scholarly journals Passage of an Anterior Odontoid Screw through Gastrointestinal Tract

2017 ◽  
Vol 2017 ◽  
pp. 1-4 ◽  
Author(s):  
L. Leitner ◽  
C. I. Brückmann ◽  
M. M. Gilg ◽  
G. Bratschitsch ◽  
P. Sadoghi ◽  
...  
Keyword(s):  
Screw Fixation ◽  
Treatment Method ◽  
Preoperative Imaging ◽  
Screw Loosening ◽  
Gi Tract ◽  
Revision Operation ◽  
Odontoid Fractures ◽  
Esophagus Perforation ◽  
And Migration

Purpose. Anterior screw fixation has become a popular surgical treatment method for instable odontoid fractures. Screw loosening and migration are a rare, severe complication following anterior odontoid fixation, which can lead to esophagus perforation and requires revision operation. Methods. We report a case of screw loosening and migration after anterior odontoid fixation, which perforated the esophagus and was excreted without complications in a 78-year-old male patient. Results. A ventral dislocated anterior screw perforated through the esophagus after eight years after implantation and was excreted through the gastrointestinal (GI) tract. At a 6-month follow-up after the event the patient was asymptomatic. Conclusion. Extrusion via the GI tract is not safe enough to be considered as a treatment option for loosened screws. Some improvements could be implemented to prevent such an incident. Furthermore, this case is a fine example that recent preoperative imaging is mandatory before revision surgery for screw loosening.

scholarly journals Direct anterior screw fixation for recent and remote odontoid fractures

2000 ◽  
Vol 8 (6) ◽  
pp. 1-10 ◽  
Author(s):  
Ronald I. Apfelbaum ◽  
Russell R. Lonser ◽  
Robert Veres ◽  
Adrian Casey
Keyword(s):  
Screw Fixation ◽  
Fusion Rate ◽  
Odontoid Fractures ◽  
Hardware Failure ◽  
University Of Utah ◽  
Bone Fusion ◽  
Anterior Screw Fixation ◽  
Operative Findings ◽  
The University

Object The management of odontoid fractures remains controversial. Only direct anterior screw fixation provides immediate stabilization of the spine and may preserve normal C1–2 motion. To determine the indications, optimum timing, and results for direct anterior screw fixation of odontoid fractures, the authors reviewed the surgery-related outcome of patients who underwent this procedure at two institutions. Methods One hundred forty-seven consecutive patients (98 males and 49 females) who underwent direct anterior screw fixation for a recent fracture (< 6 months postinjury [129 patients]) or remote (≥ 18 months postinjury [18 patients]) Type II (138 cases) or III (nine cases) odontoid fractures at the University of Utah (94 patients) and National Institute of Traumatology in Budapest, Hungary (53 patients) between 1986 and 1998 are included in this study (mean follow-up period 18.2 months). Data obtained from clinical examination, review of hospital charts, operative findings, and imaging studies were used to analyze the surgery-related results in these patients. In patients with recent fractures there was an overall bone fusion rate of 88%. The rate of anatomical bone fusion of recent fractures was significantly (p ≤ 0.05) higher in fractures oriented in the horizontal and posterior oblique direction (as compared with anterior oblique), but this finding was independent (p ≥ 0.05) of age, sex, number of screws placed (one or two), and the degree or the direction of odontoid displacement. In patients with remote fractures there was a significantly lower rate of bone fusion (25%). Overall, complications related to hardware failure occurred in 14 patients (10%) and unrelated to hardware in three patients (2%). There was one death (1%) related to surgery. Conclusions Direct anterior screw fixation is an effective and safe method for treating recent odontoid fractures (< 6 months postinjury). It confers immediate stability, preserves C1–2 rotatory motion, and achieves a fusion rate that compares favorably with alternative treatment methods. In contradistinction, in patients with remote fractures (≥ 18 months postinjury) a significantly lower rate of fusion is found when using this technique, and these patients are believed to be poor candidates for this procedure.

