scholarly journals P.138 Minimally invasive treatment of syringomyelia using tubular retractors

2018 ◽  
Vol 45 (s2) ◽  
pp. S53-S53
Author(s):  
K Yang ◽  
M Sourour ◽  
N Zagzoog ◽  
K Reddy
Keyword(s):  
Minimally Invasive ◽  
Chart Review ◽  
Case Series ◽  
Retrospective Chart Review ◽  
Senior Author ◽  
Invasive Technique ◽  
Single Center ◽  
Invasive Treatment ◽  
Multiple Modalities ◽  
Subarachnoid Spaces

Background: Multiple modalities have been used in the treatment of syringomyelia, including direct drainage, shunting into peritoneal, pleural and subarachnoid spaces. The authors report their experience of surgical treatment of syringomyelia in a minimally invasive fashion. Methods: We conducted a single-center retrospective chart review on our syringomyelia cases treated with minimally invasively using Metrx Quadrant retractor system since January 2011. Lateral fluoroscopy was used to guide the placement of the retractor onto the lamina of the corresponding level. This was followed by laminectomy and a small durotomy. Once the syrinx cavity was identified and the proximal end of the tubing was inserted into the syrinx cavity, the tubing was tunneled into the pleural incision subcutaneously. Insertion of the pleural end of the shunt was performed under the microscope, with removal of a small amount of the rib at its upper edge. Results: 10 procedures were performed in 7 patients by the senior author. Etiologies of syringomyelia included Chiari malformation, trauma, diastematomyelia and kyphoscoliosis. All patients improved neurologically. No patients had immediate postoperative complications. One patient underwent two revisions of syringopleural shunts due to multilobulated nature of syringomyelia. Conclusions: Our case series presents a novel, minimally invasive technique for shunting of syringomyelia with results comparable to open procedures.

scholarly journals Calcaneal Stress Reaction with Distal Anchor Fixation for Mid-Substance Achilles Ruptures

2020 ◽  
Vol 5 (4) ◽  
pp. 2473011420S0044
Author(s):  
Seth C. Shoap ◽  
Christina Freibott ◽  
Hans Polzer ◽  
J. Turner Vosseller
Keyword(s):  
Minimally Invasive ◽  
Achilles Tendon ◽  
Achilles Tendon Rupture ◽  
Case Series ◽  
Retrospective Chart Review ◽  
Senior Author ◽  
Stress Reaction ◽  
Stress Reactions ◽  
Invasive Treatment ◽  
Anchor Fixation

Category: Sports; Other Introduction/Purpose: Minimally invasive Achilles rupture treatment has been purported to lead to superior outcomes relative to open treatment. Various forms of minimally invasive treatment exist. One newer technique involves the use of suture proximally that anchors into interference screws distally in the calcaneus. This treatment paradigm potentially addresses some deficiencies of other techniques. However, the authors have noted calcaneal stress reactions in some patients with this technique and here we report our experience. Methods: We conducted a retrospective chart review of patients that had minimally invasive Achilles tendon repair performed by the senior author. Patient demographics, medical history, social history, surgical details, and additional surgeries were recorded. The presence of a calcaneal stress reaction, as evidenced by pain near the calcaneal anchor insertion and confirmed via MRI was reviewed. A comparison was made between those patients that did and did not have a stress reaction. Results: Of the 30 included patients, the average age was 36.93 (+-13.17) and 63.3% were male. The mean BMI in this cohort was 28.76 (+-7.62). 66.7% injured themselves while played a sport. 4 patients (13.3%) had a stress reaction from suture anchors. When comparing those who had a stress reaction to those who did not, independent samples t-test revealed that age (p=0.168) and BMI (p=0.568) were not significantly different between the groups. Chi square noted that gender (p=0.87), ASA score (p=0.449), and mechanism of injury (p=0.486) were not significantly associated. All of the patients that sustained a stress reaction were very fit and active. Conclusion: This case series notes the presence of calcaneal stress reaction in 4/30 patients treated for an Achilles tendon rupture with distal anchor fixation. This stress reaction has not been previously reported. It should be noted that the stress reaction was self-limited in all patients. It typically became symptomatic around the 3-4 month after surgery mark and resolved by 5-6 months.

