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  1 / 8799 MEDLINE  
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[PMID]:29505514
[Au] Autor:Lin YP; Li YJ; Chen BL; Guo YH
[Ad] Endereço:Guangdong Provincial Hospital of Chinese Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China.
[Ti] Título:Lumbar laminotomy and replantation for the treatment of adult spinal epidermoid cyst: A case report.
[So] Source:Medicine (Baltimore);97(1):e9334, 2018 Jan.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Adult spinal epidermoid cyst (SEC) is a rare tumor. Lumbar laminectomy and tumor removal was a routine surgical procedure for adult spinal epidermoid cyst according to the literature, but postoperative lumbar instability and intractable low back pain may occur. In this study, we presented a brief report of an adult lumbar epidermoid cyst and introduced another surgical approach. PATIENT CONCERNS: This 28-year-old woman has been complaining of the severe right buttock pain and right thigh radiating pain for half a year. She had been diagnosed as sacroiliitis, spinal arthritis, and lumbar disc herniation at 3 different hospitals before coming to our hospital. And she received a variety of conservative treatments, including non-steroidal anti-inflammatory drugs, aspirin, acetaminophen, glucocorticoids, acupuncture, physical therapy, and so on. However, her pain did not diminish at all. Finally, we find a space-occupying lesion in her lumbar magnetic resonance images (MRI). The lesion was slightly low, equal, and uneven equal-low signals on T1WI. T2WI showed slightly higher, equal, and uneven equal-high signals. And a thin-rim enhancement was observed on Gd-DTPA-enhanced MRI. DIAGNOSES: Adult spinal epidermoid cyst. INTERVENTIONS: The patient underwent a surgery of lumbar laminectomy, tumor excision, and spinous process-vertebral plate in situ replantation. OUTCOMES: Postoperative pathology prompted that the tumor was cystoid. The patient's symptoms were completely removed 1 week after surgery. Three-month postoperative MRI confirmed that the spinal epidermoid cyst had been completely removed and three-dimensional CT prompted lumbar lamina in situ. Bony fusion occurred at 6 months after the surgery. LESSONS: Lumbar laminotomy and replantation provides an ideal option to treat adult spinal epidermoid cyst because it can completely remove the cyst and simultaneously reduce the risk of iatrogenic lumbar instability.
[Mh] Termos MeSH primário: Cisto Epidérmico/cirurgia
Laminectomia/métodos
Vértebras Lombares/cirurgia
Reimplante
Doenças da Coluna Vertebral/cirurgia
[Mh] Termos MeSH secundário: Adulto
Cisto Epidérmico/diagnóstico por imagem
Feminino
Seres Humanos
Vértebras Lombares/diagnóstico por imagem
Doenças da Coluna Vertebral/diagnóstico por imagem
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180309
[Lr] Data última revisão:
180309
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180306
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009334


