RESUMEN
INTRODUCTION: Anterior cervical discectomy (ACD) is used in the surgical treatment of cervical degenerative disc disease (DDD). Besides the low incidence of postoperative complications, they can affect the postoperative course for patients. MATERIAL AND METHODS: From January 2015 to December 2019, 789 cervical DDD patients with ACD were investigated. This study aims to identify the risk factors for postoperative complications and evaluate the quality of life for ACD patients using the Visual Analog Pain Scale (VAS) and Neck Disability Index (NDI). RESULTS: Among the 789 cervical patients, postoperative complications were identified in 88 patients. In analyzing independently risk factors for postoperative complications, we don't record the male gender, age, number of treated segments, diabetes mellitus, and hypertension with significant risk. A BMI higher than 23.5, a longer surgery of more than 82.5 min, and blood loss of more than 95 ml were found as independent risk factors for postoperative complications. The three-year follow-up quality of life was evaluated in 565 because of the loss of 224 patients. We found improved quality of life in the whole group of patients. Moreover, we have not confirmed significant differences in groups of patients, with and without postoperative complications. CONCLUSION: The result of our study documented a low incidence of postoperative complications after ACD. We identified high BMI level, increased blood loss, and prolonged operation time as independent risk factors for the increased incidence of postoperative complications. Moreover, we demonstrated that postoperative complications do not significantly influence the patient's quality of life (Tab. 5, Ref. 32).
Asunto(s)
Degeneración del Disco Intervertebral , Calidad de Vida , Humanos , Masculino , Estudios de Seguimiento , Discectomía/efectos adversos , Degeneración del Disco Intervertebral/cirugía , Vértebras Cervicales/cirugía , Complicaciones Posoperatorias/epidemiología , Complicaciones Posoperatorias/etiología , Resultado del Tratamiento , Estudios RetrospectivosRESUMEN
Pathogenic variants in LRRK2 are one of the most common genetic risk factors for Parkinson's disease (PD). Recently, the lesser-known p.L1795F variant was proposed as a strong genetic risk factor for PD, however, further families are currently lacking in literature. A multicentre young onset and familial PD cohort (n = 220) from 9 movement disorder centres across Central Europe within the CEGEMOD consortium was screened for rare LRRK2 variants using whole exome sequencing data. We identified 4 PD cases with heterozygous p.L1795F variant. All 4 cases were characterised by akinetic-rigid PD phenotype with early onset of severe motor fluctuations, 2 receiving LCIG therapy and 2 implanted with STN DBS; all 4 cases showed unsatisfactory effect of advanced therapies on motor fluctuations. Our data also suggest that p.L1795F may represent the most common currently known pathogenic LRRK2 variant in Central Europe compared to the more studied p.G2019S, being present in 1.81% of PD cases within the Central European cohort and 3.23% of familial PD cases. Together with the ongoing clinical trials for LRRK2 inhibitors, this finding emphasises the urgent need for more ethnic diversity in PD genetic research.