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Preoperative neurological clearance

Jixin Zhang, Shiyong Lu, Suzhen Wang, Naiyun Zhou, Guoliang Li
Objective: This study was aimed to compare and analyze the effects and safety of minimally invasive and craniotomy in the treatment of hypertensive intracerebral hemorrhage. Methods: A total of 130 patients with hypertensive intracerebral hemorrhage were recruited. The patients were randomly divided into two groups (research and control group). Research group was treated with endoscopic minimally invasive surgery, while control group was treated with craniotomy and hematoma clearance...
May 2018: Pakistan Journal of Medical Sciences Quarterly
H Wu, D-X Zhao, R Jiang, X-Y Zhou
We aimed to describe the surgical technique and clinical outcomes of paraspinal-approach reduction and fixation (PARF) in a group of patients with Denis type B thoracolumbar burst fracture (TLBF) with neurological deficiencies. A total of 62 patients with Denis B TLBF with neurological deficiencies were included in this study between January 2009 and December 2011. Clinical evaluations including the Frankel scale, pain visual analog scale (VAS) and radiological assessment (CT scans for fragment reduction and X-ray for the Cobb angle, adjacent superior and inferior intervertebral disc height, and vertebral canal diameter) were performed preoperatively and at 3 days, 6 months, and 1 and 2 years postoperatively...
2016: Brazilian Journal of Medical and Biological Research
Simret Singh Randhawa, Angel Khor Nee Kwan, Chee Kidd Chiu, Chris Yin Wei Chan, Mun Keong Kwan
We report two patients with cauda equina syndrome (CES) secondary to L5 giant cell tumour (GCT) who achieved good neurological recovery after treatment with denosumab without surgery. The first patient was a 26-year-old man with L5 GCT causing CES who regained bowel and urinary control, muscle power improvement from grade 2 to grade 4 and Oswestry disability index (ODI) improvement from 48 to 23 after denosumab treatment. The second patient was a 25-year-old woman with L5 GCT causing CES who regained bowel and urinary control, muscle power improvement from grade 0 to grade 4 and ODI improvement from 42 to 20 after denosumab treatment...
October 2016: Asian Spine Journal
Shawn M Stevens, Brendan P O'Connell, Ted A Meyer
PURPOSE OF REVIEW: This article aims to review relevant implications of obesity and associated comorbid conditions for the otology and neurotology surgical subspecialties. RECENT FINDINGS: Both the incidence and prevalence of obesity are rising worldwide. This condition, along with its many associated comorbidities, can adversely affect the perioperative management of patients undergoing otologic and neurotologic procedures. Preoperative assessment of the cardiopulmonary system and airway are imperative as compromise of either may lead to death...
October 2015: Current Opinion in Otolaryngology & Head and Neck Surgery
Aya Tanaka, Ryuichi Shimono, Hiroyuki Kubo, Takayuki Fujii, Nobuyuki Miyatake
PURPOSE: This study aimed to evaluate esophageal function before and after antireflux surgery (ARS) in neurologically impaired (NI) patients using 24 h multichannel intraluminal impedance (MII)-pH measurement. METHODS: Seven NI patients (age, 0-33 years; median, 13 years) were assessed before and after ARS using 24 h MII-pH. We described reflux parameters such as pH reflux index, bolus exposure index, number of acidic and nonacidic reflux episodes, mean acid clearance time and median bolus clearance time, and esophageal motility parameters in dry swallows such as bolus presence time (BPT), total bolus transit time (TBTT), and total propagation velocity (TPV)...
October 2015: Pediatric Surgery International
Daniel J Blizzard, Christopher P Hills, Robert E Isaacs, Christopher R Brown
The purpose of this study was to evaluate our initial experience utilizing extreme lateral interbody fusion (XLIF; NuVasive, San Diego, CA, USA) with percutaneous posterior instrumentation to treat 11 spondylodiscitis patients between January 2011 and February 2014. Although medical management is the first line treatment for spondylodiscitis, many patients fail antibiotic therapy and bracing, or present with instability, neurologic deficits, or sepsis, requiring operative debridement and stabilization. High rates of fusion and infection clearance have been reported with anterior lumbar interbody fusion (ALIF), but this approach requires a morbid exposure, associated with non-trivial rates of vascular and peritoneal complications...