  2 / 8799 MEDLINE  
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[PMID]:29390372
[Au] Autor:Notani N; Miyazaki M; Yoshiiwa T; Ishihara T; Kanezaki S; Tsumura H
[Ad] Endereço:Department of Orthopaedic Surgery, Faculty of Medicine, Oita University, Oita, Japan.
[Ti] Título:Dynamic paraspinal muscle impingement causing acute hemiplegia after C1 posterior arch laminectomy: A case report.
[So] Source:Medicine (Baltimore);96(50):e9264, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Acute neurological deficits following spinal surgery commonly result from epidural hematoma, surgical trauma, vascular compromise, and graft or hardware impingement, with the cause identified by magnetic resonance imaging (MRI). We present a rare case of dynamic paraspinal muscle impingement after C1 posterior arch laminectomy, which was diagnosed by myelography, with no significant findings on MRI. PATIENT CONCERNS: An 81-year-old, severely obese male, was referred to our department for the treatment of vertebral disease of the lumbar spine. The patient presented with bilateral weakness and numbness of the upper extremities and gait disturbances. Based on MRI, a diagnosis of retro-odontoid pseudotumor was made, and C1 posterior arch laminectomy, in combination with C4 partial laminectomy and C5 to C6 laminoplasty, was performed. On postoperative day 3, the patient's neurological status deteriorated, with right upper extremity and right lower extremity weakness increasing with neck extension. Although there was no evidence of epidural hematoma formation on MRI, obstruction of the flow of contrast medium by an external posterior compression in neck extension at the level of C1 was identified by myelography. Revision surgery was performed and local muscle swelling at the surgical site identified with no hematoma formation. Occiput to C3 fixation, with instrumentation, was performed. OUTCOMES: Muscle strength of the right upper extremity and lower extremities recovered postsurgery, and the patient has continued to improve function 3 years after surgery, with no further neurological episodes. LESSONS: Dynamic paraspinal muscle impingement following C1 laminectomy in a muscular man was diagnosed by myelography, with no significant findings on standard MRI. CONCLUSION: The possibility of dynamic paraspinal muscle impingement should be considered in patients developing acute, progressive, neurological deficits after posterior cervical decompression, with myelography being the imaging method of choice for diagnosis.
[Mh] Termos MeSH primário: Vértebras Cervicais/cirurgia
Hemiplegia/etiologia
Processo Odontoide/cirurgia
Músculos Paraespinais/cirurgia
Complicações Pós-Operatórias/etiologia
Doenças da Medula Espinal/diagnóstico
Doenças da Medula Espinal/cirurgia
[Mh] Termos MeSH secundário: Idoso de 80 Anos ou mais
Seres Humanos
Laminectomia
Imagem por Ressonância Magnética
Masculino
Mielografia
Procedimentos Neurocirúrgicos
Recuperação de Função Fisiológica
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180301
[Lr] Data última revisão:
180301
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180203
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009264


  3 / 8799 MEDLINE  
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[PMID]:29390371
[Au] Autor:Lee HD; Han SH; Park SB; Ko Y; Lee KH
[Ad] Endereço:Department of Rehabilitation Medicine.
[Ti] Título:An intradural extramedullary bronchogenic cyst in the thoracolumbar spine: A case report.
[So] Source:Medicine (Baltimore);96(50):e9263, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: We report the symptoms beginning with weakness and the clinical courses of a patient who was diagnosed with an intradural extramedullary bronchogenic cyst. PATIENT CONCERNS: The patient was a 44-year-old man visited the Department of Physical Medicine and Rehabilitation for walking difficulties characterized by limping due to muscle weakness of left lower extremity for 5 months and atrophy in left calf muscle. DIAGNOSES: Lumbar spine MRI was repeated, since radiating pain in the left hip and posterior thigh with low back pain developed 16 months later. Intraspinal mass of T12 and L1 levels that was not found in the first MRI was newly found in the follow-up MRI. INTERVENTIONS: Total tumor removal was conducted with laminectomy. It was finally diagnosed as an intradural extramedullary bronchogenic cyst on the basis of the pathological analysis results. OUTCOMES: His left calf circumference was increased compared to before surgery the radiating pain also disappeared. LESSONS: If the patient's MRI findings are not correlated with the electrophysiologic and physical examination findings, additional MRI should be accompanied with other tests for an early detection.
[Mh] Termos MeSH primário: Cisto Broncogênico/diagnóstico
Dura-Máter/patologia
Dor Lombar/diagnóstico
[Mh] Termos MeSH secundário: Adulto
Cisto Broncogênico/diagnóstico por imagem
Cisto Broncogênico/patologia
Cisto Broncogênico/cirurgia
Dura-Máter/cirurgia
Seres Humanos
Laminectomia
Dor Lombar/patologia
Dor Lombar/cirurgia
Vértebras Lombares/patologia
Vértebras Lombares/cirurgia
Imagem por Ressonância Magnética
Masculino
Vértebras Torácicas/patologia
Vértebras Torácicas/cirurgia
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180301
[Lr] Data última revisão:
180301
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180203
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009263


  4 / 8799 MEDLINE  
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[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


