Assessment of Health-Related Quality of Life in Patients With Traumatic Fractures Following Thoracolumbar Fusion: Short-Term Results.

INTRODUCTION: Thoracolumbar vertebral fractures (TVFs) constitute frequent injuries with specific therapeutic challenges and remarkable implications for affected individuals. The aim of this study is to investigate the alteration of overall health-related quality of life (HRQoL) in patients with traumatic TVFs undergoing thoracolumbar fusion surgery. MATERIALS AND METHODS: A total of 72 patients with single-level traumatic thoracic or lumbar vertebral fractures (AO type A3 or A4) were enrolled in this prospective cohort study. All patients were subjected to thoracolumbar spinal fusion surgery with or without posterior decompression, being followed up for a two-year period. Clinical assessment was conducted via the implementation of the Visual Analog Scale (VAS) and 36-item Short-Form Survey Questionnaire (SF-36) for the evaluation of pain and HRQoL, respectively. Patient assessment was performed in determined postoperative follow-up intervals. RESULTS: Recorded values of assessed outcome measures demonstrated a statistically significant improvement during the entire two-year follow-up period. This improvement was more pronounced throughout the first three to six postoperative months, subsequently demonstrating a plateau. No statistically significant correlation between age, SF-36, and VAS was found, with the exception of the bodily pain index, the improvement of which was observed to be positively correlated with age. Transient causalgia and cerebrospinal fluid leak were recorded in 5% of evaluated individuals. CONCLUSIONS: Thoracolumbar fusion constitutes a safe and efficient option for the surgical management of single-level traumatic vertebral fractures. Nevertheless, rehabilitation is a lasting procedure that may last over six months until final amelioration is observed. Clinical improvement may be more pronounced in older patients, potentially due to different expectations.

Posterolateral Instrumented Fusion in Elderly Patients With a Single Osteoporotic Vertebral Fracture: Evaluation of Health-Related Quality of Life.

Introduction Treatment of osteoporotic vertebral fractures (OVFs) is a factor that affects the quality of life and should be considered during management. In patients with a single OVF and neurologic deficit, surgical procedures aiming at neural decompression with instrumented fusion should be considered in elderly individuals. Posterolateral instrumented fusion (PLF) constitutes a largely performed fusion surgery for patients featuring indications for fusion surgery. The aim of this study was to determine the safety, effectiveness, and impact on health-related quality of life (HRQoL) of PLF surgery in elderly patients diagnosed with a single OVF. Methods This study was conducted at Interbalkan European Medical Center, Thessaloniki, Greece. Eighty (80) consecutive individuals with OVFs were subjected to PLF and recruited in this prospectively designed non-randomized study. Clinical evaluation was performed preoperatively and postoperatively at particular chronic intervals at one, three, six, and 12 months and two years. The assessment was conducted via the standardized Visual Analogue Scale (VAS) and Short-Form 36 (SF-36) Medical Health Survey Questionnaire for pain and HRQoL, respectively. Results No major perioperative complications were observed. All parameters of SF-36 presented significant improvement over the entire follow-up period with VAS scores reaching a plateau at six months. Depicted improvement of these parameters proves the beneficial role of PLF in elderly patients who suffered from a single OVF with or without referable neurological deficit. Conclusion OVFs have a significant impact on the quality of life of elderly patients, and surgical treatment with PLF with or without decompression can lead to functional recovery, pain relief, and HRQoL amelioration. Our results demonstrated that the outcomes of PLF in the surgical treatment of these patients are remarkably favorable, demonstrating the safety and efficacy of the technique.

Avulsion fracture of the ischial tuberosity: A surgical dilemma.

The clinician should make the treatment choice considering the patient's requirements. Thus, surgical treatment can successfully achieve long-lasting satisfactory results and provide the best chance for a rapid return to sports.

Left Sided Appendicitis: Once Burned Twice Shy.

Acute appendicitis is one of the most common surgical conditions that are diagnosed in children presenting with acute abdominal pain in the emergency department. An atypical presentation of symptoms is encountered in 30% of cases. Atypical localization of the appendix as in left sided appendicitis, although rare, has an increased risk of missed or delayed diagnosis. We present two consecutive cases of left sided appendicitis in order to describe how increased awareness in the second case helped us to avoid pitfalls in the management and diagnosis of this atypical and variant condition. Increased cautiousness and awareness of left sided appendicitis can assist emergency physicians to avoid pitfalls in the management and diagnosis of this atypical and variant condition.

Parameatal Urethral Cyst in a Newborn-A Case Report and Review of the Literature.

Parameatal urethral cysts are rare congenital lesions of the penis that are usually <1cm in diameter in the paediatric population and do not create any urinary difficulties. Their natural course is either to resolve or to be surgically excised without any postoperative complications. We report a case of a newborn with a parameatal urethral cyst that produced voiding difficulties and was treated by surgical excision.

Carcinoid tumors of the appendix - last decade experience.

INTRODUCTION: Carcinoid of the appendix is a rare clinical entity in childhood and usually has a good clinical outcome. The impact of the operative preparations appendix ranges between 0.1-0.9%. The aim of our study is to report the experiences of our department in the management of appendiceal carcinoid tumors in children. MATERIALS AND METHODS: Data of all patients aged 15 y or less who underwent appendectomy at the 2nd Department of Pediatric Surgery of Aristotle University of Thessaloniki between January 2004 and February 2014 were evaluated for the existence of appendiceal carcinoid tumors in pathological specimens. The collected data included: gender, patient's age, clinical indications and surgical intervention, tumor localization in the appendix and the diameter of lesion, histological type of the tumor and postoperative care (follow up) of patients. RESULTS: Four cases (3 girls, 1 boy) with carcinoid treated at our department during a 10 y period. Median patient age was 10.75 y (9- 12 y). In all cases the diagnosis was after appendectomy on ground of acute appendicitis. A single incident brought findings of gangrenous appendicitis. In three cases the tumor's diameter was smaller than 1cm, while the incident with the gangrenous appendicitis was larger than 1cm in diameter. In four cases the tumor was localized at the apex of the appendix without extending to the surrounding tissues. In all patients with carcinoid tumor followed a further testing based on specific monitoring protocol. In no case was residual or metastatic disease identified and no further treatment was required. No relapse was observed during follow-up. CONCLUSION: Our study confirms the good prognosis of appendiceal carcinoid.