November 2015: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Rongchun Chen, Yunsheng Chen, Yunfeng Zeng, Chaoyang Guo, Qin Chen, Minghong Li
OBJECTIVE: To investigate the effectiveness of retroperitoneal laparoscopic approach combined with anterolateral mini-incision for lumbar spine tuberculosis. METHODS: A retrospective analysis was made on the clinical data of 22 patients with lumbar spine tuberculosis undergoing focus clearance, fusion, and internal fixation by retroperitoneal laparoscopic approach combined with anterolateral mini-incision between June 2006 and June 2012. There were 14 males and 8 females, with an average age of 42...
November 2014: Chinese Journal of Reparative and Reconstructive Surgery
Domenico Paparella, Pietro Guida, Valerio Mazzei, Carmine Carbone, Giuseppe Speziale, Vitantonio Fanelli, Salvatore Zaccaria, Cataldo Labriola, Giuseppe Scrascia
BACKGROUND: Acute Kidney Injury (AKI) after cardiac surgery is a complication influencing postoperative outcome. Preoperative hemoglobin is a predictor of postoperative AKI. We aimed to identify preoperative predictors of Renal Replacement Therapy (RRT) and to develop a new risk-scoring system including hemoglobin to better stratify the risk of events. METHODS: We evaluated 3288 consecutive patients of the Regional Cardiac Surgery Registry of Puglia operated in 2011-2012...
October 20, 2014: International Journal of Cardiology
Zhouming Deng, Hui Zou, Lin Cai, Ansong Ping, Yongzhi Wang, Qiyong Ai
This study aims to investigate the efficacy of posterior short-segment pedicle instrumentation without fusion in curing thoracolumbar burst fracture. All of the 53 patients were treated with short-segment pedicle instrumentation and laminectomy without fusion, and the restoration of retropulsed bone fragments was conducted by a novel custom-designed repositor (RRBF). The mean operation time and blood loss during surgery were analyzed; the radiological index and neurological status were compared before and after the operation...
2014: TheScientificWorldJournal
Limin Liu, Yueming Song, Quan Gong, Chunguang Zhou, Yonggang An
OBJECTIVE: To explore the effectiveness and safety of treatment of thoracic tuberculosis with thoracoscope supported by digital technology. METHODS: Between June 2010 and February 2012, 11 patients with thoracic tuberculosis were treated and the clinical data were retrospectively analyzed. There were 7 males and 4 females with an average age of 23.6 years (range, 16-47 years) and an average disease duration of 16 months (range, 6-18 months). Two vertebral bodies and one intervertebral space were involved at T6-ll...
January 2014: Chinese Journal of Reparative and Reconstructive Surgery
Cağdaş Akgüllü, Ufuk Eryılmaz, Tünay Kurtoğlu
A 41-year-old female was admitted to our hospital with an unidentified source of fever, dyspnea and dizziness. Transthoracic echocardiography demonstrated severe mitral valve regurgitation, and further examination with transesophageal echocardiography (TEE) revealed a 7 mm vegetation on the anterior mitral leaflet. Blood cultures were negative, and after 45 days of empiric 12 g/day ampicillin-sulbactam therapy, the vegetation was shown to have disappeared. However, due to ongoing severe mitral regurgitation and valve deformity, a prosthetic metallic mitral valve replacement was performed...
September 2013: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
Neeraj Bhalla, David J Husband, Robin Pillay, Nicki Thorp
A woman underwent breast conservation surgery and axillary clearance for T1N1M0 breast carcinoma, followed by adjuvant chemotherapy, radiotherapy and hormone therapy. At 3-year follow-up she presented with lumbar back pain and developed bilateral lower limb weakness. MRI spine demonstrated an expansile lesion at L1 causing cauda equina compression. The mass, unusually, was centred on the spinous process; metastases typically involve pedicles. The patient underwent surgical decompression with complete resolution of neurological signs...
2013: BMJ Case Reports
Amy A Pruitt
Symptomatic neurologic complications of IE are frequent, and asymptomatic cerebral embolism diagnosed by magnetic resonance imaging (MRI) occurs in many more patients. Neurologic complications increase mortality and complicate surgical decision-making. The most common neurologic complication is stroke due to septic embolism. Other complications include micro- and macro-abscesses, infectious aneurysms, and more general toxic-metabolic encephalopathies, cerebrospinal fluid (CSF) pleocytosis, and seizures. Neurologic complications influence diagnosis, management, and prognosis...
