Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 5 de 5
Filtrar
Mais filtros








Base de dados
Intervalo de ano de publicação
1.
J Ayub Med Coll Abbottabad ; 30(1): 58-63, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29504331

RESUMO

BACKGROUND: Spinal injuries are the most devastating injuries and affect every aspect of patients' lives. This may cause lifelong disability due to spinal cord injury. Recovery of neurological functions is highly desirable. Early or late surgical intervention is still debatable, but majority recommend early intervention. The result of late surgical intervention in term of neurological recovery is not clear. This study focuses on neurological recovery after late surgical intervention. The objective of this study was to assess neurological recovery in term of ASIA grading in patients with traumatic spinal cord injury. METHODS: This descriptive cross-sectional study was performed from June 2013 to June 2016. All patients treated for spinal trauma with spinal cord injury, operated after 24 hrs of injury were included in the study. Neurology was assessed according to ASIA scale preoperative and at 6 months. Data was analysed with the help of SPSS. RESULTS: Total of 149 patients, 32 (21.5%) were female and 117 (78.5%) male were included. mean age was 32±13.11 years. Ninety-six (64.4%) patients presented with fall while 53 (35.6%) presented with motor vehicular accidents (MVA). according to AO comprehensive classification 76 (51.1%) patients were type C, 47 (31.5) were type B and 26 (17.4%) were type A. preoperative neurology was ASIA A 65 (43.6%), B12 (8.1%), C 59 (39.6%) and D 13 (8.7%). Mean delay in surgery was 3.6±1.8 days with minimum of 1 and maximum 14 days. ASIA grading on 6 months was ASIA "A" 61 (40.9%), B4 (2.7%), C 26 (17.4%), D 33 (22.1%) and E 25 (16.8%). the overall improvement in neurology was in 67 (45%) of patients. improvement by one grade was documented in 49 (32.9%) patients, by two grades in 17 (11.4%) and by three grades in one patient (.7%). CONCLUSIONS: fall from height is a major cause of spine injuries in our set up followed by RTA. Preventive measures need to be instituted to lessen the devastating outcome.


Assuntos
Traumatismos da Medula Espinal , Traumatismos da Coluna Vertebral , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Doenças do Sistema Nervoso , Recuperação de Função Fisiológica , Traumatismos da Medula Espinal/epidemiologia , Traumatismos da Medula Espinal/cirurgia , Traumatismos da Coluna Vertebral/epidemiologia , Traumatismos da Coluna Vertebral/cirurgia , Resultado do Tratamento , Adulto Jovem
2.
J Pak Med Assoc ; 65(11 Suppl 3): S94-9, 2015 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-26878547

RESUMO

OBJECTIVE: To evaluate the results of non-union of tibia treated with Ilizarov fixator. METHODS: The case series was conducted at Hayatabad Medical Complex, Peshawar, from January 2012 to April 2015, and comprised consecutive patients with non-union of the tibia. Patients of either gender, with complex non-union of the tibia from the age of 18 to 65 years were included, while patients with intra-articular fractures, vascular injury, smokers and steroid users were excluded. Outcome of the treatment was graded by using the scoring system of Association for the Study and Application of Methods of Ilizarov. RESULTS: There were 21 patients with a mean age of 40±13.89 years (range: 18-65 years). There were 7(33.3%) female and 14(66.6%) male patients. There were 14(66.6%) patients who had one previous surgery, 5(23.8%) had 2 surgeries and 2(9.5%) had 3. Bone results were excellent in 12(57.1%) patients, good in 6(28.6%) and fair in 3(14.3%). Functional results were excellent in 7(33.3%) patients, good in 9(42.9%), fair in 4(19%) and poor in 1(4.8%). CONCLUSIONS: Ilizarov fixator gave good to excellent results in tibialnon-union, by eradicating the infection, filling the defect with bone transport, correcting the deformity and the limb length discrepancy.

