scholarly journals Dorsolumbar Vertebroplasty- A Retrospective Study

2021 ◽  
Author(s):  
Murat Yilmaz ◽  
Nihat Acar ◽  
Ahmet Aybar ◽  
Ahmet Karakasli
Keyword(s):  
Retrospective Study ◽  
Spinal Canal ◽  
Posterior Longitudinal Ligament ◽  
Cement Leakage ◽  
Radicular Pain ◽  
Decompression Surgery ◽  
Inclusion Criteria ◽  
Vertebral Metastasis ◽  
Disc Space ◽  
The Mean

Introduction: Percutaneous Vertebroplasty (PVP) is a procedure frequently performed to obtain pain relief and mechanical strengthening of the collapsed vertebral body which may be caused by variant reasons. Aim: To assess frequent complications commonly encountered during vertebroplasty procedure. Materials and Methods: A retrospective study was conducted on 1375 patients followed from January 2005 and June 2012 in Department of Neurosurgery, faculty of medicine, Dokuz Eylül University. Severe vertebral fracture collapse (vertebra plana), vertebral metastasis, quadriplegic patients and bed-ridden patients were excluded from this study, whereas active mobile patients without associated severe co-morbidities were included in the study. Pain, pattern of cement leakage and associated complications had been assessed. Results: Total 601 patients who fullfilled the inclusion criteria {244 (40.5%) males, 357 (59.5%) females}, average age was 63.04±7.4 (range 34 to 90) years, had undergone the PVP procedure. Mean preoperative Visual Analog Scale (VAS) was 8.51±1.5, whereas after one and six months, the mean postoperative VAS were 1.94±1.0 and 2.53±2.2, respectively. Central spinal canal leakage has been observed in four cases. Three patients had developed transient monoparesis and radiculopathy symptoms. Whereas, the fourth patient developed paraplegia. Cement leakage had been tolerated well by one patient, where symptomatic resolution occurred within one month. However, decompressive foraminotomy had been performed for two patients on the 24th and 38thdays postoperatively due to intractable radicular pain. Immediate total laminectomy and decompression surgery had been performed for removal of the cement leakage to the spinal canal for the patient who developed total paraplegia. Asymptomatic leakage had been recognised beneath the posterior longitudinal ligament in 42 patients (6.9%), beneath the anterior longitudinal ligament in 18 patients (2.9%) and into disc space in 31 patients (5.1%). Venous leakage occurred in four patients (0.6%) and was asymptomatic in all of them. Conclusion: Vertebroplasty should be performed in a fully equipped operation theater in order to be able to revert quickly to open surgery in case of cement leakage into the spinal canal.

scholarly journals Prevalence of Dermatological Presentations of Canine Leishmaniasis in a Nonendemic Area: A Retrospective Study of 100 Dogs

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Roberta Perego ◽  
Daniela Proverbio ◽  
Giada Bagnagatti De Giorgi ◽  
Eva Spada
Keyword(s):  
Immune System ◽  
Retrospective Study ◽  
Medical Records ◽  
Canine Leishmaniasis ◽  
Inclusion Criteria ◽  
Continuous Stimulation ◽  
Exfoliative Dermatitis ◽  
The Mean ◽  
Endemic Areas ◽  
Stimulation Of

This retrospective study determined the prevalence of dermatological lesions associated with canine leishmaniasis (CanL) in a nonendemic area in Italy. The medical records of 131 dogs with CanL were reviewed and, of these, 115/131 dogs (88%) had dermatological manifestations of which 100/131 dogs (76%) met the inclusion criteria. Sixty-two percent of dogs were male and 38% were female and the mean age was 6.4 years. Thirty-two percent of dogs were mixed breeds; the remainder represented a variety of pure breeds. In 79% of dogs dermatological signs occurred in association with systemic signs of CanL, whilst 21% of dogs had only dermatological manifestations. The most common dermatological manifestation was exfoliative dermatitis (74%), followed by ulcerative (18%) and nodular (11%) lesions. In 51% of dogs the lesions were localized mainly on the pinnae, head, and pressure points; in the remaining 49% lesions were generalized. The only statistically significant association was between Retriever breed and animals with only dermatological signs (P=0.0034, OD 5.97, CI 0.996–37.933). In this study dermatological manifestations of CanL were very commonly reported, and their prevalence is similar to previous studies in endemic areas despite the fact that dogs living in nonendemic areas are not exposed to repeated infectious bites and continuous stimulation of the dermal immune system.