August 2013: Current Treatment Options in Neurology
F Racca, T Mongini, A Wolfler, A Vianello, R Cutrera, L Del Sorbo, E C Capello, C Gregoretti, R Massa, D De Luca, G Conti, V Tegazzin, A Toscano, V M Ranieri
Patients with neuromuscular disorders are at high risk of intraoperative and postoperative complications. General anesthesia in these patients may exacerbate respiratory and cardiovascular failure due to a marked sensitivity to several anesthetic drugs. Moreover, succinylcholine and halogenated agents can trigger life-threatening reactions, such as malignant hyperthermia, rhabdomyolysis and severe hyperkalemia. Therefore, regional anesthesia should be used whenever possible. If general anesthesia is unavoidable, special precautions must be taken...
April 2013: Minerva Anestesiologica
Nancy E Epstein
BACKGROUND: Although we routinely utilize medical consultants for preoperative clearance and postoperative patient follow-up, we as spine surgeons need to know more medicine to better select and care for our patients. METHODS: This study provides additional medical knowledge to facilitate surgeons' "cross-talk" with medical colleagues who are concerned about how multiple comorbid risk factors affect their preoperative clearance, and impact patients' postoperative outcomes...
2012: Surgical Neurology International
Xu Cui, Yuan-zheng Ma, Hong-wei Li, Xing Chen, Xiao-jun Cai, Yi-bing Bai, Li-xin Guo, Hai-bin Xue
OBJECTIVE: To compare the outcomes of anterior verus posterior instrumentation under different surgical procedures in the surgical management of thoracolumbar spinal tuberculosis (TB). METHODS: Between January 2004 and December 2009, 241 adult patients with thoracolumbar spinal TB underwent radical debridement and strut grafting plus anterior or posterior instrumentation in single-stage or two-stages. The mean age was 39 years (range: 16 - 67). The mean follow-up period for 189 patients was 37 months (range: 22 - 72)...
May 22, 2012: Zhonghua Yi Xue za Zhi [Chinese medical journal]
Philippe Nabbout, Gennady Slobodov, Adamantios M Mellis, Daniel J Culkin
BACKGROUND AND PURPOSE: Patients with spinal neuropathy are at an increased risk for urolithiasis. Data on percutaneous nephrolithotomy (PCNL) in this population are limited. Our objective is to review our experience in managing stones with PCNL in patients with spinal neuropathy. PATIENTS AND METHODS: Twenty-one patients with spinal neuropathy underwent PCNL at our institution between January 2005 and August 2011. Their medical records were reviewed retrospectively to collect data relating to stone characteristics, treatment outcomes, and complications...
December 2012: Journal of Endourology
Timothy Deer, Richard Bowman, Sandford Matthew Schocket, Christopher Kim, Matthew Ranson, Kasra Amirdelfan, Louis Raso
OBJECTIVES:   Spinal cord stimulation (SCS) has become a mainstay in the continuum of care for patients suffering from chronic neuropathic pain of the trunk and limbs. Options for placing these devices have included a percutaneous method of using an epidural needle to place a cylindrical (percutaneous) lead to stimulate the spinal cord, or an open laminotomy method for placing a paddle lead at the location of the surgical decompression of the laminae. Both of these methods have been successful in a high percentage of patients, but neither have been ideal...
January 2012: Neuromodulation: Journal of the International Neuromodulation Society
Yuan Zheng Ma, Xu Cui, Hong Wei Li, Xing Chen, Xiao Jun Cai, Yi Bing Bai
PURPOSE: There are few articles in the literature comparing outcomes between anterior and posterior instrumentation in the management of thoracic and lumbar spinal tuberculosis (TB). METHODS: Between January 2004 and December 2009, 217 adult patients, average age 39 (range 16-67) years with thoracic and lumbar spinal TB were treated by anterior radical debridement and fusion plus instrumentation, anterior radical debridement with fusion and posterior fusion with instrumentation, posterolateral debridement and fusion plus posterior instrumentation or transpedicular debridement and posterior fusion with instrumentation in a single- or two-stage procedure...
February 2012: International Orthopaedics
Ana Presedo, Fabrice Megrot, Brice Ilharreborde, Keyvan Mazda, Georges-François Penneçot
BACKGROUND: Children with spastic diplegia frequently show excessive knee extension (stiff-knee gait) throughout swing phase, which may interfere with foot clearance. Abnormal rectus femoris activity is commonly associated with a stiff-knee gait. Rectus femoris transfer has been recommended to enhance knee flexion during swing. However, recent studies suggest the transfer does not generate a knee flexor moment but diminishes knee extension moment in swing and MRI studies show the transferred tendons can be constrained by scarring to underlying muscles...
May 2012: Clinical Orthopaedics and related Research
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