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Sample records for cervical decompression morbidity

  1. Use of autologous bone graft in anterior cervical decompression: morbidity & quality of life analysis.

    LENUS (Irish Health Repository)

    Heneghan, Helen M

    2009-01-01

    BACKGROUND: Autologous iliac crest graft has long been the gold standard graft material used in cervical fusion. However its harvest has significant associated morbidity, including protracted postoperative pain scores at the harvest site. Thus its continued practice warrants scrutiny, particularly now that alternatives are available. Our aims were to assess incidence and nature of complications associated with iliac crest harvest when performed in the setting of Anterior Cervical Decompression (ACD). Also, to perform a comparative analysis of patient satisfaction and quality of life scores after ACD surgeries, when performed with and without iliac graft harvest. METHODS: All patients who underwent consecutive ACD procedures, with and without the use of autologous iliac crest graft, over a 48 month period were included (n = 53). Patients were assessed clinically at a minimum of 12 months postoperatively and administered 2 validated quality of life questionnaires: the SF-36 and Cervical Spine Outcomes Questionnaires (Response rate 96%). Primary composite endpoints included incidence of bone graft donor site morbidity, pain scores, operative duration, and quality of life scores. RESULTS: Patients who underwent iliac graft harvest experienced significant peri-operative donor site specific morbidity, including a high incidence of pain at the iliac crest (90%), iliac wound infection (7%), a jejunal perforation, and longer operative duration (285 minutes vs. 238 minutes, p = 0.026). Longer term follow-up demonstrated protracted postoperative pain at the harvest site and significantly lower mental health scores on both quality of life instruments, for those patients who underwent autologous graft harvest CONCLUSION: ACD with iliac crest graft harvest is associated with significant iliac crest donor site morbidity and lower quality of life at greater than 12 months post operatively. This is now avoidable by using alternatives to autologous bone without compromising clinical

  2. Anterior cervical decompression and fusion with caspar plate fixation

    International Nuclear Information System (INIS)

    Objective: To evaluate the role of anterior cervical decompression and fixation with Caspar plating in cervical spine injury on neurological outcome. Study Design: A case series. Place and Duration of Study: Department of Neurosurgery, Jinnah Postgraduate Medical Centre, Karachi, from July 2008 to March 2011. Methodology: Thirty patients admitted with cervical spine injuries were inducted in the study. All cases were evaluated for their clinical features, level of injury and degree of neurological injury was assessed using Frankel grading. Pre and postoperative record with X-rays and MRI were maintained. Cervical traction was applied to patients with sub-luxation. All patients underwent anterior cervical decompression, fusion and Caspar plate fixation. The follow-up period was 6 months with clinical and radiological assessment. Results: Among 30 patients, 24 (80%) were males and 6 (20%) were females. Age ranged from 15 to 55 years. Causes of injury were road traffic accident (n = 20), fall (n = 8) and assault (n = 2). Commonest mode of injury was road traffic accident (66.6%). Postoperative follow-up showed that pain and neurological deficit were improved in 21 patients. There was no improvement in 7 patients, one patient deteriorated and one expired. All patients developed pain at donor site. Conclusion: Anterior decompression, fusion and fixation with Caspar plate is an effective method with good neurological and radiological outcome. However, it is associated with pain at donor site. (author)

  3. Endoscopic anterior decompression in cervical disc disease

    Directory of Open Access Journals (Sweden)

    Yad Ram Yadav

    2014-01-01

    Full Text Available Background: Although microscopic anterior cervical discectomy with or without fusion are common surgical procedures for treatment of cervical herniated discs, loss of disc height, pseudarthrosis, and adjacent disc degeneration are some of the problems associated with it. This study is aimed to evaluate results of endoscopic microforaminotomy in cervical disc diseases. Materials and Methods: A prospective study of 50 patients of mono segmental soft or hard disc causing myeloradiculopathy was undertaken. A visual analogue scale (VAS for neck and arm pain and functional outcomes using the Nurick grading system were assessed. There were 28, 12, 8, and 2 patients at C5-6, C6-7, C4-5, and C3-4 levels disc diseases, respectively. Patients with two or more level disc, instabilities, disc extending more than half vertebral body height, and previous operation at the same segment were excluded. Results: Age ranged from 21 to 67 years. Average postoperative reduction in disc height, operating time, and blood loss was 1.1 mm, 110 minutes, and 30 ml, respectively. Average pre-operative VAS score for arm pain and Nurick grading was 7.6 and 2.7, which improved to 1.9 and 0.82, respectively. All patients improved; 1, 2, 3 grade improvement was seen in 10, 27, and 10 patients, respectively. There was no significant complication or any mortality. Conclusion: Although longer follow up of large number of patients is required, endoscopic microforaminotomy is a safe and an effective alternative to microscopic anterior discectomy with or without fusion.

  4. Multilevel cervical spondylotic myelopathy treated by anterior cervical decompression in subsection and autograft fusion

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    Objective:To investigate a novel surgical method for multilevel cervical spondylotic myelopathy (CSM). Methods: Totally 21 patients with multilevel CSM undergoing a novel surgical procedure from April 2001 to January 2004 were analyzed retrospectively. All patients experienced anterior cervical decompression surgery in subsection, autograft fusion and internal fixation. Preoperative, immediate postoperative and follow-up image data, X-rays and semi-quantitative Japanese orthopaedics association (JOA) scores were used to evaluate the restoration of lordosis (Cobb's angle), intervertebral heights, the stability of the cervical spine and the improvement of neurological impairment. Results: Preoperative symptoms were markedly alleviated or disappeared in most of the patients. According to the JOA scores, the ratio of improvement in neurological function was 72.2%, including excellent in 9 cases (42.9%), good in 7 cases (33.3%), fair in 3 cases (14.3%) and poor in 2 cases (9.5%). Immediate postoperative X-rays showed obvious improvements in lordosis and in the intervertebral height of the cervical spine (P<0.01). There is no evidence of instrument failure during the mean follow-up period of 14.2 months (9-24 months, P>0.01). Conclusion:Anterior cervical decompression in subsection, autograft fusion and internal fixation is a rational effective method for the surgical treatment of multilevel CSM.

  5. Clinical application of anterior cervical decompression and fusion under METRx system

    Institute of Scientific and Technical Information of China (English)

    ZHOU Yue; ZHANG Xia; WANG Wei-dong; LI Chang-qing; CHU Tong-wei; ZHANG Zheng-feng; WANG Jian; ZHENG Wen-jie

    2005-01-01

    Objective: To explore the feasibility and effect of anterior cervical decompression and fusion under METRx system. Methods: Between Nov. 2001 and Nov. 2003, totally 23 consecutive patients were performed anterior cervical decompression and fusion under METRx system. The clinical outcome was evaluated by Odom standard. Results: Decompression and fusion along with internal fixation was obtained in all the 23 patients with minimal tissue damage and operation-caused scar. There were no wound infection, neurological injuries, throat discomfort and other complications. The total rate of excellent and good outcome in patients with degenerative cervical diseases was 94%. Conclusion: Cervical decompression and fusion can be performed under METRx system with its own advantages, such as minimal tissue damage and operation-caused scar, less throat discomfort.

  6. Comparative evaluation of surgical alternatives in the treatment of acute cervical myelopathy and in the decompression of cervical spinal canal

    OpenAIRE

    Gábor Czigléczki; Zoltán Papp; Csaba Padányi; Péter Banczerowski

    2014-01-01

    Symptoms of cervical myelopathy are caused by the compression of the cervical spinal cord in the narrowed spinal canal. Several techniques including less invasive and minimally invasive methods have been developed with the aim of decompressing the cervical spinal canal, preserving posterior motion segments and paraspinal muscles as much as possible, reducing iatrogenic consequences and promoting faster recoveries of patients. The purpose of this article is to summarize these procedures and ev...

  7. Decompressive cervical laminectomy and lateral mass screw-rod arthrodesis. Surgical analysis and outcome

    OpenAIRE

    Obaidat Mouness H; Dabbas Waleed F; Qudsieh Tareq M; Obeidat Moutasem M; Audat Ziad A; Al Barbarawi Moh'd M; Malkawi Anas A

    2011-01-01

    Abstract Background This study evaluates the outcome and complications of decompressive cervical Laminectomy and lateral mass screw fixation in 110 cases treated for variable cervical spine pathologies that included; degenerative disease, trauma, neoplasms, metabolic-inflammatory disorders and congenital anomalies. Methods A retrospective review of total 785 lateral mass screws were placed in patients ages 16-68 years (40 females and 70 males). All cases were performed with a polyaxial screw-...

  8. Minimally invasive posterior cervical decompression using tubular retractor: The technical note and early clinical outcome

    Directory of Open Access Journals (Sweden)

    Jung-Woo Hur

    2014-01-01

    Full Text Available Background: The aim of this work is to present a novel decompression technique that approaches cervical spine posteriorly, but through minimal invasive method using tubular retractor avoiding detachment of posterior musculature. Methods: Six patients underwent minimally invasive posterior cervical decompression using the tubular retractor system and surgical microscope. Minimally invasive access to the posterior cervical spine was performed with exposure through a paramedian muscle-splitting approach. With the assistance of a specialized tubular retraction system and deep soft tissue expansion mechanism, multilevel posterior cervical decompression could be accomplished. This approach also allows safe docking of the retractor system on the lateral mass, thus avoiding the cervical spinal canal during exposure. A standard operating microscope was used with ×10 magnification and 400 mm focal length. The hospital charts, magnetic resonance imaging studies, and follow-up records of all the patients were reviewed. Outcome was assessed by neurological status and visual analog scale (VAS for neck and arm pain. Results: There was no significant complication related to operation. The follow-up time was 4-12 months (mean, 9 months. Muscle weakness improved in all patients; sensory deficits resolved in four patients and improved in two patients. Analysis of the mean VAS for radicular pain and VAS for neck pain showed significant improvement. Conclusions: The preliminary experiences with good clinical outcome seem to promise that this minimally invasive technique is a valid alternative option for the treatment of cervical spondylotic myelopathy.

  9. Application of Percutaneous Cervical Nucleoplasty Using the Navigable Disc Decompression Device in Patient of Cervical Herniated Intervertebral Disc: A Case Report

    OpenAIRE

    Lim, Ji-Hoon; Lee, Hye-Jin; Lee, Sang-Heon

    2013-01-01

    Recent years, various percutaneous procedures including cervical nucleoplasty have been developed for disc decompressions to relieve radicular pains caused by disc herniations. We report the application of percutaneous cervical nucleoplasty (PCN) by using the navigable disc decompression device in two patients of cervical herniated intervertebral discs (HIVD). A 38-year-old female diagnosed with C4-C5 disc extrusion with bilateral C5 roots impingement received nucleoplasty twice at C4-C5 disc...

  10. Myelopathic signs and functional outcome following cervical decompression surgery: a proposed myelopathy scale.

    Science.gov (United States)

    El-Zuway, Salem; Farrokhyar, Forough; Kachur, Edward

    2016-06-01

    OBJECTIVE Cervical spondylotic myelopathy (CSM) is the most common cause of spinal cord dysfunction in adults. In spite of this, the impact of the changes in myelopathic signs following cervical decompression surgery and their relationship to functional outcome measures remains unclear. The main goals of our study were to prospectively assess changes in myelopathic signs with a functional outcome scale (the modified Japanese Orthopaedic Association [mJOA] scale) following cervical decompression surgery and to objectively test a proposed new myelopathy scale (MS). METHODS Between 2008 and 2011, 36 patients with CSM were observed following cervical decompression surgery. Patient data including mJOA and MS scores were prospectively collected and analyzed preoperatively and at 1 year after surgery. RESULTS In this cohort, reflex, Babinski, and proprioception signs showed statistically significant improvement following surgery at 1 year (p = < 0.001, p = 0.008, and p = 0.015, respectively). A lesser degree of improvement was observed with the Hoffman sign (p = 0.091). No statistically significant improvement in clonus occurred (p = 0.368). There was a significant improvement in mJOA (p ≤ 0.001) and MS (p ≤ 0.001) scores at 1 year compared with the preoperative scores. The results showed an inverse correlation between MS and mJOA scores both pre- and postoperatively (Spearman's correlation coefficient = -0.202 preoperatively and -0.361 postoperatively). CONCLUSIONS Improvement in myelopathic signs was noted following cervical decompression surgery in patients with CSM. The newly devised MS scale demonstrated these findings, and the new MS scale correlates with improvement in mJOA scores in this patient cohort. PMID:26849710

  11. Comparative evaluation of surgical alternatives in the treatment of acute cervical myelopathy and in the decompression of cervical spinal canal

    Directory of Open Access Journals (Sweden)

    Gábor Czigléczki

    2014-01-01

    Full Text Available Symptoms of cervical myelopathy are caused by the compression of the cervical spinal cord in the narrowed spinal canal. Several techniques including less invasive and minimally invasive methods have been developed with the aim of decompressing the cervical spinal canal, preserving posterior motion segments and paraspinal muscles as much as possible, reducing iatrogenic consequences and promoting faster recoveries of patients. The purpose of this article is to summarize these procedures and evaluate their efficacy with comparing them to each other. The applicable methods are presented shortly but the differences between them are discussed in details. Comprehensive examination did not reveal the proven superiority of any techniques and in most cases the less invasive or minimally invasive treatment choices should be individually determined, considering the location and extension of pathology and the familiarity of surgeon with techniques.

  12. Decompressive cervical laminectomy and lateral mass screw-rod arthrodesis. Surgical analysis and outcome

    Directory of Open Access Journals (Sweden)

    Obaidat Mouness H

    2011-05-01

    Full Text Available Abstract Background This study evaluates the outcome and complications of decompressive cervical Laminectomy and lateral mass screw fixation in 110 cases treated for variable cervical spine pathologies that included; degenerative disease, trauma, neoplasms, metabolic-inflammatory disorders and congenital anomalies. Methods A retrospective review of total 785 lateral mass screws were placed in patients ages 16-68 years (40 females and 70 males. All cases were performed with a polyaxial screw-rod construct and screws were placed by using Anderson-Sekhon trajectory. Most patients had 12-14-mm length and 3.5 mm diameter screws placed for subaxial and 28-30 for C1 lateral mass. Screw location was assessed by post operative plain x-ray and computed tomography can (CT, besides that; the facet joint, nerve root foramen and foramen transversarium violation were also appraised. Results No patients experienced neural or vascular injury as a result of screw position. Only one patient needed screw repositioning. Six patients experienced superficial wound infection. Fifteen patients had pain around the shoulder of C5 distribution that subsided over the time. No patients developed screw pullouts or symptomatic adjacent segment disease within the period of follow up. Conclusion decompressive cervical spine laminectomy and Lateral mass screw stabilization is a technique that can be used for a variety of cervical spine pathologies with safety and efficiency.

  13. Chronic hypertrophic nonunion of the Type II odontoid fracture causing cervical myelopathy: Case report and review of literature

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    Mohammed F Shamji

    2016-01-01

    Conclusion: Rarely, nonunion of Type II odontoid fractures may be hypertrophic where both instability and compression cause neurological morbidity. Such cases require anterior transoral decompression, posterior cervical decompression, and instrumented fusions.

  14. Cervical total disc replacement is superior to anterior cervical decompression and fusion: a meta-analysis of prospective randomized controlled trials.

    Directory of Open Access Journals (Sweden)

    Yujie Zhang

    Full Text Available Despite being considered the standard surgical procedure for symptomatic cervical disc disease, anterior cervical decompression and fusion invariably accelerates adjacent segment degeneration. Cervical total disc replacement is a motion-preserving procedure developed as a substitute to fusion. Whether cervical total disc replacement is superior to fusion remains unclear.We comprehensively searched PubMed, EMBASE, Medline, and the Cochrane Library in accordance with the inclusion criteria to identify possible studies. The retrieved results were last updated on December 12, 2014. We classified the studies as short-term and midterm follow-up.Nineteen randomized controlled trials involving 4516 cases were identified. Compared with anterior cervical decompression and fusion, cervical total disc replacement had better functional outcomes (neck disability index [NDI], NDI success, neurological success, neck pain scores reported on a numerical rating scale [NRS], visual analog scales scores and overall success, greater segmental motion at the index level, fewer adverse events and fewer secondary surgical procedures at the index and adjacent levels in short-term follow-up (P 0.05.Cervical total disc replacement presented favorable functional outcomes, fewer adverse events, and fewer secondary surgical procedures. The efficacy and safety of cervical total disc replacement are superior to those of fusion. Longer-term, multicenter studies are required for a better evaluation of the long-term efficacy and safety of the two procedures.

  15. Anterior cervical fusion versus minimally invasive posterior keyhole decompression for cervical radiculopathy

    Directory of Open Access Journals (Sweden)

    Richard M. Young

    2015-12-01

    Conclusion: ACDF has been demonstrated to be an effective surgical procedure in treating degenerative spine disease in patients with radiculopathy and/or myelopathy. However, in a population with isolated radiculopathy and radiological imaging confirming an anterolateral disc or osteophyte complex, the MIPKF can provide similar results without the associated risks that accompany an anterior cervical spine fusion.

  16. Recurrence of cervical myelopathy secondary to a strut graft fracture 20 years after anterior decompression and fusion: a case report.

    Science.gov (United States)

    Kida, Kazunobu; Takaya, Shogo; Tadokoro, Nobuaki; Kumon, Masashi; Kiyasu, Katsuhito; Kato, Tomonari; Takemasa, Ryuichi; Ikeuchi, Masahiko; Tani, Toshikazu

    2015-08-01

    This study reports on a 70-year-old man with recurrent cervical myelopathy 20 years after anterior decompression and fusion of C4-7 using a free vascularised strut graft. The recurrent myelopathy was secondary to a kyphotic deformity of a fractured graft and residual ossification of the posterior longitudinal ligament with stenosis at C3/4. Intraoperative spinal cord-evoked potentials indicated that spinal cord traction secondary to progressive kyphosis of the cervical spine after the graft fracture was the cause. The patient underwent laminoplasty at C3 and laminectomy at C4 to decompress the stenosis at C3/4 as well as posterior cervical spinal fusion at C3-7 with pedicle screws and a lateral mass screw and a bone graft to prevent further progression of the kyphosis. At postoperative 18 months, the patient's Japanese Orthopaedic Association score had improved to 14 from 8, and he could walk without support. PMID:26321562

  17. Laminoplasty and laminectomy hybrid decompression for the treatment of cervical spondylotic myelopathy with hypertrophic ligamentum flavum: a retrospective study.

    Directory of Open Access Journals (Sweden)

    Huairong Ding

    Full Text Available OBJECTIVE: To report the outcomes of a posterior hybrid decompression protocol for the treatment of cervical spondylotic myelopathy (CSM associated with hypertrophic ligamentum flavum (HLF. BACKGROUND: Laminoplasty is widely used in patients with CSM; however, for CSM patients with HLF, traditional laminoplasty does not include resection of a pathological ligamentum flavum. METHODS: This study retrospectively reviewed 116 CSM patients with HLF who underwent hybrid decompression with a minimum of 12 months of follow-up. The procedure consisted of reconstruction of the C4 and C6 laminae using CENTERPIECE plates with spinous process autografts, and resection of the C3, C5, and C7 laminae. Surgical outcomes were assessed using Japanese Orthopedic Association (JOA score, recovery rate, cervical lordotic angle, cervical range of motion, spinal canal sagittal diameter, bone healing rates on both the hinge and open sides, dural sac expansion at the level of maximum compression, drift-back distance of the spinal cord, and postoperative neck pain assessed by visual analog scale. RESULTS: No hardware failure or restenosis was noted. Postoperative JOA score improved significantly, with a mean recovery rate of 65.3 ± 15.5%. Mean cervical lordotic angle had decreased 4.9 degrees by 1 year after surgery (P<0.05. Preservation of cervical range of motion was satisfactory postoperatively. Bone healing rates 6 months after surgery were 100% on the hinge side and 92.2% on the open side. Satisfactory decompression was demonstrated by a significantly increased sagittal canal diameter and cross-sectional area of the dural sac together with a significant drift-back distance of the spinal cord. The dural sac was also adequately expanded at the time of the final follow-up visit. CONCLUSION: Hybrid laminectomy and autograft laminoplasty decompression using Centerpiece plates may facilitate bone healing and produce a comparatively satisfactory prognosis for CSM patients

  18. Decompressive Hemicraniectomy in a South American Population--Morbidity and Outcomes Analysis.

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    Roberto Bezerra Vital

    Full Text Available Malignant cerebral artery strokes have a poor prognosis, with nearly 80% of mortality in some series despite intensive care. After a large randomized trial, decompressive hemicraniectomy has been performed more often in stroke patients. Here, we describe patients in a tertiary teaching hospital in Brazil, emphasizing the impact of age on outcomes.A retrospective cohort of patients, with malignant strokes which received a decompressive hemicraniectomy, from paper and electronic medical records, from January 2010 to December 2013 was divided into two groups according to age.The final analysis included 60 patients. The overall mortality was higher among patients older than 60 yrs (67% vs. 41%; p = 0.039, whose group also had a worse outcome (76% with mRS 5 or 6 at 90 days (OR 3.91 CI95% 1.30-11.74, whereas only 24% had mRS of 0-4 (p = 0.015. All patients who presented with sepsis died (p = 0.003. The incidence of pulmonary infection was very high in the elderly group (76% with significant intergroup differences (p = 0.027, OR 8.32 CI95% 0.70-98.48.Older patients present more commonly with infections, more disabilities and a higher mortality, highlighting very poor results in elderly population. These results should be proved with a South American trial, and if confirmed, it can impact on future decisions regarding decompressive craniectomy for acute ischemic stroke in our region.

  19. Decompressive Hemicraniectomy in a South American Population – Morbidity and Outcomes Analysis

    Science.gov (United States)

    Vital, Roberto Bezerra; Hamamoto Filho, Pedro Tadao; Luvizutto, Gustavo Jose; Ducati, Luis Gustavo; Braga, Gabriel Pereira; Nunes, Helio Rubens de Carvalho; Romero, Flavio Ramalho; Ganem, Eliana Marisa; Zanini, Marco Antonio; Bazan, Rodrigo

    2016-01-01

    Background Malignant cerebral artery strokes have a poor prognosis, with nearly 80% of mortality in some series despite intensive care. After a large randomized trial, decompressive hemicraniectomy has been performed more often in stroke patients. Here, we describe patients in a tertiary teaching hospital in Brazil, emphasizing the impact of age on outcomes. Methods A retrospective cohort of patients, with malignant strokes which received a decompressive hemicraniectomy, from paper and electronic medical records, from January 2010 to December 2013 was divided into two groups according to age. Results The final analysis included 60 patients. The overall mortality was higher among patients older than 60 yrs (67% vs. 41%; p = 0.039), whose group also had a worse outcome (76% with mRS 5 or 6) at 90 days (OR 3.91 CI95% 1.30–11.74), whereas only 24% had mRS of 0–4 (p = 0.015). All patients who presented with sepsis died (p = 0.003). The incidence of pulmonary infection was very high in the elderly group (76%) with significant intergroup differences (p = 0.027, OR 8.32 CI95% 0.70–98.48). Conclusions Older patients present more commonly with infections, more disabilities and a higher mortality, highlighting very poor results in elderly population. These results should be proved with a South American trial, and if confirmed, it can impact on future decisions regarding decompressive craniectomy for acute ischemic stroke in our region. PMID:26764485

  20. Two Cases of Klippel-Feil Syndrome with Cervical Myelopathy Successfully Treated by Simple Decompression without Fixation.

    Science.gov (United States)

    Kim, Jin Bum; Park, Seung Won; Lee, Young Seok; Nam, Taek Kyun; Park, Yong Sook; Kim, Young Baeg

    2015-09-01

    Klippel-Feil syndrome (KFS) is a congenital developmental disorder of cervical spine, showing short neck with restricted neck motion, low hairline, and high thoracic cage due to multilevel cervical fusion. Radiculopathy or myelopathy can be accompanied. There were 2 patients who were diagnosed as KFS with exhibited radiological and physical characteristics. Both patients had stenosis and cord compression at C1 level due to anterior displacement of C1 posterior arch secondary to kyphotic deformity of upper cervical spine, which has been usually indicative to craniocervical fixation. One patient was referred due to quadriparesis detected after surgery for aortic arch aneurysmal dilatation. The other patient was referred to us due to paraparesis and radiating pain in all extremities developed during gynecological examinations. Decompressive C1 laminectomy was done for one patient and additional suboccipital craniectomy for the other. No craniocervical fixation was done because there was no spinal instability. Motor power improved immediately after the operation in both patients. Motor functions and spinal stability were well preserved in both patients for 2 years. In KFS patients with myelopathy at the C1 level without C1-2 instability, a favorable outcome could be achieved by a simple decompression without spinal fixation. PMID:26512291

  1. Evaluation of urologic morbidity after radiotherapy for cervical carcinoma by urodynamic examinations and patient voiding schemes: a prospective study

    DEFF Research Database (Denmark)

    Lajer, Henrik; Thranov, Ingrid R; Bagi, Per;

    2002-01-01

    To assess urologic morbidity in a 5-year period by urodynamic examinations and patient voiding schemes after radiotherapy and brachytherapy for cervical carcinoma.......To assess urologic morbidity in a 5-year period by urodynamic examinations and patient voiding schemes after radiotherapy and brachytherapy for cervical carcinoma....

  2. Application of anterior decompression and reconstruction using titanium mesh with locking plates in the management of cervical spondylotic myelopathy

    Institute of Scientific and Technical Information of China (English)

    Maolin He; Zengming Xiao; Shide Li; Qianfen Chen

    2008-01-01

    Objective:To observe the clinical effect of anterior decompression and reconstruction using titanium mesh with locking plates in the treatment of cervical spondylotic myelopathy.Methods:One hundred and twenty patients with cervical spondylotic myelopathy were treated by anterior decompression and reconstruction using titanium mesh with locking plates.There were 66 men and 54 women ranges in age from 37 to 72 Years(mean age, 58.3 years).The mean Japanese orthopedic surgery association(JOA) scale was 9.6 points before operation.Patients were followed up clinically and radiographically.Results:Having stood surgery well, the operation time ranged between 60-100 min and bleeding during operation ranged between 20-200 ml.There were no case of postoperative infection, recurrent laryngeal nerve palsy, or esophageal or tracheal laceration or rupture.The average follow-up period was 14.3 months(range, 12 to 24 months) in 96 who were followed up.At the last follow-up visit the mean JOA scale had improved to 14.4 points, reflecting an improve ment of 4.8 points.The results were considered to be excellent in 87 patients, good in 25, fair in 6, and poor in 2.No hardware-related complications or adjacent segment degenerative changes were encountered during the follow-up periods.Stable bone union was observed in all cases and the average time required for fusion was 5.7 months.Conclusion:Titanium mesh filled with autologous bone graft can avoid the complications associated with harvesting bone from the iliac crest donor site.When combined with cervical anterior locking plate, it can obtain satisfatory clinical results for the treatment of cervical spondylotic myelopathy.

  3. 颈前路减压植骨治疗脊髓型颈椎病%Treatment of Anterior Cervical Decompression and Fusion with Cervical Spinal Cord

    Institute of Scientific and Technical Information of China (English)

    余润泽; 喻德富; 章杰斌; 陶学顺; 王家顺; 吕建军

    2011-01-01

    Objective To observe the cervical spinal column fusion anterior cervical decompression and clinical efficacy. Methods 21 cases of single or double in patients with cervical myclopathy were selected,Central Bank of antcrior cervical discectomy and decompression saws,implantation of autologous iliac bone fusion columnar neck immobilization were performed.The patients were followed up by cervical spine X-ray observations,fell,clinical functional evaluation of nerve function recovery.Results 21 patients were followed up for 12 to 24 months( mean 16 months ). Recovery after surgery,bone fusion,the basic life of patients were satisfactory, Some patients returned to work.Neurological function according to the Japanese Orthopacdic Association(JOA) evaluation system,excellent in 16 cases,good in 2 cases,in 2 cases,1 patient;JOA score improved from(9.3±2.1) points up to postoperative(15.4±1.6) points.Conclusion Anterior decompression and fusion was a single,double cervical myclopathy effective treatment,with complete decompression,shorter operation time,trauma,neurological recovery was good,and with low cost advantage.%目的 观察脊髓型颈稚病颈前路减压柱状植骨融合的临床疗效.方法 21例单或双节段脊髓型颈椎病患者,行颈前路环锯椎间盘切除减压,自体柱状髂骨植入融合,颈托外固定.术后随访观察颈椎X线片、自我感觉、临床功能评价、神经功能恢复情况.结果 21例患者全部获得随访,随访时间12~24个月(平均16个月).术后恢复满意,植骨全部融合,患者生活基本可自理,部分患者重返工作.神经功能改善依据日本矫形外科学会(JOA)评定标准,优16例,良2例,中2例,无效1例;JOA评分由术前(9.3±2.1)分上升至术后的(15.4±1.6)分.结论 前路减压植骨是单、双节段脊髓型颈椎病的有效治疗方法,具有减压彻底,手术时间短,创伤小,神经恢复好,费用低等优点;术后需较长期外固定.

  4. Comparative study on the effect of anterior and posterior decompression in the treatment of multi-segmental cervical spondylotic myelopathy

    Institute of Scientific and Technical Information of China (English)

    Liang Li; Mei-Lin Jiang; Xiao-Jun Yang

    2016-01-01

    Objective: To analyze and compare the clinical efficacy of anterior and posterior decompression in the treatment of multi-segmental cervical spondylotic myelopathy (MCSM), providing certain guidance for the clinical treatment. Methods:A total of 72 patients with MCSM who were admitted in our hospital from September, 2012 to October, 2014 were included in the study and divided into the anterior group (n=37) and the posterior group (n=35) according to different surgical methods. The patients in the anterior group were given anterior cervical discectomy fusion (ACDF) and anterior cervical corpectomy fusion (ACCF), while the patients in the posterior group were given laminoplasty (LP). The general materials, surgical materials, and postoperative functional recovery in the two groups were compared. Results:The comparison of gender, age, course, preoperative JOA score, follow-up time, and affected segment between the two groups was not statistically significant. The operation time in the anterior group was significantly longer than that in the posterior group, but the intraoperative amount of bleeding was significantly less than that in the posterior group. The postoperative spinal cord function in the two groups was significantly improved when compared with before operation;moreover, the improved degree in the anterior group was more obvious. The postoperative cervical physiological curvature in the anterior group was significantly increased, but in the posterior group was significantly reduced. The comparison of the occurrence rate of postoperative complications between the two groups was not statistically significant. Conclusions:The anterior and posterior surgeries in the treatment of MCSM can significantly improve the postoperative spinal cord function, among which the anterior surgery can effectively recover the cervical physiological curvature. It is recommended that an appropriate surgical method should be reasonably selected by comprehensively considering the

  5. A Global Perspective on the Outcomes of Surgical Decompression in Patients With Cervical Spondylotic Myelopathy: Results From the Prospective Multicenter AOSpine International Study on 479 Patients

    NARCIS (Netherlands)

    Fehlings, M.G.; Ibrahim, A.; Tetreault, L.; Albanese, V.; Alvarado, M.; Arnold, P.; Barbagallo, G.; Bartels, R.H.; Bolger, C.; Defino, H.; Kale, S.; Massicotte, E.; Moraes, O.; Scerrati, M.; Tan, G.; Tanaka, M.; Toyone, T.; Yukawa, Y.; Zhou, Q.; Zileli, M.; Kopjar, B.

    2015-01-01

    STUDY DESIGN: Prospective, multicenter international cohort. OBJECTIVE: To evaluate outcomes of surgical decompression for cervical spondylotic myelopathy (CSM) at a global level. SUMMARY OF BACKGROUND DATA: CSM is a degenerative spine disease and the most common cause of spinal cord dysfunction wor

  6. The clinical study of percutaneous disc decompression of treating herniation of cervical disc with Nd:YAG laser

    Science.gov (United States)

    Zhang, Dianxue; Cheng, Hefu; Wang, Jindong

    2005-07-01

    Objective: The possibility of PLDD (percutaneous laser disc decompression) and an ideal non-operative method which is long everlasting effect for PLDD was investigated. Methods: 159 patients of Cervical Disc Herniation with PLDD were studied. All the herniated discs were irradiated with 10­15J/S Nd:YAG laser quantum through optical-fiber under the supervision of C-arm X-ray. Results: All the patients were followed and reexamined CT or MRI after one to six months of PLDD. The result of cured (67.92%), excellent (24.53%), moderation (5.66%), non-effect (1.88%) was got. The excellent rate was 88.24%. The effective rate was 97.65%. Non-effective rate was 2.35%. Conclusion: When irradiated with Nd:YAG laser, the nucleus pulposus was vapouring, charring and coagulating. The volume and inner-pressure of the disc decreased. So the symptoms and signs improved. The main value of this methods were micro-damage, non-operation, no bleeding, no bone injury, good therapy effect, quick recovery, lesser pain, safety and excellent long everlasting effect. It is an ideal non-operative method of treating PLDD.

  7. Segmental anterior cervical decompression with fusion for treating multilevel cervical myelopathy%颈前路分节段减压融合治疗多节段颈椎病

    Institute of Scientific and Technical Information of China (English)

    林昊; 何仿; 李健; 崔庆元; 陈小强; 田纪伟

    2011-01-01

    Objective To evaluate the clinical value of the segmental anterior cervical decompression with fusion for treating multilevel cervical myelopathy.Methods 24 patients of multilevel cervical myelopathy with 3 or 4 consecutive segments were treated with segmental anterior cervical decompression with fusion.All patientst' cervical plain films,magnetic resonance imaging( MRI ) on preoperation and cervical plain films on postoperation were ohserved.The JOA scores of preoperation and 3 months postoperatively were collected.Results 24 cases were followed up from 3 months to 48 months, average 28 months.All patients improved their functional status in different degree.No complications such as graft nonunion and graft suhsidence occurred.The mean preoperative JOA score of all patients was ( 8.20 ±2.26 ),the postoperative of 3 months was ( 13.50 ± 1.28 ) , the average JOA recovery rate was 60.2%.Fusion rate was 100%.Conclusions The segmental anterior cervical decompression with fusion for treating multilevel cervical myelopathy appears to be effective in decompressing spinal cord, improving nerve functional status and restoring lordosis to the cervical spine with high fusion rate and fewer complications.%目的 评价颈前路分节段减压植骨融合术治疗多节段颈椎病的临床疗效.方法 对24例连续3或4个节段病变的颈椎病患者采用分节段减压融合术治疗.均行术前X线、MRI和术后X线片检查.均于术前及术后3个月进行JOA评分.结果 24例均获随访,时间3~48(28±20)个月.患者功能均有不同程度的改善.无植骨块不愈合、内置物下沉等并发症发生.JOA评分术前平均为(8.20±2.26)分,术后3个月平均为(13.50±1.28),改善率为60.2%,植骨融合率100%.结论 颈椎前路分节段减压融合术具有减压彻底、术后神经功能恢复好、恢复颈椎曲度、融合率高、并发症少等优点.

  8. Fusion of Adjacent Segment Degeneration after Anterior Portion Cervical Decompression%颈前路融合术后相邻节段退变120例

    Institute of Scientific and Technical Information of China (English)

    占蓓蕾; 叶舟

    2014-01-01

    目的:探讨颈椎前路减压融合术后相邻节段退变的因果关系。方法:对237例患者行前路椎间节段减压植骨融合术(87例),椎体次全切除减压植骨融合术(109例),椎间节段减压、椎体次全切除减压植骨融合术(41例)。通过影像学检查,观察不同手术方法术后相邻节段退变发生情况。结果:术后随访时间2.6~13年,平均6.8年;发生相邻节段明显退变的120例(50.6%),头侧相邻节段退变发生率明显高于尾侧邻近节段(P<0.05),其中27例(22.2%)需2次翻修手术。结论:颈椎前路融合术后可导致颈椎相邻节段的退变。%Objective To investigate the result of anterior cervical decompression and fusion of adjacent segment degeneration after causality. Methods among 237 patients(87 cases) weretreated with anterior decom-pression and interbody fusion intervertebral segments, 109cases with subtotal excision of the vertebral body with decompression and interbody fusion,and 41 cases with intervertebral segmental decompression, vertebral body subtotal resection decompression and interbody fusion.By imaging examination, different surgical methods and postoperative adjacent segment degeneration were observed. Results Postoperative follow-up at time of 2.6~13 years, averaging 6.8 years; showed significantly degeneration of adjacent segments in 120 cases (50.6%), the cranial adjacent segment degeneration rate significantly higher than that of the caudal adjacent segment (P<0.05), among them,27 cases (22.2%)needed 2 times of revision surgery. Conclusion The anterior cervical fu-sion surgery can lead to cervical vertebral adjacent segment degeneration.

  9. Quality of life, urogynecological morbidity, and lymphedema after radical vaginal trachelectomy for early-stage cervical cancer

    DEFF Research Database (Denmark)

    Frøding, Ligita Paskeviciute; Ottosen, Christian; Mosgaard, Berit Jul;

    2015-01-01

    OBJECTIVE: Radical vaginal trachelectomy (RVT) offers a possibility for future childbearing for young women with early-stage cervical cancer. However, the literature on quality of life and self-reported morbidity in patients undergoing RVT is scarce. The aim of this study was to prospectively...... severe lymphedema of the legs as assessed by the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Cervical Cancer Module. The Global Health Status scores of the RVT patients improved over time but were significantly lower than in the healthy controls during...

  10. Adjacent segment disease after anterior cervical decompression and fusion: analysis of risk factors on X-ray and magnetic resonance imaging

    Institute of Scientific and Technical Information of China (English)

    Zhao Yanbin; Sun Yu; Zhou Feifei; Wang Shaobo; Zhang Fengshan; Pan Shengfa

    2014-01-01

    Background Adjacent segment disease (ASD) is common after cervical fusion.The aim of this study was to evaluate the risk factors for ASD on X-ray and magnetic resonance imaging (MRI).Methods Patients included in this study had received revision surgeries after developing symptomatic ASD following anterior decompression and fusion.A control group that had not developed ASD was matched 1:1 by follow-up time and fusion segments.Plate-to-disc distances (PDDs),developmental cervical canal stenosis on X-ray,cervical disc degeneration grading,and cervical disc bulge impingements on preoperative MRI were measured and compared between the ASD group and the control group.Results Thirty-four patients with complete radiographic data were included in the ASD group.The causative segments of ASD included nine cases of C3-4,18 cases of C4-5,three cases of C5-6,and four cases of C6-7.The ASD occurred at the upper adjacent segments in 26 patients and at the lower adjacent segments in eight patients.PDD distributions were similar between the ASD group and the control group.Developmental cervical canal stenosis was a risk factor for ASD,with an odd ratio value of 2.88.Preoperative cervical disc degenerations on MRI were similar between the ASD group and the control group.In the upper-level ASD group,the disc bulge impingement was (19.7±9.7)%,which was significantly higher than that of the control group of (11.8±4.8)%.Conclusions ASD was more likely to develop above the index level of fusion.Developmental cervical canal stenosis and greater disc bulge impingement may be risk factors for the development of ASD.

  11. Adjacent segment degeneration after single-level anterior cervical decompression and fusion: disc space distraction and its impact on clinical outcomes.

    Science.gov (United States)

    Li, Jia; Li, Yongqian; Kong, Fanlong; Zhang, Di; Zhang, Yingze; Shen, Yong

    2015-03-01

    The purpose of this study was to find whether excessive distraction of the disc space for cage insertion was a risk factor for adjacent segment degeneration (ASD) after anterior cervical decompression and fusion (ACDF). One hundred and sixteen consecutive patients who underwent ACDF for single-level cervical disc herniation between June 2006 and November 2008 were retrospectively reviewed. Preoperative, postoperative and final follow-up disc height (DH), sagittal segmental alignment (SSA), and sagittal alignment of the cervical spine (SACS) were measured and compared between the ASD group and non-ASD group. In 116 patients, ASD was radiographically proven in 28 (24.1%) patients. The clinical outcomes were significantly improved compared to the preoperative scores in both groups. However, the postoperative and final follow-up DH of the ASD group were significantly higher than in the non-ASD group (p<0.05). In addition, the postoperative DH was significantly correlated with the postoperative or final follow-up SSA (p<0.05). However, postoperative DH was not found to significantly correlate with postoperative or final follow-up SACS (p=0.072 and p=0.096, respectively). Multivariate analysis showed that postoperative DH was the most significant risk factor for ASD. The clinical outcomes of ACDF for single-level degenerative cervical disc disease were satisfactory. Postoperative DH (the distracted distance) had the greatest impact on the incidence of ASD. Excessive disc space distraction is a considerable risk factor for the development of radiographic ASD.

  12. Postoperative dysphagia correlates with increased morbidity, mortality, and costs in anterior cervical fusion.

    Science.gov (United States)

    Joseph, Jacob R; Smith, Brandon W; Mummaneni, Praveen V; La Marca, Frank; Park, Paul

    2016-09-01

    Anterior cervical fusion (ACF) after discectomy and/or corpectomy is a common procedure with traditionally good patient outcomes. Though typically mild, postoperative dysphagia can result in significant patient morbidity. In this study, we examine the relationship between postoperative dysphagia and in-hospital outcomes, readmissions, and overall costs. The University HealthSystem Consortium (UHC) database was utilized to perform a retrospective cohort study of all adults who underwent a principal procedure of ACF of the anterior column (International Classification of Diseases, Ninth Revision [ICD-9] procedure code 81.02) between 2013 and 2015. Patients with a diagnosis of dysphagia (ICD-9 78720-78729) were compared to those without. Patient demographics, length of stay, in-hospital mortality, 30-day readmissions, and direct costs were recorded. A total of 49,300 patients who underwent ACF were identified. Mean age was 54.5years and 50.2% were male. Dysphagia was documented in 3,137 patients (6.4%) during their hospital stay. Patients with dysphagia had an average 2.1 comorbidities, while patients without dysphagia had 1.5 (p<0.01). Mean length of stay was 6.38days in patients with dysphagia, and 2.13days in those without (p<0.01). In-hospital mortality was 0.10% in patients without dysphagia, and 0.61% in those with dysphagia (p<0.01). Direct costs were $13,099 in patients without dysphagia, and $21,245 in those with dysphagia (p<0.01). Thirty-day readmission rate was 2.9% in patients without dysphagia, and 5.3% in those with dysphagia (p=0.01). In summary, dysphagia in patients who undergo ACF correlates with significantly increased length of stay, 30-day readmissions, and in-hospital mortality. Direct costs are similarly increased as a result.

  13. Postoperative dysphagia correlates with increased morbidity, mortality, and costs in anterior cervical fusion.

    Science.gov (United States)

    Joseph, Jacob R; Smith, Brandon W; Mummaneni, Praveen V; La Marca, Frank; Park, Paul

    2016-09-01

    Anterior cervical fusion (ACF) after discectomy and/or corpectomy is a common procedure with traditionally good patient outcomes. Though typically mild, postoperative dysphagia can result in significant patient morbidity. In this study, we examine the relationship between postoperative dysphagia and in-hospital outcomes, readmissions, and overall costs. The University HealthSystem Consortium (UHC) database was utilized to perform a retrospective cohort study of all adults who underwent a principal procedure of ACF of the anterior column (International Classification of Diseases, Ninth Revision [ICD-9] procedure code 81.02) between 2013 and 2015. Patients with a diagnosis of dysphagia (ICD-9 78720-78729) were compared to those without. Patient demographics, length of stay, in-hospital mortality, 30-day readmissions, and direct costs were recorded. A total of 49,300 patients who underwent ACF were identified. Mean age was 54.5years and 50.2% were male. Dysphagia was documented in 3,137 patients (6.4%) during their hospital stay. Patients with dysphagia had an average 2.1 comorbidities, while patients without dysphagia had 1.5 (p<0.01). Mean length of stay was 6.38days in patients with dysphagia, and 2.13days in those without (p<0.01). In-hospital mortality was 0.10% in patients without dysphagia, and 0.61% in those with dysphagia (p<0.01). Direct costs were $13,099 in patients without dysphagia, and $21,245 in those with dysphagia (p<0.01). Thirty-day readmission rate was 2.9% in patients without dysphagia, and 5.3% in those with dysphagia (p=0.01). In summary, dysphagia in patients who undergo ACF correlates with significantly increased length of stay, 30-day readmissions, and in-hospital mortality. Direct costs are similarly increased as a result. PMID:27234612

  14. Cervical nerve root decompression by lateral approach as salvage operation after failed anterior transdiscal surgery: technical case report

    OpenAIRE

    Cornelius, Jan Frédérick; George, Bernard

    2009-01-01

    Cervical nerve root compression caused by disco-osteophytic changes is classically operated by anterior transdiscal approach with disc replacement. If compression persists or recurs, reoperation via the same surgical route may be difficult, because of scar tissue and/or implants. An alternative approach may be necessary. We recommend the lateral cervical approach (retrojugular) as salvage operation in such cases. We report a patient with cervical nerve root compression operated by anterior tr...

  15. Late urologic morbidity in 177 consecutive patients after radiotherapy for cervical carcinoma: a longitudinal study

    DEFF Research Database (Denmark)

    Lajer, Henrik; Thranow, Ingrid R.; Skovgaard, Lene Theil;

    2002-01-01

    Radiotherapy; carcinoma of the uterine cervix; Urologic morbidity; Franco-Italian glossary; Actuarial estimate......Radiotherapy; carcinoma of the uterine cervix; Urologic morbidity; Franco-Italian glossary; Actuarial estimate...

  16. Laminoplasty for Cervical Myelopathy

    OpenAIRE

    Ito, Manabu; Nagahama, Ken

    2012-01-01

    This article reviews cervical laminoplasty. The origin of cervical laminoplasty dates back to cervical laminectomy performed in Japan ~50 years ago. To overcome poor surgical outcomes of cervical laminectomy, many Japanese orthopedic spine surgeons devoted their lives to developing better posterior decompression procedures for the cervical spine. Thanks to the development of a high-speed surgical burr, posterior decompression procedures for the cervical spine showed vast improvement from the ...

  17. Two Cases of Klippel-Feil Syndrome with Cervical Myelopathy Successfully Treated by Simple Decompression without Fixation

    OpenAIRE

    Kim, Jin Bum; Park, Seung Won; Lee, Young Seok; Nam, Taek Kyun; Park, Yong Sook; Kim, Young Baeg

    2015-01-01

    Klippel-Feil syndrome (KFS) is a congenital developmental disorder of cervical spine, showing short neck with restricted neck motion, low hairline, and high thoracic cage due to multilevel cervical fusion. Radiculopathy or myelopathy can be accompanied. There were 2 patients who were diagnosed as KFS with exhibited radiological and physical characteristics. Both patients had stenosis and cord compression at C1 level due to anterior displacement of C1 posterior arch secondary to kyphotic defor...

  18. Laminoplasty instead of laminectomy as a decompression method in posterior instrumented fusion for degenerative cervical kyphosis with stenosis

    OpenAIRE

    Yeh, Kuang-Ting; Lee, Ru-Ping; Chen, Ing-Ho; Yu, Tzai-Chiu; Liu, Kuan-Lin; Peng, Cheng-Huan; Wang, Jen-Hung; Wu, Wen-Tien

    2015-01-01

    Background Posterior laminectomy with instrumented fusion is a standard procedure for treating degenerative cervical kyphosis with stenosis (DCKS). Two major disadvantages of the surgery are adhesion of the dural membrane with significant disfiguring of cervical spine and a small fusion bed around the lateral mass. One of the advantages of laminoplasty over laminectomy is the protection of the dural membrane from adhesion through preservation of posterior bony elements. This study presents th...

  19. Anterior cervical decompression and fusion by microscope for the treatment of cervical spondylotic myelopathy%显微镜下减压融合术治疗脊髓型颈椎病

    Institute of Scientific and Technical Information of China (English)

    宋红浦; 郭峭峰; 张晓文; 张春

    2012-01-01

    目的:探讨显微镜下颈前路减压融合术治疗脊髓型颈椎病的疗效.方法:2005年2月至2010年3月,在显微镜辅助下经颈前路减压融合术治疗脊髓型颈椎病21例,男13例,女8例;年龄32~71岁,平均51.5岁;病程6个月~3年,平均12.5个月.手术操作:在显微镜下应用高速磨钻等工具进行减压操作,脊髓充分减压后取自体髂骨植骨融合加内固定.对手术前后JOA颈椎病评分进行比较并评价其疗效.结果:21例患者均获随访,时间18~24个月,平均20个月.患者脊髓神经功能均有不同程度提高,JOA评分由术前9.26±1.72增加至术后的13.64±1.38 (t=2.452,P=0.000).根据JOA评分评定疗效:优12例,良7例,一般2例.结论:显微镜下颈前路减压融合术具有操作精细、减压充分等优点,治疗脊髓型颈椎病安全、有效.%Objective: To explore clinical effects of anterior cervical decompression and fusion by microscope in treating cervical spondylotic myelopathy. Methods:From February 2005 to March 2010,21 patients with cervical spondylotic myelopathy, 13 males and 8 females with an average age of 51.5 years (ranged, 32 to 71) ,were treated with anterior cervical decompression using high-speed bur,then bone grafting and fusion with auto iliac bone and internal fixation by microscope. According to JOA score of cervical spondylosis to evaluate clinical effects before and after operation. Results: All patients were followed up from 18 to 24 months with an average of 20 months. JOA score improved significantly from preoperative 9.26±1.72 to postoperative 13.64±1.38 (t=2.452,P=0.000). According to JOA score, 12 cases were excellent,7 good and 2 fair. Conclusion : Anterior cervical decompression and fusion by microscope is a refined, safe and effective surgical procedure for cervical spondylotic myelopathy.

  20. Cardiovascular morbidity after radiotherapy or chemoradiation in patients with cervical cancer

    NARCIS (Netherlands)

    Maduro, John; den Dekker, Heleen; Pras, Elisabeth; de Vries, E.G.; van der Zee, A.G.; Klokman, W.J.; Reyners, A.K.; van Leeuwen, F.E.; Langendijk, J.A.; de Bock, G.H.; Gietema, J.A.

    2010-01-01

    PURPOSE: To evaluate the risk of cardiovascular events (CVE) in patients with cervical cancer treated with radiotherapy or chemoradiation. METHODS AND MATERIALS: The incidence of CVE in patients treated between 1989 and 2002 by radiotherapy or chemoradiation was compared with a Dutch reference popul

  1. Discover颈人工椎间盘置换术联合颈椎前路减压融合术治疗颈椎病的临床疗效%The clinic effect of discover cervical artificial disc replacement combined with anterior cervical decompression and fusion in treatment of cervical spondylosis

    Institute of Scientific and Technical Information of China (English)

    吴兴林

    2014-01-01

    Objective To explore the clinic effect of discover cervical artificial disc replacement combined with anterior cervical decompression and fusion in treatment of cervical spondylosis. Methods 96 patients were selected from our hospital,and the they were evenly divied into two group by random,experimental group patients were treated with discover cervical artificial disc replacement combined with anterior cervical decompression,the control group patients were treated with anterior cervical decompression and fusion.Compared and analyzed the two groups'cervical spine,the average hospital stay,postoperative cervical fixation time,normal activity recovery time and clinical effect after treatment. Results The experimental group's cervical average activity was (44.6±4.7) degree which was higher than control group,and the difference was significantly(P < 0.05);The experimental group was shorter than control group in average hospital stay,postoperative cervical fixation time,normal activity recovery time,and the difference was significantly(P < 0.05);Experimental group's total effective rate was 97.9% which was higher than the control group(87.5%),and the difference was significantly(P<0.05). Conclusion Discover cervical artificial disc replacement combined with anterior cervical decompression and fusion can reduce the average hospital stay,postoperative cervical fixation time,normal activity recovery time,can ensure the patients's cervical average activity to recover normal,and can improve the clinical effect.%目的:探讨分析Discover颈人工椎间盘置换术联合颈椎前路减压融合术的临床疗效。方法选择我院96例患者,将其随机均分为两组,实验组行Discover颈人工椎间盘置换术联和颈椎前路减压融合术治疗;对照组行颈椎前路减压融合术治疗,比较患者术后颈椎活动度、平均住院时间、术后颈椎固定时间、恢复正常活动时间以及患者临床疗效,并进行统计学分析。

  2. Comparison of the extraction force of different interbody graft fixation at cervical vertebra after anterior cervical decompression%颈椎间不同植入物拔出载荷的比较

    Institute of Scientific and Technical Information of China (English)

    刘锦波; 唐天驷; 杨惠林

    2001-01-01

    目的:比较颈前路减压后分别植入钛合金螺纹融合支架、异体骨螺纹融合支架和自体髂骨的拔出载荷。方法:以人尸体颈椎为标本,颈前路环锯减压后,分别植入钛合金螺纹融合支架、异体骨螺纹融合支架和自体髂骨,测试以上植入物的最大拔出载荷。结果:减压后植入钛合金螺纹融合支架、异体骨螺纹融合支架、自体骼骨的最大拔出载荷分别为(114.7±23.3)、 (101.5±15.7)、 (58.7±8.3)N。结论:Cloward术减压后,钛合金螺纹融合支架、异体骨螺纹融合支架拔出载荷均大于植入自体髂骨。%Objective:To compare the extraction force of different interbody graft fixation at C4 and C5 after cervical decompression with the method of Cloward.Methods:Cervical vertebra was operated at C4 and C5 using orifice through anterior approach.The extraction force was measured after the allograft threaded fusion cage,titanium threaded fusion cage and autograft iliac bone graft were inserted separately into the interbody space.Results:The extraction force of titanium threaded fusion cage,allograft threaded fusion cage and autograft iliac bone graft were 114.0±23.3N and 101.5±15.7N and 58.7±8.3N respectively.Conclusion:Measured with the method of Cloward,the extraction forces of the allograft threaded fusion cage and titanium threaded fusion cage at C4 and C5 are bigger than that of autograft iliac bone graft after cervical decompression.

  3. Clinical significance of perioperative methylprednisolone on anterior cervical decompression operation%甲泼尼龙在颈椎前路减压术中的应用

    Institute of Scientific and Technical Information of China (English)

    刘建东; 卢承志; 林斌; 周亮; 张文龙; 姚猛飞

    2013-01-01

    Objective To investigate the effects of methylprednisolone (MP) on patients with cervical spondylotic myelopathy (CSM) underwent anterior decompression.Methods Fifty patients scheduled for elective anterior decompression were randomly divided into two groups of 25 each:control group (C) and methylprednisolone group (MP).Group MP received methylprednisolone 30 mg/kg and group C received same volume of normal saline instead of methylprednisolone as control Blood samples were taken from vein for determination of plasma TNF-α,IL-6 and SOD concentrations before induction of anesthesia (T1),1 h after (T2),6 h after (T3) and 24 h (T4) after termination of operation.All of these was estimated by enzyme-linked immunosorbent assay (ELISA).Results There was no significant difference between two groups in plasma TNF-α,IL-6 and SOD level at T1.The level of TNF-α,IL-6 at T2-T4 and SOD at T2-T3 was significantly increased compared with that before operation in both groups.However,the plasma concentrations of TNF-α and IL-6 were significantly lower at T2-T4 while the concentration of SOD was significantly higher at T2-T3 in group MP than those in group C.Conclusion Methylprednisolone can reduce the increased amplitude of plasma levels of TNF-α and IL-6,whereas enhance the increased amplitude of the plasma SOD levels in anterior cervical decompression operation.In other words,Methylprednisolone posseses the effect to decrease ischemical reperfusion injury and down-regulate inflammatory response during operation.%目的 探讨甲泼尼龙(MP)在脊髓型颈椎病(CSM)前路减压术中的应用价值.方法 选择行颈椎前路减压术的CSM 50例,随机分为甲泼尼龙组(MP组)和对照组(C组),每组25例.MP组给予MP 30 mg/kg,C组予与等容量生理盐水.分别于麻醉诱导前(T1),术后1 h(T2),术后6 h(T3),术后24 h(T4)抽取静脉血,用酶联免疫吸附法(ELISA)测定血浆肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)及超氧化

  4. Biomechanical evaluation of an interfacet joint decompression and stabilization system.

    Science.gov (United States)

    Leasure, Jeremi M; Buckley, Jenni

    2014-07-01

    A majority of the middle-aged population exhibit cervical spondylosis that may require decompression and fusion of the affected level. Minimally invasive cervical fusion is an attractive option for decreasing operative time, morbidity, and mortality rates. A novel interfacet joint spacer (DTRAX facet screw system, Providence Medical) promises minimally invasive deployment resulting in decompression of the neuroforamen and interfacet fusion. The present study investigates the effectiveness of the device in minimizing intervertebral motion to promote fusion, decompression of the nerve root during bending activity, and performance of the implant to adhere to anatomy during repeated bending loads. We observed flexion, extension, lateral bending, and axial rotation resonant overshoot mode (ROM) in cadaver models of c-spine treated with the interfacet joint spacer (FJ spacer) as stand-alone and supplementing anterior plating. The FJ spacer was deployed bilaterally at single levels. Specimens were placed at the limit of ROM in flexion, extension, axial bending, and lateral bending. 3D images of the foramen were taken and postprocessed to quantify changes in foraminal area. Stand-alone spacer specimens were subjected to 30,000 cycles at 2 Hz of nonsimultaneous flexion-extension and lateral bending under compressive load and X-ray imaged at regular cycle intervals for quantitative measurements of device loosening. The stand-alone FJ spacer increased specimen stiffness in all directions except extension. 86% of all deployments resulted in some level of foraminal distraction. The rate of effective distraction was maintained in flexed, extended, and axially rotated postures. Two specimens demonstrated no detectable implant loosening (<0.25 mm). Three showed unilateral subclinical loosening (0.4 mm maximum), and one had subclinical loosening bilaterally (0.5 mm maximum). Results of our study are comparable to previous investigations into the stiffness of other stand

  5. Zero-P zero incisura anterior cervical interbody fusion fixation system (ACIF) in anterior cervical decompression and fusion applications%ACIF 在颈前路减压融合术的应用

    Institute of Scientific and Technical Information of China (English)

    汪冉; 王炤; 赵志芳

    2012-01-01

    目的 探讨Zero-P 零切迹颈椎前路椎间融合固定系统(ACIF)在颈前路融合术中的临床疗效.方法 回顾分析自2009-01-2010-12 对36 例颈椎患者采用的颈前路椎间盘切除减压Zero-P椎间融合术治疗.采用日本骨科学会(JOA)及视觉模拟评分(VAS)评分,观察术前、术后3 天、3 个月、12 个月疗效.结果 所有患者采用JOA 评分,术前(8.57±1.03)分,随访终末评分:(14.3±1.22)分.VAS 评分:(6.73±1.12)分,随访终末评分(2.03±1.06)分.术后12 个月植骨融合率为100%,手术前Cobb 角为11.2°(-5.5°~17.1°),随访终末Cobb 角为15.7°(0°~19.1°).术前与术后差异均有统计学意义(P<0.05).术后均无感染、喉返神经、喉上神经及椎动脉损伤,切口均一期愈合,无翻修手术者.结论 Zero-P零切迹颈椎前路椎间融合固定系统(ACIF)能使融合节段获得即刻稳定,融合率高,疗效满意,具有创伤小、神经损伤风险小、可预防临近节段的骨化、操作简便的优点.%Objective To explore the Zero-P zero ineisura anterior cervical interbocly fusion fixation system (ACIF.J in cervical anterior fusion in clinical efficacy. Methods Retrospective analysis from January 2009 to December 2010 in 36 eases of cervical spondylosls with anterior cervical discectomy ir.tervertebral fusion for the treatment of decompression of Zero —P. Using the Japanese Orthopaedic Association (Japanese orthopaedics association ,JOA.) and visual analogue scale (visualanalogous scale,VASJ score, observation of prcoperatlve,postoperative 3days,3 months, 3.2 months, curative effect. Results All the patients with JO A score, preoperative (8.57 + 1.03), follow—up final score: (14.3 + 1.22,) points. The score of VAS: (6.73 + 1.12), follow—up final score (2.03+1.06) points. 12 months after bone grafting fusion rate of 300%, before the operation of Cobb angle is 11.2 degrees (-5.5° to 17.3.°), follow-up of terminal Cobb( s angle 3.5.7° (0° to 19.1

  6. Multilevel decompressive laminectomy and transpedicular instrumented fusion for cervical spondylotic radiculopathy and myelopathy: A minimum follow-up of 3 years

    OpenAIRE

    Kadir Kotil; Emine Ozyuvaci

    2011-01-01

    Objective: Cervical laminectomies with transpedicular insertion technique is known to be a biomechanically stronger method in cervical pathologies. However, its frequency of use is low in the routine practice, as the pedicle is thin and risk of neurovascular damage is high. In this study, we emphasize the results of cervical laminectomies with transpedicular fixation using fluoroscopy in degenerative cervical spine disorder. Materials and Methods: Postoperative malposition of the transpedicul...

  7. 颈椎前路不同方式减压固定对颈椎稳定性影响的生物力学研究%Biomechanical effects of different anterior decompressions on the stability of cervical vertebra

    Institute of Scientific and Technical Information of China (English)

    刘世敬; 袁国栋; 余正红; 赵卫东; 梁栋柱; 钟世镇

    2009-01-01

    Objectives: To study biomechanical effects of different anterior decompression and fusion on the stability of cervical vertebrae. Methods: 18 cadaveric specimens of cervical spine were divided into three group randomly: ①anterior cervical discectomy and fusion (ACDF); ②anterior cervical hybrid decompression and fusion(combined with corpectomy and discectomy (ACHDF) ; ③anterior cervical corpectomy and fusion (ACCF); Specimens of every group endured the movements of flexion, extension, lateral bending, and axial rotation. The range of motion of all directions was recorded stereophotogrammetrieally niter flexion-extension fatigue loading of 2000 cycles on the specimens of 3 groups. Results: Anterior plate made all of specimens more stable. After flexion-extension fatigue loading of 1200 cycles, there were no changes of ROM between ACDF and ACHDF groups, however, ROM of ACCF group increased. After 2000 cycles, SPIROM and SPINZ of ACDF and ACHDF groups had no difference, however, that of ACCF group decreased. Conclusions: Three kinds of anterior decompression and fusion technique could restore the stability of cervical vertebrae. Under the fatigue loading, the stability and tolerance of ACDF and ACHDF groups are superior to that of ACCF group.%目的:研究颈椎前路多节段病变不同减压、融合固定方式对生物力学稳定性的影响.方法:18具新鲜人尸体颈椎标本,分别行前路椎间盘切除植骨融合(ACDF)、分节段混合减压植骨融合(ACHDF)及椎体次全切除植骨融合(ACCF)术,依次测定正常状态、减压植骨后、钢板固定后、疲劳2000次后的三维活动度,计算稳定潜能指数(SPI),测定疲劳2000次后尾端螺钉和椎体间的活动度.结果:3种方式减压、植骨、钢板固定后,稳定性均明显提高;届伸疲劳1200次后,ACDF、ACHDF组标准化的螺钉-椎体间活动度曲线无变化,而ACCF组曲线升高;疲劳2000次后,ACDF组三维运动SPIROM及SPINZ无变

  8. Non-surgical spinal decompression traction treatment of nerve root type cervical spondylosis%非手术脊柱减压牵引治疗神经根型颈椎病疗效观察

    Institute of Scientific and Technical Information of China (English)

    黄莉华; 白跃宏

    2013-01-01

    Objective To observe the SDS9900 cervical spinal decompression system of curative effect in patients with cervical spondylosis of nerve root type. Methods 60 patients with cervical spondylosis of nerve root type were randomly divided into treatment group and control group. Treat-ment group using SDS 9900 cervical spinal decompression treatment traction system,the control group with conventional traction,two groups give the dynamic interference electric traction or after treatment. Before treatment and 4 weeks after treatment using the method of visual analog score (VAS) and quality of life scale for SF-36 pairs of two groups of patients with curative effect e-valuation. Results Two groups of patients after treatment for 4 weeks respectively,found that the VAS score and the result of SF-36 scale was better,the margin of improvement and the above in-dexes in the treatment group is significant,and the differences between the control group with sta-tistical significance (P<0.05);Conclusion SDS 9900 cervical spinal decompression system can re-duce the pain of nerve root type of cervical spondylosis patients, and significantly improve the pa-tients quality of life.%目的:观察SDS9900颈椎脊柱减压系统对神经根型颈椎病患者的临床疗效。方法将60例神经根型颈椎病患者随机分为治疗组及对照组,治疗组采用SDS 9900颈椎脊柱减压牵引系统治疗,对照组用常规颈椎牵引;两组牵引后均给予动态干扰电治疗。治疗前、治疗4周后采用目测类比评分法(VAS)及生存质量量表SF-36对两组患者进行疗效评定。结果两组患者分别经4周治疗后,VAS评分及SF-36评分结果均较治疗前好转,治疗组的改善幅度较显著,与对照组间差异具有统计学意义(P<0.05);结论 SDS 9900颈椎脊柱上述指标均以减压系统能缓解神经根型颈椎病患者的疼痛,并显著提高患者生活质量。

  9. Artificial cervical disc replacement and anterior cervical decompression and fusion for the treatment of single segmental cervical disc herniation:a 3-year follow-up%颈椎人工间盘置换与前路减压融合修复单节段颈椎间盘突出症:3年随访

    Institute of Scientific and Technical Information of China (English)

    程俊杰; 眭江涛; 马原; 田慧中

    2015-01-01

    stages. Artificial disc replacement can not only play a role in mitigation of cervical disease neurological symptoms and signs, but also maintain stability and semental activity of cervical spine, and reduce secondary adjacent segmental degeneration. These two methods which applied in cervical degenerative intervertebral disc herniation stil remain controversial. OBJECTIVE:To investigate the short-term effect of artificial cervical disc replacement and anterior cervical decompression and fusion for the treatment of single segmental cervical disc herniation. METHODS:Total y 48 patients with single segment radiculopathy or myelopathy cervical diseases induced by cervical disc herniation that required surgery and received a three-month fol ow-up were included and retrospectively analyzed. These patients were divided into replacement group (n=21) and fusion group (n=27) according to the different repair programs. Patients in the replacement group were subjected to Prestige LP cervical artificial disc replacement, and patients in the fusion group were subjected to disc fusion using interbody fusion cage of Johnson or al ogeneic fibularing. They were fol owed up at 1 week, 3, 6, 12, 24, 36 months after treatment. Complications were recorded during the fol ow-up. The pain of patients was evaluated using neck and upper limb pain visual analogue scale scores. The therapeutic effect was evaluated using Japanese Orthopaedic Association (JOA) score. The clinical symptoms improvement and daily functional status of patients after treatment were evaluated using cervical disability index. RESULTS AND CONCLUSION:During the final fol ow-up, the fusion rate in fusion group was 93%(25/27). Comparisons between groups:at the 1 week and final fol ow-up after treatment, the visual analog scale scores of neck and upper limbs and cervical dysfunction indexes were al lower than those before treatment;the Japanese Orthopaedic Association scores were higher than those before treatment (P0.05). The

  10. Depression contributed a dissatisfied cervical surgery outcome of the posterior decompression in cervical spondylotic myelopathy%抑郁对脊髓型颈椎病后路减压手术预后的不良影响

    Institute of Scientific and Technical Information of China (English)

    宗雅琪; 雪原; 赵莹; 林威; 丁怀荣; 何冬; 李志阳; 唐炎铭; 王一

    2015-01-01

    目的:探讨抑郁对脊髓型颈椎病后路减压手术疗效的影响。方法2006年10月至2011年10月接受后路椎板切除或椎板成形减压手术的脊髓型颈椎病患者396例纳入研究,男132例,女264例;年龄39~84岁,平均60.2岁。术前按贝克抑郁量表(Beck depression inventory,BDI)评分将患者分为抑郁组与非抑郁组,两组患者年龄、性别、吸烟情况、症状持续时间、工作情况(是否从事当前工作)的差异均无统计学意义。术后影像学评价指标包括脊髓膨胀面积、脊髓后移距离、颈椎曲率指数;临床疗效评价指标包括日本骨科协会(Japanese Orthopedic Association,JOA)评分、颈椎失能指数(neck disability index,NDI)、疼痛视觉模拟评分(visual analogue scale,VAS)及BDI。术后1.5个月对两组患者上述指标进行评价,并进行统计学分析。结果全部396例均获得随访,随访时间24~50个月,平均32个月。抑郁组与非抑郁组术后颈椎曲率指数下降分别为7.1%±2.1%和6.8%±1.5%、脊髓膨胀面积分别为(130.9±7.0)mm2和(150.8±5.2)mm2、脊髓后移距离分别为(5.7±1.2)mm和(6.2±0.8)mm,差异均无统计学意义。抑郁组与非抑郁组患者术后JOA评分分别提高(1.42±0.56)分和(6.76±3.12)分,差异有统计学意义;NDI分别下降7.31±2.18和21.11±11.36,差异有统计学意义;VAS评分分别下降(16.08±19.76)分和(23.85±20.79)分,差异有统计学意义。抑郁组与非抑郁组患者术后BDI评分均有所改善,但与术前比较差异均无统计学意义。结论术前抑郁状态对脊髓型颈椎病后路减压术后的功能恢复、伤残指数下降及疼痛缓解有不良影响。%Objective To investigate the effect of depression symptoms on surgical outcome of posterior decompression among cervical spondylotic myelopathy (CSM) patients. Methods Between October 2006 and October 2011

  11. Operative Outcomes for Cervical Myelopathy and Radiculopathy

    Directory of Open Access Journals (Sweden)

    J. G. Galbraith

    2012-01-01

    Full Text Available Cervical spondylotic myelopathy and radiculopathy are common disorders which can lead to significant clinical morbidity. Conservative management, such as physical therapy, cervical immobilisation, or anti-inflammatory medications, is the preferred and often only required intervention. Surgical intervention is reserved for those patients who have intractable pain or progressive neurological symptoms. The goals of surgical treatment are decompression of the spinal cord and nerve roots and deformity prevention by maintaining or supplementing spinal stability and alleviating pain. Numerous surgical techniques exist to alleviate symptoms, which are achieved through anterior, posterior, or circumferential approaches. Under most circumstances, one approach will produce optimal results. It is important that the surgical plan is tailored to address each individual's unique clinical circumstance. The objective of this paper is to analyse the major surgical treatment options for cervical myelopathy and radiculopathy focusing on outcomes and complications.

  12. Cervical radiculopathy.

    Science.gov (United States)

    Iyer, Sravisht; Kim, Han Jo

    2016-09-01

    Cervical radiculopathy is a common clinical scenario. Patients with radiculopathy typically present with neck pain, arm pain, or both. We review the epidemiology of cervical radiculopathy and discuss the diagnosis of this condition. This includes an overview of the pertinent findings on the patient history and physical examination. We also discuss relevant clinical syndromes that must be considered in the differential diagnosis including peripheral nerve entrapment syndromes and shoulder pathology. The natural history of cervical radiculopathy is reviewed and options for management are discussed. These options include conservative management, non-operative modalities such as physical therapy, steroid injections, and operative intervention. While the exact indications for surgical intervention have not yet been elucidated, we provide an overview of the available literature regarding indications and discuss the timing of intervention. The surgical outcomes of anterior cervical decompression and fusion (ACDF), cervical disc arthroplasty (CDA), and posterior cervical foraminotomy (PCF) are discussed. PMID:27250042

  13. Insertion of PCBto treat traumatic cervical intervertebral disc herniation

    Institute of Scientific and Technical Information of China (English)

    马远征; 陈兴; 等

    2002-01-01

    Objective:To evaluate the clinical effect of PCB(a new anterior cervical instrumental system combining an intradiscal cage with an integrated plate)in treating taunatic cervical intervertebral disc herniation.Methods:Anterior decompression and PCB internal fixation were used in 22patients with traumatic cervical intervertebral disc herniation.They were followed up from3to16months and analyzed by symptom and imape data.Among them,16 patients underwent fixation at one level and 6patients at two levels.Results:This technique did not cause intraoperative complications.After surgery on screw backout or device failure was found.Based on the JOAgrade,20 patients improved clinically and 2gently because of serious cervical stenosis.The general excellent rate was90.9%.Conclusions:PCB internal fixation is stable.Morbidity of donor and acceptor sites is less.No collars are needed after surgery.

