Base de dados : MEDLINE
Pesquisa : C05.116.900.825 [Categoria DeCS]
Referências encontradas : 5157 [refinar]
Mostrando: 1 .. 10   no formato [Detalhado]

página 1 de 516 ir para página                         

  1 / 5157 MEDLINE  
              next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:29480873
[Au] Autor:Makino T; Honda H; Fujiwara H; Yoshikawa H; Yonenobu K; Kaito T
[Ad] Endereço:Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Suita.
[Ti] Título:Low incidence of adjacent segment disease after posterior lumbar interbody fusion with minimum disc distraction: A preliminary report.
[So] Source:Medicine (Baltimore);97(2):e9631, 2018 Jan.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:STUDY DESIGN: A retrospective review of prospectively collected data. OBJECTIVE: To investigate the incidence of radiographic and symptomatic adjacent segment disease (ASD) and identify possible risk factors for ASD after posterior lumbar interbody fusion (PLIF) with minimum disc distraction by selecting low-height interbody cages. SUMMARY OF BACKGROUND DATA: Excessive disc space distraction is reportedly 1 of the risk factors for ASD after PLIF; however, the incidence and other risk factors of ASD after PLIF with minimum disc distraction remain unclear. METHODS: Forty-one consecutive patients who underwent PLIF at L4-L5 and were postoperatively followed up for a minimum of 2 years were included. The height and shape (box or bullet shape) of interbody cages was determined according to the disc height and morphology of the intervertebral space assessed on preoperative computed tomography scans to avoid excessive distraction. The incidence of radiographic and symptomatic ASD was evaluated and all demographic and radiographic parameters were compared between patients with and without ASD. Multivariate logistic regression analysis was performed to identify risk factors for ASD among the variables with P < .20 in univariate analysis. RESULTS: The overall incidence of ASD was 12.2% (5/41 patients): radiographic ASD, 7.3% (3 patients); symptomatic ASD, 4.9% (2 patients). Multivariate analysis revealed preoperative retrolisthesis of L3 on extension as the sole risk factor for ASD after PLIF with minimum disc distraction (odds ratio, 2.13; 95% confidence interval, 1.00-4.05; P = .049). CONCLUSIONS: The incidence of ASD in this study was lower than that of ASD in our previous study about PLIF with distraction of disc space (12.2% vs. 31.8%). Minimum disc distraction by selection of low-height interbody cages is a simple and effective method to prevent ASD at the surgeons' discretion, although preexisting retrolisthesis at the adjacent upper segment should be taken into consideration.
[Mh] Termos MeSH primário: Degeneração do Disco Intervertebral/epidemiologia
Degeneração do Disco Intervertebral/etiologia
Vértebras Lombares/cirurgia
Complicações Pós-Operatórias/epidemiologia
Fusão Vertebral
Estenose Espinal/cirurgia
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Feminino
Seguimentos
Seres Humanos
Incidência
Degeneração do Disco Intervertebral/diagnóstico por imagem
Vértebras Lombares/diagnóstico por imagem
Masculino
Meia-Idade
Análise Multivariada
Razão de Chances
Complicações Pós-Operatórias/diagnóstico por imagem
Dados Preliminares
Estudos Prospectivos
Estudos Retrospectivos
Fatores de Risco
Estenose Espinal/diagnóstico por imagem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180305
[Lr] Data última revisão:
180305
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180227
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009631