Minimally Invasive Scoliosis Correction in Parkinson Disease: Retrospective Case Series

2020 ◽  
Author(s):  
Ravi S Nunna ◽  
Richard G Fessler
Keyword(s):  
Minimally Invasive ◽  
Parkinson Disease ◽  
Chart Review ◽  
Retrospective Chart Review ◽  
The United States ◽  
Invasive Technique ◽  
Radiographic Findings ◽  
Presenting Symptoms ◽  
Scoliosis Correction

Abstract BACKGROUND Parkinson disease (PD) is the second most common neurodegenerative disease in the United States. In the context of the disability inherent to PD, the additional physical challenges and pain from scoliosis can be debilitating for these patients. However, the magnitude of surgery required to correct the deformity combined with the medical co-morbidities and frailty in this population of patients makes surgery very risky. OBJECTIVE To investigate clinical presentations and outcomes of patients with PD that underwent minimally invasive long-segment fusion for scoliosis correction. METHODS A retrospective chart review was performed over the years 2007 to 2017 for patients diagnosed with PD undergoing long-segment spinal fusion (5 or more levels) with the use of circumferential minimally invasive spine surgery techniques. Data including age, sex, race, medical co-morbidities, presenting symptoms, radiographic findings, surgical procedure, case history, and complications were collected from the medical record. RESULTS Retrospective chart review revealed three patients that met the inclusion criteria. They included 2 males and 1 female, with a mean age of 68.7 yr (range 63-75 yr). Ability to maintain upright posture, return to activities of daily living, and visual analog scale (VAS)-back improved in all patients at 1-yr follow-up. Results were durable at 2-yr follow-up. No medical complications were observed. CONCLUSION The generally positive results suggest that minimally invasive technique could have significant benefits in this high-risk group of patients.

scholarly journals Invasive pulmonary aspergillosis in COVID-19. A case series at Gregorio Maranon University General Hospital

2021 ◽  
Author(s):  
Alba Burgos Santamaría ◽  
María Lema T. ◽  
Ana Gloria Pizarro C.
Keyword(s):  
At Risk ◽  
General Hospital ◽  
Chart Review ◽  
Distress Syndrome ◽  
Invasive Pulmonary Aspergillosis ◽  
Case Series ◽  
Retrospective Chart Review ◽  
Single Center ◽  
Secondary Complications ◽  
Pulmonary Aspergillosis

Purpose: Patients with acute respiratory distress syndrome (ARDS) due to viral infection admitted at ICU are at risk for secondary complications like invasive pulmonary aspergillosis. Our study evaluates severe ARDS due to COVID-19 associated invasive pulmonary aspergillosis at a single center in Madrid, Spain. Materials and Methods: A retrospective chart review of patients with COVID-19 associated ARDS admitted to two of the five ICUs that were available at the Gregorio Maranon University General Hospital, Madrid, Spain. Results: COVID-19 associated invasive pulmonary aspergillosis was found in 4 of 79 critically ill patients with severe ARDS. Conclusion: Patients with ARDS triggered by COVID-19 seem to be at risk of developing invasive pulmonary aspergillosis, being necessary the early diagnosis and treatment in order to improve their prognosis.

Stereotactic Electroencephalography Is Associated With Reduced Pain and Opioid Use When Compared with Subdural Grids: A Case Series

2021 ◽  
Author(s):  
Jonathan P Scoville ◽  
Evan Joyce ◽  
Joshua Hunsaker ◽  
Jared Reese ◽  
Herschel Wilde ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Chart Review ◽  
Statistical Tests ◽  
Case Series ◽  
Length Of Hospital Stay ◽  
Retrospective Chart Review ◽  
Opioid Use ◽  
Pain Scores ◽  
Surgical Methods ◽  
Significant Difference