  14. Insertion of PCB to treat traumatic cervical intervertebral disc herniation

    Institute of Scientific and Technical Information of China (English)

    马远征; 隰建成; 陈兴; 关长勇; 全长彬

    2002-01-01

    Objective: To evaluate the clinical effect of PCB (a new anterior cervical instrumental system combining an intradiscal cage with an integrated plate) in treating traumatic cervical intervertebral disc herniation. Methods: Anterior decompression and PCB internal fixation were used in 22 patients with traumatic cervical intervertebral disc herniation. They were followed up from 3 to 16 months and analyzed by symptom and image data. Among them, 16 patients underwent fixation at one level and 6 patients at two levels. Results: This technique did not cause intraoperative complications. After surgery no screw backout or device failure was found. Based on the JOA grade, 20 patients improved clinically and 2 gently because of serious cervical stenosis. The general excellent rate was 90.9%. Conclusions: PCB internal fixation is stable. Morbidity of donor and acceptor sites is less. No collars are needed after surgery.

  15. 颈椎椎体间融合器的临床应用(附135例报告)%Anterior Decompression and Fusion with Cages in the Cervical Spine

    Institute of Scientific and Technical Information of China (English)

    陈德玉; 赵定麟; 贾连顺; 倪斌; 肖建如; 沈强; 叶晓健; 朱海波

    2001-01-01

    To observe and compare the stability and fusion rate of three kinds of the interbody fusion cages after anterior decompression in the cervical spine.Methods:135 patients with cervical spondylosis and disc herniation were stabilized by using interbody fusion cages after anterior decompression,among them,65 cases with BAK,42 cases with CHTF and 28 cases with InterFix technique.X-ray films and CT were taken after operation to observe the stability and fusion of the segments.Results:The patients were followed up from 8 months to 31 months.The operated segments were stable.There was no difference in the fusion rate among three interbody fusion techniques.Conclusion:The immediate stability of the operated segments can be obtained by using interbody fusion cages.These techniques eliminate the complications of autograft and may be an alternative for replacing the traditional cervical interbody fusion with bone graft.%目的:观察比较3种颈椎椎体间融合器前路减压后椎体间融合的固定及融合效果。方法:采用BAK、CHTF和InterFix?3种颈椎椎体间融合器行颈椎病及颈椎间盘突出症前路减压后椎体间融合135例,其中BAK 65例,CHTF 42例,InterFix 技术28例。术后颈椎X线片及CT检查,观察手术椎节的稳定性和融合情况。结果:随访8~31月,施术节段稳定,3种颈椎椎体间融合器固定融合率无显著差异。结论:颈椎椎体间固定融合技术使施术椎节立即稳定,避免了自体植骨引起的并发症,可作为替代传统颈前路椎体间植骨融合术的方法之一。

  16. Comparison of anterior decompression and fusion versus laminoplasty in the treatment of multilevel cervical ossification of the posterior longitudinal ligament: a systematic review and meta-analysis

    Directory of Open Access Journals (Sweden)

    Liu W

    2016-04-01

    Full Text Available Weijun Liu,1,* Ling Hu,2,* Po-Hsin Chou,3 Ming Liu,1 Wusheng Kan,1 Junwen Wang1 1Department of Orthopedics, Pu Ai Hospital, Affiliated to Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People’s Republic of China; 2Department of Anesthesiology, Tianyou Hospital, Affiliated to Wuhan University of Science and Technology, Wuhan, People’s Republic of China; 3Department of Orthopedics & Traumatology, Taipei Veterans General Hospital, School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC *These authors contributed equally to this work Purpose: A meta-analysis was conducted to evaluate the clinical outcomes, complications, reoperation rates, and late neurological deterioration between anterior decompression and fusion (ADF and laminoplasty (LAMP in the treatment of multilevel cervical ossification of the posterior longitudinal ligament (OPLL. Methods: All related studies published up to August 2015 were acquired by searching PubMed and EMBASE. Exclusion criteria were case reports, revision surgeries, combined anterior and posterior surgeries, the other posterior approaches including laminectomy or laminectomy and instrumented fusion, non-English studies, and studies with quality assessment scores of <7. The main end points including Japanese Orthopedic Association (JOA score, recovery rate of JOA, cervical lordosis, complication rate, reoperation rate, and late neurological deterioration were analyzed. All available data was analyzed using RevMan 5.2.0 and Stata 12.0. Results: A total of seven studies were included in the meta-analysis. The mean surgical level of ADF was 3.1, and the mean preoperative occupation ratios of ADF and LAMP group were 55.9% and 51.9%, respectively. No statistical difference was observed with regard to preoperative occupation ratio and preoperative JOA score. Although LAMP group had a higher preoperative cervical lordosis than ADF group (P<0.05, weighted mean difference [WMD

  17. Multilevel decompressive laminectomy and transpedicular instrumented fusion for cervical spondylotic radiculopathy and myelopathy: A minimum follow-up of 3 years

    Directory of Open Access Journals (Sweden)

    Kadir Kotil

    2011-01-01

    Full Text Available Objective: Cervical laminectomies with transpedicular insertion technique is known to be a biomechanically stronger method in cervical pathologies. However, its frequency of use is low in the routine practice, as the pedicle is thin and risk of neurovascular damage is high. In this study, we emphasize the results of cervical laminectomies with transpedicular fixation using fluoroscopy in degenerative cervical spine disorder. Materials and Methods: Postoperative malposition of the transpedicular screws of the 70 pedicles of the 10 patients we operated due to degenerative stenosis in the cervical region, were investigated. Fixation was performed between C3 and C7, and we used resected lamina bone chips for fusion. Clinical indicators included age, gender, neurologic status, surgical indication, and number of levels stabilized. Dominant vertebral artery of all the patients was evaluated with Doppler ultrasonography. Preoperative and postoperative Nurick grade of each patient was documented. Results: No patients experienced neurovascular injury as a result of pedicle screw placement. Two patients had screw malposition, which did not require reoperation due to minor breaking. Most patients had 32-mm screws placed. Postoperative computed tomography scanning showed no compromise of the foramen transversarium. A total of 70 pedicle screws were placed. Good bony fusion was observed in all patients. At follow-up, 9/10 (90% patients had improved in their Nurick grades. The cases were followed-up for an average of 35.7 months (30-37 months. Conclusions: Use of the cervical pedicular fixation (CPF provides a very strong three-column stabilization but also carries vascular injury without nerve damage. Laminectomies technique may reduce the risk of malposition due to visualization of the spinal canal. CPF can be performed in a one-stage posterior procedure. This technique yielded good fusion rate without complications and can be considered as a good

  18. Endoscopic Transnasal Approach for Urgent Decompression of the Craniocervical Junction in Acute Skull Base Osteomyelitis.

    Science.gov (United States)

    Burns, Terry C; Mindea, Stefan A; Pendharkar, Arjun V; Lapustea, Nicolae B; Irime, Ioana; Nayak, Jayakar V

    2015-07-01

    Ventral epidural abscess with osteomyelitis at the craniocervical junction is a rare occurrence that typically mandates spinal cord decompression via a transoral approach. However, given the potential for morbidity with transoral surgery, especially in the setting of immunosuppression, together with the advent of extended endonasal techniques, the transnasal approach could be attractive for selected patients. We present two cases of ventral epidural abscess and osteomyelitis at the craniocervical junction involving C1/C2 that were successfully treated via the endoscopic transnasal approach. Both were treated in staged procedures involving posterior cervical fusion followed by endoscopic transnasal resection of the ventral C1 arch and odontoid process for decompression of the ventral spinal cord and medulla. Dural repairs were successfully performed using multilayered, onlay techniques where required. Both patients tolerated surgery exceedingly well, had brief postoperative hospital stays, and recovered uneventfully to their neurologic baselines. Postoperative magnetic resonance imaging confirmed complete decompression of the foramen magnum and upper C-spine. These cases illustrate the advantages and low morbidity of the endonasal endoscopic approach to the craniocervical junction in the setting of frank skull base infection and immunosuppression, representing to our knowledge a unique application of this technique to osteomyelitis and epidural abscess at the craniocervical junction. PMID:26251807

  19. 颈椎间盘置换及前路椎间融合治疗单节段颈椎间盘突出症:谁更多影响邻近节段发生退变?%Anterior cervical disc replacement and anterior cervical decompression and fusion for treating single segment cervical disc herniation:which has greater effects on adjacent segment degeneration?

    Institute of Scientific and Technical Information of China (English)

    刘威; 盛伟斌; 张健; 邓强; 郭海龙

    2016-01-01

    背景:有研究表明,颈椎间盘置换及前路固定融合治疗颈椎病可以取得较好的临床效果,但是哪种术式在避免邻近节段退变方面更具优势尚无定论。目的:比较颈椎间盘置换与前路固定融合治疗单节段颈椎间盘突出症对邻近节段的近期影响。方法:收集2009年1月至2012年12月以“颈椎间盘突出症”为诊断收入院并行单节段颈椎间盘置换或颈前路椎间盘切除融合患者178例的临床资料,进行回顾性分析,其中前路固定融合组116例,颈椎间盘置换组62例。结果与结论:①评价:两组患者末次随访时目测类比评分、日本骨科协会评估治疗评分、颈椎功能障碍指数均较治疗前明显改善(P 0.05)。前路固定融合组术后3个月时手术节段基本融合,活动度丧失,末次随访时邻近上位节段活动度与邻近下位节段活动度明显增加,且上位节段活动度增加的度数较下位节段大(P 0.05). At 3 months after surgery, in the anterior cervical decompression and fusion group, surgical segment was confluent, and range of motion lost. During final fol ow-up, range of motion of adjacent upper segment and adjacent lower segment was significantly increased, and the increased range of motion in the upper segment was bigger than that of the lower segment (P < 0.05). (3) During final fol ow-up, X-ray films and MRI images revealed the number of degenerated adjacent segment was more in the anterior cervical decompression and fusion group than in the anterior cervical disc replacement group (P <0.05). The number of degenerated middle and upper segments was more than that of the lower segment in both groups (P < 0.05). (4) The findings confirmed that anterior cervical disc replacement or anterior cervical decompression and fusion for treating cervical disc herniation could effectively relieve nerve symptoms of patients. However, compared with the anterior cervical disc

  20. Post laminoplasty cervical kyphosis—Case report

    Directory of Open Access Journals (Sweden)

    D.E. Dugoni

    2014-01-01

    CONCLUSION: The anterior approach is a good surgical option in flexible cervical kyphosis. It is of primary importance the sagittal alignment of the cervical spine in order to decompress the nervous structures and to guarantee a long-term stability.

  1. “White Cord Syndrome” of Acute Tetraplegia after Anterior Cervical Decompression and Fusion for Chronic Spinal Cord Compression: A Case Report

    Directory of Open Access Journals (Sweden)

    Kingsley R. Chin

    2013-01-01

    Full Text Available Paralysis is the most feared postoperative complication of ACDF and occurs most often due to an epidural hematoma. In the absence of a clear etiology, inadequate decompression or vascular insult such as ischemia/reperfusion injury are the usual suspects. Herewith we report a case of complete loss of somatosensory evoked potentials (SSEPs during elective ACDF at C4-5 and C5-6 followed by postoperative C6 incomplete tetraplegia without any discernible technical cause. A postoperative MRI demonstrated a large area of high signal changes on T2-weighted MRI intrinsic to the cord “white cord syndrome” but no residual compression. This was considered consistent with spinal cord gliosis with possible acute edema. The acute decompression of the herniated disc resulted in cord expansion and rush-in reperfusion. We postulate that this may have led to disruption in the blood brain barrier (BBB and triggered a cascade of reperfusion injuries resulting in acute neurologic dysfunction. At 16 months postoperatively our patient is recovering slowly and is now a Nurick Grade 4.

  2. Adjuvant chemoradiation after laparoscopically assisted radical vaginal hysterectomy (LARVH) in patients with cervical cancer. Oncologic outcome and morbidity

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    Gruen, Arne; Musik, Thabea; Stromberger, Carmen; Budach, Volker; Marnitz, Simone [Charite Univ. Medicine Berlin, Campus Virchow-Klinikum, Berlin (Germany). Dept. of Radiooncology; Koehler, Christhardt; Schneider, Achim [Charite Univ. Medicine Berlin, Campus Mitte- und Benjamim Franklin, Berlin (Germany). Dept. of Gynaecology; Fueller, Juergen; Wendt, Thomas [Jena Univ. Hospital (Germany). Dept. of Radiooncology

    2011-06-15

    Compared to laparotomic surgery, laparoscopically assisted radical vaginal hysterectomy (LARVH) offers decreased blood loss during surgery and faster convalescence of the patient postoperatively, while at the same time delivering similar oncologic results. However, there is no data on outcome and toxicity of LARVH followed by (chemo)radiation. A total of 55 patients (range 28-78 years) with cervical cancer on FIGO stages IB1-IIIA (Tables 1 and 2) with risk factors were submitted to either external beam radiotherapy alone [EBRT, n = 8 (14%), including paraaortic irradiation, n = 4 (2.2%); EBRT and brachytherapy (BT), n = 33 (60%); BT alone, n = 14 (25.5%)] or chemoradiation after LARVH. At a median follow-up of 4.4 years, the 5-year disease-free survival (DFS) was 81.8% with 84.5% overall survival (OS). Acute grade 3 side effects were seen in 4 patients. These were mainly gastrointestinal (GI) and genitourinary (GU) symptoms. Grade 4 side effects were not observed. With similar oncologic outcome data and mostly mild side effects, LARVH followed by (chemo)radiation is a valid alternative in the treatment of cervical cancer patients. (orig.)

  3. Adjuvant chemoradiation after laparoscopically assisted radical vaginal hysterectomy (LARVH) in patients with cervical cancer. Oncologic outcome and morbidity

    International Nuclear Information System (INIS)

    Compared to laparotomic surgery, laparoscopically assisted radical vaginal hysterectomy (LARVH) offers decreased blood loss during surgery and faster convalescence of the patient postoperatively, while at the same time delivering similar oncologic results. However, there is no data on outcome and toxicity of LARVH followed by (chemo)radiation. A total of 55 patients (range 28-78 years) with cervical cancer on FIGO stages IB1-IIIA (Tables 1 and 2) with risk factors were submitted to either external beam radiotherapy alone [EBRT, n = 8 (14%), including paraaortic irradiation, n = 4 (2.2%); EBRT and brachytherapy (BT), n = 33 (60%); BT alone, n = 14 (25.5%)] or chemoradiation after LARVH. At a median follow-up of 4.4 years, the 5-year disease-free survival (DFS) was 81.8% with 84.5% overall survival (OS). Acute grade 3 side effects were seen in 4 patients. These were mainly gastrointestinal (GI) and genitourinary (GU) symptoms. Grade 4 side effects were not observed. With similar oncologic outcome data and mostly mild side effects, LARVH followed by (chemo)radiation is a valid alternative in the treatment of cervical cancer patients. (orig.)

  4. Clinical Observation on Anterior Cervical Decompression and Bone Graft Fusion with Locking Plate Internal Fixation in Treatment of Cervical Spinal Cord Injury without Fracture and Dislocation%颈前路减压植骨融合带锁钛板内固定治疗无骨折脱位型颈脊髓损伤的临床探讨

    Institute of Scientific and Technical Information of China (English)

    孙海中

    2016-01-01

    Objective To discuss the effect of anterior cervical decompression and bone graft fusion with locking plate inter-nal fixation in treatment of cervical spinal cord injury without fracture and dislocation (SCIWORA). Methods 60 cases of patients with SCIWORA treated in our hospital from March 2011 to March 2014 were selected as the research object and randomly divided into two groups, the control group were given anterior cervical decompression and bone graft treatment, and the observation group were given anterior cervical decompression and bone graft fusion with locking plate internal fixa-tion treatment, both groups were scored by Japan department of orthopedics association (JOA)before and after operation, and the improvement rates of clinical symptoms after operation and the intervertebral fusion rates after half a year of the two groups were evaluated. Results Six months later after operation, the intervertebral fusion rate in the observation group was obviously higher than that in the control group (96.67%vs 80.0%), the difference was statistically significant (P<0.05), the JOA scores after three months of operation and six months of operation in the observation group were respectively (12.38± 1.69)points and (15.96±2.33)points, which were obviously higher than those in the control group, and the differences were statistically significant (P<0.05). Conclusion The curative effect of anterior cervical decompression and bone graft fusion with locking plate internal fixation in treatment of SCIWORA is definite.%目的 探讨颈前路减压植骨融合带锁钛板内固定治疗无骨折脱位型颈脊髓损伤(SCIWORA)的效果. 方法 整群选取该院2011年3月—2014年3月收治的无骨折脱位型颈脊髓损伤(SCIWORA)患者60例作为研究对象,采用数字随机对照表将患者分为对照组和观察组,对照组行颈前路减压植骨融合术治疗,观察组在对照组基础上加锁钛板内固定治疗,手术前后均行日本骨科协

  5. Clinical Observation on Anterior Cervical Decompression and Bone Graft Fusion with Locking Plate Internal Fixation in Treatment of Cervical Spinal Cord Injury without Fracture and Dislocation%颈前路减压植骨融合带锁钛板内固定治疗无骨折脱位型颈脊髓损伤的临床探讨

    Institute of Scientific and Technical Information of China (English)

    孙海中

    2016-01-01

    目的 探讨颈前路减压植骨融合带锁钛板内固定治疗无骨折脱位型颈脊髓损伤(SCIWORA)的效果. 方法 整群选取该院2011年3月—2014年3月收治的无骨折脱位型颈脊髓损伤(SCIWORA)患者60例作为研究对象,采用数字随机对照表将患者分为对照组和观察组,对照组行颈前路减压植骨融合术治疗,观察组在对照组基础上加锁钛板内固定治疗,手术前后均行日本骨科协会(JOA)评分,评估两组术后临床症状好转率及半年后植骨融合率.结果 观察组术后半年后植骨融合率为96.67%显著高于对照组80.0%,差异具有统计学意义(P<0.05);观察组术后3、6个月JOA评分分别为(12.38±1.69)分、(15.96±2.33)分均显著高于对照组,差异具有统计学意义(P<0.05). 结论 颈前路减压植骨融合带锁钛板内固定治疗SCIWORA疗效确切.%Objective To discuss the effect of anterior cervical decompression and bone graft fusion with locking plate inter-nal fixation in treatment of cervical spinal cord injury without fracture and dislocation (SCIWORA). Methods 60 cases of patients with SCIWORA treated in our hospital from March 2011 to March 2014 were selected as the research object and randomly divided into two groups, the control group were given anterior cervical decompression and bone graft treatment, and the observation group were given anterior cervical decompression and bone graft fusion with locking plate internal fixa-tion treatment, both groups were scored by Japan department of orthopedics association (JOA)before and after operation, and the improvement rates of clinical symptoms after operation and the intervertebral fusion rates after half a year of the two groups were evaluated. Results Six months later after operation, the intervertebral fusion rate in the observation group was obviously higher than that in the control group (96.67%vs 80.0%), the difference was statistically significant (P<0.05), the JOA scores after three

  6. 非手术脊柱减压系统牵引与普通牵引对颈棘旁肌表面肌电信号的影响%Nonsurgical spinal decompression and common cervical traction compared

    Institute of Scientific and Technical Information of China (English)

    徐洋; 贾功伟; 谭波涛; 王愉乐; 代良波; 虞乐华

    2014-01-01

    Objective To compare the effects of nonsurgical spinal decompression system (SDS) cervical traction and common cervical traction using surface electromyography (sEMG).Methods Twenty-two volunteers' sEMG signals were recorded before,during and after two modes of cervical traction:the conventional traction in sitting and SDS traction in supine.The interval between the two modes of traction was no shorter than 24 hours.The mean and peak amplitudes of their sEMG signals were observed before,during and after traction.The sEMG signals of the posterior cervical muscle while sitting or lying were compared at different stages of the traction.Results There was no statistically significant difference in sEMG signals between the subjects' right and left posterior cervical muscles.The sEMG signals decreased significantly during both traction trials.With common cervical traction the mean and peak amplitudes of the left posterior cervical muscle pre-and post-traction were higher than during traction,and the same as that of the right posterior cervical muscle.In the SDS trials the sEMG signals during traction and post-traction were significantly lower than those pre-traction.After traction the sEMG signals while sitting (common cervical traction) were significantly higher than those post-traction while lying (SDS cervical traction),and the sEMG signals post-traction while either lying or sitting were stronger than during traction while lying.The post-traction signals in sitting were stronger than those in lying.Conclusions Both nonsurgical SDS and common cervical traction can relax the posterior cervical muscles.The effect of nonsurgical SDS was better than that of common cervical traction.%目的 观察非手术脊柱减压系统(SDS)牵引及普通牵引对颈棘旁肌表面肌电信号的影响.方法 随机选取健康青年志愿者22例,采用SDS和普通牵引对受试者进行测试,不同测试间需相隔24 h以上,测试时利用表面肌电图仪对受试者双侧颈

  7. An audit of decompressive craniectomies

    Directory of Open Access Journals (Sweden)

    Kapadia F

    2006-01-01

    Full Text Available Background: The management of acute intracranial hypertension refractory to medical management remains a challenging endeavour. Mortality and morbidity rates remain high despite optimal medical management. Decompressive craniectomy has been proposed as an effective treatment for patients who have raised intracranial pressure (ICP refractory to medical management. This study examined the outcome of patients who underwent this procedure. Aim: To assess the outcome of patients who underwent decompressive craniectomy. Materials and Methods: We conducted a prospective audit of consecutive patients of one neurosurgical unit, who underwent decompressive craniectomy at a tertiary care centre between 01/01/2004 to 31/03/2005. A complete neurological assessment, including Glasgow coma scale (GCS and pupils was done and recorded at the time of admission, deterioration, post-op one wk and post-op three wks. End points were Glasgow outcome score (GOS and Karnofsky score at 30 days, at discharge and at 6 months. Results: We studied 12 patients who were aged 30 to 69 yrs (Mean = 47 yrs. Unlike most interventions in critical care, survival is not an acceptable single end point. Good recovery ( Karnofsky score ³80 / GOS³4 was seen in five patients. Three patients were alive with severe disability ( Karnofsky score 1-70 / GOS 2-3, at follow up. Four patients died (Karnofsky score 0 / GOS 1. Conclusion: Eight patients who underwent decompressive craniectomy survived. Five of these patients had a good recovery. The other three survived with severe disability.

  8. 显微镜辅助下颈前路精细化减压治疗多节段脊髓型颈椎病的研究%Elaborative decompression under microscope through anterior cervical approach for treatment of multilevel cervical spondylotic myelopathy

    Institute of Scientific and Technical Information of China (English)

    邵进; 杨铁毅; 刘树义; 张岩; 吴亮; 黄国华; 宋超; 范鑫斌

    2015-01-01

    目的:探讨显微镜辅助下颈前路精细化椎间隙减压内固定治疗多节段脊髓型颈椎病的临床效果。方法2011年1月~2014年1月,第二军医大学附属上海市浦东新区公利医院骨科52例多节段脊髓型颈椎病患者给予了显微镜辅助下精细化减压治疗。摄颈椎正侧位X线片,测量颈椎曲度,运用日本矫形外科学会(JOA)评分标准进行神经功能评价。结果所有52例患者均获得随访,术前、术后3 d、术后6个月和术后12个月颈椎生理曲分别为(14.92±2.81)º、(19.85±3.37)º、(19.57±2.69)º、(19.49±3.05)º,日本矫形外科学会(JOA)评分分别为(9.82±3.32)、(13.72±3.23)、(13.63±3.17)、(13.56±3.24)分,术后3 d、6个月和术后12个月颈椎生理曲度较术前均明显恢复、JOA评分较术前均明显提高(P<0.01);末次随访示植骨融合。除1例患者术后10 d发生血肿致呼吸困难,即刻清除血肿后恢复正常外,未发生切口感染、钛板断裂、螺钉松动以及融合器下沉或移位等并发症。结论显微镜辅助下颈前路手术,具备视野清晰、配合默契、彻底精细减压、术后即刻功能恢复等优势,显著提高颈椎前路手术优良率。%Objective To investigate the clinical efficacy of elaborative decompression under microscope through anterior cervical approach for treatment of multilevel cervical spondylotic myelopathy. Methods From January 2011 to January 2014, a total of 52 patients of multilevel cervical spondylotic myelopathy was carried out elaborative decompression under microscope through anterior cervical approach. The cervical curvature was measured by anterior-posterior and lateral X-ray of the cervical vertebrae, and the neurological function was evaluated using JOA score. Results All the 52 patients were followed up. The cervical curvature of preoperation, 3 days, 6 months and 12 months was (14.92±2.81)o, (19.85±3.37)o, (19.57±2.69)o, (19.49±3.05)orespectively. The JOA

  9. 前路减压植骨融合术后颈椎相邻节段生物力学变化%Biomechanical changes of the adjacent segments after anterior cervical decompression and fusion

    Institute of Scientific and Technical Information of China (English)

    尹飞; 郭丽; 朱庆三; 赵东旭; 巩固; 李然; 赵昆池; 王迎智

    2013-01-01

    Objective To study the biomechanical changes of the adjacent segments after anterior cervical decompression and fusion (ACDF).Methods EB composite resin was used to mimic the fuion effect after anterior cervical decompression.The motion range and biomechanical changes of the adjacent segments were measured.Results Under the same torque of 2.0 Nm,the motion range of the adjacent segments was from 4.3 to 8.0 degrees,which was not significantly different from that before fusion (P >0.05).Increasing the torque gradually to let the samples reach their normal range of motion,the range of motion of the adjacent segments increased significantly.There are significant differences of them after and before fusion (P < 0.05).Conclusion If people keep the normal range of motion of cervical spine after ACDF,their adjacent segment's movement will increase significantly.This might be the main cause of the degeneration after fusion.By limiting the neck movement can reduce,or even avoid postoperative degeneration.%目的 观察颈椎前路减压植骨融合术后相邻节段生物力学变化.方法 采用EB复合树脂黏合的方法模拟颈椎前路减压植骨术后融合的效果,检测颈椎融合前、后相邻节段运动范围及生物力学的变化.结果 在2.0 Nm力矩不变的情况下,融合节段相邻间隙的运动范围为4.3°~8.0°,与融合前比较差异无统计学意义(P>0.05);加大力矩使融合后的颈椎尽量达到术前正常运动范围时融合节段相邻间隙运动范围明显增加,与融合前比较差异有统计学意义(P<0.05).结论 颈椎融合术后如果仍要达到术前正常的运动范围,其相邻节段的运动范围明显增加,这可能是造成其退变的主要原因.限制颈部术后活动可以减少、甚至避免术后退变的发生.

  10. 前路减压植骨融合内固定术治疗颈椎间盘突出症的疗效分析%Analysis of anterior cervical decompression and autograft fusion combined with internal fixation in the treatment of cervical disc protrusion

    Institute of Scientific and Technical Information of China (English)

    杨朝晖; 吴险峰; 邹磊

    2013-01-01

    Objective To explore the clinical outcome of treatment of the anterior cervical discertomy and fusion with rigid plate fixation for cervical disc herniation. Methods Twenty five patients with cervical disc herniation had been treated by multilevel anterior cervical discectomy and fusion with rigid plate fixation from Oct 2008 to Oct 2011. Results All patients had been followed - up for 8 to 24 months ( I I months in average ). Bone union was achieved in all patients. All cases were scored after operation to assess the curative effect. There were 15 cases that belonged to the excellent, 8 to the good, 2 to the fair and 0 to the poor based on the Jndet criteria. The good and excellence rate was 92% in patients. Conclusion The treatment of traumatic cervical disc protrusion with anterior cervical decompression and bone autograft fusion combined with internal fixation has satisfactory clinical effect with fewer complications.%目的 探讨前路减压植骨融合钢板内固定治疗颈椎间盘突出症的疗效.方法 对收治的25例颈椎椎间盘突出症患者行颈椎前路减压,取自体髂骨植骨融合内固定治疗.结果 本组患者均获得随访,随访时间8~24个月,平均11个月.植骨均达到骨性愈合,无骨不连发生.25例患者神经功能获得改善,根据JOA神经功能评定标准,优15例,良8例,可2例,差0例,优良率92%.结论 颈椎前路减压、椎间盘切除、植骨融合钢板内固定是治疗颈椎间盘突出症的一种有效方法.

  11. 人工椎间盘置换加颈前路椎体次全切减压植骨融合术治疗多节段颈椎病%Artificial Disc Replacement Combined with Anterior Cervical Decompression and Autograft Bone Fusion for the Treatment of Multi-segment Cervical Spondylosis

    Institute of Scientific and Technical Information of China (English)

    廖维峰; 肖晟; 黄象望; 刘向阳; 张毅; 向铁城

    2014-01-01

    [目的]探讨人工椎间盘置换加颈前路椎体次全切减压植骨融合术治疗多节段颈椎病的临床疗效。[方法]湖南省人民医院2008年2月至2012年6月收治的12例多节段颈椎病手术病例,均行人工椎间盘置换加颈前路椎体次全切减压植骨融合术,随访时间为12~18个月,平均随访15.5个月,均摄术前、术后及末次随访时的颈椎正侧位及颈椎过伸过屈位X线片及磁共振检查,观察植骨融合、内固定及人工椎间盘的情况,以JO A评分评价神经功能改善情况。[结果]所有病例内置物无松动、移位,植骨融合时间在3~6个月,平均4.9个月。置换间隙活动度术后1年时为12.5°±5.0°,与术前(12.3°±4.9°)比较无统计学差异(P>0.05)。术前JOA 评分平均为9.3分,术后6个月时平均为16.1分,平均改善率为91.2%。[结论]人工椎间盘置换加颈前路椎体次全切减压植骨融合术治疗多节段颈椎病近期疗效满意,是治疗多节段颈椎病的一种可行方法。%[Objective]To explore the clinical efficacy of cervical artificial disc replacement combined with anterior cervical decompression and autograft bone fusion for the treatment of multi -segment cervical spon-dylosis .[Methods]Twelve patients with multi- segment cervical spondylosis operated in Hunan provincial people's hospital from Feb .2008 to June 2012 underwent cervical artificial disc replacement combined with an-terior cervical decompression and autograft bone fusion .The follow up time was 12~18 months(average 15 .5 months) .Cervical MRI and X-ray films of cervical normal lateral position ,hyperextension and hyperflexion position were performed before and after operation and at the last time of follow up .Bone fusion ,internal fixa-tion and artificial disc were observed .JOA score was used to evaluate the improvement of neurological func-tion .[Results]No loosening and displacement of

  12. Is posterior fusion necessary with laminectomy in the cervical spine?

    OpenAIRE

    McAllister, Beck D.; Rebholz, Brandon J.; Wang, Jeffery C.

    2012-01-01

    Background: Cervical decompressive laminectomy is a common procedure for addressing multilevel cervical spine pathology. The most common reasons for performing simultaneous posterior cervical fusion include the prevention of progressive postlaminectomy kyphotic deformity or other types of instability which can contribute to late neurological deterioration. Methods: The medical literature (Pub Med with MeSH) concerning cervical laminectomy, posterior cervical fusion, and complications of lamin...

  13. Measurement and clinical significance on anatomic landmark of anterior cervical decompression%颈椎前路减压手术解剖标志定位测量及其临床意义

    Institute of Scientific and Technical Information of China (English)

    林永绥; 王万明; 张发惠; 郑和平; 王春

    2014-01-01

    Objective The primary purpose of the current study is to provide more scientific landmarks for safe and efficient decompression within limited operating field in cervical anterior decompression. Methods Relative data were observed and measured at C3~7 of 15 adult cadaveric specimens and some data were calculated basing on above data:the ratio of anterior crus of uncinate process-medial border of longus colli muscle distance and medial border of longus colli muscle-median sagittal plane distance(AULD/MLPD), the ratio of anterior crus of uncinate process- medial border of foramen transversarium distance and anterior crus of uncinate process-medial border of longus colli muscle distance (AUTD/AULD), the ratio of anterior crus of uncinate process-lateral border of dural sac perpendicular distance and posterior crus of uncinate process-lateral border of dural sac distance(AUDD/PUDD), and the ratio of the nearest point of uncinate process and nerve root-anterior crus of uncinate process perpendicular distance and anteroposterior crus of uncinate process perpendicular distance(UNAD/APUD). Results AULD/MLPD averaged 0.83 at C3, 0.55 at C4, 0.20 at C5, 0.34 at C6, and 0.27 at C7. AUTD/AULD averaged 2.71, AUDD/PUDD averaged 0.28, and UNAD/APUD averaged 0.34. Conclusion Anterior crus of uncinate process is a consistent anatomic landmark at anterior border of cervical vertebrae, which could serve as a stationary and reliable landmark in cervical anterior decompression, and facilitate the location of dural sac, cervical nerve root and vertebral artery during operation according to the ratios of AUDD/PUDD, UNAD/APUD and AUTD/AULD.%目的:为颈椎前路减压手术在有限显露术野中达到安全、有效减压提供更科学的减压标志。方法在15具成人尸体标本上,解剖观测C3~7节段相关解剖数据,以所测量的数据为基础,计算:(1)椎体钩前脚至颈长肌内侧缘的距离/颈长肌内侧缘至正中矢状面的距离(AULD/MLPD);(2

  14. Segmental anterior cervical decompression with fusion for treating multilevel cervical myelopathy: Comparison of fusion rates among three methods%颈前路分节段减压植骨融合术治疗多节段颈椎病:3种方法移植骨融合率的比较

    Institute of Scientific and Technical Information of China (English)

    袁文; 徐盛明; 王新伟; 张涛; 刘百峰

    2007-01-01

    院时间均明显少于/短于长节段减压组(P<0.05),平均住院费用明显高于长节段减压组(P<0.05).分节段减压组、三间隙减压组和长节段减压组术后JOA评分提高分数和植骨融合率相近(P>0.05).结论:综合植骨融合率、神经功能恢复情况、手术时间、术中出血量、住院时间多种因素,3种术式中以颈前路分节段减压植骨融合术为治疗多节段颈椎病的手术方式较佳方案.%BACKGROUND:As a traditional treatment for multilevel cervical myelopathy,nterior long-segmental decompression has the shortcomings of great operative trauma,high difficulty,low fusion rate,etc.,which can affect the postoperative efficacy.OBJ ECTIVE:To evaluate the clinical effects of three different anterior surgeries on multilevel cervical myelopathy.DESIGN:A comparative observation.SETTING:Department of Orthopaedics,Changzheog Hospital,the Second Military Medical University of Chinese PLA.PARTICIPANTS:Thirty-six patients with multilevel cervical myelopathy of 3 consecutive segments,who were surgically treated,were selected from the Department of Orthopaedics,Changzheng Hospital,the Second Military Medical University of Chinese PLA from June 1999 to June 2003,including 25 males and 11 females,35-62 years of age,the disease course ranged from 3 to 26 months. According to the clinical manifestations and imaging esults,they were diagnosed as multilevel cervical myelopathy,and they were not suffering from consecutive ossification of posterior longitudinal ligament and ossification of ligamenta flava. Informed contents were obtained from all the patients and their relatives.METHODS:All the patients were grafted with utologous bone. Autologous ilium or cancellous bone excluding vertebral body was filled into titan net or Cage,which were made of titan and characterized by high intensity,tolerance to decay,good biocompatibility,etc. According to the operative manner,the patients were divided into 3 groups:① two

  15. 枕颈融合联合枕下减压术治疗枕颈畸形并脊髓损伤%Treatment of occipital -cervical deformity and spinal cord injury with foramen magnum decompression combined with occipital -cervical fusion

    Institute of Scientific and Technical Information of China (English)

    喻志; 刘学森; 严鹏辉; 郝志全; 李兵兵; 黄宗强

    2016-01-01

    目的:探讨枕颈融合联合枕下减压内固定术治疗枕颈畸形并脊髓损伤的临床疗效及安全性。方法选择郑州大学第一附属医院2011年7月至2014年7月收治的38例枕颈畸形并脊髓损伤患者作为研究对象,男22例,女16例,年龄16~57(38.2±12.1)岁,入院后均行枕颈融合联合枕下减压植骨融合钛板内固定术。通过随访对术前、术后JOA 评分进行对比,评估患者神经功能改善情况。根据术后随访影像学资料评价椎管减压、植骨融合等情况。结果所有病例均获随访,平均15.6个月。术中未出现脊髓、椎动脉损伤等严重并发症。术后螺钉位置良好,无松动、断钉,均呈骨性愈合。所有患者神经功能恢复良好,JOA 评分:术前5~12(7.1±1.8)分,术后12个月8~17(14.9±1.6)分,差异有统计学意义(P <0.05)。结论枕颈融合联合枕下减压内固定术是治疗枕颈畸形并脊髓损伤的简单、安全、有效方法,值得临床推广。%Objective To investigate the clinical efficacy and safety of foramen magnum decompression combined with occipital -cervical fusion for the treatment of occipital -cervical deformity and spinal cord injury.Methods 38 patients with occipital -cervical deformity and spinal cord injury from July of 201 1 to July of 201 4 were selected as the research objects, including 22 males and 1 6 females,aged 1 6 ~57(38.2 ±1 2.1 )years old.All the patients were treated with foramen magnum decompression combined with occipital -cervical fusion with internal fixation.The improvement of neurological function was eval-uated by the comparison of preoperative JOA scores and postoperative JOA scores.The spinal canal decompression and bone graft fusion were monitored by radiology or computed tomography.Results All cases were followed up for an average of 1 5.6 months. There was no serious complication such as spinal cord and vertebral

  16. Incidences of C5 nerve palsy after multi-segmental cervical decompression through different approaches%各种多节段颈椎减压术后颈5神经根麻痹发生率的比较

    Institute of Scientific and Technical Information of China (English)

    孟海亮; 方向义; 郝定均; 王卫东

    2015-01-01

    Objective To investigate the incidence of C5 nerve root palsy after multi-segmental cervical decompression through different approaches. Methods This study was conducted among 375 patients undergoing multi- segmental cervical decompression in anterior corpectomy and fusion fixation, anterior cervical corpectomy and fusion fixation + posterior decompression and fusion fixation, posterior cervical laminectomy decompression, fusion and internal fixation, and posterior laminoplasty and fusion groups. The exclusion criteria included lack of follow- up data, spinal cord injury preventing preoperative or postoperative motor testing, or surgery not involving the C5 level. The incidence of C5 palsy was determined and the potential risk factors C5 palsy were analyzed including age, sex, revision surgery, preoperative weakness, diabetes, smoking, number of levels decompressed, and a history of previous upper extremity surgery. Results Of the 375 patients, 60 patients were excluded and the data of 315 patients were analyzed, including 146 women and 169 men with a mean age of 57.7 years (range 39-72 years). The overall incidence of C5 nerve palsy was 6.03% (19/315) in these patients; in the subgroups receiving different surgeries, the incidence was 8.62%in the cervical road laminectomy and fusion fixation group, 7.79%in the anterior cervical corpectomy and fusion fixation+posterior decompression and fusion and internal fixation, 4.68%in the anterior corpectomy and fusion fixation group, and 3.85%in the posterior laminoplasty and fusion group. No significant difference was found in the incidences among the subgroups, but men were more likely than women to develop cervical nerve root palsy (8.28%vs 3.42%, P<0.05). Conclusion The overall incidence of C5 nerve palsy following postoperative cervical spinal decompression was 6.03%in our cohort. The incidence of C5 nerve palsy did not differ significantly following different cervical decompression surgeries, but the incidence was the

  17. Decompressive craniectomy in herpes simplex encephalitis

    Directory of Open Access Journals (Sweden)

    Muhammed Jasim Abdul Jalal

    2015-01-01

    Full Text Available Intracranial hypertension is a common cause of morbidity in herpes simplex encephalitis (HSE. HSE is the most common form of acute viral encephalitis. Hereby we report a case of HSE in which decompressive craniectomy was performed to treat refractory intracranial hypertension. A 32-year-old male presented with headache, vomiting, fever, and focal seizures involving the right upper limb. Cerebrospinal fluid-meningoencephalitic profile was positive for herpes simplex. Magnetic resonance image of the brain showed swollen and edematous right temporal lobe with increased signal in gray matter and subcortical white matter with loss of gray, white differentiation in T2-weighted sequences. Decompressive craniectomy was performed in view of refractory intracranial hypertension. Decompressive surgery for HSE with refractory hypertension can positively affect patient survival, with good outcomes in terms of cognitive functions.

  18. Cervical motion segment replacement

    OpenAIRE

    Bryan, Vincent E.

    2002-01-01

    When symptoms bring to light a cervical spine degenerative disc process that requires surgical intervention, a symptom relieving procedure such as decompression, followed by functional restoration, arthroplasty, offers the benefit of prophylaxis of accelerated spondylosis at the operated level. In addition, by altering the biomechanical stress factors at adjacent levels, theoretically it should offer prophylactic benefit at these levels as well. The design requirements for a cervical disc pro...

  19. Clinical efficacy and changes of radiology imaging of multilevel anterior cervical decompression and fusion for cervi-cal spondylosis in elderly%老年颈椎病前路多节段减压融合内固定术后的临床疗效和影像学变化

    Institute of Scientific and Technical Information of China (English)

    张良; 王林; 王强; 申剑; 孙常太

    2014-01-01

    目的:探讨老年颈椎病前路多节段减压融合内固定术后的临床疗效,观察其影像学变化。方法2003年1月~2012年12月收治167例多节段颈椎病患者,其中33例获得完整随访的患者资料纳入本次研究。33例患者术前和末次随访时均拍摄颈椎正侧位、过伸过屈位X线片,比较分析手术前后Cobb角和相邻节段活动度( range of motion, ROM)的变化以及术后颈椎手术节段Cobb角在动力位X线片上的变化。行颈椎日本骨科学会( Japanese Orthopaedic Association, JOA)评分,分析相邻节段退变骨赘形成情况及其与钛板长度的相关性,并用Epstein标准对手术结果行主观评价。结果33例患者术后Cobb角和相邻节段ROM较术前明显增大。术后颈椎手术节段Cobb角在过屈及过伸位X片上变化不明显。骨赘形成与钛板是否偏长之间无相关性。术后JOA评分较术前明显减少,改善率为66.35%。患者主观评价结果优良率为75.76%。结论应用颈椎前路多节段经椎间隙减压融合内固定术治疗老年颈椎病,能有效改善颈椎手术节段Cobb角,手术疗效良好;术后相邻节段可能退变;部分患者术后相邻节段有骨赘形成,但与钛板是否偏长无关。%Objective To investigate the clinical efficacy of the multilevel anterior cervical decompression and fusion for cervical disease in elderly , and to observe imaging changes of radiology .Methods From January 2003 to december 2012, 167 patients with multilevel cervical spondylosis were treated by anterior cervical decompression and fusion ( ACDF ) .Of all patients, 33 cases that got complete follow-up were involved in this study .The cervical X-ray films and the cervical Japanese Orthopaedic Association (JOA) scores of all 33 patients before surgery and at the final follow-up were analyzed.The Cobb’s angle of the surgical segment , the range of motion ( ROM) of adjacent segments , and

  20. Endoscopic Intermetatarsal Ligament Decompression.

    Science.gov (United States)

    Lui, Tun Hing

    2015-12-01

    Morton neuroma is an entrapment of the intermetatarsal nerve by the deep intermetatarsal ligament. It is usually treated conservatively. Surgery is considered if there is recalcitrant pain that is resistant to conservative treatment. The surgical options include resection of the neuroma or decompression of the involved nerve. Decompression of the nerve by release of the intermetatarsal ligament can be performed by either an open or minimally invasive approach. We describe 2-portal endoscopic decompression of the intermetatarsal nerve. The ligament is released by a retrograde knife through the toe-web portal under arthroscopic guidance through the plantar portal. PMID:27284515

  1. 牵引复位联合前路减压内固定治疗低位颈椎骨折脱位的疗效分析%The efficacy analysis of lower cervical spine fracture-dislocation treated by traction reduction combined with anterior decompression and internal fixation

    Institute of Scientific and Technical Information of China (English)

    邱小波; 潘显明; 公丕安; 黎娇

    2012-01-01

    Objective To investigate the efficacy of lower cervical spine fracture-dislocation treated by traction reduction combined with anterior decompression and internal fixation. Methods A total of 22 patients with lower cervical spine fracture-dislocation were treated by operation from October 2007 to October 2010. The skull traction under local anesthesia was performed in the first step, and then under traction reduction anterior decompression and internal fixation were carried out in the second step. Results After surgery, all patients were followed up for more than 12 months. According to the X-ray films, the fracture-dislocation was made in a complete reset, the natural array of the cervical spine and physiological circular measure regained and the implanted bone was completely fused, without internal fixation breaking or loosening. According to the Frangkel grading, the grade of 6 cases were remarkably reduced (2 levels), 3 cases effectively reduced (1 level), and 3 cases were invalid. Conclusions The treatment of lower cervical spine fracture-dislocation with traction reduction combined with anterior decompression and internal fixation is effective.%目的 探讨牵引复位联合前路减压内固定治疗低位颈椎骨折脱位的疗效.方法 对2007年10月至2010年10月22例低位颈椎骨折脱位患者,第一步在局部麻醉下行颅骨牵引术,第二步在牵引复位情况下,行前路减压内固定术.结果 该组病例术后随访12个月以上,X线片显示骨折脱位均复位,颈椎的正常序列及生理弧度恢复,植骨全部融合,无内固定断裂及松动.按Frangkel分级,显效(降低2级)6例,有效(降低1级) 13例,无效3例.结论 在颈椎牵引复位的基础上行前路减压植骨融合内固定是治疗低位颈椎骨折脱位的有效方法.

  2. The analysis of therapeutic effect of Halo-vest reduction combined with anterior decompression and internal fixation on lower cervical spine fracture-dislocation%Halo-vest复位单纯前路减压内固定治疗下颈椎骨折脱位的疗效分析

    Institute of Scientific and Technical Information of China (English)

    姚关锋; 王新家; 罗滨; 王伟东; 曾机灿

    2013-01-01

    Objective:To investigate the efficacy of lower cervical spine fracture-dislocation treated by Halo-vest reduction combined with anterior decompression and internal fixation. Methods:A total of 17 patients with lower cervical spine fracture-dislocation were treated by operation from January 2009 to December 2011.The Halo-vest external fixation was performed under 1oca1 anesthesia in the first step, and then under reduction anterior decompression and internal fixation were carried out in the second step.Results: After surgery, al patients were fol owed up for more than 12 months.According to the X-ray films and CT scan,the fracture-dislocation was made in a complete reset,the natural arrangement of the cervical spine and physiological circular measure regained and the implanted bone was completely fused,without internal fixation breaking or loosening.According to the Frankel grading,the grade of 5 cases were remarkably reduced(2 levels),10 cases effectively reduced(1 leve1),and 2 cases were invalid.Conclusions: The treatment of lower cervical spine fracture-dislocation with Halo-vest reduction combined with anterior decompression and internal fixation is effective.%  目的探讨Halo-vest复位单纯前路减压内固定治疗下颈椎骨折脱位的疗效。方法对2009年l月至2011年12月17例下颈椎骨折脱位患者,首先在局麻下行Halo-vest固定术,然后逐步撑开,在复位情况下,行前路减压内固定术。结果术后随访12~24个月,平均15.4个月。常规X光正侧位片显示骨折脱位均复位,恢复颈椎的正常序列及生理弧度,CT显示植骨融合,未发现内固定断裂及松动。按Frankel分级,显效(降低2级)5例,有效(降低1级)10例,无效2例。结论在Halo-vest复位的基础上行前路减压植骨融合内固定是治疗下颈椎骨折脱位的安全有效方法。

  3. Manifestation Pattern of Early-Late Vaginal Morbidity After Definitive Radiation (Chemo)Therapy and Image-Guided Adaptive Brachytherapy for Locally Advanced Cervical Cancer: An Analysis From the EMBRACE Study

    Energy Technology Data Exchange (ETDEWEB)

    Kirchheiner, Kathrin, E-mail: kathrin.kirchheiner@meduniwien.ac.at [Department of Radiation Oncology, Comprehensive Cancer Center, Medical University of Vienna/General Hospital of Vienna (Austria); Christian Doppler Laboratory for Medical Radiation Research for Radiation Oncology, Medical University of Vienna (Austria); Nout, Remi A. [Department of Clinical Oncology, Leiden University Medical Center (Netherlands); Tanderup, Kari; Lindegaard, Jacob C. [Department of Oncology, Aarhus University Hospital (Denmark); Westerveld, Henrike [Department of Radiotherapy, Academic Medical Centre, University of Amsterdam (Netherlands); Haie-Meder, Christine [Department of Radiotherapy, Gustave-Roussy, Villejuif (France); Petrič, Primož [Department of Radiotherapy, Institute of Oncology Ljubljana (Slovenia); Department of Radiotherapy, National Center for Cancer Care and Research, Doha (Qatar); Mahantshetty, Umesh [Department of Radiation Oncology, Tata Memorial Hospital, Mumbai (India); Dörr, Wolfgang; Pötter, Richard [Department of Radiation Oncology, Comprehensive Cancer Center, Medical University of Vienna/General Hospital of Vienna (Austria); Christian Doppler Laboratory for Medical Radiation Research for Radiation Oncology, Medical University of Vienna (Austria)

    2014-05-01

    Background and Purpose: Brachytherapy in the treatment of locally advanced cervical cancer has changed substantially because of the introduction of combined intracavitary/interstitial applicators and an adaptive target concept, which is the focus of the prospective, multi-institutional EMBRACE study ( (www.embracestudy.dk)) on image-guided adaptive brachytherapy (IGABT). So far, little has been reported about the development of early to late vaginal morbidity in the frame of IGABT. Therefore, the aim of the present EMBRACE analysis was to evaluate the manifestation pattern of vaginal morbidity during the first 2 years of follow-up. Methods and Materials: In total, 588 patients with a median follow-up time of 15 months and information on vaginal morbidity were included. Morbidity was prospectively assessed at baseline, every 3 months during the first year, and every 6 months in the second year according to the Common Terminology Criteria for Adverse Events, version 3, regarding vaginal stenosis, dryness, mucositis, bleeding, fistula, and other symptoms. Crude incidence rates, actuarial probabilities, and prevalence rates were analyzed. Results: At 2 years, the actuarial probability of severe vaginal morbidity (grade ≥3) was 3.6%. However, mild and moderate vaginal symptoms were still pronounced (grade ≥1, 89%; grade ≥2, 29%), of which the majority developed within 6 months. Stenosis was most frequently observed, followed by vaginal dryness. Vaginal bleeding and mucositis were mainly mild and infrequently reported. Conclusion: Severe vaginal morbidity within the first 2 years after definitive radiation (chemo)therapy including IGABT with intracavitary/interstitial techniques for locally advanced cervical cancer is limited and is significantly less than has been reported from earlier studies. Thus, the new adaptive target concept seems to be a safe treatment with regard to the vagina being an organ at risk. However, mild to moderate vaginal morbidity

  4. Endoscopic Intermetatarsal Ligament Decompression

    OpenAIRE

    Lui, Tun Hing

    2015-01-01

    Morton neuroma is an entrapment of the intermetatarsal nerve by the deep intermetatarsal ligament. It is usually treated conservatively. Surgery is considered if there is recalcitrant pain that is resistant to conservative treatment. The surgical options include resection of the neuroma or decompression of the involved nerve. Decompression of the nerve by release of the intermetatarsal ligament can be performed by either an open or minimally invasive approach. We describe 2-portal endoscopic ...

  5. 护理干预在下颈椎骨折脱位前路复位减压植骨手术中的应用%Application of Nursing Intervention in Anterior Reduction and Decompression and Bone Graft Surgery in Lower Cervical Spine Fracture and Dislocation

    Institute of Scientific and Technical Information of China (English)

    李永岩

    2015-01-01

    目的:研究分析护理干预应用于下颈椎骨折脱位前路复位减压植骨手术的使用情况。方法根据我院2007年1月~2010年12月的35例下颈椎骨折脱位前路复位减压植骨手术治疗患者来进行研究分析。结果不完全性脊髓损伤的患者术后神经功能恢复Ⅰ级以上;完全性脊髓损伤的患者术后神经功能恢复无明显改善,患者疼痛缓解,肌力改善,没有肺部感染和泌尿系统症状存在。结论下颈椎骨折脱位前路复位减压植骨治疗手术需要提前做好准备,让患者的颈椎稳定,做好患者的生命体征以及并发症观察和预防,提升手术治疗效果,让患者的生活质量得到改善。%Objective To study and analyze the application of anterior reduction and decompression of the lower cervical spine fracture and dislocation of the lower cervical spine fracture and dislocation.MethodsAccording to our hospital from January 2007 to December 2010, 35 cases of lower cervical spine fracture and dislocation anterior reduction and bone graft surgery for patients to study and analysis.ResultsPatients with incomplete spinal cord injury recovered more than one grade. After surgery, patients with complete spinal cord injury had no obvious improvement in neurological function recovery. ConclusionAnterior reduction and decompression and bone grafting in the treatment of lower cervical spine fracture and dislocation need to be prepared in advance, so that patients with cervical stability, good life signs and complications observation and prevention, improve the surgical treatment effect, so that the quality of life of patients has been improved.

  6. 两种颈前路减压重建术治疗多节段脊髓型颈椎病的疗效比较%Two procedures of anterior cervical decompression and reconstruction in the treatment of multilevel cervical spondylotic myelopathy

    Institute of Scientific and Technical Information of China (English)

    李会明; 夏刚; 田融

    2016-01-01

    目的 探讨两种颈椎前路减压重建术治疗多节段脊髓型颈椎病的临床疗效.方法 我院2009至2013年采用颈椎前路单节段间盘切除、椎间融合器植骨融合钛板内固定术(A组)及颈椎前路椎体次全切除、钛网椎间植骨钛板内固定术(B组)治疗的多节段脊髓型颈椎病患者210例,根据手术方式分为两组,进行疗效分析.结果 术后7d、术后3个月、术后6个月、术后18个月各时间点,A组患者神经功能改善[日本骨科协会(JOA)评分]分别为(12.94±3.82)、(13.95±3.19)、(4.12±3.95)、(14.06±3.85)分和B组(12.73±3.53)、(13.39±3.95)、(14.09±3.53)、(14.11±2.98)分,两组JOA评分均较术前明显改善,两组比较JOA评分的差异无统计学意义(P>0.05);两组患者术后椎间隙高度比较差异无统计学意义(P>0.05),A组颈椎生理曲度深度(弧弦距)分别为(9.11±2.34)、(9.36±1.88)、(9.89±2.46)、(9.61±1.62) mm和B组(7.57±0.78)、(7.76±0.91)、(7.21±0.33)、(7.36±0.79) mm,A组均大于B组,A组植骨融合率为96.3%,B组为89.0%,A组高于B组.结论 两组术后神经功能恢复较好,两组术后均能保持椎间隙高度;但椎间融合器植骨融合率较钛网椎间植骨融合率高,而且椎间融合器组与钛网组比较能较好的维持颈椎生理曲度.%Objective To investigate the clinical curative effect of two procedures of anterior cervical decompression and reconstruction in the treatment of multilevel cervical spondylotic myelopathy.Methods In our hospital from 2009 to 2013 the anterior cervical single segmental discectomy,interbody bone graft fusion and titanium plate internal fixation (group A),and anterior cervical subtotal resection,titanium mesh cage bone and titanium plate internal fixation (group B) were used in 210 patients with multilevel cervical spondylotic cervical spondylosis.The efficacy was evaluated.Results On the 7th day,3rd month,6th month,and 18th month after the surgery,the scores of

  7. Applie danatomy on the landmark of anterior decompression surgery in cervical vertebrae%颈椎病前路手术减压范围标志的解剖学研究

    Institute of Scientific and Technical Information of China (English)

    韩伟峰; 林欣; 李小光; 崔维; 熊英

    2009-01-01

    Objective: To explore the suitable anatomic marks as safe border of transverse decompression in anterior border of cervical vertebral surgery. Methods: Anatomic data of vertebral artery were measured on 12 adult embalmed cadavers (44 sides), for locating vertebral artery during three-dimensional CT reconstructing. Under the microscope, the distance between bilateral medial borders of longus colli muscles was measured, while the features of vertebral artery, nerve root, uncinate joint were observed and analyzed. Results:The distances between horizontal tangent of anterior vertebral body and anterior transversal foramen, bilateral root of anterior wall of transversal foramens, and bilateral medial borders of iongus colli muscles gradually decreased from downside to upside. The distance between anterior angle oftmcinate process was (17.3±2.92) mm averagely, and dural sac width (16.5±0.42)mm. The distance between the medial border of iongus colli muscles and medial margin of the vertebral artery, medial border of longns colli muscles and median sagittal plane had no significant difference at C4~6 level, however, which had significant difference at C3 and C7 level (P<0,05). Hyperplasia of uncinate joint can be found in senile cadavers, with the most serious case of which covering the vertebral artery completely and pushing it posterolaterally. Conclusions: For anterior approach, it is necessary to analyze image data carefully before the surgery, make sure operation process individually, and consider about the hyperplasy of uncovertebral joint.%目的:探讨颈前路手术减压范围及安全界限的解剖标志.方法:对12具成人尸体标本进行三维CT重建,并测量定位椎动脉所需解剖数据,在显微镜下测量颈长肌内侧缘间距等数据,并观察椎动脉、神经根、钩椎关节及其对应关系.结果:椎体前缘与横突孔前缘水平切线间距离、双侧横突孔内侧壁距离及颈长肌内侧缘间距由下端至上端逐渐

  8. 一期前后联合手术减压固定治疗严重下颈椎骨折脱位效果观察%The Dislocation Efficacy of Ⅰ Before and After Surgical Decompression and Fixation in Combined Treatment With Severe Lower Cervical Fracture

    Institute of Scientific and Technical Information of China (English)

    冷华平

    2015-01-01

    Objective To observe the effect of treating severe fracture and dislocation of the lower cervical spine with primary combined anterior-posterior decompression and fixation.Methods26 cases of patients with fracture and dislocation of the lower cervical spine admitted in our hospital at the time of February 2013 to August 2013 were chosen for study,they received the treatment of primary combined anterior-posterior decompression and fixation and the relevant nursing intervention.Results During the time of 3 to 16 months after the operation,tracking surveys of the patients were carried out, neurological functions of the patients were greatly improved at least one grade,there was no complications associated with the surgeries,also no cases of loosening of the implant and chain scission,the patients made a good recovery.Conclusion Primary combined anterior-posterior decompression and fixation has a certain effect in the treatment of lower cervical fractures and dislocations,it is beneficial to the rapid rehabilitation of the patients.%目的:对一期前后联合手术减压固定治疗严重下颈椎骨折脱位效果观察。方法选取我院2013年2~8月收治的下颈椎骨折脱位患者26例,采用一期前后联合手术减压固定的手段进行治疗与护理。结果手术之后的3~16个月,对患者实行跟踪调查,神经功能得到了较大的改善,都在一级以上,没有出现与手术相关的并发症,也没有出现内植物松动与断链的病例,患者恢复良好。结论一期前后联合手术减压固定对下颈椎骨折脱位的治疗具有一定的效果,有利于患者的快速康复。

  9. Observation on effect of percutaneous puncture nucleus pulposus forceps holder decompression combined ozone under DSA guide treatment of cervical disc herniation%DSA引导下经皮穿刺髓核钳夹减压术联合臭氧治疗颈椎间盘突出症的疗效观察

    Institute of Scientific and Technical Information of China (English)

    吴越宏; 符彦基; 庞亮明; 钟海英; 郭绍彬

    2016-01-01

    目的:观察颈椎间盘突出症于DSA引导下经皮穿刺髓核钳夹减压术联合臭氧治疗后的疗效。方法选取我院2012年5月~2015年6月间186例颈椎间盘突出症患者,所有患者均于DSA引导下经皮穿刺髓核钳夹减压术联合臭氧治疗,观察其治疗效果。结果186例患者治愈146例(78.5%),好转37例(19.8%),疗效不佳3例(1.6%),总有效率为98.4%。与治疗前比较,治疗后24 h、1周、l个月、3个月、6个月视觉模拟评分(VAS)降低,差异有统计学意义(P<0.05)。结论 DSA引导下经皮穿刺髓核钳夹联合臭气治疗颈椎间突出症创伤小、有效、安全,值得临床推广。%Objective To observe the effect of percutaneous puncture nucleus pulposus forceps holder decompression combined ozone under DSA guide in the treatment of cervical disc herniation.Methods To select 186 patients with cervical disc herniation in our hospital from May 2012 to June 2015, to treat with percutaneous puncture nucleus pulposus forceps holder decompression combined ozone under DSA guide in all patients, to observe the treatment effect.ResultsOf the 186 patients, the total effective rate was 98.4%, with cured 146 cases(78.5%), improvement 37 cases(19.8%), and poor therapeutic effect 3 cases(1.6%). The visual analogue score(VAS) after 24h, 1 week, 1 month, 3 months, 6 months treatment had reduced compared with which before treatment, the differences was statically significant(P<0.05).Conclusion Percutaneous puncture nucleus pulposus forceps holder decompression combined ozone under DSA guide in the treatment of cervical disc herniation has less trauma, is effective and safe, is worthy of clinical popularization.

  10. Risk factors and treatment strategy for adjacent segment diseases after anterior cervical decompression and fusion%颈椎前路融合术后邻近节段退变性疾病的原因分析及治疗策略

    Institute of Scientific and Technical Information of China (English)

    王洪立; 姜建元; 吕飞舟; 马晓生; 夏新雷; 王立勋

    2014-01-01

    目的 探讨颈椎前路融合术后邻近节段退变性疾病的发生原因及治疗策略.方法 对2005年12月至2012年8月颈椎前路减压融合术后并发邻近节段退变性疾病的14例进行回顾性分析.男10例,女4例,初次手术年龄36~68岁,平均(52.0±11.0)岁.测量初次手术后颈椎整体曲度、手术节段局部曲度、钢板与上、下间隙的距离.二次手术时对节段数量≤2个且不伴严重后纵韧带或黄韧带骨化的9例采用颈椎前路减压融合内固定术,对节段数量≥3个且不伴明显后凸畸形、排列不稳及严重黄韧带骨化的3例采用颈椎后路减压椎管扩大成形术,对伴有明显后凸畸形、排列不稳且因技术原因无法行前路减压及合并严重黄韧带骨化的2例采用颈椎后路全椎板切除减压融合术.结果 初次术后邻近节段退变性疾病的发生时间为(9.3±4.4)年,二次手术时患者年龄(61.3±12.4)岁.初次术后颈椎整体曲度与手术节段局部曲度分别为12.4°±10.8°、1.5°±6.8°;钢板与上、下间隙的距离分别为(0.9±1.8)mm、(3.8±3.2) mm.二次术后平均随访(30.4±17.8)个月,末次随访时日本骨科学会颈椎病疗效评分改善率为73.9%±9.7%.结论 钢板与邻近间隙距离过小、手术节段局部曲度恢复不良可能是前路融合术后邻近节段退变性疾病的发生原因;二次手术方案的选择应根据病变累及节段、致压因素、颈椎曲度等因素进行综合分析.%Objective To investigate the risk factors and treatment strategy in treating adjacent segment diseases (ASD) after anterior cervical decompression and fusion.Methods Fourteen patients with ASD after anterior cervical decompression and fusion from December 2005 to August 2012 were analyzed.The overall curvature of the cervical spine,local curvature of surgical segments,and the distances between the plate and the upper and lower intervertebral space were measured and analyzed.10 males

  11. Treatment of multilevel cervical spondylotic myelopathy by conjugation of anterior vertebral subtotal resection and intervertebral space decompression and bone graft fusion%前路椎体次全切除结合椎间隙减压植骨融合术治疗多节段脊髓型颈椎病

    Institute of Scientific and Technical Information of China (English)

    刘斐文; 张彤; 孙川江; 谢涛江; 王永亮; 张雪锋

    2016-01-01

    Objectives To evaluate clinical effect of multilevel cervical spondylotic myelopathy( CSM) treated by an-terior vertebral subtotal resection conjugated with intervertebral space decompression and bone graft fusion. Methods Forty-six cases of CSM whose three segments were received anterior approach treatment. Among them, 24 cases re-ceived vertebral subtotal resection conjugated with single cell gap decompression and bone graft fusion as Group A, and the other 22 cases were given subtotal resection decompression of two vertebral bodies and decompression and bone graft fusion as Group B. Operation time and bleeding, bone graft fusion rate, nerve function amelioration and cervical vertebra physiological curvature restoration were observed and compared. Results All patients were followed up for 15~36 months. Operation time in Group A was (105 ± 20) min, while that in Group B was (180 ± 30) min, bleeding during operation were (120 ± 35) ml in group A and (210 ± 25) ml in group B, the difference of the data between two groups were statistically significant ( P0. 05). Postopera-tion cervical vertebra physiological curvature of both groups were obviously ameliorated, without statistical significance (P>0. 05). Conclusions Multilevel CSM treatment by anterior vertebral subtotal resection conjugated with interver-tebral space decompression and bone graft fusion can gain satisfactory effect, with advantages such as relatively simp-ler operations, less bleeding, shorter operation time, higher bone graft fusion rates, and so on. It is a safe, effective operation method which can also reduce complications.%目的:评价前路椎体次全切除结合椎间隙减压植骨融合术治疗多节段脊髓型颈椎病( CSM )的临床疗效。方法采用前路手术治疗累及3个节段的CSM患者46例。其中24例行椎体次全切除+单间隙减压植骨融合术( A组);22例行2个椎体次全切除减压植骨融合术( B组)。观察比较两组手术时间、术中

  12. Whole-Earth Decompression Dynamics

    CERN Document Server

    Herndon, J M

    2005-01-01

    The principles of Whole-Earth Decompression Dynamics are disclosed leading to a new way to interpret whole-Earth dynamics. Whole-Earth Decompression Dynamics incorporates elements of and unifies the two seemingly divergent dominant theories of continential displacement, plate tectonics theory and Earth expansion theory. Whole-Earth decompression is the consequence of Earth formation from within a Jupiter-like protoplanet with subsequent loss of gases and ices and concomitant rebounding. The initial whole-Earth decompression is expected to result in a global system of major primary decompression cracks appearing in the rigid crust which persist as the basalt feeders for the global, mid-oceanic ridge system. As the Earth subsequently decompresses, the area of the Earth's surface increases by the formation of secondary decompression cracks, often located near the continental margins, presently identified as oceanic trenches. These secondary decompression cracks are subsequently in-filled with basalt, extruded fr...

  13. Treatment of anterior decompression, bone grafting and internal fixation combined with coblation neucleoplasty for patients with cervical spondylosis involved multilevel%前路减压植骨内固定联合髓核成形术治疗多节段受累颈椎病

    Institute of Scientific and Technical Information of China (English)

    张非; 李青; 张爱明; 梁道臣

    2013-01-01

    目的:探讨前路减压植骨内固定联合等离子髓核成形术治疗多节段受累颈椎病的临床效果。方法回顾性分析2012年3月至12月中山市人民医院采用前路减压植骨内固定结合等离子髓核成形术治疗的30例多节段受累颈椎病患者的临床资料,采用日本骨科学会(JOA)评分对术后临床症状改善情况进行评价。结果30例患者均获得有效随访,随访时间4~9个月(平均6.8个月)。患者术前不适症状均有不同程度改善,无神经功能加重及内固定松动、骨笼脱出等严重并发症发生。术后3个月JOA评分为(14±1)分,较术前的(10±2)分明显改善(t =8.143,P=0.000),JOA改善率为45%。结论前路减压植骨内固定结合等离子髓核成形术治疗多节段受累颈椎病近期效果稳定,并发症少。%Objective To explore clinical effect of anterior decompression, bone grafting and internal fixation combined with coblation neucleoplasty in the treatment of multilevel cervical spondylosis. Methods Clinical data of 30 patients with multilevel cervical spondylosis from March 2012 to December 2012 were retrospectively analyzed and all of them were treated by mono-segmented cervical anterior decompression, bone grafting and internal fixation combined with coblation neucleoplasty in Zhongshan People's Hospital. Clinical effects were evaluated by Japanese Orthopaedic Association (JOA) score. Results All patients obtained follow-up with the average time of 6.8 months (4-9 months). Discomfort symptoms were improved after the operation. No nerve function aggravation occurred, also, no serious complications such as internal fixation loosening or cage pull-out had happened. Compared to preoperative JOA score, JOA score at 3 months postoperatively was improved from (10 ± 2) to (14 ± 1) (t = 8.143,P = 0.000), JOA improvement rate was 45%. Conclusions Mono-segmented cervical anterior decompression, bone graft fusion

  14. Tratamento cirúrgico por via anterior na mielopatia cervical espondilótica com seguimento mínimo de dez anos Tratamiento quirúrgico por vía anterior en la mieolopatía cervical espondilótica con seguimiento mínimo de diez años Anterior decompression and fusion for spondilotic cervical mielopathy with a minimal ten-year follow-up

    Directory of Open Access Journals (Sweden)

    Rui Peixoto Pinto

    2010-06-01

    promedio de 11.9 años. Ocurrieron cinco óbitos: tres pacientes en el postoperatorio inmediato, uno durante el primer año y uno durante el restante periodo. En promedio, fueron operados 2.7±1.0 niveles por paciente (1 a 4. El valor promedio de Nurick pre operatorio fue de 3.8±0.9. Hubo una mejora significativa del estado neurológico un año después de la cirugía (2.2±1.1; pOBJECTIVE: cervical spondylotic myelopathy (CSM is a common cause of spinal cord dysfunction in the adult population. The treatment implies early surgical decompression. The objective was to present a retrospective study of anterior decompression and arthrodesis for CSM with a minimal ten years follow-up. METHODS: patients operated between January 1990 and December 1994 were evaluated for sex, age, number of levels operated, functional evaluation with Nurick scale preoperatively, one year after surgery and at the final revision that took place in 2004, evidence of consolidation and complications. RESULTS: 91 patients were evaluated, 69 male, 22 female, with a mean age of 56.6 years (42-86 and mean follow-up of 11.9 years. Five deaths occurred: three patients died in the immediate postoperative period, one in the first year and one during the follow-up. A mean of 2.7±1.0 levels for patient was performed (1-4. The mean value of preoperative Nurick was 3.8±0.9. There was a significant improvement in neurological condition after one year (2.2±1.1; p<0.001, and between preoperative period and final evaluation (2.3±1.2; p<0.001. The degradation between the first year and the final evaluation was statistically significant (p=0.004. There was a strong correlation between age and the number of operated levels (r=0.391; p=0.01, age and initial neurologic status (r=0.238; p=0.05, initial neurological status and number of operated levels (r=0.251; p=0.05 and sex and number of operated levels, with women being operated for more levels (r=0.208; p=0.05. There was also a stronger neurological deterioration

  15. Cervical Disc Disease: Biomechanical Aspects

    OpenAIRE

    Kolstad, Frode

    2011-01-01

    Degenerative disc disease in the cervical spine may cause significant pain and disability. Patients present themselves with neck pain, radiculopathy, and/or myelopathy. When the symptoms do not improve with conservative treatment, surgical treatment is considered. The goal of surgical treatment is to decompress nervous structures and to restore the normal anatomical conditions of disc height, alignment, and stability.The present thesis concerns four studies involving the treatment of cervical...

  16. 桥形椎间锁定融合器(ROI-C)在颈椎病前路减压融合术中应用的临床研究%Bridge Intervertebral Fusion Lock Device (ROI - C) in Cervical Spondylosis Anterior Decompression Fusion Application in Clinical Research

    Institute of Scientific and Technical Information of China (English)

    何彦国

    2015-01-01

    objective to study and analyze the bridge between vertebra locking fusion in cervical spondylosis application of the clinical effect of anterior decompression fusion.Methods to collect a total of 100 patients with cervical spondylosis, randomly divided into observation group and control group, the 50 cases, control group patients with cage combined anterior internal fixation with titanium plate, observation group carries on the bridge a locked intervertebral fusion, both before and after operation for X-ray inspection, two group of patients with cervical physiological curvature and lesion intervertebral height, the incidence of dysphagia observation and comparison.Results the observation group of patients with cervical physiological curvature of the improvement of the degree of improvement and pathology of the intervertebral height was significantly higher than that of control group, the incidence of dysphagia in patients with significantly lower than the control group,P<0.05).Conclusion in the cervical spine anterior decompression fusion, application of bridge intervertebral target fusion can make cervical physiological curvature and pathological changes of intervertebral height effectively restore, and lower the incidence of postoperative patients with dysphagia, shorter operation time, simple operation, is worthy of popularization and application.%目的:研究和分析桥形椎间锁定融合器在颈椎病前路减压融合术中应用的临床效果。方法收集颈椎病患者共100例,随机分为观察组与对照组,各50例,对照组患者进行cage联合前路钛板内固定,观察组进行桥形椎间锁定融合器固定,手术前后均进行了X线片的检查,将两组患者的颈椎生理曲度、病变椎间高度、吞咽困难发生率等进行观察和对比。结果观察组患者的颈椎生理曲度的改善程度、病变椎间高度的改善程度明显高于对照组,患者的吞咽困难发生

  17. Sub-axial cervical spine injuries: Modified Stellerman′s algorithm

    Directory of Open Access Journals (Sweden)

    Arjun Shetty

    2011-01-01

    Conclusion: We feel that on table decompression and reduction followed by anterior stabilization can be used as the initial surgical approach to manage most types of cervical injuries. In rotation/translational cases where reduction cannot be achieved, monitored cervical traction on the decompressed spine can safely achieve reduction and hence avoid the need for a posterior facetectomy in a large percentage of cases.