  2 / 5157 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:29465576
[Au] Autor:Diao Y; Sun Y; Wang S; Zhang F; Pan S; Liu Z
[Ad] Endereço:Department of Orthopaedics, Peking University Third Hospital, Beijing, China. Beijing Key Laboratory of Spinal Disease, Beijing, China.
[Ti] Título:Delayed epidural pseudoaneurysm following cervical laminectomy and instrumentation in a patient with canal stenosis secondary to skeletal fluorosis: A case report.
[So] Source:Medicine (Baltimore);97(8):e9883, 2018 Feb.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: The typical intraoperative presentation of vertebral artery injury (VAI) usually involves profuse bleeding and requires immediate treatment. However, an occult VAI may occur intraoperatively and result in delayed life-threatening epidural pseudoaneurysm several days postoperatively. PATIENT CONCERNS: A 21-year-old man with compressive cervical myelopathy resulting from canal stenosis of skeletal fluorosis underwent decompression of C1 to C7 and instrumentation from C2 to C7. No impressive bleeding event occurred during the operation. On postoperative day 40, progressive quadriplegia developed. DIAGNOSES: Pseudoaneurysm of the VA was established by angiography. INTERVENTIONS: After occlusion of the right VA, the patient underwent hematoma clearing. OUTCOMES: Fortunately, the patient experienced significant recovery of neurologic function after the second surgery. LESSONS: From this case, we realize even in the absence of obvious signs of VAI during a cervical operation, postoperative evaluation should be mandatory for suspected bleeding events occurring at VAI-prone sites during surgery. Moreover, the bone morphological abnormality of skeletal fluorosis was determined to be the most important risk contributing to VAI in this case. The safety limits of bone removal should be determined preoperatively to avoid the effects of bone morphological abnormalities.
[Mh] Termos MeSH primário: Falso Aneurisma/etiologia
Doenças Ósseas/complicações
Vértebras Cervicais/cirurgia
Intoxicação por Flúor/complicações
Laminectomia/efeitos adversos
Compressão da Medula Espinal/cirurgia
Estenose Espinal/cirurgia
Artéria Vertebral/lesões
[Mh] Termos MeSH secundário: Constrição Patológica
Seres Humanos
Complicações Intraoperatórias
Masculino
Complicações Pós-Operatórias
Compressão da Medula Espinal/etiologia
Estenose Espinal/etiologia
Adulto Jovem
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180227
[Lr] Data última revisão:
180227
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180222
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009883


  3 / 5157 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:29351748
[Au] Autor:Oka H; Matsudaira K; Takano Y; Kasuya D; Niiya M; Tonosu J; Fukushima M; Oshima Y; Fujii T; Tanaka S; Inanami H
[Ad] Endereço:Department of Medical Research and Management for Musculoskeletal Pain, 22nd Century Medical & Research Center, Faculty of Medicine, University of Tokyo, Hongo 7-3-1, Bunkyo, Tokyo, 113-8655, Japan. okah-tky@umin.ac.jp.
[Ti] Título:A comparative study of three conservative treatments in patients with lumbar spinal stenosis: lumbar spinal stenosis with acupuncture and physical therapy study (LAP study).
[So] Source:BMC Complement Altern Med;18(1):19, 2018 Jan 19.
[Is] ISSN:1472-6882
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Although the efficiency of conservative management for lumbar spinal stenosis (LSS) has been examined, different conservative management approaches have not been compared. We have performed the first comparative trial of three types of conservative management (medication with acetaminophen, exercise, and acupuncture) in Japanese patients with LSS. METHODS: Patients with L5 root radiculopathy associated with LSS who visited our hospital for surgical treatment were enrolled between December 2011 and January 2014. In this open-label study, patients were assigned to three treatment groups (medication, exercise, acupuncture) according to the visit time. The primary outcomes were Zurich claudication questionnaire (ZCQ) scores before and after 4 weeks of treatment. Least square mean analysis was used to assess the following dependent variables in the treatment groups: changes in symptom severity and physical function scores of the ZCQ and the ZCQ score of patient's satisfaction after treatment. RESULTS: Thirty-eight, 40, and 41 patients were allocated to the medication, exercise, and acupuncture groups, respectively. No patient underwent surgical treatment during the study period. The symptom severity scores of the ZCQ improved significantly after treatment in the medication (p = 0.048), exercise (p = 0.003), and acupuncture (p = 0.04) groups. The physical function score improved significantly in the acupuncture group (p = 0.045) but not in the medication (p = 0.20) and exercise (p = 0.29) groups. The mean reduction in the ZCQ score for physical function was significantly greater for acupuncture than for exercise. The mean ZCQ score for treatment satisfaction was significantly greater for acupuncture than for medication. CONCLUSIONS: Acupuncture was significantly more effective than physical exercise according to the physical function score of the ZCQ and than medication according to the satisfaction score. The present study provides new important information that will aid decision making in LSS treatment. TRIAL REGISTRATION: This study was registered with the UMIN Clinical Trials Registry ( UMIN000006957 ).
[Mh] Termos MeSH primário: Terapia por Acupuntura
Vértebras Lombares/fisiopatologia
Modalidades de Fisioterapia
Estenose Espinal/fisiopatologia
Estenose Espinal/terapia
[Mh] Termos MeSH secundário: Idoso
Tratamento Conservador
Feminino
Seres Humanos
Masculino
Satisfação do Paciente
[Pt] Tipo de publicação:CLINICAL TRIAL; COMPARATIVE STUDY; JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180216
[Lr] Data última revisão:
180216
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180121
[St] Status:MEDLINE
[do] DOI:10.1186/s12906-018-2087-y