  5 / 8799 MEDLINE  
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[PMID]:29252651
[Au] Autor:Zhang Y; Ilaslan H; Krishnaney AA; Bauer TW
[Ad] Endereço:Department of Pathology, Robert J. Tomsich Pathology & Laboratory Medicine Institute (Y.Z. and T.W.B.), Department of Diagnostic Radiology (H.I.), Department of Neurosurgery and Center for Spine Health (A.A.K. and T.W.B.), and Department of Orthopaedic Surgery (T.W.B.), Cleveland Clinic, Clevela
[Ti] Título:Morphological Transformation of Giant-Cell Tumor of Bone After Treatment with Denosumab: A Case Report.
[So] Source:JBJS Case Connect;6(3):e74, 2016 Jul-Sep.
[Is] ISSN:2160-3251
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:CASE: Denosumab, an inhibitor of RANKL (receptor activator of nuclear factor κ-B ligand), was recently introduced for the treatment of giant-cell tumor of bone (GCTB). We describe the clinical, radiographic, and histological features of a GCTB of the spine in a 24-year-old woman that progressed after neoadjuvant treatment with denosumab. Disappearance of the multinuclear osteoclastic giant cells was accompanied by newly formed woven bone, which was deposited in interconnected strands with a prominent fibrovascular stroma that was histologically and radiographically similar to that of an osteoblastoma. CONCLUSION: Pathologists, radiologists, and surgeons should be aware of this post-treatment transformation to avoid misdiagnosis.
[Mh] Termos MeSH primário: Conservadores da Densidade Óssea/uso terapêutico
Denosumab/uso terapêutico
Tumor de Células Gigantes do Osso/patologia
Neoplasias da Coluna Vertebral/patologia
Vértebras Torácicas/patologia
[Mh] Termos MeSH secundário: Conservadores da Densidade Óssea/farmacologia
Denosumab/farmacologia
Feminino
Tumor de Células Gigantes do Osso/diagnóstico por imagem
Tumor de Células Gigantes do Osso/tratamento farmacológico
Tumor de Células Gigantes do Osso/cirurgia
Seres Humanos
Laminectomia
Neoplasias da Coluna Vertebral/diagnóstico por imagem
Neoplasias da Coluna Vertebral/tratamento farmacológico
Neoplasias da Coluna Vertebral/cirurgia
Vértebras Torácicas/diagnóstico por imagem
Vértebras Torácicas/efeitos dos fármacos
Vértebras Torácicas/cirurgia
Adulto Jovem
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Bone Density Conservation Agents); 4EQZ6YO2HI (Denosumab)
[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:171219
[St] Status:MEDLINE
[do] DOI:10.2106/JBJS.CC.16.00015


  6 / 8799 MEDLINE  
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[PMID]:29390549
[Au] Autor:Yasuda T; Kawaguchi Y; Suzuki K; Nakano M; Seki S; Watabnabe K; Kanamori M; Kimura T
[Ad] Endereço:Departments of Orthopaedic Surgery, Faculty of Medicine, University of Toyama.
[Ti] Título:Five-year follow up results of posterior decompression and fixation surgery for delayed neural disorder associated with osteoporotic vertebral fracture.
[So] Source:Medicine (Baltimore);96(51):e9395, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Usually, after osteoporotic vertebral fracture (OVF), bone healing follows a normal clinical course leading to bone union with conservative treatment using a brace. However, some patients with OVF do not undergo the normal fracture healing process for a few months, possibly leading to delayed union and/or pseudoarthrosis. In these cases, we performed posterior surgery with combined decompression, vertebroplasty, and posterior spinal fusion with spinal instrumentation. This study aimed to determine the clinical results of posterior surgery for delayed neural disorder secondary to OVF over a 5-year follow-up.Forty-one Japanese patients who had posterior surgery for delayed paralysis secondary to OVF were enrolled in this study. All patients were followed for ≥5 years (mean, 67 months; range, 61-86 months). Patients comprised 12 men and 29 women with an average age of 76.3 ± 6.2 years (range 63-87 years) at the time of operation. We performed posterior fixation from 2 levels above to 1 level below the decompression and vertebroplasty as an all in one procedure. Vertebral height index (VHI) and kyphotic angle (KA) were evaluated on radiogram. For clinical symptoms, a visual analog scale of back and leg pain and the Frankel classification and Japanese Orthopaedic Association scores were used.During the operation and perioperative period, no serious complications occurred. In all patients, symptoms improved within 1 month and were maintained for 5 years postoperatively. In all patients, VHI and KA improved after surgery; however, reduction losses of 7.7% of VHI and 23% of KA were recognized. Five of 41 patients required reoperation due to adjacent vertebral fracture (AVF) and recollapse of the vertebral body.Operation time and blood loss were acceptable, even for elderly patients. In all patients, alignment and subjective symptoms improved. However, reoperation owing to AVF and recollapse was necessary within 1 year in 5 of 41 (12%) patients. Careful follow-up is required within 1 year after surgery for OVF.
[Mh] Termos MeSH primário: Laminectomia/métodos
Fraturas por Osteoporose/complicações
Paralisia/cirurgia
Pseudoartrose/complicações
Fraturas da Coluna Vertebral/complicações
Fusão Vertebral/métodos
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Estudos de Casos e Controles
Feminino
Seguimentos
Seres Humanos
Masculino
Meia-Idade
Fraturas por Osteoporose/cirurgia
Paralisia/etiologia
Pseudoartrose/cirurgia
Fraturas da Coluna Vertebral/cirurgia
Fusão Vertebral/instrumentação
Resultado do Tratamento
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180214
[Lr] Data última revisão:
180214
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180203
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009395