3.
J Pak Med Assoc ; 64(12 Suppl 2): S22-6, 2014 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-25989774

RESUMO

OBJECTIVE: To find the frequency of deformity correction, functional outcome and complications of single-stage vertebral column resection in patients with kyphotic deformity. METHODS: The prospective case series was conducted at Hayatabad Medical Complex, Peshawar, and Aman Hospital, Peshawar, from January 2012 to December 2013, and comprised all patients who underwent single-stage posterior vertebral column resection. Only patients with severe rigid sharp deformity of different aetiology that required more than 40 degree correction and who had at least 3-month follow-up were included. Data was processed using SPSS 16. RESULTS: Of the total 18 patients, 11(61.1%) were male and 7(38.9%) were female, with an overall mean age of 28.7±13.6 years (range: 12-60 years). Among them, 8(44.4%) patients had congenital kyphosis, 5(27.8%) had posttraumatic origin, 4(22.2%) had post-tuberculous deformity, while 1(5.6%) had iatrogenic kyphosis. The apex of the deformity was in thoracic spine in 12(66.7%) patients, while in 6(33.3%) patients it was in the lumbar spine. The average pre- and post-operative Cobb's angle was 66.2±18.9 degrees and 18.8±12.8 degrees respectively. Mean correction of deformities was 47.3±13.3 degrees. The mean correction achieved in percentage terms was 73.5±8.6 per cent (range: 56-87%). There were no patients with post-operative deterioration of neurological status. Two (11%) patients underwent re-exploration of the wounds with wash and cultures due to wound discharge. CONCLUSIONS: Posterior vertebral column resection was found to be a very effective method of correction of severe kyphotic deformities in expert hands with acceptable morbidity.

4.
J Pak Med Assoc ; 64(12 Suppl 2): S83-6, 2014 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-25989789

RESUMO

OBJECTIVE: To determine the surgical outcome of patients with axial cervical spine fractures. METHODS: The study was conducted at the Spine Unit of Hayatabad Medical Complex, Peshawar, and Aman Hospital, Peshawar, from January 2012 to March 2013. Patients with sub-axial cervical spine fractures were treated surgically. The outcome was measured using Visual Analogue Score, Neck Disability Index, by neurology and on the basis of complications. SPSS 16 was used for statistical analysis. RESULTS: Of the 50 patients in the study, 7(14%) were females, while 43(86%) were male. Overall mean age was 30.3±7.9 years (range: 18-60 years). Major cause of injury was road traffic accidents in 29(58%). A total of 29(58%) patients had dislocation of the spine which was successfully reduced in 22(75.9%). Mean postoperative visual analogue score was 2.9±1.5 (range: 1-7) at last follow-up. Mean neck disability index score was 10.9±5.2 (range: 4-26). Dysphagia was the most common complication in 12(24%). CONCLUSIONS: Majority of the sub-axial fractures can be treated effectively with good outcome through anterior approach. Gradual axial skull traction is an easy and safe method for reduction of cervical fracture dislocations.

5.
J Pak Med Assoc ; 64(12 Suppl 2): S87-90, 2014 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-25989790

RESUMO

OBJECTIVE: To evaluate the outcome of local corticocancellous bone chips used for fusion in various kinds of spine surgeries. METHODS: The observational prospective study was conducted at the Hayatabad Medical Complex, Peshawar, and Aman Hospital, Peshawar, from April 2011 to April 2013, and comprised cases in which locally harvested bone chips removed during decompression were used as bone graft for arthodesis. All cases were successfully followed up for at least one year. SPSS 16 was used for statistical analysis. RESULTS: Of the80 patients in the study, 44(55%) were female and 36(45%) were male. The overall mean age was 39.5±12.7 years (range: 13-75 years). Besides, 34(42.5%) were operated for spine surgery, 22(27.5%) for spondylolisthesis, 12(15.0%) for disc degeneration and 12 (15%) for spinal stenosis. In 54(67.5%) patients posterio-lateral fusion with decompression was done, while in 26(32.5%) transforaminal lumbar interbody fusion was done. Oswestry Disability Index scoreat last follow-up ranged from 4 to 56 with a mean of 17.7±10.7. CONCLUSIONS: Locally harvested bone chips are reasonable alternative to iliac crest bone graft, having comparable results while avoiding donor site morbidity associated with iliac crest bone grafts.

SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA