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1.
Front Neurol ; 10: 1099, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31681158

RESUMO

The Willis covered stent (WCS) may prolapse into the aneurysmal sac due to device migration or foreshortening. We present a useful salvage strategy that can reorient a prolapsed WCS into a more suitable alignment. An intra-procedural prolapse of a WCS into a large cavernous aneurysm occurred in a 70-year-old female patient. A pipeline embolization device (PED) was used to retrieve the WCS and successfully accomplish flow diversion. Maintaining proximal access and ensuring that the microwire is securely held within the central axis of the herniated stent are critical until the entire parent vessel can be reconstructed. This salvage technique may help to regain proximal access and reposition the flow diversion constructs following WCS prolapse.

2.
World Neurosurg ; 122: e838-e846, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30391763

RESUMO

BACKGROUND: Recurrent intracranial aneurysms (RAs) remain a daunting challenge for neurosurgeons. This study aimed to explore a potential optimal management strategy of RAs by reviewing the characteristics and management outcomes of 117 RAs. METHODS: A total of 117 patients with RAs were treated in a single neurosurgical center from January 2011 to January 2017. The demographic and angiographic characteristics of the patients, treatment approaches, and follow-up outcomes were evaluated. RESULTS: Of the 117 patients with RAs, 16 (13.7%) and 101 (86.3%) initially underwent microsurgical clipping and endovascular coiling, respectively. Coil embolization was used in 75 cases, microsurgical clipping was used in 32 cases, and conservative treatment occurred in 10 cases. Complete clipping was achieved in all 32 aneurysms by microsurgery, and remnants were observed in 25 aneurysms after coiling (33.3%, P < 0.001). Operation-related cerebral infarction occurred in 4 cases (12.5%) with complex and large RA in the clipping group and in 1.3% (1/75) of patients treated with coiling (P = 0.027). Follow-up found similar favorable outcomes in patients after coiling, clipping, and conservative treatment (90.3% vs. 86.7% vs. 80%, respectively; P = 0.711). Follow-up rates of recurrence were significantly higher in the coiling group than the clipping group (26% vs. 0%, respectively; P = 0.003). CONCLUSIONS: The follow-up outcomes appeared to be acceptable and comparable between the 2 groups. However, in large or giant recurrent aneurysms, sound judgment and the careful selection of treatment are strongly suggested because direct microsurgery has a higher morbidity, even in experienced hands, whereas endovascular coiling is complicated with a higher incomplete occlusion rate.


Assuntos
Gerenciamento Clínico , Procedimentos Endovasculares/métodos , Aneurisma Intracraniano/diagnóstico por imagem , Aneurisma Intracraniano/cirurgia , Microcirurgia/métodos , Instrumentos Cirúrgicos , Adolescente , Adulto , Idoso , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Recidiva , Estudos Retrospectivos , Resultado do Tratamento , Adulto Jovem
3.
J Neurosurg ; : 1-7, 2018 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-30497155

RESUMO

OBJECTIVERecurrent aneurysms after coil embolization remain a challenging issue. The goal of the present study was to report the authors' experience with recurrent aneurysms after coil embolization and to discuss the radiographic classification scheme and recommended management strategy.METHODSAneurysm treatments from a single institution over a 6-year period were retrospectively reviewed. Ninety-seven aneurysms that recurred after initial coiling were managed during the study period. Recurrent aneurysms were classified into the following 5 types based on their angiographic characteristics: I, pure recanalization inside the aneurysm sac; II, pure coil compaction without aneurysm growth; III, new aneurysm neck formed without coil compaction; IV, new aneurysm neck formed with coil compaction; and V, newly formed aneurysm neck and sac.RESULTSAneurysm recurrences resulted in rehemorrhages in 6 cases (6.2%) of type III-V aneurysms, but in none of type I-II aneurysms. There was a significantly higher proportion of ophthalmic artery aneurysms and complex internal carotid artery aneurysms presenting as types I and II than presented as the other 3 types (63.3% vs 16.4%, p < 0.001). In contrast, for posterior communicating artery aneurysms and anterior communicating artery aneurysms, a higher proportion of type III-V aneurysms was observed than for the other 2 types, but without a significant difference in the multivariate model (56.7% vs 23.3%). In addition, giant (> 25 mm) aneurysms were more common among type I and II lesions than among type III and IV aneurysms (36.7% vs 9.0%, p = 0.001), which exhibited a higher proportion of small (< 10 mm) lesions (65.7% vs 13.3%, p < 0.001). A single reembolization procedure was sufficient to occlude 80.0% of type I recurrences and 83.3% of type II recurrences from coil compaction but only 65.6% of type III-V recurrences from aneurysm regrowth.CONCLUSIONSAneurysm size and location represent the determining factors of the angiographic recurrence types. Type I and II recurrences were safely treated by reembolization, whereas type III-V recurrences may be best managed surgically when technically feasible.