  18. 颈椎骨折经前路减压融合内固定术患者的围手术期的护理%Nursing Experience in Perioperative Period of Patients with Cervical Spine Fracture by Anterior Decompression and Internal Fixation

    Institute of Scientific and Technical Information of China (English)

    包秀梅

    2015-01-01

    Objective To investigate the cervical spine fracture by anterior decompression and fusion with internal fixation in patients with perioperative nursing.Methods A retrospective analysis of patients with general information from patients with anterior cervical surgery,preoperative and postoperative analysis of 2 nursing intervention patients,and observation of patients with complications. Results For 10 patients with anterior cervical spine surgery, the patients were given comprehensive, comprehensive and careful nursing, and no complications were found.Conclusion Careful nursing measures can promote the rehabilitation of patients, improve the quality of life of patients.%目的探讨颈椎骨折经前路减压融合内固定术患者的围手术期的护理。方法回顾性分析10例颈椎前路手术患者的一般资料,从术前、术后2方面分析给予患者的护理措施,并观察患者并发症的情况。结果对于10例颈椎前路手术患者的术前术后均给予全面、综合、精心的护理,未发现任何的并发症。结论精心的护理措施能促进患者的康复,提高患者的生活质量。

  19. Whole-Earth Decompression Dynamics

    OpenAIRE

    Herndon, J. Marvin

    2005-01-01

    The principles of Whole-Earth Decompression Dynamics are disclosed leading to a new way to interpret whole-Earth dynamics. Whole-Earth Decompression Dynamics incorporates elements of and unifies the two seemingly divergent dominant theories of continential displacement, plate tectonics theory and Earth expansion theory. Whole-Earth decompression is the consequence of Earth formation from within a Jupiter-like protoplanet with subsequent loss of gases and ices and concomitant rebounding. The i...

  20. A review of spinal cord injury decompression in experimental animals

    Directory of Open Access Journals (Sweden)

    Vafa Rahimi-Movaghar

    2010-03-01

    Full Text Available Background: Traumatic spinal cord injury (SCI is major permanent sequelae of trauma with high burden and low frequency. In the setting of SCI is there any correlation between the timing of surgical decompression and sensory-motor improvement.Material and Methods: A literature review was performed using PUBMED from 1966 to 25th January 2010. Cross referencing of discovered articles was also reviewed.Results: The results of animal studies have shown that aside from the kind of procedure and species, when compression is less severe and of shorter duration, the neurological and histopathological recovery is significantly good. One meta-analysis, nine prospective studies, and one randomized clinical trial were identified. Conclusion: There are presently no standards regarding the role and timing of decompression in acute SCI. As a practice guideline, early surgery in less than 24 hours can be done safely in patients with acute SCI and urgent decompression is a reasonable practice option. Traction is the most practical method of achieving urgent decompression after cervical SCI. There are class III data to support a recommendation for urgent decompression in any patient with incomplete SCI with or without neurologic deterioration, with or without bilateral irreducible facet dislocations. There is emerging evidence that surgery within 24 hours may reduce both the length of intensive care unit stay and incidence of medical complications

  1. Feasibility of low anterior cervical approach decompression and bone graft fusion for internal fixation in the treatment of patients with spine and spinal cord trauma in cervicothoracic junction%低位颈前入路减压植骨融合内固定治疗颈胸段脊柱脊髓损伤的可行性

    Institute of Scientific and Technical Information of China (English)

    刘明明; 程建; 华臻

    2015-01-01

    Objective:To explore the feasibility of low anterior cervical approach decompression and bone graft fusion for internal fixation in the treatment of patients with spine and spinal cord trauma in cervicothoracic junction.Methods:20 patients with spine and spinal cord trauma in cervicothoracic junction were selected.All patients were treated with low anterior cervical approach decompression and bone graft fusion for internal fixation.We discussed the efficacy and postoperative recovery of the patients. Results:All patients recovered well,and there was no case with loosening of the screws,loss of the titanium plate,the fracture of the titanium plate and other circumstances.Only 1 case with the position of titanium mesh not well fixed when detected by X tablets after operation.It has been adjusted after six months of surgery,after 1 year of operation,it recovered well,no titanium mesh moved. Conclusion:Patients with spine and spinal cord trauma in cervicothoracic junction with low anterior cervical approach decompression and bone graft fusion and internal fixation for the treatment can effectively promote the patients with cervicothoracic spine sequence returned to normal,and improve the patients' postoperative recovery.%目的:探讨低位颈前入路减压植骨融合内固定治疗颈胸段脊柱脊髓损伤的可行性。方法:收治颈胸段脊柱脊髓损伤患者20例,实施低位颈前入路减压植骨融合内固定治疗,对术后疗效及恢复情况进行探讨。结果:所有患者恢复良好,无一例患者出现螺钉松动、脱落、钛板断裂等情况,只有1例在术后经过X片检测后发现其钛网位置固定不佳,术后0.5年对其进行了调整,术后1年检测见其恢复良好,没有出现钛网移动情况。结论:颈胸段脊柱脊髓损伤患者采用低位颈前入路减压植骨融合内固定治疗,可以有效促进患者颈胸段脊柱序列恢复正常,改善患者的术后恢复情况。

  2. Operative techniques for cervical radiculopathy and myelopathy.

    LENUS (Irish Health Repository)

    Moran, C

    2012-02-01

    The surgical treatment of cervical spondylosis and resulting cervical radiculopathy or myelopathy has evolved over the past century. Surgical options for dorsal decompression of the cervical spine includes the traditional laminectomy and laminoplasty, first described in Asia in the 1970\\'s. More recently the dorsal approch has been explored in terms of minimally invasive options including foraminotomies for nerve root descompression. Ventral decompression and fusion techniques are also described in the article, including traditional anterior cervical discectomy and fusion, strut grafting and cervical disc arthroplasty. Overall, the outcome from surgery is determined by choosing the correct surgery for the correct patient and pathology and this is what we hope to explain in this brief review.

  3. Operative Outcomes for Cervical Degenerative Disease: A Review of the Literature

    OpenAIRE

    Kazuya Nishizawa; Kanji Mori; Yasuo Saruhashi; Yoshitaka Matsusue

    2012-01-01

    To date, several studies were conducted to find which procedure is superior to the others for the treatment of cervical myelopathy. The goal of surgical treatment should be to decompress the nerves, restore the alignment of the vertebrae, and stabilize the spine. Consequently, the treatment of cervical degenerative disease can be divided into decompression of the nerves alone, fixation of the cervical spine alone, or a combination of both. Posterior approaches have historically been considere...

  4. 经皮激光椎间盘减压术联合臭氧注射治疗神经根型颈椎病疗效分析%Treatment effect analysis of percutaneous laser disk decompression combined with ozone therapy for the treatment on cervical radiculopathy

    Institute of Scientific and Technical Information of China (English)

    陈嘉华; 黄凯; 李朝辉; 陈光福; 邓烨

    2011-01-01

    Objective To explore the treatment effect of percutaneous laser disk decompression(PLDD)combined with ozone therapy for the treatment on cervical radiculopathy. Methods There were 208 cases in the control group which were only treated with PLDD; while 152 cases in the trial group were treated with PLDD and ozone therapy.The clinical treatment effect evaluation was based on the VAS. 1 d , 7 d, and 3 months after the surgery, took a telephone follow-up visit. Results After the surgery, 90% patients in trial group were good or excellent, while only 62% patients in control group were good or excellent. There was statistical difference between them (P< 0.05). Conclusions PLDD combined with ozone therapy can improve the clinical treatment effect of cervical radiculopathy.%目的 探讨经皮激光椎间盘减压术(PLDD)联合臭氧注射治疗神经根型颈椎病的临床疗效.方法 对照组208例,单纯行PLDD治疗;试验组152例,PLDD联合臭氧注射治疗.临床疗效采用VAS评分,分别评价术后1 d、7 d的疗效,电话随访3个月疗效.结果 术后的优良率试验组90%,对照组62%.组间比较差异有显著性(P<0.05).结论 PLDD联合臭氧注射治疗,可以提高神经根型颈椎病的临床疗效.

  5. Quantitative morphometric analysis of the lumbar vertebral facets and evaluation of feasibility of lumbar spinal nerve root and spinal canal decompression using the Goel intraarticular facetal spacer distraction technique: A lumbar/cervical facet comparison

    Directory of Open Access Journals (Sweden)

    Savni R Satoskar

    2014-01-01

    Full Text Available Objective : The authors evaluate the anatomic subtleties of lumbar facets and assess the feasibility and effectiveness of use of ′Goel facet spacer′ in the treatment of degenerative spinal canal stenosis. Materials and Methods : Twenty-five lumbar vertebral cadaveric dried bones were used for the purpose. A number of morphometric parameters were evaluated both before and after the introduction of Goel facet spacers within the confines of the facet joint. Results : The spacers achieved distraction of facets that was more pronounced in the vertical perspective. Introduction of spacers on both sides resulted in an increase in the intervertebral foraminal height and a circumferential increase in the spinal canal dimensions. Additionally, there was an increase in the disc space or intervertebral body height. The lumbar facets are more vertically and anteroposteriorly oriented when compared to cervical facets that are obliquely and transversely oriented. Conclusions : Understanding the anatomical peculiarities of the lumbar and cervical facets can lead to an optimum utilization of the potential of Goel facet distraction arthrodesis technique in the treatment of spinal degenerative canal stenosis.

  6. Endoscopic posterior decompression of lumbar canal stenosis

    Directory of Open Access Journals (Sweden)

    Yad Ram Yadav

    2013-01-01

    Full Text Available Lumbar canal stenosis (LCS is quite common. Surgery is indicated when patient fails to improve after conservative treatment. Endoscopic technique can be used in LCS and lateral recess stenosis. It can be performed in degenerative canal stenosis or with disc bulges. Bilateral severe bony canal stenosis and unstable spine are the contraindications. This procedure should be avoided in patients with a history of trauma. Detailed history and thorough physical examination should be performed to find out exact level of pathology responsible for symptoms. Patient′s symptoms must correlate with radiological findings. Magnetic resonance imaging is the investigation of choice because of its superior visualization of soft-tissue. Computed tomography scan does give a more accurate and detailed picture of the bony anatomy. Although the operative time and the complication rate could be more in the initial learning curve, the results of endoscopic decompression are comparable with conventional open procedures with the additional benefit of decreased complications and lower morbidity, when sufficient experience is gained. Complications in endoscopic surgery for LCS could be dural tears, hematomas and root and facet injury. This procedure is also associated with limitations such as steep learning curve and the contra lateral decompression may not be as good as ipsilateral side. Some of the limitations of this technique can be overcome by attending live operative workshop, practice on models and hands on cadaveric dissection. Conversion to an open procedure may be required when there is disorientation, management of dural tear and for control of bleeding.

  7. Cervicogenic vertigo treated by c1 transverse foramen decompression : a case report.

    Science.gov (United States)

    Park, Junhee; Lee, Chulkyu; You, Namkyu; Kim, Sanghyun; Cho, Kihong

    2014-09-01

    Cervicogenic vertigo was known as Bow hunter's syndrome. Occlusion of vertebral artery causes vertebrobasilar insufficiency and we reported cervicogenic vertigo case which was treated by simple decompression of transverse foramen of C1. The patient was 48 years old female who had left side dominant vertebral artery and vertigo was provoked when she rotated her head to right side. Angiography showed complete obliteration of blood flow of left vertebral artery when her head was rotated to right side. The operation was decompression of left vertebral artery at C1 level. Posterior wall of transverse foramen was resected and vertebral artery was exposed and decompressed. After surgery, vertigo of the patient was disappeared, and angiography showed patent left vertebral artery when her head was rotated to right side. Vertigo caused by compression of cervical vertebral artery could be treated by decompression without fusion or instrumentation, especially in C1 transverse foramen. PMID:25346772

  8. Pseudarthrosis of the Cervical Spine: Risk Factors, Diagnosis and Management

    Science.gov (United States)

    Leven, Dante

    2016-01-01

    Cervical myelopathy and radiculopathy are common pathologies that often improve with spinal decompression and fusion. Postoperative complications include pseudarthrosis, which can be challenging to diagnose and manage. We reviewed the literature with regard to risk factors, diagnosis, controversies, and management of cervical pseudarthrosis. PMID:27559462

  9. Cervical dysplasia

    Science.gov (United States)

    ... by your provider. Make sure to get the HPV vaccine when it is offered to you. This vaccine prevents many cervical cancers. ... Early diagnosis and prompt treatment cures most cases of cervical ... severe cervical dysplasia may change into cervical cancer.

  10. Spontaneous C1 anterior arch fracture as a postoperative complication of foramen magnum decompression for Chiari malformation type 1

    OpenAIRE

    Hirano, Yoshitaka; Sugawara, Atsushi; Mizuno, Junichi; Takeda, Masaaki; Watanabe, Kazuo; OGASAWARA, Kuniaki

    2011-01-01

    Background: C1 fracture accounts for 2% of all spinal column injuries and 10% of cervical spine fractures, and is most frequently caused by motor vehicle accidents and falls. We present a rare case of C1 anterior arch fracture following standard foramen magnum decompression for Chiari malformation type 1. Case Description: A 63-year-old man underwent standard foramen magnum decompression (suboccipital craniectomy and C1 laminectomy) under a diagnosis of Chiari malformation type 1 with syringo...

  11. Acute Hydrocephalus Following Cervical Spinal Cord Injury

    OpenAIRE

    Son, Seong; Lee, Sang Gu; Park, Chan Woo; Kim, Woo Kyung

    2013-01-01

    We present a case of acute hydrocephalus secondary to cervical spinal cord injury in a patient with diffuse ossification of the posterior longitudinal ligament (OPLL). A 75-year-old male patient visited the emergency department with tetraparesis and spinal shock. Imaging studies showed cervical spinal cord injury with hemorrhage and diffuse OPLL from C1 to C4. We performed decompressive laminectomy and occipitocervical fusion. Two days after surgery, his mental status had deteriorated to drow...

  12. 三种颈前路减压术式治疗多节段脊髓型颈椎病的并发症比较%Comparative analysis of complications of different anterior decompression procedures for treating multilevel cervical spondylotic myelopathy

    Institute of Scientific and Technical Information of China (English)

    祁敏; 王新伟; 刘洋; 梁磊; 陈华江; 杨立利; 袁文

    2012-01-01

    目的:分析比较不同颈前路减压术式治疗多节段脊髓型颈椎病术后并发症的差异.方法:回顾性分析2006年1月~2011年8月手术治疗的327例三节段脊髓型颈椎病患者的临床资料,根据手术方式不同分为三组:前路椎间盘切除减压融合术(anterior cervical discectomy with fusion,ACDF) (A组)、前路椎体切除减压融合术(anterior cervical corpectomy with fusion,ACCF)(B组)和ACDF+ACCF“混合式”减压术(C组),其中A组男性69例,女性55例,平均年龄53.48±8.50岁;B组男性51例,女性43例,平均年龄54.36±7.82岁;C组男性61例,女性48例,平均年龄53.68±7.80岁,组间比较无统计学差异.对三种不同手术方式并发症情况进行比较.结果:平均随访时间3.5年(1.5~5年).共有69例在手术后出现多种并发症,包括植骨未融合11例,其中C组3例(2.75%),B组8例(8.51%),B组植骨不愈合发生率显著高于A组和C组(P<0.05);声音嘶哑12例,其中A组5例(4.03%),B组3例(3.19%),C组4例(3.67%);吞咽困难26例,其中A组11例(8.87%),B组7例(7.45%),C组8例(7.34%);C5神经根麻痹12例,其中A组2例(1.61%),B组5例(5.32%),C组5例(4.59%);脑脊液漏5例,其中A组3例,C组2例;切口感染3例,其中B组2例,C组1例.A组患者并发症发生率为16.94%,B组为26.60%,C组为21.10%,B组患者术后并发症的发生率显著高于其余两组(P<0.05).结论:多节段脊髓型颈椎病患者手术治疗中,ACDF的并发症发生率最低,ACCF术式应慎用,其并发症的发生率较高.%Objectives: Comparative analysis of complications of different anterior decompression procedures for treating multilevel cervical spondylotic myelopathy(CSM). Methods: This study retrospectively reviewed the postoperative complications in 327 patients with three-level CSM in whom the anterior cervical surgery was performed between January 2006 and August 2011. According to the decompression procedure, patients were divided into

  13. Post laminoplasty cervical kyphosis—Case report

    Science.gov (United States)

    Dugoni, D.E.; Mancarella, C.; Landi, A.; Tarantino, R.; Ruggeri, A.G.; Delfini, R.

    2014-01-01

    INTRODUCTION Cervical kyphosis is a progressive cervical sagittal plane deformity that may cause a reduction in the ability to look horizontally, breathing and swallowing difficulties, sense of thoracic oppression and social isolation. Moreover, cervical kyphosis can cause myelopathy due to a direct compression by osteo-articular structures on the spinal cord or to a transitory ischaemic injury. The treatment of choice is surgery. The goals of surgery are: nervous structures decompression, cervical and global sagittal balance correction and vertebral stabilization and fusion. PRESENTATION OF CASE In October 2008 a 35 years old woman underwent surgical removal of a cervical-bulbar ependymoma with C1–C5 laminectomy and a C2–C5 laminoplasty. Five months after surgery, the patient developed a kyphotic posture, with intense neck and scapular girdle pain. The patients had a flexible cervical kyphosis. Therefore, we decided to perform an anterior surgical approach. We performed a corpectomy C4–C5 in order to achieve the anterior decompression; we placed a titanium expansion mesh. DISCUSSION Cervical kyphosis can be flexible or fixed. Some authors have reported the use of anterior surgery only for flexible cervical kyphosis as discectomy and corpectomy. This approach is useful for anterior column load sharing however it is not required for deformity correction. CONCLUSION The anterior approach is a good surgical option in flexible cervical kyphosis. It is of primary importance the sagittal alignment of the cervical spine in order to decompress the nervous structures and to guarantee a long-term stability. PMID:25462050

  14. Surface electromyography activity in the upper limbs of patients following surgery for compressive cervical myelopathy

    Directory of Open Access Journals (Sweden)

    Ananth P Abraham

    2015-01-01

    Conclusion: Surface EMG is an objective tool to detect improvement in spasticity following decompressive surgery for compressive cervical myelopathy even in those patients who showed no improvement on the MMAS.

  15. Single or double-level anterior interbody fusion techniques for cervical degenerative disc disease (Review)

    NARCIS (Netherlands)

    Jacobs, W.; Willems, P.C.P.H.; Limbeek, J. van; Bartels, R.H.M.A.; Pavlov, P.; Anderson, P.G.; Oner, C.

    2011-01-01

    BACKGROUND: The number of surgical techniques for decompression and solid interbody fusion as treatment for cervical spondylosis has increased rapidly, but the rationale for the choice between different techniques remains unclear. OBJECTIVES: To determine which technique of anterior interbody fusion

  16. Clinical Outcomes After Cervical Transcorporeal Microdecompression and Vertebral Body Access Channel Repair

    OpenAIRE

    David W Lowry; Tuinstra, Scott M.; Liang, Kevin; Sclafani, Joseph A.

    2015-01-01

    Background Although anterior cervical decompression and fusion (ACDF) can be performed using minimally invasive techniques, the extensive removal of anatomical keystones during decompression requires a segmental fusion to restore biomechanical stability. Treatment with arthrodesis techniques may result in a prolonged recovery time, loss of motion, and the need for further treatment if a pseudarthosis or adjacent segment disease occur. Transcorporeal micro decompression (TCMD) is a newly devel...

  17. Rabbit lung injury induced by explosive decompression

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    Objective: To study the mechanism of rabbit lunginjury caused by explosive decompression. Methods: A total of 42 rabbits and 10 rats were served as the experimental animals. A slow recompressiondecompression test and an explosive decompression test were applied to the animals, respectively. And the effects of the given tests on the animals were discussed. Results: The slow recompression-decompression did not cause an obvious lung injury, but the explosive decompression did cause lung injuries in different degrees. The greater the decompression range was, the shorter the decompression duration was, and the heavier the lung injuries were. Conclusions: Explosive decompression can cause a similar lung injury as shock wave does. The primary mechanical causes of the lung injury might be a tensile strain or stress in the alveolar wall and the pulmonary surface's impacts on the inside wall of the chest.

  18. The Research of Artificial Cervical Disc Replacement

    Institute of Scientific and Technical Information of China (English)

    Zhao Zhua; Qiang Shenb

    2008-01-01

    Cervical arthroplasty after anterior decompression with insertion of a prosthetic total disc replacement has been suggested as an alternate to anterior cervical fusion. It develops quickly during recent years. Currently there are several cervical arthroplasty devices. Each device varies in terms of materials, range of motion and constraint. Early studies suggest that in the short term, the complication rate and efficacy is no worse than fusion surgery. Long-term results have not yet been reported. This review examines the current prostheses as well as discussing issues regarding indications and technique. It is hoped that an improvement of cervical arthroplasty occurs in terms of materials and design as spinal surgeons enter a new dines of the management of cervical spine disease.

  19. Imaging of cervical spine injuries of childhood

    Energy Technology Data Exchange (ETDEWEB)

    Khanna, Geetika; El-Khoury, Georges Y. [University of Iowa Hospitals and Clinics, Department of Radiology, 3951 JPP, Iowa, IA (United States)

    2007-06-15

    Cervical spine injuries of children, though rare, have a high morbidity and mortality. The pediatric cervical spine is anatomically and biomechanically different from that of adults. Hence, the type, level and outcome of cervical spine injuries in children are different from those seen in adults. Normal developmental variants seen in children can make evaluation of the pediatric cervical spine challenging. This article reviews the epidemiology of pediatric cervical spine trauma, normal variants seen in children and specific injuries that are more common in the pediatric population. We also propose an evidence-based imaging protocol to avoid unnecessary imaging studies and minimize radiation exposure in children. (orig.)

  20. Physiotherapy after subacromial decompression surgery

    DEFF Research Database (Denmark)

    Christiansen, David Høyrup; Falla, Deborah; Frost, Poul;

    2015-01-01

    This paper describes the development and details of a standardised physiotherapy exercise intervention designed to address pain and disability in patients with difficulty returning to usual activities after arthroscopic decompression surgery for subacromial impingement syndrome. To develop...... the intervention, the literature was reviewed with respect to the effectiveness of postoperative exercises, components of previous exercise programmes were extracted, and input from clinical physiotherapists in the field was obtained through a series of workshops. The physiotherapy exercise intervention...

  1. 颈前路减压并桥形椎间锁定融合器内固定术治疗Ⅱ型及Ⅱa型Hangman骨折%Anterior cervical decompression with double-way connection intervertebral fusion device implantation for type Ⅱ or type H a Hangman fracture

    Institute of Scientific and Technical Information of China (English)

    曹贵君; 孟纯阳; 张卫红; 孔祥清; 张聪

    2016-01-01

    目的 探讨颈前路减压并桥形椎间锁定融合器(ROI-C)内固定术治疗Ⅱ型及Ⅱa型Hangman骨折的临床疗效. 方法 回顾性分析自2011年2月至2014年3月14例行颈前路ROI-C置入治疗的Ⅱ型及Ⅱa型Hangman骨折患者.其中男11例,女3例;年龄22 ~46岁,平均26.4岁.致伤原因:交通伤9例,坠落伤4例,砸伤1例.按照Levine-Edwards分型:Ⅱ型9例,Ⅱa型5例.所有患者入院均行颈椎正侧位X线片、CT平扫及三维重建、MRI检查.术前神经功能按美国脊髓损伤协会(ASIA)分级均为E级.记录术前及末次随访时的创伤后颈椎临床评分、视觉模拟评分(VAS)、枢椎移位及成角数据;观察椎问节段融合情况,有无椎间隙塌陷、融合器移位及畸形愈合. 结果 14例患者均手术顺利,手术时间平均为61 min(45 ~ 116 min).术中无喉上神经、舌下神经、咽喉壁及血管损伤;术后无喉头水肿、吞咽困难、舌肌瘫痪、血肿形成及伤口感染等并发症.平均随访24.2个月(4~32个月),手术融合节段及骨折部位平均于术后3个月时骨性融合,末次随访时融合器无下沉、移位,椎间无塌陷,未见畸形愈合.创伤后颈椎临床评分:术前(53.1±7.2)分,末次随访时(91.1±5.0)分(P<0.05);颈部疼痛VAS:术前3.38 (2.43,4.33)分,末次随访时0.58(0,1.29)分(P<0.05);枢椎移位:术前(4.0±1.5)mm,末次随访时(1.3±1.2)mm(P<0.05);枢椎成角:术前(9.2±4.7)°,末次随访时(2.1±1.9)°(P<0.01). 结论 应用ROI-C行颈前路融合手术治疗Ⅱ型及Ⅱa型Hangman骨折,可以获得良好的融合率,临床疗效满意.%Objective To analyze the clinical effect of anterior cervical decompression with double-way connection intervertebral fusion device (ROI-C) implantation for type Ⅱ or type Ⅱ a Hangman fracture.Methods A retrospective study was made on 14 patients with type Ⅱ or type Ⅱ a Hangman fracture treated with anterior cervical ROI-C implantation between February 2011

  2. Management of cervical polyradiculopathy through multisegmental laminoforaminotomies

    Directory of Open Access Journals (Sweden)

    Hosam Eldin Abdel Azim Mostafa Habib

    2014-12-01

    Conclusion: Cervical laminoforaminotomy is an effective technique in addressing multisegmental cervical radicular compression. Moreover, this technique eliminates the need of fusion and possible internal fixation, which are essential if the alternative anterior procedure was performed; thus, reducing the overall cost and morbidity.

  3. Minimal Invasive Decompression for Lumbar Spinal Stenosis

    Directory of Open Access Journals (Sweden)

    Victor Popov

    2012-01-01

    Full Text Available Lumbar spinal stenosis is a common condition in elderly patients and may lead to progressive back and leg pain, muscular weakness, sensory disturbance, and/or problems with ambulation. Multiple studies suggest that surgical decompression is an effective therapy for patients with symptomatic lumbar stenosis. Although traditional lumbar decompression is a time-honored procedure, minimally invasive procedures are now available which can achieve the goals of decompression with less bleeding, smaller incisions, and quicker patient recovery. This paper will review the technique of performing ipsilateral and bilateral decompressions using a tubular retractor system and microscope.

  4. The Comparison between Cervical Artificial Disc Arthroplasty and Anterior Cervical Decompression and Fusion on the Influence of the Adjacent Segments Degeneration%颈椎间盘置换术与颈椎前路减压融合术对邻近节段退变情况影响的比较

    Institute of Scientific and Technical Information of China (English)

    王鲲鹏; 邱玉金; 王玉凤; 刘守勇; 吴磊磊

    2013-01-01

    Objective To compare CADR with ACDF on the influence of the adjacent segments degenera-tion.Methods From February 2008 to October 2010,a total of 62 cases of cervical spondylosis was retrospectively re-viewed.All the patients were divided into CADR group and ACDF group ,depending on different surgical methods .The symptoms and neurological function were evaluated by the cervical Japanese Orthopaedic Association ( JOA) Scores and neck disability index ( NDI ) .The Cobb angle of C 2~7 and the mobility of adjacent segments were valuated the cervical range of mobility and degeneration .Results Compared with the preoperation , the last follow-up neurological function significantly improved ,the difference was statistically significant ( P0 .05 ) .At last follow-up Cobb angle of C 2~7 and the mobility of adjacent upper and lower segments in CADR group were similar to the preoperative ,there was no significant difference statistically (P>0.05).And there was significant difference statistically in ACDF group and between the groups ( P<0.05) .Conclusion CADR is less influ-ential on the adjacent segments degeneration postoperative .%目的:比较分析颈椎间盘置换术( CADR )与颈椎前路减压融合术( ACDF )对邻近节段退变情况的影响。方法回顾性分析2008年2月~2011年10月手术治疗的62名患者,根据术式不同,分为CADR组与ACDF组。采用颈椎JOA、NDI评分评价症状及神经功能,C2~7 Cobb角和手术相邻节段活动度评价颈椎活动范围及退变情况。结果与术前比较,末次随访时两组患者神经功能明显改善,组内差异有显著性(P<0.05),但组间比较差异无显著性(P>0.05)。与术前相比,末次随访时CADR组C2~7 Cobb角和手术相邻上、下节段活动度相近,差异无显著性(P>0.05);ACDF组内比较与两组间末次随访时比较C2~7 Cobb角和手术相邻上、下节段活动度,差异有显著性( P<0.05

  5. [Orbital decompression for Graves' ophthalmopathy].

    Science.gov (United States)

    Boulétreau, P; Breton, P; Freidel, M

    2005-04-01

    Graves' ophthalmopathy is a complex orbital condition with a controversial pathogenesis. It is the clinical expression of a discordance between the inextensible orbit and hypertrophic muscular and fatty elements within the orbit responding to immunological stimulation. The relationship between the orbital and its content can be improved by surgical expansion which increases the useful volume of the orbit. This procedure can be combined with lipectomy to decrease the volume of the orbital contents. We briefly recall the history of surgical decompression techniques and present our experience with Graves' ophthalmopathy patients.

  6. Endoscopic and Microscopic Microvascular Decompression.

    Science.gov (United States)

    Piazza, Matthew; Lee, John Y K

    2016-07-01

    The introduction of the endoscope into the neurosurgeon's armamentarium has revolutionized ventral and anterior skull-base surgery and, more recently, has been used in the surgical treatment of cerebellopontine angle (CPA) pathology. The utilization of the endoscope in microvascular decompression (MVD) for trigeminal neuralgia and other associated cranial nerve hyperactivity syndromes allows for unparalleled panoramic views and illumination of the neurovascular structures within the CPA and identification of vessel-nerve contact traditionally unseen using the microscope. In this article, the technical advantages and challenges of using the endoscope for MVD, operative technique, and patient outcomes of endoscopic MVD are discussed. PMID:27324997

  7. Tratamento cirúrgico por via anterior na mielopatia cervical espondilótica com seguimento mínimo de dez anos Tratamiento quirúrgico por vía anterior en la mieolopatía cervical espondilótica con seguimiento mínimo de diez años Anterior decompression and fusion for spondilotic cervical mielopathy with a minimal ten-year follow-up

    OpenAIRE

    Rui Peixoto Pinto; José Oliveira; Rui Matos; Nuno Neves; Manuel Ribeiro da Silva; Pedro Cacho Rodrigues; Rui M Barros; Abel Trigo Cabral

    2010-01-01

    OBJETIVO: a mielopatia cervical espondilótica (MEC) é uma causa frequente de disfunção da medula espinhal na população adulta. O tratamento implica em descompressão cirúrgica precoce. O objetivo foi apresentar um estudo retrospectivo da descompressão anterior e artrodese para MEC com um seguimento mínimo de dez anos. MÉTODOS: pacientes operados entre Janeiro de 1990 e Dezembro de 1994 foram avaliados por sexo, idade, número de níveis operados, avaliação funcional pela escala de Nurick pré-ope...

  8. Graphics processing unit-assisted lossless decompression

    Energy Technology Data Exchange (ETDEWEB)

    Loughry, Thomas A.

    2016-04-12

    Systems and methods for decompressing compressed data that has been compressed by way of a lossless compression algorithm are described herein. In a general embodiment, a graphics processing unit (GPU) is programmed to receive compressed data packets and decompress such packets in parallel. The compressed data packets are compressed representations of an image, and the lossless compression algorithm is a Rice compression algorithm.

  9. [Laminoplasty for cervical spondylotic myelopathy].

    Science.gov (United States)

    Fransen, P

    2014-10-01

    Cervical spondylotic myelopathy (CSM) is a common condition. Uninstrumented laminectomy may be complicated by postoperative instability, whereas anterior or posterior decompression with fusion may be associated with stiffness and adjacent segment disease. Cervical laminoplasty, initially oriented towards pediatric patients and ossification of the posterior longitudinal ligament, becomes an interesting surgical alternative to decompress and reconstruct cervical anatomy without fusion. Eighteen patients (12 men, 6 women), mean age 64.2 who presented with CSM were treated surgically using multilevel laminoplasty, and reviewed after 1 month, 6 months, 1 year and 2 years. Clinical evaluation was performed based on the Benzel-JOA and Nurick scores. The preoperative mean Benzel-JOA score was 13.55; Preoperative mean Nurick score was 1.88. Preoperative MRI was carried-out in 16/18 patients. Intramedullary hyperintensity in T2 was observed in 6 patients. The operation was performed on 2 levels (4 patients) 3 levels (11 patients) and 4 levels (3 patients). We used the open-door hinged laminoplasty technique, using metallic implants, without bone graft. At one month FU, mean JOA score was 15.44, and Nurick dropped to 1.05. At 6 months, mean JOA was 16.28 and Nurick was 0.71. At one year, the mean JOA score was 16.16, and Nurick was 0.83. At 2 years, mean JOA was 17.5, and Nurick was 0.25. One infection, one dural tear and one transient episode of C5 paresthesia were observed. We conclude that spinal cord decompression by open-door laminoplasty for CSM allows significant clinical improvement observed progressively in the two years following surgery. PMID:25239380

  10. Cervical Cancer

    Centers for Disease Control (CDC) Podcasts

    2007-03-06

    Did you know that cervical cancer rates differ by race/ethnicity and region? Or that cervical cancer can usually be prevented if precancerous cervical lesions are found by a Pap test and treated? Find out how getting regular Pap tests can save a woman's life.  Created: 3/6/2007 by National Breast and Cervical Cancer Early Detection Program.   Date Released: 4/25/2007.

  11. A comparative study on the treatment of cervical spondylosis with the surgery of dynamic cervical implant implantation and anterior decompression fusion with cage%颈椎动态稳定器植入与颈前路减压融合内固定治疗脊髓型颈椎病的比较

    Institute of Scientific and Technical Information of China (English)

    贾杰; 刘宏建; 尚国伟; 吴志彬; 王俊魁; 周权发; 皮国富

    2015-01-01

    目的 比较颈椎动态稳定器(DCI)植入术与颈前路减压融合内固定术(ACDF)治疗单节段脊髓型颈椎病的中期疗效.方法 对行DCI植入术(DCI组)的23例患者,与行颈前路减压融合内固定术(ACDF组)的47例患者进行随访,分别于术后24、36、48个月末行日本矫形外科协会(JOA)评分,并拍摄X线片观察手术节段椎间隙的高度和活动度以及上下邻近节段的活动度.结果 两组术后各期的JOA评分和椎间隙高度与术前比较差异均有统计学意义(P<0.05),随访各期组间比较差异无统计学意义(P>0.05).DCI组手术节段的活动度在各随访期末与术前比较差异无统计学意义(P>0.05);其上下邻近节段的活动度在随访期末[(6.99±0.56)°、(6.83±0.35)°]与术前[(6.78±0.51)°、(6.63 ±0.48)°]比较差异无统计学意义(P>0.05),而ACDF组随访期末上下邻近节段活动度[(8.56 ±0.51)°、(8.34±0.43)°]均较术前[(6.81±0.53)°、(6.67±0.49)°]增加(P<0.05).结论 两种手术均能明显缓解患者症状,恢复并维持椎间隙高度.与ACDF比较,DCI为手术节段提供持续的动态稳定,可减缓邻近节段的退变,但手术节段的椎体可能出现退变增生.%Objective To compare post-operative mid-term clinical outcomes between dynamic cervical implant (DCI) non-fusion group and anterior cervical discectomy and fusion (ACDF) group.Methods From March 2011 to January 2013, 23 patients were subjected to DCI non-fusion and 47 to ACDF respectively.The clinical outcomes were evaluated by the Japanese Orthopaedic Association (JOA) scores and all treated patients re-examined by lateral (full extention) views during follow-up at 24th month, 36 month, and 48 month respectively aiming to observe the intervertebral height of the treated level and the segmental range of motion (ROM) of adjacent levels of treated 1 evel in both two groups.Results Both the two groups showed good clinical outcomes by JOA scores.We found no

  12. Anterior Cervical Corpectomy and Fusion Accelerates Degenerative Disease at Adjacent Vertebral Segments

    OpenAIRE

    Pickett, Gwynedd E.; Duggal, Neil; Theodore, Nicholas; Sonntag, Volker K.H.

    2008-01-01

    Background Anterior cervical corpectomy provides the most direct and thorough surgical approach for anterior decompression when spinal cord compression is found directly behind the vertebral body. However, anterior cervical fusion has been shown to be associated with the development of new degenerative changes at levels immediately adjacent to the fused segments. Th e incidence of adjacent segment disease (ASD) following anterior cervical corpectomy has not been widely reported. We set out to...

  13. Cervical Disc Herniation Causing Brown-Séquard's Syndrome: A Case Report and Literature Review

    Directory of Open Access Journals (Sweden)

    Tarush Rustagi

    2011-01-01

    Full Text Available Brown-Séquard's syndrome (BSS is caused by hemisection or hemicompression of the cord leading to ipsilateral motor deficit and contralateral sensory loss. Cervical disc herniation has been reported to be a rare cause of Brown-Séquard's syndrome. We describe a rare case of multilevel cervical disc herniation presenting as BSS. The condition was confirmed by MRI scan. Cervical corpectomy, decompression, and fusion gave a satisfying result. Pertinent literature has been reviewed.

  14. Cervical Disc Herniation Causing Brown-Séquard's Syndrome: A Case Report and Literature Review

    Science.gov (United States)

    Rustagi, Tarush; Badve, Siddharth; Maniar, Hemil; Parekh, Aseem N.

    2011-01-01

    Brown-Séquard's syndrome (BSS) is caused by hemisection or hemicompression of the cord leading to ipsilateral motor deficit and contralateral sensory loss. Cervical disc herniation has been reported to be a rare cause of Brown-Séquard's syndrome. We describe a rare case of multilevel cervical disc herniation presenting as BSS. The condition was confirmed by MRI scan. Cervical corpectomy, decompression, and fusion gave a satisfying result. Pertinent literature has been reviewed. PMID:23259105

  15. Cervical Disc Herniation Causing Brown-Séquard's Syndrome: A Case Report and Literature Review.

    Science.gov (United States)

    Rustagi, Tarush; Badve, Siddharth; Maniar, Hemil; Parekh, Aseem N

    2011-01-01

    Brown-Séquard's syndrome (BSS) is caused by hemisection or hemicompression of the cord leading to ipsilateral motor deficit and contralateral sensory loss. Cervical disc herniation has been reported to be a rare cause of Brown-Séquard's syndrome. We describe a rare case of multilevel cervical disc herniation presenting as BSS. The condition was confirmed by MRI scan. Cervical corpectomy, decompression, and fusion gave a satisfying result. Pertinent literature has been reviewed.

  16. libpolycomp: Compression/decompression library

    Science.gov (United States)

    Tomasi, Maurizio

    2016-04-01

    Libpolycomp compresses and decompresses one-dimensional streams of numbers by means of several algorithms. It is well-suited for time-ordered data acquired by astronomical instruments or simulations. One of the algorithms, called "polynomial compression", combines two widely-used ideas (namely, polynomial approximation and filtering of Fourier series) to achieve substantial compression ratios for datasets characterized by smoothness and lack of noise. Notable examples are the ephemerides of astronomical objects and the pointing information of astronomical telescopes. Other algorithms implemented in this C library are well known and already widely used, e.g., RLE, quantization, deflate (via libz) and Burrows-Wheeler transform (via libbzip2). Libpolycomp can compress the timelines acquired by the Planck/LFI instrument with an overall compression ratio of ~9, while other widely known programs (gzip, bzip2) reach compression ratios less than 1.5.

  17. [Therapy of cervical rheumatoid arthritis].

    Science.gov (United States)

    Kothe, R; Wiesner, L; Rüther, W

    2004-08-01

    The rheumatoid involvement of the cervical spine can be divided into three phases. In the early stage of the disease there is an isolated atlantoaxial subluxation (AAS), followed by vertical instability and subaxial instability. If patients show clear symptoms of cervical myelopathy, which can occur during any stage of the disease, the progression cannot be stopped by conservative treatment, which is of great importance at the beginning of the cervical manifestation. Patient education, physiotherapy and immobilization with a stiff collar can significantly reduce pain. Early and effective DMARD therapy can have a positive effect on the natural history of the disease. In case of progressive instability, cervical myelopathy or severe pain operative treatment is indicated. If there is an isolated AAS, fusion can be restricted to the C1/C2 segment. The Magerl transarticular screw fixation is the preferred technique for stabilization. If there is evidence for vertical instability or severe destruction of the C0/C1 joints, occipital cervical fusion has to be performed. Durin the preoperative planning it is necessary to look for signs of subaxial instability. If this is the case, fusion should include the entire cervical spine. Transoral decompression may be necessary when there is persistent anterior compression of the myelon, typically seen in fixed AAS. Non-ambulatory myelopathic patients are more likely to develop severe surgical complications. Therefore, it is important to avoid the development of severe cervical instability by early surgical intervention. The right timing for surgery is still a matter of controversy. Future prospective randomized trials should address this topic to improve the treatment concept for the rheumatoid patient.

  18. Cancer morbidity in alcohol abusers

    DEFF Research Database (Denmark)

    Tønnesen, H; Møller, Henrik; Andersen, J R;

    1994-01-01

    = 1.5; 95% CI 1.3-1.8). Significantly increased incidences were found of cancer in the tongue, mouth, pharynx, oesophagus, liver, larynx, lung and pleura and secondary cancer. The women had significantly increased risk of cervical cancer (RR = 2.0; 95% CI 1.2-3.0). The men developed prostatic cancer...... and the liver are confirmed. In addition, this study indicates an increased occurrence of cancer of the prostate gland, pleura and uterine cervix in alcohol abusers.......Data on the association between alcohol abuse and cancer morbidity are scarce in large cohorts of non-hospitalised alcoholic men and women. Of 18,368 alcohol abusers who entered an outpatient clinic in Copenhagen during 1954-87, 18,307 were followed and their cancer incidence was compared...

  19. Comparison of adjacent segment degeneration five years after single level cervical fusion and cervical arthroplasty:a retrospective controlled study

    Institute of Scientific and Technical Information of China (English)

    SUN Yu; ZHAO Yan-bin; PAN Sheng-fa; ZHOU Fei-fei; CHEN Zhong-qiang; LIU Zhong-jun

    2012-01-01

    Background Cervical arthroplasty is indicated to preserve cervical motion and prevent accelerated adjacent segment degeneration.Whether accelerated adjacent segment degeneration is prevented in the long term is unclear.This trial compared adjacent segment degeneration in Bryan disc arthroplasty with that in anterior cervical decompression and fusion five years after the surgery.Methods We studied patients with single level degenerative cervical disc disease.The extent of adjacent segment degeneration was estimated from lateral X-rays.Results Twenty-six patients underwent single level Bryan disc arthroplasty and twenty-four patients underwent single level anterior cervical decompression and fusion.All patients were followed up for an average of sixty months.In the Bryan arthroplasty group,nine(17.6%)segments developed adjacent segment degeneration,which was significantly lower than that(60.4%)in the anterior cervical decompression and fusion group.Eleven segments in the Bryan arthroplasty group developed heterotopic ossification according to McAfee's classification and two segments had range of motion less than 2°.In the heterotopic ossification group,four(19.5%)segments developed adjacent segment degeneration,similar to the number in the non-heterotopic ossification group(16.7%).Adjacent segment degeneration rate was 50% in gradeⅣ?group but 11.8% in gradeⅡ?to Ⅲ.Conclusions Adjacent segment degeneration was accelerated after anterior cervical decompression and fusion.However,Bryan disc arthroplasty avoided accelerated adjacent segment degeneration by preserving motion.Patients with gradeⅣ?heterotopic ossification lost motion,and the rate of adjacent segment degeneration was higher than that in patients without heterotopic ossification.

  20. Laminoplasty Techniques for the Treatment of Multilevel Cervical Stenosis

    Directory of Open Access Journals (Sweden)

    Lance K. Mitsunaga

    2012-01-01

    Full Text Available Laminoplasty is one surgical option for cervical spondylotic myelopathy. It was developed to avoid the significant risk of complications associated with alternative surgical options such as anterior decompression and fusion and laminectomy with or without posterior fusion. Various laminoplasty techniques have been described. All of these variations are designed to reposition the laminae and expand the spinal canal while retaining the dorsal elements to protect the dura from scar formation and to preserve postoperative cervical stability and alignment. With the right surgical indications, reliable results can be expected with laminoplasty in treating patients with multilevel cervical myelopathy.

  1. Application of magnetic resonance imaging in cervical spondylotic myelopathy

    Institute of Scientific and Technical Information of China (English)

    Chuan; Zhang; Sushant; K; Das; Dong-Jun; Yang; Han-Feng; Yang

    2014-01-01

    Cervical spondylotic myelopathy(CSM) is the most common cause of spinal cord dysfunction and is caused by static or dynamic repeated compression of the spinal cord resulting from degenerative arthritis of the cervical spine and some biological injuries to the cervical spine. The T2 signal change on conventional magnetic resonance imaging(MRI) is most commonly associated with neurological deficits. Diffusion tensor imaging and MR spectroscopy show altered microstructure and biochemistry that reflect patient-specific pathogenesis and can be used to predict neurological outcome and response to intervention. Functional MRI can help to assess the neurological functional recovery after decompression surgery for CSM.

  2. Prediction of tissue decompression in orbital surgery

    CERN Document Server

    Luboz, V; Ambard, D; Boutault, F; Payan, Y; Swider, P

    2004-01-01

    Objective: A method to predict the relationships between decompressed volume of orbital soft tissues, backward displacement of globe after osteotomy, and force exerted by the surgeon, was proposed to improve surgery planning in exophthalmia reduction. Design: A geometric model and a poroelastic finite element model were developed, based on Computed Tomography scan data. Background: The exophthalmia is characterised by a protrusion of the eyeball. Surgery consists in an osteotomy of the orbit walls to decompress the orbital content. A few clinical observations ruling on an almost linear relationship between globe backward displacement and tissue decompressed volume are described in the literature. Methods: Fast prediction of decompressed volume is derived from the geometric model: a sphere in interaction with a cone. Besides, a poroelastic Finite Element model involving morphology, material properties of orbital components and surgical gesture was implemented. Results: The geometric model provided a better dec...

  3. Evidence Report: Risk of Decompression Sickness (DCS)

    Science.gov (United States)

    Conkin, Johnny; Norcross, Jason R.; Wessel, James H., III; Klein, Jill S.; Dervay, Joseph P.; Gernhardt, Michael L.

    2016-01-01

    Given that tissue inert gas partial pressure is often greater than ambient pressure during phases of a mission, primarily during extravehicular activity (EVA), there is a possibility of decompression sickness (DCS).

  4. Microvascular decompression for trigeminal neuralgia

    International Nuclear Information System (INIS)

    Background: Trigeminal Neuralgia (TGN) is the most frequently diagnosed type of facial pain. In idiopathic type of TGN it is caused by the neuro-vascular conflict involving trigeminal nerve. Microvascular decompression (MVD) aims at addressing this basic pathology in the idiopathic type of TGN. This study was conducted to determine the outcome and complications of patients with idiopathic TGN undergoing MVD. Method: In a descriptive case series patients with idiopathic TGN undergoing MVD were included in consecutive manner. Patients were diagnosed on the basis of detailed history and clinical examination. Retromastoid approach with craniectomy was used to access cerebellopontine angle (CP-angle) and microsurgical decompression was done. Patients were followed up for 6 months. Results: A total of 53 patients underwent MVD with mean age of 51.6±4.2 years and male predominance. In majority of cases (58.4 percentage) both Maxillary and Mandibular divisions were involved. Per-operatively superior cerebellar artery (SCA) was causing the neuro-vascular conflict in 33 (62.2 percentage) of the cases, anterior inferior cerebellar artery (AICA) in 6 (11.3 percentage) cases, both CSA and AICA in 3 (5.6 percentage) cases, venous compressions in only 1 (1.8percentage) patient and thick arachnoid adhesions were seen in 10 (18.9 percentage) patients. Postoperatively, 33 (68 percentage) patients were pain free, in 14 (26.45 percentage) patients pain was significantly improved whereas in 3 (5.6 percentage) patients there was mild improvement in symptoms. Three (5.6 percentage) patients did not improve after the primary surgery. Cerebrospinal fluid (CSF) leak was encountered in 7 (13.2 percentage) patients post-operatively, 4 (7.5 percentage) patients developed wound infection and 1 (1.8 percentage) patient developed aseptic meningitis. Three (5.6 percentage) patients had transient VII nerve palsy while one patient developed permanent VII nerve palsy. Conclusion: MVD is a safe and

  5. Design and clinical application of cervical hollow threaded fixator

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    Objective Cervical hollow threaded fixator (CHTY) was designed and applied to stabilize tha cervical spine following anterior decompression due to cervical spondylosis or acute cervical disc herniation. Methods Medical use titanium alloy with no magnetism was made into a hollow threaded structure with holes on the wall of the fixator. Forly-two patients with cervical spondylosis and acute cervical disc herniation were stabilized using the CHTF technique after anterior decompression. X-ray films and CT scans were taken after the oberation to observe the stability ann fusion rate of the segments. Results Patients were allowed to walk one day after the operation and were followed up for 6 to 36 months. The operated segments were stable and solid fusion was observed 3-6 months after surgery. Conclusions Immediate stability of the operated segments can be obtained using the CHTF technique. Patients ware easy to manage after5 the operation and returned to their jobs in a short time.The CHTF technique is safe and simpa to perfoirme and eliminates the complications of an autograft.It may be an alternative to traditional cervical interbody fusion with bone graft.

  6. 360-degree cervical spinal arthrodesis for treatment of pediatric cervical spinal tuberculosis with kyphosis

    OpenAIRE

    Zeng, Hao; Shen, Xiongjie; Luo, Chengke; Xu, Zhengquan; Zhang, Yupeng; Liu, Zheng; Wang, Xiyang; Cao, Yong

    2016-01-01

    Background There is limited evidence to guide treatment for pediatric cervical spinal tuberculosis with kyphosis (PCSTK). This study retrospectively evaluates the safety, feasibility and efficacy of 360-degree arthrodesis combined with anterior debridement and decompression for treating PCSTK, while simultaneously emphasizing the role of posterior fixation for the correction and maintenance of the kyphosis angle. Methods From May 2006 to December 2012, a total of 12 children with PCSTK underw...

  7. Transverse cervical skin incision and vertical platysma splitting approach for anterior cervical vertebral column exposure

    Directory of Open Access Journals (Sweden)

    Agrawal Amit

    2014-03-01

    Full Text Available Anterior surgical approaches provide direct access to symptomatic areas of the cervical spine, allow management of the vast spectrum of cervical spine pathologies and there are many articles in the literature that discussed these techniques in detail. Cosmesis is an important issue for patients who undergone surgeryon neck structures as an improperly placed incision attracting significant morbidity and few publications discuss this issue in details. The purpose of the present article is to describe our experience with transverse cervical skin incision and vertical platysma splitting approach for anterior cervical vertebral column exposure.

  8. A computed tomography morphometric study of occipital bone and C2 pedicle anatomy for occipital-cervical fusion

    OpenAIRE

    Nicolas K.K. King; Tiruchelvarayan Rajendra; Ivan Ng; Wai Hoe Ng

    2014-01-01

    Background: Occipital-cervical fusion (OCF) has been used to treat instability of the occipito-cervical junction and to provide biomechanical stability after decompressive surgery. The specific areas that require detailed morphologic knowledge to prevent technical failures are the thickness of the occipital bone and diameter of the C2 pedicle, as the occipital midline bone and the C2 pedicle have structurally the strongest bone to provide the biomechanical purchase for cranio-cervical instrum...

  9. Diaphragm paralysis from cervical disc lesions.

    Science.gov (United States)

    Cloward, R B

    1988-01-01

    An opera singer, who "made her living with her diaphragm", developed a post-traumatic unilateral radiculopathy due to cervical disc lesions, C3 to C6. During one year of severe neck and left arm pain she gradually lost the ability to sing difficult operatic passages which brought an end to her music career. Following a three level anterior cervical decompression and fusion, the neck and arm pain was immediately relieved. One week later her voice and singing ability returned to its full strength and power permitting her to resume her activities as a vocalist. The diagnosis of paresis of the left hemi-diaphragm as part of the cervical disc syndrome was implied by postoperative retrospective inference.

  10. CERVICAL CANCER – THE PRESENT SCENE

    Directory of Open Access Journals (Sweden)

    Singh

    2013-10-01

    Full Text Available ABSTRACT : Recent advances in cervical cancer management with well defined indications of surgery, radiotherapy and chemotherapy have resulted in significant increase in survivors with better QOL. Ongoing recent trials pertaining to further refinement of treatment protocols to make it more cure specific and less morbid will bring more changes in the present scene. This article is a concise review of salient features regarding cervical cancer screening diag nosis & management at present.

  11. Analysis of amelioration of neurological function on cervical degeneration disease after treatment with cervical spine locking plate%颈椎带锁钢板内固定术对颈椎退变性疾病神经功能改善的分析

    Institute of Scientific and Technical Information of China (English)

    赖志军; 谢惠缄; 谢唏衷; 肖建如

    2002-01-01

    Objective To discuss the clinical effect of treatment with anterior decompression, bone graft and cervical locking plate fixation for cervical degeneration disease.Method 23 patients with cervical spondylotic myelopathy and cervical ossification of the posterior longitudinal ligament have undergone the treatment of anterior cervical spine locking plate fusion.Neurological signs and symptoms were evaluated before and after surgery, and mean follow up time was 11.3 months.Result In all cases,radiography demonstrated a solid bony fusion.Additional general complications include a large wound hematoma in one and hoarseness in one.All patients' neurological function were improved.Conclusion The clinical effect of treatment with anterior decompression, bone graft and cervical locking plate fixation for cervical degeneration disease is satisfactory.

  12. DIAGNOSTIC AND THERAPEUTIC POSSIBILITIES IN THE PROPHYLAXIS OF CERVICAL CANCER

    OpenAIRE

    Marzena Wrześniewska; Olga Adamczyk-Gruszka; Jakub Gruszka; Beata Bąk

    2013-01-01

    Poland is one of the countries with high cervical cancer morbidity and mortality. The main means to change this situation is to manage an active and modern programme of cervical cancer prophylaxis and diagnostics. To a large extent, the effectiveness of a cervical cancer prophylaxis programme is decided by the availability of modern diagnostic research. The conventional Papanicolaou test and modern LBC cytology techniques were discussed in the article, taking into consideration HPV diagno...

  13. Different decompressions and internal fixations for treating multilevel cervical spondylotic myelopathy: Effect of magnetic resonance image on measuring the sagittal diameter of dural sac and evaluating the recovery rate%不同减压植骨及内固定方式治疗多节段脊髓型颈椎病:MRI测量硬脊膜囊矢状径及膨胀恢复率的疗效评价

    Institute of Scientific and Technical Information of China (English)

    胡朝晖; 李兵; 李龙; 李康华; 陈雷

    2007-01-01

    BACKGROUND: Compression occurs in several horizontal spinal cords of patients with multilevel cervical spondylotic myelopathy (CSM), especially compression is attacked on both ends of spinal cord. Therefore, there are so many choices of approach and way for operation. However, which approach and way have good effects and few complications is still controversial up to now.OBJECTIVE: To observe the therapeutic effect of anterior multilevel decompression and internal fixation on multilevel CSM and compare with posterior mono-open-door vertebral canal expanding laminoplasty.DESIGN: Contrast analysis.SETTING: Department of Orthopaedics, Xiangya Hospital of South China University; Department of Orthopaedics, People's Hospital of Liuzhou.PARTICIPANTS: A total of 68 patients with multilevel CSM were selected from the Department of Orthopaedics, Xiangya Hospital of South China University from January 2000 to June 2005. All patients were divided into anterior approach surgery group (n =33) and posterior approach surgery group (n =35). Baseline data between the two groups were comparable.METHODS:①Anterior approach surgery group: All 33 patients received bone-transplanting and internal fixation through cervical spine. Among them, auto-iliac bone-graft was transplanted into 17 cases, Cage auto-bone graft combining with allogenic bone was transplanted into 11 cases, and titan-net and auto-bone combining with allogenic bone was transplanted into 5 cases. In addition, long segments were dealt with internal fixation of anterior cervical spine locking plate (CSLP). Among them, 12 cases used Orion plate, 13 cased used Zephir palte, and 8 cases used Codman plate. ②Posterior approach surgery group: Fifteen patients received total laminectomy for decompression and other twenty patients received mono-open-door vertebral canal expanding laminoplasty. After laminoplasty, all patients received negative pressure and neck support fixation for three months.MAIN OUTCOME MEASURES:

  14. Portal Decompression Using the Inferior Mesenteric Vein

    Directory of Open Access Journals (Sweden)

    Paolo Gorini

    1998-01-01

    Full Text Available We report five patients with variceal hemorrhage, in three cases secondary to diffuse thrombosis of the portal, superior mesenteric and splenic veins. Mesenteric angiography demonstrated patency of the inferior mesenteric vein (IMV in each, and successful portal decompression by anastomosis of the IMV to the left renal vein (n=4 or the inferior vena cava (n=1 was accomplished. Bleeding was permanently controlled: four patients have survived from one to eight years post-operatively. Because shunt procedures utilizing the IMV are technically straightforward, subtotally decompress the portal system and avoid the right upper quadrant, they may be advantageous in certain clinical settings.

  15. Decompression-Induced Crystallization of Hydrous Basalt

    Science.gov (United States)

    Teasdale, R.; Brooker, R. A.

    2014-12-01

    Decompression-induced crystallization of hydrous basalt during magma ascent from 1.5 kb (150 MPa) is quantified using isothermal decompression TZM experiments. The starting composition is a synthetic glass based on the 1921 Kilauea basalt, with 1% H2O added. In all cases, the liquidus phase is aluminous spinel, followed by clinopyroxene, then plagioclase. The plagioclase liquidus temperatures for isobaric (equilibrium) experiments range from 1175°C (at 1.5 kb) to 1217°C (at 200b), which are 35-75°C hotter than predicted by MELTS (Ghiorso & Sack 1995). Experiments were decompressed at 1kb/hr and quenched at 800, 400, 200, or 100b for three temperatures (1160°, 1150°, and 1140°C). Plagioclase crystals formed during decompression have long axes that range from less than 1 micron to 20 microns. Increasing decompression yields larger plagioclase crystal sizes and aspect ratios for experiments at equal temperatures. However, the number of crystals does not vary systematically, indicating that crystallization is dominated by growth rather than nucleation during decompression. Plagioclase compositions for experiments were measured with University of Bristol's Electron Microprobe and the Hyperprobe with Field Emission Gun. Plagioclase compositions from equilibrium experiments (An60-An80) span the range of those from decompression experiments (An60-An73). Equilibrium experiments generated higher An compositions at lower pressures (500b) than at higher pressure (1.5kb) but do not systematically vary with temperature. Variations in plagioclase compositions are minimal above H2O saturation (100-200°C, based on Papale et al., 2006). Below H2O saturation, An content decreases slightly, by approximately 4% An. One application of this work is better characterization of groundmass crystallization in hydrous basalt as it traverses the conduit during eruption. This work also provides a means of distinguishing groundmass plagioclase related to decompression from crystals

  16. Morbidity and GH deficiency

    DEFF Research Database (Denmark)

    Stochholm, Kirstine; Laursen, Torben; Green, Anders;

    2008-01-01

    identified in the National Patient Registry. Lag time until first admission was used as a measure of morbidity. Patients were divided into childhood onset (CO) and adult onset (AO), discriminated by an age cut-off of 18 years at onset of GHD. METHOD: Sex- and cause-specific hazard ratios (HRs) in CO and AO......; diseases of the eye, ear, and circulatory diseases; and traumas. Fractures were significantly increased in AO females, not in males. CONCLUSIONS: Morbidity was significantly increased in the GHD patients. The increased morbidity was due to a variety of disorders, some of which can readily be explained by...

  17. Cervical Stenosis

    Science.gov (United States)

    ... Accumulation of pus in the uterus is called pyometra. Symptoms Before menopause, cervical stenosis may cause menstrual ... present but not cause symptoms. A hematometra or pyometra can cause pain or cause the uterus to ...

  18. Cervical spondylosis

    Science.gov (United States)

    ... Past neck injury (often several years before) Past spine surgery Ruptured or slipped disk Severe arthritis Small fractures ... Kshettry VR. Cervical spondylosis. In: Benzel EC, ed. Spine Surgery . 3rd ed. Philadelphia, PA: Elsevier Saunders; 2012:chap ...

  19. Cervical Cancer

    Science.gov (United States)

    ... Cervical cancer is caused by a virus called HPV. The virus spreads through sexual contact. Most women's bodies are able to fight HPV infection. But sometimes the virus leads to cancer. You're at higher risk ...

  20. Cervical Cancer

    Science.gov (United States)

    ... 162 KB) This information in Spanish (en español) Female reproductive system Select image to view larger Related ... D., FACS, Captain, U.S. Public Health Service Medical Director, National Breast and Cervical Cancer Early Detection Program, ...

  1. Cervical Synovial Cyst Causing Cervical Radiculomyelopathy: Case Report and Review of the Literature.

    Science.gov (United States)

    Corredor, José A; Quan, Gerald

    2015-08-01

    Study Design Case report. Objective Synovial cysts in the subaxial cervical spine are rare and are most commonly reported at the cervicothoracic junction. Only six cases of symptomatic C5-C6 synovial cysts have been reported in the literature; the condition is usually treated with decompressive laminectomy. We present a patient with a synovial cyst arising from the C5-C6 facet joint, associated with spondylolisthesis, and causing radiculomyelopathy. The patient was treated with a posterior excision of the cyst, decompressive laminectomy, and fusion. Methods A 67-year-old man had vertebral canal stenosis at C5-C6 secondary to a synovial cyst and spondylolisthesis with symptoms and signs of radiculopathy and myelopathy. Surgical management involved C5-C6 posterior decompressive laminectomy and excision of the cyst and C4-C6 instrumented fusion with lateral mass screws and rods. A literature review of symptomatic cervical synovial cysts is presented. Results The imaging studies identified grade I spondylolisthesis and a 3.3 × 4.3-mm extradural lentiform-like mass associated with focal compression of the spinal cord and exiting the C6 nerve root. After the surgery, the patient had an immediate full recovery and was asymptomatic by the 6-month examination. No operative complications were reported. The histologic report confirmed the presence of a synovial cyst. Conclusions C5-C6 is an unusual localization for symptomatic synovial cysts. Similar cases reported in the literature achieved excellent results after cyst excision and decompressive laminectomy. Because spondylolisthesis plus laminectomy are risk factors for segmental instability in the cervical spine, we report a case of a C5-C6 facet synovial cyst successfully treated with posterior laminectomy and C4-C6 fusion. PMID:26225291

  2. Cervical spondylosis with spinal cord encroachment: should preventive surgery be recommended?

    Directory of Open Access Journals (Sweden)

    Murphy Donald R

    2009-08-01

    Full Text Available Abstract Background It has been stated that individuals who have spondylotic encroachment on the cervical spinal cord without myelopathy are at increased risk of spinal cord injury if they experience minor trauma. Preventive decompression surgery has been recommended for these individuals. The purpose of this paper is to provide the non-surgical spine specialist with information upon which to base advice to patients. The evidence behind claims of increased risk is investigated as well as the evidence regarding the risk of decompression surgery. Methods A literature search was conducted on the risk of spinal cord injury in individuals with asymptomatic cord encroachment and the risk and benefit of preventive decompression surgery. Results Three studies on the risk of spinal cord injury in this population met the inclusion criteria. All reported increased risk. However, none were prospective cohort studies or case-control studies, so the designs did not allow firm conclusions to be drawn. A number of studies and reviews of the risks and benefits of decompression surgery in patients with cervical myelopathy were found, but no studies were found that addressed surgery in asymptomatic individuals thought to be at risk. The complications of decompression surgery range from transient hoarseness to spinal cord injury, with rates ranging from 0.3% to 60%. Conclusion There is insufficient evidence that individuals with spondylotic spinal cord encroachment are at increased risk of spinal cord injury from minor trauma. Prospective cohort or case-control studies are needed to assess this risk. There is no evidence that prophylactic decompression surgery is helpful in this patient population. Decompression surgery appears to be helpful in patients with cervical myelopathy, but the significant risks may outweigh the unknown benefit in asymptomatic individuals. Thus, broad recommendations for decompression surgery in suspected at-risk individuals cannot be made

  3. Hyperthyroidism and psychiatric morbidity

    DEFF Research Database (Denmark)

    Brandt, Frans; Thvilum, Marianne; Pedersen, Dorthe Almind;

    2014-01-01

    Thyroid hormones are essential for the normal development of the fetal brain, while hyperthyroidism in adults is associated with mood symptoms and reduced quality of life. We aimed to investigate the association and temporal relation between hyperthyroidism and psychiatric morbidity.......Thyroid hormones are essential for the normal development of the fetal brain, while hyperthyroidism in adults is associated with mood symptoms and reduced quality of life. We aimed to investigate the association and temporal relation between hyperthyroidism and psychiatric morbidity....

  4. Percutaneous cervical nucleoplasty in the treatment of cervical disc herniation.

    Science.gov (United States)

    Li, Jian; Yan, Deng-lu; Zhang, Zai-Heng

    2008-12-01

    Percutaneous disc decompression procedures have been performed in the past. Various percutaneous techniques such as percutaneous discectomy, laser discectomy, and nucleoplasty have been successful. Our prospective study was directly to evaluate the results of percutaneous cervical nucleoplasty (PCN) surgery for cervical disc herniation, and illustrate the effectiveness of PCN in symptomatic patients who had cervical herniated discs. From July of 2002 to June of 2005, 126 consecutive patients with contained cervical disc herniations have presented at the authors' clinic and treated by PCN. The patients' gender distribution for PCN was 65 male, 61 female. The age of patients ranged from 34 to 66 years (mean 51.9 +/- 10.2 years). The levels of involvement were 21 cases at C3-4, 30 cases at C4-5, 40 cases at C5-6, and 35 cases at C6-7. The clinical outcomes, pain reduction and the segment stability were all recorded during this study. A clinical outcome was quantified by the Macnab standard and using VAS. The angular displacement (AD) > or =11 degrees or horizontal displacement (HD) > or =3 mm was considered to be radiographically unstable. In the results of this study, puncture of the needle into the disc space was accurately performed under X-ray guidance in all cases. There was one case where the Perc-D Spine Wand had broken in the disc space during the procedure. The partial Perc-D Spine Wand, which had broken in the disc space could not be removed by the percutaneous cervical discectomy and thus remained there. There were no recurrent cases or complications in our series. Macnab standard results were excellent in 62 cases, good in 41 cases and fair in 23 cases. The rate of excellent and good was 83.73%. The VAS scores demonstrated statistically significant improvement in PCN at the 2-week, 1, 3, 6, and 12-month follow-up visits when compared to preoperational values (P PCN procedure. There was no significant difference in stability either preoperatively or

  5. Activ C cervical disc replacement for myelopathy

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    L McGonagle

    2011-01-01

    Full Text Available Background: Cervical disc replacement is becoming an increasingly popular treatment option for cervical myelopathy. It retains motion at the affected segment, unlike anterior cervical discectomy and fusion. The aim of this study is to assess the outcomes of a series of patients who underwent Activ C disc replacement for cervical myelopathy. Materials and Methods: A series of patients at the above Trust with clinical and radiological evidence of cervical myelopathy who were suitable for cervical disc replacement from 2007 to 2009 were included. Implants were inserted by one of two consultant surgeons {IMS, MO′M}. Patients were assessed preoperatively and at six, 12 and 24 months, postoperatively, with a visual analogue score (VAS for neck and arm pain severity and frequency, the Neck Disability Index questionnaire (NDI and the Centre for Epidemiologic Studies Depression questionnaire (CES-D. Results: Ten patients underwent surgery between May 2007 and July 2009, 6 women, and 4 men. Average age was 54 years (40-64. Disc levels replaced were: four at C4-5; eight at C5-6; seven at C6-7. Three patients had one disc replaced, five patients had two discs replaced, and two patients had three discs replaced. The VAS for neck pain improved from 5.9 pre-operatively to 1.4-24 months postoperatively and the VAS arm pain improved from 5.4 to 2.6. The NDI improved from 51% preoperatively to 26.8% at 24 months postoperatively. The CES-D showed a slight increase from 19.5 preoperatively to 21.7 at 24 months, postoperatively. Conclusion: Cervical decompression and disc replacement improves pain and function in patients with cervical myelopathy. This benefit is maintained at 24 months post op, with no cases requiring revision.

  6. Bilateral failure of adduction following orbital decompression.

    OpenAIRE

    Kinsella, F; Kyle, P.; Stansfield, A

    1990-01-01

    We report a case of bilateral complete failure of adduction following bilateral translid antralethmoidal orbital decompression. We believe the probable mechanism is neuropraxia (temporary dysfunction) of the third cranial nerves' supply to the medial recti, owing to these nerves' occupying an anatomically abnormal position. Partial recovery of adduction occurred over the ensuing six months.

  7. Long arm decompression osteotomy for hallux limitus.

    Science.gov (United States)

    Robinson, Stephen C; Frank, Ryan P

    2005-04-01

    This article presents a new osteotomy for stage I or II hallux limitus. The long arm decompression osteotomy can be used to shorten and plantarflex the first metatarsal. The indications, surgical technique, advantages, and disadvantages are described in detail. PMID:15833423

  8. Spontaneous extracranial decompression of epidural hematoma

    Energy Technology Data Exchange (ETDEWEB)

    Neely, John C. [Marshall University School of Medicine, Huntington, WV (United States); Jones, Blaise V. [Cincinnati Children' s Hospital Medical Center, Department of Radiology, Cincinnati, OH (United States); Crone, Kerry R. [Cincinnati Children' s Hospital Medical Center, Division of Neurosurgery, Cincinnati, OH (United States)

    2008-03-15

    Epidural hematoma (EDH) is a common sequela of head trauma in children. An increasing number are managed nonsurgically, with close clinical and imaging observation. We report the case of a traumatic EDH that spontaneously decompressed into the subgaleal space, demonstrated on serial CT scans that showed resolution of the EDH and concurrent enlargement of the subgaleal hematoma. (orig.)

  9. Chronic Synovitis after Open Carpal Tunnel Decompression.

    Science.gov (United States)

    Yousef, Justin; Chan, Patrick; Rahdon, Richard

    2016-06-01

    Open carpal tunnel decompression is a common procedure with potential long-term complications such as scar tenderness, pillar pain and neuroma. We present the case of a 65 year-old male with chronic lipomatous hypertrophy of the wrist and chronic flexor tenosynovitis after open carpal tunnel release for its rarity and severity of symptoms that required further surgery. PMID:27454645

  10. Internal fixation on the lower cervical spine – biomechanics and clinical practice of procedures and implants

    OpenAIRE

    Ulrich, Chr.; Arand, M.; Nothwang, J.

    2001-01-01

    The decision to opt for a particular internal fixation procedure of a traumatized unstable lower cervical spine should be based on analysis and implementation of scientific and clinical data on the biomechanics of the intact, the unstable and the implant-fixed spine. The following recommendations for surgical stabilization of the lower cervical spine seem, therefore, to be justified. Firstly, the surgical procedure should be to bring about decompression, realignment, and stability. Secondly, ...