scholarly journals Microendoscopic Decompression Surgery for Lumbar Spinal Canal Stenosis via the Paramedian Approach: Preliminary Results

2012 ◽  
Vol 2 (2) ◽  
pp. 087-093 ◽  
Author(s):  
Kazunori Nomura ◽  
Munehito Yoshida
Keyword(s):  
Spinal Canal ◽  
Spinous Process ◽  
Japanese Orthopaedic Association ◽  
Spinal Canal Stenosis ◽  
Decompression Surgery ◽  
Lumbar Spinal Canal Stenosis ◽  
Canal Stenosis ◽  
The Mean ◽  
Lumbar Spinal Canal ◽  
Lumbar Spinal

The objective of this study was to evaluate the efficacy of a microendoscopic spinal decompression surgical technique using a novel approach for the treatment of lumbar spinal canal stenosis (LSCS). The following modifications were made to the conventional microendoscopic bilateral decompression via the unilateral approach: the base of the spinous process was first resected partially to secure a working space, so as not to separate the spinous process from the lamina. The tip of the tubular retractor was placed at the midline of the lamina, where laminectomy was performed microendoscopically. A total of 126 stenotic levels were decompressed in 70 patients. The mean operating time per level was 77.0 minutes, and the mean intraoperative blood loss per level was 15.0 mL. There were no dural tears or neurological injuries intraoperatively. Fracture of the spinous process was detected postoperatively in two patients, both of whom were asymptomatic. All patients could be followed up for at least 12 months. Their median Japanese Orthopaedic Association (JOA) score improved significantly from 16 points preoperatively to 27.5 points after the surgery (p < 0.001). The case series showed that the modifications of the technique improved the safety and ease of performance of the microendoscopic decompression surgery for LSCS.

scholarly journals Nomogram for Predicting Intradiscal Cement Leakage Following Percutaneous Vertebroplasty in Patients with Osteoporotic Related Vertebral Compression Fractures

2017 ◽  
Vol 4 (20;4) ◽  
pp. E513-E550
Author(s):  
Gao-Jun Teng
Keyword(s):  
Risk Factors ◽  
Retrospective Study ◽  
Percutaneous Vertebroplasty ◽  
Cement Leakage ◽  
Vertebral Compression Fractures ◽  
Compression Fractures ◽  
Kummell’S Disease ◽  
Independent Risk Factors ◽  
The Mean ◽  
Kümmell’S Disease

Background: Intradiscal cement leakage (ICL) is a common complication following percutaneous vertebroplasty (PVP). However, the risk factors for such a complication are under debate and there is no accurate predictive nomogram to predict ICL. Objectives: To establish an effective and novel nomogram for ICL following PVP in patients with osteoporotic-related vertebral compression fractures (OVCFs). Study Design: This was a retrospective study approved by the Institutional Review Board of our institution. Setting: This study consists of patients from a large academic center. Methods: Patients with OVCFs who underwent their first PVP in our department between January 2007 and December 2013 were included in this study. All the potential risk factors of ICL after PVP were recorded. Univariate and multivariate analyses were used to identify the independent risk factors. The nomogram was then created based on the identified independent risk factors. Results: A total of 241 patients and 330 vertebrae were included. The mean age of the patients was 73.5 (SD 7.9) years old, and the mean number of treated vertebrae was 1.4 per person. ICL was observed in 93 (28.2%) of the treated vertebrae. Greater fracture severity (P = 0.016), cortical disruption of the endplate (P < 0.0001), absence of Kummell’s disease (P = 0.010), and higher computed tomography (CT) values (P = 0.050) were the independent risk factors for ICL. Limitations: The main limitation of this study is that it is a retrospective study. Conclusion: Greater fracture severity, cortical disruption of the endplate, absence of Kummell’s disease, and higher CT values are the independent risk factors for ICL. The novel nomogram gives an accurate prediction of ICL. Key words: Osteoporotic vertebral compression fracture, percutaneous vertebroplasty, intradiscal cement leakage, risk factors, prediction, nomogram