4.
World Neurosurg ; 112: 86-93, 2018 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-29367001

RESUMO

OBJECTIVE: To compare the efficacy and safety in the management of lumbar diseases performed by either posterior lumbar interbody fusion (PLIF) or transforaminal lumbar interbody fusion (TLIF). Interbody fusion is considered the "gold standard" in the treatment of lumbar degenerative diseases. Both PLIF and TLIF have been advocated, and it remains controversial as to the best operative technique. METHODS: The electronic databases including Embase, PubMed, and Cochrane library were searched to identify relevant studies up to September 2017. The primary outcomes were fusion rate, complications, and clinical satisfaction. The secondary outcomes were length of hospitalization, operation time, blood loss, postoperative visual analog scale, Oswestry Disability Index, and Japanese Orthopaedic Association Score. Data analysis was conducted with RevMan 5.3 software. RESULTS: A total of 16 studies involving 1502 patients (805 patients in PLIF group and 697 in TLIF group) were included in the meta-analysis. The pooled analysis showed that there was no significant difference in terms of fusion rate (P > 0.05) and clinical satisfaction (P > 0.05) between the 2 groups. TLIF was superior to PLIF with significantly lower incidence of nerve root injury (P < 0.05) and dural tear (P < 0.05). However, there was no significant difference regarding wound infection (P > 0.05) and graft malposition (P > 0.05). PLIF required significant longer operation time (P < 0.05) and was associated with more blood loss (P < 0.05). Although TLIF was associated with better postoperative visual analog scale, Oswestry Disability Index, and Japanese Orthopaedic Association Score than PLIF, there was no statistical difference regarding these results. CONCLUSIONS: The available evidence suggests that both TLIF and PLIF could achieve similar clinical satisfaction and fusion rate in the management of degenerative lumbar diseases. However, TLIF was superior to PLIF with shorter operation time, less blood loss, and lower incidence of nerve root injury and dural tear. There is no significant difference between both groups regarding wound infection and graft malposition.


Assuntos
Degeneração do Disco Intervertebral/cirurgia , Fusão Vertebral/métodos , Humanos , Região Lombossacral/cirurgia
5.
Neurol India ; 66(1): 105-114, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29322968

RESUMO

AIM: Limited clinical and angiographic data exists for patients with traumatic cervico-cerebral pseudoaneurysms. In this paper, we present our limited experience with various management strategies for traumatic cervico-cranial pseudoaneurysms. MATERIALS AND METHODS: We retrospectively analyzed 37 consecutive cases of traumatic pseudoaneurysms involving the cervico-cranial or the cerebral arteries diagnosed at our center from September 2009 to December 2014. The demographic data, etiology, clinical presentation, lesion location, treatment modality, and follow-up outcomes of these patients were reviewed. Among these 37 patients, 5 patients were treated by surgery, while 29 patients were treated by the endovascular approach and 3 received conservative treatment. RESULTS: During the study period, 42 pseudoaneurysms were identified in 37 patients with a history of head or neck injury. Five patients underwent surgical exploration of the lesion with an uneventful postoperative course. Twenty-nine patients were treated by endovascular interventions with various embolization materials including coils, stents, detachable balloons, liquid embolic agents, and a combination of these agents. The angiographic follow-up imaging demonstrated complete exclusion of the aneurysm from the circulation with the patient being free from any additional neurological deficits. CONCLUSION: Proper selection of an appropriate approach is essential to address the management of traumatic cervico-cerebral pseudoaneurysms. The treatment of traumatic cervico-cerebral pseudoaneurysms should be selected according to the location and the clinical features of the pseudoaneurysms. The endovascular treatment is a safe and effective modality and should be the first-line choice for treatment of traumatic pseudoaneurysms.


