Long-Term Results of Conservative Treatment of Osteomyelitis Spine

10.12737/5912 ◽  
2014 ◽  
Vol 21 (3) ◽  
pp. 108-112 ◽  
Author(s):  
Веретельникова ◽  
I. Veretelnikova ◽  
Носков ◽  
V. Noskov ◽  
Стариков ◽  
...  

The purpose of this study was to analyze long-term results of conservative treatment of patients with osteomyelitis of the spine. The authors examined 135 patients with osteomyelitis of the spine. Conservative treatment was made in 67 (50%) patients, other patients was carried out surgical treatment. Indications for treatment included: early diagnosis of the disease, the absence of sig-nificant lesions destruction of vertebral bodies, neurological complications, the presence of comorbidity and organ failure. The complex conservative treatment consisted of: antibacterial and detoxification therapies, orthopedic immobilization, immune-corrective and tonic medicines. In the preoperative and long-term period (time from 1 year to 15 years after surgery) the clinical, paraclinical, radiation methods and classification developed by Frankel H.L.et al (1969) were used for evaluation of neurological disorders. Long-term results included assessment of pain on VAS and quality of life questionnaire developed by Oswestry and SF-36. For statistical analysis of the material was used the software package Statistica 6.1 (license agreement BXXR006B092218FAN11). Long-term clinical, laboratory and x-ray methods didn’t shown recurrence of the disease. In 16 patients with neurological complications after treatment, regression of neurological symptoms was revealed. Pains in the spine, associated with symptoms of degenerative disc disease without neurological deficit, were established in some patients. At most patients the presence of spontaneous fibrous or bone block is marked at the level of former inflammatory process with symptoms of degenerative disc disease in the lower divisions. All patients returned to their previous jobs in terms from 6 to 12 months after the treatment. Thus, the authors concluded that conservative treatment of the patients with osteomyelitis of the spine is defensible, harmless and effective method in particular indicated cases.

2019 ◽  
Vol 10 (1) ◽  
pp. 30-38
Author(s):  
Haider Kareem ◽  
Christian Ulbricht

Study Design: Prospective cohort study. Objective: To evaluate the long-term effectiveness of a posterior dynamic spine stabilization (PDS) System called PercuDyn system as a treatment for low back pain (LBP) in patients with degenerative disc disease who have failed conservative treatment. Methods: Thirty-five patients (21 males, 14 females, mean age 36 years) with chronic LBP due to degenerative disc disease underwent percutaneous facet augmentation with the PercuDyn system. Indications for implanting the PercuDyn device were chronic LBP without sciatica, significant disc degeneration, and who failed conservative treatment. Follow-up after surgery ranged from 4 to 8 years. Patients were clinically evaluated using visual analogue scale (VAS), Oswestry Disability Index (ODI) questionnaire, and the EQ-5D3L. Results: The VAS scale and ODI scores improved at 6 months, 1 year, 2 years, and 4 to 8 years in comparison with the baseline values ( P < .001 and P < .01, respectively). Equally, data from the EQ-5D-3L questionnaire suggested improvements in all domains, including pain and discomfort, over the follow-up period. However, during follow-up, 16 patients (46%) have had unsatisfactory outcome including failure of implant to resolve symptoms (n = 8), developed symptomatic disc protrusion (n = 4), and loosening of the screws (n = 4). Conclusion: Our clinical experience highlights the rather high overall failure rate of this system. Although, some patients show significant improvement in their symptoms, we believe that patients with LBP related to degenerative disc disease are a poor indication for this PDS device.However, large scale studies, with optimised selection criteria are needed to demonstrate the exact role of this device in spinal patients.


Author(s):  
О. A. Danilenko ◽  
E. R. Makarevich ◽  
N. S. Serdiuchenko

The effectiveness of the developed approaches to the conservative treatment of traumatic injuries of the rotatory-bicepital complex is assessed. The long-term results of conservative treatment of 29 patients for the period from 2004 to 2017 and treated in the Mogilyov regional hospital and the SCTC of the 6th Minsk city clinical hospital were studied. The conservative treatment indications were considered to be the cases with traumatic partial local or extensive injuries of the rotator-bicepital complex in the presence of clinical manifestations in the form of pain syndrome and limitation of limb movements and in the absence of a decrease in limb strength in the sectoral testing of elements. The proposed tactical approaches implied immobilization, physiotherapy, local injection therapy.The developed conservative approaches to treating patients with damage to the rotary element of RBC allowed one to achieve a favorable outcome in the absolute majority of cases with long periods of patient follow-up, which improved the performance evaluation indicators according to the Oxford questionnaire for Me shoulder from 56 [48–58] to 12 [12–32] (Me [Q25–Q75]). The applied conservative approaches to treating patients with damage to the rotary element of RBC are a promising way to improve the clinical treatment results of patients with partial injuries of the rotator-bicepital complex.


2021 ◽  
Vol 105 (2) ◽  
pp. e25-e27
Author(s):  
David C. Noriega ◽  
Francisco Ardura ◽  
Rubén Hernández-Ramajo ◽  
Miguel Ángel Martín-Ferrero ◽  
Israel Sánchez-Lite ◽  
...  

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