Revisiting the Natural History of Chronic Scaphoid Nonunions: A Retrospective Study of 20 Cases

2021 ◽  
Author(s):  
J. Terrence Jose Jerome
Keyword(s):  
Retrospective Study ◽  
Natural History ◽  
Functional Outcome ◽  
Grip Strength ◽  
Scaphoid Nonunion ◽  
Proximal Pole ◽  
Degenerative Arthritis ◽  
Level Of Evidence ◽  
History Of ◽  
The Mean

Abstract Background The natural history of scaphoid nonunion is the development of degenerative arthritis. A lot of information is still unclear about this progression. The purpose of this study is to analyze patients with scaphoid nonunions who had not received any kind of treatment and to assess the functional outcome. Materials and Methods This is a retrospective study that analyzed the patients with chronic scaphoid nonunions between 2009 and 2019. None of the patients received any treatment. The age at the time of injury, examination, pattern of fracture, types of scaphoid nonunion, symptoms, and duration of nonunion were noted. Diagnosis was confirmed by radiographs, computed tomography (CT) scan, and magnetic resonance imaging (MRI). Scapholunate and radiolunate angles were recorded. Pain score, modified mayo wrist score, grip strength, range of movement, and the functional outcome of these scaphoid nonunions were analyzed. A statistical correlation between the scaphoid nonunion presentations and the functional outcome was assessed. Results The mean age of the patients was 62 years (range: 35–82 years.). There were 17 male and 3 female patients. There were 9 waist and 11 proximal pole scaphoid nonunions. The mean duration of scaphoid nonunion was 34 years (range: 10–62 years). None of the patients had avascular necrosis (AVN) of the proximal scaphoid. The age at examination, gender, side of injury, fracture pattern (waist/proximal pole), fracture displacement ≤ 1 mm or > 1 mm, nonunion duration, and radiographic arthritic parameters had no significant impact on the functional outcome. Conclusions Untreated chronic scaphoid nonunion leads to the development of degenerative arthritis over a period of years, which is still unpredictable. Most of the patients become aware of the nonunion following a precedent injury or other reasons. Most of the patients have fair/good functional outcome despite reduced range of movements and grip strength. Many do not favor surgical intervention in the course of nonunion. Chronic nonunions open a lot of unanswered questions. Clinical relevance There have been numerous studies on the treatment aspects of scaphoid nonunion, with little knowledge about certain people with nonunion who did not have any kind of treatment. The demographics, clinical findings, and radiological parameters do confirm the progression of these nonunion to arthritis, but most of them had fair-to-good outcome throughout their life. It opens our thinking about the real need of treatment in such nonunions and raises numerous questions about the disease. Level of evidence This is a Level IV study.