Assuntos
Falso Aneurisma/etiologia , Falso Aneurisma/terapia , Traumatismos Craniocerebrais/complicações , Lesões do Pescoço/complicações , Adolescente , Adulto , Doenças das Artérias Carótidas/etiologia , Doenças das Artérias Carótidas/terapia , Doenças Arteriais Cerebrais/etiologia , Doenças Arteriais Cerebrais/terapia , Criança , Embolização Terapêutica , Procedimentos Endovasculares , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Artérias Temporais/patologia , Resultado do Tratamento , Adulto Jovem
6.
J Back Musculoskelet Rehabil ; 31(2): 299-304, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29171978

RESUMO

BACKGROUND: Retrospective study of 68 patients of symptomatic cervical spondylosis who were treated by anterior cervical discectomy and fusion (ACDF). OBJECTIVE: The purpose of this study was to compare the clinical and radiological outcomes of patients with single level cervical spondylosis using either zero-profile spacer (group A) or anterior cervical plate and cage (group B). METHODS: Clinical and radiological data of 68 patients undergoing ACDF from C3-C7 were collected retrospectively. There were 35 patients with a mean age of 54.05 years who received treatment by zero-profile implant. A total of 33 patients with a mean age of 52.09 years underwent fusion by traditional plate with cage. Group A and group B were followed up for an average of 23.68 months and 24.39 months, respectively. Age, blood loss, and operation time were assessed. The clinical outcomes were evaluated by JOA and VAS score before and after surgery. In addition, incidence of dysphagia was recorded. The Cobb angle (from C2 to C7) change was measured on the lateral cervical spine radiographs. RESULTS: There was no significant difference in terms of operation time and blood loss between two groups. The postoperative JOA significantly increased and the VAS decreased correspondently in both groups. The postoperative Cobb angle increased and showed statistical difference compared with preoperative Cobb angle in both groups. There was no significant difference between group A and group B in achieving clinical symptoms and radiograph improvement according to postoperative JOA, VAS and Cobb angle comparison. The incidence of postoperative dysphagia was lower in the group A than group B. CONCLUSIONS: Our study suggests that the application of zero-p spacer can achieve similar clinical and radiological improvement compared with traditional plate and cage. Meanwhile, zero-p is superior to plate and cage with a lower incidence of postoperative dysphagia.


Assuntos
Próteses e Implantes , Fusão Vertebral/instrumentação , Espondilose/cirurgia , Transtornos de Deglutição/etiologia , Transtornos de Deglutição/prevenção & controle , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias , Estudos Retrospectivos
7.
J Orthop Sci ; 22(5): 828-833, 2017 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-28641907

RESUMO

OBJECTIVE: The purpose of this meta-analysis was to compare the efficacy and safety between patients with thoracolumbar burst fracture who underwent posterior fixation alone (non-fusion) and supplemented with fusion. METHODS: A comprehensive search of related literature was performed in PubMed, Embase and the Cochrane library. Clinical outcomes (LBOS and VAS), surgical outcomes (operation time, blood loss, hospital stay and perioperative complications), and radiographic outcomes (kyphotic angle, decreased vertebral body height and segmental motion) were assessed in the meta-analysis. Data analysis was conducted with RevMan 5.3 software. RESULTS: Five RCTs and three retrospective studies including a total of 445 cases were identified. We found that there was no significant difference in terms of LBOS, VAS, implant-related complications, kyphotic and VBH parameters. However, there was a significant difference regarding blood loss, operation time, segmental motion and donor site pain between fusion and non-fusion. CONCLUSION: This meta-analysis demonstrated that posterior fixation alone could achieve satisfactory clinical and radiological results in treating thoracolumbar burst fracture. Moreover, posterior fixation without fusion was superior to additional fusion with less blood loss, shorter operation time, better segmental motion and lower donor site pain.