  11. Cognition of cervical spondylosis%颈椎病之我见

    Institute of Scientific and Technical Information of China (English)

    赵定麟

    2015-01-01

    In 1976, Dr. Zhao Dinglin and Dr. Zhang Wenming made the breakthrough. Based on the purpose of releasing bone induced pressure they had completed the first anterior radical cervical decompression and bone grafting + partial rotation. Since then, chinese scholars had continuously explored the pathogenesis, pathological anatomy, pathophysiological features, reasonable classiifcation and many other related issues of cervical spondylosis. In several years from 1970s, the author proposed the concept of cervical nonfusion technology, to accomplish various designs and producing, which was subsequently used in clinical treatment. We brought forward Luschka’s joint diseases and anterior-lateral decompression surgery on the purpose of resecting Luschka’s joints. To reduce the damage to the cervical spine anatomy, we had designed a cervical anterior undermining decompression instrument ( including “L” shape, “T” shape, “Y” shape and single vertebrae ). We cooperated with Shanghai No. Six Surgical Instruments Factory and produced both conventional and special instruments on cervical spine surgery to improve the accuracy and security in operations. After that, we designed cervical hollow threaded ifxator, artiifcial cervical vertebra body and artiifcial vertebra plate. Combined with the research results concluded by three national forums, we elaborated basic concepts and definitions of cervical researches at different periods. On this basis we introduced those crucial issues such as the natural outcome of the cervical spondylosis, pathological anatomy features, pathogenesis and so on. Also, for some related trending topics we expressed personal viewpoints. For instance, selection of operative approach ( anterior or posterior ), origin, choice and effectiveness of nonfusion technique, and operative essentials of less invasion. Furthermore we put forward the main points on more common clinical diseases: Luschka’s joint diseases and anterior central spinal artery

  12. Pictorial essay: Role of ultrasound in failed carpal tunnel decompression

    Directory of Open Access Journals (Sweden)

    Rajesh Botchu

    2012-01-01

    Full Text Available USG has been used for the diagnosis of carpal tunnel syndrome. Scarring and incomplete decompression are the main causes for persistence or recurrence of symptoms. We performed a retrospective study to assess the role of ultrasound in failed carpal tunnel decompression. Of 422 USG studies of the wrist performed at our center over the last 5 years, 14 were for failed carpal tunnel decompression. Scarring was noted in three patients, incomplete decompression in two patients, synovitis in one patient, and an anomalous muscle belly in one patient. No abnormality was detected in seven patients. We present a pictorial review of USG findings in failed carpal tunnel decompression.

  13. Percutaneous endoscopic cervical discectomy using working channel endoscopes.

    Science.gov (United States)

    Ahn, Yong

    2016-06-01

    Percutaneous endoscopic cervical discectomy has evolved as an efficient, minimally invasive spine surgery for cervical disc herniation or radiculopathy. The development of the working channel endoscope makes definitive decompression surgery through a percutaneous approach feasible. There are two methods of approach to target the pathology: anterior and posterior approach. The approach can be determined according to the zone of pathology or the surgeon's preference. The most significant benefits of this endoscopic surgical technique are minimal access tissue trauma and early recovery from the intervention. However, this technique is still evolving and have a steep learning curve. Extensive development of surgical technique and working channel endoscopes will enable us to treat cervical disc herniation more practically. The objective of this review is to describe the cutting-edge techniques of endoscopic surgery in the cervical spine and to discuss the pros and cons of these minimally invasive surgical techniques. PMID:27086505

  14. Avaliação da dor e morbidade local da retirada do enxerto ósseo da crista ilíaca para artrodese cervical anterior Evaluación del dolor y morbilidad local del injerto extraído de la cresta ilíaca para artrodesis cervical anterior Evaluation of the pain and local morbidity of the insertion taken out from the iliac crest to the anterior cervical arthrodesis

    OpenAIRE

    Rafael Barreto Silva; Paulo Tadeu Maia Cavali; Ivan Guidolin Veiga; Marcelo Italo Risso-Neto; Wagner Pasqualini; Marcus Alexandre Mello Santos; Alexander Junqueira Rossato; Maurício Antonelli Lehoczki; Elcio Landim

    2010-01-01

    OBJETIVO: avaliar as possíveis complicações associadas à retirada de enxerto da crista ilíaca anterior em cirurgia para artrodese cervical anterior, em especial a dor residual. MÉTODOS: foi realizado estudo retrospectivo com análise de prontuários e aplicação de questionário via telefone com 20 pacientes no período compreendido entre Agosto de 2008 e Novembro de 2009. Todos os pacientes foram submetidos à mesma técnica cirúrgica para extração do enxerto, sendo operados pela mesma equipe no Ho...

  15. Morbidity from episiotomy

    International Nuclear Information System (INIS)

    Objective: To assess the morbidity from episiotomy. Methods: The prospective randomised control study was conducted at the Military Hospital Rawalpindi's Gynaecology and Obstetrics Department from January 2006 to April 2008. It comprised 100 patients who were given a mediolateral episiotomy at the crowning of the foetal head (group 1). Another group of 100 patients were delivered without an episiotomy (group 2). Postpartum morbidity was compared in the two groups. Morbidity included perineal damage by tears, subjective assessment of pain at perineum, dyspareunia after puerperium, feeling of pressure puerperium, incontinence and objective assessment of prolapse after puerperium. Results: Morbidity including perineal damage by tears, pain at perineum and dyspareunia, was much more in group I as compared to the group II. There was no significant difference in feeling of pressure perineum, subjective feeling of urinary and flatus incontinence or objective assessment of prolapse of vagina and uterus. Conclusion: There are no significant advantages of episiotomy. In fact, it leads to morbidity which is otherwise avoidable in deliveries that are episiotomy-free. (author)

  16. MORBIDITY AGENTS: A REVIEW

    Directory of Open Access Journals (Sweden)

    Shrivastava Neelesh

    2011-09-01

    Full Text Available This paper discuss on clinical representation of morbid jealousy which often termed delusional jealousy or ‘Othello Syndrome’ is a psychiatric condition where a lover believes against all reason and their beloved is being sexually unfaithful. Patients will be preoccupied with their partner’s perceived lack of sexual fidelity and will often behave in an unacceptable or extreme way as they endeavor to prove their ideas. Misuse of any psychomotor is an important association cause morbidity jealousy agents, like CNS stimulants that release the catecholamine, particularly dopamine, from pre synaptic terminals substance should be treated as a priority. Where higher levels of violence are reported Sildenafil may be useful as a diagnostic as well as therapeutic test in such cases .Many studies have shown an association between high alcohol consumption and developing morbid jealousy. Amphetamine-induced psychosis has been extensively studied because of its close resemblance to schizophrenia.

  17. Laminoplasty Techniques for the Treatment of Multilevel Cervical Stenosis

    OpenAIRE

    Mitsunaga, Lance K.; Klineberg, Eric O.; Gupta, Munish C.

    2012-01-01

    Laminoplasty is one surgical option for cervical spondylotic myelopathy. It was developed to avoid the significant risk of complications associated with alternative surgical options such as anterior decompression and fusion and laminectomy with or without posterior fusion. Various laminoplasty techniques have been described. All of these variations are designed to reposition the laminae and expand the spinal canal while retaining the dorsal elements to protect the dura from scar formation ...

  18. Intraoperative Myelography in Cervical Multilevel Stenosis Using 3D Rotational Fluoroscopy: Assessment of Feasibility and Image Quality

    Directory of Open Access Journals (Sweden)

    Thomas Westermaier

    2015-01-01

    Full Text Available Background. Intraoperative myelography has been reported for decompression control in multilevel lumbar disease. Cervical myelography is technically more challenging. Modern 3D fluoroscopy may provide a new opportunity supplying multiplanar images. This study was performed to determine the feasibility and image quality of intraoperative cervical myelography using a 3D fluoroscope. Methods. The series included 9 patients with multilevel cervical stenosis. After decompression, 10 mL of water-soluble contrast agent was administered via a lumbar drainage and the operating table was tilted. Thereafter, a 3D fluoroscopy scan (O-Arm was performed and visually evaluated. Findings. The quality of multiplanar images was sufficient to supply information about the presence of residual stenosis. After instrumentation, metal artifacts lowered image quality. In 3 cases, decompression was continued because myelography depicted residual stenosis. In one case, anterior corpectomy was not completed because myelography showed sufficient decompression after 2-level discectomy. Interpretation. Intraoperative myelography using 3D rotational fluoroscopy is useful for the control of surgical decompression in multilevel spinal stenosis providing images comparable to postmyelographic CT. The long duration of contrast delivery into the cervical spine may be solved by preoperative contrast administration. The method is susceptible to metal artifacts and, therefore, should be applied before metal implants are placed.

  19. CASINO: Surgical or nonsurgical treatment for cervical radiculopathy, a randomised controlled trial

    NARCIS (Netherlands)

    S. van Geest; B. Kuijper (Barbara); M. Oterdoom (Marinus); W.B. van den Hout (Wilbert); R. Brand (René); Th. Stijnen (Theo); P. Assendelft (Pim); B.W. Koes (Bart); W. Jacobs (Wouter); W.C. Peul (Wilco); C.L.A.M. Vleggeert-Lankamp (Carmen)

    2014-01-01

    textabstractBackground: Cervical radicular syndrome (CRS) due to a herniated disc can be safely treated by surgical decompression of the spinal root. In the vast majority of cases this relieves pain in the arm and restores function. However, conservative treatment also has a high chance on relieving

  20. CASINO: Surgical or Nonsurgical Treatment for cervical radiculopathy, a randomised controlled trial

    NARCIS (Netherlands)

    Geest, S. de; Kuijper, B.; Oterdoom, M.; Hout, W. van den; Brand, R.; Stijnen, T.; Assendelft, P.; Koes, B.; Jacobs, W.; Peul, W.; Vleggeert-Lankamp, C.

    2014-01-01

    BACKGROUND: Cervical radicular syndrome (CRS) due to a herniated disc can be safely treated by surgical decompression of the spinal root. In the vast majority of cases this relieves pain in the arm and restores function. However, conservative treatment also has a high chance on relieving symptoms. T

  1. Single or double-level anterior interbody fusion techniques for cervical degenerative disc disease

    NARCIS (Netherlands)

    Jacobs, Wilco; Willems, Paul C.; van Limbeek, Jacques; Bartels, Ronald; Pavlov, Paul; Anderson, Patricia G.; Oner, Cumhur

    2011-01-01

    Background The number of surgical techniques for decompression and solid interbody fusion as treatment for cervical spondylosis has increased rapidly, but the rationale for the choice between different techniques remains unclear. Objectives To determine which technique of anterior interbody fusion g

  2. Emergency percutaneous needle decompression for tension pneumoperitoneum

    Directory of Open Access Journals (Sweden)

    Körner Markus

    2011-05-01

    Full Text Available Abstract Background Tension pneumoperitoneum as a complication of iatrogenic bowel perforation during endoscopy is a dramatic condition in which intraperitoneal air under pressure causes hemodynamic and ventilatory compromise. Like tension pneumothorax, urgent intervention is required. Immediate surgical decompression though is not always possible due to the limitations of the preclinical management and sometimes to capacity constraints of medical staff and equipment in the clinic. Methods This is a retrospective analysis of cases of pneumoperitoneum and tension pneumoperitoneum due to iatrogenic bowel perforation. All patients admitted to our surgical department between January 2005 and October 2010 were included. Tension pneumoperitoneum was diagnosed in those patients presenting signs of hemodynamic and ventilatory compromise in addition to abdominal distension. Results Between January 2005 and October 2010 eleven patients with iatrogenic bowel perforation were admitted to our surgical department. The mean time between perforation and admission was 36 ± 14 hrs (range 30 min - 130 hrs, between ER admission and begin of the operation 3 hrs and 15 min ± 47 min (range 60 min - 9 hrs. Three out of eleven patients had clinical signs of tension pneumoperitoneum. In those patients emergency percutaneous needle decompression was performed with a 16G venous catheter. This improved significantly the patients' condition (stabilization of vital signs, reducing jugular vein congestion, bridging the time to the start of the operation. Conclusions Hemodynamical and respiratory compromise in addition to abdominal distension shortly after endoscopy are strongly suggestive of tension pneumoperitoneum due to iatrogenic bowel perforation. This is a rare but life threatening condition and it can be managed in a preclinical and clinical setting with emergency percutaneous needle decompression like tension pneumothorax. Emergency percutaneous decompression is no

  3. Decompressive Craniectomy for Intractable Intracranial Hypertension

    Directory of Open Access Journals (Sweden)

    Bulent Bakar

    2012-10-01

    Full Text Available Aim: This retrospective study was established to analyse the effects of the decompressive craniectomy on patients with different causes of increased intracranial pressure. Material and Method: Nine patients at risk of developing malignant cerebral edema aged between 18 and 75 years were included in this study. Four patients suffered from severe traumatic brain injury, two patients from subarachnoid haemorrhage (SAH and vasospastic ischemia, and 3 patients from malignant infarction of the middle cerebral artery. Results: Nine patients underwent decompressive craniectomy as the last therapeutic choice. At first admission mean intracranial pressure (ICP was 22.6 ± 6.7 mmHg; mean preoperative ICP value was 40.8 ± 16.3 mmHg; and mean postoperative ICP value was 9.3± 3.6 mmHg. In two patients bilateral; and in seven patients unilateral frontotemporoparietal craniectomy was preferred. Mean time of the re-implantation of the bone flap was 25.75±10.0 days. One patient with SAH died postoperatively and eight patients survived (mortality rate 11.1%. Mean value of the Glasgow Outcome Scale score as evaluated at 36 months after the decompression was approximately 4. Discussion: This surgical procedure is successful for treatment of the acute or delayed intractable intracerebral hypertension with a low rate of complication if it is performed timely and carefully.

  4. Bilateral decompression of multilevel lumbar spinal stenosis through a unilateral approach.

    Science.gov (United States)

    Haba, Katsuhiko; Ikeda, Masato; Soma, Mariko; Yamashima, Tetsumori

    2005-02-01

    Lumbar canal stenosis due to hypertrophy and calcification of the facet joints and/or ligamentum flavum is a common condition in the elderly. Although a large number of individuals are symptom-free, the degenerative process, usually encroaching on both central and lateral pathways, may lead to symptoms of itself or decompensate a preexisting narrow canal. Even at an advanced age, decompression surgery is effective for symptomatic stenosis. Less invasive procedures preserving maximal bony and ligamentous structures have recently been recommended to reduce associated morbidity. This paper introduces a unilateral surgical approach for bilateral decompression by ligamentectomy, partial facetectomy and foraminal unroofing. Using a specially designed, one-side retractor, after the ipsilateral nerve root decompression the contralateral dural sac and nerve roots were approached through an 8 x 15 mm window in the interspinous ligament. The contralateral ligamentum flavum, facet joints and foraminal roof were resected, preserving the supraspinous ligament complex and much of the contralateral musculature. This technique, preserving anatomy and biomechanical function of the lumbar spine, is useful for surgery on multilevel lumbar canal stenoses.

  5. Facial nerve paralysis after cervical traction.

    Science.gov (United States)

    So, Edmund Cheung

    2010-10-01

    Cervical traction is a frequently used treatment in rehabilitation clinics for cervical spine problems. This modality works, in principle, by decompressing the spinal cord or its nerve roots by applying traction on the cervical spine through a harness placed over the mandible (Olivero et al., Neurosurg Focus 2002;12:ECP1). Previous reports on treatment complications include lumbar radicular discomfort, muscle injury, neck soreness, and posttraction pain (LaBan et al., Arch Phys Med Rehabil 1992;73:295-6; Lee et al., J Biomech Eng 1996;118:597-600). Here, we report the first case of unilateral facial nerve paralysis developed after 4 wks of intermittent cervical traction therapy. Nerve conduction velocity examination revealed a peripheral-type facial nerve paralysis. Symptoms of facial nerve paralysis subsided after prednisolone treatment and suspension of traction therapy. It is suspected that a misplaced or an overstrained harness may have been the cause of facial nerve paralysis in this patient. Possible causes were (1) direct compression by the harness on the right facial nerve near its exit through the stylomastoid foramen; (2) compression of the right external carotid artery by the harness, causing transient ischemic injury at the geniculate ganglion; or (3) coincidental herpes zoster virus infection or idiopathic Bell's palsy involving the facial nerve.

  6. [Cervical radiculopathy].

    Science.gov (United States)

    Kuijper, B

    2014-10-01

    Cervical radiculopathy is a common cause of pain in the arm. It is caused by nerve root compression in the neck, as a consequence of a herniated disc, or spondyliotic foraminal stenosis. It causes severe pain, especially during the first few weeks, and paraesthesias in the forearm and hand. Patients also suffer from neck pain and loss of strength in the relevant arm. The arm pain can be exacerbated by certain movements of the head; these should be avoided as much as possible. Diagnosis can be made on the basis of history and physical examination. The pain generally disappears without active patient treatment. A semi-rigid cervical collar is recommended to accelerate pain relief. In cases of persistent pain, surgery will be considered. In such cases an MRI should be performed to show the cause and level of nerve root compression. PMID:26185991

  7. Cervical Synovial Cyst Causing Cervical Radiculomyelopathy: Case Report and Review of the Literature

    OpenAIRE

    Corredor, José A.; Quan, Gerald

    2014-01-01

    Study Design Case report. Objective Synovial cysts in the subaxial cervical spine are rare and are most commonly reported at the cervicothoracic junction. Only six cases of symptomatic C5–C6 synovial cysts have been reported in the literature; the condition is usually treated with decompressive laminectomy. We present a patient with a synovial cyst arising from the C5–C6 facet joint, associated with spondylolisthesis, and causing radiculomyelopathy. The patient was treated with a posterior ex...

  8. Outpatient cervical and lumbar spine surgery is feasible and safe: A consecutive single center series of 1449 patients

    OpenAIRE

    Helseth, Øystein; Lied, Bjarne Lidvar; Halvorsen, Charlotte Marie; Ekseth, Kåre; Helseth, Eirik

    2015-01-01

    BACKGROUND: There is an increasing demand for surgery of degenerative spinal disease. Limited healthcare resources draw attention to the need for cost-effective treatments. Outpatient surgery, when safe and feasible, is more cost effective than inpatient surgery. OBJECTIVE: To study types and rates of complications after outpatient lumbar and cervical spine decompressions. METHODS: Complications were recorded prospectively in 1449 (1073 lumbar, 376 cervical) outpatients undergoing micro...

  9. Spatial domain entertainment audio decompression/compression

    Science.gov (United States)

    Chan, Y. K.; Tam, Ka Him K.

    2014-02-01

    The ARM7 NEON processor with 128bit SIMD hardware accelerator requires a peak performance of 13.99 Mega Cycles per Second for MP3 stereo entertainment quality decoding. For similar compression bit rate, OGG and AAC is preferred over MP3. The Patent Cooperation Treaty Application dated 28/August/2012 describes an audio decompression scheme producing a sequence of interleaving "min to Max" and "Max to min" rising and falling segments. The number of interior audio samples bound by "min to Max" or "Max to min" can be {0|1|…|N} audio samples. The magnitudes of samples, including the bounding min and Max, are distributed as normalized constants within the 0 and 1 of the bounding magnitudes. The decompressed audio is then a "sequence of static segments" on a frame by frame basis. Some of these frames needed to be post processed to elevate high frequency. The post processing is compression efficiency neutral and the additional decoding complexity is only a small fraction of the overall decoding complexity without the need of extra hardware. Compression efficiency can be speculated as very high as source audio had been decimated and converted to a set of data with only "segment length and corresponding segment magnitude" attributes. The PCT describes how these two attributes are efficiently coded by the PCT innovative coding scheme. The PCT decoding efficiency is obviously very high and decoding latency is basically zero. Both hardware requirement and run time is at least an order of magnitude better than MP3 variants. The side benefit is ultra low power consumption on mobile device. The acid test on how such a simplistic waveform representation can indeed reproduce authentic decompressed quality is benchmarked versus OGG(aoTuv Beta 6.03) by three pair of stereo audio frames and one broadcast like voice audio frame with each frame consisting 2,028 samples at 44,100KHz sampling frequency.

  10. Water boiling kinetic in rapid decompression

    International Nuclear Information System (INIS)

    This study entering in the frame of a CEA, EDF and Framatome collaboration, has for objective to modelize two-phase flows in case of PWR Loca. The objective is to find, by taking in account the all imbalances, a formulation for the mass transfer at the interface water-vapor by the study of water boiling phenomenon in case of fast decompression such as a primary circuit break. In this accident, the estimation of boiling speeds in an essential parameter for determining the break discharge which conditions the safety systems design

  11. Avaliação da dor e morbidade local da retirada do enxerto ósseo da crista ilíaca para artrodese cervical anterior Evaluación del dolor y morbilidad local del injerto extraído de la cresta ilíaca para artrodesis cervical anterior Evaluation of the pain and local morbidity of the insertion taken out from the iliac crest to the anterior cervical arthrodesis

    Directory of Open Access Journals (Sweden)

    Rafael Barreto Silva

    2010-12-01

    Full Text Available OBJETIVO: avaliar as possíveis complicações associadas à retirada de enxerto da crista ilíaca anterior em cirurgia para artrodese cervical anterior, em especial a dor residual. MÉTODOS: foi realizado estudo retrospectivo com análise de prontuários e aplicação de questionário via telefone com 20 pacientes no período compreendido entre Agosto de 2008 e Novembro de 2009. Todos os pacientes foram submetidos à mesma técnica cirúrgica para extração do enxerto, sendo operados pela mesma equipe no Hospital de Clinicas da Unicamp (HC Unicamp. As variantes analisadas foram dor residual, taxa de infecção, lesão neurológica ou vascular e ocorrência de fratura da asa do ilíaco. Os dados foram colocados em uma tabela e as médias e porcentagens foram calculadas. RESULTADOS: dos 20 pacientes, 12 homens e 8 mulheres, com média de idade de 51,75 anos (29-74 e follow-up médio de 11,83 meses (2-29, não houve nenhuma lesão grave, como fratura, lesão arterial ou neurológica. Houve um caso de infecção superficial (5% e 25% dos pacientes queixaram-se de desconforto leve e dificuldade para deambular não incapacitante. CONCLUSÃO: a retirada de enxerto da crista ilíaca anterior está associada a muitas complicações, sendo importante o conhecimento de outras opções de enxerto e exposição ao paciente das possíveis complicações. Por meio deste levantamento, não verificamos nenhuma complicação grave, e o percentual de pacientes com dor residual acompanha os achados na literatura, podendo ser diminuído com uma dissecção cuidadosa da crista ilíaca.OBJETIVO: evaluar las posibles compilaciones asociadas a la retirada del injerto de la cresta ilíaca anterior en cirugía para artrodesis cervical anterior, principalmente los dolores residuales. MÉTODOS: fue realizado un estudio retrospectivo con análisis de prontuarios y con aplicación de cuestionario por teléfono para 20 pacientes entre agosto de 2008 y noviembre de 2009

  12. Syringomyelia secondary to cervical spondylosis: Case report and review of literature

    Directory of Open Access Journals (Sweden)

    Savitr Sastri Bhagavathula Venkata

    2014-01-01

    Full Text Available Syringomyelia secondary to cervical spondylosis is a rare entity to encounter in clinical practice. We discuss the case of a 53-year-old lady who presented with a syringomyelic syndrome and was found to have cervical spondylosis on imaging. Cine-MRI revealed an obstruction of cerebrospinal fluid (CSF flow in the cervical spinal subarachnoid space. Decompression of the same led to clinical and radiological improvement. There is a potential causal association between cervical spondylosis and syringomyelia. MRI CSF flow studies may help in deciding the course of treatment in such cases. A subset of patients with cervical spondylosis and concurrent spinal cord signal intensity changes may show reversal of the same following intervention.

  13. Laryngeal morbidity after tracheal intubation

    DEFF Research Database (Denmark)

    Sørensen, M K; Rasmussen, N; Kristensen, M S;

    2013-01-01

    BACKGROUND: Tracheal intubation may cause vocal fold damage. The trial was designed to assess laryngeal morbidity comparing the Endoflex(®) tube with a conventional endotracheal tube with stylet. We hypothesised that laryngeal morbidity within the first 24 h after extubation would be lower...... in the shimmer values in that group implies that the Endoflex may be associated with less laryngeal morbidity....

  14. Submarine tower escape decompression sickness risk estimation.

    Science.gov (United States)

    Loveman, G A M; Seddon, E M; Thacker, J C; Stansfield, M R; Jurd, K M

    2014-01-01

    Actions to enhance survival in a distressed submarine (DISSUB) scenario may be guided in part by knowledge of the likely risk of decompression sickness (DCS) should the crew attempt tower escape. A mathematical model for DCS risk estimation has been calibrated against DCS outcome data from 3,738 exposures of either men or goats to raised pressure. Body mass was used to scale DCS risk. The calibration data included more than 1,000 actual or simulated submarine escape exposures and no exposures with substantial staged decompression. Cases of pulmonary barotrauma were removed from the calibration data. The calibrated model was used to estimate the likelihood of DCS occurrence following submarine escape from the United Kingdom Royal Navy tower escape system. Where internal DISSUB pressure remains at - 0.1 MPa, escape from DISSUB depths 60% DCS risk predicted for a 200-meter escape from saturation at 0.21 MPa. Using the calibrated model to predict DCS for direct ascent from saturation gives similar risk estimates to other published models. PMID:25109085

  15. Collagen levels are normalized after decompression of experimentally obstructed colon

    DEFF Research Database (Denmark)

    Rehn, Martin; Ågren, Sven Per Magnus; Syk, I

    2011-01-01

    Our aim was to define the dynamics in collagen concentrations in the large bowel wall following decompression of experimental obstruction.......Our aim was to define the dynamics in collagen concentrations in the large bowel wall following decompression of experimental obstruction....

  16. Posterior cervical foraminotomy: anatomic study in cadavers

    Directory of Open Access Journals (Sweden)

    Luizio Augusto Arantes Júnior

    2014-03-01

    Full Text Available OBJECTIVE: This study was designed to use different segments of the cervical spine in cadavers to determine how much lateral mass should be resected for adequate foraminal decompression. METHODS: Six cadavers were used. The region of the cervical spine from C1 to the C7-T1 transition was dissected and exposed. The lateral mass of each vertebra was measured bilaterally before the foraminotomy in the following segments: C2-C3, C3-C4, C4-C5, C5-C6 and C6-C7. The procedure was performed with a high-speed drill and through surgical microscopy. Three foraminotomies were performed (F1, F2, F3 in each level. Lateral masses were measured after foraminotomy procedures and compared to the initial measurement, creating a percentage of lateral mass needed for decompression.. The value of the entire surface was defined as 100%. RESULTS: There was a statistical difference between the amounts of the resected lateral mass through each foraminotomy (F1, F2, F3 at the same level. However, there was no statistical significant difference among the different levels. The average percentage of resection of the lateral masses in F2 were 27.7% at C2-C3, 24.8% at C3-C4, 24.4% at C4-C5 and 23.8% and 31.2% at C5-C6 and C6-C7, respectively. In F3, the level that needed greater resection of the lateral masses was C6-C7 level, where the average resection ranged between 41.2% and 47.9%. CONCLUSION: In all segments studied, the removal of approximately 24 to 32% of the facet joint allowed adequate exposure of the foraminal segment, with visualization of the dural sac and the exit of the cervical root.

  17. Evaluation of characteristics and surgical outcomes in cervical spondylotic amyotrophy

    Directory of Open Access Journals (Sweden)

    Hong-Li Wang

    2014-01-01

    Full Text Available Background: Cervical spondylotic amyotrophy (CSA is a rare clinical syndrome resulting from cervical spondylosis. Surgical treatment includes anterior cervical decompression and fusion (ACDF, and laminoplasty with or without foraminotomy. Some studies indicate that ACDF is an effective method for treating CSA because anterior decompression with or without medial foraminotomy can completely eliminate anterior and/or anterolateral lesions. We retrospectively evaluated outcome of surgical outcome by anterior cervical decompression and fusion (ACDF. Materials and Methods: 28 CSA patients, among whom 12 had proximal type CSA and 16 had distal type CSA, treated by ACDF, were evaluated clinicoradiologically. The improvement in atrophic muscle power was assessed by manual muscle testing (MMT and the recovery rate of the patients was determined on the basis of the Japanese Orthopedic Association (JOA scores. Patient satisfaction was also examined. Results: The percentage of patients, who gained 1 or more grades of muscle power improvement, as determined by MMT, was 91.7% for those with proximal type CSA and 37.5% for those with distal type CSA (P < 0.01. The JOA score-based recovery rates of patients with proximal type and distal type CSA were 60.8% and 41.8%, respectively (P < 0.05. Patient satisfaction was 8.2 for those with proximal type CSA and 6.9 for those with distal type CSA (P < 0.01. A correlation was observed among the levels of improvement in muscle power, JOA score based recovery rate, patient satisfaction and course of disease (P < 0.05. Conclusion: ACDF can effectively improve the clinical function of patients with CSA and result in good patient satisfaction despite the surgical outcomes for distal type CSA being inferior to those for proximal type CSA. Course of disease is the fundamental factor that affects the surgical outcomes for CSA. We recommend that patients with CSA undergo surgical intervention as early as possible.

  18. Bone graft substitutes in anterior cervical discectomy and fusion

    OpenAIRE

    Chau, Anthony M.T.; Mobbs, Ralph J.

    2009-01-01

    Anterior cervical discectomy with fusion is a common surgical procedure for patients suffering pain and/or neurological deficits and unresponsive to conservative management. For decades, autologous bone grafted from the iliac crest has been used as a substrate for cervical arthrodesis. However patient dissatisfaction with donor site morbidity has led to the search for alternative techniques. We present a literature review examining the progress of available grafting options as assessed in hum...

  19. The clinical evaluation of anterior/posterior decompression in treating radiculopathy and axial symptoms caused by multilevel cervical spondylosis%多节段颈椎病前路与后路减压对神经根及轴性症状的疗效评估

    Institute of Scientific and Technical Information of China (English)

    王坤; 陈赞; 吴浩; 菅凤增

    2012-01-01

    Objective To evaluate the clinical outcomes about root and axial symptoms of multilevel cervical spondylosis operated via anterior or posterior approach.Methods We retrospectively,analyzed the JOA scores,JOA recovery rate,NDI,VAS and Nurick grades of 85 patients with multilevel cervical spondylosis who were divided into the anterior and posterior groups by method of different approach,then SPSS 17.0 was used to analyze the related status.Results The mean JOA scores of the anterior and posterior groups were,respectively,improved by 3.33 and 3.77 points,meanwhile,the corresponding JOA recovery rates were (62.79 ±41.12)% and (50.86 ±50.49)%,and no differences exist between the two groups.We used Median M (25%,75 % ) to describe Nurick grades,the pre - and post -operation M were ( 1,3,3 ),( 1,3,4) VS(0,0,2),(0,1,3)and there was no significant difference.However,in the aspects of NDI and VAS,via nonparametric test,the result showed the anterior group was superior.All surgery related complications occurred in the anterior group. Conclusions In the respect of releasing root/axial symptoms,the anterior approach was probably superior to the posterior group,but the complications related to surgery should be paid cautiously.%目的 评估多节段颈椎病前路与后路减压对神经根及轴性症状的疗效.方法 回顾性分析85例多节段颈椎病患者手术前后JOA评分及其改善率,NDI及VAS评分,Nurick分级.根据不同手术方式对85例患者分成前路及后路手术两组,并对手术疗效进行统计学分析.结果 前后路手术组JOA评分分别提升3.33分、3.77分,JOA改善率分别为(62.79±41.12)%、(50.86±50.49)%,两组间差异无统计学意义,P<0.05.Nurick分级采用中位数M(25%、75%)表示,前后路两组术前分别为(1、3、3)和(1、3、4),术后分别为(0、0、2)和(0、1、3),均比术前有改善,两组间差异无统计学意义.但在NDI、VAS评分方面,经非参数检验后,结果显示前

  20. Cervical ossification of the posterior longitudinal ligament: Anterior versus posterior approach

    Directory of Open Access Journals (Sweden)

    Dasheng Lin

    2012-01-01

    Full Text Available Background: The optimal approach to provide satisfactory decompression and minimize complications for ossification of the posterior longitudinal ligament (OPLL involving multiple levels (3 levels or more remains controversial. The purpose of this study was to compare the results of two surgical approaches for cervical OPLL involving multiple levels; anterior direct decompression and fixation, and posterior indirect decompression and fixation. We present a retrospective review of 56 cases followed at a single Institution. Materials and Methods: We compared patients of multiple levels cervical OPLL that were treated at a single institution either with anterior direct decompression and fixation or with posterior indirect decompression and fixation. The clinical records of the patients with a minimum duration of follow-up of 2 years were reviewed. The associated complications were recorded. Results: Fifty-six patients constitute the clinical material. 26 cases were treated by anterior corpectomy and fixation and 30 cases received posterior laminectomy and fixation. The two populations were similar. It was found that both anterior and posterior decompression and fixation can achieve satisfactory outcomes, and posterior surgery was accomplished in a shorter period of time with lesser blood loss. Although patients had comparable preoperative Japanese Orthopaedics Association (JOA scores, those with a canal occupancy by OPLL more than 50% and managed anteriorly had better outcomes. However, for those with more severe stenosis, anterior approach was more difficult and associated with higher risks and complications. Despite its limitations in patients with high occupancy OPLLs, through the multiple level laminectomy, posterior fixation can achieve effective decompression, maintaining or restoring stability of the cervical spine, and thereby improving neural outcome and preventing the progression of OPLL. Conclusions: The posterior indirect decompression

  1. Microvascular decompression for elderly patients with trigeminal neuralgia.

    Science.gov (United States)

    Phan, Kevin; Rao, Prashanth J; Dexter, Mark

    2016-07-01

    Microvascular decompression (MVD) has been demonstrated to be an excellent surgical treatment approach in younger patients with trigeminal neuralgia (TN). However, it is not clear whether there are additional morbidity and mortality risks for MVD in the elderly population. We performed a systematic literature review using six electronic databases for studies that compared outcomes for MVD for TN in elderly (cut-off ⩾60, 65, 70years) versus younger populations. Outcomes examined included success rate, deaths, strokes, thromboembolism, meningitis, cranial nerve deficits and cerebrospinal fluid leaks. There were 1524 patients in the elderly cohort and 3488 patients in the younger cohort. There was no significant difference in success rates in elderly versus younger patients (87.5% versus 84.8%; P=0.47). However, recurrence rates were lower in the elderly (11.9% versus 15.6%; P=0.03). The number of deaths in the elderly cohort was higher (0.9% versus 0.1%; P=0.003). Rates of stroke (2.5% versus 1%) and thromboembolism (1.1% versus 0%) were also higher for elderly TN patients. No differences were found for rates of meningitis, cranial nerve deficits or cerebrospinal fluid leak. MVD remains an effective and reasonable strategy in the elderly population. There is evidence to suggest that rates of complications such as death, stroke, and thromboembolism may be significantly higher in the elderly population. The presented results may be useful in the decision-making process for MVD in elderly patients with TN. PMID:26944213

  2. Anterior cervical surgery methods for central cord syndrome without radiographic spinal fracture-dislocation

    Institute of Scientific and Technical Information of China (English)

    Chengwei JING; Qin FU; Xiaojun XU

    2009-01-01

    This study was aimed to explore the anterior cervical surgery methods to treat central cord syndrome without radiographic spinal fracture-dislocation (CCSWORFD), retrospectively analyze the cases of CCSWORFD, and evaluate the curative effect of anterior cervical surgery methods for CCSWORFD. Twenty four cases of CCSWORFD (19 males and 5 females), all suffering from cervical hyperextension injury, between 45-68 (average 59) years old, were operated on by anterior cervical surgery methods. Among these, 18 cases had been followed up for 6-24 (average 15) months; 18 cases, who had anterior decompression and plate fixation with titanium mesh bone grafting or iliac bone grafting achieved reliable effects based on the Japanese Orthopedics Association (JOA) evaluation (improved scores of cases with titanium mesh bone grafting, t = 2.800, P0.05). Most of these cases had degeneration of cervical vertebra. The decompression which relieves the oppression to the spinal cord can help lessen edema of the spinal cord, and early fixation for stability of cervical vertebra is better for the recovery of spinal cord injury. Anterior operation with titanium mesh bone grafting or iliac bone grafting are both reliable curative methods for CCSWORFD, and titanium mesh bone grafting can avoid the trauma of the supplying graft. Mesh bone grafting can also shorten hospital stay.

  3. National trends in outpatient surgical treatment of degenerative cervical spine disease.

    Science.gov (United States)

    Baird, Evan O; Egorova, Natalia N; McAnany, Steven J; Qureshi, Sheeraz A; Hecht, Andrew C; Cho, Samuel K

    2014-08-01

    Study Design Retrospective population-based observational study. Objective To assess the growth of cervical spine surgery performed in an outpatient setting. Methods A retrospective study was conducted using the United States Healthcare Cost and Utilization Project's State Inpatient and Ambulatory Surgery Databases for California, New York, Florida, and Maryland from 2005 to 2009. Current Procedural Terminology, fourth revision (CPT-4) and International Classification of Diseases, ninth revision Clinical Modification (ICD-9-CM) codes were used to identify operations for degenerative cervical spine diseases in adults (age > 20 years). Disposition and complication rates were examined. Results There was an increase in cervical spine surgeries performed in an ambulatory setting during the study period. Anterior cervical diskectomy and fusion accounted for 68% of outpatient procedures; posterior decompression made up 21%. Younger patients predominantly underwent anterior fusion procedures, and patients in the eighth and ninth decades of life had more posterior decompressions. Charlson comorbidity index and complication rates were substantially lower for ambulatory cases when compared with inpatients. The majority (>99%) of patients were discharged home following ambulatory surgery. Conclusions Recently, the number of cervical spine surgeries has increased in general, and more of these procedures are being performed in an ambulatory setting. The majority (>99%) of patients are discharged home but the nature of analyzing administrative data limits accurate assessment of postoperative complications and thus patient safety. This increase in outpatient cervical spine surgery necessitates further discussion of its safety.

  4. Bubble dynamics in perfused tissue undergoing decompression.

    Science.gov (United States)

    Meisel, S; Nir, A; Kerem, D

    1981-02-01

    A mathematical model describing bubble dynamics in a perfused tissue undergoing decompression is presented, taking into account physical expansion and inward diffusion from surrounding supersaturated tissue as growth promoting factors and tissue gas elimination by perfusion, tissue elasticity, surface tension and inherent unsaturation as resolving driving forces. The expected behavior after a step reduction of pressure of a bubble initially existing in the tissue, displaying both growth and resolution has been demonstrated. A strong perfusion-dependence of bubble resolution time at low perfusion rates is apparent. The model can account for various exposure pressures and saturation fractions of any inert gas-tissue combination for which a set of physical and physiological parameters is available.

  5. Do general practices adhere to organizational guidelines for effective cervical cancer screening?

    NARCIS (Netherlands)

    Hermens, R P; Hak, E; Hulscher, M E; Mulder, J; Braspenning, J C; Grol, R P

    1998-01-01

    BACKGROUND: Well-organized cervical screening has been shown to be effective in the reduction of both morbidity and mortality from cancer of the uterine cervix. In The Netherlands, the GP plays an important role in the cervical screening. The question is whether the general practices are able to org

  6. Dysphagia due to anterior cervical osteophytosis: case report

    Directory of Open Access Journals (Sweden)

    Frederico Miguel Santos Silva Marquez Correia

    2014-12-01

    Full Text Available The objective of this study is to highlight the possibility of dysphagia induced by anterior cervical osteophytes. When not diagnosed early this condition may be responsible for complications such as severe dysphagia and potential lung aspiration, especially in elderly patients. Analysis of a case report of a 72-year old woman who presented cervical pain and progressive dysphagia. Imaging studies have shown anterior cervical osteophytosis and multilevel degenerative changes in the cervical spine. The patient underwent surgical excision of the cervical anterior osteophytes (C4, C5 and C6 and C5/C6 arthrodesis through anterior approach. The postoperative period was uneventful and symptoms resolved within 2 weeks. Early diagnosis and treatment led to complete resolution, avoiding late and serious complications associated with this pathology in the geriatric population, especially severe and progressive dysphagia and risk of pulmonary aspiration, and the consequent morbidity and mortality associated. A multidisciplinary approach is essential for the correct assessment of this condition

  7. DIAGNOSTIC AND THERAPEUTIC POSSIBILITIES IN THE PROPHYLAXIS OF CERVICAL CANCER

    Directory of Open Access Journals (Sweden)

    Marzena Wrześniewska

    2013-11-01

    Full Text Available Poland is one of the countries with high cervical cancer morbidity and mortality. The main means to change this situation is to manage an active and modern programme of cervical cancer prophylaxis and diagnostics. To a large extent, the effectiveness of a cervical cancer prophylaxis programme is decided by the availability of modern diagnostic research. The conventional Papanicolaou test and modern LBC cytology techniques were discussed in the article, taking into consideration HPV diagnostics in the procedures for carefully selected cytological diagnosis, in the so called in-depth stage of preventive screening tests and the role of the p16 biomarker in predicting the development of a higher degree of epithelial-cell pathologies of the cervix. Colposcopy as a diagnostic method for the verification of cytological and virological abnormalities. The modern LEEP/LLETZ procedure used in diagnosis and treatment of cervical changes is used to realise the in-depth stage of cervical cancer prophylaxis programmes.

  8. Decompression sickness ('the bends') in sea turtles.

    Science.gov (United States)

    García-Párraga, D; Crespo-Picazo, J L; de Quirós, Y Bernaldo; Cervera, V; Martí-Bonmati, L; Díaz-Delgado, J; Arbelo, M; Moore, M J; Jepson, P D; Fernández, Antonio

    2014-10-16

    Decompression sickness (DCS), as clinically diagnosed by reversal of symptoms with recompression, has never been reported in aquatic breath-hold diving vertebrates despite the occurrence of tissue gas tensions sufficient for bubble formation and injury in terrestrial animals. Similarly to diving mammals, sea turtles manage gas exchange and decompression through anatomical, physiological, and behavioral adaptations. In the former group, DCS-like lesions have been observed on necropsies following behavioral disturbance such as high-powered acoustic sources (e.g. active sonar) and in bycaught animals. In sea turtles, in spite of abundant literature on diving physiology and bycatch interference, this is the first report of DCS-like symptoms and lesions. We diagnosed a clinico-pathological condition consistent with DCS in 29 gas-embolized loggerhead sea turtles Caretta caretta from a sample of 67. Fifty-nine were recovered alive and 8 had recently died following bycatch in trawls and gillnets of local fisheries from the east coast of Spain. Gas embolization and distribution in vital organs were evaluated through conventional radiography, computed tomography, and ultrasound. Additionally, positive response following repressurization was clinically observed in 2 live affected turtles. Gas embolism was also observed postmortem in carcasses and tissues as described in cetaceans and human divers. Compositional gas analysis of intravascular bubbles was consistent with DCS. Definitive diagnosis of DCS in sea turtles opens a new era for research in sea turtle diving physiology, conservation, and bycatch impact mitigation, as well as for comparative studies in other air-breathing marine vertebrates and human divers.

  9. Estimation of morbidity effects

    International Nuclear Information System (INIS)

    Many researchers have related exposure to ambient air pollution to respiratory morbidity. To be included in this review and analysis, however, several criteria had to be met. First, a careful study design and a methodology that generated quantitative dose-response estimates were required. Therefore, there was a focus on time-series regression analyses relating daily incidence of morbidity to air pollution in a single city or metropolitan area. Studies that used weekly or monthly average concentrations or that involved particulate measurements in poorly characterized metropolitan areas (e.g., one monitor representing a large region) were not included in this review. Second, studies that minimized confounding ad omitted variables were included. For example, research that compared two cities or regions and characterized them as 'high' and 'low' pollution area were not included because of potential confounding by other factors in the respective areas. Third, concern for the effects of seasonality and weather had to be demonstrated. This could be accomplished by either stratifying and analyzing the data by season, by examining the independent effects of temperature and humidity, and/or by correcting the model for possible autocorrelation. A fourth criterion for study inclusion was that the study had to include a reasonably complete analysis of the data. Such analysis would include an careful exploration of the primary hypothesis as well as possible examination of te robustness and sensitivity of the results to alternative functional forms, specifications, and influential data points. When studies reported the results of these alternative analyses, the quantitative estimates that were judged as most representative of the overall findings were those that were summarized in this paper. Finally, for inclusion in the review of particulate matter, the study had to provide a measure of particle concentration that could be converted into PM10, particulate matter below 10

  10. Understanding cervical cancer in the context of developing countries

    Directory of Open Access Journals (Sweden)

    Farhad Ali

    2012-01-01

    Full Text Available Cancer is one of the leading causes of deaths worldwide. Among the women, gynecological cancers are most common. Cervical cancer is a main gynecological cancer of the women. The global burden of cervical cancer is disproportionately high among the developing countries where 85 per cent of the estimated 493, 000 new cases and 273, 000 deaths occur worldwide. There are several dimensions of the problem. Cervical cancer is a problem where people are poor, where the socio-economic status of the women is low and sometimes specific ethnicity also posses additional risk to the women to develop cervical cancer. Human papillomavirus infection is a main risk factor for the cervical cancer however there are some other factors which increase the risk. Among them some are number of sexual partners, age of first sexual intercourse, infection of sexually transmitted diseases, use of hormonal contraceptives, parity, age, smoking, food and diet. Apart from these factors, some other issues, such as policy on cancer, capacity of health system, socio-economic and cultural factors and awareness among the women are also associated with the cervical cancer related morbidity and mortality across the developing countries. There some interventions which give promising results in terms of reducing cervical cancer related morbidity and mortality. Among them visual inspection of cervix with acetic acid followed by treatment is one such effective method.

  11. Posterior-Only Circumferential Decompression and Reconstruction in the Surgical Management of Lumbar Vertebral Osteomyelitis.

    Science.gov (United States)

    Skovrlj, Branko; Guzman, Javier Z; Caridi, John; Cho, Samuel K

    2016-02-01

    Study Design Case report. Objective The purpose of this report is to discuss the surgical management of lumbar vertebral osteomyelitis with a spinal epidural abscess (SEA) and present a single-stage, posterior-only circumferential decompression and reconstruction with instrumentation using an expandable titanium cage and without segmental nerve root sacrifice as an option in the treatment of this disease process. Methods We report a 42-year-old man who presented with 3 days of low back pain and chills who rapidly decompensated with severe sepsis following admission. Magnetic resonance imaging of his lumbosacral spine revealed intramuscular abscesses of the left paraspinal musculature and iliopsoas with SEA and L4 vertebral body involvement. The patient failed maximal medical treatment, which necessitated surgical treatment as a last resort for infectious source control. He underwent a previously undescribed procedure in the setting of SEA: a single-stage, posterior-only approach for circumferential decompression and reconstruction of the L4 vertebral body with posterior segmental instrumented fixation. Results After the surgery, the patient's condition gradually improved; however, he suffered a wound dehiscence necessitating a surgical exploration and deep wound debridement. Six months after the surgery, the patient underwent a revision surgery for adjacent-level pseudarthrosis. At 1-year follow-up, the patient was pain-free and off narcotic pain medication and had returned to full activity. Conclusion This patient is the first reported case of lumbar osteomyelitis with SEA treated surgically with a single-stage, posterior-only circumferential decompression and reconstruction with posterior instrumentation. Although this approach is more technically challenging, it presents another viable option for the treatment of lumbar vertebral osteomyelitis that may reduce the morbidity associated with an anterior approach. PMID:26835214

  12. Simultaneously anterior decompression and posterior instrumentation by extrapleural retroperitoneal approach in thoracolumbar lesions

    Directory of Open Access Journals (Sweden)

    Jain Anil

    2010-01-01

    Full Text Available Background: Anterior decompression with posterior instrumentation when indicated in thoracolumbar spinal lesions if performed simultaneously in single-stage expedites rehabilitation and recovery. Transthoracic, transdiaphragmatic approach to access the thoracolumbar junction is associated with significant morbidity, as it violates thoracic cavity; requires cutting of diaphragm and a separate approach, for posterior instrumentation. We evaluated the clinical outcome morbidity and feasibility of extrapleural retroperitoneal approach to perform anterior decompression and posterior instrumentation simultaneously by single "T" incision outcome in thoracolumbar spinal trauma and tuberculosis. Patients and Methods: Forty-eight cases of tubercular spine (n = 25 and fracture of the spine (n = 23 were included in the study of which 29 were male and 19 female. The mean age of patients was 29.1 years. All patients underwent single-stage anterior decompression, fusion, and posterior instrumentation (except two old traumatic cases via extrapleural retroperitoneal approach by single "T" incision. Tuberculosis cases were operated in lateral position as they were stabilized with Hartshill instrumentation. For traumatic spine initially posterior pedicle screw fixation was performed in prone position and then turned to right lateral position for anterior decompression by same incision and approach. They were evaluated for blood loss, duration of surgery, superficial and deep infection of incision site, flap necrosis, correction of the kyphotic deformity, and restoration of anterior and posterior vertebral body height. Results: In traumatic spine group the mean duration of surgery was 269 minutes (range 215-315 minutes including the change over time from prone to lateral position. The mean intraoperative blood loss was 918 ml (range 550-1100 ml. The preoperative mean ASIA motor, pin prick and light touch score improved from 63.3 to 74.4, 86 to 94.4 and 86 to 96 at

  13. Use of MRI in the diagnosis of cervical myelopathy

    Energy Technology Data Exchange (ETDEWEB)

    Nagase, Joji; Itahashi, Takashi; Yuyama, Takuo; Lee, Motohiro; Watanabe, Tsuneo; Inoue, Schun-ichi; Arimizu, Noboru; Uematsu, Sadao; Morita, Fuminori.

    1987-12-01

    Magnetic resonance imaging (MRI) was performed in 18 cases of cervical myelopathy. They were ''disc herniation'' 8 cases, ''canal stenosis'' 5 cases, and ''ossification of posterior longitudinal ligament (OPLL)'' 5 cases. The midsagittal section was obtained in each cases. The pulse sequence was Spin Echo (SE) technique with both T/sub 1/-weighted SE (Tr = 400, Te = 40) and T/sub 2/-weighted SE (Tr = 2000, Te = 80). Cervical-cord compression by herniated disc, yellow ligament, OPLL, or osteophyte was shown very clealy on the T/sub 1/-weighted image. Cord compression was increased by cervical extension and decreased by flexion. MRI was very useful in detecting the involved levels and in selecting the operative procedures. T/sub 2/-weighted image was taken in 9 cases. High signal intensity area was noted at the cord which was compressed in 7 cases. The true mechanism of this phenomenon is unknown yet, but this might be a clue to solve the pathogenesis of myelopathy. MRI was performed in 9 cases in order to evaluate post-operative cord decompression. Cord decompression was confirmed in 8 cases except for one case. MRI was also useful for postoperative evaluation.

  14. Percutaneous treatment of cervical and lumbar herniated disc

    Energy Technology Data Exchange (ETDEWEB)

    Kelekis, A., E-mail: akelekis@med.uoa.gr; Filippiadis, D.K., E-mail: dfilippiadis@yahoo.gr

    2015-05-15

    Therapeutic armamentarium for symptomatic intervertebral disc herniation includes conservative therapy, epidural infiltrations (interlaminar or trans-foraminal), percutaneous therapeutic techniques and surgical options. Percutaneous, therapeutic techniques are imaging-guided, minimally invasive treatments for intervertebral disc herniation which can be performed as outpatient procedures. They can be classified in 4 main categories: mechanical, thermal, chemical decompression and biomaterials implantation. Strict sterility measures are a prerequisite and should include extensive local sterility and antibiotic prophylaxis. Indications include the presence of a symptomatic, small to medium sized contained intervertebral disc herniation non-responding to a 4–6 weeks course of conservative therapy. Contraindications include sequestration, infection, segmental instability (spondylolisthesis), uncorrected coagulopathy or a patient unwilling to provide informed consent. Decompression techniques are feasible and reproducible, efficient (75–94% success rate) and safe (>0.5% mean complications rate) therapies for the treatment of symptomatic intervertebral disc herniation. Percutaneous, imaging guided, intervertebral disc therapeutic techniques can be proposed either as an initial treatment or as an attractive alternative prior to surgery for the therapy of symptomatic herniation in both cervical and lumbar spine. This article will describe the mechanism of action for different therapeutic techniques applied to intervertebral discs of cervical and lumbar spine, summarize the data concerning safety and effectiveness of these treatments, and provide a rational approach for the therapy of symptomatic intervertebral disc herniation in cervical and lumbar spine.

  15. Isolated Blunt Duodenal Trauma: Delayed Diagnosis and Favorable Outcome with "Quadruple Tube" Decompression

    Directory of Open Access Journals (Sweden)

    Stefano Crippa

    2007-09-01

    Full Text Available Context Isolated blunt duodenal injury is a rare finding associated with high morbidity and significant mortality. The early identification of a duodenal injury is usually difficult, considering the anatomical location of the duodenum and lack of peritoneal signs and diagnostic delay is part of the clinical picture in most cases. Case report A 43-year-old man was admitted to our hospital after a motor vehicle collision. At admission he underwent emergency surgery because of lower extremities fractures. Twelve hours later he started to complain an increasing abdominal pain; blood tests showed serum amylase up to 180 U/L and a CT scan demonstrated a perforation of the third duodenal portion. At laparotomy a Grade III injury of the duodenum was evident. The laceration was sutured and a “quadruple-tube” decompression was performed. The postoperative course was uneventful. One year after surgery he is well without any long-term complication. Conclusion A high degree of suspicion is necessary for early diagnosis of blunt duodenal trauma and CT scan should be performed in case of all significant epigastric trauma. In most cases primary direct repair of duodenal wounds can be safely achieved and duodenal decompression via triple or quadriple tube technique is required to decrease the risk of duodenal fistula.

  16. Co-morbidity in psoriasis

    DEFF Research Database (Denmark)

    Lønnberg, Ann Sophie; Skov, Lone

    2016-01-01

    for the clinic to be able to recognize such co-morbidities. AREAS COVERED: This is a review of studies investigating and discussing co-morbidities of psoriasis and screening. Literature was retrieved by searching on the PubMed database using individual and combined search terms related to relevant co...

  17. Minimally invasive lumbar decompression-the surgical learning curve.

    Science.gov (United States)

    Kim, Choll W

    2016-08-01

    Commentary On: Ahn J, Iqbal A, Manning BT, Leblang S, Bohl DD, Mayo BC, et al. Minimally invasive lumbar decompression-the surgical learning curve. Spine J 2016:16:909-16. (in this issue). PMID:27545398

  18. Hindbrain decompression in a dog with scoliosis associated with syringomyelia.

    Science.gov (United States)

    Takagi, Satoshi; Kadosawa, Tsuyoshi; Ohsaki, Tomohiro; Hoshino, Yuki; Okumura, Masahiro; Fujinaga, Toru

    2005-04-15

    A 6-month-old female Border Collie was examined because of a 1-month history of progressive curvature of the cervical portion of the vertebral column. Radiography revealed severe cervical and thoracic scoliosis. Cervical syringomyelia and hydrocephalus were observed by means of magnetic resonance imaging. Suboccipital craniotomy and laminectomy of the first cervical vertebra were performed, and substantial improvement in the scoliosis and syringomyelia was observed 3 months after surgery. No recurrences were seen during the first year after surgery. PMID:15844429

  19. One stage anterior-posterior approach for traumatic at- lantoaxial instability combined with subaxial cervical spinal cord injury

    Directory of Open Access Journals (Sweden)

    WANG Chang-sheng

    2011-06-01

    Full Text Available 【Abstract】 Objectives: To explore the clinical fea- tures of traumatic atlantoaxial instability combined with subaxial cervical spinal cord injury (CSCI, and to analyze the feasibility, indication and therapeutic effects of ante- rior-posterior approach in such cases. Methods: From March 2004 to September 2009, 16 cases with this trauma were admitted and surgically treated in our department. Before surgery, skull traction was performed. Posterior atlantoaxial pedicle screw internal fixa- tion and bone graft fusion were conducted to manage trau- matic atlantoaxial instability . As for subaxial CSCI, anterior cervical corpectomy or discectomy decompression, bone grafting and internal fixation with steel plates were applied. Results: All operations were successful. The average operation time was 3 hours and operative blood loss 400 ml. Satisfactory reduction of both the upper and lower cervical spine and complete decompression were achieved. All pa- tients were followed up for 12 to 36 months. Their clinical symptoms were improved by various levels. The Japanese Orthopaedic Association (JOA scores ranged from 10 to 16 one year postoperatively, 13.95±2.06 on average (improvement rate=70.10%. X-rays, spiral CT and MRI con- firmed normal cervical alignments, complete decompression and fine implants’ position. There was no breakage or loos- ening of screws, nor exodus of titanium mesh or implanted bone blocks. The grafted bone achieved fusion 3-6 months postoperatively and no atlantoaxial instability was observed. Conclusions: Traumatic atlantoaxial instability may combine with subaxial CSCI, misdiagnosis of which should be especially alerted and avoided. For severe cases, one stage anterior-posterior approach to decompress the upper and lower cervical spine, together with reposition, bone grafting and fusion, as well as internal fixation can immedi- ately restore the normal alignments and stability of the cer- vical spine and effectively

  20. One stage anterior-posterior approach for traumatic atlantoaxial instability combined with subaxial cervical spinal cord injury

    Institute of Scientific and Technical Information of China (English)

    WANG Chang-sheng; LIU Mou-jun; LIN Jian-hua; XU Wei-hong; LUO Hong-bin

    2011-01-01

    Objectives: To explore the clinical features of traumatic atlantoaxial instability combined with subaxial cervical spinal cord injury (CSCI), and to analyze the feasibility, indication and therapeutic effects of anterior-posterior approach in such cases.Methods: From March 2004 to September 2009, 16cases with this trauma were admitted and surgically treated in our department. Before surgery, skull traction was performed. Posterior atlantoaxial pedicle screw internal fixation and bone graft fusion were conducted to manage traumatic atlantoaxial instability. As for subaxial CSCI, anterior cervical corpectomy or discectomy decompression, bone grafting and internal fixation with steel plates were applied.Results: All operations were successful. The average operation time was 3 hours and operative blood loss 400 ml. Satisfactory reduction of both the upper and lower cervical spine and complete decompression were achieved. All patients were followed up for 12 to 36 months. Their clinical symptoms were improved by various levels. The Japanese Orthopaedic Association (JOA) scores ranged from 10to 16 one year postoperatively, 13.95±2.06 on average (improvement rate= 70.10% ). X-rays, spiral CT and MRI confirmed normal cervical alignments, complete decompression and fine implants' position. There was no breakage or loosening of screws, nor exodus of titanium mesh or implanted bone blocks. The grafted bone achieved fusion 3-6 months postoperatively and no atlantoaxial instability was observed.Conclusions: Traumatic atlantoaxial instability may combine with subaxial CSCI, misdiagnosis of which should be especially alerted and avoided. For severe cases, one stage anterior-posterior approach to decompress the upper and lower cervical spine, together with reposition, bone grafting and fusion, as well as internal fixation can immediately restore the normal alignments and stability of the cervical spine and effectively improve the spinal nervous function, thus being an ideal

  1. Cervical Cancer Screening

    Science.gov (United States)

    ... Cancer found early may be easier to treat. Cervical cancer screening is usually part of a woman's health ... may do more tests, such as a biopsy. Cervical cancer screening has risks. The results can sometimes be ...

  2. Ho: Yag laser-assisted lumbar disc decompression: A minimally invasive procedure under local anesthesia

    Directory of Open Access Journals (Sweden)

    Agarwal S

    2003-01-01

    Full Text Available The morbidity associated with open procedures for lumbar intervertebral disc prolapse has led to the development of minimally invasive techniques. Ho: LADD (Laser-assisted disc decompression is a very cost-effective minimally invasive procedure. The procedure is carried out under local anesthesia The patient can be mobilized immediately after the surgery. The study involved 36 cases treated with Ho: LADD for contained lumbar intervertebral disc prolapse. 35 cases were available for follow-up. There was a 91.5% success rate and a minimal complication rate. All cases adhered to strict inclusion and exclusion criteria and were evaluated with the modified Macnab criteria for the assessment of postoperative results.

  3. Fenestration of bone flap during decompressive craniotomy for subdural hematoma

    OpenAIRE

    Ha Son Nguyen; Ninh Doan; Christopher Wolfla; Glen Pollock

    2016-01-01

    Background: Persistent/recurrent extra-axial hemorrhage may occur after decompression of a subdural hematoma (SDH) followed by an immediate replacement of bone flap. A fenestration of the bone flap may encourage extra-axial fluid absorption; however, the literature has not explored this technique. Methods: Forty-four consecutive patients who underwent surgical decompression of SDH with immediate replacement of bone flap were divided into two groups: Fenestration (F), n = 33, and no fenest...

  4. Prophylactic decompression of extensor pollicis longus to prevent rupture

    OpenAIRE

    Navaratnam, A V; Ball, S; Eckersley, R

    2013-01-01

    We present a case of a patient with spontaneous rupture of right extensor pollicis longus (EPL) tendon, who had also developed left wrist pain and weakness in his left EPL that MRI studies confirmed to be caused by tendinosis. Subsequently, decompression of left EPL and reconstruction of right EPL with palmaris longus tendon graft was undertaken. In this case, decompression of the left EPL tendon led to resolution of the patient's symptoms as well as preventing tendon rupture. We advocate the...

  5. Artificial cervical disc replacement: Principles, types and techniques

    Directory of Open Access Journals (Sweden)

    Sekhon L

    2005-01-01

    Full Text Available Cervical arthroplasty after anterior decompression with insertion of a prosthetic total disc replacement has been suggested as an alternate to anterior cervical fusion. Currently there are four cervical arthroplasty devices available on the market whose results in clinical use have been reported. Each device varies in terms of materials, range of motion, insertion technique and constraint. It is not known which device is ideal. Early studies suggest that in the short term, the complication rate and efficacy is no worse than fusion surgery. Long-term results have not yet been reported. This review examines the current prostheses available on the market as well as discussing issues regarding indications and technique. Pitfalls are discussed and early experiences reviewed. In time, it is hoped that a refinement of cervical arthroplasty occurs in terms of both materials and design as well as in terms of indications and clinical outcomes as spinal surgeons enter a new era of the management of cervical spine disease.

  6. Rare bilateral C3 cervical spondylolysis:Report of four cases and a literature review

    Institute of Scientific and Technical Information of China (English)

    Huaiyu Tong; Hongzhen Jiang; Xinguang Yu; Yuanzheng Zhang

    2015-01-01

    Objective:To review and discuss the etiology, diagnosis and treatment C3 of bilateral cervical spondylolysis. Methods:This was a retrospective review of the clinical features, imaginge findings, and treatment of 4 cases of bilateral C3 cervical spondylolysis, with a review of the literature. Results:A 21‐year‐old woman, a 26‐year‐old man, a 14‐year‐old boy, and a 46‐year‐old man were diagnosed with bilateral C3 cervical spondylolysis. The patients had characteristic bilateral clefts between the articular pillar and the facets of C3, as well as spina bifida on CT. Although spondylolisthesis was not observed, spinal cord compression was definitive. All patients underwent posterior decompression with satisfactory results. Conclusions:C3 cervical spondylolysis is rare condition. The cause is most likely congenital. Diagnosis is dependent on characteristic radiological features. Surgical treatment is the first choice.

  7. Decompression to altitude: assumptions, experimental evidence, and future directions.

    Science.gov (United States)

    Foster, Philip P; Butler, Bruce D

    2009-02-01

    Although differences exist, hypobaric and hyperbaric exposures share common physiological, biochemical, and clinical features, and their comparison may provide further insight into the mechanisms of decompression stress. Although altitude decompression illness (DCI) has been experienced by high-altitude Air Force pilots and is common in ground-based experiments simulating decompression profiles of extravehicular activities (EVAs) or astronauts' space walks, no case has been reported during actual EVAs in the non-weight-bearing microgravity environment of orbital space missions. We are uncertain whether gravity influences decompression outcomes via nitrogen tissue washout or via alterations related to skeletal muscle activity. However, robust experimental evidence demonstrated the role of skeletal muscle exercise, activities, and/or movement in bubble formation and DCI occurrence. Dualism of effects of exercise, positive or negative, on bubble formation and DCI is a striking feature in hypobaric exposure. Therefore, the discussion and the structure of this review are centered on those highlighted unresolved topics about the relationship between muscle activity, decompression, and microgravity. This article also provides, in the context of altitude decompression, an overview of the role of denitrogenation, metabolic gases, gas micronuclei, stabilization of bubbles, biochemical pathways activated by bubbles, nitric oxide, oxygen, anthropometric or physiological variables, Doppler-detectable bubbles, and potential arterialization of bubbles. These findings and uncertainties will produce further physiological challenges to solve in order to line up for the programmed human return to the Moon, the preparation for human exploration of Mars, and the EVAs implementation in a non-zero gravity environment.

  8. Arthroscopic Decompression for a Giant Meniscal Cyst.

    Science.gov (United States)

    Ohishi, Tsuyoshi; Suzuki, Daisuke; Matsuyama, Yukihiro

    2016-01-01

    The authors report the case of a giant medial meniscal cyst in an osteoarthritic knee of an 82-year-old woman that was successfully treated with only arthroscopic cyst decompression. The patient noticed a painful mass on the medial side of the right knee that had been gradually growing for 5 years. Magnetic resonance imaging showed an encapsulated large medial cystic mass measuring 80×65×40 mm that was adjacent to the medial meniscus. An accompanying horizontal tear was also detected in the middle and posterior segments of the meniscus. The medial meniscus was resected up to the capsular attachment to create bidirectional flow between the joint and the cyst with arthroscopic surgery. Magnetic resonance imaging performed 14 months postoperatively showed that the cyst had completely disappeared, and no recurrence was observed during a 2-year follow-up period. An excellent result could be obtained by performing limited meniscectomy to create a channel leading to the meniscal cyst, even though the cyst was large. Among previously reported cases of meniscal cysts, this case is the largest to be treated arthroscopically without open excision.

  9. Cervical Cancer Stage IA

    Science.gov (United States)

    ... historical Searches are case-insensitive Cervical Cancer Stage IA Add to My Pictures View /Download : Small: 720x576 ... Large: 3000x2400 View Download Title: Cervical Cancer Stage IA Description: Stage IA1 and IA2 cervical cancer; drawing ...

  10. Postoperative Cervical Haematoma Complicated by Ipsilateral Carotid Thrombosis and Aphasia after Anterior Cervical Fusion: A Case Report

    Directory of Open Access Journals (Sweden)

    Kingsley R. Chin

    2013-01-01

    Full Text Available Hematoma alone is the most common vascular complication reported after anterior cervical decompression and fusion (ACDF. We present this case to report the occurrence of postoperative cervical hematoma complicated by ipsilateral carotid thrombosis and aphasia after an uncomplicated C4–6 ACDF. This is a case of a 65-year-old woman who underwent revision fusions of the C4-5 and C6-7 levels complicated by postoperative cervical hematoma and carotid thrombosis. The patient's history, clinical examination, imaging findings, and treatment are reported. The revision fusions were performed and deemed routine. Approximately eight hours later 200 mL of blood was evacuated from a postoperative cervical hematoma. The patient became unresponsive and disoriented a few hours after evacuating the hematoma. Computed tomography and magnetic resonance imaging of the brain were normal, but magnetic resonance angiography demonstrated total occlusion of the left carotid artery. Thrombectomy was performed and the patient was discharged without residual deficits. At the latest followup she is fully functional and asymptomatic in her neck. We suggest, after evacuating a cervical hematoma, an evaluation of the carotids be made with MRA or cerebral angiography, as this may demonstrate a clot before the patient develops symptoms.

  11. Effects of Lateral Mass Screw Rod Fixation to the Stability of Cervical Spine after Laminectomy

    Science.gov (United States)

    Rosli, Ruwaida; Kashani, Jamal; Kadir, Mohammed Rafiq Abdul

    There are many cases of injury in the cervical spine due to degenerative disorder, trauma or instability. This condition may produce pressure on the spinal cord or on the nerve coming from the spine. The aim of this study was, to analyze the stabilization of the cervical spine after undergoing laminectomy via computational simulation. For that purpose, a three-dimensional finite element (FE) model for the multilevel cervical spine segment (C1-C7) was developed using computed tomography (CT) data. There are various decompression techniques that can be applied to overcome the injury. Usually, decompression procedures will create an unstable spine. Therefore, in these situations, the spine is often surgically restabilized by using fusion and instrumentation. In this study, a lateral mass screw-rod fixation was created to stabilize the cervical spine after laminectomy. Material properties of the titanium alloy were assigned on the implants. The requirements moments and boundary conditions were applied on simulated implanted bone. Result showed that the bone without implant has a higher flexion and extension angle in comparison to the bone with implant under applied 1Nm moment. The bone without implant has maximum stress distribution at the vertebrae and ligaments. However, the bone with implant has maximum stress distribution at the screws and rods. Overall, the lateral mass screw-rod fixation provides stability to the cervical spine after undergoing laminectomy.

  12. Análise biomecânica de tratamentos cirúrgicos da coluna cervical

    OpenAIRE

    Rodrigues, Diana Rebecca Esteves Cardoso Gavazzo

    2011-01-01

    The main objective of this thesis was to study the biomechanical implications related to different surgical procedures for decompressing the intervertebral discs in the cervical spine. The different surgical techniques were evaluated so as to assess how load transfer to the adjacent vertebrae would be affected, thereby ascertaining the potential risks of failure of these vertebrae when compared to the vertebrae in the native (healthy) state. For this purpose an initial analy...

  13. Radiofrequency thermocoagulation rhizotomy for recurrent trigeminal neuralgia after microvascular decompression

    Institute of Scientific and Technical Information of China (English)

    ZHANG Liang-wen; LIU Yu-guang; WU Cheng-yuan; XU Shu-jun; ZHU Shu-gan

    2011-01-01

    Background Microvascular decompression (MVD) is a well accepted surgical treatment strategy for trigeminal neuralgia (TN) with satisfying long-term outcome.However,considerable recurrent patients need more effective management.The purpose of this study was to evaluate the effectiveness of radiofrequency thermocoagulation rhizotomy (RTR) on patients with recurrent TN after MVD.Methods Totally 62 cases of recurrent TN after MVD undergoing RTR from January 2000 to January 2010 were retrospectively evaluated.Based on surgical procedures undertaken,these 62 cases were classified into two subgroups:group A consisted of 23 cases that underwent traditional RTR by free-hand; group B consisted of 39 cases that underwent RTR under the guidance of virtual reality imaging technique or neuronavigation system.The patients in group Awere followed up for 14 to 70 months (mean,40±4),and those in group B were followed up for 13 to 65 months (mean,46±7).Kaplan-Meier analyses of the pain-free survival curves were used for the censored survival data,and the log-rank test was used to compare survival curves of the two groups.Results All patients in both groups A and B attained immediate pain relief after RTR.Both groups attained good pain relief rate within the first two years of follow-up:92.3%,84.6% and 82.6%,69.6% respectively (P >0.05).After 2 years,the virtual reality or neuronavigation assisted RTR group (group B) demonstrated higher pain relief rates of 82.5%,76.2% and 68.8% at 3,4 and 5 years after operation respectively,while those in group A was 57.2%,49.6%,and 36.4% (P <0.05).Low levels of minor complications were recorded,while neither mortalities nor significant morbidity was documented.Conclusions RTR was effective in alleviating the pain of TN cases suffering from unsuccessful MVD management.With the help of virtual reality imaging technique or neuronavigation system,the patients could attain better long-term pain relief.

  14. Preoperative alcoholism and postoperative morbidity

    DEFF Research Database (Denmark)

    Tonnesen, H; Kehlet, H

    1999-01-01

    BACKGROUND: Preoperative risk assessment has become part of daily clinical practice, but preoperative alcohol abuse has not received much attention. METHODS: A Medline search was carried out to identify original papers published from 1967 to 1998. Relevant articles on postoperative morbidity...... in alcohol abusers were used to evaluate the evidence. RESULTS: Prospective and retrospective studies demonstrate a twofold to threefold increase in postoperative morbidity in alcohol abusers, the most frequent complications being infections, bleeding and cardiopulmonary insufficiency. Wound complications...... to postoperative morbidity. CONCLUSION: Alcohol consumption should be included in the preoperative assessment of likely postoperative outcome. Reduction of postoperative morbidity in alcohol abusers may include preoperative alcohol abstinence to improve organ function, or perioperative alcohol administration...