Comparison of Heffner Criteria and Light Criteria in Differentiating Exudative and Transudative Pleural Effusion

2020 ◽  
Vol 22 (3) ◽  
pp. 141-145
Author(s):  
Krishna Chandra Devkota ◽  
S Hamal ◽  
PP Panta
Keyword(s):  
Pleural Effusion ◽  
Cross Sectional Study ◽  
Pleural Space ◽  
Sectional Study ◽  
Inclusion Criteria ◽  
Cross Sectional ◽  
Medical College ◽  
The Common ◽  
The Mean ◽  
Exudative Pleural Effusion

Pleural effusion is present when there is >15ml of fluid is accumulated in the pleural space. It can be divided into two types; exudative and transudative pleural effusion. Tuberculosis and parapneumonic effusion are the common cause of exudative pleural effusion whereas heart failure accounts for most of the cases of transudative pleural effusion. This study was a hospital based cross sectional study performed at Nepal Medical College during the period of January 2016-December 2016. A total of 50 patients who fulfilled the inclusion criteria were enrolled. Pleural effusion was confirmed by clinical examination and radiology. After confirmation of pleural effusion, pleural fluid was aspirated and was analysed for protein, LDH, cholesterol. The Heffner criteria was compared with Light criteria to classify exudative or transudative pleural effusion. Among 50 patients, 30 were male and 20 were female. The mean age of patient was 45.4±21.85 years. The sensitivity and specificity of using Light criteria to detect the two type of pleural effusion was 100% and 90.9%, whereas using Heffner criteria was 94.87%, 100% respectively(P<0.01). There are variety of causes for development of pleural effusion and no one criteria is definite to differentiate between exudative or transudative effusion. In this study Light criteria was more sensitive whereas Heffner criteria was more specific to classify exudative pleural effusion. Hence a combination of criteria might be useful in case where there is difficulty to identify the cause of pleural effusion.

Connection of discontinuous segments in early functional recovery from thoracic ossification of the posterior longitudinal ligament treated with posterior instrumented surgery

2020 ◽  
Vol 32 (2) ◽  
pp. 200-206
Author(s):  
Kei Ando ◽  
Kazuyoshi Kobayashi ◽  
Masaaki Machino ◽  
Kyotaro Ota ◽  
Satoshi Tanaka ◽  
...  
Keyword(s):  
Early Stage ◽  
Morphological Changes ◽  
Japanese Orthopaedic Association ◽  
Multislice Ct ◽  
Posterior Longitudinal Ligament ◽  
Ct Images ◽  
Rigid Fixation ◽  
Disc Space ◽  
Fusion Surgery ◽  
Estimated Blood Loss

OBJECTIVEThe objective of this study was to investigate the relationship between morphological changes in thoracic ossification of the posterior longitudinal ligament (T-OPLL) and postoperative neurological recovery after thoracic posterior fusion surgery. Changes of OPLL morphology and postoperative recovery in cases with T-OPLL have not been examined.METHODSIn this prospective study, the authors evaluated data from 44 patients (23 male and 21 female) who underwent posterior decompression and fusion surgery with instrumentation for the treatment of T-OPLL at our hospital. The patients’ mean age at surgery was 50.7 years (range 38–68 years). The minimum duration of follow-up was 2 years. The location of thoracic ossification of the ligamentum flavum (T-OLF), T-OLF at the OPLL level, OPLL morphology, fusion range, estimated blood loss, operative time, pre- and postoperative Japanese Orthopaedic Association (JOA) scores, and JOA recovery rate were investigated. Reconstructed sagittal multislice CT images were obtained before and at 3 and 6 months and 1 and 2 years after surgery. The basic fusion area was 3 vertebrae above and below the OPLL lesion. All parameters were compared between patients with and without continuity across the disc space at the OPLL at 3 and 6 months after surgery.RESULTSThe preoperative morphology of OPLL was discontinuous across the disc space between the rostral and caudal ossification regions on sagittal CT images in all but one of the patients. Postoperatively, these segments became continuous in 42 patients (97.7%; occurring by 6.6 months on average) without progression of OPLL thickness. Patients with continuity at 3 months had significantly lower rates of diabetes mellitus (p < 0.05) and motor palsy in the lower extremities (p < 0.01). The group with continuity also had significantly higher mean postoperative JOA scores at 3 (p < 0.01) and 6 (p < 0.05) months and mean JOA recovery rates at 3 and 6 months (both p < 0.01) after surgery.CONCLUSIONSPreoperatively, discontinuity of rostral and caudal ossified lesions was found on CT in all patients but one of this group of 44 patients who needed surgery for T-OPLL. Rigid fixation with instrumentation may have allowed these segments to connect at the OPLL. Such OPLL continuity at an early stage after surgery may accelerate spinal cord recovery.