Results of Long-Term Follow-Up in Patients Undergoing Anterior Screw Fixation for Type II and Rostral Type III Odontoid Fractures

Spine ◽  
2005 ◽  
Vol 30 (6) ◽  
pp. 661-669 ◽  
Author(s):  
Kostas N. Fountas ◽  
Eftychia Z. Kapsalaki ◽  
Ioannis Karampelas ◽  
Carlos H. Feltes ◽  
Vassilios G. Dimopoulos ◽  
...  
Keyword(s):  
Screw Fixation ◽  
Type Ii ◽  
Odontoid Fractures ◽  
Type Iii ◽  
Anterior Screw Fixation ◽  
Long Term Follow Up

Efficacy of anterior odontoid screw fixation in elderly patients with Type II odontoid fractures

2000 ◽  
Vol 8 (6) ◽  
pp. 1-4 ◽  
Author(s):  
James S. Harrop ◽  
Gregory J. Przybylski ◽  
Alexander R. Vaccaro ◽  
Kennedy Yalamanchili
Keyword(s):  
Elderly Patients ◽  
Screw Fixation ◽  
Demographic Data ◽  
Treatment Method ◽  
Outcome Data ◽  
High Risk Group ◽  
Type Ii ◽  
Halo Vest ◽  
Odontoid Fractures ◽  
Fusion Procedure

Object Type II odontoid fractures are the most common trauma-related dens fracture. Although Type III odontoid fractures have a high union rate when external immobilization is applied, Type II fractures are associated with high rates of nonunion, particularly in elderly patients and those with posteriorly displaced fractures or fractures displaced by more than 6 mm. Because elderly patients may not also tolerate external immobilization in a halo vest, alternative techniques should be explored to identify a method for managing these higher-risk patients. In this study the authors examine the efficacy of anterior odontoid screw fixation in a high-risk group of 10 elderly patients (> 65 years of age) treated for Type II odontoid fractures. Methods A retrospective review of all patients with Type II odontoid fractures treated at two institutions between September 1997 and March 2000 was performed. Demographic data, neurological examination, fracture type and degree of displacement, treatment method, and outcome data were examined at discharge. Ten patients older than 65 years who had sustained a trauma-related odontoid fracture and had undergone an anterior odontoid screw placement procedure were retrospectively reviewed. Fracture displacement (mean 6.6 mm) was observed in all but one patient, and in seven there were posteriorly displaced fractures. Seven were successfully treated with anterior screw fixation and external orthosis alone; in one patient in whom poor intraoperative screw purchase had been observed, the fracture healed after undergoing halo vest therapy. Only one patient was shown to develop a nonunion requiring a subsequent posterior fusion procedure. Conclusions Odontoid screw fixation can be safely performed in elderly patients, and frequent bone union is demonstrated. However, osteopenia may preclude adequate screw fixation in some patients.

scholarly journals A case report of duodenal arteriovenous malformation: usefulness of intraoperative indocyanine green angiography for precise identification of the lesion

2022 ◽  
Vol 8 (1) ◽  
Author(s):  
Yoshihiro Kurata ◽  
Koichi Hayano ◽  
Keisuke Matsusaka ◽  
Hisashi Mamiya ◽  
Masaya Uesato ◽  
...  
Keyword(s):  
Arteriovenous Malformation ◽  
Indocyanine Green ◽  
Duodenal Bulb ◽  
Pancreatic Head ◽  
Complete Resection ◽  
Preoperative Imaging ◽  
Gi Tract ◽  
Precise Identification ◽  
Icg Angiography

