Surgical Techniques ◽  
Pain Syndrome ◽  
Early Postoperative Period ◽  
Main Group ◽  
Control Group ◽  
Surgical Interventions ◽  
Comparative Group ◽  
Operative Wound

Results of randomized prospective study with participation of 94 patients aged from 20 to 70 years with monosegmental lumbar spine lesions are presented. Minimum invasive surgical interventions were performed in 55 patients from the main group. Control group consisted of 39 patients in whom decompressive-stabilizing operations via conventional posteromedian approach with skeletization of posterior segments of vertebral column were performed. Average size of operative wound in open interventions more than 10 times exceeded that size in minimum invasive interventions and made up 484 ± 56 and 36 ± 12 sq.cm, respectively. Mean blood loss was 326.6 ± 278.0 ml in the main group and 855.1 ± 512.0 ml in the comparative one. In the main group no one patient required substitution hemotransfusion, while in 13 patients from the comparative group donor erythrocytic mass and/or fresh-frozen plasma were used to eliminate the deficit of blood components. Intensity of pain syndrome in the zone of surgical intervention by visual analog scale in the main group was lower than in comparative group. In the main and comparative groups the duration of hospitalization made up 6.1 ± 2.7 and 9.7 ± 3.7 bed days, respectively. In no one patient from the main group complications in the zone of operative wound were noted. Three patients from the comparative group required secondary debridement and in 1 patient early deep operative wound suppuration was observed. Application of low invasive surgical techniques for the treatment of patients with degenerative lumbar spine lesions enabled to perform radical surgical treatment with minimal iatrogenic injury. The method possessed indubitable advantages over the conventional open operations especially intraoperatively and in early postoperative period.

scholarly journals Radical Dorsal Interventions in Treatment of Kyphotic Deformities (Literature Review)

2015 ◽  
Vol 22 (2) ◽  
pp. 66-75
Author(s):  
M. V Mikhailovskiy ◽  
V. V Novikov ◽  
I. G Udalov
Keyword(s):  
Clinical Practice ◽  
Literature Review ◽  
Vertebral Column ◽  
Surgical Techniques ◽  
Pedicle Subtraction Osteotomy ◽  
Treatment Results ◽  
Vertebral Column Resection ◽  
Surgical Interventions ◽  
Ponte Osteotomy ◽  
Spine Deformities

Widely used in clinical practice surgical interventions directed to the correction of severe kyphotic spine deformities, i.e. Ponte osteotomy, Smith-Peterson osteotomy, pedicle subtraction osteotomy and vertebral column resection are presented. Surgical techniques, surgery planning based on spinal and pelvic sagittal contour parameters, treatment results are described.

Morphometric Analysis of Orbit: A Study on Dry Indian Human Skulls

2017 ◽  
Vol 6 (3) ◽  
pp. 297-301
Author(s):  
Pratima Kulkarni ◽  
◽  
Saurabh Kulkarni ◽  
Shivaji Sukre ◽  
◽  
...  
Keyword(s):  
Morphometric Analysis ◽  
Human Skulls

Craniovertebral Junction Anomalies in Small Breed Dogs with Atlantoaxial Instability: A Multicentre Case–Control Study

2018 ◽  
Vol 32 (01) ◽  
pp. 033-040
Author(s):  
Beatriz Vidondo ◽  
Inés Carrera ◽  
Angel Hernandez-Guerra ◽  
Pierre Moissonnier ◽  
Ioannis Plessas ◽  
...  
Keyword(s):  
Case Control Study ◽  
Craniovertebral Junction ◽  
Case Control ◽  
Occipital Bone ◽  
Atlantoaxial Instability ◽  
Tomographic Images ◽  
Computed Tomographic ◽  
Matched Case ◽  
Control Study ◽  
Small Breed