Abstract BACKGROUND Minimally invasive surgery (MIS) has been shown to decrease length of hospital stay and opioid use. OBJECTIVE To identify whether surgery for epilepsy mapping via MIS stereotactically placed electroencephalography (SEEG) electrodes decreased overall opioid use when compared with craniotomy for EEG grid placement (ECoG). METHODS Patients who underwent surgery for epilepsy mapping, either SEEG or ECoG, were identified through retrospective chart review from 2015 through 2018. The hospital stay was separated into specific time periods to distinguish opioid use immediately postoperatively, throughout the rest of the stay and at discharge. The total amount of opioids consumed during each period was calculated by transforming all types of opioids into their morphine equivalents (ME). Pain scores were also collected using a modification of the Clinically Aligned Pain Assessment (CAPA) scale. The 2 surgical groups were compared using appropriate statistical tests. RESULTS The study identified 43 patients who met the inclusion criteria: 36 underwent SEEG placement and 17 underwent craniotomy grid placement. There was a statistically significant difference in median opioid consumption per hospital stay between the ECoG and the SEEG placement groups, 307.8 vs 71.5 ME, respectively (P = .0011). There was also a significant difference in CAPA scales between the 2 groups (P = .0117). CONCLUSION Opioid use is significantly lower in patients who undergo MIS epilepsy mapping via SEEG compared with those who undergo the more invasive ECoG procedure. As part of efforts to decrease the overall opioid burden, these results should be considered by patients and surgeons when deciding on surgical methods.

Short-Term Radiographic Outcomes of Calcaneus Fractures Treated With 2-Incision, Minimally Invasive Approach

2019 ◽  
Vol 40 (9) ◽  
pp. 1060-1067
Author(s):  
Snow B. Daws ◽  
Kaitlin Neary ◽  
Gregory Lundeen
Keyword(s):  
Minimally Invasive ◽  
Sensory Nerve ◽  
Case Series ◽  
Fracture Reduction ◽  
Minimally Invasive Approach ◽  
Invasive Treatment ◽  
Level Of Evidence ◽  
Invasive Approach ◽  
Calcaneus Fractures ◽  
Böhler’S Angle

Background: The treatment of displaced, intra-articular calcaneus fractures is controversial. The extensile lateral approach has been historically preferred because it provides excellent exposure and visualization for fracture reduction. However, soft tissue complications with this approach can lead to poor outcomes for patients. Recently, there has been an interest in the minimally invasive treatment of calcaneus fractures. The purpose of the present study was to determine the radiographic reduction of displaced, intra-articular calcaneus fractures and the rate of complications using a 2-incision, minimally invasive approach. Methods: A dual-incision, minimally invasive approach with plate and screw fixation was utilized for the treatment of 32 patients with displaced, intra-articular calcaneus fractures. Preoperative and postoperative calcaneal measurements were taken to assess fracture reduction. Additionally, a retrospective chart review was performed to assess for complications. Results: The mean preoperative Bohler’s angle measurement was 12.9 (range, –5 to 36) degrees and the final postoperative Bohler’s angle was 31.7 (range, 16-40) degrees. One patient (3.1%) had postoperative numbness related to the medial incision in the calcaneal branch sensory nerve distribution. Two patients (6.2%) had a wound infection treated with local wound care and oral antibiotics, while 1 patient (3.1%) had a deep infection that required a secondary surgery for irrigation and debridement. Two patients (6.2%) returned to the operating room for removal of symptomatic hardware. Conclusion: Operative fixation of displaced, intra-articular calcaneus fractures treated with a 2-incision, minimally invasive approach resulted in acceptable fracture reduction with a minimal rate of complications. Level of Evidence: Level IV, retrospective case series.

scholarly journals Penile Prosthesis Placement with Immediate Buried Penis Correction: A Retrospective Chart Review

2021 ◽  
pp. 1-3
Author(s):  
Christopher J. Salgado ◽  
Christopher J. Salgado ◽  
Genesis Navas ◽  
Lalama Maria ◽  
Lindsay M. Tanner ◽  
...  
Keyword(s):  
Erectile Dysfunction ◽  
Chart Review ◽  
Functional Performance ◽  
Case Series ◽  
Penile Prosthesis ◽  
Retrospective Chart Review ◽  
Combined Approach ◽  
Suspensory Ligament ◽  
Cosmetic Appearance ◽  
Buried Penis