Abstract Background Arteriovenous malformation (AVM) of the gastrointestinal (GI) tract can cause bleeding. The treatment choice for GI tract AVM is surgical resection of the involved bowel segment with complete resection of the nidus. The AVM formed in the duodenum or pancreatic head could also cause gastrointestinal bleeding, and there are several reports of pancreaticoduodenectomy as its treatment. However, if the area of AVM can be accurately identified during surgery, it may be possible to completely resect the AVM while preserving the organ. We report a case of duodenal AVM in a patient successfully treated with a subtotal stomach-preserving duodenal bulb resection using intraoperative indocyanine green (ICG) angiography technique. Case presentation An 18-year-old man was diagnosed with duodenal AVM after several examinations for anemia and was referred to our hospital for further treatment. Preoperative imaging studies showed that the inflow vessels of this duodenal AVM were the inferior pyloric artery and the superior duodenal artery, and the AVM was localized to the duodenal bulb. Thereafter, stomach-preserving duodenal bulb resection preceded by ligation of the inflow vessels was performed. During the surgery, ICG angiography clearly demonstrated the area, where the nidus was distributed, and a duodenal bulb resection with complete resection of the AVM was successfully performed. There was no recurrence at the 6-month follow-up. Conclusions Intraoperative ICG angiography was a useful procedure for precise identification of the AVM of the GI tract.

scholarly journals DIFFICULTIES IN THE DIAGNOSIS AND SURGICAL TREATMENT OF XANTOGRANULOMATOUS PYELONEPHRITIS

2020 ◽  
Vol 18 (2) ◽  
pp. 131-135
Author(s):  
E. Enchev ◽  
G. Minkov ◽  
E. Dimitrov ◽  
S. Nikolov ◽  
A. Petrov ◽  
...  
Keyword(s):  
Treatment Method ◽  
Excretory Urography ◽  
Preoperative Imaging ◽  
Kidney Tumors ◽  
The Past ◽  
History Of ◽  
Extracorporeal Lithotripsy ◽  
Abdominal Echography ◽  
Current Report

Purpose: The diagnosis of xanthogranulomatous pyelonephritis is primarily histological. The mandatory studies that have to be performed are: abdominal echography, excretory urography, CT, and renal angiography. Methods: The current report covers a period of 16 years (1992-2008) and presents clinical material from 9 patients with a long history of nephrolithiasis. In the past, six of them have undergone surgical or extracorporeal lithotripsy. Results and conclusion: The performed preoperative imaging studies showed kidney tumors, and the operative treatment method used was nephrectomy. The post-operative follow-up did not detect any complications in any of these patients

Intraocular tuberculosis, a challenge in diagnosis and treatment

2020 ◽  
Vol 3 ◽  
pp. 4
Author(s):  
Martina Larroude ◽  
Gustavo Ariel Budmann
Keyword(s):  
Developing Countries ◽  
Clinical Signs ◽  
Steady Increase ◽  
Ocular Tuberculosis ◽  
Industrial Countries ◽  
Choroidal Granuloma ◽  
History Of ◽  
And Migration ◽  
Ocular Tb

Ocular tuberculosis (TB) is an extrapulmonary tuberculous condition and has variable manifestations. The incidence of TB is still high in developing countries, and a steady increase in new cases has been observed in industrial countries as a result of the growing number of immunodeficient patients and migration from developing countries. Choroidal granuloma is a rare and atypical location of TB. We present a case of a presumptive choroidal granuloma. This case exposes that diagnosis can be remarkably challenging when there is no history of pulmonary TB. The recognition of clinical signs of ocular TB is extremely important since it provides a clinical pathway toward tailored investigations and decision making for initiating anti-TB therapy and to ensure a close follow-up to detect the development of any complication.

Implant Complications in 20 Triple Pelvic Osteotomies

1993 ◽  
Vol 06 (04) ◽  
pp. 202-207 ◽  
Author(s):  
Cindy Fries ◽  
Audrey Remedios
Keyword(s):  
Postoperative Complication ◽  
Hip Dysplasia ◽  
Pelvic Osteotomy ◽  
Implant Failure ◽  
Screw Loosening ◽  
Common Complication ◽  
Implant Complications ◽  
Gait Abnormalities