  15. Hemoglobin, radiation, morbidity and survival

    International Nuclear Information System (INIS)

    Analyses concerned with a group of patients treated by radiotherapy for carcinoma of the bronchus give evidence to support the view that oxygen tension at the time of radiation therapy is important both in determining tumor control and radiation morbidity

  16. Modified steel basket technique for the treatment of equine cervical vertebral stenotic myelopathy - a case report

    Directory of Open Access Journals (Sweden)

    Frederico Fernandes Araújo

    2015-08-01

    Full Text Available Cervical vertebral stenotic myelopathy (CVSM, also known as cervical ataxia or wobbler syndrome, is caused by the narrowing of the medullary canal due to a malformation of the cervical vertebrae, resulting in compression of the spinal cord and neurological alterations such as ataxia, hypermetria, weakness, and abnormal stance. The treatment options can be conservative or surgical, with varied effectiveness. The most appropriate surgical technique in the majority of cases is arthrodesis, providing quick and efficient decompression of the spinal cord. The goal of this case report is to present an equine patient with CVSM that was surgically treated using a new modified cage model. The diagnosis was based on history, clinical signs and radiographic evidence of spinal cord compression between the C3 and C4 vertebrae, after ruling out possible infectious agents. The surgical procedure for the decompression and stabilization of the point of stenosis was performed using a modified Cloward’s technique and a new cage model fixed with two screws. Evidence of fusion was obtained by periodic radiographs over six months of postoperative care. The new cage model used in this surgery proved to be efficient for the decompression and stabilization of the vertebrae, allowing arthrodesis development and remission of the clinical signs. Fixation of the cage with screws reduces the risk of migration of the implant.

  17. Delayed recompression for decompression sickness: retrospective analysis.

    Directory of Open Access Journals (Sweden)

    Amir Hadanny

    Full Text Available Most cases of decompression sickness (DCS occur soon after surfacing, with 98% within 24 hours. Recompression using hyperbaric chamber should be administrated as soon as feasible in order to decrease bubble size and avoid further tissue injury. Unfortunately, there may be a significant time delay from surfacing to recompression. The time beyond which hyperbaric treatment is non effective is unclear. The aims of the study were first to evaluate the effect of delayed hyperbaric treatment, initiated more than 48 h after surfacing for DCS and second, to evaluate the different treatment protocols.From January 2000 to February 2014, 76 divers had delayed hyperbaric treatment (≥48 h for DCS in the Sagol center for Hyperbaric medicine and Research, Assaf-Harofeh Medical Center, Israel. Data were collected from their medical records and compared to data of 128 patients treated earlier than 48 h after surfacing at the same hyperbaric institute.There was no significant difference, as to any of the baseline characteristics, between the delayed and early treatment groups. With respect to treatment results, at the delayed treatment divers, complete recovery was achieved in 76% of the divers, partial recovery in 17.1% and no improvement in 6.6%. Similar results were achieved when treatment started early, where 78% of the divers had complete recovery, 15.6% partial recovery and 6.2% no recovery. Delayed hyperbaric treatment using US Navy Table 6 protocol trended toward a better clinical outcome yet not statistically significant (OR=2.786, CI95%[0.896-8.66], p=0.07 compared to standard hyperbaric oxygen therapy of 90 minutes at 2 ATA, irrespective of the symptoms severity at presentation.Late recompression for DCS, 48 hours or more after surfacing, has clinical value and when applied can achieve complete recovery in 76% of the divers. It seems that the preferred hyperbaric treatment protocol should be based on US Navy Table 6.

  18. Surgical Procedures of Morbid Obesity

    Directory of Open Access Journals (Sweden)

    Zinat Salem

    2013-02-01

    Full Text Available Background: Surgical intervention has been recently advocated in the treatment of morbid obesity. The objective of this study was to review surgery as an alternative in the treatment of morbidly obese adolescents. Materials and Methods: This research was conducted by searching English websites such as PubMed, Up to Date, and Google Scholar, as well as some Persian websites including SID, Iranmedex, and Magiran. Articles published from 2000 to 2010 on interventional and clinical trials were reviewed for treatment of morbid obesity in adolescents. Keywords used in internet searches include obesity; adolescence; and surgery.Results: The results obtained from the studies indicated that 4% of American adolescents suffer from morbid obesity. So far, pharmacological treatment and other approaches toward this type of obesity have been inefficient. Hence, surgery was employed as one of the new approaches to the treatment of this disorder. According to the National Health Institute criteria, in the treatment of adolescent candidates for surgery, anthropometric measurements are performed together with the measurement of other co-morbidities of obesity. Adolescents whose percentiles are ≥99 are considered as morbidly obese patients. Conclusion: The results of the studies suggested that for the extremely obese adolescents, who do not respond to other types of medical interventions within 6 months, surgery can be performed. Adolescents with BMI of ≥40 kg/m2 and skeletal maturity, or those with co morbidities of obesity, or 13-year-old girls and boys ≥15 years of age can be candidates for surgery. However, the side effects of obesity should not be neglected. Therefore, before the adolescent obesity become morbid obesity, preventive measures should be taken through changes in lifestyle.

  19. Cervical disc herniation manifesting as a Brown-Sequard syndrome

    Directory of Open Access Journals (Sweden)

    Kunio Yokoyama

    2012-01-01

    Full Text Available Brown-Sequard syndrome is commonly seen in the setting of spinal trauma or an extramedullary spinal neoplasm. The clinical picture reflects hemisection of the spinal cord. We report a rare case of Brown-Sequard syndrome caused by a large cervical herniated disc. A 63-year-old man presented with progressive right hemiparesis and disruption of pain and temperature sensation on the left side of the body. Magnetic resonance imaging showed large C3-C4 disc herniation compressing the spinal cord at that level, with severe canal stenosis from C4 through C7. Decompressive cervical laminoplasty was performed. After surgery, complete sensory function was restored and a marked improvement in motor power was obtained.

  20. Challenges of cervical reconstruction for destructive spondyloarthropathy in renal osteodystrophy.

    Science.gov (United States)

    Elder, Benjamin D; Petteys, Rory J; Sciubba, Daniel M; Wolinsky, Jean-Paul

    2016-08-01

    Patients with end stage renal disease on hemodialysis may present with destructive spondyloarthropathy of the spine, most commonly in the subaxial cervical and lumbar spine, often with severe stenosis and instability. However, surgical management of these patients is challenging due to a high pseudarthrosis rate, poor bone quality, and medical frailty. We present a 49-year-old man on hemodialysis who presented with C4-C5 vertebral body destruction and a focal kyphotic deformity with myelopathy. The patient underwent a 360 degree decompression and reconstructive procedure that resulted in posterior instrumentation failure. Several salvage techniques were used in order to adequately stabilize the spine while preserving the patient's remaining cervical motion. PMID:27052255

  1. Anterior Cervical Surgery Cervical Disc Experience%颈椎前路手术治疗颈椎间盘突出症体会

    Institute of Scientific and Technical Information of China (English)

    吴向东; 刘绍武; 唐佩福

    2012-01-01

    Objective:Observation of the anterior cervical surgical treatment of cervical disc herniation .Methods:52cases of cervical disc herniation, anterior cervical decompression, bone graft and application of cervical locking anterior plate internal fixation. Results:46 cases after 2~ 18months, anaverage of 8.2 months of follow-up of all cases of graft to achieve bone fusion, the integration time of 12 ~ 16 weeks, with an average of 12.6 weeks, 100% of the fusion rate; MRI examination of spinal cord deformation. The compression performance of spinal cord function tests, with the exception of three cases of unsatisfactory outside. The results were satisfactory in all cases bone graft. Conclusion:Indications to choose the right anterior cervical decompression surgery bone graft and plate system is simple and can provide a fixed segmental stability, conducive to the recovery of neurological function, applicable to the treatment of cervical disc herniation, cervical trauma. Anterior cervical surgery for two cervical disc, three vertebrae. Power and restricted anterior cervical fixation materials was no significant differencein clinical therapy.%目的:观察颈椎前路手术治疗颈椎间盘突出症的疗效.方法:对52例颈椎间盘突出症,行颈椎前路减压、植骨并应用锁定型颈椎前路钢板内固定.结果:46例经过2~18个月、平均8.2月的随访,所有病例植骨均达到骨性融合,融合时间12~16周,平均12.6周,融合率100%;MRI检查无脊髓变形、受压表现,脊髓功能检查,除3例不理想外.所有病例植骨疗效满意.结论:适应症选择正确,颈椎前路手术减压植骨、钢板系统操作简单,可提供有效的固定节段稳定性,利于神经功能恢复,适用于颈椎间盘突出症、颈椎外伤的治疗.颈椎前路手术适用于2个颈椎间盘,3个椎体.动力性和限制性颈椎前路内固定材料在临床治疗疗效上无明显差别.

  2. Syringomyelia associated with cervical spondylosis: A rare condition.

    Science.gov (United States)

    Landi, Alessandro; Nigro, Lorenzo; Marotta, Nicola; Mancarella, Cristina; Donnarumma, Pasquale; Delfini, Roberto

    2013-06-16

    Spinal spondylosis is an extremely common condition that has only rarely been described as a cause of syringomyelia. We describe a case of syringomyelia associated with cervical spondylosis admitted at our division and treated by our institute. It is the case of a 66-year-old woman. At our observation she was affected by moderate-severe spastic tetraparesis. T2-weighted magnetic resonance imaging (MRI) showed an hyperintense signal within spinal cord from C3 to T1 with a more sharply defined process in the inferior cervical spinal cord. At the same level bulging discs, facets and ligamenta flava hypertrophy determined a compression towards subarachnoid space and spinal cord. Spinal cord compression was more evident in hyperextension rather than flexion. A 4-level laminectomy and subsequent posterior stabilization with intra-articular screws was executed. At 3-mo follow up there was a regression of tetraparesis but motor deficits of the lower limbs residuated. At the same follow up postoperative MRI was executed. It suggested enlargement of the syrinx. Perhaps hyperintensity within spinal cord appeared "bounded" from C3 to C7 with clearer margins. At the level of surgical decompression, subarachnoid space and spinal cord enlargement were also evident. A review of the literature was executed using PubMed database. The objective of the research was to find an etiopathological theory able to relate syringomyelia with cervical spondylosis. Only 6 articles have been found. At the origin of syringomyelia the mechanisms of compression and instability are proposed. Perhaps other studies assert the importance of subarachnoid space regard cerebrospinal fluid (CSF) dynamic. We postulate that cervical spine instability may be the cause of multiple microtrauma towards spinal cord and consequently may damage spinal cord parenchyma generating myelomalacia and consequently syrinx. Otherwise the hemorrhage within spinal cord central canal can cause an obstruction of CSF outflow

  3. C5 Nerve root palsies following cervical spine surgery: A review

    Directory of Open Access Journals (Sweden)

    Nancy E Epstein

    2015-01-01

    Full Text Available Background: Cervical C5 nerve root palsies may occur in between 0% and 30% of routine anterior or posterior cervical spine operations. They are largely attributed to traction injuries/increased cord migration following anterior/posterior decompressions. Of interest, almost all studies cite spontaneous resolution of these deficits without surgery with 3-24 postoperative months. Methods: Different studies cite various frequencies for C5 root palsies following anterior or posterior cervical spine surgery. In their combined anterior/posterior series involving C4-C5 level  decompressions, Libelski et al. cited up to a 12% incidence of C5 palsies. In Gu et al. series, C5 root palsies occurred in 3.1% of double-door laminoplasty, 4.5% of open-door laminoplasty, and 11.3% of laminectomy. Miller et al. observed an intermediate 6.9% frequency of C5 palsies followed by posterior cervical decompressions and fusions (PCDF. Results: Gu et al. also identified multiple risk factors for developing C5 palsies following posterior surgery; male gender, ossification of the posterior longitudinal ligament (OPLL, narrower foramina, laminectomy, and marked dorsal spinal cord drift. Miller et al. also identified an average $1918 increased cost for physical/occupational therapy for patients with C5 palsies. Conclusions: The incidence of C5 root deficits for anterior/posterior cervical surgery at C4-C5 was 12% in one series, and ranged up to 11.3% for laminectomies, while others cited 0-30%. Although identification of preoperative risk factors for C5 root deficits may help educate patients regarding these risks, there is no clear method for their avoidance at this time.

  4. Screening for cervical cancer: when theory meets reality

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    Nygård Mari

    2011-06-01

    Full Text Available Abstract Cervical cancer screening reduces morbidity and mortality due to cervical cancer. However, there are many factors that determine the success of any cervical cancer prevention effort: the prevalence of human papillomavirus infection in general population, the existence of an organized screening program and the corresponding coverage, the existence and quality of the field and laboratory facilities for screening and diagnostic follow-up, and the facilities available for treating diagnosed lesions. Monitoring the patient path or "chain of action" for each patient with an abnormal screening result is of crucial importance. Cost-effectiveness models are widely used by decision-makers to determine which cervical cancer screening program would maximize health benefits within a given, usually limited, set of resources. Regardless of their level of sophistication, however, these models cannot replace empirical evaluations of the effectiveness of screening programs. Cervical cancer prevention activities need to be monitored and evaluated in each country where they are introduced to see that they meet performance standards. Policy-makers responsible for allocating resources for cervical cancer prevention have a duty to allocate resources not only for cervical cancer screening, but also for screening program surveillance.

  5. Advancing cervical cancer prevention in India: implementation science priorities.

    Science.gov (United States)

    Krishnan, Suneeta; Madsen, Emily; Porterfield, Deborah; Varghese, Beena

    2013-01-01

    Cervical cancer is the leading cause of cancer mortality in India, accounting for 17% of all cancer deaths among women aged 30 to 69 years. At current incidence rates, the annual burden of new cases in India is projected to increase to 225,000 by 2025, but there are few large-scale, organized cervical cancer prevention programs in the country. We conducted a review of the cervical cancer prevention research literature and programmatic experiences in India to summarize the current state of knowledge and practices and recommend research priorities to address the gap in services. We found that research and programs in India have demonstrated the feasibility and acceptability of cervical cancer prevention efforts and that screening strategies requiring minimal additional human resources and laboratory infrastructure can reduce morbidity and mortality. However, additional evidence generated through implementation science research is needed to ensure that cervical cancer prevention efforts have the desired impact and are cost-effective. Specifically, implementation science research is needed to understand individual- and community-level barriers to screening and diagnostic and treatment services; to improve health care worker performance; to strengthen links among screening, diagnosis, and treatment; and to determine optimal program design, outcomes, and costs. With a quarter of the global burden of cervical cancer in India, there is no better time than now to translate research findings to practice. Implementation science can help ensure that investments in cervical cancer prevention and control result in the greatest impact.

  6. Connectivity-Based Segmentation for GPU-Accelerated Mesh Decompression

    Institute of Scientific and Technical Information of China (English)

    Jie-Yi Zhao; Min Tang; Ruo-Feng Tong

    2012-01-01

    We present a novel algorithm to partition large 3D meshes for GPU-accelerated decompression.Our formulation focuses on minimizing the replicated vertices between patches,and balancing the numbers of faces of patches for efficient parallel computing.First we generate a topology model of the original mesh and remove vertex positions.Then we assign the centers of patches using geodesic farthest point sampling and cluster the faces according to the geodesic distance to the centers.After the segmentation we swap boundary faces to fix jagged boundaries and store the boundary vertices for whole-mesh preservation.The decompression of each patch runs on a thread of GPU,and we evaluate its performance on various large benchmarks.In practice,the GPU-based decompression algorithm runs more than 48x faster on NVIDIA GeForce GTX 580 GPU compared with that on the CPU using single core.

  7. A critical review of physiological bubble formation in hyperbaric decompression.

    Science.gov (United States)

    Papadopoulou, Virginie; Eckersley, Robert J; Balestra, Costantino; Karapantsios, Thodoris D; Tang, Meng-Xing

    2013-05-01

    Bubbles are known to form in the body after scuba dives, even those done well within the decompression model limits. These can sometimes trigger decompression sickness and the dive protocols should therefore aim to limit bubble formation and growth from hyperbaric decompression. Understanding these processes physiologically has been a challenge for decades and there are a number of questions still unanswered. The physics and historical background of this field of study is presented and the latest studies and current developments reviewed. Heterogeneous nucleation is shown to remain the prime candidate for bubble formation in this context. The two main theories to account for micronuclei stability are then to consider hydrophobicity of surfaces or tissue elasticity, both of which could also explain some physiological observations. Finally the modeling relevance of the bubble formation process is discussed, together with that of bubble growth as well as multiple bubble behavior. PMID:23523006

  8. POST - OPERATIVE NEUROLOGICAL RECOVERY PATTERN IN DEGENERATIVE CERVICAL MYELOPATHY AND RADICULOPATHY

    Directory of Open Access Journals (Sweden)

    Raju B

    2015-07-01

    Full Text Available OBJECTIVE : To study the neurological recovery pattern and clinical recovery after surgical intervention in patients of degenerative cervical myelopathy and radiculopathy to know the surgical outcome, at L okmanya T ilak M unicipal M edical C ollege , Mumbai, Maharashtra . METHOD : We ca rried out prospective and retrospective observational study of 30 patients with functional disability secondary to cervical degenerative myelopathy and radiculopathy who underwent surgery for decompression of the cervical spinal cord with or without spinal stabilization. March 2012 to March 2013 were studied and followed for more than 1year. All patients were operated by a single surgeon and reviewed independently. All the patients had received appropriate conservative management before undergoing surgical intervention . Data was analysed by using appropriate software. RESULTS : The study group comprised of 27 males and 3 females aged between 36 and 75 years with a mean age of 56 years that presented with functional disability secondary to cervical myelopathy and radiculopathy. Pain and neurological examination were used as criteria at sequential follow – ups. Functional outcome was assessed using Japanese Orthopaedic Association score, Oswestry Disability Index and Visual Analogue Scale. It was found that neuro logical recovery for myelopathy by mJOA score at intervals between 15 days to 3 months was significant after which recovery was occurring but was not significant. Anterior cervical discectomy with fusion for 1 - 2 levels has given good results than posterior laminectomy for 3 or more levels. Cervical radiculopathy alone has good recovery results after decompression surgery than myelopathy or myelopathy with radiculopathy. CONCLUSION: Based on this study, we found that the results of surgery for cervical spon dylotic myelopathy and radiculopathy are excellent. The best neurological and functional recovery is seen in patients with mild to moderate

  9. Cervical instability in Klippel-Feil syndrome:case report and review of the literature

    Institute of Scientific and Technical Information of China (English)

    Aaron Wessell; Peter DeRosa; Abraham Cherrick; Jonathan H.Sherman

    2015-01-01

    Background: The authors present a case of cervical myelopathy and radiculopathy in the setting of multiple Klippel-Feil syndrome abnormalities treated surgically with a single-level C3-C4 anterior cervical discectomy and fusion.We discuss the clinical presentation, radiographic findings, and various treatment options for cervical spine abnormalities in Klippel-Feil syndrome.Case Presentation: This 22-year-old female with Klippel-Feil syndrome presented with intermittent neck pain, left upper extremity weakness, and paresthesias.Preoperative MRI, CT, and X-rays of the cervical spine revealed anterolisthesis at C3/4 with unstable movement on flexion and extension imaging.In addition, there were multiple segmental fusion abnormalities including hemivertebrae and other congenital fusion abnormalities.A C3-C4 anterior cervical discectomy and fusion was performed with intervertebral disc spacer.Adequate decompression was achieved with postoperative resolution of the patient's symptoms and improvement in neurological exam.Conclusions: Single-level anterior cervical discectomy and fusion can be utilized for treatment of cervical myelopathy and radiculopathy in the setting of multiple congenital Klippel-Feil syndrome abnormalities.

  10. Get Tested for Cervical Cancer

    Science.gov (United States)

    ... Cervical Cancer Print This Topic En español Get Tested for Cervical Cancer Browse Sections The Basics Overview ... be cured. How often should I get screened (tested)? How often you should get screened for cervical ...

  11. Cervical cancer - screening and prevention

    Science.gov (United States)

    Cancer cervix - screening; HPV - cervical cancer screening; Dysplasia - cervical cancer screening ... Almost all cervical cancers are caused by HPV (human papilloma virus). HPV is a common virus that spreads through sexual contact. Certain ...

  12. Treatment Option Overview (Cervical Cancer)

    Science.gov (United States)

    ... Cancer Prevention Cervical Cancer Screening Research Cervical Cancer Treatment (PDQ®)–Patient Version General Information About Cervical Cancer ... Certain factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery) depends on ...

  13. Reasons for revision surgery after orbital decompression for Graves’ orbitopathy

    Directory of Open Access Journals (Sweden)

    Stefano Sellari-Franceschini

    2008-06-01

    Full Text Available Stefano Sellari-Franceschini1, Luca Muscatello1, Veronica Seccia1, Riccardo Lenzi1, Amelia Santoro1, Marco Nardi2, Barbara Mazzi3, Aldo Pinchera3, Claudio Marcocci31Department of Neuroscience, 1st ENT division, 2Ophthalmology Division, 3Department of Endocrinology and Metabolism, Orthopaedics and Traumatology, Occupational Medicine, University of Pisa, ItalyObjectives: An analysis of complications and causes of failure in orbital decompression necessitating a second operation.Methods: Between December 1992 and April 2007, 375 patients (719 orbits were operated on using various techniques. Fourteen patients were initially operated on in our unit: 8 (group A1 were re-operated on after a short time due to complications connected with the decompression operation, 7 (group A2 were operated on after some time due to recurrence of the illness or unsatisfactory decompression (one patient is in both group A1 and A2. Five patients (group B underwent a first operation elsewhere.Results: For group A1 the most serious complications were connected to the nasal approach. For group A2 the operations were performed either because of a neuropathy recurrence or for further proptosis reduction due to recurrence or patient dissatisfaction. Lack of preoperative data hinders conclusions about group B, apart from one patient where the operation had not resolved a serious optic neuropathy after decompression based on Olivari technique combined with three-wall operation according to Mourits and colleagues (1990.Conclusions: We can deduce from group A1 that extreme attention is necessary during endonasal access, from group A2 that balancing the eyes is advisable, sacrificing maximum proptosis reduction to gain greater patient satisfaction, and from group B that decompression of the orbital apex is fundamental in the case of neuropathy.Keywords: orbital decompression, Graves’ orbitopathy, revision surgery

  14. Cervical Myelopathy Secondary to Atlanto-occipital Assimilation: The Usefulness of the Simple Decompressive Surgery

    OpenAIRE

    Kim, Kang Rae; Lee, Young Min; Kim, Young Zoon; Cho, Yong Woon; Kim, Joon Soo; Kim, Kyu Hong; Lee, In Chang

    2013-01-01

    Atlanto-occipital assimilation is one of the most common osseous anomalies observed at the craniocervical junction. Most patients with atlas assimilation show no symptom, but some have neurological problems such as myelopathy that may require surgical treatment. Occipitocervical fusion may be required if atlato-occipital assimilation is accompanied by occipito-axial instability. However, in cases of symptomatic atlas assimilation with minor cord compression without instability, simple decompr...

  15. Cervical chondroid chordoma in a standard dachshund: a case report

    Directory of Open Access Journals (Sweden)

    Stigen Øyvind

    2011-10-01

    Full Text Available Abstract A ten-year-old male standard dachshund was presented with a history of neck pain and progressive gait disturbances. Following a neurological examination and diagnostic imaging, including CT, a neoplastic lesion involving the third and fourth cervical vertebrae was suspected. The lesion included an extradural mass on the right side of the spinal canal causing a local compression of the cervical cord. Surgery, using a modified dorsal laminectomy procedure, was performed in order to decompress the cervical spinal cord. Histopathological examination of the extradural mass indicated that the tumour was a chondroid chordoma. Following discharge, the quality of life for the dog was very good for a sustained period, but clinical signs recurred at 22 months. The dog was euthanased 25 months post-surgery. On post-mortem examination, a regrowth of neoplastic tissue was found to have infiltrated the bone and spinal cord at C3-C4. This is the first report to show that palliative surgery can offer successful long-lasting treatment of chondroid chordoma of the cervical spine in the dog.

  16. Decompression surgery for spinal metastases: a systematic review.

    Science.gov (United States)

    Bakar, Dara; Tanenbaum, Joseph E; Phan, Kevin; Alentado, Vincent J; Steinmetz, Michael P; Benzel, Edward C; Mroz, Thomas E

    2016-08-01

    OBJECTIVE The aim of this study was to systematically review the literature on reported outcomes following decompression surgery for spinal metastases. METHODS The authors conducted MEDLINE, Scopus, and Web of Science database searches for studies reporting clinical outcomes and complications associated with decompression surgery for metastatic spinal tumors. Both retrospective and prospective studies were included. After meeting inclusion criteria, articles were categorized based on the following reported outcomes: survival, ambulation, surgical technique, neurological function, primary tumor histology, and miscellaneous outcomes. RESULTS Of the 4148 articles retrieved from databases, 36 met inclusion criteria. Of those included, 8 were prospective studies and 28 were retrospective studies. The year of publication ranged from 1992 to 2015. Study size ranged from 21 to 711 patients. Three studies found that good preoperative Karnofsky Performance Status (KPS ≥ 80%) was a significant predictor of survival. No study reported a significant effect of time-to-surgery following the onset of spinal cord compression symptoms on survival. Three studies reported improvement in neurological function following surgery. The most commonly cited complication was wound infection or dehiscence (22 studies). Eight studies reported that preoperative ambulatory or preoperative motor status was a significant predictor of postoperative ambulatory status. A wide variety of surgical techniques were reported: posterior decompression and stabilization, posterior decompression without stabilization, and posterior decompression with total or subtotal tumor resection. Although a wide range of functional scales were used to assess neurological outcomes, four studies used the American Spinal Injury Association (ASIA) Impairment Scale to assess neurological function. Four studies reported the effects of radiation therapy and local disease control for spinal metastases. Two studies reported that

  17. Cervical Total Disc Arthroplasty

    OpenAIRE

    Basho, Rahul; Hood, Kenneth A.

    2012-01-01

    Symptomatic adjacent segment degeneration of the cervical spine remains problematic for patients and surgeons alike. Despite advances in surgical techniques and instrumentation, the solution remains elusive. Spurred by the success of total joint arthroplasty in hips and knees, surgeons and industry have turned to motion preservation devices in the cervical spine. By preserving motion at the diseased level, the hope is that adjacent segment degeneration can be prevented. Multiple cervical disc...

  18. 人工颈椎间盘植入治疗颈椎病%Artificial cervical disc replacement in cervical spondylosis

    Institute of Scientific and Technical Information of China (English)

    王贵怀; 陈思源; 杨俊

    2009-01-01

    Objective Anterior cervical fusion has been a routine method for the surgical treatment of cervical spondylosis, but concerns for the possibility of acceleration of adjacentsegment disease after fusion have been growing. The artificial cervical disc replacement provides the opportunity to preserve motion after neural decompression while providing stability, which opens a new pathway for the surgical therapy of cervical spondylosis. Method We summarized the results of 16 patients of cervical herniated disc treated by artificial cervical disc replacement after cervical microdecompression and arthroplasty from December 2005 to March 2008. The average followup time was 17 momths. Results All patients got improved neurological function postoperatively. The cervical flextion and extention X - film showed good curvature and motion. 1 patient developed temporary hoarseness and recovered within 1 week. There was no other complications. Conclusions Cervical microdecompression with Bryan disc replacement is a good choice for adequate patient of cervical degenerative disc disease.%目的 颈椎病前路融合术后颈椎活动度下降与邻近节段椎间盘退变加速越来越受到人们的重视,人工颈椎间盘置换术可在进行脊髓减压并提供稳定的同时保持手术节段颈椎的活动度,为颈椎病的外科治疗开辟了新的途径.方法 自2005年12月至2008年3月,对16例颈椎病患者进行显微减压后椎间植入Bryan人工颈椎间盘,平均随访时间17个月.结果 所有患者术后症状均明显缓解,脊髓功能明显改善,颈椎活动度良好,1例术后发生短暂声音嘶哑,无手术死亡率.结论 人工颈椎间盘植入为颈椎病的外科治疗开辟了新的手段,在提供颈椎稳定的同时保持手术节段颈椎的良好活动度,把握严格的适应证和手术技术能取得满意的效果.

  19. Radicular Pain due to Subsidence of the Nitinol Shape Memory Loop for Stabilization after Lumbar Decompressive Laminectomy.

    Science.gov (United States)

    Son, Byung-Chul; Kim, Deog-Ryeong

    2015-01-01

    A number of dynamic stabilization systems have been used to overcome the problems associated with spinal fusion with rigid fixation recently and the demand for an ideal dynamic stabilization system is greater for younger patients with multisegment disc degeneration. Nitinol, a shape memory alloy of nickel and titanium, is flexible at low temperatures and regains its original shape when heated, and the Nitinol shape memory loop (SML) implant has been used as a posterior tension band mostly in decompressive laminectomy cases because the Nitinol implant has various characteristics such as high elasticity and a tensile force, flexibility, and biological compatibility. The reported short-term outcomes of the application of SMLs as posterior column supporters in cervical and lumbar decompressive laminectomies seem to be positive, and complications are minimal except for the rare occurrence of pullout and fracture of the SML. However, there was no report of neurological complications related to neural compression in spite of the use of the loop of SML in the epidural space. The authors report a case of delayed development of radiating pain caused by subsidence of the SML resulting epidural compression. PMID:25674347

  20. Preventing cervical cancer globally.

    Science.gov (United States)

    Schmeler, Kathleen M

    2012-11-01

    Cervical cancer is one of the leading causes of cancer and cancer-related deaths among women worldwide. More than 85% of cases and deaths occur in the developing world where the availability of effective screening is limited. In this issue of the journal, Pierce and colleagues (beginning on page 1273) describe a novel technique using a high-resolution microendoscope (HRME) to diagnose cervical dysplasia. This perspective reviews the limitations of existing cervical cancer screening methods currently in use in low-resource settings and the potential for HRME imaging to contribute to cervical cancer prevention in the developing world.

  1. Eruptive dynamics during magma decompression: a laboratory approach

    Science.gov (United States)

    Spina, L.; Cimarelli, C.; Scheu, B.; Wadsworth, F.; Dingwell, D. B.

    2013-12-01

    A variety of eruptive styles characterizes the activity of a given volcano. Indeed, eruptive styles can range from effusive phenomena to explosive eruptions, with related implications for hazard management. Rapid changes in eruptive style can occur during an ongoing eruption. These changes are, amongst other, related to variations in the magma ascent rate, a key parameter affecting the eruptive style. Ascent rate is in turn dependent on several factors such as the pressure in the magma chamber, the physical properties of the magma and the rate at which these properties change. According to the high number of involved parameters, laboratory decompression experiments are the best way to achieve quantitative information on the interplay of each of those factors and the related impact on the eruption style, i.e. by analyzing the flow and deformation behavior of the transparent volatile-bearing analogue fluid. We carried out decompression experiments following different decompression paths and using silicone oil as an analogue for the melt, with which we can simulate a range of melt viscosity values. For a set of experiments we added rigid particles to simulate the presence of crystals in the magma. The pure liquid or suspension was mounted into a transparent autoclave and pressurized to different final pressures. Then the sample was saturated with argon for a fixed amount of time. The decompression path consists of a slow decompression from the initial pressure to the atmospheric condition. Alternatively, samples were decompressed almost instantaneously, after established steps of slow decompression. The decompression path was monitored with pressure transducers and a high-speed video camera. Image analysis of the videos gives quantitative information on the bubble distribution with respect to depth in the liquid, pressure and time of nucleation and on their characteristics and behavior during the ongoing magma ascent. Furthermore, we also monitored the evolution of

  2. Airway management and morbid obesity

    DEFF Research Database (Denmark)

    Kristensen, Michael S

    2010-01-01

    Morbidly obese patients present with excess fatty tissue externally on the breast, neck, thoracic wall and abdomen and internally in the mouth, pharynx and abdomen. This excess tissue tends to make access (intubation, tracheostomy) to and patency (during sedation or mask ventilation) of the upper...

  3. Why do we need optic nerve decompression of traumatic optic neuropathy patients?

    OpenAIRE

    Seong Rok Han, M.D., Ph.D.

    2014-01-01

    Traumatic optic neuropathy can be treated by various methods including high-dose steroids and surgical decompression. Neurosurgical decompression could be required in patients with mechanical compression of the optic nerve by displaced orbital roof fracture fragments. We describe two patients of traumatic optic neuropathy due to orbital roof fracture who had improved pupil reflex and visual acuity after decompression of the optic nerve.

  4. Electrical Bioimpedance Analysis: A New Method in Cervical Cancer Screening

    OpenAIRE

    Lopamudra Das; Soumen Das; Jyotirmoy Chatterjee

    2015-01-01

    Cervical cancer is the second most common female cancer worldwide and a disease of concern due to its high rate of incidence of about 500,000 women annually and is responsible for about 280,000 deaths in a year. The mortality and morbidity of cervical cancer are reduced through mass screening via Pap smear, but this technique suffers from very high false negativity of around 30% to 40% and hence the sensitivity of this technique is not more than 60%. Electrical bioimpedance study employing cy...

  5. Decompression illness treated in Denmark 1999-2013

    DEFF Research Database (Denmark)

    Svendsen Juhl, Christian; Hedetoft, Morten; Bidstrup, Daniel;

    2016-01-01

    INTRODUCTION: The incidence, diver characteristics and symptomatology of decompression illness (DCI) in Denmark has not been assessed since 1982, and the presence of long-term residual symptoms among divers receiving hyperbaric oxygen therapy in Denmark has never been estimated to our knowledge. ...

  6. Treatment of atypical trigeminal neuralgia with microvascular decompression

    Directory of Open Access Journals (Sweden)

    Hai Jian

    2006-01-01

    Full Text Available Aim: To explore the methods for achieving pain relief in patients with atypical trigeminal neuralgia (TN using microvascular decompression (MVD. Study Design and Settings: Retrospective study of 26 patients treated during the years 2000 to 2004. Materials and Methods: Twenty-six patients in whom vascular compression of the trigeminal nerve was identified by high definition magnetic resonance tomographic angiography (MRTA were treated with MVD for atypical TN in our department. Clinical presentations, surgical findings and clinical outcomes were analyzed retrospectively. Results: In this study, single trigeminal division was involved in only 2 patients (8% and two or three divisions in the other 24 patients (92%. Of prime importance is the fact that in 46.2% of the patients, several conflicting vessels were found in association. Location of the conflicts around the circumference of the trigeminal root was supero-medial to the root in 53.5%, supero-lateral in 30.8% and inferior in 15.7%. MVD for atypical TN resulted in complete pain relief in 50% of the patients with complete decompression, partial pain relief in 30.8% and poor pain relief or pain recurrence in 19.2% of the patients without complete decompression postoperatively. Conclusions: Complete decompression of the entire trigeminal root plays an important role in achieving pain relief in patients with atypical TN with MVD.

  7. Microbubbles are detected prior to larger bubbles following decompression.

    Science.gov (United States)

    Swan, J G; Wilbur, J C; Moodie, K L; Kane, S A; Knaus, D A; Phillips, S D; Beach, T L; Fellows, A M; Magari, P J; Buckey, J C

    2014-04-01

    Using dual-frequency ultrasound (DFU), microbubbles (multiple sites, 2) appear in the presence and absence of bmdVGE, and 3) occur before bmdVGE. This supports the hypothesis that microbubbles precede larger VGE bubbles. Microbubble presence may be an early marker of decompression stress. Since DFU is a low-power ultrasonic method, it may be useful for operational diving applications.

  8. Radiological case: cervical teratoma

    OpenAIRE

    Macedo, F.

    2011-01-01

    We present a case of a third trimester fetus with a cervical mass. Fetal MRI was performed to better evaluate the extension of the mass and the risk of obstruction of the airway in the neonatal period. MRI is very useful in the evaluation of fetal cervical masses.

  9. CDC's Cervical Cancer Study

    Science.gov (United States)

    ... in Cancer Moonshot Stay Informed CDC’s Cervical Cancer Study Language: English Español (Spanish) Recommend on Facebook Tweet ... year. As part of CDC’s Cervical Cancer (Cx3) Study, we surveyed a sample of both health care ...

  10. Airway management in cervical spine ankylosing spondylitis: Between a rock and a hard place

    Directory of Open Access Journals (Sweden)

    Naveen Eipe

    2013-01-01

    Full Text Available We report the perioperative course of a patient with long standing ankylosing spondylitis with severe dysphagia due to large anterior cervical syndesmophytes at the level of the epiglottis. He was scheduled to undergo anterior cervical decompression and the surgical approach possibly precluded an elective pre-operative tracheostomy. We performed a modified awake fibreoptic nasal intubation through a split nasopharyngeal airway while adequate oxygenation was ensured through a modified nasal trumpet inserted in the other nares. We discuss the role of nasal intubations and the use of both the modified nasopharyngeal airways we used to facilitate tracheal intubation. This modified nasal fibreoptic intubation technique could find the application in other patients with cervical spine abnormalities and in other anticipated difficult airways.

  11. Alcohol abuse and postoperative morbidity

    DEFF Research Database (Denmark)

    Tønnesen, Hanne

    2003-01-01

    patients admitted to surgery should be offered a health promoting dialogue with the surgeon, anaesthesiologist, general practitioner, or other health professionals, which focuses on alcohol among other risk factors in relation to the operative treatment, diagnosis and prognosis. A beneficial effect......Patients who drink too much have more complications after surgery. The aim of this thesis was to evaluate the evidence, possible mechanisms, and prevention of the increased postoperative morbidity in alcohol abusers, defined by a consumption of at least five drinks per day. The literature could...... be criticised for several methodological flaws. Nevertheless, the results are in agreement showing moderate to strong evidence of increased postoperative morbidity after surgical procedures on alcohol abusers. There is weak to moderate evidence of increased postoperative mortality, hospital stay, and re...

  12. Neurosurgery in morbidly obese patients

    Directory of Open Access Journals (Sweden)

    S Mohanaselvi

    2016-01-01

    Full Text Available Obesity has significant impact on various organ systems of the body and thus needs a well-planned anaesthetic management. Obese patients with multiple co morbidities are expected to have more complications than normal individuals. Obesity may influence the risk of aneurysm formation and rupture and/or the outcome of patients who have aneurysmal SAH. Most of the neurosurgeries require different patient positions for adequate exposure of surgical site. Moreover morbidly obese patient means a huge and heavy patient who will require bigger operating table and other accessories and their implications. Confusion regarding the risks and benefits of mechanical and pharmacological prophylaxis in neurosurgical patients for DVT with risks of major and minor haemorrhage still persists. The anesthetic concerns in an obese patient undergoing neurosurgery have not been studied so far. This review aims in discussing obesity in neurosurgical patients.

  13. Alcohol abuse and postoperative morbidity

    DEFF Research Database (Denmark)

    Tønnesen, Hanne

    2003-01-01

    Patients who drink too much have more complications after surgery. The aim of this thesis was to evaluate the evidence, possible mechanisms, and prevention of the increased postoperative morbidity in alcohol abusers, defined by a consumption of at least five drinks per day. The literature could...... be criticised for several methodological flaws. Nevertheless, the results are in agreement showing moderate to strong evidence of increased postoperative morbidity after surgical procedures on alcohol abusers. There is weak to moderate evidence of increased postoperative mortality, hospital stay, and re......-operation. The personal and economic consequences are tremendous. The incidence of alcohol abusers undergoing surgery was 7% to 49%, according to gender and diagnosis. They have been identified by a self-reported alcohol intake, which implies the possibility of underestimation. Alcohol markers could be used for a more...

  14. Misdiagnosed bilateral C5-C6 dislocation causing cervical spine instability: a case report

    OpenAIRE

    Gelalis, Ioannis D.; Christoforou, Georgios; Arnaoutoglou, Christina M.; Politis, Angelos N.; Manoudis, Gregory; Xenakis, Theodoros A

    2009-01-01

    Introduction The diagnosis of cervical spine injuries remains a significant problem in many blunt trauma patients. Correct and early diagnosis of these injuries is imperative as delayed or missed diagnoses result in increased morbidity and mortality. Case presentation A 57-year-old Caucasian woman presented with a misdiagnosed bilateral C5-C6 dislocation one month after a fall and head injury, without clearance of the cervical spine in her previous visits to two physicians and having already ...

  15. Removal versus preservation of the posterior longitudinal ligament in Bryan cervical disc arthroplasty

    Institute of Scientific and Technical Information of China (English)

    YANG Da-long; DING Wen-yuan; ZHANG Ying-ze; ZHANG Wei; XU Jia-xin; SHEN Yong

    2013-01-01

    Background Bryan cervical disc arthroplasty can be used to restore and maintain the mobility and function of the involved cervical spinal segments.The efficiency of posterior longitudinal ligament (PLL) resection in anterior cervical decompression and fusion has been demonstrated.However,no clinical reports have compared PLL removal with preservation in Bryan cervical disc arthroplasty.This study aimed to assess the role of removal of PLL in Bryan cervical disc arthroplasty at an 18-month follow-up.Methods We performed a prospective investigation of clinical and radiological outcomes in patients after Bryan cervical disc arthroplasty.Sixty patients who underwent Bryan cervical disc arthroplasty were included.The PLL was removed in 35 patients (investigational group) and preserved in 25 patients (control group).All of the patients were followed up for more than 18 months.Clinical (Japanese Orthopedic Association score and Visual Analogue Scale pain score) and radiological (functional spinal unit (FSU) angle,range of movement (ROM),and diameter of the spinal cord) parameters were compared between the two groups before and after surgery (18 months).Results Clinical outcomes in the investigational group were significantly superior to those in the control group.There were no significant differences in the FSU angle and ROM (P=-0.41 and 0.16,respectively) between the two groups.However,the increase in diameter of the spinal cord in the investigational group was significantly greater than that in the control group (P <0.01).Conclusions Removal of the PLL can improve the clinical outcomes of Bryan cervical disc arthroplasty.This procedure does not have a large effect on imbalance and motion of the cervical spine.

  16. Criteria for preferring anterior approach in surgical treatment of cervical spondylotic myeloradiculopathy

    Directory of Open Access Journals (Sweden)

    Yurdal Gezercan

    2014-08-01

    Full Text Available Cervical spondylosis is a progressive, chronic and insidious degenerative disease, which origins from the cervical intervertebral disc and then diffuses to surrounding bony and soft tissues. If the spine and nerve roots are involved due to degenerative changes, this is called as cervical spondylotic myeloradiculopathy (CSMR and it is the most frequent cause of myelopathy over age of 50. Cases with progressive character and functional neurological deficits and cases with a prolonged course refractory to conservative therapy shall be treated surgically. The aim of the surgical treatment is to relieve the pressure on the spinal cord and nerve roots, to preserve the proper anatomical alignment of the cervical vertebrae or to reestablish correct anatomical positioning if it is distorted and lastly to increase the life quality by relieving patients neurological signs and complaints. While achieving these goals, complications shall be avoided as much as possible. These goals can be accomplished by anterior or posterior surgical approaches to the cervical vertebrae. The style of the surgical approach can only be decided by a detailed evaluation of the patient's clinical and radiological features. The utmost aim of the surgical procedure, which is to achieve sufficient neurological decompression and to preserve/establish proper cervical vertebral alignment, can be provided best by anterior approaches. In our current study, the criteria to prefer anterior approach in surgical treatment of CSMR will be reviewed. [Cukurova Med J 2014; 39(4.000: 669-678

  17. Indication for the operative methods in surgical treatment of cervical spondylotic myelopathy

    International Nuclear Information System (INIS)

    Indication for the operative methods for cervical spondylotic myelopathy was examined in 16 patients undergoing CT-myelography before and after operation. There was a highly significant correlation between the anteroposterior (A-P) diameter of the spinal cord and clinical symptoms. Patients with shorter A-P diameter of the spinal cord tended to have severer preoperative clinical symptoms. Clinical symptoms improved as the post operative A-P diameter of the spinal cord increased. Fixation with decompression of the anterior spinal cord should be indicated when constriction of 5 mm or less of the spinal cord is seen segmentally at the level of the intervertebral disc. Dilation of the spinal cavity should be indicated when the constriction of the spinal cord is 5 mm or less at all levels of the cervical spinal cord. In performing fixation with anterior decompression, 15 mm is considered to be the most suitable width for complete and safe decompression of the flattened spinal cord with a wide transverse diameter. (Namekawa, K)

  18. MRI and PET Imaging in Predicting Treatment Response in Patients With Stage IB-IVA Cervical Cancer

    Science.gov (United States)

    2016-06-24

    Cervical Adenocarcinoma; Cervical Adenosquamous Carcinoma; Cervical Squamous Cell Carcinoma; Cervical Undifferentiated Carcinoma; Recurrent Cervical Carcinoma; Stage IB2 Cervical Cancer; Stage IIA Cervical Cancer; Stage IIB Cervical Cancer; Stage IIIA Cervical Cancer; Stage IIIB Cervical Cancer; Stage IVA Cervical Cancer

  19. The clinical efficacy and prognosis of hemisphere skull bone flap decompression and mild hypothermia treatment for severe craniocerebral trauma

    Directory of Open Access Journals (Sweden)

    YANG Hua-tang

    2013-10-01

    Full Text Available In this study, 1626 patients with severe craniocerebral trauma were assessed by Glasgow Coma Scale (GCS, 886 patients of 3-5 score and 740 of 6-8 score. Patients were divided into 2 groups. Ninety hundred and eleven patients (496 of 3-5 score and 415 of 6-8 score underwent hemisphere calvarial bone flap decompression with auxiliary mild hypothermia (experiment group, and 715 patients (390 of 3-5 score and 325 of 6-8 score underwent traditional frontal, temporal, parietal large traumatic craniotomy (control group. After operation the treatment of 2 groups was basically the same. Compared with control group, the intracranial pressure of experiment group on the 1st, 3rd, 5th and 7th days after surgery decreased significantly (P < 0.05, for all; the consciousness recovery time was significantly shorter (P < 0.05, for all; the prognosis after 3 months was better (P < 0.05, for all. Hemisphere calvarial bone flap decompression with auxiliary mild hypothermia treatment could significantly reduce the morbidity and mortality, and improve the quality of life and prognosis of patients with severe craniocerebral trauma.

  20. Human papillomavirus vaccination in the prevention of cervical neoplasia.

    LENUS (Irish Health Repository)

    Astbury, Katharine

    2012-02-01

    Cervical cancer remains a major cause of morbidity and mortality for women worldwide. Although the introduction of comprehensive screening programs has reduced the disease incidence in developed countries, it remains a major problem in the developing world. The recent licensing of 2 vaccines against human papillomavirus (HPV) type 16 and HPV-18, the viruses responsible for 70% of cervical cancer cases, offers the hope of disease prevention. In this article, we review the role of HPV in the etiology of cervical cancer and the evidence to support the introduction of vaccination programs in young women and discuss the potential obstacles to widespread vaccination. In addition, we discuss the issues that remain to be elucidated, including the potential need for booster doses of the vaccine and the role of concomitant vaccination in men.

  1. Clinical Application Of Locking Cervical lntervertebral Fusion Cage In Unisegmental Intervertebral Disk Hernia Of Cervical Vertebrae%锁定式颈椎融合器治疗单节段颈椎问盘突出症

    Institute of Scientific and Technical Information of China (English)

    范磊; 何斌; 邵增务; 王云华

    2011-01-01

    目的 探讨应用颈椎前路减压结合锁定式颈椎融合器治疗单节段颈椎间盘突出症的临床疗效.方法 21例单节段颈椎间盘突出症应用颈椎前路减压加锁定式颈椎融合器植骨融合术治疗,并对其疗效进行评价.结果 所有病例随访12~24个月,平均17.6个月.6个月后椎体间均达到骨性融合,无并发症出现,脊髓功能状态评分术后1个月及术后6个月优良率分别达66.67%、85.71%.结论 应用颈椎前路减压结合锁定式颈椎融合器治疗单节段颈椎间盘突出症疗效肯定.%Objective To evaluate the clinic curative effect of anterior cervical decompression and implantation of cervical intervertebral fusion cage in the treatment of unisegmental intervertebral disk hernia of cervical vertebrae. Methods 21 cases of unisegmental intervertebral disk hernia of cervical vertebrae were treated with anterior cervical decompression and implantation of locking cervical Intervertebral fusion cage and the curative effect was evaluated. Results All cases were followed up for 12~24 months (17. 6 months in average). All patients gained osseous fusion 6 monthes after the operation and there was no complication. According to the functional status score of spinal cord. The fineness rate was 66. 67% 1 month after the operation and 85. 71% 6 monthes after the operation. Conclusion The curative effect of the treatment of unisegmental intervertebral disk hernia of cervical vertebrae anterior cervical decompression and implantation of locking cervical Intervertebral fusion cage was affirmative.

  2. Acute obstructive hydrocephalus complicating decompression surgery of the craniovertebral junction

    Science.gov (United States)

    Ohya, Junichi; Chikuda, Hirotaka; Nakatomi, Hirofumi; Sakamoto, Ryuji; Saito, Nobuhito; Tanaka, Sakae

    2016-01-01

    Obstructive hydrocephalus has been described as a rare complication following foramen magnum decompression for Chiari malformation. However, there are few reports of obstructive hydrocephalus after spinal surgery for other pathologies of the craniovertebral junction (CVJ). The authors herein report a 52-year-old female with achondroplasia presenting with an 8-month history of myelopathy due to spinal cord compression at CVJ. She underwent resection of the C1 posterior arch and part of the edge of the occipital bone. A computed tomography (CT) scan obtained 1-week after the surgery revealed bilateral infratentorial fluid collection. The patient was first managed conservatively; however, on the 17th day, her consciousness level showed sudden deterioration. Emergency CT demonstrated marked hydrocephalus due to obstruction of the cerebral aqueduct. Acute obstructive hydrocephalus can occur late after decompression surgery at the CVJ, and thus should be included in the differential diagnosis of a deteriorating mental status. PMID:27366268

  3. Ondine's curse after posterior fossa decompression: report of one case

    Institute of Scientific and Technical Information of China (English)

    XU Lun-shan; XU Min-hui

    2001-01-01

    A case of Ondine's curse after posterior fossa decompression was reported. A 33-year-old woman was admitted complaining 2 years of dizziness and progressive worsening of gait disturbances, and 1year of repetitively ictal nausea. The diagnosis of Arnold-Chiari malformations was established. Results: The patient underwent suboccipital craniectomy and C1-3 laminectomy. In addition to this decompression measure, a fascial graft was sutured between the edges of the dural incision. Postoperatively, the patient lost automatic control of her respiration during sleep and became hypercapnic and hypoxemic. Assisted ventilation was initiated. Conclusion: Ondine's curse is possibly due to insensitivity of central chemoreceptors to carbon dioxide resulting in defective control of minute ventilation.Propofol is not recommended in cases of Ondine's curse, and assisted ventilation until the restoration of automatic control of respiration can be of value. Oxygen inspiration alone is rather harmful than beneficial.

  4. Natural gas decompression energy recovery: Energy savings potential in Italy

    International Nuclear Information System (INIS)

    This paper surveyed the natural gas distribution systems employed in the Italian civil, industrial and thermoelectric sectors to identify those installations which can make use of gas decompression energy recovery systems (consisting of turbo-expanders or alternative expanders) to economically generate electric power. Estimates were then made of the total amount of potential energy savings. The study considered as eligible for energy savings interventions only those plants with a greater than 5,000 standard cubic meter per hour plant capacity. It was evaluated that, with suitable decompression equipment installed at 50 key installations (33 civil, 15 industrial), about 200 GWh of power could be produced annually, representing potential savings of about 22,000 petroleum equivalent tonnes of energy. A comparative analysis was done on three investment alternatives involving inputs of varying amounts of Government financial assistance

  5. A New Basis of Geoscience: Whole-Earth Decompression Dynamics

    CERN Document Server

    Herndon, J Marvin

    2013-01-01

    Neither plate tectonics nor Earth expansion theory is sufficient to provide a basis for understanding geoscience. Each theory is incomplete and possesses problematic elements, but both have served as stepping stones to a more fundamental and inclusive geoscience theory that I call Whole-Earth Decompression Dynamics (WEDD). WEDD begins with and is the consequence of our planet's early formation as a Jupiter-like gas giant and permits deduction of:(1) Earth's internal composition, structure, and highly-reduced oxidation state; (2) Core formation without whole-planet melting; (3) Powerful new internal energy sources - proto-planetary energy of compression and georeactor nuclear fission energy; (4) Georeactor geomagnetic field generation; (5) Mechanism for heat emplacement at the base of the crust resulting in the crustal geothermal gradient; (6) Decompression driven geodynamics that accounts for the myriad of observations attributed to plate tectonics without requiring physically-impossible mantle convection, an...

  6. Doppler bubble detection and decompression sickness: a prospective clinical trial.

    Science.gov (United States)

    Bayne, C G; Hunt, W S; Johanson, D C; Flynn, E T; Weathersby, P K

    1985-09-01

    Decompression sickness in human beings exposed to high ambient pressure is thought to follow from gas bubble formation and growth in the body during return to low pressure. Detection of Doppler-shifted ultrasonic reflections in major blood vessels has been promoted as a noninvasive and sensitive indicator of the imminence of decompression sickness. We have conducted a double-blind, prospective clinical trial of Doppler ultrasonic bubble detection in simulated diving using 83 men, of whom 8 were stricken and treated for the clinical disease. Diagnosis based only on the Doppler signals had no correlation with clinical diagnosis. Bubble scores were only slightly higher in the stricken group. The Doppler technique does not appear to be of diagnostic value in the absence of other clinical information.

  7. Airway management and morbid obesity

    DEFF Research Database (Denmark)

    Kristensen, Michael S

    2010-01-01

    airway and the function of the lungs (decreased residual capacity and aggravated ventilation perfusion mismatch) worse than in lean patients. Proper planning and preparation of airway management is essential, including elevation of the patient's upper body, head and neck. Preoxygenation is mandatory...... solely on whether morbid obesity is present or not. It is important to ensure sufficient depth of anaesthesia before initiating manipulation of the airway because inadequate anaesthesia depth predisposes to aspiration if airway management becomes difficult. The intubating laryngeal mask airway is more...

  8. Liver morphology in morbid obesity

    DEFF Research Database (Denmark)

    Andersen, T; Gluud, C

    1984-01-01

    Literature on liver morphology in untreated obesity reveals varying prevalences of various pathological findings. The purpose of this literature study was to summarize and evaluate the published observations and to discuss discrepant findings. A complete search was aimed at utilizing bibliographic...... methods including a computerized survey. Forty-one original articles were included, comprising information on liver morphology in 1515 morbidly obese patients. Liver biopsy was considered normal in 12 per cent of the cases. The most frequent abnormality reported was fatty change, present in 80 per cent...

  9. “Fast Track” nasogastric decompression of rectal cancer surgery

    Institute of Scientific and Technical Information of China (English)

    Ka Li; Zongguang Zhou; Zengrong Chen; Yi Zhang; Cun Wang

    2011-01-01

    This study evaluates the application of fast track (FT) nasogastric decompression in patients who underwent anterior resection of rectal cancer.A randomized control trial was performed comparing the group with the fast track treatment (n =57) and the group with traditional nasogastric decompression (n =84).Preoperative characteristics and postoperative recovery indices were recorded and analyzed.The results indicate no significant differences in gender (P =0.614),age (P =0.653),tumor location (P =0.113),and TNM stages (P =0.054) were observed between the 2 groups.The differences in the type of resection,anastomosis,and adoption of protective colostomy were all not significant between the FT and the traditional group.During the first 24 hours after surgery,the volume of nasogastric drainage averaged 197 ml in the FT group and 155 ml in the traditional group (P =0.197).The initiation of test-meal (P =0.000),semiliquid diet (P =0.002),and ordinary diet (P =0.008)were all significantly shorter in the FT group.Furthermore,compared with the other group,the patients in the FT group enjoyed earlier removal of the abdominal drainage,urinary catheter,and shorter hospital stays (P =0.000).Based on a correlation test,the duration of nasogastric decompression is related to the time of test-meal and semiliquid diet.The routine usage of nasogastric decompression in rectal surgery is unnecessary.The fast track procedure might help in facilitating postoperative functional and diet recovery,reducing the time of catheterization,and shortening hospital stay.

  10. Immunotherapy for Cervical Cancer

    Science.gov (United States)

    In an early phase NCI clinical trial, two patients with metastatic cervical cancer had a complete disappearance of their tumors after receiving treatment with a form of immunotherapy called adoptive cell transfer.

  11. Rapid decompression and desorption induced energetic failure in coal

    Directory of Open Access Journals (Sweden)

    Shugang Wang

    2015-06-01

    Full Text Available In this study, laboratory experiments are conducted to investigate the rapid decompression and desorption induced energetic failure in coal using a shock tube apparatus. Coal specimens are recovered from Colorado at a depth of 610 m. The coal specimens are saturated with the strong sorbing gas CO2 for a certain period and then the rupture disc is suddenly broken on top of the shock tube to generate a shock wave propagating upwards and a rarefaction wave propagating downwards through the specimen. This rapid decompression and desorption has the potential to cause energetic fragmentation in coal. Three types of behaviors in coal after rapid decompression are found, i.e. degassing without fragmentation, horizontal fragmentation, and vertical fragmentation. We speculate that the characteristics of fracture network (e.g. aperture, spacing, orientation and stiffness and gas desorption play a role in this dynamic event as coal can be considered as a dual porosity, dual permeability, dual stiffness sorbing medium. This study has important implications in understanding energetic failure process in underground coal mines such as coal gas outbursts.

  12. Rapid decompression and desorption induced energetic failure in coal

    Institute of Scientific and Technical Information of China (English)

    Shugang Wang a; Derek Elsworth a; Jishan Liu b

    2015-01-01

    In this study, laboratory experiments are conducted to investigate the rapid decompression and desorption induced energetic failure in coal using a shock tube apparatus. Coal specimens are recovered from Colorado at a depth of 610 m. The coal specimens are saturated with the strong sorbing gas CO2 for a certain period and then the rupture disc is suddenly broken on top of the shock tube to generate a shock wave propagating upwards and a rarefaction wave propagating downwards through the specimen. This rapid decompression and desorption has the potential to cause energetic fragmentation in coal. Three types of behaviors in coal after rapid decompression are found, i.e. degassing without fragmen-tation, horizontal fragmentation, and vertical fragmentation. We speculate that the characteristics of fracture network (e.g. aperture, spacing, orientation and stiffness) and gas desorption play a role in this dynamic event as coal can be considered as a dual porosity, dual permeability, dual stiffness sorbing medium. This study has important implications in understanding energetic failure process in under-ground coal mines such as coal gas outbursts.

  13. Interspinous Process Decompression: Expanding Treatment Options for Lumbar Spinal Stenosis

    Directory of Open Access Journals (Sweden)

    Pierce D. Nunley

    2016-01-01

    Full Text Available Interspinous process decompression is a minimally invasive implantation procedure employing a stand-alone interspinous spacer that functions as an extension blocker to prevent compression of neural elements without direct surgical removal of tissue adjacent to the nerves. The Superion® spacer is the only FDA approved stand-alone device available in the US. It is also the only spacer approved by the CMS to be implanted in an ambulatory surgery center. We computed the within-group effect sizes from the Superion IDE trial and compared them to results extrapolated from two randomized trials of decompressive laminectomy. For the ODI, effect sizes were all very large (>1.0 for Superion and laminectomy at 2, 3, and 4 years. For ZCQ, the 2-year Superion symptom severity (1.26 and physical function (1.29 domains were very large; laminectomy effect sizes were very large (1.07 for symptom severity and large for physical function (0.80. Current projections indicate a marked increase in the number of patients with spinal stenosis. Consequently, there remains a keen interest in minimally invasive treatment options that delay or obviate the need for invasive surgical procedures, such as decompressive laminectomy or fusion. Stand-alone interspinous spacers may fill a currently unmet treatment gap in the continuum of care and help to reduce the burden of this chronic degenerative condition on the health care system.

  14. Decompression of the facial nerve in cases of hemifacial spasm

    Directory of Open Access Journals (Sweden)

    Karsten Kettel

    1954-12-01

    Full Text Available Among 11 patients a complete cure was obtained in one case, a fair result in 4 cases, while in 6 cases the effect of the operation has only been temporary and full recurrence has taken place. Even if decompression has thus resulted in a few recoveries and improvements, the results in the majority of cases have been disappointing. Everything points to hemifacial spasm being due to a disorder of the lower motor neuron. Intracranial lesions in the vicinity of the facial nerve are known to have resulted in irritation and spasm. It may be perfectly true that the majority of cases of hemifacial spasm are due to a lesion, the nature of which may vary, in the Fallopian canal near the stylomastoid foramen, not least the postparalytic following Bell's palsy. But the disappointing results of decompression seems to indicate that at the time of operation irreparable damage to the nerve has in the majority of cases been already done. Consequently I gave up decompression in cases of hemifacial spasm some years ago. Good results from injections of alcohol into the nerve have been reported13 but I prefer selective sections of the branches to the muscles involved as described by German and Greenwood8.

  15. Influence of repeated daily diving on decompression stress.

    Science.gov (United States)

    Zanchi, J; Ljubkovic, M; Denoble, P J; Dujic, Z; Ranapurwala, S; Pollock, N W

    2014-06-01

    Acclimatization (an adaptive change in response to repeated environmental exposure) to diving could reduce decompression stress. A decrease in post-dive circulating venous gas emboli (VGE or bubbles) would represent positive acclimatization. The purpose of this study was to determine whether four days of daily diving alter post-dive bubble grades. 16 male divers performed identical no-decompression air dives on 4 consecutive days to 18 meters of sea water for 47 min bottom times. VGE monitoring was performed with transthoracic echocardiography every 20 min for 120 min post-dive. Completion of identical daily dives resulted in progressively decreasing odds (or logit risk) of having relatively higher grade bubbles on consecutive days. The odds on Day 4 were half that of Day 1 (OR 0.50, 95% CI: 0.34, 0.73). The odds ratio for a >III bubble grade on Day 4 was 0.37 (95% CI: 0.20, 0.70) when compared to Day 1. The current study indicates that repetitive daily diving may reduce bubble formation, representing a positive (protective) acclimatization to diving. Further work is required to evaluate the impact of additional days of diving and multiple dive days and to determine if the effect is sufficient to alter the absolute risk of decompression sickness.

  16. Protective effects of fluoxetine on decompression sickness in mice.

    Directory of Open Access Journals (Sweden)

    Jean-Eric Blatteau

    Full Text Available Massive bubble formation after diving can lead to decompression sickness (DCS that can result in central nervous system disorders or even death. Bubbles alter the vascular endothelium and activate blood cells and inflammatory pathways, leading to a systemic pathophysiological process that promotes ischemic damage. Fluoxetine, a well-known antidepressant, is recognized as having anti-inflammatory properties at the systemic level, as well as in the setting of cerebral ischemia. We report a beneficial clinical effect associated with fluoxetine in experimental DCS. 91 mice were subjected to a simulated dive at 90 msw for 45 min before rapid decompression. The experimental group received 50 mg/kg of fluoxetine 18 hours before hyperbaric exposure (n = 46 while controls were not treated (n = 45. Clinical assessment took place over a period of 30 min after surfacing. At the end, blood samples were collected for blood cells counts and cytokine IL-6 detection. There were significantly fewer manifestations of DCS in the fluoxetine group than in the controls (43.5% versus 75.5%, respectively; p = 0.004. Survivors showed a better and significant neurological recovery with fluoxetine. Platelets and red cells were significantly decreased after decompression in controls but not in the treated mice. Fluoxetine reduced circulating IL-6, a relevant marker of systemic inflammation in DCS. We concluded that fluoxetine decreased the incidence of DCS and improved motor recovery, by limiting inflammation processes.

  17. Co-morbidities in heart failure

    NARCIS (Netherlands)

    van Deursen, Vincent M.; Damman, Kevin; van der Meer, Peter; Wijkstra, Peter J.; Luijckx, Gert-Jan; van Beek, Andre; van Veldhuisen, Dirk J.; Voors, Adriaan A.

    2014-01-01

    Heart failure is a clinical syndrome characterized by poor quality of life and high morbidity and mortality. Co-morbidities frequently accompany heart failure and further decrease in both quality of life and clinical outcome. We describe that the prevalence of co-morbidities in patients with heart f

  18. The benefits of reduced morbidity

    International Nuclear Information System (INIS)

    Morbidity benefits refer to increases in utility arising from reductions in incidents of acute health impairments and from increases in the probability of developing chronic diseases. The impairments would run the gamut from a cough-day to a bed-disability-day, while the chronic diseases include classic pollution-related diseases, such as cancer, to in utero effects and learning disabilities. As with mortality benefits, there could be benefits to oneself and family and friends as well as benefits based on altruism. A major difference between the mortality and morbidity valuation literatures is that while estimates of the former are always based on risk (one is never trying to obtain values for avoiding certain death), estimates of the latter generally are not. That is, most of the theory and empirical estimates are based on models where the effect to be avoided is certain. This assumption holds reasonably well for estimating common acute effects, for example, the willingness to pay (WTP) for one less cough-day. It works less well, if at all, for chronic illness endpoints, where benefits seem to be appropriately expressed in terms of reduced risk of developing a disease or impairment

  19. [Combined surgical and physical treatment in traumatic painful syndromes of the cervical spine].

    Science.gov (United States)

    Stachowski, B; Kaczmarek, J; Nosek, A; Kocur, L

    1976-01-01

    Clinical observations suggest the need for changing therapeutic management to a more active one in cases of cervical spine injury with damage to the spinal cord and nerve roots or brachial plexus. In 248 patients with these injuries treated initially conservatively the incidence of cervicobrachial pain was analysed. Neuralgic pains were present in 31.5% of cases, causalgic pains in 2.4% and sympathalgic pains in 2%. Conservative treatment conducted in these patients (89 cases) during many months after trauma had no effect on return of mobility. Long-term application of physioterapy prevented only temporarily the development of trophic changes and only partially relieved pains. Only surgical decompression of the spinal cord or spinal nerves with stabilization of damaged vertebrae caused disappearance of painful syndromes and improvement in the motor activity of the extremities. These observations show that early surgical intervention for decompression of the spinal cord, roots or brachial plexus should be advocated in these cases.

  20. [Combined surgical and physical treatment in traumatic painful syndromes of the cervical spine].

    Science.gov (United States)

    Stachowski, B; Kaczmarek, J; Nosek, A; Kocur, L

    1976-01-01

    Clinical observations suggest the need for changing therapeutic management to a more active one in cases of cervical spine injury with damage to the spinal cord and nerve roots or brachial plexus. In 248 patients with these injuries treated initially conservatively the incidence of cervicobrachial pain was analysed. Neuralgic pains were present in 31.5% of cases, causalgic pains in 2.4% and sympathalgic pains in 2%. Conservative treatment conducted in these patients (89 cases) during many months after trauma had no effect on return of mobility. Long-term application of physioterapy prevented only temporarily the development of trophic changes and only partially relieved pains. Only surgical decompression of the spinal cord or spinal nerves with stabilization of damaged vertebrae caused disappearance of painful syndromes and improvement in the motor activity of the extremities. These observations show that early surgical intervention for decompression of the spinal cord, roots or brachial plexus should be advocated in these cases. PMID:980212

  1. Clinical features, outcome and risk factors in cervical cancer patients after surgery for chronic radiation enteropathy

    International Nuclear Information System (INIS)

    Radical hysterectomy and radiotherapy have long been mainstays of cervical cancer treatment. Early stage cervical cancer (FIGO stage IB1–IIA) is traditionally treated using radical surgery combined with radiotherapy, while locally advanced cervical cancer is treated using radiotherapy alone or chemoradiotherapy. In this retrospective study, we describe and analyse the presenting clinical features and outcomes in our cohort and evaluate possible risk factors for postoperative morbidity in women who underwent surgery for chronic radiation enteropathy (CRE). One hundred sixty-six eligible cervical cancer patients who underwent surgery for CRE were retrospectively identified between September 2003 and July 2014 in a prospectively maintained database. Among them, 46 patients received radical radiotherapy (RRT) and 120 received radical surgery plus radiotherapy (RS + RT). Clinical features, postoperative morbidity and mortality, and risk factors for postoperative morbidity were analysed. RS + RT group patients were more likely to present with RTOG/EORTC grade III late morbidity (76.1 % vs 92.5 %; p = 0.004), while RRT group patients tended to show RTOG/EORTC grade IV late morbidity (23.9 % vs 7.5 %; p = 0.004). One hundred forty patients (84.3 %) were treated with aggressive resection (anastomosis 57.8 % and stoma 26.5 %). Overall and major morbidity, mortality and incidence of reoperation in the RRT and RS + RT groups did not differ significantly (63 % vs 64.2 % [p = 1.000], 21.7 % vs 11.7 % [p = 0.137], 6.5 % vs 0.8 % [p = 0.065] and 6.5 % vs 3.3 % [p = 0.360], respectively). However, incidence of permanent stoma and mortality during follow-up was higher in the RRT group than in the RS + RT group (44.2 % vs 12.6 % [p = 0.000] and 16.3 % vs 3.4 % [p = 0.004], respectively). In multivariate analysis, preoperative anaemia was significantly associated with overall morbidity (p = 0.015), while severe intra-abdominal adhesion (p = 0.017), ASA grades III–V (P = 0

  2. Surgical treatment for ossification of the posterior longitudinal ligament in the cervical spine.

    Science.gov (United States)

    An, Howard S; Al-Shihabi, Laith; Kurd, Mark

    2014-07-01

    Although classically associated with patients of East Asian origin, ossification of the posterior longitudinal ligament (OPLL) may cause myelopathy in patients of any ethnic origin. Degeneration of the PLL is followed by endochondral ossification, resulting in spinal cord compression. Specific genetic polymorphisms and medical comorbidities have been implicated in the development of OPLL. Patients should be evaluated with a full history and neurologic examination, along with cervical radiographs. Advanced imaging with CT and MRI allows three-dimensional evaluation of OPLL. Minimally symptomatic patients can be treated nonsurgically, but patients with myelopathy or severe stenosis are best treated with surgical decompression. OPLL can be treated via an anterior (ie, corpectomy and fusion) or posterior (ie, laminectomy and fusion or laminoplasty) approach, or both. The optimal approach is dictated by the classification and extent of OPLL, cervical spine sagittal alignment, severity of stenosis, and history of previous surgery. Anterior surgery is associated with superior outcomes when OPLL occupies >50% to 60% of the canal, despite increased technical difficulty and higher complication rates. Posterior surgery is technically easier and allows decompression of the entire cervical spine, but patients may experience late deterioration because of disease progression. PMID:24966248

  3. Tantalum trabecular metal implants in anterior cervical corpectomy and fusion: 2-year prospective analysis.

    Science.gov (United States)

    King, V; Swart, A; Winder, M J

    2016-10-01

    Anterior cervical decompression for two or more cervical spondylotic levels can be performed using either multiple anterior cervical discectomies and fusion or anterior cervical corpectomy and fusion (ACCF). A variety of options for ACCF implants exist but to our knowledge, there is no clinical data for the use of tantalum trabecular metal implants (TTMI) for ACCF. A retrospective review was performed of prospectively collected data for ten patients undergoing ACCF with TTMI between 2011 and 2012. Radiological outcome was assessed by measuring the change in cervical (C) lordosis (fusion Cobb and C2-C7 Cobb), graft subsidence (anterior/posterior, determined by the subsidence of anterior/posterior body height of fused segments; cranial/caudal, determined by the cranial/caudal plate-to-disc distances) and rate of fusion using lateral cervical X-rays of patients at 0, 6, 12 and 24months post-operatively. The Neck Disability Index (NDI) assessed clinical outcome pre-operatively and at 6, 12 and 24months post-operatively. Cervical lordosis (Cobb angle of fused segment) was 5.2° (± 4.2°) at 0months and 6.0° (± 5.7°) at 24months post-operatively. Graft subsidence was observed to occur at 6months post-operatively and continued throughout follow-up. Anterior, posterior and caudal subsidence occurred more in the first 12months post-operatively than in the following 12months (p<0.05). Average pre-operative NDI was 45%. Average NDIs were 18%, 13% and 10% at 6, 12 and 24months post-operatively, respectively. ACCF patients treated with TTMI demonstrated stable cervical lordosis over 2years of follow-up and 100% fusion rates after 2years. Measures of subsidence appeared to decrease with time. Patients experienced improved clinical outcomes over the 2-year period. PMID:27515543

  4. SPECIFICITIES OF MORTALITY AND MORBIDITY

    Directory of Open Access Journals (Sweden)

    A Nadim

    1971-07-01

    Full Text Available Mortality case registration is one of the oldest statistical data keeping, more for the legal reasons. Mortality statistical data are used for demographic and health purposes, if they classified and adjusted for factors such as age, gender, etc. Deficiencies in mortality registration are absence of descriptive factors, absence of some case reports, inaccuracy in reported cases, and changes of description of the cause of disease in time. Specificities of mortality are: age, gender, and disease. Of the age related one, three categories are the most important, children under the age of one, 1-4 years group, and relative death rate, that is, percentage of death related to the group of over 50 years. In present time, the mortality specific data are based on reports on the Ministry of Health which is obtained from the reports of the cemeteries in Tehran and several large cities. According to these reports, children mortality in the large cities is 29 to 145 in 1000. Independent studies in the rural areas showed this rate to be 112.8 to 217 in 1000. Reported figures for the mortality rate of 1-4 years old age group in the large cities vary from 281 to 2206 per 1000. The reason for this difference is considered to be the deficiencies in the methods of reports of the regions. In all reported figures, the sex related group showed higher mortality rate in men, but due to deficiencies of the system of registration, this difference can not be considered real. The more important causes of death in Iran are related to malnutrition and infections. Sources of data for determination of morbidity rates are consistent reports of the contagious diseases, registration of all cases of chronic and non contagious diseases, and collection of data from the people as morbidity survey. In Iran, most of the cases are not reported; also, diagnoses are mostly on the bases of suspicions and guesses. For these reasons, the published statistical data and their variations can not

  5. Anterior Cervical Spinal Surgery for Multilevel Cervical Myelopathy.

    OpenAIRE

    Jung-Ju Huang; Lih-Huei Chen; Chi-Chien Niu; Tsai-Sheng Fu; Po-Liang Lai; Wen-Jer Chen

    2004-01-01

    Background: In multilevel spinal cord compression caused by cervical spondylosis, surgeonsface the choice of performing a posterior route as a laminectomy orlaminoplasty, or an anterior route as multiple adjacent interbody decompressionsor corpectomies. The anterior cervical operation is not considered bysome clinicians because of concerns about complications and the complexityof multilevel anterior cervical surgery.Methods: In this retrospective study, 14 patients with multilevel cervical sp...