  4 / 5157 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:29381941
[Au] Autor:Wang F; Hou HT; Wang P; Zhang JT; Shen Y
[Ad] Endereço:Department of Spine Surgery, The Third Hospital of Hebei Medical University, The Key Laboratory of Orthopedic Biomechanics of Hebei Province.
[Ti] Título:Symptomatic adjacent segment disease after single-lever anterior cervical discectomy and fusion: Incidence and risk factors.
[So] Source:Medicine (Baltimore);96(47):e8663, 2017 Nov.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The purpose of this study was to determine the incidence and risk factors of symptomatic adjacent segment disease (ASD) following single-lever anterior cervical discectomy and fusion (ACDF) for cervical degenerative diseases.From January 2000 to December 2010, a total of 582 patients with cervical radiculopathy and myelopathy who had undergone single-lever ACDF surgery in the authors' institution were reviewed retrospectively. Patients who had a revision surgery for symptomatic ASD were selected for this study. The authors analyzed the incidence for ASD after single-lever ACDF. And univariate analysis and logistic regression analysis were performed to identify the risk factors of ASD.Among the 582 patients, 36 patients received subsequent surgical management for ASD after initial single-lever ACDF for an overall prevalence of 6.2%. The average onset time of ASD was 8.5 (2-15) years. The univariate analysis showed that there were no significant differences in sex, duration of disease, BMI, DM, smoking, operative levels, and follow-up period (P > .05) between the 2 groups with and without ASD. There were statistically significant differences in age at the time of operation (χ = 4.361, P = .037), and developmental canal stenosis (χ = 4.181, P = .041) between patients with and without ASD. The variables of age at the time of operation and developmental canal stenosis were included in a logistic regression model. The logistic regression analysis revealed that age at the time of operation ≤50 years (P = .045, OR = 3.015, 95% CI = 1.024-8.882) and developmental canal stenosis (P = .042, OR = 2.797, 95% CI = 1.039-7.527) were the risk factors for ASD after single-lever ACDF.In the present study, the incidence of symptomatic ASD after single-lever ACDF was 6.2%. And the age at the time of operation ≤50 years and developmental canal stenosis were the risk factors for ASD. The patients ≤50 years old at the time of operation or with developmental canal stenosis are more likely to develop ASD after surgery, and the risk of reoperation will increase.
[Mh] Termos MeSH primário: Discotomia/efeitos adversos
Degeneração do Disco Intervertebral
Complicações Pós-Operatórias
Radiculopatia/cirurgia
Reoperação/estatística & dados numéricos
Doenças da Medula Espinal/cirurgia
Fusão Vertebral/efeitos adversos
Estenose Espinal
[Mh] Termos MeSH secundário: Fatores Etários
Vértebras Cervicais/diagnóstico por imagem
Vértebras Cervicais/patologia
Vértebras Cervicais/cirurgia
China/epidemiologia
Discotomia/métodos
Feminino
Seres Humanos
Incidência
Degeneração do Disco Intervertebral/diagnóstico
Degeneração do Disco Intervertebral/epidemiologia
Degeneração do Disco Intervertebral/etiologia
Degeneração do Disco Intervertebral/cirurgia
Masculino
Meia-Idade
Avaliação de Processos e Resultados (Cuidados de Saúde)
Complicações Pós-Operatórias/diagnóstico
Complicações Pós-Operatórias/epidemiologia
Complicações Pós-Operatórias/cirurgia
Estudos Retrospectivos
Fatores de Risco
Fusão Vertebral/métodos
Estenose Espinal/diagnóstico
Estenose Espinal/epidemiologia
Estenose Espinal/etiologia
Estenose Espinal/cirurgia
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180208
[Lr] Data última revisão:
180208
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180201
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000008663