Introduction: We present a case report on six patients who underwent a combined approach to improve the cosmetic appearance and functional performance of their buried penis. Aim: To report our combined approach to improve both buried penis and erectile dysfunction. Methods: In one surgery, we performed: a malleable penile prosthesis, ventral phalloplasty, and penile suspensory ligament release followed by a suprapubic lipectomy. Results: Postoperatively, all patients had an increase in penile length and were able to achieve successful penetrative intercourse. The average difference between the pre-operational and post-operational flaccid length of our six patients was 3.5 cm ± 1.38 (range, 1.9 to 5.08 cm). Conclusion: This case series serves as successful examples of using a combined approach in one stage to not only improve the cosmetic appearance of a buried penis but also address erectile dysfunction.

scholarly journals A New Minimally Invasive Technique for Repairing Achilles Tendon Rupture:A Biomechanical Study

2019 ◽  
Author(s):  
Peng zhao ◽  
Dawei Sun ◽  
Yaru Xiong ◽  
Ribo Zhuo
Keyword(s):  
Minimally Invasive ◽  
Achilles Tendon ◽  
Research Group ◽  
Tendon Rupture ◽  
Achilles Tendon Rupture ◽  
Biomechanical Study ◽  
New Technique ◽  
Invasive Technique ◽  
Invasive Treatment ◽  
Cyclical Loading

AbstractIntroductionThe incidence of Achilles tendon rupture shows a gradually increasing trend, which is mainly managed by minimally invasive treatment due to its advantages, such as low wound infection rate. At present, the firmness of the commonly applied minimally invasive suture method for Achilles tendon remains controversial. Our research group has developed a novel suture method for Achilles tendon, which has achieved favorable clinical outcomes. Therefore, this experiment aimed to explore the optimal approach to repair Achilles tendon rupture through comparing the biomechanical strength of the commonly used Achilles tendon suture methods currently.Materials and methods6 fresh frozen human cadaveric Achilles tendon specimens were sutured by three kinds of technique, and were tested through the cyclical loading after repair.ResultsResults of cyclical loading showed that, the repair using the new technique was stronger after 10 cycles, 1000 cycles, and rupture. Moreover, the new technique had displayed superior anti-deformation strength to that of the Ma-Griffith technique.ConclusionsOur experimental results demonstrate that, the new technique proposed by our research group can attain comparable biomechanical properties to those of the Krachow technique. However, the sample size in this study is small, and further clinical trials are warranted.

scholarly journals Achilles tendon repair by a minimally invasive technique using Tenolig®

2020 ◽  
Vol 14 (3) ◽  
pp. 269-273
Author(s):  
Vinicius Oliveira ◽  
Sérgio Prata
Keyword(s):  
Minimally Invasive ◽  
Achilles Tendon ◽  
Postoperative Infection ◽  
Tendon Rupture ◽  
Achilles Tendon Rupture ◽  
Case Series ◽  
Minimally Invasive Technique ◽  
Invasive Technique ◽  
Aofas Score ◽  
Functional Scores

Objective: To assess the degree of postoperative satisfaction of patients with acute Achilles tendon rupture who underwent surgical reconstruction by a minimally invasive technique using Tenolig®. Methods: A retrospective observational study was conducted with 18 patients with acute Achilles tendon rupture diagnosed by a positive Thompson test who underwent surgery. Outcomes were assessed using the American  arthopaedic Foot and Ankle Society (AOFAS) score and the Foot Function Index (FFI). Furthermore, quantitative variables were descriptively treated, and patients’ age was correlated with FII and AOFAS score using Spearman’s correlation coefficient at a significance level of 5%. Results: Patients underwent surgery from one to six days after injury and were discharged one day later. Only one patient had a superficial postoperative infection. Patients’ AOFAS scores ranged from 75 to 100 points, and FFI ranged from 0 to 20%. The patient withsuperficial postoperative infection had an AOFAS score and a FFI of 75 points and 20%, respectively. Conclusion: Percutaneous repair of complete Achilles tendon rupture with Tenolig® resulted in high functional scores and a low rate of complications. Level of Evidence IV; Therapeutic Studies; Case Series.

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