  6. Cervical syphilitic lesions mimicking cervical cancer: a rare case report

    Directory of Open Access Journals (Sweden)

    Xiaoqing Zhu

    2015-02-01

    Full Text Available A woman presented to the hospital due to postcoital vaginal bleeding. The patient was initially diagnosed with cervical carcinoma by clinicians at a local hospital. However, a biopsy of the cervical lesions revealed chronic inflammation and erosion of the cervical mucosa, and the rapid plasma reagin ratio titer was 1:256. The patient was eventually diagnosed with syphilitic cervicitis and treated with minocycline 0.1 g twice a day. The patient was cured with this treatment.

  7. Zoledronic acid induces apoptosis and autophagy in cervical cancer cells.

    Science.gov (United States)

    Wang, I-Te; Chou, Shou-Chu; Lin, Ying-Chin

    2014-12-01

    Cervical cancer is one of the most common gynecological cancers in association with high mortality and morbidity. The present study was aimed to investigate the in vitro effects of zoledronic acid (ZA) on viability and induction of apoptosis and autophagy as well as inflammatory effects in three human cervical cancer cell lines (HeLa, SiHa, and CaSki). Cell viability was measured by 3-(4,5-Dimethylthiazol-2-yl)-2,5-Diphenyltetrazolium Bromide (MTT) assay. Induction of apoptosis was determined by quantitation of expression level of B cell lymphoma 2 (Bcl-2) and Bax messenger RNA (mRNA) and identification of the proteolytic cleavage of poly (ADP)-ribose polymerase (PARP) and caspase-3. Autophagic effects were examined by quantitation of mRNA expression of autophagy protein 5 (ATG5) and beclin1 and identifying accumulation of microtubule-associated protein 1 light chain 3 (LC3)-II. Inflammatory effect was determined by measuring expression and production of IL-6 and cyclooxygenase-2 (Cox-2). The results showed ZA significantly inhibited cell viability of cervical cancer cells. ZA-induced cell death displayed features characteristic to both apoptosis and autophagy and was associated with different changes in the levels of Bcl-2 and Bax in the various cervical cancer lines. Expression of metastatic cytokines, IL-6 and Cox-2, was upregulated in the presence of ZA at low concentration. Our data revealed that ZA inhibits cervical cancer cells through the synergistic effect of apoptosis induction and autophagy activation.

  8. Why do we need optic nerve decompression of traumatic optic neuropathy patients?

    Directory of Open Access Journals (Sweden)

    Seong Rok Han, M.D., Ph.D.

    2014-09-01

    Full Text Available Traumatic optic neuropathy can be treated by various methods including high-dose steroids and surgical decompression. Neurosurgical decompression could be required in patients with mechanical compression of the optic nerve by displaced orbital roof fracture fragments. We describe two patients of traumatic optic neuropathy due to orbital roof fracture who had improved pupil reflex and visual acuity after decompression of the optic nerve.

  9. Metabolic Alterations in Obstructive Jaundice: Effect of Duration of Jaundice and Bile-Duct Decompression

    OpenAIRE

    R.N. Younes; Vydelingum, N. A.; Derooij, P.; Scognamiglio, F.; Andrade, L.; Posner, M. C.; Brennan, M. F.

    1991-01-01

    We examined the effect of prolonged bile duct obstruction, and subsequent biliary decompression, on biochemical and metabolic parameters, using a reversible jaundice model in male Fischer 344 rats. The animals were studied after biliary obstruction for varying periods (4 days, one week, and two weeks) and following decompression. They were sacrificed one or two weeks following decompression. All the rats were compared to sham operated, pair-fed, controls. Obstructive jaundice rapidly increase...

  10. Operative treatment for cervical fracture and dislocation with blunt unilateral vertebral artery injury

    Institute of Scientific and Technical Information of China (English)

    JIANG Tao; REN Xian-jun; WANG Wei-dong; ZHANG Xia; LI Chang-qing; HAO Yong

    2010-01-01

    Objective: To investigate risks and clinical effects of operative treatment for cervical vertebral fracture and dislocation associated with unilateral vertebral artery injury.Methods: This group consisted of 76 cases of closed cervical spine trauma combined with unilateral vertebral artery injury (23 cases of bilateral facet dislocation, 28 unilateral facet dislocation and 25 fracture). All patients underwent prospective examination of cervical spine MRI and vertebral artery two-dimensional time-of-flight (2D TOF)magnetic resonance angiography (MRA), and anterior cervical decompression. The healthy vertebral artery paths were evaluated before the surgery, and were protected during the surgery according to the anatomical signs.Results: There were no acute or chronic clinical damage symptoms in 76 cases after surgery. No neural damage symptoms were observed in patients with normal neural functions. The neural functions of incomplete paralyzed patients were improved in different grades.Conclusions: Reliable anterior operation can produce good results for cervical fracture and dislocation with unilateral vertebral artery injury. Detecting the course of uninjured vertebral artery before operation and locating the anatomical site during operation are effective to avoid damaging vertebral artery of uninjured side.

  11. Cervical Cord Compression as Initial Presentation of Papillary Thyroid Carcinoma: a Case Report.

    Science.gov (United States)

    Selvakumar, Veda Padma Priya; Goel, Ashish; Kumar, Kapil

    2016-09-01

    Cervical cord compression secondary to extension of a long standing papillary thyroid carcinoma as well as multiple cases of distal cord compression from occult follicular thyroid carcinoma have been reported. But cervical cord compression from Papillary Thyroid Carcinoma has not been reported so far. Forty eight year old lady presented with progressive quadriparesis of 2 months duration. MRI of the cervical spine showed destructive lesion with soft tissue component in vertebral bodies and posterior elements of C4-C6 vertebrae with cord compression along with a large thyroid mass extending to retrosternal region likely malignant. USG guided FNAC & Biopsy of thyroid lesion was inconclusive. She underwent Preoperative Selective angioembolisation for vertebral metastasis followed by total thyroidectomy with cervical cord decompression, bone grafting and plating. HPE reported follicular variant of Papillary Thyroid carcinoma. Four weeks postoperatively she underwent radioiodine ablation by 263 mci of I 131. She then received palliative EBRT to cervical and dorsal spine 30 Gy/10 fractions. She is alive and neurologically stable at 6 months follow up. Papillary thyroid carcinoma has an excellent prognosis. Hence a prompt management of primary disease and aggressive approach to metastatic lesion may prolong survival and allow favorable prognosis. PMID:27651699

  12. Volumetric analysis of syringomyelia following hindbrain decompression for Chiari malformation Type I: syringomyelia resolution follows exponential kinetics

    Science.gov (United States)

    Coumans, Jean-Valery; Walcott, Brian P.; Butler, William E.; Nahed, Brian V.; Kahle, Kristopher T.

    2013-01-01

    Object Resolution of syringomyelia is common following hindbrain decompression for Chiari malformation, yet little is known about the kinetics governing this process. The authors sought to establish the volumetric rate of syringomyelia resolution. Methods A retrospective cohort of patients undergoing hindbrain decompression for a Chiari malformation Type I with preoperative cervical or thoracic syringomyelia was identified. Patients were included in the study if they had at least 3 neuroimaging studies that detailed the entirety of their preoperative syringomyelia over a minimum of 6 months postoperatively. The authors reconstructed the MR images in 3 dimensions and calculated the volume of the syringomyelia. They plotted the syringomyelia volume over time and constructed regression models using the method of least squares. The Akaike information criterion and Bayesian information criterion were used to calculate the relative goodness of fit. The coefficients of determination R2 (unadjusted and adjusted) were calculated to describe the proportion of variability in each individual data set accounted for by the statistical model. Results Two patients were identified as meeting inclusion criteria. Plots of the least-squares best fit were identified as 4.01459e−0.0180804x and 13.2556e−0.00615859x. Decay of the syringomyelia followed an exponential model in both patients (R2 = 0.989582 and 0.948864). Conclusions Three-dimensional analysis of syringomyelia resolution over time enables the kinetics to be estimated. This technique is yet to be validated in a large cohort. Because syringomyelia is the final common pathway for a number of different pathological processes, it is possible that this exponential only applies to syringomyelia related to treatment of Chiari malformation Type I. PMID:21882909

  13. Human Papillomavirus and Cervical Cancer

    OpenAIRE

    D. Jenkins(University of York, UK)

    2003-01-01

    Of the many types of human papillomavirus (HPV), more than 30 infect the genital tract. The association between certain oncogenic (high-risk) strains of HPV and cervical cancer is well established. Although HPV is essential to the transformation of cervical epithelial cells, it is not sufficient, and a variety of cofactors and molecular events influence whether cervical cancer will develop. Early detection and treatment of precancerous lesions can prevent progression to cervical cancer. Ident...

  14. Gout Initially Mimicking Rheumatoid Arthritis and Later Cervical Spine Involvement

    Directory of Open Access Journals (Sweden)

    Eduardo Araújo Santana Nunes

    2014-01-01

    Full Text Available Gout is clinically characterized by episodes of monoarthritis, but if not treated properly, it can lead to a chronic polyarthritis, which may eventually mimic rheumatoid arthritis (RA. We present the case of a 59-year-old man, with a history of symmetrical polyarthritis of the large and small joints with later development of subcutaneous nodules, which was initially misdiagnosed as RA, being treated with prednisone and methotrexate for a long period of time. He complained of occipital pain and paresthesia in his left upper limb, and computed tomography (CT and magnetic resonance imaging (MRI revealed the presence of an expansive formation in the cervical spine with compression of the medulla. He was admitted for spinal decompressive surgery and the biopsy specimen demonstrated a gouty tophus. Chronic gout can mimic RA and rarely involves the axial skeleton, and thus its correct diagnosis and the implementation of adequate therapy can halt the development of such damaging complications.

  15. Preventing cervical cancer : overviews of the National Breast and Cervical Cancer Early Detection Program and 2 US immunization programs.

    Science.gov (United States)

    Khan, Kris; Curtis, C Robinette; Ekwueme, Donatus U; Stokley, Shannon; Walker, Chastity; Roland, Katherine; Benard, Vicki; Saraiya, Mona

    2008-11-15

    Three federal programs with the potential to reduce cervical cancer incidence, morbidity, and mortality, especially among underserved populations, are administered by the Centers for Disease Control and Prevention (CDC): the National Breast and Cervical Cancer Early Detection Program (NBCCEDP), the Vaccines for Children (VFC) Program, and the Section 317 immunization grant program. The NBCCEDP provides breast and cervical cancer screening and diagnostic services to uninsured and underinsured women. The VFC program and the Section 317 immunization grant program provide vaccines, including human papillomavirus (HPV) vaccine, to targeted populations at no cost for these vaccines. This article describes the programs, their histories, populations served, services offered, and roles in preventing cervical cancer through HPV vaccination and cervical cancer screening. Potential long-term reduction in healthcare costs resulting from HPV vaccination is also discussed. As an example of an initiative to vaccinate uninsured women aged 19-26 years through a cancer services program, a state-based effort that was recently launched in New York, is highlighted.

  16. Deep cervical infection?

    Directory of Open Access Journals (Sweden)

    Bernardo T

    2012-06-01

    Full Text Available Introduction: Inflammatory cervical swelling may have several causes. The jugular vein thrombosis is a rare entity, often forgotten. Most frequently arises due to a cervical sepsis by the use of a central venous catheter or intravenous drug abuse (drug addicts. Rarely, is secondary to a hypercoagulability state associated with a visceral carcinoma (Trousseau Syndrome. Material and Methods: The authors present the case of a 65 years old male, who used the ENT Emergency Service due to a painful left cervical swelling with local and systemic inflammatory signs of 3 days duration. Results: An cervical ultrasound suggested a neck abscess. CT was performed and confirmed the ultrasound results. Because of its location in the path of the internal jugular vein, we requested re-evaluation by CT with intravenous contrast and doppler ultrasound, obtaining the diagnosis of thrombosis of the internal jugular vein. Further studies were conduct to clarify the hypercoagulability state, since the patient had no known predisposing factor. Finally the diagnosis of unresectable gastric carcinoma was made. Discussion and Conclusion: The ENT must be aware and be able to understand any cervical imagiologic studies. A deep knowledge of the anatomical imagiología is important for the diagnosis of jugular thrombosis. When we have a case of spontaneous jugular thrombosis, we must look for possible visceral carcinoma.

  17. Microscopic Posterior Transdural Resection of Cervical Retro-Odontoid Pseudotumors.

    Science.gov (United States)

    Fujiwara, Yasushi; Manabe, Hideki; Sumida, Tadayoshi; Tanaka, Nobuhiro; Hamasaki, Takahiko

    2015-12-01

    Retro-odontoid pseudotumors are noninflammatory masses formed posterior to the odontoid process. Because of their anatomy, the optimal surgical approach for resecting pseudotumors is controversial. Conventionally, 3 approaches are used: the anterior transoral approach, the lateral approach, and the posterior extradural approach; however, each approach has its limitations. The posterior extradural approach is the most common; however, it remains challenging due to severe epidural veins. Although regression of pseudotumors after fusion surgery has been reported, direct decompression and a pathologic diagnosis are ideal when the pseudotumor is large. We therefore developed a new microscopic surgical technique; transdural resection. After C1 laminectomy, the dorsal and ventral dura was incised while preserving the arachnoid. Removal of the pseudotumor was performed and both of the dura were repaired. The patient's clinical symptoms subsequently improved and the pathologic findings showed degenerative fibrocartilaginous tissue. In addition, no neurological deterioration, central spinal fluid leakage, or arachnoiditis was observed. Currently, the usefulness of the transdural approach has been reported for cervical and thoracic disk herniation. According to our results, the transdural approach is recommended for resection of retro-odontoid pseudotumors because it enables direct decompression of the spinal cord and a pathologic diagnosis. PMID:26544168

  18. Therapeutic strategy for traumatic instability of subaxial cervical spine

    Institute of Scientific and Technical Information of China (English)

    CAO Peng; LIANG Yu; GONG Yao-cheng; ZHENG Tao; ZHANG Xin-kai; WU Wen-jian

    2008-01-01

    Background A simple, safe and effective therapeutic strategy for traumatic instability of the subaxial cervical spine, as well as its prognostic assessment, is still controversial.Methods The therapeutic options for 83 patients of traumatic instability of the subaxial cervical spine, whose average age was 35 years, were determined, according to the Allen-Ferguson classification, general health and concomitant traumatic conditions, neurological function, position of compression materials, concomitant traumatic disc herniation/damage, concomitant locked-facet dislocation, the involved numbers and position, and the patients' economic conditions. An anterior, posterior or combination approach was used to decompress and reconstruct the cervical spine. No operations with an anterior-posterior-anterior approach were performed.Results The average follow-up was three years and nine months. Distraction-flexion and compression-flexion were the most frequent injury subtypes. There were 46, 28 and 9 cases of anterior, posterior and combination operations, respectively. The average score of the Japanese Orthopaedics Association, visual analog scale and American Spinal Cord Injury Association (ASIA) motor index improved from 11.2, 7.8 and 53.5, respectively, before operation, to 15.3, 2.6 and 67.8, respectively, at final follow-up. For incomplete spinal cord injury (SCI), the average ASIA neurological function scale was improved by 1-2 levels. Patients with complete SCI had no neurological recovery, but recovery of nerve root function occurred to different extents. After surgery, radiological parameters improved to different extents. Fusion was achieved in all patients and 12 developed complications.Conclusions The best surgical strategy should be determined by the type of subaxial cervical injury, patients' general health, local pathological anatomy and neurological function.

  19. SLAP repair with arthroscopic decompression of spinoglenoid cyst

    Directory of Open Access Journals (Sweden)

    Hashiguchi Hiroshi

    2016-01-01

    Full Text Available Introduction: A spinoglenoid cyst with suprascapular nerve disorders is highly associated with superior labrum anterior posterior (SLAP lesion. Conservative or surgical treatment is applied to relieve pain and neurological symptoms. The purpose of this study was to evaluate clinical outcomes of patients treated by arthroscopic surgery for SLAP lesion with a spinoglenoid cyst. Methods: The subjects of this study were six patients with SLAP lesion with a spinoglenoid cyst who underwent arthroscopic surgery. There was one female and five males with a mean age of 48.5 years. SLAP lesion was found in all the patients at arthroscopy. A small tear of the rotator cuff was found in the two patients. The SLAP lesion was repaired using suture anchors, and the rotator cuff tears were repaired by suture-bridge fixation. The spinoglenoid cyst was decompressed through the torn labrum in three patients, and through the released superior to posterior portion of the capsule in the other three patients. Results: All patients showed excellent improvement in pain and muscle strength at the final follow-up examination. The mean Constant score was improved from 60.5 points preoperatively to 97.2 points postoperatively. The mean visual analog scale (VAS score decreased from 4.5 on the day of the surgery to 2.5 within one week postoperatively. Postoperative MRI showed disappearance or reduction of the spinoglenoid cyst in four and two patients, respectively. There were no complications from the surgical intervention and in the postoperative period. Discussion: The patients treated by decompression through the released capsule obtained pain relief at an early period after the surgery. Arthroscopic treatment for a spinoglenoid cyst can provide a satisfactory clinical outcome. Arthroscopic decompression of a spinoglenoid cyst through the released capsule is recommended for a safe and reliable procedure for patients with suprascapular nerve disorders.

  20. A step-by-step approach to early stage cervical cancer treatment

    NARCIS (Netherlands)

    Lande, J. van de

    2013-01-01

    The treatment of choice for early stage cervical cancer to date has been a radical hysterectomy including pelvic lymph node dissection. In case of more extensive disease chemoradiation is given in an adjuvant setting. On one hand the combination of both modalities may lead to severe morbidity, and,

  1. Rising rates of caesarean deliveries at full cervical dilatation: a concerning trend.

    LENUS (Irish Health Repository)

    Unterscheider, J

    2011-08-01

    To audit caesarean sections performed at full cervical dilatation over a three year period in a tertiary referral centre in Ireland. To evaluate (i) the rate of caesarean deliveries in the second stage of labour, (ii) the indication for delivery and (iii) the associated fetal and maternal morbidity in this cohort of women.

  2. The degenerative cervical spine.

    Science.gov (United States)

    Llopis, E; Belloch, E; León, J P; Higueras, V; Piquer, J

    2016-04-01

    Imaging techniques provide excellent anatomical images of the cervical spine. The choice to use one technique or another will depend on the clinical scenario and on the treatment options. Plain-film X-rays continue to be fundamental, because they make it possible to evaluate the alignment and bone changes; they are also useful for follow-up after treatment. The better contrast resolution provided by magnetic resonance imaging makes it possible to evaluate the soft tissues, including the intervertebral discs, ligaments, bone marrow, and spinal cord. The role of computed tomography in the study of degenerative disease has changed in recent years owing to its great spatial resolution and its capacity to depict osseous components. In this article, we will review the anatomy and biomechanical characteristics of the cervical spine, and then we provide a more detailed discussion of the degenerative diseases that can affect the cervical spine and their clinical management. PMID:26878769

  3. Surgical decompression for notalgia paresthetica: a case report.

    Science.gov (United States)

    Williams, Eric H; Rosson, Gedge D; Elsamanoudi, Ibrahim; Dellon, A Lee

    2010-01-01

    Notalgia paresthetica is a rare nerve compression. From the Greek word noton, meaning "back," and algia, meaning "pain," "notalgia paresthetica" implies that symptoms of burning pain, itching, and/or numbness in the localized region between the spinous processes of T2 through T6 and the medial border of the scapula constitute a nerve compression syndrome. The compressed nerve is the dorsal branch of the spinal nerve. It is compressed by the paraspinous muscles and fascia against the transverse process of these spinal segments. This is the first report of symptomatic relief by decompression of this nerve. PMID:19790177

  4. Eight years of follow-up after laminectomy of calcium pyrophosphate crystal deposition in the cervical yellow ligament of patient with Coffin–Lowry syndrome

    Science.gov (United States)

    Morino, Tadao; Ogata, Tadanori; Horiuchi, Hideki; Yamaoka, Shintaro; Fukuda, Mitsumasa; Miura, Hiromasa

    2016-01-01

    Abstract Background: We report 8 years of follow-up after decompression to treat cervical myelopathy in a patient with Coffin–Lowry syndrome (CLS). CLS is a rare X-linked semidominant syndrome associated with growth and psychomotor retardation, general hypotonia, and skeletal abnormalities. In this patient, the spinal cord was compressed by calcium pyrophosphate crystal deposition in the cervical yellow ligament (YL). To date, only 1 report has described clinical features after surgery for calcified cervical YL in CLS. Methods: A 15-year-old male with tetraplegia secondary to compression of the cervical spinal cord induced by a hypoplastic posterior arch of C1 and calcification of the YL from C2 to C7 was treated surgically with laminectomy from C1 to C7. The patient's history, clinical examination, imaging findings, and treatment are reported. The patient was incapable of speech because of mental retardation, so he could not describe his symptoms. Gait disturbance worsened over the 2 months before admission to our hospital. At admission, the patient could not move his extremities, and tendon reflexes of the upper and lower extremities were significantly increased. Computed tomography of the cervical spine showed YL calcification from C2 to C7. Magnetic resonance imaging showed consecutive compression of the cervical spinal cord. We diagnosed quadriplegia secondary to cervical cord damage and performed emergency surgery. Results: During C1–C7 laminectomy, YL calcification in C2–C7 was observed. The calcification was confirmed as calcium pyrophosphate by crystal analysis. Quadriplegia gradually resolved, and almost disappeared by 2 weeks after the operation. Cervical hyperlordosis was observed in radiographs starting from 1 month after the operation, but it has not progressed and is not associated with any symptoms. Conclusions: The efficacy of decompression continued, and no postoperative complications have occurred during at least 8 years of follow-up. PMID

  5. Can We Be Less Radical with Surgery for Early Cervical Cancer?

    Science.gov (United States)

    Macdonald, Madeleine C; Tidy, John A

    2016-03-01

    Although a rare cancer in the developed world due to the success of cervical screening programmes, cervical cancer remains one of the most common cancers diagnosed in women under the age of 35 years old. Radical hysterectomy and more recently radical trachelectomy have been highly effective in curing the majority of women with early stage disease. Many, however, are left with long-term 'survivorship' issues including bowel, bladder and sexual dysfunction. In view of these chronic co-morbidities, many clinicians now consider whether a less radical approach to surgery may be an option for some women. This review focuses on the current evidence for the safety of conservative surgery for early stage cervical cancer with regard to cure rates in comparison to standard management, as well as any improvement in short and long-term morbidity associated with a more conservative approach. PMID:26838586

  6. Cervical spine chordoma

    Directory of Open Access Journals (Sweden)

    Díez-González L

    2012-03-01

    Full Text Available Chordomas are neoplasms that arise from notochord embryonic remnants, been the sacrococcygeal spine the main site of involvement; the cervical spine site is uncommon and it account for less than 10% of chordomas. Because of their slow growth, the diagnosis is delayed until they reach a large size, despite which they are locally aggressive tumours due to their relation to critical neurovascular structures and present a high rate of local recurrence. Radical surgery is the elective treatment and proton radiotherapy is used when residual tumour tissue and recurrences.Because of the uncommonness of this pathology, we report a case of a patient with cervical chordoma.

  7. CERVICAL NECROTIZING FASCIITIS

    Directory of Open Access Journals (Sweden)

    G. Dimofte

    2009-05-01

    Full Text Available Cervical necrotizing fasciitis is an unusual encounter in the general surgical practice, but is a life-threatening condition requiring early recognition and adequate surgical treatment. We present the case of a 65 year old male patient referred to our department from a General Hospital. Large excisions of both superficial and deep cervical fascia were required together with necrotic skin on a very large surface. Rapid recovery with early sterilization allowed adequate skin grafting with good results. We advocate for aggressive debridment with excision in viable healthy tissue, with no concern for the future reconstruction followe by early grafting of the skin defect.

  8. Morbidity and GH deficiency: a nationwide study

    DEFF Research Database (Denmark)

    Stochholm, K.; Laursen, T.; Green, A.;

    2008-01-01

    Objective: To estimate morbidity in Denmark in all patients with GH deficiency (GHD). Design: Morbidity was analyzed in 1794 GHD patients and 8014 controls matched on age and gender. All records in the GHD patients were studied and additional morbidity noted. Diagnoses and dates of admissions were...... identified in the National Patient Registry. Lag time until first admission was used as a measure of morbidity. Patients were divided into childhood onset (CO) and adult onset (AO), discriminated by an age cut-off of 18 years at onset of GHD. Method: Sex- and cause-specific hazard ratios (HRs) in CO and AO...

  9. Cervical Spondylotic Myelopathy Secondary to Dropped Head Syndrome: Report of a Case and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Abolfazl Rahimizadeh

    2016-01-01

    Full Text Available The dropped head syndrome (DHS is a disabling condition caused by severe weakness of the neck extensor muscles causing progressive reducible kyphosis of the cervical spine and the inability to hold the head up. Weakness can occur in isolation or in association with a generalized neuromuscular disorder. Isolated cases are owed to the late onset of noninflammatory myopathy designated as INEM, where persistent chin to chest deformity may gradually cause or aggravate preexisting degenerative changes of the cervical spine and ultimately result in myelopathy. In review of the literature, we could find only 5 cases, with no unique guidelines to address the management of these two concomitant pathologies. Herein, a 69-year-old man who had developed cervical myelopathy 2 years after being affected by isolated dropped head syndrome is presented. Chin to chest deformity and cervical myelopathy were managed through three-level anterior cervical discectomy and fusion (ACDF combined with decompressive cervical laminectomy and stabilization with C2 to C7 pedicle screw-rod construct. At 4-month follow-up, despite recovery in patient’s neurological status, flexion deformity reappeared with recurrence of dropped head due to C7 pedicle screws pull-out. However, this was successfully managed with extension of the construct to the upper thoracic levels.

  10. Decompression sickness among Moroami diving fishermen in Jakarta

    Directory of Open Access Journals (Sweden)

    Chichi Wahab

    2008-09-01

    Full Text Available Indonesia is an archipelago with many traditional divers, however research on decompression sickness (DCS has not yet elaborated. The aim of the study was to identify the prevalence of DCS and factors related to it. The study was conducted on October-November 2007 among fisherman moroami divers in Seribu Island Jakarta. Anamnesis and physical examination was taken before and three times after diving. Subject was diagnosed as having DCS if experienced one of these symptom or sign: myalgia, muscle pain, skin rash, ankle weakness, bowel movement & bladder dysfunction, visual disturbances, headache, vertigo, dyspnoe, chest pain, convulsion, unconsciousness, nausea and vomiting. Among 123 potential divers, five were having upper respiratory infection, so only 117 divers participated in this study. Final model analysis showed that regulator, valsava when having ear pain, ascending speed to surface, and lack of training were risk factors to obtain DCS. Divers whose ascending speed more than 9 m per minutes had two times risk to get DCS [adjusted ratio = 2.2; 95% confidence interval (CI= 1.11 – 3.56]. Having DCS before diving, increased risk 20% (RRa = 1.20; 95% CI = 0.86-1.68; P=0,285. Beside knowledge to use regulator correctly and valsava, fisherman Moroami divers need to be trained to ascend speed to sea level surface less than 9 m per minute. (Med J Indones 2008; 17: 197-202Keywords: decompression sickness, ascending speed, regulator, valsava

  11. Estimating Serious Decompression Sickness after Loss of Spacecraft Atmosphere

    Science.gov (United States)

    Gernhardt, Michael; Abercromby, Andrew F. J.

    2016-01-01

    INTRODUCTION: Pressure suits are worn inside spacecraft to protect crewmembers in the event of contamination or depressurization of the spacecraft cabin. Protection against serious (Type II) decompression sickness (DCS) in the event of an unplanned rapid cabin depressurization depends on providing adequate suit pressure to crewmembers because there is no opportunity for oxygen prebreathe. METHODS: A model was developed using literature reports from 41 altitude chamber tests totaling 3,256 decompressions (1,445 including exercise at altitude) with 282 cases of serious DCS. All data involved prebreathe durations symptoms are experienced following cabin depressurization. A suit pressure of 5.8 psia provides significantly greater protection to crewmembers than lower pressure alternatives. Lower pressure suits may protect against ebullism and hypoxia but may not be effective at preventing serious DCS following a cabin depressurization. Learning Objectives: 1. A process is described to repurpose published data about serious DCS into a probability model that has specific application to low-pressure exposures without prior denitrogenation. 2. This process provides one approach to quantify risk of serious DCS where no guidance is currently available.

  12. Laser Disc Decompression In Emam Khomeini Hospital 1996-1999

    Directory of Open Access Journals (Sweden)

    Ghaffar Poor. M

    2002-07-01

    Full Text Available Low back pain is among the most frequent medical complaints and a major public health problem. 1.7 percent of cases are caused by herniated disc, 20 percent of which require interventional treatment. Percutaneous laser disc decompression (P.L.DD can be considered as an effective therapeutic alternative in certain cases."nMaterials and Methods: To determine the efficacy of this method in Iran in patient's with low back pain due to disc herniation, 40 patients according to medical history, physical examination and MRI findings were selected for this study. Patients who had canal stenosis, marginal, osteophyte, advanced disc dehydration, ruptured posterior ligament and other contraindication were excluded. CT scan was used only for needle navigation. After proper positioning of needle, nucleous pulposus was evapourated with Nd-YAG laser. Total energy was 1200-1600j. The procedure was done out patient and follow up has been done at 1 day, 1 week, 1,3, 6 and 12 months."nResults: There was no serious complication. 80 percent of patients in one-year follow up showed significant clinical improvement."nConclusion: Our findings suggests that percutaneous laser disc decompression can be considered as an effective alternative method of treatment for disc herniation and patient selection is the critical factor which determines success rate.

  13. Decompression syndrome (Caisson disease in an Indian diver

    Directory of Open Access Journals (Sweden)

    Phatak Uday

    2010-01-01

    Full Text Available Acute decompression syndrome (Caisson′s disease is an acute neurological emergency in divers. It is caused due to release of nitrogen gas bubbles that impinge the blood vessels of the spinal cord and brain and result in severe neurodeficit. There are very few case reports in Indian literature. There are multiple factors in the pathogenesis of Acute decompression syndrome (Caisson′s disease such as health problems in divers (respiratory problems or congenital heart diseases like atrial septal defect, patent ductus arteriosus etc, speed of ascent from the depth and habits like smoking that render divers susceptible for such neurological emergency. Usually, immediate diagnosis of such a condition with MRI is not possible in hospitals in the Coastal border. Even though, MRI is performed, it has very low specificity and sensitivity. Facilities like hyperbaric oxygen treatment are virtually non-existent in these hospitals. Therefore, proper education of the divers and appropriate preventive measures in professional or recreational divers is recommended.

  14. Late radiotherapeutic morbidity in patients with carcinoma of the uterine cervix: the application of the French-Italian glossary

    International Nuclear Information System (INIS)

    Background and purpose. The aim of this study was to perform a retrospective analysis of the complications observed and the importance of delayed symptoms for radiotherapeutic morbidity in patients treated by radiotherapy alone for cervical cancer. Materials and methods. From 1979 to 1991, 145 patients with primary uterine cervical cancer were treated with external radiotherapy and intracavitary applications. During the follow-up, all signs, symptoms and therapy of late treatment complications were recorded. Complications were graded according to the French-Italian glossary. This glossary is used for recording morbidity after treatment of gynaecological cancer. Results. Overall, 119 late complications were recorded. They were most frequently located in the gastro-intestinal system (53%) with a median time to development of 9 months. Urinary complications were recorded in 20%. Very few complications were recorded in vagina/uterus (12%) and pelvic soft tissue (5%). The probability of surviving without tumour recurrence and/or late combined moderate to severe organ morbidity decreased with increasing FIGO stage. Conclusions. For reporting gynaecological morbidity, the French-Italian glossary is useful. Treatment optimization must take into account actuarial estimates of survival and morbidity

  15. New morbidity of the young

    Directory of Open Access Journals (Sweden)

    Stanković Biljana

    2002-01-01

    Full Text Available In the present phase of epidemiological transition, the most frequent causes of youth morbidity are disorders in reproductive health, mental disorders and injuries which are not life threatening. This, so-called new youth morbidity, is most often caused by their risky behavior, which in the field of sexuality often leads to unplanned pregnancies and abortions, as well as sexually transmitted infections. Misuse of tobacco, alcohol and narcotics, which is most commonly started in adolescence, has an unfavorable short-term and long-term influence on the psycho-physical health of the young. All research, in the world and in our country, indicate gradual yet constant growth of sexual activity of the youth and the age decrease of its starting point, especially when girls are in question. Due to insufficient maturity and inadequate knowledge and consciousness on the necessity of protecting reproductive health, sexual behavior of young people can often be characterized as insufficiently responsible and not supplemented with the usage of adequate protective measures. The result is frequently abortion, which terminates 90% of unplanned and unwanted pregnancies in this age. This creates health and psychosocial risks, as well as giving birth in adolescence which is contrary to the modern health concepts that giving birth should not be performed too early, while the young are still developing. A significant increase in the frequency of sexually transmitted diseases is also present, to which the youth are especially susceptible due to the specific development period in which they are in. A serious medical and sociopathological problem of contemporary society represents the greater and greater misuse of psychoactive substances among the young people, with a tendency of decreasing the average age they are consumed for the first time, as well as the use of drugs and alcohol. With the increase of the anti-smoking campaign and restrictive measures in highly

  16. Prevent Cervical Cancer

    Science.gov (United States)

    ... Risk? What Are the Symptoms? What Should I Know About Screening? Statistics Related Links Inside Knowledge Campaign What CDC Is Doing Research AMIGAS Fighting Cervical Cancer Worldwide Stay Informed Printable Versions Standard quality PDF [PDF-877KB] High-quality PDF for professional ...

  17. Prevent Cervical Cancer!

    Centers for Disease Control (CDC) Podcasts

    2015-01-08

    Cervical cancer can be prevented. Listen as two friends—one a doctor—talk about screening tests and early detection. Learn what test you might need.  Created: 1/8/2015 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).   Date Released: 1/8/2015.

  18. Cervical silicone lymphadenopathy.

    Science.gov (United States)

    Gilbert, Latoni Kaysha; Thiruchelvam, Janavikulam

    2016-07-01

    A patient presented to the department of oral and maxillofacial surgery with a rare case of cervical silicone lymphadenopathy. She had a painless ovoid mass in the left side of her neck and had had cosmetic breast augmentation 10 years before. Radiological imaging and core biopsy examination were consistent with silicone lymphadenopathy. PMID:26830068

  19. Severe morbidity after antiretroviral (ART) initiation

    DEFF Research Database (Denmark)

    Abo, Yao; Zannou Djimon, Marcel; Messou, Eugène;

    2015-01-01

    BACKGROUND: The causes of severe morbidity in health facilities implementing Antiretroviral Treatment (ART) programmes are poorly documented in sub-Saharan Africa. We aimed to describe severe morbidity among HIV-infected patients after ART initiation, based on data from an active surveillance sys...

  20. Intubation of the morbidly obese patient

    DEFF Research Database (Denmark)

    Ydemann, Mogens; Rovsing, Marie Louise; Lindekaer, A L;

    2012-01-01

    Several potential problems can arise from airway management in morbidly obese patients, including difficult mask ventilation and difficult intubation. We hypothesised that endotracheal intubation of morbidly obese patients would be more rapid using the GlideScope(®) (GS) (Verathon Inc Corporate H...

  1. Can radical parametrectomy be omitted inoccult cervical cancer afterextrafascial hysterectomy?

    Institute of Scientific and Technical Information of China (English)

    Huai-WuLu,; JingLi,; Yun-YunLiu,; Chang-HaoLiu,; Guo-CaiXu,; Ling-LingXie,; Miao-FangWu; Zhong-QiuLin

    2015-01-01

    Background:Occult invasive cervical cancer discovered after simple hysterectomy is not common, radical parame‑trectomy (RP) is a preferred option for young women. However, the morbidity of RP was high. The aim of our study is to assess the incidence of parametrial involvement in patients who underwent radical parametrectomy for occult cervical cancer or radical hysterectomy for early‑stage cervical cancer and to suggest an algorithm for the triage of patients with occult cervical cancer to avoid RP. Methods:A total of 13 patients with occult cervical cancer who had undergone RP with an upper vaginectomy and pelvic lymphadenectomy were included in this retrospective study. Data on the clinicopathologic characteristics of the cases were collected. The published literature was also reviewed, and low risk factors for parametrial involvement in early‑stage cervical cancer were analyzed. Results:Of the 13 patients, 9 had a stage IB1 lesion, and 4 had a stage IA2 lesion. There were four patients with grade 1 disease, seven with grade 2 disease, and two with grade 3 disease. The median age of the entire patients was 41years. The most common indication for extrafascial hysterectomy was cervical intraepithelial neoplasia 3. Three patients had visible lesions measuring 10–30mm, in diameter and ten patients had cervical stromal invasions with depths ranging from 4 to 9mm; only one patient had more than 50% stromal invasion, and four patients had lymph‑vascular space invasion (LVSI). Perioperative complications included intraoperative bowel injury, blood transfusion, vesico‑vaginal ifstula, and ileus (1 case for each). Postoperative pathologic examination results did not show residual disease or parametrial involvement. One patient with positive lymph nodes received concurrent radiation therapy. Only one patient experienced recurrence. Conclusions:Perioperative complications following RP were common, whereas the incidence of parametrial involve‑ment was very low

  2. Laboratory evidence of fragmentation during slow decompression of a magma analogue containing volatiles and solid particles.

    Science.gov (United States)

    Rivalta, Eleonora; Pascal, Karen; Phillips, Jeremy; Bonaccorso, Alessandro

    2010-05-01

    With the motivation of studying switches in the eruption regime at Stromboli volcano, we performed a series of shock-tube experiments decompressing Gum Rosin dissolved in acetone (GRA mixture) as a volatile-bearing analog of magma, obtaining for the first time evidence of fragmentation of a natural system containing solved volatiles and solid particles during slow decompression. We exposed the magma analog to sudden decompression and to slow decompressions of the order of about 100-400 Pa s-1 from atmospheric pressure patm down to different pressures pL. We used five different concentrations of acetone in the mixture: 15%, 23%, 30%, 35%, 40%. This corresponds to about 2 - 6% H2O in magma. We use our sudden decompression experiments to draw a phase diagram of our mixture. During fast decompression, we first observe bubble nucleation for pL ≈ 25 kPa. For 13 kPa samples at the microscope. Fragmentation events during slow decompression occurred only - but not always -when decompressing the mixtures at 35% and 40%, while we never observed it for mixtures of 30% concentration or below. Using the 40% mixture, fragmentation occurred about in half of the cases (4 times out of 8), for the 35% it occurred in one case out of four. In conclusion, fragmentation during slow decompression occurs when the gas content is high (or when the content in particles is relatively low). A pressure threshold exists, which is about half of the pressure of the acetone's boiling point and might mark the onset of homogeneous nucleation. This process seems to be highly non-linear since different runs of the experiment in approximately the same conditions lead to different results. Further studies are necessary in order to constrain better the conditions promoting fragmentation during slow decompression and to make inferences on the dynamics of the plumbing system at Stromboli volcano.

  3. Simple in situ decompression for idiopathic cubital tunnel syndrome using minimal skin incision

    Directory of Open Access Journals (Sweden)

    Jeon In-Ho

    2010-01-01

    Full Text Available Cubital tunnel syndrome is one of the most frequently occurring compression neuropathy in the upper limb next to carpal tunnel syndrome. Recent minimal invasive technique has prompted us to gain clinical experience with simple in situ decompression with minimal skin incision for idiopathic cubital tunnel syndrome. Sixty six consecutive patients with cubital tunnel syndrome were treated using minimal skin incision technique. The mean age of the patients was 49.7 (range: 15-77 years and average follow up period was 23.9 months (range: 12-60 months. The severity of ulnar neuropathy was classified according to the McGowan classification: there were 17 in grade I , 47 in grade II and 2 in grade III. A preoperative nerve conduction study was done by inching method, which revealed motor conduction delay around the medial epicondyle. All operations were carried out in a day surgery unit under local anesthetics. The postoperative outcome was evaluated by Messina classification. The mean duration of the operation was 12 minutes. The technique was highly satisfactorily esthetic for all. Over 80% of the patients were completely satisfied with the procedure taking into consideration their symptoms. Postoperative outcome measures and patient satisfactions (pain, return to normal activities and work, scar and pillar tenderness were comparable with published series of anterior transposition. The overall satisfactory results were recorded 81% in the patients of McGowan stage I and II. There were 2 cases of hematoma as a postoperative complication. This procedure is comparably effective alternative which involves less surgical trauma, morbidity and rehabilitation time with good surgical outcomes especially in mild and moderate degrees. Minimal skin incision is a simple, safe and effective method to treat patients with idiopathic cubital tunnel syndrome.

  4. Plants survive rapid decompression: Implications for bioregenerative life support

    Science.gov (United States)

    Wheeler, R. M.; Wehkamp, C. A.; Stasiak, M. A.; Dixon, M. A.; Rygalov, V. Y.

    2011-05-01

    Radish (Raphanus sativus), lettuce (Latuca sativa), and wheat (Triticum aestivum) plants were grown at either 98 kPa (ambient) or 33 kPa atmospheric pressure with constant 21 kPa oxygen and 0.12 kPa carbon dioxide in atmospherically closed pressure chambers. All plants were grown rockwool using recirculating hydroponics with a complete nutrient solution. At 20 days after planting, chamber pressures were pumped down as rapidly as possible, reaching 5 kPa after about 5 min and ˜1.5 kPa after about 10 min. The plants were held at 1.5 kPa for 30 min and then pressures were restored to their original settings. Temperature (22 °C) and humidity (65% RH) controls were engaged throughout the depressurization, although temperatures dropped to near 16 °C for a brief period. CO2 and O2 were not detectable at the low pressure, suggesting that most of the 1.5 kPa atmosphere consisted of water vapor. Following re-pressurization, plants were grown for another 7 days at the original pressures and then harvested. The lettuce, radish, and wheat plants showed no visible effects from the rapid decompression, and there were no differences in fresh or dry mass when compared to control plants maintained continuously at 33 or 98 kPa. But radish storage root fresh mass and lettuce head fresh and dry masses were less at 33 kPa compared to 98 kPa for both the controls and decompression treatment. The results suggest that plants are extremely resilient to rapid decompression, provided they do not freeze (from evaporative cooling) or desiccate. The water of the hydroponic system was below the boiling pressure during these tests and this may have protected the plants by preventing pressures from dropping below 1.5 kPa and maintaining humidity near 1.5 kPa. Further testing is needed to determine how long plants can withstand such low pressure, but the results suggest there are at least 30 min to respond to catastrophic pressure losses in a plant production chamber that might be used for life

  5. Cervical cellulitis and mediastinitis following esophageal perforation: A case report

    Institute of Scientific and Technical Information of China (English)

    Christian A Righini; Basilide Z Tea; Emile Reyt; Karim A Chahine

    2008-01-01

    Chicken bone is one of the most frequent foreign bodies (FB) associated with upper esophageal perforation.Upper digestive tract penetrating FB may lead to life threatening complications and requires prompt management.We present the case of a 52-year-old man who sustained an upper esophageal perforation associated with cervical cellulitis and mediastinitis.Following CT-scan evidence of FB penetrating the esophagus,the impacted FB was successfully extracted under rigid esophagoscopy.Direct suture was required to close the esophageal perforation.Cervical and mediastinal drainage were made immediately.Nasogastric tube decompression,broad-spectrum intravenous antibiotics,and parenteral hyperalimentation were administered for 10 d postoperatively.An esophagogram at d 10 revealed no leak at the repair site,and oral alimentation was successfully reinstituted.Conclusion:Rigid endoscope management of FB esophageal penetration is a simple,safe and effective procedure.Primary esophageal repair with drainage of all affected compartments are necessary to avoid life-threatening complications.

  6. Cervical spinal canal narrowing and cervical neurologi-cal injuries

    OpenAIRE

    Zhang, Ling; Chen, Hai-Bin; Wang, Yi; ZHANG Li-ying; Liu, Jing-cheng; WANG Zheng-guo

    2012-01-01

    【Abstract】Cervical spinal canal narrowing can lead to injury of the spinal cord and neurological symptoms in-cluding neck pain, headache, weakness and parasthesisas. According to previous and recent clinical researches, we investigated the geometric parameters of normal cervical spinal canal including the sagittal and transverse diameters as well as Torg ratio. The mean sagittal diameter of cervical spinal canal at C 1 to C 7 ranges from 15.33 mm to 20.46 mm, ...

  7. Cetuximab, Cisplatin, and Radiation Therapy in Treating Patients With Stage IB, Stage II, Stage III, or Stage IVA Cervical Cancer

    Science.gov (United States)

    2014-12-29

    Cervical Adenocarcinoma; Cervical Adenosquamous Carcinoma; Cervical Small Cell Carcinoma; Cervical Squamous Cell Carcinoma; Stage IB Cervical Cancer; Stage IIA Cervical Cancer; Stage IIB Cervical Cancer; Stage III Cervical Cancer; Stage IVA Cervical Cancer

  8. Cisplatin and Radiation Therapy Followed by Paclitaxel and Carboplatin in Treating Patients With Stage IB-IVA Cervical Cancer

    Science.gov (United States)

    2016-03-16

    Cervical Adenocarcinoma; Cervical Adenosquamous Carcinoma; Cervical Squamous Cell Carcinoma; Stage IB Cervical Cancer; Stage IIA Cervical Cancer; Stage IIB Cervical Cancer; Stage IIIA Cervical Cancer; Stage IIIB Cervical Cancer; Stage IVA Cervical Cancer

  9. Surgical Treatment of Cervical Spondylotic Myelopathy Associated Hypertension--A Retrospective Study of 309 Patients.

    Directory of Open Access Journals (Sweden)

    Ze-qun Li

    Full Text Available Hypertension is the most prevalent cardiovascular disease, and various risk factors are known to be involved in it. Cervical spondylotic myelopathy (CSM is the most common non-traumatic cause of myelopathy, which displays neurological symptoms and may induce systemic symptoms. To date, it is still unknown whether CSM is associated with hypertension, and if so, whether the decompression operations can attenuate CSM associated hypertension. Here, a total of 309 patients with CSM who received anterior or posterior decompression surgery were enrolled as subjects. Blood pressure measurements were performed before and within one week after the surgery. Among the 309 subjects, 144 (46.6% of them exhibited hypertension before surgery, a significantly higher ratio than that of the whole population. One week after surgery, blood pressure of 106 (73.6% patients turned back to normal. Blood pressure of another 37(25.7% patients decreased with different degrees, although still higher than normal. Moreover, it appears that both approaches were effective in improving blood pressure, while the posterior approach was more effective in decreasing systolic blood pressure. We speculate this type of hypertension might result from hyperactivity of sympathetic nervous system as the heart rate of these patients decreased after surgery as well. Collectively, compression of spinal cord in CSM patients might be associated with hypertension, and decompression surgery largely attenuated this type of hypertension. These findings prove CSM to be a potential associated factor of high blood pressure and may shed light on therapies of hypertension in clinics.

  10. Influence of developmental cervical stenosis on dural sac space

    Institute of Scientific and Technical Information of China (English)

    Tang Yanchao; Yu Miao; Liu Zhongjun; Sun Yu; Liu Xiaoguang

    2014-01-01

    Background This retrospective study aimed to investigate the difference of the intra-dural reserving space for spinal cord in magnetic resonance imaging (MRI) between patients with and without developmental cervical stenosis and its clinical significance.Methods A total of 264 patients with cervical spondylotic myelopathy who had decompression surgeries were recruited.The average follow-up was 29 months.Based on their lateral radiographs,they were divided into stenosis group and non-stenosis group.On the magnetic resonance images,the ratio of the sagittal diameter of the dural sac to that of the vertebral body was measured and calculated as MRI Pavlov ratio at the mid-vertebral level on T2-weighted sagittal images from C3 to C7.The ratio of the transverse area of the spinal cord to that of the dural sac was measured and calculated as occupation ratio on T2-weighted axial images at the same levels.The MRI Pavlov ratio and occupation ratio were compared between the two groups.The stenosis group was further divided into space-reserving and non-space-reserving subgroups based on the occupation ratios; then clinical parameters were compared between the two subgroups to determine the clinical significance of the reserving space.Results The MRI Pavlov ratio of the stenosis group was significantly smaller than that of the non-stenosis group at C3-C7 (P <0.01),while the occupation ratio was significantly larger only at C7 (P <0.05).For the space-reserving subgroup,the postoperative recovery rate was lower (P <0.05).The postoperative recovery rate was (23±6)% in anterior approach,larger than (-23±15)% in posterior approach (P <0.05).Conclusions Developmental cervical stenosis is associated with a smaller sagittal diameter of the dural sac,but does not lead to a significant decrease in intra-dural space available for the cord.For patients with normal intra-dural space,the recovery after anterior decompression surgery was better than posterior approach.

  11. Intravenous Fluid Therapy in Traumatic Brain Injury and Decompressive Craniectomy

    Directory of Open Access Journals (Sweden)

    Hernando Raphael Alvis-Miranda

    2014-01-01

    Full Text Available The patient with head trauma is a challenge for the emergency physician and for the neurosurgeon. Currently traumatic brain injury constitutes a public health problem. Knowledge of the various supportive therapeutic strategies in the pre-hospital and pre-operative stages is essential for optimal care. The immediate rapid infusion of large volumes of crystalloids to restore blood volume and blood pressure is now the standard treatment of patients with combined traumatic brain injury (TBI and hemorrhagic shock (HS. The fluid in patients with brain trauma and especially in patients with brain injur y is a critical issue. In this context we present a review of the literature about the history, physiology of current fluid preparations, and a discussion regarding the use of fluid therapy in traumatic brain injury and decompressive craniectomy.

  12. Maternal morbid obesity and obstetric outcomes.

    LENUS (Irish Health Repository)

    Farah, Nadine

    2012-02-01

    OBJECTIVE: The purpose of this retrospective cohort study was to review pregnancy outcomes in morbidly obese women who delivered a baby weighing 500 g or more in a large tertiary referral university hospital in Europe. METHODS: Morbid obesity was defined as a BMI > or =40.0 kg\\/m2 (WHO). Only women whose BMI was calculated at their first antenatal visit were included. The obstetric out-comes were obtained from the hospital\\'s computerised database. RESULTS: The incidence of morbid obesity was 0.6% in 5,824 women. Morbidly obese women were older and were more likely to be multigravidas than women with a normal BMI. The pregnancy was complicated by hypertension in 35.8% and diabetes mellitus in 20.0% of women. Obstetric interventions were high, with an induction rate of 42.1% and a caesarean section rate of 45.3%. CONCLUSIONS: Our findings show that maternal morbid obesity is associated with an alarmingly high incidence of medical complications and an increased level of obstetric interventions. Consideration should be given to developing specialised antenatal services for morbidly obese women. The results also highlight the need to evaluate the effectiveness of prepregnancy interventions in morbidly obese women.

  13. The Mars Project: Avoiding Decompression Sickness on a Distant Planet

    Science.gov (United States)

    Conkin, Johnny

    2000-01-01

    A cost-effective approach for Mars exploration is to use available resources, such as water and atmospheric gases. Nitrogen (N2) and argon (Ar) are available and could form the inert gas component of a habitat atmosphere at 8.0, 9.0, or 10.0 pounds per square inch (psia). The habitat and space suit are designed as an integrated system: a comfortable living environment about 85% of the time and a safe working environment about 15% of the time. A goal is to provide a system that permits unrestricted exploration of Mars, but the risk of decompression sickness (DCS) during the extravehicular activity in a 3.75-psia suit, after exposure to any of the three habitat conditions, may limit unrestricted exploration. I evaluate here the risk of DCS since a significant proportion of a trinary breathing gas in the habitat might contain Ar. I draw on past experience and published information to extrapolate into untested, multivariable conditions to evaluate risk. A rigorous assessment of risk as a probability of DCS for each habitat condition is not yet possible. Based on many assumptions about Ar in hypobaric decompressions, I conclude that the presence of Ar significantly increases the risk of DCS. The risk is significant even with the best habitat option: 2.56 psia oxygen, 3.41 psia N2, and 2.20 psia Ar. Several hours of prebreathing 100% 02, a higher suit pressure, or a combination of other important variables such as limited exposure time on the surface or exercise during prebreathe would be necessary to reduce the risk of DCS to an acceptable level. The acceptable level for DCS risk on Mars has not yet been determined. Mars is a great distance from Earth and therefore from primary medical care. The acceptable risk would necessarily be defined by the capability to treat DCS in the Rover vehicle, in the habitat, or both.

  14. Unilateral ossified ligamentum flavum in the high cervical spine causing myelopathy

    Directory of Open Access Journals (Sweden)

    Singhal Udit

    2009-01-01

    Full Text Available High cervical ossified ligamentum flavum (OLF is rare and may cause progressive quadriparesis and respiratory failure . Our two patients had unilateral OLF between C1 and C4 levels. MR showed a unilateral, triangular bony excrescence with low signal and a central, intermediate or high signal on all pulse sequences due to bone marrow within. There was Type I thecal compression (partial deficit of contrast media ring. The first patient had a linear and nodular OLF with calcification within tectorial membrane, C2-3 fusion and unilateral C2-facetal hypertrophy; and the second patient, a lateral, linear OLF with loss of lordosis and C3-6 spondylotic changes. A decompressive laminectomy using "posterior floating and enbloc resection" brought significant relief in myelopathy. Histopathology showed mature bony trabeculae, bone marrow and ligament tissue. The coexisting mobile cervical vertebral segment above and congenitally fused or spondylotic rigid segment below the level of LF may have led to abnormal strain patterns within resulting in its unilateral ossification. In dealing with cervical OLF, carefully preserving facets during laminectomy or laminoplasty helps in maintaining normal cervical spinal curvature.

  15. Self-reported skin morbidity in Denmark

    DEFF Research Database (Denmark)

    Miller, Iben Marie; Zarchi, Kian; Ellervik, Christina;

    2016-01-01

    and possible socio-demographic and -economic associations in the Danish general population, and furthermore compare this data to that reported in Norway. A population-based cross-sectional study of the adult Danish suburban population was performed. Participants (n = 20,164) completed the Norwegian validated...... skin morbidities more frequently than men. Participants in employment reported fewer skin morbidities compared to unemployed participants. Skin morbidities in Denmark are common, and the distribution of prevalence estimates in the Danish population parallel those of the Norwegian population, although...

  16. Co-morbid disorders in Tourette syndrome

    DEFF Research Database (Denmark)

    Debes, Nanette Marinette Monique

    2013-01-01

    Tourette syndrome (TS) is often accompanied by other symptoms and syndromes. The two best-known co-morbidities are Attention Deficit Hyperactivity Disorder (ADHD) and Obsessive Compulsive Disorder (OCD), but also other conditions like rage-attacks, depression, and sleeping disturbances are frequent...... in persons with TS. Both in clinical cohorts and in population-based cohorts the prevalence of co-morbidities is high. The presence of co-morbid ADHD and/or OCD has an impact on psychosocial, educational, and neuropsychological consequences of TS and it is associated with higher rates of other co...

  17. Degenerative cervical myelopathy.

    Science.gov (United States)

    Kato, So; Fehlings, Michael

    2016-09-01

    Cervical myelopathy is the most common cause of acquired spinal cord compromise. The concept of degenerative cervical myelopathy (DCM), defined as symptomatic myelopathy associated with degenerative arthropathic changes in the spine axis, is being introduced. Given its progressive nature, treatment options have to be chosen in a timely manner. Surgical options include anterior discectomy and fusion (ACDF), anterior corpectomy and fusion (ACCF), arthroplasty (in highly select cases), posterior laminectomy with/without fusion, and laminoplasty. Indications for each should be carefully considered in individual patients. Riluzole, a sodium-glutamate antagonist, is a promising option to optimize neurologic outcomes post-surgery and is being examined in the CSM-Protect Randomized Controlled Trial. Preoperative risk assessment is mandatory for prognostication. Sagittal alignment is known to play an important role to optimize surgical outcome. Guidelines for optimal management of DCM are in process. In principle, all but the mildest cases of DCM should be offered surgery for optimal outcome. PMID:27250040

  18. Operations for cervical incompetence.

    Science.gov (United States)

    Branch, D W

    1986-06-01

    At present, cervical cerclage is indicated in those patients with a classic history of cervical incompetence. For the majority of these patients, a postconceptional cerclage procedure is better suited because it is done after the fetus has been evaluated ultrasonographically for obvious abnormalities and after the risk for spontaneous abortion is past. The greatest experience is with the Shirodkar and the McDonald procedures; allowing for operator differences, neither appears to have an important advantage. The transabdominal cervicoisthmic cerclage may be a useful postconceptional procedure in the selected patient whose cervix is either markedly foreshortened, deeply lacerated, or infected. Preconceptional cerclages are best reserved for those rare patients in whom a markedly foreshortened incompetent cervix is associated with early second-trimester pregnancy losses (preconceptional isthmic cerclage) or in whom the cervix has a single, identifiable scar or deep laceration extending through the internal os (Lash procedure). PMID:3522005

  19. Electrical Bioimpedance Analysis: A New Method in Cervical Cancer Screening

    Directory of Open Access Journals (Sweden)

    Lopamudra Das

    2015-01-01

    Full Text Available Cervical cancer is the second most common female cancer worldwide and a disease of concern due to its high rate of incidence of about 500,000 women annually and is responsible for about 280,000 deaths in a year. The mortality and morbidity of cervical cancer are reduced through mass screening via Pap smear, but this technique suffers from very high false negativity of around 30% to 40% and hence the sensitivity of this technique is not more than 60%. Electrical bioimpedance study employing cytosensors over a frequency range offers instantaneous and quantitative means to monitor cellular events and is an upcoming technique in real time to classify cells as normal and abnormal ones. This technology is exploited for label-free detection of diseases by identifying and measuring nonbiological parameters of the cell which may carry the disease signature.

  20. Decompression-induced bubble formation in salmonids: comparison to gas bubble disease.

    Science.gov (United States)

    Beyer, D L; D'Aoust, B G; Smith, L S

    1976-12-01

    The relationship of gas bubble disease (GBD) in fish to decompression-induced bubble formation was investigated with salmonids. Acute bioassays were used to determine equilibration times for critical effects in fish decompressed from depths to 200 fsw. It was found that equilibration of critical tissues was complete in 60-90 min. Salmonids and air-breathers are sensitive to decompressions at similar levels of supersaturation if elimination of excess gas following decompression is unrestricted. However, if elimination is restricted, bubble formation and growth increase accordingly. Tests with mixtures of He-O2, Ar-O2, N2-O2 (80% inert gas: 20% O2) and pure oxygen demonstrated that gas solubility as well as supersaturation (delta P), pressure ratio (initial pressure: final pressure), and absolute pressure must be considered in setting tolerance limits for any decompression. Gases with higher solubility are more likely to produce bubbles upon decompression. Oxygen, however, does not follow this relationship until higher pressures are reached, probably owing to its function in metabolism and in binding with hemoglobin. Tissue responses observed in both GBD and decompressed fish involved similar pathological effects at acute exposures. The circulatory system was consistently affected by bubbles that occluded vessels and blocked flow through the heart.

  1. [Preventing cervical cancer].

    Science.gov (United States)

    Simon, P; Noël, J-C

    2015-09-01

    The incidence of cervical cancer has hopefully been dropping down in our industrialized countries since the introduction of both primary and secondary prevention. Nevertheless, it is still lethal in one out of two affected women though the introduction of cytological screening has dramatically reduced the mortality. Progressive diffusion of anti-HPV vaccination, the broadening of the viral types concerned, its association with existing screening measures and finally the introduction of viral detection as a screening tool must optimize the results already obtained.

  2. SUPERFICIAL CERVICAL PLEXUS BLOCK

    Directory of Open Access Journals (Sweden)

    Komang Mega Puspadisari

    2014-01-01

    Full Text Available Superficial cervical plexus block is one of the regional anesthesia in  neck were limited to thesuperficial fascia. Anesthesia is used to relieve pain caused either during or after the surgery iscompleted. This technique can be done by landmark or with ultrasound guiding. The midpointof posterior border of the Sternocleidomastoid was identified and the prosedure done on thatplace or on the level of cartilage cricoid.

  3. Case Studies - Cervical Cancer

    Centers for Disease Control (CDC) Podcasts

    2010-10-15

    Dr. Alan Waxman, a professor of obstetrics and gynecology at the University of New Mexico and chair of the American College of Obstetricians and Gynecologists (ACOG) committee for the underserved, talks about several case studies for cervical cancer screening and management.  Created: 10/15/2010 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), Division of Cancer Prevention and Control (DCPC).   Date Released: 6/9/2010.

  4. Future Directions - Cervical Cancer

    Centers for Disease Control (CDC) Podcasts

    2009-10-15

    Dr. Alan Waxman, a professor of obstetrics and gynecology at the University of New Mexico and chair of the American College of Obstetricians and Gynecologists (ACOG) committee for the underserved, talks about possible changes in cervical cancer screening and management.  Created: 10/15/2009 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), Division of Cancer Prevention and Control (DCPC).   Date Released: 6/9/2010.

  5. [Pediatric orthopedic cervical spine problems].

    Science.gov (United States)

    Helenius, Ilkka

    2016-01-01

    Treatment-requiring diseases of the cervical spine in children are rare. The most common cases requiring medical assessment and treatment are acute torticollis and various accidents. A torticollis having lasted for more than a week should be recognized, because it can be treated by skull traction. Cervical spine fractures in children under school age are very rare, the most common being a fracture of the base of the dens of the second cervical vertebra. Cervical spine instability is almost always associated with an underlying disease. PMID:27400588

  6. The Extended Oxygen Window Concept for Programming Saturation Decompressions Using Air and Nitrox.

    Directory of Open Access Journals (Sweden)

    Jacek Kot

    Full Text Available Saturation decompression is a physiological process of transition from one steady state, full saturation with inert gas at pressure, to another one: standard conditions at surface. It is defined by the borderline condition for time spent at a particular depth (pressure and inert gas in the breathing mixture (nitrogen, helium. It is a delicate and long lasting process during which single milliliters of inert gas are eliminated every minute, and any disturbance can lead to the creation of gas bubbles leading to decompression sickness (DCS. Most operational procedures rely on experimentally found parameters describing a continuous slow decompression rate. In Poland, the system for programming of continuous decompression after saturation with compressed air and nitrox has been developed as based on the concept of the Extended Oxygen Window (EOW. EOW mainly depends on the physiology of the metabolic oxygen window--also called inherent unsaturation or partial pressure vacancy--but also on metabolism of carbon dioxide, the existence of water vapor, as well as tissue tension. Initially, ambient pressure can be reduced at a higher rate allowing the elimination of inert gas from faster compartments using the EOW concept, and maximum outflow of nitrogen. Then, keeping a driving force for long decompression not exceeding the EOW allows optimal elimination of nitrogen from the limiting compartment with half-time of 360 min. The model has been theoretically verified through its application for estimation of risk of decompression sickness in published systems of air and nitrox saturation decompressions, where DCS cases were observed. Clear dose-reaction relation exists, and this confirms that any supersaturation over the EOW creates a risk for DCS. Using the concept of the EOW, 76 man-decompressions were conducted after air and nitrox saturations in depth range between 18 and 45 meters with no single case of DCS. In summary, the EOW concept describes

  7. Decompression wave speed in CO2 mixtures: CFD modelling with the GERG-2008 equation of state

    International Nuclear Information System (INIS)

    Highlights: • CFD models for decompression simulation of CO2 mixtures. • Incorporation of GERG-2008 EOS into CFD code for decompression modelling. • Predicted decompression wave speed validated by measurements. • Studies of effects of initial temperature and impurities on decompression wave speed. - Abstract: The development of CO2 pipelines for Carbon Capture and Storage (CCS) raises new questions regarding the control of ductile fracture propagation and fracture arrest toughness criteria. The decompression behaviour in the fluid must be determined accurately in order to estimate the proper pipe toughness. However, anthropogenic CO2 may contain impurities that can modify the fluid decompression characteristics quite significantly. To determine the decompression wave speed in CO2 mixtures, the thermodynamic properties of these mixtures must be determined by using an accurate equation of state. In this paper we present a new decompression model developed using the Computational Fluid Dynamics (CFD) package ANSYS Fluent. The GERG-2008 Equation of State (EOS) was implemented into this model through User Defined Functions (UDF) to predict the thermodynamic properties of CO2 mixtures. The model predictions were in good agreement with the experimental data of two ‘shock tube’ tests. A range of representative CO2 mixtures was examined in terms of the changes in fluid properties from the initial conditions, with time and distance, immediately after a sudden pipeline opening at one end. Phase changes that may occur within the fluid due to condensation of ‘impurities’ in the fluid were also investigated. Simulations were also conducted to examine how the initial temperature and impurities would affect the decompression wave speed

  8. Smoking and the compression of morbidity

    NARCIS (Netherlands)

    W.J. Nusselder (Wilma); C.W.N. Looman (Caspar); P.J. Marang-van de Mheen; H. van de Mheen (Dike); J.P. Mackenbach (Johan)

    2000-01-01

    textabstractOBJECTIVE: To examine whether eliminating smoking will lead to a reduction in the number of years lived with disability (that is, absolute compression of morbidity). DESIGN: Multistate life table calculations based on the longitudinal GLOBE study (the Nether

  9. Overpaying morbidity adjusters in risk equalization models.

    Science.gov (United States)

    van Kleef, R C; van Vliet, R C J A; van de Ven, W P M M

    2016-09-01

    Most competitive social health insurance markets include risk equalization to compensate insurers for predictable variation in healthcare expenses. Empirical literature shows that even the most sophisticated risk equalization models-with advanced morbidity adjusters-substantially undercompensate insurers for selected groups of high-risk individuals. In the presence of premium regulation, these undercompensations confront consumers and insurers with incentives for risk selection. An important reason for the undercompensations is that not all information with predictive value regarding healthcare expenses is appropriate for use as a morbidity adjuster. To reduce incentives for selection regarding specific groups we propose overpaying morbidity adjusters that are already included in the risk equalization model. This paper illustrates the idea of overpaying by merging data on morbidity adjusters and healthcare expenses with health survey information, and derives three preconditions for meaningful application. Given these preconditions, we think overpaying may be particularly useful for pharmacy-based cost groups. PMID:26420555

  10. CDC WONDER: Sexually Transmitted Disease (STD) morbidity

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Sexually Transmitted Disease (STD) Morbidity online databases on CDC WONDER contain case reports reported from the 50 United States and D.C., Puerto Rico,...

  11. CDC WONDER: Sexually Transmitted Disease (STD) Morbidity

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Sexually Transmitted Disease (STD) Morbidity online databases on CDC WONDER contain case reports reported from the 50 United States and D.C., Puerto Rico,...

  12. Rationale, Science, and Economics of Surgical Nerve Decompression for Diabetic Neuropathy Foot Complications.

    Science.gov (United States)

    Nickerson, David Scott

    2016-04-01

    Nerve decompression is effective and safe for dealing with the pain and numbness symptoms of the frequent nerve compression entrapments in diabetic symmetric peripheral neuropathy (DSPN). Evidence has accumulated of balance and stability improvements and protection against diabetic foot ulceration, recurrence and its complication cascade. Nerve decompression proffers significant benefit versus the large socioeconomic costs of DSPN complications. Advancing understanding of the mechanism of nerve compression and altered axonal activity in diabetes clarifies the basis of clinical benefit. Clinicians should seek out and recognize nerve entrapments and consider advising nerve decompression for relief of DSPN symptoms and prevention of complications. PMID:27013417

  13. [Intravascular decompressive aerogenesis ultrasonography in a practice of diving medical physician].

    Science.gov (United States)

    Miasnikov, A A; Goloviashkin, G V; Shitov, A Iu; Motasov, G P; Chumakov, A V; Sukhoroslova, I E; Bobrov, Iu M

    2014-06-01

    The aim of research was substantiation of necessity and accessibility of acoustic indication of intravascular decompressive aerogenesis in a practice of diving medical. Authors define possibilities of portable ultrasound blood flow indicator for location of decompressive gas bubbles. It was found that acoustic indication of intravascular decompressive gas bubbles made by simple portable ultrasonic blood flow meter allows to reveal moving gas bubble in blood flow. Authors came to conclusion that it is necessary to include portable ultrasonic diagnostic equipment into the norms of medical supply for ships, vessels and military units of the Armed Forces of the Russian Federation. PMID:25286575

  14. Assessing morbidity in the paediatric community

    Directory of Open Access Journals (Sweden)

    Escuder Maria Mercedes L

    1999-01-01

    Full Text Available INTRODUCTION: Morbidity information is easily available from medical records but its scope is limited to the population attended by the health services. Information on the prevalence of diseases requires community surveys, which are not always feasible. These two sources of information represent two alternative assessments of disease occurrence, namely demand morbidity and perceived morbidity. The present study was conceived so as to elicit a potential relationship between them so that the former could be used in the absence of the latter. METHODS: A community of 13,365 families on the outskirts of S. Paulo, Brazil, was studied during the period from 15/Nov/1994 to 15/Jan/1995. Data regarding children less than 5 years old were collected from a household survey and from the 2 basic health units in the area. Prevalence of diseases was ascertained from perceived morbidity and compared to estimates computed from demand morbidity. RESULTS: Data analysis distinguished 2 age groups, infants less than 1 year old and children 1 to less than 5. The most important groups of diseases were respiratory diseases, diarrhoea, skin problems and infectious & parasitical diseases. Basic health units presented a better coverage for infants. Though disease frequencies were not different within or outside these units, a better coverage was found for diarrhoea and infectious & parasitical diseases in the infant group, and for diarrhoea in the older age group. Equivalence between the two types of morbidity was found to be limited to the infant group and concerned only the best covered diseases. The odds of a disease being seen at the health service should be of at least 4:10 to ensure this equivalence. CONCLUSION: It was concluded that, provided that health service coverage is good, demand morbidity can be taken as a reliable estimate of community morbidity.