SummaryIn 12 dogs with hip dysplasia, 20 triple pelvic osteotomies (eight bilateral and four unilateral) were performed. Screw loosening, occurring in six of 12 dogs (seven of 20 osteotomies), was the most common complication after surgery. Implants loosened from the cranial ilium in six hemipelvises (30%) and from both fragments in one hemipelvis, two to six weeks (mean — three) after the operation. Medial acetabular displace-ment caused pelvic narrowing (6 to 9%, mean = 8%) in three of four dogs. Medial ischial displacement decreased pelvic diameter (11 to 21%, mean = 17%) in four of seven osteotomies. All of the dogs with implant failure were treated conservatively with cage rest and in two cases Ehmer slings were used. Although none were lame, gait abnormalities were evident in three of seven dogs on follow-up examinations four to 12 months (mean = six) later.Screw loosening, occurring in seven of 20 hemipelvises, was the most common postoperative complication associated with triple pelvic osteotomy. Fixation failures were managed conservatively. Despite decreased pelvic diameter in four of seven animals, none were lame or showed signs of pelvic obstruction at follow-up examinations four to 12 months later.

scholarly journals Percutaneous posteroanterior screw fixation for Haraguchi type 1 posterior malleolar fracture in tri-malleolar fracture: Operative technique and randomized clinical results

2021 ◽  
Vol 29 (1) ◽  
pp. 230949902199799
Author(s):  
Tianming Yu ◽  
Jichong Ying ◽  
Jianlei Liu ◽  
Dichao Huang ◽  
Hailin Yan ◽  
...  
Keyword(s):  
Screw Fixation ◽  
Malleolar Fracture ◽  
Malleolar Fractures ◽  
Posterior Malleolar Fracture ◽  
Post Traumatic ◽  
Group 2 ◽  
Traumatic Arthritis ◽  
Group 1

Purpose: The study described a novel surgical treatment of Haraguchi type 1 posterior malleolar fracture in tri-malleolar fracture and patient outcomes at intermediate period follow-up. Methods: All patients from January 2015 to December 2017 with tri-malleolar fracture of which posterior malleolar fractures were Haraguchi type 1, were surgically treated in this prospective study. Lateral and medial malleolar fractures were managed by open reduction and internal fixation through dual incision approaches. 36 cases of Haraguchi type 1 posterior malleolar fractures were randomly performed by percutaneous posteroanterior screw fixation with the aid of medial exposure (group 1). And 40 cases were performed by percutaneous anteroposterior screw fixation (group 2). Clinical outcomes, radiographic outcomes and patient-reported outcomes were recorded. Results: Seventy-six patients with mean follow-up of 30 months were included. There were no significant differences in the mean operation time (81.0 ± 11.3 vs. 77.2 ± 12.4), ankle function at different periods of follow-up, range of motions and visual analog scale (VAS) at 24 months between the two groups ( p > 0.05). However, the rate of severe post-traumatic arthritis (Grade 2 and 3) and the rate of step-off rather than gap in radiological evaluation were lower in group 1 than that in group 2 ( p < 0.05). Conclusion: Using our surgical technique, more patients had good outcome with a lower rate of severe post-traumatic arthritis, compared with the group of percutaneous anteroposterior screw fixation. Percutaneous posteroanterior screw fixation can be a convenient and reliable alternative in treating Haraguchi type 1 posterior malleolar fracture.

scholarly journals Posterior thoracolumbar hemivertebra resection and short-segment fusion in congenital scoliosis: surgical outcomes and complications with more than 5-year follow-up

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Beixi Bao ◽  
Qingjun Su ◽  
Yong Hai ◽  
Peng Yin ◽  
Yaoshen Zhang ◽  
...  
Keyword(s):  
Pedicle Screw ◽  
Surgical Outcomes ◽  
Screw Fixation ◽  
Congenital Scoliosis ◽  
Pedicle Screw Fixation ◽  
Rigid Fixation ◽  
Short Segment ◽  
Hemivertebra Resection ◽  
Main Curve