  5 / 5157 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:29369203
[Au] Autor:Xu B; Xu H; Ma X; Liu Y; Yang Q; Jiang H; Li N; Ji N
[Ti] Título:Bilateral decompression and intervertebral fusion via unilateral fenestration for complex lumbar spinal stenosis with a mobile microendoscopic technique.
[So] Source:Medicine (Baltimore);97(4):e9715, 2018 Jan.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:For complex lumbar spinal stenosis, using of endoscopy technique may provide clear vision with less invasive dissection of paravertebral muscle. The objective of this study was to evaluate the feasibility and clinical efficacy of bilateral decompression and intervertebral fusion via unilateral fenestration for complex lumbar spinal stenosis using mobile microendoscopic discectomy (MMED) technique.A total of 61 patients with complex lumbar spinal stenosis (lumbar canal stenosis combined with degenerative spondylolisthesis, instability, and scoliosis) were treated with this procedure. Patients with isolated lumbar spinal stenosis or spondylolisthesis greater than grade II were excluded. The index levels included L4/5 in 52 patients, L5/S1 in 6 patients, L3-L5 in 2 patients and L4-S1 in 1 patient. The preoperative Oswestry Disability Index (ODI) score was 42.6 ±â€Š10.2, lumbar visual analog scale (VAS) score was 6.1 ±â€Š4.2, and leg VAS score was 7.1 ±â€Š5.1. During the operation, ipsilateral enlarged fenestration was made using the MMED technique. The disc and cartilage endplate were thoroughly removed, and the contralateral ligamentum flavum and the inner layer of lamina were undercut to release the contralateral nerve root. The intervertebral space was released and prepared, followed by bone grafting and cage insertion. Percutaneous pedicle system was used for reduction and fixation. The operative time and blood loss were recorded, and patients were followed-up for at least 3 years (36-48 months, average 41 months) to evaluate the clinical efficacy.The procedure was successful in all patients, with no nerve injury or conversion to open operation. The mean operative time was 120 minutes (range, 100-180 minutes), with a mean blood loss of 100 mL (range, 50-200 mL). Postoperative x-ray and CT showed sufficient decompression and improvement of spinal alignment. At 3 years after surgery, the ODI scores, lumbar and leg VAS scores decreased from preoperative 42.6 ±â€Š10.2, 6.1 ±â€Š4.2, and 7.1 ±â€Š5.1 to 8.6 ±â€Š7.0, 1.8 ±â€Š1.3, and 0.9 ±â€Š0.6, respectively (P = .00 for each comparison). The clinical results were excellent in 36 cases, good in 23, and fair in 2, according to the MacNab scale.The procedure of bilateral decompression and intervertebral fusion via unilateral fenestration using the MMED technique can provide satisfactory clinical results for complex lumbar spinal stenosis.
[Mh] Termos MeSH primário: Descompressão Cirúrgica/métodos
Discotomia/métodos
Endoscopia/métodos
Fusão Vertebral/métodos
Estenose Espinal/cirurgia
[Mh] Termos MeSH secundário: Idoso
Estudos de Viabilidade
Feminino
Seres Humanos
Vértebras Lombares/cirurgia
Masculino
Meia-Idade
Estenose Espinal/patologia
Resultado do Tratamento
[Pt] Tipo de publicação:EVALUATION STUDIES; JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180208
[Lr] Data última revisão:
180208
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180126
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009715