  7 / 8799 MEDLINE  
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[PMID]:29245289
[Au] Autor:Hirakawa M; Nishihara T; Nakanishi K; Kitamura S; Fujii S; Ikemune K; Dote K; Takasaki Y; Yorozuya T
[Ad] Endereço:aDepartment of Anesthesiology and Resuscitology, Ehime University Hospital, Shitsukawa, ToonbDepartment of Anesthesia and Perioperative Medicine, Ehime University Graduate School of MedicinecIntensive Care Unit, Ehime University Hospital, Shitsukawa, Toon, Ehime, Japan.
[Ti] Título:Perioperative management of a patient with Coffin-Lowry syndrome complicated by severe obesity: A case report and literature review.
[So] Source:Medicine (Baltimore);96(49):e9026, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Coffin-Lowry syndrome (CLS) is a rare inherited disease with specific clinical features, such as mental retardation, facial dysmorphism, and cardiac abnormality. In particular, the characteristic facial features of CLS, including retrognathia and large tongue, are associated with difficult ventilation and/or intubation, which is a serious problem of anesthesia management. However, case reports on anesthesia management of CLS are very limited as there are only two published English reports till date. In this case report, we discuss anesthetic and postoperative considerations in patients with CLS, focusing on difficult airway management, and summarize past reports including some Japanese articles. PATIENT CONCERNS: A 25-year-old man with CLS was planning to undergo laminectomy because of progressive quadriplegia caused by calcification of the yellow ligament. We suspected difficulty in airway management because of several factors in his facial features, short thyromental and sternomental distances in computed tomography, severe obesity, and sleep apnea syndrome. DIAGNOSES: Difficult airway was suspected. However, because of mental retardation, awake intubation was considered difficult. INTERVENTIONS: We selected bronchofiberscope-guided nasotracheal intubation, maintaining spontaneous breathing under moderate sedation with a propofol target-controlled infusion. OUTCOMES: Airway management was safely performed during anesthesia induction. LESSONS: In many patients with CLS, difficult intubation was reported, and sedation or slow induction maintaining spontaneous breathing was mainly selected for anesthesia induction. Spontaneous breathing should be maintained during anesthesia induction in case of CLS patients.
[Mh] Termos MeSH primário: Manuseio das Vias Aéreas/métodos
Síndrome de Coffin-Lowry/complicações
Laminectomia/métodos
Obesidade Mórbida/complicações
[Mh] Termos MeSH secundário: Adulto
Seres Humanos
Deficiência Intelectual/complicações
Intubação Intratraqueal/métodos
Masculino
Síndromes da Apneia do Sono/complicações
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180105
[Lr] Data última revisão:
180105
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171217
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009026


