RESUMO
AIM: To assess the results of use of lumbar spine on-line registry in 2012 (IV quarter). MATERIAL AND METHODS: The Burdenko Neurosurgery Institute of the Russian Academy of Medical Sciences (RAMS) and the System Analysis Institute of the Russian Academy of Sciences (RAS) have developed an electronic "on-line" portal of the Spine Registry for Degenerative Lumbar Spine Diseases. The data on 1295 retrospective and 145 prospective patients who underwent treatment in Burdenko Neurosurgery Institute, the "AXIS" clinic, Medical Centre of the Bank of Russia, "Marina Spine Clinic" LA, USA and in the Neurosurgery department of Research Institute of Traumatology and Orthopedics, Nizhny Novgorod were analyzed. Since May 2012 to the present time outcomes of 1295 (retrospective group) and 145 (prospective group) patients with Degenerative Lumbar Spine Diseases, which underwent treatment from 2002 to 2012 were entered into online registry and subsequently analyzed. The current study has revealed two problems that need to be discussed. First problem is that the archived information is not sufficient for data base update. The second problem is low activity of many physicians in inputting data into the register. We believe that the solution of these problems lies in the plane of synchronization of on-line registry with electronic medical records. This synchronization between registry and online records will allow studying their joint work. If found to be successful after the development of the other sections of the register they will be added to an already running version as provided by the principles of its work - scalability and extesibility. The results of this work will be profile of vertebrological version of electronic medical records. In the future it could be used in clinics dealing with spine disorders. RESULTS: Since May 2012 the outcomes of 1295 (retrospective group) and 145 (prospective group) patients with Degenerative Lumbar Spine Diseases, who were operated on in Burdenko Neurosurgery Institute (Moscow, Russia), minimally invasive spinal surgery clinic "AXIS" (Moscow, Russia), Medical Centre of The Bank of Russia (Moscow, Russia), "Marina Spine Clinic" (LA, USA) and Neurosurgery department of Research Institute of Traumatology and Orthopedics (Nizhny Novgorod, Russia) from 2002 to 2012 were analyzed. The perspective of this work is development of other parts of spine registry (for cervical and thoracic spine) and improving the outcome assessment process in Russian spinal surgery clinics.
Assuntos
Corpo Caloso/fisiologia , Dominância Cerebral/fisiologia , Eletroencefalografia , Atividade Motora/fisiologia , Adolescente , Adulto , Neoplasias do Ventrículo Cerebral/fisiopatologia , Neoplasias do Ventrículo Cerebral/cirurgia , Corpo Caloso/cirurgia , Craniofaringioma/fisiopatologia , Craniofaringioma/cirurgia , Cistos/fisiopatologia , Cistos/cirurgia , Eletroencefalografia/estatística & dados numéricos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Período Pós-Operatório , Terceiro Ventrículo/fisiopatologia , Terceiro Ventrículo/cirurgia , Fatores de TempoRESUMO
255 patients have been examined in the early postoperative period after the removal of tumors located in diencephalic and sella turcica regions. The early postoperative period was complicated by circulation disturbances in the vascular bed of the anterior cerebral or anterior communicative arteries. The clinical pattern, CT scans and morphological data were analysed. Three principal clinical syndromes of the postoperative period were lined out: 1) extrapyramidal-diencephalic syndrome; 2) extrapyramidal-capsular syndrome; 3) frontal-corpocallosal syndrome. The reason for these syndromes was the occlusion of the anterior cerebral and anterior communicative arteries or their branches. The diencephalic syndrome had poor prognosis. The postoperative therapy included hormones. It was necessary to prevent the onset of adrenal insufficiency and diabetes insipidus. The differential diagnosis of thrombosis and vasospasm was of great importance. In case of vasospasm, such medicines as sermion, redergine and nimodipine had a strong therapeutic effect. In vascular thrombosis these medicines were ineffective. Systemic approach to circulation disturbances seems of utmost importance for the analysis of postoperative complications.
Assuntos
Neoplasias Encefálicas/cirurgia , Transtornos Cerebrovasculares/etiologia , Cuidados Críticos , Complicações Pós-Operatórias/terapia , Adolescente , Adulto , Idoso , Transtornos Cerebrovasculares/terapia , Feminino , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
From clinical analysis of the course of the early postoperative period in 255 patients who underwent removal of extracerebral tumors of mediobasal localization and from clinico-morphological comparison in 24 patients who died, the authors set apart and describe 3 main syndromes of cerebral circulatory disorders in the basin of the anterior cerebral artery: subcortical-diencephalic, subcortical-capsular, and parasagittal. The prognostic significance of each syndrome is shown. The variants of the syndrome are caused by predominant affection (obturation thrombosis, persisting spasm) of different segments of the anterior cerebral artery.