  15. Transvaginal Appendectomy in Morbidly Obese Patient

    OpenAIRE

    Mehmet Ali Yagci; Cuneyt Kayaalp; Mustafa Ates

    2014-01-01

    Introduction. Laparoscopic appendectomy has significant benefits in obese patients. However, morbid obesity can be accepted as an exclusion criterion for natural orifice transluminal endoscopic surgery (NOTES). Here, we present a transvaginal appendectomy in a 66-year-old morbidly obese (BMI 36 kg/m2, ASA III) patient. Case and Technique. Acute appendicitis was suspected based on history, physical examination, laboratory tests, and ultrasound findings. During laparoscopic surgery, a 5 mm troc...

  16. Morbidity is related to a green environment

    OpenAIRE

    Maas, J; Verheij, R. A.; de Vries, S.

    2009-01-01

    ABSTRACT Background: As a result of increasing urbanisation, people face the prospect of living in environments with few green spaces. There is increasing evidence for a positive relation between green space in people’s living environment and self-reported indicators of physical and mental health. This study investigates whether physicianassessed morbidity is also related to green space in people’s living environment. Methods: Morbidity data were derived from electronic medical records of 195...

  17. 颈前路手术治疗脊髓型颈椎病并颈椎外伤所致急性颈髓损伤19例临床分析%Clinical analysis on 19 cases of anterior cervical surgical treatment of acute cervical spinal cord injury caused by cervical spondylotic myelopathy and cervical trauma

    Institute of Scientific and Technical Information of China (English)

    张明友; 陈德元

    2014-01-01

    目的 探讨颈前路椎体次全切并后纵韧带切除减压植骨融合术治疗脊髓型颈椎病并颈椎外伤所导致的急性颈髓损伤的疗效.方法 回顾性分析采用颈前路椎体次全切并后纵韧带切除减压植骨融合术治疗的脊髓型颈椎病并颈椎外伤所导致的急性颈髓损伤的19例患者病历资料,对患者外伤前(T1)、外伤后(T2)、术后1周内(T3)、术后10个月后(T4)四个时期的颈椎曲度及神经功能评分(JOA)变化进行分析,判断手术疗效.结果 所有患者均获得10~24个月随访,平均(15.2±6.7)个月.T1、T2、T3、T4四个时期的颈椎曲度分别为(28.621±1.850)°、(29.326±2.416)°、(38.384±2.611)°、(37.316±2.521)°.T1、T2、T3、T4四个时期的JOA脊髓型颈椎病评分分别为(12.79±1.316)、(4.00±2.082)、(9.68±3.001)、(11.68±3.334).结论 颈前路椎体次全切并后纵韧带切除减压植骨融合术可达到有效减压效果、可重建颈椎曲度,能提供脊髓型颈椎病并颈椎外伤所导致的颈髓损伤有效康复条件;术后积极康复治疗也是改善神经功能的重要方法.%Objective To explore the effect of anterior cervical corpectomy and posterior longitudinal ligament resection and decompression and fusion for the therapeutic in acute cervical spinal cord injury caused by cervical spondylotic myelopathy and cervical trauma.Methods Retrospective analysis was carried out to 19 cases of acute cervical spinal cord injury caused by cervical spondylotic myelopathy and cervical trauma who used anterior cervical corpectomy and posterior longitudinal ligament resection and decompression and fusion for the therapeutic,and analysis of patients before trauma (T)1,post-traumatic (T2),within 1 week after operation (T3),10 months after operation (T4) these four periods about the changes of cervical curvature and neural function (JOA score) were analyzed,then evaluated the operation curative effect.Results All patients were followed

  18. Significance of cervical length and cervical gland area in cervical maturation

    Directory of Open Access Journals (Sweden)

    Channaveeregowda Savitha

    2016-08-01

    Results: Amongst 160 pregnant women who were induced (20 women were excluded has they underwent LSCS for some other reasons during latent phase cervical length by sonography 4. Cervical length 4. Conclusions: Sonographically detected cervical gland area and cervical length was evaluated in predicting response to induction. Absent CGA and CL < 2cm was associated with greater incidence of successful labor induction. This results show the CL and CGA has significant role in predicting outcome of labor. [Int J Reprod Contracept Obstet Gynecol 2016; 5(8.000: 2634-2639

  19. Morbidity and survival patterns in patients after radical hysterectomy and postoperative adjuvant pelvic radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Fiorica, J.V.; Roberts, W.S.; Greenberg, H.; Hoffman, M.S.; LaPolla, J.P.; Cavanagh, D. (Univ.ersity of South Florida College of Medicine, Tampa (USA))

    1990-03-01

    Morbidity and survival patterns were reviewed in 50 patients who underwent radical hysterectomy, pelvic lymphadenectomy, and adjuvant postoperative pelvic radiotherapy for invasive cervical cancer. Ninety percent of the patients were FIGO stage IB, and 10% were clinical stage IIA or IIB. Indications for adjuvant radiotherapy included pelvic lymph node metastasis, large volume, deep stromal penetration, lower uterine segment involvement, or capillary space involvement. Seventy-two percent of the patients had multiple high-risk factors. An average of 4700 cGy of whole-pelvis radiotherapy was administered. Ten percent of the patients suffered major gastrointestinal complications, 14% minor gastrointestinal morbidity, 12% minor genitourinary complications, one patient a lymphocyst, and one patient lymphedema. Of the five patients with major gastrointestinal morbidity, all occurred within 12 months of treatment. Three patients required intestinal bypass surgery for distal ileal obstructions and all are currently doing well and free of disease. All of the patients who developed recurrent disease had multiple, high-risk factors. The median time of recurrence was 12 months. All patients recurred within the radiated field. Actuarial survival was 90% and disease-free survival 87% at 70 months. It is our opinion that the morbidity of postoperative pelvic radiotherapy is acceptable, and benefit may be gained in such a high-risk patient population.

  20. Juvenile Stroke: Cervical Artery Dissection in a Patient after a Polytrauma

    Directory of Open Access Journals (Sweden)

    Nicole Marschner-Preuth

    2013-01-01

    Full Text Available Dissections of the cervical arteries cause about 20% of total juvenile strokes. Approximately 4% of the carotid artery dissections are due to a (polytrauma such as car accidents. Despite improved diagnostic facilities, traumatic dissections are often underdiagnosed or diagnosed too late due to a lack of awareness of potential initial signs and symptoms.We report here a case of a delayed embolic stroke after a car accident caused by a dissection of the carotid artery and subsequent pseudoaneurysm.To reduce the long-term morbidity or mortality of multiple trauma patients, an early detection of cervical carotid and vertebral dissections is strictly necessary.

  1. NECROTIZING FASCIITIS OF THE POSTERIOR CERVICAL COMPARTMENT: AN ATYPICAL CASE DUE TO STREPTOCOCCUS AGALACTIAE

    Directory of Open Access Journals (Sweden)

    Alessandro Abramo

    2012-11-01

    Full Text Available Necrotizing fasciitis is a fulminant infection that affects the deep and superficial fascia while initially sparing the overlying skin and underlying muscle. The involvement of the cervicalcompartment is associated with a high morbidity and mortality rate. Immunocompromised patients are prone to this infection. We present a case of a 80 year-old diabetic woman suffering from streptococcal cervical NF (probably secondary to a arm injury with an uncommon involvement of the posterior cervical compartment, highlighting the atypical responsible microorganism (Streptococcus Agalactiae, the role of imaging for early diagnosis and the timely surgical and medical treatment for a successful outcome.

  2. Uterine didelphys with cervical incompetence

    OpenAIRE

    Aher Gautam S, Gavali Urmila G, Kulkarni Meghana

    2013-01-01

    Uterine didelphys represents a uterine malformation where the uterus is present as a paired organ. There is presence of double uterine bodies with two separate cervices, and often a double or septate vagina as well. We report a case of single pregnancy in the right sided uterine body of a didelphic uterus with cervical incompetence.

  3. Uterine didelphys with cervical incompetence

    Directory of Open Access Journals (Sweden)

    Aher Gautam S, Gavali Urmila G, Kulkarni Meghana

    2013-04-01

    Full Text Available Uterine didelphys represents a uterine malformation where the uterus is present as a paired organ. There is presence of double uterine bodies with two separate cervices, and often a double or septate vagina as well. We report a case of single pregnancy in the right sided uterine body of a didelphic uterus with cervical incompetence.

  4. Anterior cervical discectomy and fusion with titanium cages for simple or multilevel herniated discs and spur of the cervical spine: Report of 2 cases and experience in Bali

    Science.gov (United States)

    Mahadewa Tjokorda, G. B.; Nyoman, Golden; Sri, Maliawan; Junichi, Mizuno

    2016-01-01

    This report presents two cases of cervicobrachialgia and radiculopathy due to multiple cervical herniated discs and spur formation that dealt with anterior cervical discectomy and fusion (ACDF) using different titanium interbody cages. The description of the clinical presentation, magnetic resonance imaging (MRI) appearances and management strategy are discussed. Both cases showed chronic neck pain and radiating pain from the shoulder to the arm. They had a history of blurry vision, cluster head ache, weakness, and numbness on the shoulder for 2 years. MRI revealed multiple herniated discs between C4-7 and accompanied by the spur formation leading to the narrowness of the spinal canal and its foramina bilaterally. ACDF were performed and complete decompression of the spinal canal and its foramina were carried out. Twin M-cages (Ammtec Inc.-Japan) were placed in the first case at C5-7 levels and single cage of Smith Robinson (SR) was placed in the second case at C5-6 levels. There were no more blurry vision, cluster headache, weakness, and numbness, immediately after surgery. To our knowledge, this is the first reported cases of ACDF, using twin M-cages and single SR cage in Indonesia, with improvement immediately after surgery. Cervical spondylosis can present with cervicobrachialgia and radiculopathy and surgical treatment produces good functional outcome. PMID:27695567

  5. EXPERIMENTAL STUDY OF DECOMPRESSION, PERMEABILITY AND HEALING OF SILICATE ROCKS IN FAULT ZONES

    Directory of Open Access Journals (Sweden)

    V. Ya. Medvedev

    2015-09-01

    Full Text Available The article presents results of petrophysical laboratory experiments in studies of decompression phenomena associated with consequences of abrupt displacements in fault zones. Decompression was studied in cases of controlled pressure drop that caused sharp changes of porosity and permeability parameters, and impacts of such decompression were analyzed. Healing of fractured-porous medium by newly formed phases was studied. After experiments with decompression, healing of fractures and pores in silicate rock samples (3×2×2 cm, 500 °C, 100 MPa took about 800–1000 hours, and strength of such rocks was restored to 0.6–0.7 of the original value. In nature, fracture healing is influenced by a variety of factors, such as size of discontinuities in rock masses, pressure and temperature conditions, pressure drop gradients, rock composition and saturation with fluid. Impacts of such factors are reviewed.

  6. Application of inferior major bone flap craniotomy decompression in brain injury

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    Objective: To summarize the application of inferior major boneflap craniotomy decompression in brain injury operation.Methods: A retrospective analysis was done in 218 cases with brain injuries who were admitted to our department from January 1995 to December 1999 and treated with the inferior major bone flap craniotomy decompression.Results: Of 218 cases, 121 cases (55.50%) were cured according to GOS, 39 (18.30%) were with good recovery or moderate disability, 13 (5.60%) with severe deformity, 3 (1.40%) vegetative life, the rest 42 (19.20%) died after operation; no encephalocele or incarceration were found.Conclusions: The inferior major bone flap craniotomy decompression can remove hematoma timely and completely, is better than general craniotomy decompression and has a positive effect on brain injuries especially when bone flap is small.

  7. The microendoscopic decompression of lumbar stenosis: a review of the current literature and clinical results.

    Science.gov (United States)

    Wong, Albert P; Smith, Zachary A; Lall, Rohan R; Bresnahan, Lacey E; Fessler, Richard G

    2012-01-01

    Lumbar stenosis is a well-defined pathologic condition with excellent surgical outcomes. Empiric evidence as well as randomized, prospective trials has demonstrated the superior efficacy of surgery compared to medical management for lumbar stenosis. Traditionally, lumbar stenosis is decompressed with open laminectomies. This involves removal of the spinous process, lamina, and the posterior musculoligamentous complex (posterior tension band). This approach provides excellent improvement in symptoms, but is also associated with potential postoperative spinal instability. This may result in subsequent need for spinal fusion. Advances in technology have enabled the application of minimally invasive spine surgery (MISS) as an acceptable alternative to open lumbar decompression. Recent studies have shown similar to improved perioperative outcomes when comparing MISS to open decompression for lumbar stenosis. A literature review of MISS for decompression of lumbar stenosis with tubular retractors was performed to evaluate the outcomes of this modern surgical technique. In addition, a discussion of the advantages and limitations of this technique is provided. PMID:22900163

  8. Exploiting Aerobic Fitness to Reduce Risk of Hypobaric Decompression Sickness

    Science.gov (United States)

    Conkin, J.; Gernhardt, M. L.; Wessel, J. H.

    2007-01-01

    Decompression sickness (DCS) is multivariable. But we hypothesize an aerobically fit person is less likely to experience hypobaric DCS than an unfit person given that fitness is exploited as part of the denitrogenation (prebreathe, PB) process prior to an altitude exposure. Aerobic fitness is peak oxygen uptake (VO2pk, ml/kg/min). Treadmill or cycle protocols were used over 15 years to determine VO2pks. We evaluated dichotomous DCS outcome and venous gas emboli (VGE) outcome detected in the pulmonary artery with Doppler ultrasound associated with VO2pk for two classes of experiments: 1) those with no PB or PB under resting conditions prior to ascent in an altitude chamber, and 2) PB that included exercise for some part of the PB. There were 165 exposures (mean VO2pk 40.5 plus or minus 7.6 SD) with 25 cases of DCS in the first protocol class and 172 exposures (mean VO2pk 41.4 plus or minus 7.2 SD) with 25 cases of DCS in the second. Similar incidence of the DCS (15.2% vs. 14.5%) and VGE (45.5% vs. 44.8%) between the two classes indicates that decompression stress was similar. The strength of association between outcome and VO2pk was evaluated using univariate logistic regression. An inverse relationship between the DCS outcome and VO2pk was evident, but the relationship was strongest when exercise was done as part of the PB (exercise PB, coef. = -0.058, p = 0.07; rest or no PB, coef. = -0.005, p = 0.86). There was no relationship between VGE outcome and VO2pk (exercise PB, coef. = -0.003, p = 0.89; rest or no PB, coef. = 0.014, p = 0.50). A significant change in probability of DCS was associated with fitness only when exercise was included in the denitrogenation process. We believe a fit person that exercises during PB efficiently eliminates dissolved nitrogen from tissues.

  9. Preoperative serum squamous cell carcinoma antigen levels in clinical decision making for patients with early-stage cervical cancer

    NARCIS (Netherlands)

    Reesink-Peters, N; van der Velden, J; ten Hoor, KA; Boezen, HM; de Vries, EGE; Schilthuis, MS; Mourits, MJE; Nijman, HW; Aalders, JG; Hollema, H; Pras, E; Duk, JM; van der Zee, AGJ

    2005-01-01

    PURPOSE: To prevent morbidity associated with double modality treatment, early-stage cervical cancer patients should only be offered surgery when there is a low likelihood for adjuvant radiotherapy. We analyzed whether serum squamous cell carcinoma antigen (SCC-ag) analysis allows better preoperativ

  10. Biliary metal stents are superior to plastic stents for preoperative biliary decompression in pancreatic cancer

    OpenAIRE

    Decker, Christopher; Christein, John D.; Phadnis, Milind A.; Mel Wilcox, C.; Varadarajulu, Shyam

    2011-01-01

    Background It is unclear whether plastic or metal stents are more suitable for preoperative biliary decompression in pancreatic cancer. The objective of this study was to compare the rate of endoscopic reinterventions in patients with pancreatic cancer undergoing plastic or self-expandable metal stent (SEMS) placements for preoperative biliary decompression. Methods This was a retrospective study of all patients with obstructive jaundice secondary to pancreatic head cancer who underwent their...

  11. Spinal cord decompression reduces rat neural cell apoptosis secondary to spinal cord injury*

    OpenAIRE

    Xu, Kan; Chen, Qi-xin; Li, Fang-cai; Chen, Wei-Shan; Lin, Min; Wu, Qiong-hua

    2009-01-01

    Objective: To determine whether spinal cord decompression plays a role in neural cell apoptosis after spinal cord injury. Study design: We used an animal model of compressive spinal cord injury with incomplete paraparesis to evaluate neural cell apoptosis after decompression. Apoptosis and cellular damage were assessed by staining with terminal deoxynucleotidyl transferase (TdT)-mediated deoxyuridine triphosphate nick-end labelling (TUNEL) and immunostaining for caspase-3, Bcl-2 and Bax. Meth...

  12. Radiotherapy of Cervical Cancer.

    Science.gov (United States)

    Vordermark, Dirk

    2016-01-01

    Curative-intent radical radiotherapy of cervical cancer consists of external-beam radiotherapy, brachytherapy, and concomitant chemotherapy with cisplatin. For each element, new developments aim to improve tumor control rates or treatment tolerance. Intensity-modulated radiotherapy (IMRT) has been shown to reduce gastrointestinal toxicity and can be used to selectively increase the radiotherapy dose. Individualized, image-guided brachytherapy enables better adaptation of high-dose volumes to the tumor extension. Intensification of concomitant or sequential systemic therapy is under evaluation. PMID:27614991

  13. Electrodiagnosis of cervical radiculopathy.

    Science.gov (United States)

    Hakimi, Kevin; Spanier, David

    2013-02-01

    Cervical radiculopathy is a common diagnosis with a peak onset in the fifth decade. The most commonly affected nerve root is C7, C6, and C8. The etiology is often compressive, but may arise from noncompressive sources. Patients commonly complain of pain, weakness, numbness, and/or tingling. Examination may reveal sensory or motor disturbance in a dermatomal/myotomal distribution. Neural compression and tension signs may be positive. Diagnostic tests include imaging and electrodiagnostic study. Electrodiagnostic study serves as an extension of the neurologic examination. Electrodiagnostic findings can be useful for patients with atypical symptoms, potential pain-mediated weakness, and nonfocal imaging findings.

  14. Co-morbidities of vertiginous diseases

    Directory of Open Access Journals (Sweden)

    Ferrari Uta

    2009-07-01

    Full Text Available Abstract Background Co-morbidities of vertiginous diseases have so far not been investigated systematically. Thus, it is still unclear whether the different vertigo syndromes (e.g. benign paroxysmal positional vertigo (BPPV, Meniere's disease (MD, vestibular migraine and phobic vertigo (PPV have also different spectrums of co-morbidities. Methods All patients from a cohort of 131 participants were surveyed using a standardised questionnaire about the co-morbidities hypertension, diabetes mellitus, BMI (body mass index, migraine, other headache, and psychiatric diseases in general and the likelihood of a depression in particular. Results We noted hypertension in 29.0% of the cohort, diabetes mellitus in 6.1%, migraine in 8.4%, other headache in 32.1%, psychiatric diseases in 16.0%, overweight and obesity in 33.6% and 13.7% respectively, as well as a clinical indication for depression in 15.9%. Conclusion In general, we did not detect an increased prevalence of the co-morbidities diabetes mellitus, arterial hypertension, migraine, other headache and obesity compared to the general population. There was an increased prevalence of psychiatric co-morbidity in patients with PPV, and the prevalence of hypertension was elevated in patients with MD.

  15. HPV-vaccination for the prevention of cervical cancer in Austria: a model based long-term prognosis of cancer epidemiology

    OpenAIRE

    Zechmeister, Ingrid; Freiesleben de Blasio, Birgitte; Garnett, Geoff

    2009-01-01

    Abstract Aim Cervical cancer incidence and mortality have decreased for the last 20 years in Austria; however, they remain relatively high in comparison to other European countries. Screening quality has been suboptimal. In this paper we aim to predict the population-wide long-term effects on cervical cancer morbidity and mortality after introducing an HPV vaccination for 12-year-old girls (and boys) in addition to current screening in comparison with scr...

  16. Utilization of cervical cancer screening services and its associated factors among primary school teachers in Ilala Municipality, Dar es Salaam, Tanzania

    OpenAIRE

    Kileo, Neema Minja; Michael, Denna; Neke, Nyasule Majura; Moshiro, Candida

    2015-01-01

    Background Worldwide cervical cancer is one of the more common forms of carcinoma among women, causing high morbidity and high mortality. Despite being a major health problem in Tanzania, screening services for cervical cancer are very limited, and uptake of those services is low. We therefore conducted a study to investigate utilization of cancer screening services, and its associated factors among female primary school teachers in Ilala Municipality, Dar es Salaam. Method We conducted a cro...

  17. Endoscopic optic nerve decompression for nontraumatic compressive optic neuropathy

    Directory of Open Access Journals (Sweden)

    Cheng-long REN

    2015-11-01

    Full Text Available Objective To describe the preliminary experience with endoscopic optic nerve decompression (EOND for nontraumatic compressive optic neuropathies (NCONs. Methods The clinical data of 10 patients, male 5 and female 5, with a mean age of 44.3±5.1 years, who underwent EOND for visual loss (n=5 or visual deterioration (n=5 due to tumor compression in General Hospital of Armed Police Forces of China in the period from April 2013 to April 2014 were analyzed retrospectively. Preoperative and 6-month-postoperative clinical and imaging data of these patients were reviewed and analyzed. Results Among 5 patients who lost light perception (including 2 patients with bilateral optic nerve compression before operation, 4 of them showed visual improvement to different degrees on the 7th day after operation (with improvement of bilateral visual acuity. The other 5 patients with visual impairment before operation recovered their visual acuity to different extent after the operation. All of the patients had no obvious post-operative complications. Conclusion EOND is a safe, effective, and minimally invasive surgical technique affording recovery of visual function to NCON patients. DOI: 10.11855/j.issn.0577-7402.2015.11.12

  18. Window decompression in laser-heated MagLIF targets

    Science.gov (United States)

    Woodbury, Daniel; Peterson, Kyle; Sefkow, Adam

    2015-11-01

    The Magnetized Liner Inertial Fusion (MagLIF) concept requires pre-magnetized fuel to be pre-heated with a laser before undergoing compression by a thick solid liner. Recent experiments and simulations suggest that yield has been limited to date by poor laser preheat and laser-induced mix in the fuel region. In order to assess laser energy transmission through the pressure-holding window, as well as resultant mix, we modeled window disassembly under different conditions using 1D and 2D simulations in both Helios and HYDRA. We present results tracking energy absorption, time needed for decompression, risk of laser-plasma interaction (LPI) that may scatter laser light, and potential for mix from various window thicknesses, laser spot sizes and gas fill densities. These results indicate that using thinner windows (0.5-1 μm windows) and relatively large laser spot radii (600 μm and above) can avoid deleterious effects and improve coupling with the fuel. Sandia is a multiprogram laboratory operated by Sandia Corporation, a Lockheed Martin Company, for the National Nuclear Security Administration under DE-AC04- 94AL85000.

  19. Deep borehole excavation by hydrostatic-decompression/suction spallation

    Energy Technology Data Exchange (ETDEWEB)

    Ruhle, J.L. [California State Univ., Fullerton, CA (United States). Dept. of Geological Sciences

    1996-09-01

    Any deep drilling system that seeks to abrade or claw its way through deeply buried rock is highly energy-intensive and very much like trying to cut a pane of glass with a hacksaw. Since rock is very weak in tension, it should require far less energy input to fail the rock at the bottom of a deep borehole if the rock were subjected to tensional loads. Furthermore, a significant amount of elastic energy is stored in the matrix of deeply buried rock, and a large amount of hydraulic and pneumatic energy is stored in the pore-fluids of deeply buried rock. Given the relative ease of inducing deep-borehole breakouts by means of minor downward adjustments in drilling fluid density, and given the stress-relief core-disking effects associated with deep coring operations, the rock at the bottom of a deep borehole should readily destroy itself by means of its own self-contained energy if a deliberate and concerted effort were made to induce a rockburst at the bottom of the borehole. A drilling apparatus has recently been designed and prototyped which is intended to excavate rock at the bottom of a deep borehole by means of hydrostatic-decompression and suction-spallation effects. The initial test results are presented and evaluated.

  20. Potential Fifty Percent Reduction in Saturation Diving Decompression Time Using a Combination of Intermittent Recompression and Exercise

    Science.gov (United States)

    Gernhardt, Michael I.; Abercromby, Andrew; Conklin, Johnny

    2007-01-01

    Conventional saturation decompression protocols use linear decompression rates that become progressively slower at shallower depths, consistent with free gas phase control vs. dissolved gas elimination kinetics. If decompression is limited by control of free gas phase, linear decompression is an inefficient strategy. The NASA prebreathe reduction program demonstrated that exercise during O2 prebreathe resulted in a 50% reduction (2 h vs. 4 h) in the saturation decompression time from 14.7 to 4.3 psi and a significant reduction in decompression sickness (DCS: 0 vs. 23.7%). Combining exercise with intermittent recompression, which controls gas phase growth and eliminates supersaturation before exercising, may enable more efficient saturation decompression schedules. A tissue bubble dynamics model (TBDM) was used in conjunction with a NASA exercise prebreathe model (NEPM) that relates tissue inert gas exchange rate constants to exercise (ml O2/kg-min), to develop a schedule for decompression from helium saturation at 400 fsw. The models provide significant prediction (p saturation decompression schedule from saturation at 400 fsw required 114.5 h with a maximum Bubble Growth Index (BGI(sub max)) of 17.5. Decompression using intermittent recompression combined with two 10 min exercise periods (75% VO2 (sub peak)) per day required 54.25 h (BGI(sub max): 14.7). Combined intermittent recompression and exercise resulted in a theoretical 53% (2.5 day) reduction in decompression time and theoretically lower DCS risk compared to the standard USN decompression schedule. These results warrant future decompression trials to evaluate the efficacy of this approach.

  1. Indication for the operative methods in surgical treatment of cervical spondylotic myelopathy. Shape of the spinal cord in the CT-myelography

    Energy Technology Data Exchange (ETDEWEB)

    Kobayashi, Akira; Inoue, Shunichi; Watabe, Tsuneo; Nagase, Joji; Harada, Yoshitada (Chiba Univ. (Japan). School of Medicine)

    1984-04-01

    Indication for the operative methods for cervical spondylotic myelopathy was examined in 16 patients undergoing CT-myelography before and after operation. There was a highly significant correlation between the anteroposterior (A-P) diameter of the spinal cord and clinical symptoms. Patients with shorter A-P diameter of the spinal cord tended to have severer preoperative clinical symptoms. Clinical symptoms improved as the post operative A-P diameter of the spinal cord increased. Fixation with decompression of the anterior spinal cord should be indicated when constriction of 5 mm or less of the spinal cord is seen segmentally at the level of the intervertebral disc. Dilation of the spinal cavity should be indicated when the constriction of the spinal cord is 5 mm or less at all levels of the cervical spinal cord. In performing fixation with anterior decompression, 15 mm is considered to be the most suitable width for complete and safe decompression of the flattened spinal cord with a wide transverse diameter.

  2. [Cervical Spondylotic Amyotrophy].

    Science.gov (United States)

    Sonoo, Masahiro

    2016-05-01

    Keegan (1965) reported a patient who presented with "dissociated motor loss," an acute paralysis of the upper extremity with minimal sensory signs and no long tract signs, and documented an anterior root lesion following autopsy. Sobue et al. (1975) reported similar cases using the term "cervical spondylotic amyotrophy (CSA)," but postulated pathology of the anterior horn. Although Keegan's "dissociated motor loss" surely referred to isolated motor paresis with no or minimal sensory signs, contrary to existing criticism, a more general term, CSA, should be preferred. CSA is divided into proximal and distal types. Distal CSA often presents with a drop finger, and thus may be misdiagnosed as posterior interosseous nerve palsy. Documentation of the involvement of ulnar muscles by clinical signs and EMG would lead to the diagnosis of distal CSA. Proximal CSA may be confused with neuralgic amyotrophy (NA), although the sparing of the serratus anterior and the stereotypic involvement of deltoid, infraspinatus, biceps brachii, and brachioradialis suggest CSA. Cervical MRI is not diagnostic in around half of CSA cases, and denervation in paraspinal EMG is a more sensitive test that can exclude NA. Amyotrophic lateral sclerosis is another important differential diagnosis for CSA. PMID:27156504

  3. GENETIC INSTABILITY IN CERVICAL CARCINOMA

    Institute of Scientific and Technical Information of China (English)

    赵旻; 伍欣星; 邱小萍; 李晖; 戴天力; 谭云

    2002-01-01

    Objective: The role of human papillomavirus (HPV) in the development of cervical carcinoma has been clearly established but other factors could be involved in cervical tumorigenesis such as loss of heterozygosity (LOH) and microsatellite instability (MI). The aim of the present study was to investigate the genetic instability in cervical carcinoma tissues and provide evidence for discoveringnew tumor suppressor genes and screening diagnostic molecular marker of cervical carcinoma. Methods: Fifty primary cervical carcinoma samples from high-incidence area were analyzed by PCR for HPV16 infection, LOH and microsatellite instability. Results: HPV16 was detected in 88% of the cases. Sixty-six percent of total cases showed LOH with no more than 3 different loci per case. The highest frequency of the allelic loss was found in D18S474 (18q21, 40.5%). MI was detected in 4 cases (8%) only. Conclusion: Different percentages of LOH on specific chromosomal regions were found and MI was very infrequent in cervical carcinoma. The putative suppressor gene(s) could be located on specific chromosome regions such as 18q, and genetic instability could be involved in cervical tumorigenesis.

  4. Cardiac morbidity risk and depression and anxiety

    DEFF Research Database (Denmark)

    Tully, Phillip J; Pedersen, Susanne S.; Winefield, Helen R;

    2011-01-01

    Questionnaire and a measure of Type D personality traits. Postoperative cardiac morbidity was confirmed after surgery during the index hospitalization and included stroke,renal failure, ventilation>24 h, deep sternal wound infection, reoperation, arrhythmia and 30-day mortality at any location (n=59, 37.......3% of total). After adjustment for age, recent myocardial infarction, heart failure, hypertension, urgency of surgery and time spent on cardiopulmonary bypass generalized anxiety disorder was associated with cardiac morbidity (odds ratio [OR]=3.26, 95% confidence interval [CI] 1.10-9.67, p=0.03). Adjusted...

  5. [Expansion dilatation balloons for cervical ripening in obstetric practice].

    Science.gov (United States)

    Ducarme, G; Grange, J; Vital, M

    2016-02-01

    During recent decades, mechanical devices have been substituted by pharmacological methods. Their place in the therapeutic arsenal remains important with a renewed obstetrical interest for these devices. Due to a lack of data they are still not recommended as first-line. This review thus attempted to examine the use of expansion dilatation balloons (Foley catheter and double-balloons) to analyze their effectiveness in case of native uterus and previous cesarean section. Twenty-seven clinical trials had compared balloons catheter and prostaglandins in patients without a history of uterine scar. The risk of cesarean section did not differ. Mechanical methods seemed to be more effective in achieving delivery within 24hours, with fewer episodes of excessive uterine contractions, but they necessitated more oxytocin during labor. Ten clinical trials analyzed dilatation balloons in patients with previous cesarean section. More than 70% women had favorable cervical ripening (Bishop score>6), and vaginal delivery was reported between 35 and 70% of patients. The risk of uterine rupture was low between 0.64 and 0.72%, with neither increased risk of severe neonatal and maternal morbidity nor increased risk of infectious morbidity. Mechanical methods are effective and safe for third trimester cervical ripening, mainly in women with previous cesarean section. Potential advantages may include wide availability and reduction of some of the side effects. PMID:26774842

  6. Decompression alone versus decompression with instrumented fusion for young patients with single-level lumbar disc herniation:a short-term prospective comparative study

    Institute of Scientific and Technical Information of China (English)

    Sun Zhuoran; Li Weishi; Chen Zhongqiang; Guo Zhaoqing; Qi Qiang; Zeng Yan; Sun Chuiguo

    2014-01-01

    Background For young patients,the surgical method for lumbar disc herniation remains controversial.The aim of this study was to prospectively determine the short-term clinical outcome after surgery for young patients with lumbar disc herniation.Methods In this prospective comparative study between April 2010 and August 2011,a total of 80 patients underwent primary surgery at a single level for lumbar disc herniation.The patients were divided into two groups:decompression alone and decompression with instrumented fusion.An independent examiner clinically evaluated the patients at preoperation and at 1,3,6,and 12 months after surgery.The patients filled out the instruments for back and leg pain using a Visual Analog Scale (VAS),Oswestry Low Back Pain Disability Questionnaire (ODI),and Japanese Orthopaedic Association (JOA) scores.The differences between the two groups were analyzed.Results The mean age of all the patients at the time of surgery was 33.7 years.Of the 80 patients,38 patients underwent decompression alone and 42 patients underwent posterior lumbar interbody fusion.Increasing complexity of surgery was associated with a longer surgery time,greater blood loss,and a longer hospital stay after surgery.Both methods of surgery independently improved outcomes compared with baseline status based on VAS,ODI,and JOA scores (P <0.05),and no significant differences were found between the two groups at most of the measuring points in time,although patients with decompression alone had a higher JOA score (P=0.016) and higher JOA recovery rate (P=0.010) at the 3-month follow-up.Conclusions The short-term results of our study showed that both methods of surgery obtained effective clinical outcomes,but decompression alone had some advantages (shorter surgery time,less blood loss,shorter hospital stay,and lower cost) compared with decompression with instrumented fusion.Young patients with decompression alone could achieve great physical function earlier.

  7. Langerhans cell histiocytosis of the cervical spine: a single institution experience in four patients.

    Science.gov (United States)

    Tan, Grace; Samson, Ignace; De Wever, Ivo; Goffin, Jan; Demaerel, Philippe; Van Gool, Stefaan W

    2004-03-01

    When Langerhans cell histiocytosis (LCH) occurs at critical sites, such as in the cervical spine, there is a substantial risk for morbidity. Therefore, reports on clinical experiences with those patients remain important. We summarize the history of four patients with unifocal LCH at the cervical spine. All four patients received a biopsy to prove the histopathological diagnosis of LCH by demonstration of CD1a+cells. They were treated with oral prednisolone. All patients recovered completely and kept a normal function of the cervical spine. No reactivation of the disease occurred with an observation time of 3.4-7.3 years. This report contributes to the clinical experience for the treatment of LCH at critical sites. PMID:15076592

  8. Endoplasmic reticulum aminopeptidase 2 is highly expressed in papillary thyroid microcarcinoma with cervical lymph node metastasis

    Directory of Open Access Journals (Sweden)

    Woo Young Kim

    2015-01-01

    Full Text Available Background: The cervical lymph node metastasis (CLNM of papillary thyroid microcarcinoma (PTMC is not uncommon. However, prophylactic cervical lymph node dissection in all PTMC is debatable. Molecular markers of predicting CLNM would help to decide to either do or not do cervical lymph node dissection which might increase morbidities. Aims: We aimed to characterize gene expression profiles and molecular markers of CLNM in PTMC. Settings and Design: The thyroid frozen tissues were obtained with from six PTMC patients, who underwent total thyroidectomy. Methods: We performed oligonucleotide microarray analysis with three PTMCs with CLNM and three without CLNM. Real-time quantitative reverse transcription-polymerase chain reaction was used to validate the gene. Statistical Analysis Used: We used linear models for microarray data. Results: We identified 12 differentially expressed gene, and most one is endoplasmic reticulum aminopeptidase 2 (ERAP2. Conclusion: ERAP2 might be associated with CLNM in PTMC.

  9. Morbidity from iliac crest bone harvesting

    NARCIS (Netherlands)

    Kalk, WWI; Raghoebar, GM; Jansma, J; Boering, G

    1996-01-01

    Purpose: The iliac crest is the most common donor site for autogenous bone grafting in maxillofacial surgery. The aim of this study was to evaluate retrospectively the morbidity of bone harvesting from the inner table of the anterior iliac crest. Patients and Methods: Sixty-five patients were recall

  10. HIV, co-morbidity and ageing

    Directory of Open Access Journals (Sweden)

    Reiss P

    2012-11-01

    Full Text Available As treatment for HIV infection needs to be used continuously and lifelong, issues concerning long-term outcomes, including those involving tolerability and safety of treatment, are gaining increasing importance. Although current combination antiretroviral therapy (cART regimens are generally better tolerated than those in the early days of cART, treatment toxicity remains an important cause for discontinuation of (components of treatment. Moreover, several of the potential toxicities of cART (including cardiovascular, metabolic, renal and bone toxicity overlap with known ageing-associated co-morbidities. Given that our patient population with HIV is increasingly getting older as a result of the success of cART in reducing traditional HIV-associated morbidity and mortality, these co-morbidities are increasingly being seen and importantly influence patient management. Moreover, persons with HIV, in spite of having suppressed viraemia on cART seem to be at increased risk of the premature development of age-associated non-communicable co-morbidities, including cardiovascular, chronic kidney, liver and pulmonary disease, diabetes mellitus, osteoporosis, non-AIDS associated malignancies, and neurocognitive impairment. It has therefore been hypothesised that such individuals, despite effective cART, may be prone to accelerated ageing. The underlying pathogenesis is likely to be multifactorial and, apart from include sustained immune activation, both systemically and within the central nervous system. The presentation will review the current state of knowledge and investigation in this area.

  11. Transvaginal appendectomy in morbidly obese patient.

    Science.gov (United States)

    Yagci, Mehmet Ali; Kayaalp, Cuneyt; Ates, Mustafa

    2014-01-01

    Introduction. Laparoscopic appendectomy has significant benefits in obese patients. However, morbid obesity can be accepted as an exclusion criterion for natural orifice transluminal endoscopic surgery (NOTES). Here, we present a transvaginal appendectomy in a 66-year-old morbidly obese (BMI 36 kg/m(2), ASA III) patient. Case and Technique. Acute appendicitis was suspected based on history, physical examination, laboratory tests, and ultrasound findings. During laparoscopic surgery, a 5 mm trocar was inserted through the umbilicus and a 5 mm telescope was placed. A 12 mm trocar and a 5 mm grasper were inserted separately through the posterior fornix of the vagina under laparoscopic guidance. The appendix was divided with an endoscopic stapler through the transvaginal 12 mm trocar and removed from the same trocar. The operating time was 75 minutes with minimal blood loss (appendectomy at morbid obesity. We can say that morbid obesity does not constitute an obstacle for treatment of acute appendicitis by transvaginal endoscopic surgery. PMID:25506028

  12. Transvaginal Appendectomy in Morbidly Obese Patient

    Directory of Open Access Journals (Sweden)

    Mehmet Ali Yagci

    2014-01-01

    Full Text Available Introduction. Laparoscopic appendectomy has significant benefits in obese patients. However, morbid obesity can be accepted as an exclusion criterion for natural orifice transluminal endoscopic surgery (NOTES. Here, we present a transvaginal appendectomy in a 66-year-old morbidly obese (BMI 36 kg/m2, ASA III patient. Case and Technique. Acute appendicitis was suspected based on history, physical examination, laboratory tests, and ultrasound findings. During laparoscopic surgery, a 5 mm trocar was inserted through the umbilicus and a 5 mm telescope was placed. A 12 mm trocar and a 5 mm grasper were inserted separately through the posterior fornix of the vagina under laparoscopic guidance. The appendix was divided with an endoscopic stapler through the transvaginal 12 mm trocar and removed from the same trocar. The operating time was 75 minutes with minimal blood loss (<10 mL. The patient was discharged 16 hours after surgery uneventfully and she did not require any analgesic administration. Conclusion. To the best of our knowledge, this is the first clinical case that focuses on the transvaginal appendectomy at morbid obesity. We can say that morbid obesity does not constitute an obstacle for treatment of acute appendicitis by transvaginal endoscopic surgery.

  13. Co-Morbidity of Conditions among Prisoners

    Science.gov (United States)

    Shinkfield, Alison J.; Graffam, J.; Meneilly, Sharn

    2009-01-01

    Eighty seven adult prisoners (58 males, 29 females) completed the Beck Depression Inventory (BDI-II), Beck Anxiety Inventory (BAI), and a questionnaire on current health in order to examine both the prevalence of co-morbid conditions and the relation of depression and anxiety to ill-health and prior substance use. High prevalence rates of…

  14. Combined modality therapy for stage ⅠB cervical cancer

    Institute of Scientific and Technical Information of China (English)

    Yang Qiuan; Qian Shao; Yang Xingsheng

    2009-01-01

    Objective:To evaluate the current approaches for multimodality therapy for stage ⅠB cervical cancer. Methods:The relevant literature has served as a source for identified high or intermediate risks and management of stage ⅠB cervical cancer. Result:The high risks include pelvic lymph node metastasis (PLNM), positive resection margin (PRM), and the in-volvement of parametrium (IPM). The intermediate risks include deep stromal invasion (DSI), bulky tumor size ( BTS), lymphovascular space invasion (LVSI). Adeno-carcinomatous histo-type is the new risk feature relevant to poor prognoses. Both radical hysterectomy plus bilateral pelvic lymph node dissection(PLND) and radical radiotherapy have proven to be equally effec-tive. Surgery is more performed for stage ⅠB1 disease;radiotherapy or chemoradiotherapy is preferable for stage ⅠB2 disease. For patients with one high risk or two of intermediate risks, radical hysterectomy plus PLND followed by concurrent chemoradiotherapy can improve overall survival(OS) and disease-free survival (DFS). Conclusion:The management should be indi-vidualized for stage ⅠB cervical cancer. The optimized multidisciplinary therapy can benefit pa-tients with the best cure and minimum morbidity and complications.

  15. Modified “in-window” technique for decompressive craniotomy for severe brain injury

    Directory of Open Access Journals (Sweden)

    Jovanović Momir J.

    2015-01-01

    Full Text Available Increased intracranial pressure and decreased cerebral perfusion in patients with severe traumatic brain injury are associated with cerebral ischemia and poor outcome. Lowering intracranial pressure is one of the goals of treatment. We analyzed the effects of decompressive craniotomy on intracranial pressure levels and outcome. In addition, we compared the results of decompressive craniotomy performed with our original technique (modified “in-window” technique, with no need for cranioplasty with results of classic techniques. We formed two groups: 52 patients with TBI (GCS≤8, with monitored intracranial pressure, and the control: 45 patients without intracranial pressure monitoring. In the first group, malignant intracranial hypertension was treated by decompressive craniotomy, using a modified "in-window" technique. Results were analyzed using standard statistical methods. In the first group, with intracranial pressure monitoring, 17/52 had decompressive craniotomy, and significant reduction of intracranial pressure appeared in the early postoperative period (38.82 to 22.76 mmHg, mean, with significant decrease of intracranial pressure at the end of treatment, compared to the control group (mean=25.00, and 45.30 mmHg, respectively. Late complications were similar to results of other studies. Our results were 20% of epileptic seizures, 8% of hydrocephalus, 12% contusion/hematoma progression and 12% subdural hygroma. Outcome (measured with Glasgow Outcome Score-GOS in the first group, at the time of discharge, was better with decompressive craniotomy than without decompressive craniotomy (GOS=2.47, and GOS=1.00, respectively. Modified "in-window" technique for decompressive craniotomy in severe traumatic brain injury is safe, promising and according to our experience offers a lower rate of complications with no need for additional cranioplastic surgery.

  16. Spinal cord decompression reduces rat neural cell apoptosis secondary to spinal cord injury

    Institute of Scientific and Technical Information of China (English)

    Kan XU; Qi-xin CHEN; Fang-cai LI; Wei-shan CHEN; Min LIN; Qiong-hua WET

    2009-01-01

    Objective: To determine whether spinal cord decompression plays a role in neural cell apoptosis after spinal cord injury. Study design: We used an animal model of compressive spinal cord injury with incomplete paraparesis to evaluate neural cell apoptosis after decompression. Apoptosis and cellular damage were assessed by staining with terminal deoxynucleotidyl transferase (TdT)-mediated deoxyuridine triphosphate nick-end labelling (TUNEL) and immunostaining for caspase-3, Bcl-2 and Bax. Methods: Experiments were conducted in male Spragne-Dawley rats (n=78) weighing 300-400 g. The spinal cord was compressed posteriorly at T10 level using a custom-made screw for 6 h, 24 h or continuously, followed by decompression by removal of the screw. The rats were sacrificed on Day 1 or 3 or in Week 1 or 4 post-decompression. The spinal cord was removed en bloc and examined at lesion site, rostral site and caudal site (7.5 mm away from the lesion). Results: The numbers of TUNEL-positive cells were significantly lower at the site of decompression on Day l, and also at the rostral and caudal sites between Day 3 and Week 4 post-decompression, compared with the persistently compressed group. The numbers of cells between Day 1 and Week 4 were immunoreactive to caspase-3 and B-cell lymphoma-2 (Bcl-2)-associated X-protein (Bax), but not to Bcl-2, correlated with those of TUNEL-positive cells. Conclusion: Our results suggest that decompression reduces neural cell apoptosis following spinal cord injury.

  17. Health seeking behavior for cervical cancer in Ethiopia: a qualitative study

    OpenAIRE

    Birhanu Zewdie; Abdissa Alemseged; Belachew Tefera; Deribew Amare; Segni Hailemariam; Tsu Vivien; Mulholland Kim; Russell Fiona M

    2012-01-01

    Abstract Background Although cervical cancer is a leading cause of cancer related morbidity and mortality among women in Ethiopia, there is lack of information regarding the perception of the community about the disease. Methods Focus group discussions were conducted with men, women, and community leaders in the rural settings of Jimma Zone southwest Ethiopia and in the capital city, Addis Ababa. Data were captured using voice recorders, and field notes were transcribed verbatim from the loca...

  18. Metformin Enhances Anti-proliferative Effect of Cisplatin in Cervical Cancer Cell Line

    OpenAIRE

    Ratih D. Yudhani; Riza N. Pesik; Dono Indarto

    2016-01-01

    Cervival cancer is one of the top rank of gynecological malignancy in the world, leading to high morbidity and mortality rates. Cisplatin is a chemotherapeutic agent that is generally used to treat cervical cancer but the use of this drug is limited because of serious side effects. Metformin, a diabetic drug, decreases not only blood glucose levels but also cell viability of some cancer cells. The aim of this study was to investigate the anti-proliferative effect of combination metformin and ...

  19. Hemangiopericytoma of the cervical spine

    Directory of Open Access Journals (Sweden)

    Raghvendra V Ramdasi

    2014-01-01

    Full Text Available A 28-year-old male presented with neck pain and dysesthesias in the right upper limb. On examination, he had a firm, well-defined midline posterior cervical mass discernible on palpation at the mid-cervical level. He had no neurological deficit. Neuroradiology revealed a variegated enhancing cervical mass is arising from C3 lamina. The mass extended into the right extradural space eroding the C3 lamina and posteriorly into the intermuscular plane. The tumor was excised totally. Histopathology of the tumor showed features of hemangiopericytoma (HPC. The patient underwent postoperative radiotherapy. Primary osseous spinal HPC are rare malignant extra-axial tumors that tend to recur and metastasize. Only two cases of primary osseous HPC have been reported earlier to involve the cervical spine. The clinical presentation and management of the present case with a review of the literature is presented.

  20. Glycoprotein and Glycan in Tissue and Blood Samples of Patients With Stage IB-IVA Cervical Cancer Undergoing Surgery to Remove Pelvic and Abdominal Lymph Nodes

    Science.gov (United States)

    2016-10-26

    Cervical Adenocarcinoma; Cervical Adenosquamous Carcinoma; Cervical Small Cell Carcinoma; Cervical Squamous Cell Carcinoma, Not Otherwise Specified; Stage IB Cervical Cancer; Stage IIA Cervical Cancer; Stage IIB Cervical Cancer; Stage III Cervical Cancer; Stage IVA Cervical Cancer

  1. Percutaneous endoscopic cervical discectomy: 16 years of experience and literature review Discectomía endoscópica percutánea cervical: 16 años de experiência y revisión de la literatura Discectomia endoscópica percutânea cervical: 16 anos de experiência e revisão da literatura

    Directory of Open Access Journals (Sweden)

    Gun Choi

    2009-09-01

    Full Text Available The advancement of the percutaneous endoscopic lumbar discectomy (PECD and its clinical success have led to similar minimally invasive approaches to the cervical spine. The goal of PECD is the decompression of the cervical nerve root through a direct endoscopic visualization, removing the herniated mass and shrinking the nucleous pulposus with the use of microforceps and holmium: yttrium-aluminum-garnet (Ho:YAG laser. The senior author have performed PECD with cervical laser assisted endoscopy since 1993. The PECD is indicate to patients with constrained or unconstrained soft herniated cervical disc, positive provocative test, and no bony spur larger than 2 mm, regardless of the herniation size. The authors described the surgical technique of PECD and report their 16 years of experience in the endoscopic treatment of the herniated cervical disc.El avance en la discectomía endoscópica percutánea lumbar y su triunfo clínico llevaron a abordajes mínimamente invasivos en la columna cervical. El objetivo de la discectomía endoscópica percutánea cervical es descomprimir la raíz del nervio cervical, por una visualización endoscópica directa, eliminando el fragmento herniado y disminuyendo el núcleo pulposo, con el uso de fórceps y micro Holmio: itrio-aluminio-granada (Ho:YAG laser. La discectomía endoscópica percutánea cervical con laser ha sido utilizada desde 1993. Esta es indicada en pacientes con hernia discal contenida o no, test provocativo positivo, ausencia de osteofitos mayores que 2 mm, independientemente del tamaño de la hernia. Los autores describen la técnica quirúrgica de discectomía endoscópica percutánea cervical y relatan 16 años de experiencia en el tratamiento endoscópico de disco cervical herniado.O avanço da discectomia endoscópica percutânea lombar e seu sucesso clínico levaram a abordagens minimamente invasivas para a coluna cervical. O objetivo da discectomia endoscópica percutânea cervical é o de

  2. Reoperations Following Cervical Disc Replacement

    OpenAIRE

    Skovrlj, Branko; Lee, Dong-Ho; Caridi, John Michael; Cho, Samuel Kang-Wook

    2015-01-01

    Cervical disc replacement (CDR) has emerged as an alternative surgical option to cervical arthrodesis. With increasing numbers of patients and longer follow-ups, complications related to the device and/or aging spine are growing, leaving us with a new challenge in the management and surgical revision of CDR. The purpose of this study is to review the current literature regarding reoperations following CDR and to discuss about the approaches and solutions for the current and future potential c...

  3. Early posterior spinal canal decompression and circumferential reconstruction of rotationally unstable thoracolumbar burst fractures with neurological deficit

    Institute of Scientific and Technical Information of China (English)

    ZHENG Guo-quan; WANG Yan; TANG Pei-fu; ZHANG Yong-gang; ZHANG Xue-song; GUO Yi-zhu; TAO Sheng

    2013-01-01

    Background Among the various treatments of neurologically involved unstable thoracolumbar burst fractures,the combination of anterior and posterior instrumentation provides the most stable reconstruction.However,the use of both approaches on a trauma patient may increase the morbidity.This study is a retrospective matched cohort study to evaluate the advantages of a single stage posterior approach for spinal canal decompression in combination with circumferential reconstruction by comparing the clinical and radiographic results.Methods From March 2005 to September 2009,patients with matched type spinal fracture,ages at surgery,and involved levels in our institute underwent either a single stage posterior approach (group one,n=12) or traditional combined approach (group two,n=14) for spinal canal decompression and circumferential reconstruction were reviewed.Pre-and post-operative X-ray films were reviewed and changes in Cobb angle of thoracolumbar spine were documented.Intra-operative,post-operative,and general complications were registered.Results The mean follow-up was (27.7±9.6) months (range,14 to 56 months) in group one and (29.2±7.4) months (range,20 to 60 months) in group two (P >0.05).The mean operation time was 214 minutes (range,186-327 minutes) in group one and 284 minutes (range,219-423 minutes) in group two (P <0.05).The average volume of intraoperative blood loss was 1856 ml (range,1250-3480 ml) in group one and 2453 ml (range,1600-3680 ml) in group two (P <0.05).There was no statistical difference between the groups one and two in average vertebral body height loss at the injured level and the average Cobb angle in sagittal plane before and immediately after surgery.Postoperatively,there was an epidural hematoma in one patient in group one and two patients in group two.Bony union after stabilization was obtained in all patients,without loosening or breakage of screws.Loss of correction (5°) was seen in 1 patient in group one at the 6th month

  4. Derivation of Mortal Injury Metric for Studies of Rapid Decompression of Depth-Acclimated Physostomous Fish

    Energy Technology Data Exchange (ETDEWEB)

    McKinstry, Craig A.; Carlson, Thomas J.; Brown, Richard S.

    2007-11-05

    In 2005 the U.S. Army Corps of Engineers (USACE) began a study to investigate the response of hatchery and run-of-the-river (ROR) juvenile Chinook salmon to the effects of rapid decompression during passage through mainstem Federal Columbia River Power System (FCRPS) Kaplan turbines. In laboratory studies conducted by Pacific Northwest National Laboratory (PNNL) for USACE since 2005, juvenile fish have been exposed to rapid decompression in a barometric pressure chamber. An initial study considered the response of juvenile Chinook salmon bearing radio transmitters to rapid decompression resulting from exposure to a pressure time history simulating the worst case condition that might be experienced during passage through an operating turbine. The study in 2005 found that acclimation depth was a very important treatment factor that greatly influenced the significantly higher incidence of injury and mortality of rapidly decompressed Chinook salmon bearing radio telemetry devices. In 2006 we initiated a statistical investigation using data in hand into derivation of a new end-point measure for assessment of the physiological response of juvenile Chinook salmon to rapid decompression. Our goal was a measure that would more fully utilize both mortality and injury data while providing a better assessment of the most likely survival outcome for juvenile physostomous fish exposed to rapid decompression. The conclusion of the analysis process was to classify fish as mortally injured when any of the 8 injuries are present, regardless of whether the fish was last observed alive or not. The mortally injured classification has replaced mortality as the end point metric for our rapid decompression studies. The process described in this report is an example of how a data set may be analyzed to identify decision criterion for objective classification of test fish to a specific end-point. The resulting list of 8 mortal injuries is applicable to assess injuries from rapid

  5. Exercise with prebreathe appears to increase protection from decompression sickness: Preliminary findings

    Science.gov (United States)

    Webb, James T.; Fischer, Michele D.; Heaps, Cristine L.; Pilmanis, Andrew A.

    1994-01-01

    Extravehicular activity (EVA) from the Space Shuttle involves one hour of prebreath with 100% oxygen, decompression of the entire Shuttle to 10.2 psia for at least 12 hours, and another prebreath for 40 minutes before decompression to the 4.3 psia suit pressure. We are investigating the use of a one-hour prebreathe with 100% oxygen beginning with a ten-minute strenuous exercise period as an alternative for the staged decompression schedule described above. The 10-minute exercise consists of dual-cycle ergometry performed at 75% of the subject's peak oxygen uptake to increase denitrogenation efficiency by increasing ventilation and perfusion. The control exposures were preceded by a one-hour prebreathe with 100% oxygen while resting in a supine position. The twenty-two male subjects were exposed to 4.3 psia for 4 hours while performing light to moderate exercise. Preliminary results from 22 of the planned 26 subjects indicate 76% DCS following supine, resting prebreathe and 38% following prebreathe with exercise. The staged decompression schedule has been shown to result in 23% DCS which is not significantly different from the exercise-enhanced prebreathe results. Prebreathe including exercise appears to be comparable to the protection afforded by the more lengthy staged decompression schedule. Completion of the study later this year will enable planned statistical analysis of the results.

  6. [Surgical management of trigeminal neuralgia, hemifacial spasm, paroxysmal tinnitus and nystagmus by neurovascular decompression].

    Science.gov (United States)

    Isu, T; Abe, H; Nakagawa, Y; Aida, T; Tsuru, M; Ito, T; Murai, H

    1983-11-01

    Trigeminal neuralgia, facial spasm, tinnitus, vertigo, and glossopharyngeal neuralgia are believed to be the symptoms complex of hyperactive dysfunction of the cranial nerve caused by vascular cross compression at the root entry (exit) zone of the appropriate nerve. Posterior cranial fossa approach for the neurovascular decompression was enhanced by Jannetta et al (1975). From their experiences of surgery, they emphasized that these symptoms were relieved by surgery. In this report, we will discuss the etiology of the disease, the neurotological examination, the angiographic findings, the operative findings and results in a series of 10 patients who have undergone neurovascular decompression. The series consisted of 4 cases with trigeminal neuralgia, 5 cases with facial spasm, and 1 case with paroxysmal tinnitus accompanied by facial spasm. The postoperative progress in these all patients was excellent and relieved of the symptoms. There was neither mortality nor any significant complication. We stress that the neurovascular decompression surgery is now well justified as the definite treatment for the trigeminal neuralgia and facial spasm, because the surgery can be performed easily and safely by the neurosurgeons. The indication of the neurovascular decompression for the acoustic nerve and glossopharyngeal nerve is still controversial. In our own case, tinnitus was paroxysmal and complicated with facial spasm, not synchronous with facial spasm, but with nystagmus. This selective synchronism between tinnitus and nystagmus is a particular feature of our clinical instance. This particular clinical experience may provide some highly significant suggestions in considering the applicability of neurovascular decompression to the acoustic nerve. PMID:6671636

  7. Cervical disc arthroplasty with ProDisc-C artificial disc: 5-year radiographic follow-up results

    Institute of Scientific and Technical Information of China (English)

    ZHAO Yan-bin; SUN Yu; ZHOU Fei-fei; LIU ZHONG-jun

    2013-01-01

    Background Cervical disc arthroplasty is an alternative surgery to standard cervical decompression and fusion for disc degeneration.Different types of cervical disc prosthesis are used in China.The aim of this study was to evaluate the radiographic outcomes of cervical arthroplasty using the ProDisc-C prosthesis.Methods Radiographic evaluation,including static and dynamic flexion-extension lateral images,was performed at baseline and at final follow-up.Results Twenty six patients who had single-level ProDisc-C arthroplasty were followed up for a mean period of 63 months (56-76 months).The range of motion at the operated level was 9.3°±3.7° at baseline and 7.3°±3.5° at final follow-up,with a significant difference (P <0.05).Seventeen of 26 levels (65.4%) developed heterotopic ossification:three were classified as grade Ⅱ,13 were classified as grade Ⅲ,and 1 as grade Ⅳ,according to McAfee's classification.Forty nine adjacent segments were evaluated by lateral Ⅹ-ray and 18 (36.7%) segments developed adjacent segment degenerations.Conclusions ProDisc-C arthroplasty had acceptable radiographic results at 5-year follow-up.The range of motion was preserved.However,more than 60% of the patients developed heterotopic ossification.

  8. Commentary on article: Laminoplasty versus laminectomy and fusion for multilevel cervical myelopathy: A meta-analysis of clinical and radiological outcomes by Chang-Hyun Lee et al

    Directory of Open Access Journals (Sweden)

    Nancy E Epstein

    2015-01-01

    Full Text Available Background: This is a commentary on the article laminoplasty versus laminectomy and fusion (LF for multilevel cervical myelopathy: A meta-analysis of clinical and radiological outcomes by Chang-Hyun Lee et al. Here, the authors utilized seven studies to compare the efficacy of cervical expansive laminoplasty (EL versus laminectomy and fusion (LF to address three or more level multilevel cervical spondylotic myelopathy (CSM. Both procedures led to similar degrees of neurological recovery and short-term loss of lordosis, but found that LF led to more favorable long-term results. Methods: For patients with three or more level CSM, laminectomy followed by an instrumented fusion (LF has major advantages; open bilateral decompression of the nerve roots, while minimizing the risk of inadvertent injury to the cord, and the fusion′s maintenance of lordosis. Results: Some would argue that inadvertent cord/root injury is greater utilizing any of the EL techniques; e.g., unilateral, bilateral, or spinous process splitting techniques. In short, why risk cord/root injury by manipulating the compressive posterior/posterolateral elements, which are already threatening neural function. Conclusion: Although the results of EL versus LF appeared comparable in the short-term in these seven articles, LF resulted in better long-term outcomes. Some would also argue that LF, utilizing an open approach offers safer bilateral neural exposure and decompression.

  9. 颈椎前路锁定钢板治疗颈椎疾病的疗效观察%Effectiveness of Anterior Cervical Locking Plate System in Cervical Surgery

    Institute of Scientific and Technical Information of China (English)

    任云峰; 熊鹰; 赵烽; 张仲子

    2011-01-01

    目的 观察颈椎前路减压、取髂骨植骨结合锁定型钢板系统内固定治疗颈椎疾病的临床疗效.方法 2001年3月至2008年3月采用该方法治疗颈椎疾病34例,并进行12 ~24个月后随访.结果 术前Frankel分级A-D级31例中,25例有1 ~2级的改善,6例无明显改善.植骨块融合良好,无严重并发症发生.结论 该方法具有固定牢靠、植骨融合率高、手术操作简单、手术并发症少等优点,是一种治疗颈椎疾病的良好方法.%Objective To evaluate the effectiveness of anterior decompression, bone grafting combined with locking plate system internal fixation for cervical spinal desease.Methods From March 2001 to March 2008 34 patients were operated with anterior decompression, bone grafting and locking plate system fixation, all the patients were followed up for 12 to 24 months.Results 25 patients of Frankel's A-D were improved by to 2 degree after operation,6 patients had no obvious improvement.There was no plate or screw breaking and loosening; no dislocation of graft bone, all the bones were fusion in 6 months.Conclusion Anterior decompression , bone grafting combined with locking plate system internal fixation can provide reliable stability for the fixation segments with higher bony fusion rate,less complications,and the operation was much simple and safe.It was a good choice for treatment of cervical spinal disease.

  10. 经皮激光颈椎间盘减压术的临床研究%Clinical study of percutaneous laser disc decompression

    Institute of Scientific and Technical Information of China (English)

    付昌马; 杨祖华

    2011-01-01

    Objective To evaluate the clinical value of percutaneous laser for the treatment of cervical disc herniation. Methods Percutaneous laser disc decompression (PLDD) was performed in 16 cases with cervical disc herniation, including 6 cases of C4-5 and 4 cases of C5 -6and C4-5 disk with ND:YAG laser. Under guidance of C -ray fluoroscopy, a needle was punctured into the lumbar disc . and the laser fiber was introduced into the disc center through needle tube, and then the laser was vaporied. During the process, the gas was aspirated from the disc continually. And the energy was up to 250 ~500J joules. Results The pressure of the intervertebral disc was reduced,and the compression of nerve root and annulus fibrosis the protrusion was relieved. the total efficiency was 90%. Conclusion Percutaneous laser disc decompression (PLDD) is a safe ,effective,simple method for the treatment of intervertebral disc protrusion. And the trauma is small. Its effect is positive.%目的 探讨经皮激光椎间盘减压术治疗颈椎间盘突出症的临床运用价值.方法 使用ND:YAG激光治疗颈椎间盘突出症10例,其中C4-5椎间盘突出6例,C5-6和C4-5同时突出4例,C臂透视下将激光光纤沿穿刺针插入椎间盘髓核中进行汽化,每节总量250~500 J能量进行汽化,从而减轻椎间盘内压力.结果 椎间盘内压力减低,神经根受压解除,突出的椎间盘组织回缩,10例患者其优良率为90%.结论 经皮激光颈椎间盘减压术是一种安全、简单、有效的治疗椎间盘突出症的微创方法,因此必将受到广大患者的欢迎.

  11. Laparoscopic sleeve gastrectomy for morbid obesity

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    The incidence of obesity is steadily rising,and it has been estimated that 40% of the US population will be obese by the year 2025 if the current trend continues.In recent years there has been renewed interest in the surgical treatment of morbid obesity in concomitance with the epidemic of obesity.Bariatric surgery proved effective in providing weight loss of large magnitude,correction of comorbidities and excellent short-term and long-term outcomes,decreasing overall mortality and providing a marked survival advantage.The Laparoscopic Sleeve Gastrectomy (LSG) has increased in popularity and is currently very "trendy" among laparoscopic surgeons involved in bariatric surgery.As LSG proved to be effective in achieving considerable weight loss in the shortterm,it has been proposed by some as a sole bariatric procedure.This editorial focuses on the particular advantages of LSG in the treatment of morbid obesity.

  12. Mortality versus Morbidity in the Demographic Transition

    OpenAIRE

    Aksan, Anna-Maria; Chakraborty, Shankha

    2014-01-01

    The link between the mortality and epidemiological transitions is used to identify the effect of the former on the fertility transition: a mortality transition that is not accompanied by improving morbidity causes slower demographic and economic change. In a model where children may die from infectious disease, childhood health affects human capital and noninfectious-disease-related adult mortality. When child mortality falls from lower prevalence, as it did in western Europe, labor productiv...

  13. STUDY ON PSYCHIATRIC CO - MORBIDITY IN PSORIASIS

    OpenAIRE

    Shrikant B.; Parth S; Ashish V; Mundhada

    2015-01-01

    BACKGROUND: Psoriasis is relatively common , chronic inflammatory and hyper - proliferative skin disease that affects 1.4% to 2.0% of the population. Presence of itching , chronic recurrent course of disease and incomplete cure may contribute to great deal of psychiatric co - morbidity in these patients. the most persuasive indications of a link between stress and psoriasis comes from patients themselves , with studies illustrating that the m...

  14. Morbidity Experiences and Disability Among Canadian Women

    Science.gov (United States)

    DesMeules, Marie; Turner, Linda; Cho, Robert

    2004-01-01

    Health Issue Women are more frequently affected by chronic conditions and disability than men. Although some of these sex differences have been in part attributed to biological susceptibility, social determinants of health and other factors, these gaps have not been fully explained in the current literature. This chapter presents comparisons of hospitalization rates, and the prevalence of chronic conditions and physical disability between Canadian women and men and between various subgroups of women, adjusting for selected risk factors. The Canadian Hospital Morbidity Database (2000–2001) and Canadian Community Health Survey (2000–2001) were used to examine inpatient hospital morbidity, prevalence of chronic conditions and disability. Key Findings Hospitalization rates were 20% higher among women than men. This was due to the large number of hospitalizations for pregnancies and childbirth. When "normal" deliveries were excluded, hospitalization rates remained higher among women. Women had slightly lower rates of hospitalizations for ambulatory-care sensitive conditions than men. Prevalence of activity limitation (mild and severe) was higher among women than men, and differences remained after adjusting for age, chronic conditions, socio-economic status, and smoking. Women who reported a disability were less likely than men to be in a partnered relationship, have less tangible social support, and have lower income and employment rates. Data Gaps and Recommendations The impact of morbidity and disability on Canadian women is substantial. These results identify areas for interventions among more vulnerable subgroups, and point to the need for further research in the area of risk factors for the prevention of morbidity and disability in the population. PMID:15345073

  15. Psychiatric Morbidity Among Inmates of Leprosy Homes

    OpenAIRE

    K C Jindal; Gurvinder Pal Singh; Varinder Mohan; Mahajan, B. B.

    2013-01-01

    Context: Leprosy affected people are having high psychological distress and it in turn leads to psychiatric disorders. There is a paucity of literature from our country in this significant health problem. Aims: The aim of this study was to find the prevalence of psychiatric morbidity and its association with sociodemographic and clinical factors among the inmates of leprosy homes. Settings and Design: Study sample was obtained from individuals residing in two leprosy homes of malwa belt of Pu...

  16. Acute Infectious Morbidity in Multiple Gestation

    Directory of Open Access Journals (Sweden)

    Sarah K. Dotters-Katz

    2015-01-01

    Full Text Available Objectives. Physiologic and immunologic changes in pregnancy result in increased susceptibility to infection. These shifts are more pronounced in pregnancies complicated by multiple gestation. The objective of this study was to determine the association between multiple gestation and risk of infectious morbidity. Study Design. The Nationwide Inpatient Sample for the years 2008–2010 was used to identify pregnant women during admission for delivery with International Classification of Diseases codes. Logistic regression was used to compute odds ratios and 95% confidence intervals for demographic data, preexisting medical conditions, and acute medical and infectious complications for women with multiple versus singleton gestations. Results. Among women with multiple gestation, 38.4 per 1,000 women had an infectious complication compared to 12.8 per 1,000 women with singletons. The most significant infectious morbidity associated with multiple gestation was intestinal infections, pyelonephritis, influenza, and pneumonia. After controlling for confounding variables, infectious complications at delivery persisted for women with multiples, though the association was dependent on mode of delivery. Conclusions. Women with multiple gestations are at increased risk for infectious morbidity identified at the time of delivery. This association was diminished among women who had a cesarean suggesting that operative delivery is not responsible for this association.

  17. Morbidity and mortality of diabetes with surgery

    Directory of Open Access Journals (Sweden)

    L. L. Chuah

    2013-01-01

    Full Text Available The prevalence of Type 2 diabetes mellitus (T2DM has increased; as a result the number of patients with T2DM undergoing surgical procedures has also increased. This population is at high risk of macrovascular (cardiovascular disease, peripheral vascular disease or microvascular (retinopathy, nephropathy or neuropathy complications, both increasing their perioperative morbidity and mortality. Diabetes patients are more at risk of poor wound healing, respiratory infection, myocardial infarction, admission to intensive care, and increased hospital length of stay. This leads to increased inpatient costs. The outcome of perioperative glycaemia management remains a significant clinical problem without a universally accepted solution. The majority of evidence on morbidity and mortality of T2DM patients undergoing surgery comes from the setting of cardiac surgery; there was less evidence on non-cardiac surgery and bariatric surgery. Bariatric surgery is increasingly performed in patients with severe obesity complicated by T2DM, but is distinguished from general surgery as it immediately improves the glucose homeostasis postoperatively. The improvements in glycaemia are thought to be independent of weight loss and this requires different postoperative management. Patients usually have to follow specific preoperative diets which lead to improvement in glycaemia immediately before surgery. Here we review the available data on the mortality and morbidity of patients with T2DM who underwent elective surgery (cardiac, non-cardiac and bariatric surgery and the current knowledge of the impact that preoperative, intraoperative and postoperative glycaemic management has on operative outcomes.