  8 / 8799 MEDLINE  
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[PMID]:29245227
[Au] Autor:Wang GC; Wu SW
[Ad] Endereço:Department of Neurosurgery, Neuro-Medical Scientific Center, Buddhist Tzu Chi Hospital, Hualien, Taiwan.
[Ti] Título:Spinal intramedullary tuberculoma following pulmonary tuberculosis: A case report and literature review.
[So] Source:Medicine (Baltimore);96(49):e8673, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Spinal intramedullary tuberculoma (IMTB) is a rare disease that accounts for 1 to 2/100,000 patients with tuberculosis. We presented a case with pulmonary tuberculosis and concurrent IMTB at C3 to C5 level and reviewed the recent case series and discussed the diagnosis, treatment, and outcome. PATIENT CONCERNS: A 33-year-old male had concurrent pulmonary TB and IMTB at the C3 to C5 level. He had quadriplegia (muscle power 0 at 4 limbs) and sensory loss below C5 level. He also had incontinence, anal tone loss, and paradoxical respiratory pattern. DIAGNOSIS: Spinal magnetic resonance imaging (MRI) showed a 25 11mm intramedullary lesion at C3/C4 level. Under the impression of IMTB, he underwent surgery. INTERVENTION: We performed C3 to C5 laminectomy and en bloc removal of the tumor. The patient kept receiving anti-TB medications after the surgery. OUTCOME: His 4 limbs muscle power had improved but could not be liberated from the endotracheal tube, so tracheostomy was performed. Muscle power gradually increased to 3 points in his upper limbs and to 2 points in his lower limbs. Sensation in his 4 limbs gradually improved as well. LESSONS: IMTB is a rare disease that should be treated with a combination of medication and surgery. For patients with prominent spinal cord compression and neurological symptoms, early operation to remove the tumor is necessary.
[Mh] Termos MeSH primário: Vértebras Cervicais/diagnóstico por imagem
Tuberculoma/diagnóstico por imagem
Tuberculoma/microbiologia
Tuberculose Pulmonar/complicações
Tuberculose da Coluna Vertebral/diagnóstico por imagem
[Mh] Termos MeSH secundário: Adulto
Vértebras Cervicais/cirurgia
Seres Humanos
Laminectomia/métodos
Imagem por Ressonância Magnética
Masculino
Tuberculoma/cirurgia
Tuberculose da Coluna Vertebral/cirurgia
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171222
[Lr] Data última revisão:
171222
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171217
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000008673


  9 / 8799 MEDLINE  
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[PMID]:29074335
[Au] Autor:Jeffery ND; Harcourt-Brown TR; Barker AK; Levine JM
[Ad] Endereço:Department of Small Animal Clinical Sciences, Texas A&M University, 4474 TAMU, College Station, TX 77843, USA. Electronic address: njeffery@cvm.tamu.edu.
[Ti] Título:Choices and Decisions in Decompressive Surgery for Thoracolumbar Intervertebral Disk Herniation.
[So] Source:Vet Clin North Am Small Anim Pract;48(1):169-186, 2018 Jan.
[Is] ISSN:1878-1306
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Once decompressive surgery has been elected, the approach that maximizes the likelihood of gaining access to the herniated material for complete removal should be chosen. In most cases, a procedure that optimizes access to the ventrolateral aspect of the spinal cord will be advantageous but it is important to tailor the details of the surgical procedure to suit individual patients. Decompressive surgery for chronic (type II) herniations will frequently demand a ventral approach with partial corpectomy.
[Mh] Termos MeSH primário: Doenças do Cão/cirurgia
Deslocamento do Disco Intervertebral/veterinária
Laminectomia/veterinária
Região Lombossacral/cirurgia
Compressão da Medula Espinal/veterinária
Medula Espinal/cirurgia
[Mh] Termos MeSH secundário: Animais
Tomada de Decisões
Doenças do Cão/diagnóstico por imagem
Cães
Deslocamento do Disco Intervertebral/diagnóstico por imagem
Deslocamento do Disco Intervertebral/cirurgia
Laminectomia/métodos
Compressão da Medula Espinal/diagnóstico por imagem
Compressão da Medula Espinal/cirurgia
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171222
[Lr] Data última revisão:
171222
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171028
[St] Status:MEDLINE


  10 / 8799 MEDLINE  
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[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



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