Objective The main purpose of this study was to define criteria to systemically describe craniovertebral junction (CVJ) anomalies and to report the prevalence of CVJ anomalies in small breed dogs with and without atlantoaxial instability (AAI). Materials and Methods Retrospective multicentre matched case–control study evaluating magnetic resonance imaging and computed tomographic images of small breed dogs with and without AAI for the presence of CVJ anomalies. Results One hundred and twenty-two dogs were enrolled (61 with and 61 without AAI). Only dogs with AAI had dens axis anomalies such as separation (n = 20) or a short-rounded conformation (n = 35). Patients with AAI were more likely to have atlantooccipital overlapping based on transection of McRae's line by the dorsal arch of the atlas (odds ratio [OR] = 5.62, p < 0.01), a transection of Wackenheim's clivus line (OR = 41.62, p < 0.01) and rostral indentation of the occipital bone (OR = 2.79, p < 0.05). Patients with AAI were less likely to have a larger clivus canal angle (OR = 0.94, p < 0.01) and larger occipital bone lengths (OR = 0.89, p < 0.05). Clinical Significance Small breed dogs with AAI are more likely to have other CVJ anomalies such as atlantooccipital overlapping or dens anomalies. The grade of brachycephaly does not differ between patients with and without AAI. Certain objective criteria from human literature were found useful for the assessment of both AAI and atlantooccipital overlapping such as McRae's line, Wackenheim's clivus line, and clivus canal angle. The classification criteria used can help to evaluate CVJ anomalies in a more systematic way.

scholarly journals Combined Liver and Inferior Vena Cava Resection for Malignancies Is Safe and Feasible in a Group of High-Risk Patients

2020 ◽  
Vol 9 (4) ◽  
pp. 1100
Author(s):  
Sandra Schipper ◽  
Markus Zimmermann ◽  
Andreas Kroh ◽  
Ulf Peter Neumann ◽  
Tom Florian Ulmer
Keyword(s):  
Vena Cava ◽  
Surgical Techniques ◽  
Oncological Outcome ◽  
Best Supportive Care ◽  
Treatment Modalities ◽  
Surgical Interventions ◽  
Inferior Vena Cava Resection ◽  
Inferior Caval Vein ◽  
Risk Patients ◽  
Perioperative Risks

Background and Methods: Tumors infiltrating the inferior caval vein (ICV) have been considered irresectable in the past due to high perioperative risks. Consequently, the only treatment option for these patients was best supportive care, which resulted in reduced survival. Advancements in surgical techniques have since evolved, such that combined resections of the ICV and the hepatic malignancy are being performed. The aim of this study was the evaluation of the long-term outcomes (e.g., survival) and short-term risks of this procedure. In this single-center, retrospective cohort study (n = 24), we evaluated surgical and oncological outcome for patients undergoing hepatic surgery for oncological indications in combination with resections of the ICV. In addition, we investigated which factors are associated with survival. Results: First, we showed that perioperative mortality is as low as 4.1%. Second, we showed that perioperative co-morbidities are acceptable for this type of advanced hepatobiliary surgery. Third, the reconstruction of the ICV by means of a patch was superior in terms of survival compared to other types of reconstructions. This finding was independent of the type or the aggressiveness of tumor or the resections status. Discussion: In our cohort, many patients had undergone (multiple) preceding visceral surgical interventions or underwent multi-visceral surgery. Despite the medical complexity, survival was encouraging in this cohort, offering novel treatment modalities with a low risk of severe morbidities.

The influence of transoral odontoid resection on stability of the craniovertebral junction

1992 ◽  
Vol 77 (4) ◽  
pp. 525-530 ◽  
Author(s):  
Curtis A. Dickman ◽  
Jacqueline Locantro ◽  
Richard G. Fessler
Keyword(s):  
Rheumatoid Arthritis ◽  
Bone Destruction ◽  
Craniovertebral Junction ◽  
Transoral Surgery ◽  
Posterior Decompression ◽  
Radiographic Evidence ◽  
Content Type ◽  
Surgical Interventions ◽  
Fine Print