Lateral lumbar interbody fusion in revision surgery for restenosis after posterior decompression

2020 ◽  
Vol 49 (3) ◽  
pp. E11 ◽  
Author(s):  
Yoshifumi Kudo ◽  
Ichiro Okano ◽  
Tomoaki Toyone ◽  
Akira Matsuoka ◽  
Hiroshi Maruyama ◽  
...  
Keyword(s):  
Revision Surgery ◽  
Spinal Canal ◽  
Interbody Fusion ◽  
Decompression Surgery ◽  
Complication Rates ◽  
Lumbar Interbody Fusion ◽  
Posterior Decompression ◽  
Lateral Lumbar Interbody Fusion ◽  
Significant Difference ◽  
Dural Tears

OBJECTIVEThe purpose of this study was to compare the clinical results of revision interbody fusion surgery between lateral lumbar interbody fusion (LLIF) and posterior lumbar interbody fusion (PLIF) or transforaminal lumbar interbody fusion (TLIF) with propensity score (PS) adjustments and to investigate the efficacy of indirect decompression with LLIF in previously decompressed segments on the basis of radiological assessment.METHODSA retrospective study of patients who underwent revision surgery for recurrence of neurological symptoms after posterior decompression surgery was performed. Postoperative complications and operative factors were evaluated and compared between LLIF and PLIF/TLIF. Moreover, postoperative improvement in cross-sectional areas (CSAs) in the spinal canal and intervertebral foramen was evaluated in LLIF cases.RESULTSA total of 56 patients (21 and 35 cases of LLIF and PLIF/TLIF, respectively) were included. In the univariate analysis, the LLIF group had significantly more endplate injuries (p = 0.03) and neurological deficits (p = 0.042), whereas the PLIF/TLIF group demonstrated significantly more dural tears (p < 0.001), surgical site infections (SSIs) (p = 0.02), and estimated blood loss (EBL) (p < 0.001). After PS adjustments, the LLIF group still showed significantly more endplate injuries (p = 0.03), and the PLIF/TLIF group demonstrated significantly more dural tears (p < 0.001), EBL (p < 0.001), and operating time (p = 0.04). The PLIF/TLIF group showed a trend toward a higher incidence of SSI (p = 0.10). There was no statistically significant difference regarding improvement in the Japanese Orthopaedic Association scores between the 2 surgical procedures (p = 0.77). The CSAs in the spinal canal and foramen were both significantly improved (p < 0.001).CONCLUSIONSLLIF is a safe, effective, and less invasive procedure with acceptable complication rates for revision surgery for previously decompressed segments. Therefore, LLIF can be an alternative to PLIF/TLIF for restenosis after posterior decompression surgery.

Effect of Surgical Versus Pharmacological Decompression of Ludwig’s Angina on Airway Compromise among Nigerian Patients

2020 ◽  
Author(s):  
Ekaniyere EB
Keyword(s):  
Length Of Hospital Stay ◽  
Surgical Decompression ◽  
Airway Compromise ◽  
Inclusion Criteria ◽  
Hospital Stays ◽  
Ludwig’S Angina ◽  
The Mean ◽  
The University ◽  
Ludwig's Angina ◽  
Gender Type