  6 / 5157 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:29245329
[Au] Autor:Lim YS; Mun JU; Seo MS; Sang BH; Bang YS; Kang KN; Koh JW; Kim YU
[Ad] Endereço:aDepartment of Anesthesiology and Pain Medicine, Institute for Integrative Medicine, Catholic Kwandong University of Korea College of Medicine, International St. Mary's Hospital, IncheonbDepartment of Orthopaedic Surgery, Changwon Gyeongsang National University Hospital, Republic of KoreacDepartment of Anesthesiology and Pain Medicine, National Police Hospital, Seoul, Korea.
[Ti] Título:Dural sac area is a more sensitive parameter for evaluating lumbar spinal stenosis than spinal canal area: A retrospective study.
[So] Source:Medicine (Baltimore);96(49):e9087, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Narrowing of the dural sac cross-sectional area (DSCSA) and spinal canal cross-sectional area (SCCSA) have been considered major causes of lumbar central canal spinal stenosis (LCCSS). DSCSA and SCCSA were previously correlated with subjective walking distance before claudication occurs, aging, and disc degeneration. DSCSA and SCCSA have been ideal morphological parameters for evaluating LCCSS. However, the comparative value of these parameters is unknown and no studies have evaluated the clinical optimal cut-off values of DSCSA and SCCSA. This study assessed which parameter is more sensitive.Both DSCSA and SCCSA samples were collected from 135 patients with LCCSS, and from 130 control subjects who underwent lumbar magnetic resonance imaging (MRI) as part of a medical examination. Axial T2-weighted MRI scans were acquired at the level of facet joint from each subject. DSCSA and SCCSA were measured at the L4-L5 intervertebral level on MRI using a picture archiving and communications system.The average DSCSA value was 151.67 ±â€Š53.59 mm in the control group and 80.04 ±â€Š35.36 mm in the LCCSS group. The corresponding average SCCSA values were 199.95 ±â€Š60.96 and 119.17 ±â€Š49.41 mm. LCCSS patients had significantly lower DSCSA and SCCSA (both P < .001). Regarding the validity of both DSCSA and SCCSA as predictors of LCCSS, Receiver operating characteristic curve analysis revealed an optimal cut-off value for DSCSA of 111.09 mm, with 80.0% sensitivity, 80.8% specificity, and an area under the curve (AUC) of 0.87 (95% confidence interval, 0.83-0.92). The best cut off-point of SCCSA was 147.12 mm, with 74.8% sensitivity, 78.5% specificity, and AUC of 0.85 (95% confidence interval, 0.81-0.89).DSCSA and SCCSA were both significantly associated with LCCSS, with DSCSA being a more sensitive measurement parameter. Thus, to evaluate LCCSS patients, pain specialists should more carefully investigate the DSCSA than SCCSA.
[Mh] Termos MeSH primário: Dura-Máter/diagnóstico por imagem
Dura-Máter/patologia
Vértebras Lombares/diagnóstico por imagem
Vértebras Lombares/patologia
Estenose Espinal/diagnóstico por imagem
Estenose Espinal/patologia
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Estudos de Casos e Controles
Feminino
Seres Humanos
Imagem por Ressonância Magnética
Masculino
Meia-Idade
Manejo da Dor
Estudos Retrospectivos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180108
[Lr] Data última revisão:
180108
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171217
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009087