Assuntos
Fraturas por Compressão/cirurgia , Vértebras Lombares/lesões , Vértebras Lombares/cirurgia , Fraturas da Coluna Vertebral/cirurgia , Fusão Vertebral , Vértebras Torácicas/lesões , Vértebras Torácicas/cirurgia , Fraturas por Compressão/complicações , Humanos , Fraturas da Coluna Vertebral/complicações
8.
Eur Spine J ; 26(7): 1796-1802, 2017 07.
Artigo em Inglês | MEDLINE | ID: mdl-28315968

RESUMO

OBJECTIVE: The purpose of this meta-analysis of randomized controlled trials (RCTs) and non-RCTs was to gather data to evaluate the efficacy and safety of bipolar sealer versus standard electrocautery in the management of spinal disease. METHODS: The electronic databases including Embase, PubMed and Cochrane library were searched to identify relevant studies published from the time of the establishment of these databases up to January 2017. The primary outcomes were total blood loss, requirement of transfusion (rate and amount), and operation time. The secondary outcomes were length of hospital stay and postoperative wound infection. Data analysis was conducted with RevMan 5.3 software. RESULTS: A total of five studies involving 500 patients (261 patients in the BS group and 239 in the control group) were included in the meta-analysis. The pooled results revealed that application of bipolar sealer could decrease the total blood loss in spine surgery [WMD = -467.49, 95% CI (685.47 to -249.51); p < 0.05; I 2 = 91%]. Compared with standard electrocautery, bipolar sealer was associated with lower rates of need for transfusion [OR = 0.30, 95% CI (0.16-0.55), p < 0.05; I 2 = 0%]. In addition, patients in the BS group were likely to receive less amount of blood transfusion compared with patients in the control group[WMD = -0.73, 95% CI (-1.37 to -0.09), p < 0.05; I 2 = 76%]. The mean operative time was shorter in the BS groups compared with the control group [SMD = -0.36, 95% CI (-0.60 to -0.13), p < 0.05; I 2 = 0%]. There was no significant difference in terms of length of hospital stay [WMD = -0.73, 95% CI (-1.96 to 0.51), p = 0.25; I 2 = 67%] and postoperative wound infection [OR = 0.88, 95% CI (0.31-2.48), p = 0.81; I 2 = 0.0%] between both groups. CONCLUSIONS: The available evidence suggests that bipolar sealer is superior to standard electrocautery with less blood loss, shorter operation time and less transfusion requirement. There is no significant difference between both groups regarding length of hospitalization and wound infection. Hence, bipolar sealer is recommended in spine surgery. Because of the limitation of our study, more well-designed RCTs with large sample are required to provide further evidence of safety and efficacy between bipolar sealer and standard electrocautery in the treatment of spinal disease.


Assuntos
Perda Sanguínea Cirúrgica/prevenção & controle , Hemostasia Cirúrgica/métodos , Terapia por Radiofrequência , Perda Sanguínea Cirúrgica/estatística & dados numéricos , Transfusão de Sangue/estatística & dados numéricos , Eletrocoagulação , Humanos , Tempo de Internação/estatística & dados numéricos , Duração da Cirurgia , Infecção da Ferida Cirúrgica/epidemiologia , Infecção da Ferida Cirúrgica/prevenção & controle , Resultado do Tratamento
9.
Chin J Traumatol ; 20(1): 34-38, 2017 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-28214086

RESUMO

OBJECTIVE: To assess the early curative effect of epidural or intravenous administration of steroids during a percutaneous endoscopic lumbar discectomy (PELD). METHODS: 28 consecutive patients who underwent PELD due to large lumbar disc herniation between November 2014 and January 2016 were followed up for 6 months. These patients were divided into two groups according to the treatment they received after PELD. 14 patients (Group A) were treated by PELD and epidural steroids, while the other 14 patients (Group B) were treated by PELD and intravenous steroids. We evaluated the effectiveness by the preoperative and postoperative visual analogue scale (VAS) scores for back and leg pain, and the postoperative Oswestry disability index (ODI) at 3 weeks after surgery via the clinical charts and telephone interview. Postoperative hospital stay and time return to work were investigated as well. RESULTS: There is a significant decrease in VAS (back, leg), ODI, and time return to work (p < 0.05). For VAS (back), Group A showed a significant decrease compared with Group B at 1 day and 1 week after surgery (p = 0.011, p = 0.017). As for VAS (leg), Group A showed a significant decrease compared with Group B at 1 day, 1 week, 3 weeks, and 3 months follow-up examinations (p = 0.002, p = 0.006, p < 0.001, p < 0.001). For ODI, Group A showed a notable decrease compared with Group B (p < 0.001). The postoperative hospital stay in two groups was not statistically different (p = 0.636). But the time return to work in Group A was significantly shorter than that in Group B (p = 0.023). CONCLUSION: Patients who underwent PELD with epidural steroid administration for large lumbar disc herniation showed favorable curative effect compared with those who underwent PELD with intravenous steroid administration.