Background: Even though the decompression of the cellulitis phase of Ludwig’s angina (LA) by surgical or pharmacological approach is well documented, it is unclear which approach is more effective. Objective: We aim to compare the outcome of treatment between surgical versus pharmacological decompression in patients with LA. Subjects and Methods: A retrospective cohort study was designed. Data were collected from the case notes of patients that met the inclusion criteria from 2004 to 2018 at the University of Benin Teaching Hospital, Nigeria.The data were age, gender, type of decompression approach, length of hospital stay (LOS) and airway compromise. Result: A total of 62 patients comprising 37(59.7%) surgical decompression group and 25(40.3%) pharmacological decompression group were studied. Thirty-six (58.1%) males and 26 (41.9%) females were studied. Their mean age and standard deviation were 40.6 years and 11.9 years respectively. The mean length of hospital stays between the pharmacological and surgical decompression groups were 8.05 days and 13.8 days respectively. The incidence of airway compromise in the surgical decompression group was 19.9% lower than that of the pharmacological decompression group (P=0.47), which was not significant. The type of decompression approach also failed to influence the incidence of airway compromise (P = 0.41). Conclusion: The use of surgical versus pharmacological decompression does not significantly alter the incidence of airway compromise in the management of LA. The Patients that had surgical decompression had a shorter stay in the hospital as compared to those who had pharmacological decompression. This was not statistically significant.

Percutaneous removal of a soft tissue cement leakage complicating a percutaneous vertebroplasty by the mean of a supple biopsy forceps

2013 ◽  
Vol 40 (2) ◽  
pp. 140-142 ◽  
Author(s):  
Jérémie Durrleman ◽  
Frédéric Clarençon ◽  
Evelyne Cormier ◽  
Lise Le Jean ◽  
Jacques Chiras
Keyword(s):  
Soft Tissue ◽  
Percutaneous Vertebroplasty ◽  
Cement Leakage ◽  
Biopsy Forceps ◽  
Percutaneous Removal ◽  
The Mean

Skeletal and Dental Correction and Stability Following LeFort I Advancement in Patients With Cleft Lip and Palate With Mild, Moderate, and Severe Maxillary Hypoplasia

2021 ◽  
pp. 105566562199610
Author(s):  
Buddhathida Wangsrimongkol ◽  
Roberto L. Flores ◽  
David A. Staffenberg ◽  
Eduardo D. Rodriguez ◽  
Pradip. R. Shetye
Keyword(s):  
Retrospective Study ◽  
Outcome Measures ◽  
Cleft Lip ◽  
Outcome Measure ◽  
Cleft Lip And Palate ◽  
Inclusion Criteria ◽  
Maxillary Hypoplasia ◽  
Main Outcome Measure ◽  
Lateral Cephalograms

Objective: This study evaluates skeletal and dental outcomes of LeFort I advancement surgery in patients with cleft lip and palate (CLP) with varying degrees of maxillary skeletal hypoplasia. Design: Retrospective study. Method: Lateral cephalograms were digitized at preoperative (T1), immediately postoperative (T2), and 1-year follow-up (T3) and compared to untreated unaffected controls. Based on the severity of cleft maxillary hypoplasia, the sample was divided into 3 groups using Wits analysis: mild: ≤0 to ≥−5 mm; moderate: <−5 to >−10 mm; and severe: ≤−10 mm. Participants: Fifty-one patients with nonsyndromic CLP with hypoplastic maxilla who met inclusion criteria. Intervention: LeFort I advancement. Main Outcome Measure: Skeletal and dental stability post-LeFort I surgery at a 1-year follow-up. Results: At T2, LeFort I surgery produced an average correction of maxillary hypoplasia by 6.4 ± 0.6, 8.1 ± 0.4, and 10.7 ± 0.8 mm in the mild, moderate, and severe groups, respectively. There was a mean relapse of 1 to 1.5 mm observed in all groups. At T3, no statistically significant differences were observed between the surgical groups and controls at angle Sella, Nasion, A point (SNA), A point, Nasion, B point (ANB), and overjet outcome measures. Conclusions: LeFort I advancement produces a stable correction in mild, moderate, and severe skeletal maxillary hypoplasia. Overcorrection is recommended in all patients with CLP to compensate for the expected postsurgical skeletal relapse.

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