  7 / 5157 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:29284247
[Au] Autor:Tomaszewski KA; Klosinski M; Henry BM; Skinningsrud B; Kucharska E; Dudkiewicz Z; Chrzanowski R; Mikos M; Glowacki R; Pachalska M
[Ad] Endereço:Health Outcomes Research Unit, Faculty of Education, Ignatianum Academy, Krakow, Poland. krtomaszewski@gmail.com.
[Ti] Título:Large prospective validation and cultural adaptation of the Polish version of the Swiss Spinal Stenosis Questionnaire for patients with lumbar spinal stenosis.
[So] Source:Ann Agric Environ Med;24(4):676-682, 2017 Dec 23.
[Is] ISSN:1898-2263
[Cp] País de publicação:Poland
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: The aim of this prospective cohort study was to translate, validate and perform a cultural adaptation of the Polish version of the Swiss Spinal Stenosis Questionnaire (P-SSSQ), a disease-specific questionnaire for assessing symptom severity, physical function and satisfaction with treatment in patients with lumbar spinal stenosis (LSS). MATERIAL AND METHODS: Patients were prospectively recruited at two orthopedic centres in Krakow, Poland, between January 2011 - October 2016. During the interview, each patient completed the P-SSSQ, SF-36 Health Survey, and a demographic data questionnaire. After translation, cross-cultural adaptation, and pilot testing, assessment was made of the internal consistency, test-retest reliability, construct validity, and responsiveness of the P-SSSQ subscales. RESULTS: Finally, 171 consecutive patients were included in the study. Cronbach's alpha and ICC values were above 0.8 for all three subscales of the P-SSSQ. The symptom severity domain was highly negatively correlated with physical functioning and bodily pain of SF-36, with Pearson correlation coefficients of -0.68 and -0.63, respectively. The physical function domain was highly negatively correlated with physical functioning (r = -0.62). The satisfaction subscale was also highly negatively correlated with the change in the symptom severity (r = -0.61) and physical function scale (r = -0.65). CONCLUSIONS: The proposed version of the P-SSSQ showed excellent measurement properties and can be considered validated for use in Polish. It is easy to understand, quick to complete, and the psychometric properties of the original version are maintained.
[Mh] Termos MeSH primário: Estenose Espinal/psicologia
[Mh] Termos MeSH secundário: Adulto
Idoso
Feminino
Inquéritos Epidemiológicos
Seres Humanos
Vértebras Lombares/anormalidades
Masculino
Meia-Idade
Polônia
Estudos Prospectivos
Psicometria
Inquéritos e Questionários
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180105
[Lr] Data última revisão:
180105
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171230
[St] Status:MEDLINE