Assuntos
Betametasona/administração & dosagem , Discotomia Percutânea/métodos , Glucocorticoides/administração & dosagem , Deslocamento do Disco Intervertebral/cirurgia , Vértebras Lombares/cirurgia , Adulto , Endoscopia , Feminino , Humanos , Injeções Epidurais , Injeções Intravenosas , Tempo de Internação , Masculino , Medição da Dor , Estudos Retrospectivos
10.
Front Neurol ; 7: 224, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27999562

RESUMO

OBJECTIVE: This study aimed to assess the clinicoradiological features and treatment outcomes of intracranial dissecting aneurysms (IDAs) in childhood. METHODS: We conducted a retrospective study of pediatric patients who were treated for spontaneous IDAs in our institute between January 2010 and December 2015. The clinical presentation, aneurysm characteristics, treatment modality, and outcome were studied. RESULTS: We studied 26 pediatric patients (mean age, 13.4 years; range, 4-18 years) with 31 IDAs who comprised 6.9% of all IDA patients treated during the same period. Seventeen (65.4%) patients were males, and nine (34.6%) were females. The incidence of large (≥10 mm in size) or giant aneurysms (≥25 mm in size) was 65.5%. Twenty-one (80.8%) patients underwent endovascular or surgical treatment and five (19.2%) received conservative treatment. Perioperative complications occurred in three patients, in whom two eventually recovered completely with a Glasgow Outcome Scale (GOS) score of 5 and one partially recovered with a GOS score 4. Overall, 25 (96.2%) patients had a favorable outcome and one (3.8%) had an unfavorable outcome at a mean follow-up of 22.8 months (range, 6-60 months). CONCLUSION: Pediatric IDAs are rare. In this series, endovascular management was a relatively safe and effective method of treatment for pediatric IDAs. However, continued follow-up is required because of the possibility of aneurysm recurrence and de novo aneurysm formation after treatment.

11.
Chin J Traumatol ; 19(1): 31-4, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27033270

RESUMO

PURPOSE: To investigate the usefulness of three-dimensional (3D) printing in complex spinal surgery. METHODS: The study was conducted from October 2014 to March 2015 in Shenzhen Second Peoples' Hospital and 4 cases of complex severe spinal disorders were selected from our department. Among them one patient combined with congenital scoliosis, one with atlas neoplasm, one with atlantoaxial dislocation, and the rest one with atlantoaxial fracture-dislocation. The data of the diseased region was collected from computerized tomography scans for 3D digital reconstruction and rapid prototyping to prepare photosensitive resin models, which were applied in the treatment of these cases. RESULTS: The use of 3D models reduced operating time and intraoperative blood loss as well as the risk of postoperative complications. Furthermore, no pedicle penetrations or screw misplacement occurred according to the postoperative planar radiographic images. CONCLUSION: The tactile models from 3D printing allow direct observation and measurement, helping the orthopedists to have accurate morphometric information to provide personalized surgical planning and better communication with the patient and coworkers. Moreover, the photosensitive resin models can also guide the actual surgery with the drilling of pedicle screws and safe resection of tumor.


Assuntos
Impressão Tridimensional , Doenças da Coluna Vertebral/cirurgia , Idoso , Criança , Humanos , Masculino , Medicina de Precisão , Escoliose/cirurgia , Fraturas da Coluna Vertebral/cirurgia , Neoplasias da Coluna Vertebral/cirurgia
13.
J Back Musculoskelet Rehabil ; 29(2): 387-391, 2016 Apr 27.
Artigo em Inglês | MEDLINE | ID: mdl-26577280

RESUMO

BACKGROUND AND OBJECTIVE: Fibrous dysplasia (FD) is a benign bone lesion manifested by local pain, swelling and deformity change. We report a case of monostotic fibrous dysplasia of the first thoracic vertebrae that treated by radical removal and reconstruction. CASE REPORT: A 29-year-old man with monostotic fibrous dysplasia of the first thoracic vertebrae was admitted to our department because of persistent, dull back pain for 3 months. Radical removal of the first thoracic vertebrae and reconstruction were performed in a combined posterior-anterior approach. This patient experienced complete pain relief without any complication. CONCLUSION: This report presents a rare case of monostotic fibrous dysplasia of the first thoracic vertebrae, with symptoms of chronic back pain that was successfully treated with radical excision and reconstruction, providing a good option to the patient.


