RESUMO
PURPOSE: We aimed to determine whether there was a difference in post-operative symptomatic control and quality of life (QoL) between patients who were obese (BMI >30) and non-obese (BMI <30) pre-operatively. This information may inform the decision making of Physicians and patients whether to proceed to surgery for management of symptomatic lumbar disc prolapse. METHODS: We conducted a prospective questionnaire-based study of QoL and symptom control in 120 patients with postal follow-up at 3 and 12 months after lumbar disc surgery. This study was conducted in two United Kingdom regional neurosurgical units, with ethical approval from the North of Scotland Research Ethics Service (09/S0801/7). RESULTS: 120 patients were recruited; 37 (34.5%) were obese. Follow up was 71% at 3 months and 57% at 12 months. At recruitment, both obese and non-obese patient groups had similar functional status and pain scores. At 3 and 12 months, non-obese and obese patients reported similar and significant benefits from surgery (e.g. 12 month SF-36 80.5 vs. 68.8, respectively). In non-obese and obese patients, time to return to work was 47.5 days and 53.8 days, respectively, (p = .345). After 12 months all QoL scores were significantly improved from pre-operative levels in both groups. CONCLUSIONS: Obese patients derive significant benefit from lumbar discectomy that it is similar to the benefit experienced by non-obese patients. Obese individuals may achieve excellent results from discectomy and these patients should not be refused surgery on the basis of BMI alone.
Assuntos
Discotomia/métodos , Discotomia/psicologia , Deslocamento do Disco Intervertebral/psicologia , Deslocamento do Disco Intervertebral/cirurgia , Disco Intervertebral/cirurgia , Região Lombossacral/cirurgia , Obesidade/complicações , Obesidade/psicologia , Adulto , Idoso , Índice de Massa Corporal , Feminino , Humanos , Deslocamento do Disco Intervertebral/complicações , Masculino , Pessoa de Meia-Idade , Medição da Dor , Estudos Prospectivos , Qualidade de Vida , Retorno ao Trabalho , Inquéritos e Questionários , Resultado do Tratamento , Adulto JovemRESUMO
The discovery of air in the cavernous sinus may cause some alarm. It may well, however, simply be a consequence of retrograde air embolism from venous cannulation. It rarely has any adverse effects and is self-limiting in nature. We provide an illustrative case report.
Assuntos
Cateterismo/efeitos adversos , Seio Cavernoso , Embolia Aérea/etiologia , Adulto , Seio Cavernoso/diagnóstico por imagem , Seio Cavernoso/cirurgia , Embolia Aérea/diagnóstico por imagem , Feminino , Humanos , Radiografia , Resultado do TratamentoRESUMO
Benign intracranial hypertension is a clinical diagnosis linked to a number of medical and surgical disorders. A common aetiology has not yet been established. It would seem, however, that many, if not all, of these cases can be related to some degree of cerebral venous outflow obstruction. We present here a series of patients with extraluminal compression of the cerebral venous sinuses that has been amenable to surgical resection. These 'surgical' causes of BIH illustrate an important subset of the disease and inform us about the possible pathophysiological principles underlying the disorder.