Abstract Background Treatment of congenital hemivertebra is challenging and data on long-term follow-up (≥ 5 years) are lacking. This study evaluated the surgical outcomes of posterior thoracolumbar hemivertebra resection and short-segment fusion with pedicle screw fixation for treatment of congenital scoliosis with over 5-year follow-up. Methods This study evaluated 27 consecutive patients with congenital scoliosis who underwent posterior thoracolumbar hemivertebra resection and short-segment fusion from January 2007 to January 2015. Segmental scoliosis, total main scoliosis, compensatory cranial curve, compensatory caudal curve, trunk shift, shoulder balance, segmental kyphosis, and sagittal balance were measured on radiographs. Radiographic outcomes and all intraoperative and postoperative complications were recorded. Results The segmental main curve was 40.35° preoperatively, 11.94° postoperatively, and 13.24° at final follow-up, with an average correction of 65.9%. The total main curve was 43.39° preoperatively, 14.13° postoperatively, and 16.06° at final follow-up, with an average correction of 60.2%. The caudal and cranial compensatory curves were corrected from 15.78° and 13.21° to 3.57° and 6.83° postoperatively and 4.38° and 7.65° at final follow-up, with an average correction of 69.2% and 30.3%, respectively. The segmental kyphosis was corrected from 34.30° to 15.88° postoperatively and 15.12° at final follow-up, with an average correction of 61.9%. A significant correction (p < 0.001) in segmental scoliosis, total main curve, caudal compensatory curves and segmental kyphosis was observed from preoperative to the final follow-up. The correction in the compensatory cranial curve was significant between preoperative and postoperative and 2-year follow-up (p < 0.001), but a statistically significant difference was not observed between the preoperative and final follow-up (p > 0.001). There were two implant migrations, two postoperative curve progressions, five cases of proximal junctional kyphosis, and four cases of adding-on phenomena. Conclusion Posterior thoracolumbar hemivertebra resection after short-segment fusion with pedicle screw fixation in congenital scoliosis is a safe and effective method for treatment and can achieve rigid fixation and deformity correction.

Transverse Lag Screw Fixation in Midline Mandibulotomy

2000 ◽  
Vol 109 (3) ◽  
pp. 334-339 ◽  
Author(s):  
Joseph M. Serletti ◽  
John U. Coniglio ◽  
Salvatore J. Pacella ◽  
John D. Norante
Keyword(s):  
Reliable Method ◽  
Screw Fixation ◽  
Postoperative Radiotherapy ◽  
Major Complication ◽  
Recurrent Tumor ◽  
Minor Complication ◽  
Anterior Cortex ◽  
Lag Screw ◽  
The Mean

Vertical midline mandibulotomy has provided a relatively simple and efficient means of obtaining access to intraoral tumors that are too large or too posterior to be removed transorally. Midline mandibulotomy has had the advantage of nerve and muscle preservation and places the osteotomy outside the typical field of radiotherapy, in contrast to lateral and paramedian osteotomies. Plate and screw fixation has been the usual means of osteosynthesis for these mandibulotomies; however, plate contouring over the symphyseal surface has been a time-consuming process. Unless the plate was contoured exactly, mandibular malalignment and malocclusion in dentulous patients has occurred. Use of parallel transverse lag screws has become a popular method of osteosynthesis for parasymphyseal fractures, and we have extended their use for mandibulotomy fixation. This paper reports our clinical experience with transverse lag screw fixation of midline mandibulotomies in 9 patients from 1994 to 1997. There were 7 men and 2 women with a mean age of 56 (range 35 to 71 years). The pathological diagnosis in all patients was squamous cell carcinoma; 8 cases were primary, and 1 patient presented with recurrent tumor. No tumors involved the mandibular periosteum. One patient had had previous radiotherapy, and 3 patients underwent postoperative radiotherapy. The mean follow-up has been 17 months (range 9 to 27). There was 1 minor complication and 1 major complication related to our technique. The major complication was a delayed nonunion of the mandibulotomy. This occurred because the 2 parallel screws were placed too close to one another, and this placement resulted in a delayed sagittal fracture of the anterior cortex and subsequent nonunion. Transverse lag screw fixation has not affected occlusion in our dentulous patients. Speech and diet were normal in the majority of our patients. Transverse lag screw fixation of the midline mandibulotomy has been a relatively safe, rapid, and reliable method for tumor access and postextirpation mandibular stabilization and has significant advantages over other current methods of mandibulotomy and fixation.

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