✓ Twenty-seven cases of craniovertebral junction compression treated with transoral surgery were reviewed to assess the influences of pathological processes and surgical interventions on spinal stability. All patients presented with signs and symptoms of spinal-cord or brain-stem dysfunction. Pathology included rheumatoid arthritis in 11 patients, congenital osseous malformations in 11, spinal fractures in two, plasmacytoma in one, osteomyelitis in one, and a gunshot injury in one. Instability was defined as clear radiographic evidence of mobile subluxation in conjunction with clinical assessment. Of 19 patients (70%) requiring internal fixation, nine underwent upper cervical fusion and 10 had occipitocervical fusion. When instability occurred, all subluxations were at the C1–2 level. There were no occipitoatlantal subluxations. Eight patients (30%) had preoperative instability of the craniovertebral junction due solely to their pathology, 11 patients (40%) suffered instability after transoral surgery, and eight (30%) were without clinical or radiographic evidence of instability (mean follow-up period 14 months). Craniovertebral junction instability predominated among patients with rheumatoid arthritis: 91% required fusion and 45% presented with pre-existing instability. Among individuals with congenital osseous malformations, 45% required fusion and only one patient (9%) had pre-existing instability. Patients who required subsequent posterior decompression of a Chiari malformation were at risk for developing instability; three of four became unstable after posterior decompression. Transoral resection of the dens, the anterior arch of C-1, and the lower clivus does not fully destabilize the spine; however, this operation may potentiate incipient pathological instability. The primary determinants of instability are the extent of pathological bone destruction, ligamentous weakening, and operative bone removal. Long-term follow-up monitoring is needed after transoral surgery to detect cases of late instability.

Clinical research in surgical oncology: An analysis of clinicaltrials.gov.

2012 ◽  
Vol 30 (4_suppl) ◽  
pp. 591-591 ◽  
Author(s):  
Amber S Menezes ◽  
Alison Barnes ◽  
Adena S Scheer ◽  
Husein Moloo ◽  
Robin P Boushey ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Randomized Clinical Trials ◽  
Surgical Techniques ◽  
Surgical Oncology ◽  
The United States ◽  
Diagnostic Methods ◽  
Phase Iii ◽  
Medical Specialties ◽  
Surgical Interventions ◽  
Adjuvant Therapies

591 Background: The conduction of randomized clinical trials has expanded in medical specialties, but to a far lesser degree in surgery. This is due to design challenges with standardization of treatment, blinding and lack of surgeon equipoise. The objective of this study was to assess the current landscape of clinical trials in surgical oncology registered at clinicaltrials.gov. Methods: Data was extracted from clinicaltrials.gov using the following search engine criteria: ‘Cancer’ as Condition, ‘Surgery OR Operation OR Resection’ as Intervention, and Non-Industry sponsored. The search was limited to Canada and the United States and included trials registered from January 1, 2001 to January 1, 2011. The search was performed on March 23, 2011 by three investigators in parallel. The total number of oncology trials was also obtained. Results: Of 9990 oncology trials, 1049 (10.5%) included any type of surgical intervention. Of these trials, 125 (11.9%; 1.3% of all oncology trials) manipulated a surgical variable, 773 (73.7%) assessed adjuvant/neoadjuvant therapies, and 151 (14.4%) were observational studies. Trials assessing adjuvant therapies focused on systemic treatment (362 trials, 46.8%) and multimodal therapy (129 trials, 16.7%). Of the 125 trials where surgery was the manipulated variable, 59 trials (47.2%) focused on surgical techniques (including minimally invasive) or devices, 45 trials (36.0%) studied invasive diagnostic methods, and 21 trials (16.8%) evaluated surgery vs. no surgery. The majority of the 125 trials were non- randomized (72, 57.6%), and Phase III trials accounted for less than one-quarter (29, 23.2%). Conclusions: The number of registered surgical oncology trials is small in comparison to oncology trials as a whole. Clinical trials specifically designed to assess surgical interventions are vastly outnumbered by trials focusing on adjuvant therapies, and are frequently non-randomized. Randomized surgical oncology trials account for <1% of all registered cancer trials. Barriers to the design and implementation of randomized trials in surgical oncology need to be clarified to facilitate higher-level evidence in surgical decision making.

scholarly journals Morphometric Analysis of Piriform Aperture in Human Skulls

2018 ◽  
Vol 36 (2) ◽  
pp. 483-487
Author(s):  
Thales Marx Soares de-Araújo ◽  
Cristiano Jenes Teixeira da-Silva ◽  
Luana Karla Nóbrega de-Medeiros ◽  
Yoshyara da Costa Anacleto Estrela ◽  
Nathalie de Almeida Silva ◽  
...  
Keyword(s):  
Morphometric Analysis ◽  
Human Skulls ◽  
Piriform Aperture
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