  18. Morbidity follow-up feasibility study

    International Nuclear Information System (INIS)

    The report reviews the available sources of data within Canada for undertaking morbidity follow-up studies to both supplement and complement studies using Canadian mortality data. Such studies would permit earlier detection and more sensitive measures of differences in risk for exposures to radiation and allow timely measures to be taken to minimize any occupational and environmental health risk to radiation workers. The technical feasibility of using these sources was reviewed using the criteria of adequate personal identifying information, automation of data records, file size and the accuracy of the morbidity diagnosis information. At the present time certain of the provincial cancer registry files meet these criteria best. A work plan was prepared suggesting a morbidity pilot study to clarify the role of occupational factors in the incidence of cancer among radiation workers using the Alberta Cancer Registry file and the National Dose Registry (NDR) file of radiation workers. For the longer term a full cohort study using the National Cancer Incidence Reporting System (NCIRS) and the NDR workers as the study population would provide information on all radiation workers on a national basis. A work plan was prepared and some initial format conversion of historical data was undertaken to begin developing the NCIRS into a data base suitable for long-term health studies

  19. Dynamic cervical implant in the treatment of cervical spondylosis%颈椎动态稳定器在颈椎病治疗中的应用

    Institute of Scientific and Technical Information of China (English)

    林永绥; 王春; 刘成招; 何海龙; 史国栋; 叶晓健

    2015-01-01

    目的:探讨应用颈椎动态稳定器(dynamic cervical implant,DCI)治疗颈椎病的安全性及早期临床疗效。方法2011年9月~2012年5月施行颈前路减压DCI植入术的患者11例,统计手术时间和术中出血量;观察有无手术并发症的发生;采用疼痛视觉模拟评分法(visual analogue score,VAS)和颈椎功能障碍指数(neck disability index,NDI)评分量表评估患者术前和术后的症状,按日本骨科协会(Japanese orthopaedic association,JOA)评分行术前、术后神经功能评估。结果11例患者均得到随访,其中手术时间(63.9±20.1) min;术中出血量(58.4±22.1) ml;无切口感染,植入物松动、移位、断裂,手术节段异位骨化及颈椎后凸畸形等并发症发生;术后3个月的疼痛VAS和NDI评分与术前比较明显减小,差异有统计学意义(P<0.05);末次随访的JOA评分与术前及术后3个月比较有明显升高,差异有统计学意义(P<0.05)。结论颈前路减压DCI植入术治疗颈椎病在减轻疼痛、恢复神经功能方面是安全有效的,且近期临床疗效满意。%Objective To evaluate the safety and short-term clinical curative effect of dynamic cervical implant(DCI) in the treatment of cervical spondylosis. Methods From September 2011 to May 2012, 11 patients were treated by anterior cervical decompression and DCI implantation. The amount of bleeding and surgical duration were counted, and surgical complication was recorded. The pain visual analogue score (VAS) and neck disability index (NDI) scale were adopted to evaluate pre-and post-operative symptoms, and Japanese orthopaedic association (JOA) score was adopted to evaluate pre-and post-operative nerve function. Results All 11 cases were followed up. The amount of bleeding and the surgical duration were (58.4 ± 22.1) ml and (63.9 ± 20.1) min respectively. Incision infection, implant loosening, dislocation or breakage, operation segment

  20. Suturing-Free Artificial Dura with Dacron Heart Patch in Decompressive Craniectomy and Cranioplasty.

    Science.gov (United States)

    Wang, Fei; Xue, Yan; Zhao, Si-Shun; Yang, Ting-Jian; Song, Hao-Qing; Liu, Hong

    2015-12-01

    Dacron heart patch has been used in decompressive craniectomy, performing the function of septa, mainly to prevent extra adhesion of temporal muscle and decompressive meningeal adhesion in the second-stage cranioplasty, so as to make the operation easier. Then, we made the following modification technology: (1) We used artificial suturing-free dura participate directly in the duraplasty. (2) Dacron patch is not in need of trimming the side holes and can directly cover the decompression window. From March 2012 to October 2013, we applied the technology of artificial dura with Dacron heart patch in 23 patients; after operation, we found that the initial depressive craniectomy cost less time, due to the tension-reduced suture which was not needed, and in the second-stage cranioplasty, the temporal was easy to remove and had no adhesion with the Dacron patch, so as to reach temporal muscle anatomy preservation, and with no obvious postoperative complication. PMID:27011500

  1. Effect of nitric oxide on spinal evoked potentials and survival rate in rats with decompression sickness

    DEFF Research Database (Denmark)

    Randsøe, Thomas; Meehan, Claire Francesca; Broholm, Helle;

    2015-01-01

    or an increased nitrogen washout on decompression through augmented blood flow rate. The present experiments were conducted to investigate whether a short- or long-acting NO donor [glycerol trinitrate (GTN) or isosorbide-5-mononitrate (ISMN), respectively] would offer the same protection against spinal cord DCS...... of DCS. In total, 58 rats were divided into 6 different treatment groups. The first three received either saline (group 1), 300 mg/kg iv ISMN (group 2), or 10 mg/kg ip GTN (group 3) before compression. The last three received either 300 mg/kg iv ISMN (group 4), 1 mg/kg iv GTN (group 5), or 75 μg/kg iv...... GTN (group 6) during the dive, before decompression. In all groups, decompression caused considerable intravascular bubble formation. The ISMN groups showed no difference compared with the control group, whereas the GTN groups showed a tendency toward faster SEP disappearance and shorter survival...

  2. General Purpose Graphics Processing Unit Based High-Rate Rice Decompression and Reed-Solomon Decoding.

    Energy Technology Data Exchange (ETDEWEB)

    Loughry, Thomas A.

    2015-02-01

    As the volume of data acquired by space-based sensors increases, mission data compression/decompression and forward error correction code processing performance must likewise scale. This competency development effort was explored using the General Purpose Graphics Processing Unit (GPGPU) to accomplish high-rate Rice Decompression and high-rate Reed-Solomon (RS) decoding at the satellite mission ground station. Each algorithm was implemented and benchmarked on a single GPGPU. Distributed processing across one to four GPGPUs was also investigated. The results show that the GPGPU has considerable potential for performing satellite communication Data Signal Processing, with three times or better performance improvements and up to ten times reduction in cost over custom hardware, at least in the case of Rice Decompression and Reed-Solomon Decoding.

  3. MRI-guidance in percutaneous core decompression of osteonecrosis of the femoral head

    Energy Technology Data Exchange (ETDEWEB)

    Kerimaa, Pekka; Vaeaenaenen, Matti; Ojala, Risto; Tervonen, Osmo; Blanco Sequeiros, Roberto [Oulu University Hospital, Department of Radiology (Finland); Hyvoenen, Pekka; Lehenkari, Petri [Oulu University Hospital, Department of Surgery (Finland)

    2016-04-15

    The purpose of this study was to evaluate the usefulness of MRI-guidance for core decompression of avascular necrosis of the femoral head. Twelve MRI-guided core decompressions were performed on patients with different stages of avascular necrosis of the femoral head. The patients were asked to evaluate their pain and their ability to function before and after the procedure and imaging findings were reviewed respectively. Technical success in reaching the target was 100 % without complications. Mean duration of the procedure itself was 54 min. All patients with ARCO stage 1 osteonecrosis experienced clinical benefit and pathological MRI findings were seen to diminish. Patients with more advanced disease gained less, if any, benefit and total hip arthroplasty was eventually performed on four patients. MRI-guidance seems technically feasible, accurate and safe for core decompression of avascular necrosis of the femoral head. Patients with early stage osteonecrosis may benefit from the procedure. (orig.)

  4. [Surgical treatment of trigeminal neuralgia--neurovascular decompression established by Jannetta].

    Science.gov (United States)

    Isu, T; Abe, H; Nakagawa, Y; Mitsumori, K; Nakagawa, T; Sakuragi, M; Tsuru, M; Ito, T

    1985-01-01

    The etiology of trigeminal neuralgia has been unknown. However, recently, trigeminal neuralgia is believed to be caused by vascular cross compression at the root entry zone of the trigeminal nerve. Posterior cranial fossa approach for the neurovascular decompression was enhanced by Jannetta et al. They emphasized that the pain was relieved by surgery. In this report, we will discuss the operative findings and results in a series of 8 patients who have undergone neurovascular decompression. The postoperative progress in all of these patients was excellent and relieved of the pain. There was neither mortality nor any significant complication. We stress that the neurovascular decompression surgery is now well justified as the definite treatment for the trigeminal neuralgia. PMID:3988235

  5. Analysis of digitized cervical images to detect cervical neoplasia

    Science.gov (United States)

    Ferris, Daron G.

    2004-05-01

    Cervical cancer is the second most common malignancy in women worldwide. If diagnosed in the premalignant stage, cure is invariably assured. Although the Papanicolaou (Pap) smear has significantly reduced the incidence of cervical cancer where implemented, the test is only moderately sensitive, highly subjective and skilled-labor intensive. Newer optical screening tests (cervicography, direct visual inspection and speculoscopy), including fluorescent and reflective spectroscopy, are fraught with certain weaknesses. Yet, the integration of optical probes for the detection and discrimination of cervical neoplasia with automated image analysis methods may provide an effective screening tool for early detection of cervical cancer, particularly in resource poor nations. Investigative studies are needed to validate the potential for automated classification and recognition algorithms. By applying image analysis techniques for registration, segmentation, pattern recognition, and classification, cervical neoplasia may be reliably discriminated from normal epithelium. The National Cancer Institute (NCI), in cooperation with the National Library of Medicine (NLM), has embarked on a program to begin this and other similar investigative studies.

  6. MULTIMODAL PHYSIOTHERAPEUTIC APPROACH IN TREATING A PATIENT WITH ACUTE CERVICAL DISC PROLAPSE: A CASE REPORT

    Directory of Open Access Journals (Sweden)

    Rathish Manickam

    2015-12-01

    Full Text Available Background and Purpose: Cervical disc prolapse is one of the leading cause of morbidity and affecting the patients routine work of their ADL. Due to severity of symptoms and patients feeling of insecurity, physiotherapeutic conservative approach is questionable and has become challengeable against surgery. The purpose of this case report is to explore the efficacy of multimodal physiotherapeutic approach in treating a patient with acute cervical disc prolapse. Case Description: 33 year old male patient was diagnosed with acute cervical disc prolapse and the pain was radiating to the right upper limb associated with numbness. The patient was given initially physiotherapeutic modalities like cryotherapy, ultrasound and mechanical traction to reduce pain. Muscle Energy Technique was also implemented for initial days along with cryotherapy based on cryokinetics concept to enhance movements of cervical spine. Mckenzie exercises with appropriate techniques was administered for 10 days along with retraction exercise, basic ROM and neck isometrics as a home program. The patient received treatment for a period of 12 days. Outcome Measures: The outcome measures used were Numeric Pain Rating Scale, Neck Disability Index, Tampa Scale for Kinesiophobia, and Cervical ROM. Conclusion: Multimodal physiotherapeutic approach along with Mckenzie technique played a significant role in alleviating pain, numbness and improvement of the patient functionally for return to his normal work.

  7. Magma decompression rates during explosive eruptions of Kīlauea volcano, Hawaii, recorded by melt embayments

    Science.gov (United States)

    Ferguson, David J.; Gonnermann, Helge M.; Ruprecht, Philipp; Plank, Terry; Hauri, Erik H.; Houghton, Bruce F.; Swanson, Donald A.

    2016-10-01

    The decompression rate of magma as it ascends during volcanic eruptions is an important but poorly constrained parameter that controls many of the processes that influence eruptive behavior. In this study, we quantify decompression rates for basaltic magmas using volatile diffusion in olivine-hosted melt tubes (embayments) for three contrasting eruptions of Kīlauea volcano, Hawaii. Incomplete exsolution of H2O, CO2, and S from the embayment melts during eruptive ascent creates diffusion profiles that can be measured using microanalytical techniques, and then modeled to infer the average decompression rate. We obtain average rates of ~0.05-0.45 MPa s-1 for eruptions ranging from Hawaiian style fountains to basaltic subplinian, with the more intense eruptions having higher rates. The ascent timescales for these magmas vary from around ~5 to ~36 min from depths of ~2 to ~4 km, respectively. Decompression-exsolution models based on the embayment data also allow for an estimate of the mass fraction of pre-existing exsolved volatiles within the magma body. In the eruptions studied, this varies from 0.1 to 3.2 wt% but does not appear to be the key control on eruptive intensity. Our results do not support a direct link between the concentration of pre-eruptive volatiles and eruptive intensity; rather, they suggest that for these eruptions, decompression rates are proportional to independent estimates of mass discharge rate. Although the intensity of eruptions is defined by the discharge rate, based on the currently available dataset of embayment analyses, it does not appear to scale linearly with average decompression rate. This study demonstrates the utility of the embayment method for providing quantitative constraints on magma ascent during explosive basaltic eruptions.

  8. Roux-en-Y reconstruction does not require gastric decompression after radical distal gastrectomy

    Institute of Scientific and Technical Information of China (English)

    Cheng-Jueng Chen; Tsang-Pai Liu; Jyh-Cherng Yu; Sheng-Der Hsua; Tsai-Yuan Hsieh; Heng-Cheng Chu; Chung-Bao Hsieh; Teng-Wei Chen; De-Chuan Chan

    2012-01-01

    AIM: To determine whether routine nasogastric (NG) decompression benefitted patients undergoing radical gastric surgery.METHODS: Between January 1998 and December 2008, 519 patients who underwent distal gastrectomy for gastric cancer were retrospectively divided into 2 time-period cohorts; those treated with Billroth Ⅱ (BⅡ) reconstruction in the first 6 years and those with Roux-en-Y (RY) reconstruction in the last 5 years. In the latter group, the patients were further divided into 2 subgroups; with and without nasogastric decompression.RESULTS: Postoperatively, there were no significant differences in the number of anastomotic leaks between the 3 groups. In the tubeless RY group, time to semi-liquid diet was significantly shorter than in the other 2 groups (4.4 d ± 1.4 d vs 7.2 d ± 1.3 d and 5.9 d ± 1.2 d, P = 0.005). The length of postoperative stay was significantly increased in patients with BⅡ reconstruction compared with patients with RY reconstruction with/without NG decompression (15.4 d ± 4.3 d in BⅡgroup vs 12.6 d ± 3.1 d in decompressed RY and 11.4 d ± 3.4 d in the tubeless RY group, P = 0.035). The postoperative pneumonia rate was lowest in the tubeless group and highest in the BⅡ group (1.4% vs 4.6%, P = 0.01). Severe sore throat was noted in 59 (20.7%) members of the BⅡ group, 18 (17.4%) members of the decompressed RY group and 6 (4.2%) members of the tubeless RY group. Fewer patients in the tubeless group complained of severe sore throat (P = 0.001).CONCLUSION: This study provides support for abandoning routine NG decompression in patients undergoing subtotal gastrectomy with Roux-en-Y gastrojejunostomy.

  9. Posttraumatic hydrocephalus associated with decompressive cranial defect in severe brain-injured patients

    Directory of Open Access Journals (Sweden)

    SHI Song-sheng

    2012-02-01

    Full Text Available 【Abstract】Objective: To investigate the occurrence of posttraumatic hydrocephalus (PTH in severe brain- injured patients who underwent decompressive craniectomy (DC and to discuss the management. Methods: A total of 389 patients suffering from severe head trauma between January 2004 and May 2010 were enrolled in this study. Clinical data were analyzed retrospectively. Of them, 149 patients who underwent DC were divided into two groups according to the presence of PTH: hydrocephalus group and nonhydrocephalus group. Clinical factors including preoperative Glasgow Coma Score (GCS, bilateral or unilateral decompression, and duraplasty in DC were assessed by single factor analysis to determine its relationship with the occurrence of PTH. Results: Of the 149 patients undergoing DC, 25 (16.8% developed PTH; while 23 developed PTH (9.6% among the rest 240 patients without DC. Preoperative GCS, bilateral or unilateral decompression, duraplasty in DC were significantly associated with the development of PTH. Ventriculoperitoneal shunt was performed on 23 of 25 patients with PTH after DC. Frontal horn was preferred for the placement of the catheter. Sixteen of them were operated upon via frontal approach and 7 via occipital approach. After shunt surgery, both radiological and clinical improvements were confirmed in 19 patients. Radiological improvement was found in 2 patients. One patient died eventually of severe pneumonia. Shunt-related infection occurred in 1 patient, which led to the removal of the catheter. Conclusions: It is demonstrated that the occurrence of PTH is high in patients with large decompressive skull defect. Patients with low GCS and bilateral decompression tend to develop PTH after DC. Duraplasty in DC might facilitate reducing the occurrence of PTH. Patients with PTH concomitant skull defect should be managed deliberately to restore the anatomical and physiological integrity so as to facilitate the neurological resuscitation. Key

  10. Prevention program of cervical cancer - Enrique Pouey

    International Nuclear Information System (INIS)

    This work is about the first basic objectives in the prevention of cervical cancer in Uruguay. The Papanicolaou test, the biopsia, and the colposcopy are important studies for the early cervical cancer detection

  11. A Combined Therapy for Cervical Spondylopathy

    Institute of Scientific and Technical Information of China (English)

    李佳

    2004-01-01

    @@ Cervical spondylopathy is a common disease frequently encountered in the middle-aged and old people. It is a consequence of degeneration, strain or deformation of the physiological curvature of the cervical vertebral body.

  12. Preventing Cervical Cancer with HPV Vaccines

    Science.gov (United States)

    Cervical cancer can be prevented with HPV vaccines. NCI-supported researchers helped establish HPV as a cause of cervical cancer. They also helped create the first HPV vaccines, were involved in the vaccine trials, and contribute to ongoing studies.

  13. Three-level cervical disc herniation

    Directory of Open Access Journals (Sweden)

    St. Iencean Andrei

    2015-09-01

    Full Text Available Multilevel cervical degenerative disc disease is well known in the cervical spine pathology, with radicular syndromes or cervical myelopathy. One or two level cervical herniated disc is common in adult and multilevel cervical degenerative disc herniation is common in the elderly, with spinal stenosis, and have the same cause: the gradual degeneration of the disc. We report the case of a patient with two level cervical disc herniation (C4 – C5 and C5 – C6 treated by anterior cervical microdiscectomy both levels and fusion at C5 – C6; after five years the patient returned with left C7 radiculopathy and MRI provided the image of a left C6 – C7 disc herniation, he underwent an anterior microsurgical discectomy with rapid relief of symptoms. Three-level cervical herniated disc are rare in adults, and the anterior microdiscectomy with or without fusion solve this pathology.

  14. Nephroureteral Obstructions: The Use of Stents and Ureteral Bypass Systems for Renal Decompression.

    Science.gov (United States)

    Palm, Carrie A; Culp, William T N

    2016-11-01

    Canine and feline nephroureteral obstruction is a complex disease process that can be challenging to treat. Although the availability of various imaging modalities allows for a straightforward diagnosis to be made in most cases, the decision-making process for when a case should be taken to surgery and the optimal treatment modality that should be used for renal decompression remains controversial. In the following discussion, an overview of the perioperative management of cases with nephroureterolithiasis and nephroureteral obstruction is reviewed, with particular focus on the use of renal decompressive procedures, such as ureteral stenting and subcutaneous ureteral bypass system placement. PMID:27497503

  15. Multifocal, bone manifestation of decompression sickness in a professional pilot: A case report

    Directory of Open Access Journals (Sweden)

    Anna Kuśmierska

    2013-04-01

    Full Text Available Decompression sickness is a group of pathological processes occurring in the body, following its exposure to an excessive drop in atmospheric pressure. The paper presents a case of a 62-year-old patient with no substantial disease history, a long-standing professional military pilot who was diagnosed with multifocal, bone manifestation of decompression sickness during the diagnosis of right knee joint injury following a torsion injury. The case was presented to draw attention to the usefulness of occupational history in the process of diagnosing osteoarticular system diseases. Med Pr 2013;64(2:273–279

  16. Laparoscopic Fertility Sparing Management of Cervical Cancer

    OpenAIRE

    Chiara Facchini; Giuseppina Rapacchia; Giulia Montanari; Paolo Casadio; Gianluigi Pilu; Renato Seracchioli

    2014-01-01

    Fertility can be preserved after conservative cervical surgery. We report on a 29-year-old woman who was obese, para 0, and diagnosed with cervical insufficiency at the first trimester of current pregnancy due to a previous trachelectomy. She underwent laparoscopic transabdominal cervical cerclage (LTCC) for cervical cancer. The surgery was successful and she was discharged two days later. The patient underwent a caesarean section at 38 weeks of gestation. Laparoscopic surgery ...

  17. Vertebral artery injuries in cervical spine surgery

    OpenAIRE

    Schroeder, Gregory D.; Hsu, Wellington K.

    2013-01-01

    Background: Vertebral artery injuries during cervical spine surgery are rare, but potentially fatal. When performing cervical spine surgery, it is imperative that the surgeon has a systematic approach for avoiding, and if necessary, dealing with a vertebral artery injury. Methods: This is a review paper. Results: Upper posterior cervical spine surgeries put the vertebral artery at the highest risk, as opposed to anterior subaxial cervical spine procedures, which put the artery at the least ri...

  18. Cervical incompetence: preliminary evaluation with MR imaging.

    Science.gov (United States)

    Hricak, H; Chang, Y C; Cann, C E; Parer, J T

    1990-03-01

    The ability of magnetic resonance (MR) imaging to demonstrate cervical incompetence in nonpregnant women was investigated in a prospective study of 41 volunteers referred in random order. These included 20 patients with normal cervices, 11 with cervical incompetence of traumatic or congenital origin, and 10 with clinically small cervices due to in utero diethylstilbestrol (DES) exposure. On MR images of the normal patients, cervical length was 33.0 mm +/- 1.0 (mean +/- standard error of the mean) and the width of the internal cervical os was 3.3 mm +/- 0.1. In patients with cervical incompetence, the cervical length did not significantly differ from those in the normal group. However, the internal cervical os was significantly wider (4.5 mm +/- 0.3, P less than .001), and localized irregularity of the endocervical canal was demonstrated in two patients. The MR appearance of the cervical stroma varied from normal, uniformly low signal intensity (n = 4) to uniformly (n = 3) or partially (n = 4) medium-to-high signal intensity on T2-weighted images. In the patients with in utero DES exposure, the mean length of the cervical canal (22.9 mm +/- 1.7) was significantly shorter than that of the normal group. The width of the internal cervical os and the MR signal intensity of the cervical stroma were normal. In summary, MR findings of a cervical length shorter than 3.1 mm (95% confidence limit), an internal cervical os wider than 4.2 mm (95% confidence limit), or abnormal signal intensity in the cervical stroma are highly suggestive of incompetent cervix and should assist in planning further therapeutic decisions. PMID:2305065

  19. Developing the Evidence Base to Inform Best Practice: A Scoping Study of Breast and Cervical Cancer Reviews in Low- and Middle-Income Countries.

    Directory of Open Access Journals (Sweden)

    Margaret M Demment

    Full Text Available Breast and cervical cancers have emerged as major global health challenges and disproportionately lead to excess morbidity and mortality in low- and middle-income countries (LMICs when compared to high-income countries. The objective of this paper was to highlight key findings, recommendations, and gaps in research and practice identified through a scoping study of recent reviews in breast and cervical cancer in LMICs.We conducted a scoping study based on the six-stage framework of Arskey and O'Malley. We searched PubMed, Cochrane Reviews, and CINAHL with the following inclusion criteria: 1 published between 2005-February 2015, 2 focused on breast or cervical cancer 3 focused on LMIC, 4 review article, and 5 published in English.Through our systematic search, 63 out of the 94 identified cervical cancer reviews met our selection criteria and 36 of the 54 in breast cancer. Cervical cancer reviews were more likely to focus upon prevention and screening, while breast cancer reviews were more likely to focus upon treatment and survivorship. Few of the breast cancer reviews referenced research and data from LMICs themselves; cervical cancer reviews were more likely to do so. Most reviews did not include elements of the PRISMA checklist.Overall, a limited evidence base supports breast and cervical cancer control in LMICs. Further breast and cervical cancer prevention and control studies are necessary in LMICs.

  20. Course prognosis of cervical osteochondrosis

    Directory of Open Access Journals (Sweden)

    Kolesov V.N.

    2012-06-01

    Full Text Available

    Today we can state that in spite of a considerable number of cervical osteochondrosis studies, there is a lack of research devoted to analysis of its course. There is no correlation between initial expert evaluations of cervical osteo-chondrosis cases and further course of pathological process. Goal of the research is to develop system of course prognosis of cervical osteochondrosis taking into account environmental infuence, heredity, living conditions, psychological profle of patient’s personality. Materials and methods. Dynamics of degenerative-dystrophic changes progressing of cervical vertebrae in 236 patients was analyzed. Results. Received data demonstrated that probability of stage I changing to stage II, III and IV depended on patients’ sex, age and type of labour activity, frequent supercooling and stress. Probability of fast progression of cervical osteochondrosis (5-year cycle of stage I changing to stage III and IV was to a great extent associated with heredity, urban living, presence of endocrine system diseases, syndrome of nonspecifc dysplasia of connective tissue and low indices of quality of life. Conclusion. Proposed system allows making prognosis of morphologic changes in spinal cord, and is based on radiation methods of verifcation without taking into consideration dynamics of neurological symptomatology.

  1. Avaliação dos resultados clínicos após cirurgia descompressiva em cães com doença de disco intervertebral Evaluation of clinical results of decompressive surgery in dogs with degenerative disk disease

    Directory of Open Access Journals (Sweden)

    M.V.B. Arias

    2007-12-01

    Full Text Available Avaliaram-se os resultados clínicos após realização de cirurgia descompressiva em 45 cães com doença do disco intervertebral cervical ou toracolombar. Após a cirurgia, 35 cães (77,8% recuperaram-se totalmente, oito (17,8% parcialmente e dois (4,4% não apresentaram alteração do quadro inicial. Em oito cães com paraplegia e perda da sensibilidade dolorosa profunda houve completa melhora do quadro clínico, com recuperação total em 62,5% dos casos. Em quatro cães com tetraparesia, a cirurgia foi eficaz. A cirurgia descompressiva (slot cervical e hemilaminectomia toracolombar, com a retirada do material do disco do interior do canal vertebral, foi uma forma efetiva de gerar melhora do quadro funcional.Clinical results after decompressive surgery were evaluated in 45 dogs with cervical or thoracolumbar intervertebral disk disease. After surgery, 35 dogs recovered totally, eight (17.8% partially, and two (4.4% did not present any change in clinical findings. Eight dogs with paraplegy and loss of deep pain perception showed improvement, with total recovering in 62.5% of cases. Surgery was effective in four dogs with tetraparesy. Decompressive surgery (cervical slot or hemilaminectomy, with removal of disk material from inside the vertebral canal, was an effective form to produce functional improvement in dogs with this disease.

  2. Fusion around cervical disc prosthesis: case report.

    NARCIS (Netherlands)

    Bartels, R.H.M.A.; Donk, R.

    2005-01-01

    OBJECTIVE AND IMPORTANCE: Cervical arthroplasty is a relatively new method to maintain motion after cervical anterior discectomy. Two cases are presented in which bony fusion occurred around a cervical disc prosthesis. CLINICAL PRESENTATION: A 30-year-old man and a 49-year-old woman underwent a righ

  3. Rehabilitation intervention of cervical spondylotic myelopathy combined with thoracic spinal canal stenosis%脊髓型颈椎病合并胸椎管狭窄症的康复干预

    Institute of Scientific and Technical Information of China (English)

    宋若先; 刘晓平; 田勇; 周银; 张云昌

    2002-01-01

    Objective To investigate diagnosis and treatment characters of cervical spondylotic myelopathy combined with thoracic spinal stenosis, and to analysis effective pathway of spinal function recovery. Methods We took respective analysis on diagnosis, treatment and recovery results of 12 cases, whose symptoms, signs and MR were explicit. Results Follow ups times were from 9 months to 5 years and 8 months. Nerve function of 8 cases recovered completely or nearly completely; that of 2 cases improved apparently and that of 2 cases improved slightly. Conclusion Detailed disease history collection, particular body examination and MR reading are very important to early diagnosis of cervical spondylotic myelopathy combined with thoracic spinal stenosis. Early operation combined with cervical and thoracic spinal canal decompression at same time or at different stages is the single effective method to patients' function recovery.

  4. Colonoscopia: morbidade negligenciada Colonoscopy: neglected morbidity

    Directory of Open Access Journals (Sweden)

    Fernanda Bellotti Formiga

    2009-09-01

    Full Text Available OBJETIVO: Avaliar fatores de risco que determinam morbidade ao exame de colonoscopia. MÉTODOS: No período de março a junho de 2009 foram analisados prospectivamente 170 pacientes submetidos a exame colonoscópico. Fatores de risco como idade, sexo, indicação, exame ambulatorial/internado, efeitos adversos e qualidade do preparo intestinal, procedimento endoscópico, diagnóstico e intercorrência peri-procedimento foram relacionados. RESULTADOS: A média de idade da amostra foi 60,16 ± 14,69 anos, com predominância do sexo feminino. A indicação mais prevalente do exame foi seguimento pós-operatório. Três exames foram inconclusivos por mau preparo. Do restante, 36,53% foram normais e a maioria dos alterados apresentou pólipos, adenomatosos predominantemente. Quanto as comorbidades, 48,82% dos pacientes possuíam alguma comorbidade, sendo Hipertensão Arterial Sistêmica a mais prevalente. Apenas 22,94% dos pacientes apresentaram algum efeito adverso ao preparo. O preparo foi limpo em 65,88% dos exames, mostrando significância quando comparado a morbidade. Outro fator de significância estatística foi a realização de procedimentos (44,7% dos exames, sendo a maioria polipectomias. A morbidade chegou a 16,47%, sendo a desidratação a mais prevalente. Não houve mortalidade. CONCLUSÃO: A qualidade do preparo intestinal e a realização de procedimento endoscópico são fatores diretamente relacionados a morbidade do exame de colonoscopia.OBJECTIVE: The objective of this study is to analyze risks factors of morbidity on colonoscopy. METHOD: From March to June of 2009, 170 patients were examined and analyzed prospectively. Risks factors as age, sex, indication of exam, ambulatory or hospital exam, adverse events and quality of intestinal preparation, endoscopic procedure, diagnoses and incident before, during or after procedure were analyzed. RESULTS: The average age was 60,16±14,69 years old, with majority of female. The prevalent

  5. Co-morbidities of Interstitial Cystitis

    Directory of Open Access Journals (Sweden)

    Gisela eChelimsky

    2012-08-01

    Full Text Available Introduction: This study aimed to estimate the proportion of patients with Interstitial Cystitis/Painful Bladder Syndrome (IC/BPS with systemic dysfunction associated co-morbidities such as irritable bowel syndrome (IBS and fibromyalgia (FM. Material and Methods: Two groups of subjects with IC/BPS were included: 1 Physician diagnosed patients with IC/BPS and 2 Subjects meeting NIDDK IC/PBS criteria based on a questionnaire (ODYSA. These groups were compared to healthy controls matched for age and socio-economic status. NIDDK criteria required: pain with bladder filling that improves with emptying, urinary urgency due to discomfort or pain, polyuria > 11 times/24 hrs, and nocturia > 2 times/night. The ODYSA instrument evaluates symptoms pertaining to a range of disorders including chronic fatigue, orthostatic intolerance, syncope, IBS, dyspepsia, cyclic vomiting syndrome, headaches and migraines, sleep, Raynaud’s syndrome and chronic aches and pains. Results: IC/BPS was diagnosed in 26 subjects (mean age 47 +/- 16 yrs, 92% females, 58 had symptoms of IC/BPS by NIDDK criteria, (mean age 40 +/- 17 yrs, 79% females and 48 were healthy controls (mean age 31+/- 14 yrs, mean age 77%. Co-morbid complaints in the IC/BPS groups included gastrointestinal symptoms suggestive of IBS and dyspepsia, sleep abnormalities with delayed onset of sleep, feeling poorly refreshed in the morning, waking up before needed, snoring, severe chronic fatigue and chronic generalized pain, migraines and syncope. Discussion: Patients with IC/BPS had co-morbid central and autonomic nervous system disorders. Our findings mirror those of others in regard to IBS, symptoms suggestive of FM, chronic pain and migraine. High rates of syncope and functional dyspepsia found in the IC/BPS groups merit further study to determine if IC/BPS is part of a diffuse disorder of central, autonomic and sensory processing affecting multiple organs outside the bladder.

  6. Morbidity in newborns exposed to organophosphorus pesticides

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    Đorđević Momčilo

    2010-01-01

    Full Text Available Introduction. Insecticides are toxines by which we destroy harmful insects. The most frequent insecticides which are used today are organophosphorus pesticides. This group of compounds make substances whose activity mechanism is based on the inhibition of acetylcho­linesterase in nerve synapsis, thus producing holynergic syndrome, resulting from the accumulation of acetylcholine which developed due to the absence of decomposition under the influence of cholinesterase. In the clinical picture of acute toxication by cholinesterase inhibitors there is a clear difference between muscarinic and nicotine effects. The basic aim of the study was to establish the effects of organophosphorus pesticides present in blood and breast milk of mothers on newborns morbidity. Material and methods. The study group consisted of 18 newborns whose mothers had isolated organophosphorus pesticides in their blood and breast­milk on the third day after delivery, and the control group consisted of 84 newborns whose mothers did not have isolated organophosphorus pesticides in their blood and breastmilk. Results. Morbidity is three times greater, often in combination with some disorders of the central nervous system, and the relative risk for its appearance is eight time greater in newborns exposed to organophosphorus pesticides. Disscusion. Disorders that appear in newborns exposed to pesticides are mutagenic, cancerogenic and neurotoxic and some agenses could disturb the immune system which is reflected in morbidity increase, primarly of the central nervous system. Conclusion. The presence of organophosphorus pesticides in blood and breast milk has negative effects on newborns. In addition to acetylcho­linesterase inhibition, organophosphorus pesticides react by means of other mechanisms as well.

  7. 分期前后方减压治疗合并颅底陷入的Chiari畸形%Treatment of Chiari malformation combined with basilar invagination by staged anterior and posterior decompression

    Institute of Scientific and Technical Information of China (English)

    佟怀宇; 余新光; 张远征; 乔广宇; 王鹏; 尚爱加

    2012-01-01

    Objective There is usually anterior compression of the brain stem in Chiari malformation patients combined with basilar invagination.After anterior decompression,many patients will present elevation of the cerebellar tonsil and resolution of syringomyelia.However,still in some patients,the Chiari malformation and syringomyelia remain unchanged after anterior decompression.This article is to discuss a staged anterior and posterior decompression strategy for the treatment of these patients.Methods 9 cases of Chiari malformation combined with basilar invagination were operated by transoral transpharyngeal odontoidectomy first,observed for 1 -2 months,the Chiari malformation and syringomyelia did not relieve,then posterior foramen magnum decompression,tonsillectomy and expansion of posterior fossa dura combined with occipito - cervical fusion or C1-2 fusion were performed.The patients were followed up for 24 - 60 months ( mean 32 months).Results There was no mortality or severe complication.The clinical symptoms were improved in all patients.The Chiari malformation and syringomyelia were relieved in 8 patients,while unchange in 1 case.Conclusions For Chiari malformation patients combine with basilar invagination,anterior decompression with odontoidectomy should be performed first. In many patients,increase ofposterior fossa volume,improved CSF dynamic may be achieved,posterior fusion will be enough.While in some other patients,only symptoms of basilar invagination may be improved after anterior decompression.So posterior decompression is still important.%目的 合并颅底陷入的Chiari畸形患者常有前方脑干压迫,多数经前路减压即可使扁桃体上移,空洞缩小,但少数患者前路减压后Chiari畸形和脊髓空洞并不减轻,本文旨在探讨采用分期前后方减压治疗该类患者.方法 9例患者经口咽入路齿状突磨除,观察1-2个月后发现Chiari畸形和脊髓空洞未减轻,遂行后方枕大孔减压,小脑扁桃体切

  8. Morbidity and mortality of complex spine surgery

    DEFF Research Database (Denmark)

    Karstensen, Sven; Bari, Tanvir; Gehrchen, Martin;

    2016-01-01

    adverse events (AEs). PURPOSE: This study aimed to determine the mortality and examine the incidence of morbidity in patients undergoing complex spinal surgery, including pediatric patients, and to validate the SAVES system in a European population. STUDY DESIGN: A prospective, consecutive cohort study...... requiring revision. METHODS: All patients undergoing spinal surgery at an academic tertiary referral center in the study period were prospectively included. The newest version of SAVES system was used, and a research coordinator collected all intraoperative and perioperative data prospectively. Once a week...

  9. STUDY ON PSYCHIATRIC CO - MORBIDITY IN PSORIASIS

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    Shrikant B.

    2015-06-01

    Full Text Available BACKGROUND: Psoriasis is relatively common , chronic inflammatory and hyper - proliferative skin disease that affects 1.4% to 2.0% of the population. Presence of itching , chronic recurrent course of disease and incomplete cure may contribute to great deal of psychiatric co - morbidity in these patients. the most persuasive indications of a link between stress and psoriasis comes from patients themselves , with studies illustrating that the majority of patients believe that stress or psychological distress is a factor in the manifestations of their condition . Depression and anxiety are the most common disorders that are associated with psoriasis , but the proportion of patient also having other psychiatric co - morbid diseases which include social phobia , generalize anxiety disorder , panic disorder , psychotic diso rder , etc. Moreover , symptoms of psoriasis , especially pruritus , are related to depression. OBJECTIVES : To evaluate different psychiatric illnesses their prevalence and severity in psoriasis patients. METHODOLOGY : This was cross - sectional observational stu dy comprised of 70 consecutive patients of psoriasis attending the out - patient department of Dermatology. All the patients were subjected to detailed examinations including the elicitation of dermatological and psychiatric profile after getting written con sent for study . Data was collected using self - developed , pre tested , semi structured Pro format by interview method. RESULTS : The profile of psychiatric diagnoses obtained in the present study depressive disorder 31.4% {18.57% depression , 12.85% Depression with anxiety symptoms} , anxiety disorder 25.7% (7.14% GAD , 8.17% panic disorder , 5.71% social phobia , 4.28 specific phobia. Severity of major depressive disorder was determined with HAM - D score 53.8% had mild depression , 30.7% moderate depression and 15. 5% severe depression. Similarly when HAM - A scale was used to determined severity of generalized

  10. Morbidity before and after the diagnosis of hyperthyroidism

    DEFF Research Database (Denmark)

    Brandt, Frans; Thvilum, Marianne; Pedersen, Dorthe Almind;

    2013-01-01

    Hyperthyroidism has been linked with different morbidities, like atrial fibrillation, stroke and diabetes mellitus. However, our knowledge regarding the extent and temporal relation between hyperthyroidism and other diseases is fragmented. Here, we aimed at evaluating various morbidities before...

  11. Histomorphological Pattern of Cervical Lymphadenopathy

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    Abdul Mannan Sikder

    2013-01-01

    Full Text Available Background: Enlarged palpable cervical lymph nodes as a primary presenting sign are very common and may be due to inflammatory lesions and tumors. Correlation between clinical findings and laboratory data is essential in arriving at a diagnosis. In patients presenting with cervical lymphadenopathy, excision biopsy provides material to establish an early diagnosis. We designed this study in our population for histological evaluation of cervical lymph node biopsies that might be important in the management of these patients. Objective: Histopathological evaluation of different diseases involving the cervical lymph nodes in relation to age and sex of the study population. Materials and Methods: It was a cross sectional study conducted in the department of Pathology, Enam Medical College & Hospital, Savar, Dhaka during the period from January 2006 to December 2010. A total of 107 patients were evaluated for specific cause of cervical lymphadenopathy in relation to age and sex. Lymph node biopsies of all patients of both sexes and all age groups were included in the study. Results: Among the 107 subjects 58 (54.2% were males and 49 (45.8% were females with a male to female ratio of 1.2:1. The age of the patients ranged from 2 to 85 years with a mean age of 32.68 ± 18.01 years. Of the 107 lymph node biopsies, 34 cases (31.8% were reactive lymphadenitis, 41 cases (38.3% were tuberculosis, 2 cases (1.9% were non-caseous granuloma, 6 cases (5.6% were Hodgkin lymphoma, 8 cases (7.5% were non-Hodgkin lymphoma, 12 cases (11.2% were metastatic neoplasm and 4 cases (3.7% were other specific lesions. Conclusion: The commonest cause of cervical lymphadenopathy was tuberculosis, followed by reactive lymphadenitis, lymphoma and metastatic neoplasm.

  12. Posterior reduction and internal fixation with posterior cranial fossa cranioectomy decompression for Chiari malformation type Ⅰ with basilar invagination, atlantoaxial subluxation, and syringomyelia

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    HU Peng

    2012-08-01

    Full Text Available Background Chiari malformation type Ⅰ(CM-Ⅰ is one of the soft tissue anomalies in craniovertebral junction (CVJ. This kind of soft tissue anomaly usually develops with bone anomaly, such as atlantoaxial subluxation, basilar invagination, platybasia, C1 assimilation, etc. For these complex combined anomalies, the treatment remains unaddressed. This study was performed to evaluate the effect of posterior reduction and internal fixation with posterior cranial fossa cranioectomy decompression for Chiari malformation type Ⅰ with basilar invagination, atlantoaxial subluxation, and syringomyelia. Methods Patients with basilar invagination and atlantoaxial subluxation treated from July 2004 to September 2011 were reviewed. Including criterions were made to screen matching patients. Including patients were retrospectively analyzed on both clinical outcomes and radiographical results. Japanese Orthopaedic Association (JOA score was used to evaluate the clinical outcomes, while the syrinx maximum size was measured on transverse view of MRI T2 image. The results were analyzed by SPSS 17.0 using t -text. Significant difference was considered when P ≤ 0.05. Results Fourteen patients met the including criterions, including 4 male patients and 10 female patients, with a mean age of 31.86 ± 11.36 (standard deviation, range: 17-51 years. Mean JOA score preoperatively of 14 patients was 13.07 ± 1.59 (standard deviation, while that was 15.57 ± 1.02 (standard deviation postoperatively (t = 9.946, P = 0.000. The mean syrinx size was (7.05 ± 1.98 mm (standard deviation, while that was (2.21 ± 1.91 mm (standard deviation postoperatively (t = 7.271, P = 0.000. There were no procedure-related morbidity or mortality happened. Conclusion Direct posterior reduction and internal fixation with posterior cranial fossa cranioectomy decompression can obviously improve the clinical outcomes and shrink syrinx for patients suffered from Chiari malformation typeⅠ with

  13. Treatment of cervical dislocation with locked facets

    Institute of Scientific and Technical Information of China (English)

    YU Ze-sheng; James J.Yue; WEI Feng; LIU Zhong-jun; CHEN Zhong-qiang; DANG Geng-ting

    2007-01-01

    Background Lower cervical dislocation with locked facets is common in cervical injury. The locked facets include unilateral and bilateral types. Different successful closed reduction rates has been achieved between unilateral and bilateral types by using rapid skull traction, which was commonly used to reduce the cervical dislocation. It is important to investigate a suitable management specific to patients with different types of cervical locked facets.Methods A total of 38 patients with cervical dislocation with locked facet due to cervical injury treated by rapid skull traction and operation from 1988 to 2005 were reviewed. Rapid skull traction was used in all the patients. Successful closed reduction rate was 88.0% in patients with bilateral cervical locked facets and that was 15.4% in those with unilateral cervical locked facets. These data were then statistically compared by Chi-square test. Patients who were reduced successfully underwent anterior cervical discectomy and fusion at the injured level, and those who failed in closed reduction received posterior open reduction and fixation.Results In this series, there was statistically significant difference (P<0.05) in the rate of successful closed skull traction reduction between unilateral and bilateral locked facets dislocation. Unilateral cervical locked facets dislocation was not easily reduced by skull traction which was suitable for reduction of bilateral cervical locked facets dislocation. However,unilateral cervical locked facets dislocation can be reduced by posterior open reduction.Conclusions Unilateral cervical locked facets dislocation should be treated immediately with posterior open reduction and instrumentation. Bilateral cervical locked facets dislocation can be reduced by rapid skull traction firstly and anterior cervical discectomy and interbody fusion later.

  14. Radiculopatía cervical

    OpenAIRE

    Adriana Murillo Calderón

    2012-01-01

    La patología cervical traumática y su relación con el quehacer de la medicina legal tiene gran importancia y vigencia, principalmente cuando se hace necesario realizar valoraciones a pacientes con alteraciones cervicales y se debe definir si estas están en relación a un trauma determinado o repetitivo en el tiempo como puede ocurrir en algunos casos de riesgos de trabajo. El médico forense debe estar muy bien preparado, conocer la anatomía cervical y de los miembros superiores, realizar un in...

  15. Cervical spine in Treacher Collins syndrome.

    Science.gov (United States)

    Pun, Amy Hoi-Ying; Clark, Bruce Eric; David, David John; Anderson, Peter John

    2012-05-01

    Treacher Collins syndrome is a congenital syndrome with characteristic craniofacial malformations, which are well described in the literature. However, the presence of cervical spine dysmorphology in this syndrome has been minimally described. This study reviews cervical spine radiographs of 40 patients with Treacher Collins syndrome. In this sample, 7 of 40 patients displayed cervical spine anomalies, with 3 of these patients displaying multiple cervical spine anomalies. The patterns of spinal anomalies were variable, suggesting that the underlying genetic mutation has variable expressivity in cervical spine development as it does elsewhere in the craniofacial skeleton.

  16. Postural stability in patients with decompression sickness evaluated by means of Quantitative Romberg testing

    DEFF Research Database (Denmark)

    Hedetoft, Morten; Hyldegaard, Ole

    2015-01-01

    OBJECTIVE: The present study was designed to retrospectively evaluate the use of quantitative Romberg's testing on postural stability during the course of hyperbaric oxygen (HBO2) therapy in patients presenting with decompression sickness (DCS). METHODS: The Quantitative Romberg test was used to ...

  17. Study on animals‘ femur blood flow alteration under inadequate decompression with 133Xe isotope washout method

    Institute of Scientific and Technical Information of China (English)

    YuShao-Ning; TiaoWu-Xun; 等

    1998-01-01

    Animals' regional femur blood(F) alteration was studied under an inadequate decompression by using the inhaled isotope 133Xe washout method.Results showed that the average F on left and right side of minipigs' femur decreased from 15.4±1.8 and 16.9±2.0mg/(100g.min)(before exposure)to 10±1.8and 11.1±1.6mg(100mg.min)(after expposure for 1.5h under the pressure of 0.5 MPa and then decompression to normal with the rate of 0.03-0.04MPa/min)respectively;the blood flow of hematopoietic marrow tissues(f1) on both sides also decreased from 19.3±2.0 and 22.1±1.9ml(100mg.min)to 13.9±1.4 and 13.8±1.0ml(100mg.min).The exact same alteration also happened in the experiment on New Zealand rabbits.It indicates that inadequate decompression in hyperbaric exposure can give rise to decrease animals' one blood flow and insufficient bone blood supply serves as one of the reasons for causing decompressive osteonecrosis.

  18. Quality of life after surgical decompression for space-occupying middle cerebral artery infarction: systematic review

    NARCIS (Netherlands)

    Middelaar, T. van; Nederkoorn, P.J.; Worp, H.B. van der; Stam, J.; Richard, E.

    2015-01-01

    BACKGROUND AND PURPOSE: In patients with space-occupying middle cerebral artery infarction, surgical decompression strongly reduces risk of death and increases the chance of a favorable outcome. This comes at the expense of an increase in the risk of survival with (moderately) severe disability. We

  19. Decompression hyperostosis: cranial hyperostosis mimicking bilateral subdural hematoma on brain scintigraphy

    International Nuclear Information System (INIS)

    Scintigraphic findings suggestive of bilateral subdural hematoma developed after successful decompression of communicating hydrocephalus. These findings were secondary to cranial hyperostosis. The similarity of brain scintigraphic findings in the two disorders is pointed out, and the necessity of correlating brain scintigraphs with skull radiographs is stressed. (U.S.)

  20. Application of COMPONT Medical Adhesive Glue for Tension-Reduced Duraplasty in Decompressive Craniotomy

    Science.gov (United States)

    Zhou, Yujia; Wang, Gesheng; Liu, Jialin; Du, Yong; Wang, Lei; Wang, Xiaoyong

    2016-01-01

    Background The aim of this study was to evaluate the application of medical adhesive glue for tension-reduced duraplasty in decompressive craniotomy. Material/Methods A total of 56 cases were enrolled for this study from Jan 2013 to May 2015. All patients underwent decompressive craniotomy and the dura was repaired in all of them with tension-reduced duraplasty using the COMPONT medical adhesive to glue artificial dura together. The postoperative complications and the healing of dura mater were observed and recorded. Results No wound infection, epidural or subdural hematoma, cerebrospinal fluid leakage, or other complications associated with the procedure occurred, and there were no allergic reactions to the COMPONT medical adhesive glue. The second-phase surgery of cranioplasty was performed at 3 to 6 months after the decompressive craniotomy in 32 out of the 56 cases. During the cranioplasty we observed no adherence of the artificial dura mater patch to the skin flap, no residual COMPONT glue, or hydropic or contracture change of tissue at the surgical sites. Additionally, no defect or weakening of the adherence between the artificial dura mater patch and the self dura matter occurred. Conclusions COMPONT medical adhesive glue is a safe and reliable tool for tension-reduced duraplasty in decompressive craniotomy. PMID:27752035

  1. The Microendoscopic Decompression of Lumbar Stenosis: A Review of the Current Literature and Clinical Results

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    Albert P. Wong

    2012-01-01

    Full Text Available Lumbar stenosis is a well-defined pathologic condition with excellent surgical outcomes. Empiric evidence as well as randomized, prospective trials has demonstrated the superior efficacy of surgery compared to medical management for lumbar stenosis. Traditionally, lumbar stenosis is decompressed with open laminectomies. This involves removal of the spinous process, lamina, and the posterior musculoligamentous complex (posterior tension band. This approach provides excellent improvement in symptoms, but is also associated with potential postoperative spinal instability. This may result in subsequent need for spinal fusion. Advances in technology have enabled the application of minimally invasive spine surgery (MISS as an acceptable alternative to open lumbar decompression. Recent studies have shown similar to improved perioperative outcomes when comparing MISS to open decompression for lumbar stenosis. A literature review of MISS for decompression of lumbar stenosis with tubular retractors was performed to evaluate the outcomes of this modern surgical technique. In addition, a discussion of the advantages and limitations of this technique is provided.

  2. Metabolism and decompression tolerance of scavenging lysianassoid deep-sea amphipods

    Science.gov (United States)

    Treude, Tina; Janßen, Felix; Queisser, Wolfgang; Witte, Ursula

    2002-07-01

    Respiration, ammonia excretion and decompression tolerance were studied in several species of lysianassoid amphipods captured at four stations in the deep Arabian Sea with an isolated trap maintaining them at in situ temperature. The amphipods were decompressed from their ambient to atmospheric pressure during recovery. Six amphipods, belonging to the species Eurythenes gryllus, Paralicella caperesca and Abyssorchomene abyssorum, survived decompression from depths between 1920 and 4420 m. The physiological condition of these specimens was good inferred by the fact that their swimming and resting behaviour appeared normal, they reacted to disturbance by light and vibration, and were able to ingest food to maintain full guts. Most of the amphipods (421 individuals), however, were recovered dead, which allows information about their decompression tolerance and their vertical migration ability to be deduced. Weight-specific respiration rates of the deep-sea amphipods that were fed prior to the experiments were not lower than in shallow-water amphipods living at similar temperatures. Differences in respiration rates between the specimens are discussed with regard to body size, species specificity and food supply. Weight-specific ammonia excretion rates were extremely high when compared with shallow-water relatives, indicating a capability for rapid digestion. This may be an adaptation to the unpredictable food supply in the deep sea as it enables the amphipod to empty its digestive tract quickly, thus making it available for additional food. Rapid digestion also enables the animals to regain mobility soon after feeding, permitting them to move to new food sources.

  3. Decompressive craniectomy and early cranioplasty in a 15-year-old boy with N. meningitidis meningitis

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    Julius Hoehne

    2015-01-01

    Conclusions: This unique report shows that decompressive craniotomy with duroplasty may be a crucial therapeutic approach in bacterial meningitis with refractory increased intracranial pressure and brainstem compression. Early cranioplasty with a patient-specific implant allowed the early and full reintegration of the patient.

  4. Risk Associated With The Decompression Of High Pressure High Temperature Fluids - Study On Black Oil

    DEFF Research Database (Denmark)

    Figueroa, D. C.; Fosbøl, P. L.; Thomsen, K.

    2015-01-01

    Fluids produced from deep underground reservoirs may result in exponential increase in temperature. It is a consequence of adiabatic fluid decompression from the inverse Joule Thomson Effect (JTE). The phenomenon requires analysis in order to avoid any operational risks. This study evaluates...

  5. Compression or expansion of morbidity? A life-table approach

    NARCIS (Netherlands)

    W.J. Nusselder (Wilma)

    1998-01-01

    textabstractChanges in incidence, progression and l'ecovery of morbidity and related disability have important consequences for mortality, and, vice versa, changes in modality have important consequences for morbidity. The inter· play of changes in mortality and morbidity determines whether populati

  6. Intraoperative monitoring during decompression of the spinal cord and spinal nerves using transcranial motor-evoked potentials: The law of twenty percent.

    Science.gov (United States)

    Tanaka, Satoshi; Hirao, Jun; Oka, Hidehiro; Akimoto, Jiro; Takanashi, Junko; Yamada, Junichi

    2015-09-01

    Motor-evoked potential (MEP) monitoring was performed during 196 consecutive spinal (79 cervical and 117 lumbar) surgeries for the decompression of compressive spinal and spinal nerve diseases. MEP monitoring in spinal surgery has been considered sensitive to predict postoperative neurological recovery. In this series, transcranial stimulation consisted of trains of five pulses at a constant voltage (200-600 V). For the normalization of MEP, we recorded compound muscle action potentials (CMAP) after peripheral nerve stimulation, usually on the median nerve at the wrist 2 seconds before or after each transcranial stimulation of the motor area, for all operations. The sensitivity and specificity of MEP monitoring was 100% and 97.4%, respectively, or 96.9% with or without CMAP compensation (if the threshold of postoperative motor palsy was defined as 20% relative amplitude rate [RAR]). The mean RAR after CMAP normalization, of the most affected muscle in the patient group with excellent postoperative results (recovery rate of a Japan Orthopedic Association score of more than 50%) was significantly higher than that in the other groups (p=0.0224). All patients with an amplitude increase rate (AIR) with CMAP normalization of more than 20% achieved neurological recovery postoperatively. Our results suggest that if the RAR is more than 20%, postoperative motor palsy can be avoided in spinal surgery. If the AIR with normalization by CMAP after peripheral nerve stimulation is more than 20%, neurological recovery can be expected in spinal surgery. PMID:26142049

  7. Does Measles Immunization Reduce Diarrhoeal Morbidity

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    Reddaiah V.P

    1993-01-01

    Full Text Available Research question: 1. Will measles vaccination reduce the incidence and during of diarrhoeal episodes in children? 2. Will measles vaccination reduce the morbidity load because of diarrhoea? Objectives: 1. To provide measles immunization to rural children 9 to 24 months of age. 2. to study the occurrence of diarrhoeal episodes by domicillary visits every month for a period of 1 year. Design: Longitudinal study. Setting: Rural area in the state of Haryana. Participants: Children between the ages of 9 and 24 months with parental informed consent. Study variables: diarrhoeal episodes per child/year, duration of diarrhoea. Outcome Variable: the difference between the two groups (immunized and non- immunized of attack rate and duration of diarrhoeal episodes. Statistical Analysis: Chi square test. Results: immunization coverage was 75%. Attack rates of diarrhoea in immunized children (1.6/child/year was no different to that in the non- immunized (1.5/child/year. The mean duration of diarrhoea in both groups was 2.3 days. The prevalence diarrhoea in immunized and non-immunized was 3.85 and 3.67 respectively. Conclusion: Measles vaccination has no impact on diarrhoeal morbidity.

  8. Multimodal evaluation of CSF dynamics following extradural decompression for Chiari malformation Type I.

    Science.gov (United States)

    Quon, Jennifer L; Grant, Ryan A; DiLuna, Michael L

    2015-06-01

    OBJECT Extradural decompression is a minimally invasive technique for treating Chiari malformation Type I (CM-I) that avoids the complications of dural opening. While there is no agreement on which surgical method is optimal, mounting evidence demonstrates that extradural decompression effectively treats clinical symptoms, with a minimal reoperation rate. Neurological symptoms such as headache may be related to obstructed flow of CSF, and one aspect of successful extradural decompression is improved CSF dynamics. In this series, the authors report on their use of phase-contrast cine flow MRI to assess CSF flow as well as satisfactory decompression. METHODS The authors describe their first surgical series of 18 patients with CM-I undergoing extradural decompression and correlate clinical improvement with radiological changes. Patients were categorized as having complete, partial, or no resolution of their symptoms. Posterior fossa area, cisterna magna area, and tonsillar herniation were assessed on T2-weighted MRI, whereas improvement of CSF flow was evaluated with phase-contrast cine flow MRI. All patients received standard pre- and postoperative MRI studies; 8 (44.4%) patients had pre- and postoperative phase-contrast cine, while the rest underwent cine studies only postoperatively. RESULTS All 18 patients presented with symptomatic CM-I, with imaging studies demonstrating tonsillar herniation ≥ 5 mm, and 2 patients had associated syringomelia. All patients underwent suboccipital decompression and C-1 laminectomy with splitting of the dura. Patients with complete resolution of their symptoms had a greater relative increase in cisterna magna area compared with those with only partial improvement (p = 0.022). In addition, in those with complete improvement the preoperative cisterna magna area was smaller than in those who had either partial (0.020) or no (0.025) improvement. Ten (91%) of the 11 patients with improved flow also had improvement in their symptoms

  9. Changes in cerebrospinal fluid flow assessed using intraoperative MRI during posterior fossa decompression for Chiari malformation.

    Science.gov (United States)

    Bond, Aaron E; Jane, John A; Liu, Kenneth C; Oldfield, Edward H

    2015-05-01

    OBJECT The authors completed a prospective, institutional review board-approved study using intraoperative MRI (iMRI) in patients undergoing posterior fossa decompression (PFD) for Chiari I malformation. The purpose of the study was to examine the utility of iMRI in determining when an adequate decompression had been performed. METHODS Patients with symptomatic Chiari I malformations with imaging findings of obstruction of the CSF space at the foramen magnum, with or without syringomyelia, were considered candidates for surgery. All patients underwent complete T1, T2, and cine MRI studies in the supine position preoperatively as a baseline. After the patient was placed prone with the neck flexed in position for surgery, iMRI was performed. The patient then underwent a bone decompression of the foramen magnum and arch of C-1, and the MRI was repeated. If obstruction was still present, then in a stepwise fashion the patient underwent dural splitting, duraplasty, and coagulation of the tonsils, with an iMRI study performed after each step guiding the decision to proceed further. RESULTS Eighteen patients underwent PFD for Chiari I malformations between November 2011 and February 2013; 15 prone preincision iMRIs were performed. Fourteen of these patients (93%) demonstrated significant improvement of CSF flow through the foramen magnum dorsal to the tonsils with positioning only. This improvement was so notable that changes in CSF flow as a result of the bone decompression were difficult to discern. CONCLUSIONS The authors observed significant CSF flow changes when simply positioning the patient for surgery. These results put into question intraoperative flow assessments that suggest adequate decompression by PFD, whether by iMRI or intraoperative ultrasound. The use of intraoperative imaging during PFD for Chiari I malformation, whether by ultrasound or iMRI, is limited by CSF flow dynamics across the foramen magnum that change significantly when the patient is

  10. Does Early Decompressive Craniectomy Improve Outcome? Experience from an Active UK Recruiter Centre

    Directory of Open Access Journals (Sweden)

    E. García Vicente

    2013-01-01

    Full Text Available Introduction. The results of the recent DECRA study suggest that although craniectomy decreases ICP and ICU length of stay, it is also associated with worst outcomes. Our experience, illustrated by these two striking cases, supports that early decompressive craniectomy may significantly improve the outcome in selected patients. Case Reports. The first patient, a 20-year-old man who suffered severe brain contusion and subarachnoid haemorrhage after a fall downstairs, with refractory ICP of 35 mmHg, despite maximal medical therapy, eventually underwent decompressive craniectomy. After 18 days in intensive care, he was discharged for rehabilitation. The second patient, a 23-year-old man was found at the scene of a road accident with a GCS of 3 and fixed, dilated pupils who underwent extensive unilateral decompressive craniectomy for refractory intracranial hypertension. After three weeks of cooling, paralysis, and neuroprotection, he eventually left ICU for rehabilitation. Outcomes. Four months after leaving ICU, the first patient abseiled 40 m down the main building of St. Mary’s Hospital to raise money for the Trauma Unit. He has returned to part-time work. The second patient, was decannulated less than a month later and made a full cognitive recovery. A year later, with a titanium skull prosthesis, he is back to part-time work and to playing football. Conclusions. Despite the conclusions of the DECRA study, our experience of the use of early decompressive craniectomy has been associated with outstanding outcomes. We are currently actively recruiting patients into the RESCUEicp trial and have high hopes that it will clarify the role of the decompressive craniectomy in traumatic brain injury and whether it effectively improves outcomes.

  11. [Results of decompressive-stabilizing procedures via unilateral approach in lumbar spinal stenosis].

    Science.gov (United States)

    Krut'ko, A V

    2012-01-01

    Aim of this study was to investigate the capabilities, advantages and limitations of bilateral decompression via unilateral approach in decompressive-stabilizing procedures in patients with degenerative lumbar spine disease, and to develop the technology and its technical performance. The controlled study included 372 patients (age range was 27-74 years). All of them were operated due to clinical manifestation of lumbar spinal stenosis. The main group consisted of 44 patients who underwent bilateral decompression via unilateral approach with stabilization of involved segments. The control group included 328 patients who were operated using standard bilateral technique with stabilization. A total of 52 segments were treated in the first group and 351 in the second one. In all patients with neurogenic intermittent claudication symptoms relieved after decompressive-stabilizing surgery. Analysis of duration of surgery (considering 1 segment) demonstrated that less invasive technique requires as much time as conventional. However mean intraoperative blood loss in the first group was twice as low as the second. Neither patient from the first group required hemotransfusion while in the second group in 57 (17.4%) cases hemotransfusion was performed due to blood loss. In the early postoperative period in both groups intensity of pain (according to VAS) gradually decreased. Mean hospital stay was 9.9 +/- 3.1 day in the main group and 14.7 +/- 4.7 days in the control group. Bilateral spinal canal decompression via unilateral approach decreases surgical trauma, blood loss, complication rate and hospital stay. Postoperative results are comparable with conventional technique.

  12. Effect of mild hypothermia auxiliary therapy on recovery of patients with craniocerebral trauma after decompressive craniectomy

    Institute of Scientific and Technical Information of China (English)

    Jiang Du

    2016-01-01

    Objective:To analyze the effect of mild hypothermia auxiliary therapy on recovery of patients with craniocerebral trauma after decompressive craniectomy.Methods: 110 cases of patients with craniocerebral trauma who received decompressive craniectomy in our hospital from November 2012 to November 2014 were selected as research subjects and randomly divided into observation group and control group according to different treatment methods, each group with 55 cases. Control group received decompressive craniectomy alone, observation group received decompressive craniectomy combined with mild hypothermia auxiliary therapy, and then differences in neural function, serum NSE, SOD, NO and ET levels, cerebral blood flow level as well as serum ADH, BNP and ACTH levels of two groups were compared.Results:CPC grading of observation group 1 week after mild hypothermia auxiliary therapy was lower than that of control group and scores of GOC and ESS were higher than those of control group (P<0.05); serum NSE, NO and ET levels of observation group 1 week after treatment were lower than those of control group and SOD level was higher than that of control group (P<0.05); Vs and Vm levels of observation group 1 week after treatment were higher than those of control group and PI level was lower than that of control group (P<0.05); serum ADH and ACTH levels of observation group 1 week after treatment were lower than those of control group and BNP level was higher than that of control group (P<0.05).Conclusions:Decompressive craniectomy combined with mild hypothermia auxiliary therapy for patients with craniocerebral trauma can effectively improve patients’ neural function, promote cerebral blood flow and optimize humoral-associated factor levels, and it has positive clinical significance.

  13. Drugs Approved for Cervical Cancer

    Science.gov (United States)

    This page lists cancer drugs approved by the Food and Drug Administration (FDA) for cervical cancer. The list includes generic names, brand names, and common drug combinations, which are shown in capital letters. The drug names link to NCI's Cancer Drug Information summaries.

  14. Primary adenocarcinoma of cervical esophagus.

    Science.gov (United States)

    Alrawi, S J; Winston, J; Tan, D; Gibbs, J; Loree, T R; Hicks, W; Rigual, N; Lorè, J M

    2005-06-01

    Most upper esophageal malignancies are squamous cell carcinomas, rarely adenocarcinomas arising from Barrett's esophagus and very rarely adenocarcinomas from heterotopic gastric mucosa without evidence of Barrett's especially in the cervical part of the esophagus. We report a case of adenocarcinoma of the polypoid type in the upper esophagus (cervical esophagus) arising from ectopic gastric mucosa, in a 60 year-old man who presented with progressive dysphagia. Accurate diagnosis by esophagogram revealed a large mass in the cervical esophagus; CAT scan showed intraluminal mass at the level of thoracic inlet, esophagogastroscopy showed a fleshy polyp (3.2cm x 3.0cm) at 20 cm from the incisors with a biopsy confirming moderately differentiated adenocarcinoma with no evidence of Barrett's esophagus. Through a left cervical approach and resection of medial third of clavicle, the tumor was removed by partial esophagectomy followed by lymph node dissection, and proved to be T1NOMO, stage I (AJCC staging 6th ed.). Post operatively, the patient received chemoradiation with no evidence of recurrence or metastasis in six years of follow up. It seems this tumor has a much better prognosis than adenocarcinomas arising from Barrett's. To our knowledge only 19 cases have been reported in literature so far. PMID:16110768

  15. Treatment protocols for cervical cancer

    Directory of Open Access Journals (Sweden)

    Vujkov Tamara

    2002-01-01

    Full Text Available Introduction Cervical cancer is the second most common cancer in women worldwide and the second cause of cancer death among women. About 95% (90% in developed countries of invasive carcinomas are of sqamous types, and 5% (10% in developed countries are adenocarcinomas. FIGO classification of cervical carcinomas, based on clinical staging and prognostic factor dictate therapeutic procedures and help in designing treatment protocols. Therapeutic modalities Surgical therapy includes conization, radical hysterectomy with pelvic lymphadenectomy and palliative operation urinary diversion and colostomy. Radiotherapy, brachytherapy and teletherapy are most recently combined with chemotherapy as concurrent chemoradiation. Discussion and conclusion No change in therapeutic modalities will ever decrease mortality rate of cervical carcinoma as much as education, prevention and early screening. The 5-year survival for locally advanced disease has not improved during the last 40 years as a result of failure to deliver therapy to the paraaortic region. Paraaortic lymph nodes should be evaluated before therapy planning by different imaging procedures, or more exactly by surgical staging: laparoscopy or laparotomy. Radical operations of cervical carcinoma should be performed by experienced surgeons, educated for this type of operation, with sufficient number of cases.

  16. Nonoperative Management of Cervical Radiculopathy.

    Science.gov (United States)

    Childress, Marc A; Becker, Blair A

    2016-05-01

    Cervical radiculopathy describes pain in one or both of the upper extremities, often in the setting of neck pain, secondary to compression or irritation of nerve roots in the cervical spine. It can be accompanied by motor, sensory, or reflex deficits and is most prevalent in persons 50 to 54 years of age. Cervical radiculopathy most often stems from degenerative disease in the cervical spine. The most common examination findings are painful neck movements and muscle spasm. Diminished deep tendon reflexes, particularly of the triceps, are the most common neurologic finding. The Spurling test, shoulder abduction test, and upper limb tension test can be used to confirm the diagnosis. Imaging is not required unless there is a history of trauma, persistent symptoms, or red flags for malignancy, myelopathy, or abscess. Electrodiagnostic testing is not needed if the diagnosis is clear, but has clinical utility when peripheral neuropathy of the upper extremity is a likely alternate diagnosis. Patients should be reassured that most cases will resolve regardless of the type of treatment. Nonoperative treatment includes physical therapy involving strengthening, stretching, and potentially traction, as well as nonsteroidal anti-inflammatory drugs, muscle relaxants, and massage. Epidural steroid injections may be helpful but have higher risks of serious complications. In patients with red flag symptoms or persistent symptoms after four to six weeks of treatment, magnetic resonance imaging can identify pathology amenable to epidural steroid injections or surgery. PMID:27175952

  17. Cervical Cancer Risk Prediction Models

    Science.gov (United States)

    Developing statistical models that estimate the probability of developing cervical cancer over a defined period of time will help clinicians identify individuals at higher risk of specific cancers, allowing for earlier or more frequent screening and counseling of behavioral changes to decrease risk.

  18. Pharmacological management of acute radiation morbidity

    Energy Technology Data Exchange (ETDEWEB)

    Zimmermann, J.S.; Kimmig, B. [Klinik fuer Strahlentherapie (Radioonkologie), Christian-Albrecht-Universitaet Kiel (Germany)

    1998-11-01

    Background: The acute radiation morbidity may be a serious problem for the patient and may be decreased by pharmacological approaches. Material and methods: A database research (Medline, Cancerlit, DIMDI, etc.) was performed in order to obtain pharmacological approaches to decrease the acute radiation morbidity. The evaluation was focused on therapeutic principles but not on special drugs. Results: Different approaches may be chosen to protect healthy tissues from the effects of ionizing radiation: 1. Administration of cyto- or radioprotective agents prior to irradiation, 2. administration of agents to avoid additional secondary toxicity by inflammation or superinfection during the treatment cycle (supportive care) and 3. administration of rescue agents, such as bone marrow CSFs or hyperbaric oxygen (HBO), after therapy. For radioprotection, there are reports on cellular protection by vitamine E, vitamine C, beta carotene, ribose-cysteine, glutamine, Mgcl2/adenosine triphosphate and WR-2721 (amifostine). In general, preclinical studies show that the combination of pretreatment with amifostine, irradiation, and G-CSF after radiation enhances hematologic recovery. Assessment of these combined effects, including local supportive therapies, merits further clinical investigation. There are data from prospective studies as well as from empirical clinical experience, that radioprotection and clinical supportive care may reduce the treatment related morbidity by 10 to 30% either. Conclusions: A further improvement of the therapeutic ratio is to be expected by systemically combined application of radioprotectors, supportive care and rescue agents. (orig.) [Deutsch] Hintergrund: Die strahlentherapeutische Fruehmorbiditaet kann auf das Ergebnis einer Strahlenbehandlung Einfluss nehmen und kann durch medikamentoese Verfahren gelindert werden. Material und Methoden: Eine Datenbankrecherche (Medline, Cancerlit, DIMDI u.a.) wurde durchgefuehrt, um einen Ueberblick ueber

  19. A computed tomography morphometric study of occipital bone and C2 pedicle anatomy for occipital-cervical fusion

    Directory of Open Access Journals (Sweden)

    Nicolas K.K. King

    2014-01-01

    Full Text Available Background: Occipital-cervical fusion (OCF has been used to treat instability of the occipito-cervical junction and to provide biomechanical stability after decompressive surgery. The specific areas that require detailed morphologic knowledge to prevent technical failures are the thickness of the occipital bone and diameter of the C2 pedicle, as the occipital midline bone and the C2 pedicle have structurally the strongest bone to provide the biomechanical purchase for cranio-cervical instrumentation. The aim of this study was to perform a quantitative morphometric analysis using computed tomography (CT to determine the variability of the occipital bone thickness and C2 pedicle thickness to optimize screw placement for OCF in a South East Asian population. Methods: Thirty patients undergoing cranio-cervical junction instrumentation during the period 2008-2010 were included. The thickness of  the occipital bone and the length and diameter of the C2 pedicle were measured based on CT. Results: The thickest point on the occipital bone was in the midline with a maximum thickness below the external occipital protuberance of 16.2 mm (±3.0 mm, which was thicker than in the Western population. The average C2 pedicle diameter was 5.3 mm (±2.0 mm. This was smaller than Western population pedicle diameters. The average length of the both pedicles to the midpoint of the C2 vertebral body was 23.5 mm (±3.3 mm on the left and ±2.3 mm on the right. Conclusions: The results of this first study in the South East Asian population should help guide and improve the safety in occipito-cervical region instrumentation. Thus reducing the risk of technical failures and neuro-vascular injury.

  20. Posterior fossa decompression and cerebellar tonsil suspension of the cistern magna for treatment of Chiari malformation type I%后颅窝减压并小脑扁桃体悬吊手术治疗Chiari畸形I型

    Institute of Scientific and Technical Information of China (English)

    曾义军; 余水; 周章明

    2016-01-01

    目的:探讨后颅窝减压并小脑扁桃体悬吊治疗Chiari畸形I型的手术疗效。方法:对我院2010年6月至2014年7月收治的38例Chiari畸形患者的临床资料进行回顾性分析,按照Tator标准评价手术效果。结果:38例病例均进行颅窝减压并小脑扁桃体悬吊手术,其中5例合并脊髓空洞病例减压至C1水平,1例合并脊髓空洞患者行蛛网膜下腔分流手术,均达到很好的手术效果。结论:头晕、枕颈部疼痛及肢体感觉障碍是Chiari畸形的常见症状,对Chiari畸形I型进行后颅窝减压并小脑扁桃体悬吊手术方法有效,并且可以达到满意的预后。%Objective To explore the therapeutic of Posterior fossa decompression and cerebellar tonsil suspension in the treatment of Chiari malformation type I.Methods A retrospective analysis was conducted among 38 patients undergoing Posterior fossa decompression and cerebellar tonsil suspension from June 2010 to July 2014. The outcomes of the surgeries were evaluated using Tator criterion.Results The operation of c Posterior fossa decompression and cerebellar tonsil suspension was performed in all the 38 case.The syringomyelia were opened in the level of CI in 5 cases.Syringomyelia-subarachnoid shunt performed in one case three months postoperatively. Favorable outcomes were gained in all cases.Conclusions Dizziness,aches of occipital and cervical area,and sensory disturbance of limbs are the most common symptoms. Posterior fossa decompression and cerebellar tonsil suspension is an effective method to gain satisfied prognosis.