  8 / 5157 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:29245270
[Au] Autor:Miyazaki M; Kanezaki S; Notani N; Ishihara T; Tsumura H
[Ad] Endereço:Department of Orthopaedic Surgery, Oita University, Oita, Japan.
[Ti] Título:Spondylectomy and lateral lumbar interbody fusion for thoracolumbar kyphosis in an adult with achondroplasia: A case report.
[So] Source:Medicine (Baltimore);96(49):e8983, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Fixed thoracolumbar kyphosis with spinal stenosis in adult patients with achondroplasia presents a challenging issue. We describe the first case in which spondylectomy and minimally invasive lateral access interbody arthrodesis were used for the treatment of fixed severe thoracolumbar kyphosis and lumbar spinal canal stenosis in an adult with achondroplasia. PATIENT CONCERNS: A 61-year-old man with a history of achondroplastic dwarfism presented with low back pain and radiculopathy and neurogenic claudication. DIAGNOSES: Plain radiographs revealed a high-grade thoracolumbar kyphotic deformity with diffuse degenerative changes in the lumbar spine. The apex was located at L2, the local kyphotic angle from L1 to L3 was 105°, and the anterior area was fused from the L1 to L3 vertebrae. MRI revealed significant canal and lateral recess stenosis secondary to facet hypertrophy. INTERVENTIONS: We planned a front-back correction of the anterior and posterior spinal elements. We first performed anterior release at the fused part from L1 to L3 and XLIF at L3/4 and L4/5. Next, the patient was placed in the prone position. Spondylectomy at the L2 vertebra and posterior fusion from T10 to L5 were performed. Postoperative radiographs revealed L1 to L3 kyphosis of 32°. OUTCOMES: No complications occurred during or after surgery. Postoperatively, the patient's low back pain and neurological claudication were resolved. No worsening of kyphosis was observed 24 months postoperatively. LESSONS: Circumferential decompression of the spinal cord at the apical vertebral level and decompression of lumbar canal stenosis were necessary. Front-back correction of the anterior and posterior spinal elements via spondylectomy and lateral lumbar interbody fusion is a reasonable surgical option for thoracolumbar kyphosis and developmental canal stenosis in patients with achondroplasia.
[Mh] Termos MeSH primário: Acondroplasia/complicações
Cifose/cirurgia
Fusão Vertebral/métodos
Estenose Espinal/cirurgia
[Mh] Termos MeSH secundário: Seres Humanos
Cifose/diagnóstico por imagem
Vértebras Lombares/diagnóstico por imagem
Vértebras Lombares/cirurgia
Imagem por Ressonância Magnética
Masculino
Meia-Idade
Estenose Espinal/diagnóstico por imagem
Vértebras Torácicas/diagnóstico por imagem
Vértebras Torácicas/cirurgia
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171225
[Lr] Data última revisão:
171225
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171217
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000008983


  9 / 5157 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:29069040
[Au] Autor:Wang X; Hu Y; Zhao B; Su Y
[Ad] Endereço:aBeijing Shijitan Hospital bAnesthesiology, Capital Medical University, Beijing, China.
[Ti] Título:Predictive validity of the ACS-NSQIP surgical risk calculator in geriatric patients undergoing lumbar surgery.
[So] Source:Medicine (Baltimore);96(43):e8416, 2017 Oct.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The risk calculator of the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) has been shown to be useful in predicting postoperative complications. In this study, we aimed to evaluate the predictive value of the ACS-NSQIP calculator in geriatric patients undergoing lumbar surgery.A total of 242 geriatric patients who underwent lumbar surgery between January 2014 and December 2016 were included. Preoperative clinical information was retrospectively reviewed and entered into the ACS-NSQIP calculator. The predictive value of the ACS-NSQIP model was assessed using the Hosmer-Lemeshow test, Brier score (B), and receiver operating characteristics (ROC, also referred C-statistic) curve analysis. Additional risk factors were calculated as surgeon-adjusted risk including previous cardiac event and cerebrovascular disease.Preoperative risk factors including age (P = .004), functional independence (P = 0), American Society of Anesthesiologists class (ASA class, P = 0), dyspnea (P = 0), dialysis (P = .049), previous cardiac event (P = .001), and history of cerebrovascular disease (P = 0) were significantly associated with a greater incidence of postoperative complications. Observed and predicted incidence of postoperative complications was 43.8% and 13.7% (±5.9%) (P < .01), respectively. The Hosmer-Lemeshow test demonstrated adequate predictive accuracy of the ACS-NSQIP model for all complications. However, Brier score showed that the ACS-NSQIP model could not accurately predict risk of all (B = 0.321) or serious (B = 0.241) complications, although it accurately predicted the risk of death (B = 0.0072); this was supported by ROC curve analysis. The ROC curve also showed that the model had high sensitivity and specificity for predicting renal failure and readmission.The ACS-NSQIP surgical risk calculator is not an accurate tool for the prediction of postoperative complications in geriatric Chinese patients undergoing lumbar surgery.
[Mh] Termos MeSH primário: Avaliação Geriátrica/estatística & dados numéricos
Laminectomia/efeitos adversos
Complicações Pós-Operatórias/etiologia
Medição de Risco/estatística & dados numéricos
Estenose Espinal/cirurgia
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Feminino
Avaliação Geriátrica/métodos
Seres Humanos
Incidência
Laminectomia/métodos
Vértebras Lombares/cirurgia
Masculino
Meia-Idade
Complicações Pós-Operatórias/epidemiologia
Valor Preditivo dos Testes
Curva ROC
Estudos Retrospectivos
Medição de Risco/métodos
Fatores de Risco
Sensibilidade e Especificidade
[Pt] Tipo de publicação:JOURNAL ARTICLE; VALIDATION STUDIES
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171123
[Lr] Data última revisão:
171123
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171026
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000008416