Assuntos
Displasia Fibrosa Monostótica/diagnóstico , Procedimentos Ortopédicos/métodos , Doenças da Coluna Vertebral/diagnóstico , Vértebras Torácicas/diagnóstico por imagem , Tomografia Computadorizada por Raios X/métodos , Adulto , Displasia Fibrosa Monostótica/cirurgia , Humanos , Masculino , Doenças da Coluna Vertebral/cirurgia , Vértebras Torácicas/cirurgia
14.
Chin Med J (Engl) ; 128(14): 1916-21, 2015 Jul 20.
Artigo em Inglês | MEDLINE | ID: mdl-26168833

RESUMO

BACKGROUND: The endovascular strategy of the huge dissecting aneurysms involving the basilar artery (BA) is controversial and challenging. This study was to investigate the clinical and angiographic outcomes of the treatment of the huge dissecting aneurysms involving the BA by the internal trapping (IT) technique. METHODS: We retrospectively studied 15 patients with the huge dissecting aneurysms involving the BA treated by the IT technique between September 2005 and September 2014 in Department of Interventional Neuroradiology of Beijing Tiantan Hospital. Clinical and angiographic data were reviewed and evaluated. RESULTS: All patients were treated by the IT technique. That meant the dissecting artery and aneurysm segments were completed occlusion. After the procedure, the angiography demonstrated that all the dissecting artery and aneurysm segments were completed occlusion. Follow-up angiography was performed at 3-6 months or 12-18 months after the endovascular treatment (median 8 months), 14 patients had a good recovery. Re-canalization occurred in one patient whose aneurysm involved in bilateral vertebral arteries and the two third of the middle-lower BA. After the second treatment, the patient died by the ventricular tachycardia. CONCLUSIONS: The IT technique is a technically feasible and safe alternative for the treatment of BA dissecting aneurysms, but it is not necessarily the safest or most definitive treatment modality. The ideal treatment of the huge dissecting aneurysms involving the BA remains debatable and must be investigated on a case-by-case basis.


Assuntos
Aneurisma Dissecante/diagnóstico por imagem , Aneurisma Dissecante/terapia , Artéria Basilar/diagnóstico por imagem , Aneurisma Intracraniano/terapia , Adolescente , Adulto , Feminino , Humanos , Aneurisma Intracraniano/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Radiografia , Estudos Retrospectivos , Resultado do Tratamento , Adulto Jovem
15.
J Orthop Translat ; 3(3): 152-156, 2015 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30035052

RESUMO

Spontaneous spinal epidural haematoma (SSEH) is a rare clinical condition with unknown aetiology. Prompt diagnosis and treatment are paramount because of the risk of permanent neurological deficits without appropriate intervention. We described a case of a 48-year-old man presenting with complete quadriplegia and hypoesthesia. Magnetic resonance imaging revealed cervical cord compression due to a haematoma posterior to the spinal cord. Surgical decompression and evacuation of the haematoma was performed within 12 hours after admission to the authors' hospital. Both the patient's motor and sensory functions recovered soon after the operation. Early surgical decompression for SSEH with neurologic impairment is therefore recommended for the recovery of this patient and also serves as a relevant reference for orthopaedic clinics. Foundation number: CXZZ20140414170821148.

16.
Int J Clin Exp Med ; 8(10): 18855-60, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26770507

RESUMO

OBJECTIVE: To investigate the clinical effect of high and low viscosity bone cement in vertebroplasty for treatment of osteoporotic vertebral compression fractures. METHODS: 40 cases of patients with osteoporotic thoracolumbar compression fractures admitted into department of orthopeadics in our hospital were reviewed. All patients were divided into high viscosity bone cement group (20 cases) and low viscosity bone cement group (20 cases). Visual Analog Score (VAS), Oswestry Dability Index (ODI), injured vertebral height restoration (Cobb Angle) and bone cement leakage rate, subsequent fracture rate of vertebrae body with or without surgical treatment were measured. RESULTS: Compared with the low viscosity bone cement group, the VAS score, ODI score and Cobb angle of high viscosity bone cement group had a statistical difference (P<0.05). The postoperative complications in high viscosity bone cement group were lower than those in low viscosity bone cement group (P<0.05). CONCLUSION: Compared with low viscosity bone cement, bone cement leakage rate reduced obviously in high viscosity bone cement with good clinical effect and prognosis in vertebroplasty for treatment of osteoporotic thoracolumbar compression fractures.

