ABSTRACT
OBJECTIVE@#To explore the clinical efficacy and safety of manual therapy combined with posterior percutaneous endoscopic cervical decompression(PECD) in the treatment of intractable cervical spondylotic radiculopathy.@*METHODS@#From May 2016 to May 2018, 23 CSR patients who responded poorly to conservative treatment for at least 6 weeks underwent the combination management. Firstly, the patients received the posterior percutaneous endoscopic cervical decompression routine care for the following 4 weeks and manual therapy for another 4 weeks. A total of 23 patients were followed up, including 14 males and 9 females, the age ranged from 29 to 78 years old with an average of (50.30±12.28) years, the course of disease was 3 to 24 months with an average of (9.74±5.76) months. The lesion segment involved C4,5 in 4 cases, C5,6 in 13 cases, C6,7 in 6 cases. The visual analogue scale (VAS), neck disability index (NDI), changes of cervical physiological curvature and interbody stability, adverse events were observed before and after operation. The follow-up time points were before operation, 1 day after operation and 1, 3 and 6 months after operation.@*RESULTS@#All patients successfully completed the operation and manual treatment for 4 to 8 times. Among the 29 cases, 23 patients were followed up for more than 6 months. There was no spinal cord and nerve root injury during the treatment and follow-up. Operation time was from 80 to 120 min with a median of 90 min;intraoperative blood loss was from 35 to 80 ml with a median of 50 ml. NDI, VAS of neck, shoulder and arm each period after operation were significantly lower than those before PECD(P<0.05), while there were no significant improvement in cervical physiological curvature and target segment intervertebral space height(P>0.05);there was no significant change in interbody stability (P>0.05). After received the manual therapy, NDI significantly decreased (P<0.05), however, there was no significant difference in VAS of neck, shoulder and arm, physiological curvature of cervical spine and intervertebral space height of target segment compared with that before manual treatment (P>0.05);there was no significant change in interbody stability (P>0.05).@*CONCLUSION@#Manual therapy combined with PECD in the treatment of intractable cervical spondylotic radiculopathy can not only quickly improve the symptoms, but also alleviate the residual symptoms after PECD safely and effectively, and can not cause obvious signs of accelerated instability of cervical adjacent segments in the short term.
Subject(s)
Child , Child, Preschool , Female , Humans , Male , Cervical Vertebrae/surgery , Decompression/adverse effects , Musculoskeletal Manipulations , Radiculopathy/surgery , Retrospective Studies , Spondylosis/surgery , Treatment OutcomeABSTRACT
This study describes the case of a dentigerous cyst in a six-year-old patient treated by decompression of the lesion. The patient?s main clinical complaint was facial asymmetry with displacement of the nasal cavity. Clinical examination showed an extensive lesion in the left side of maxilla invading the nasal cavity. An interdisciplinary course of treatment for this patient was indicated to preserve the impacted permanent tooth inside the lesion. A panoramic radiograph and computed tomography scan were requested for planning the surgery. A decompression surgery was performed and an incisional biopsy revealed the presence of a dentigerous cyst in the maxilla. A second operation was performed two years later to disimpact the permanent incisor and promote its eruption by means of orthodontic traction. The patient was thoroughly followed for a few years. Bone repair at the dentigerous cyst site was perfect.
Este artigo relata o caso de um cisto dentígero em um paciente de seis anos de idade em que a técnica utilizada para tratamento foi a de descompressão. A queixa clínica principal do paciente era assimetria facial e deslocamento da cavidade nasal. Ao exame clínico pôde-se constatar uma lesão extensa na maxila, do lado esquerdo que invadia a cavidade nasal. Foi planejado um tratamento interdisciplinar com a finalidade de preservar o dente permanente impactado que se localizava no interior da lesão. Foram requisitadas para o diagnóstico e planejamento cirúrgico uma radiografia panorâmica e uma tomografia computadorizada. A cirurgia de descompressão foi inicialmente realizada e a biópsia incisional revelou a presença de um cisto dentígero na maxila. A segunda intervenção cirúrgica foi realizada após dois anos, com a finalidade de tracionar o incisivo permanente para permitir que o mesmo pudesse irromper na cavidade bucal por meio de tração ortodôntica. O paciente foi rigorosamente acompanhado por alguns anos e pôde-se observar uma perfeita reparação óssea na área em que havia o cisto dentígero.
Subject(s)
Child, Preschool , Child , Dentigerous Cyst/complications , Dentigerous Cyst/diagnosis , Dentigerous Cyst , Dentigerous Cyst/rehabilitation , Dentigerous Cyst/therapy , Decompression/adverse effects , Decompression , Maxilla/anatomy & histology , Maxilla/surgery , Maxilla/growth & developmentABSTRACT
Se realiza un estudio descriptivo de todos los casos de Enfermedad por Descompresión Inadecuada (E.D.I.), desde el primero de abril de 1985 al 31 de marzo de 1991, clasificándolos según el modelo de Golging et.al y registrando los datos en las fichas elaboradas por el Dr. Alfredo Cea Egaña. Se analizaron 125 casos, destacando que el 41 por ciento de ellos corresponde a formas graves de E.D.I., los que junto al número total de casos se incrementó hasta 1988, fecha desde la cual ha disminuído su importancia, debido a varios factores. La etiopatogenia es multifactorial y a pesar de su polimorfismo clínico es fácilmente diagnosticable, radicando su importancia en que afecta a una población en edad reproductiva, es totalmente prevenible y de buen pronóstico, con un tratamiento adecuado y oportuno
Subject(s)
Humans , Male , Decompression/adverse effects , Decompression Sickness/epidemiology , Chile , Diving/adverse effectsABSTRACT
En el presente trabajo, se ha analizado el Programa de Entrenamiento Fisiológico en el Departamento de Medicina Aeroespacial de la Dirección de Sanidad de la Fuerza Aérea de Chile, en lo que respecta a incidentes producidos durante el desarrollo de dicho programa y al que fueron sometidos tanto pilotos alumnos como instructores de vuelo de cámara hipobárica, durante los años 1983-1992. En este período se entrenó a 2.118 alumnos en vuelos de hipoxia y vuelos de descompresión rápida no registrándose ningún accidente, teniendo presente además, que los incidentes que se produjeron fueron sin consecuencias graves, tanto para alumnos como instructores. En el período analizado se produjeron un total de 274 incidentes en los alumnos correspondiendo a barotitis, barotitis tardía y barosinusitis, los porcentajes más altos. Asimismo, en los instructores el número total de incidentes fue de 56, siendo barotitis, barotitis tardía y barosinusitis los más frecuentes. Otros hechos importantes son la realización de 23 vuelos médicos y de 24 vuelos de prueba, todos sin consecuencia y con resultados altamente positivos. Cabe destacar que durante este período los incidentes han sido superados efectiva y oportunamente gracias a la preparación, capacidad y a las medidas de seguridad que en cada circunstancia específica se aplicaron