  10 / 5157 MEDLINE  
              first record previous record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:28953648
[Au] Autor:Kim SG; Shim KS; Lee DW; Kim EJ; Lee SG; Lee JH; An JH
[Ad] Endereço:Department of Anesthesiology and Pain Medicine, Daegu Fatima Hospital, Daegu, Korea.
[Ti] Título:Intramuscular hematoma with motor weakness after trigger point injection: A case report.
[So] Source:Medicine (Baltimore);96(39):e8135, 2017 Sep.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Although trigger point injection is known as an easy and low-risk procedure, it is contraindicated to patients with hemorrhagic disorders or who regularly take anticoagulants/antiplatelets. However, taking clopidogrel is not a defined contraindication to this low-risk procedure. PATIENT CONCERNS: The chief complaint of a 76-year old woman regularly taking clopidogrel was low back and left buttock pain which prolonged for several years. DIAGNOSES: The patient was diagnosed with L4-5 and L5-S1 spinal stenosis at the orthopedics department and was referred for lumbar spinal epidural steroid injection. INTERVENTION: She was treated with trigger point injection. OUTCOMES: Three hours after the injection, she complained motor weakness and pain in the injection area. A hematoma on left gluteus medium muscle was detected with ultrasonography and ultrasound-guided needle aspiration was accomplished to relieve the symptom. LESSONS: Trigger point injection for patients taking clopidogrel should be done with a caution to prevent such complication.
[Mh] Termos MeSH primário: Biópsia por Agulha Fina/métodos
Glucocorticoides/administração & dosagem
Hematoma
Injeções Epidurais
Dor Lombar/tratamento farmacológico
Estenose Espinal/complicações
Ticlopidina/análogos & derivados
[Mh] Termos MeSH secundário: Idoso
Nádegas/diagnóstico por imagem
Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/diagnóstico
Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/etiologia
Feminino
Hematoma/diagnóstico
Hematoma/etiologia
Hematoma/fisiopatologia
Seres Humanos
Biópsia Guiada por Imagem
Injeções Epidurais/efeitos adversos
Injeções Epidurais/métodos
Dor Lombar/etiologia
Debilidade Muscular/diagnóstico
Debilidade Muscular/etiologia
Músculo Esquelético/diagnóstico por imagem
Músculo Esquelético/patologia
Inibidores da Agregação de Plaquetas/uso terapêutico
Estenose Espinal/diagnóstico
Ticlopidina/uso terapêutico
Resultado do Tratamento
Pontos-Gatilho
Ultrassonografia/métodos
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Glucocorticoids); 0 (Platelet Aggregation Inhibitors); A74586SNO7 (clopidogrel); OM90ZUW7M1 (Ticlopidine)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171016
[Lr] Data última revisão:
171016
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170928
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000008135



página 1 de 516 ir para página                         
   


Refinar a pesquisa
  Base de dados : MEDLINE Formulário avançado   

    Pesquisar no campo  
1  
2
3
 
           



Search engine: iAH v2.6 powered by WWWISIS

BIREME/OPAS/OMS - Centro Latino-Americano e do Caribe de Informação em Ciências da Saúde