18.
Zhonghua Yi Xue Za Zhi ; 93(15): 1156-8, 2013 Apr 16.
Artigo em Chinês | MEDLINE | ID: mdl-23902886

RESUMO

OBJECTIVE: To discuss the relevant predicative factors of dural arteriovenous fistula (dAVF) in intracranial hemorrhage. METHODS: A total of 144 consecutive patients with dAVFs were recruited for a retrospective analysis from 1996 to 2006. The relevant factors of gender, age, fistula flow rate, arterial supply, lesion and venous drainage pattern were analyzed to evaluate the outcome of intracranial hemorrhage. RESULTS: Univariate analysis showed that gender, lesion and venous drainage pattern were statistical significant for intracranial hemorrhage of DAVF (P < 0.05). However, only venous drainage pattern was significant in the predication of intracranial hemorrhage (P < 0.05). CONCLUSION: Only venous drainage pattern is significant in the predication of dural arteriovenous fistulas in intracranial hemorrhage. Both gender and lesion may be confounding factors.


Assuntos
Malformações Vasculares do Sistema Nervoso Central/complicações , Hemorragias Intracranianas/etiologia , Adolescente , Adulto , Idoso , Drenagem/efeitos adversos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Risco , Adulto Jovem
19.
Chin Med J (Engl) ; 125(3): 539-42, 2012 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-22490418

RESUMO

This report documents the treatment of a giant aneurysm of the internal carotid artery bifurcation with a fistula to the cavernous sinus, which appeared following closed head trauma. A 39-year-old man suffered from a blunt head trauma in an automobile accident. Two weeks after the trauma, progressive chemosis of left eye was presented. Four months after the trauma, digital subtraction angiography showed an internal carotid artery bifurcation aneurysm, with drainage into the cavernous sinus. The lesion was successfully obliterated with preservation of the parent artery by using coils in conjunction with Onyx. Follow-up angiography obtained 3 months postoperatively revealed persistent obliteration of the aneurysm and fistula as well as patency of the parent artery. Endovascular treatment involving the use of coils combined with Onyx appears to be a feasible and effective option for treatment of this hard-to-treat lesion.


Assuntos
Doenças das Artérias Carótidas/diagnóstico , Artéria Carótida Interna , Seio Cavernoso/patologia , Aneurisma Intracraniano/diagnóstico , Adulto , Doenças das Artérias Carótidas/terapia , Drenagem , Humanos , Aneurisma Intracraniano/etiologia , Masculino
20.
Nan Fang Yi Ke Da Xue Xue Bao ; 31(11): 1922-5, 2011 Nov.
Artigo em Chinês | MEDLINE | ID: mdl-22126781

RESUMO

OBJECTIVE: To investigate the feasibility of vibration test in evaluation of spinal stability after instrument fixation of thoracolumbar burst fracture in pigs. METHODS: Twenty-one porcine spines (T11 to L5) were impacted longitudinally with different energy levels to simulate thoracolumbar burst fracture. The fractures were fixed by Luque, Harrington, Steffee and Kaneda techniques, and the anterior-posterior, lateral and vertical spinal stability was analyzed using vibration test. RESULTS: In the mild injury group, vibration test showed that only the first order frequency showed marked anterior shift in the vertical direction (P<0.05) but the main frequency did not, suggesting loosening between the vertebrae. In moderate- or high-energy impact groups, the main frequency markedly shifted forward in the vertical and anterior-posterior directions (P<0.05 or P<0.01), and obvious lateral shift was observed only in high-energy impact group. CONCLUSION: The dynamical characteristics of the spine indicate that the main frequency markedly shift after instrument fixation (except for Luque) of thoracolumbar burst fracture, suggesting the feasibility of vibration test for evaluating spinal injury severity and instrument fixation.


Assuntos
Fixação Interna de Fraturas , Vértebras Lombares/lesões , Fraturas da Coluna Vertebral/cirurgia , Vértebras Torácicas/lesões , Vibração , Animais , Fenômenos Biomecânicos , Instabilidade Articular/diagnóstico , Vértebras Lombares/cirurgia , Fusão Vertebral/métodos , Suínos , Vértebras Torácicas/cirurgia
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