scholarly journals Sacroplasty: A Ten-Year Analysis of Prospective Patients Treated with Percutaneous Sacroplasty: Literature Review and Technical Considerations

2017 ◽  
Vol 7 (20;7) ◽  
pp. E1063-E1072
Author(s):  
Christopher Warner

Background: The treatment of sacral fractures has evolved since its first description in 1982. Several techniques for sacral augmentation have been developed since 2001, and the rate of improvement is rapid with over 50% reduction in pain achieved prior to post-procedure discharge of the patient. Pain reduction occurs primarily within the first 3 months and is sustained at 12 months; however, the long-term outcomes have not previously been studied. Objectives: We aim to evaluate the long-term efficacy of sacroplasty versus non-surgical management (NSM) in treating sacral insufficiency fractures (SIFs), including the effect on pain relief, opioid and other analgesic use, patient satisfaction, and complication rates. Additionally, we aim to review the most current sacroplasty literature. Study Design: A 10-year prospective, observational cohort study of patients with SIFs treated with sacral augmentation. Setting: A single-center interventional pain management private practice. Methods: Two-hundred and forty-four patients with SIFs were treated with sacroplasty (210 patients) or NSM (34 patients) beginning in January 2004 and then followed for 10 years. The patients’ gender, age, pre-procedure pain duration, analgesic use, pain level, and satisfaction were recorded at baseline and at post-procedure follow-up intervals of 2, 4, 12, 24, 52 weeks, and 2 years. The experimental group was then contacted at 10 years. Post-procedure complications before discharge and at each follow-up were also evaluated. Results: Both NSM and sacroplasty resulted in statistically significant drops in visual analog scale (VAS) scores from pre-treatment to 2-year follow-up (P < 0.001). When measured from followup to follow-up, the NSM group’s only significant decrease in the mean VAS score was between pre-treatment and 2 weeks (P = 0.002). The experimental group had significant decreases over the periods pre-op through post-op (P < 0.001), post-op through 2 weeks (P < 0.001), 12 weeks through 24 weeks (P = 0.014), and 24 weeks through one year (P = 0.002). The experimental cohort experienced statistically significant drops in the mean VAS scores between follow-ups for a longer period of time. Opioid and non-opioid analgesic use was markedly decreased preoperatively to postoperatively and was sustained at the 10-year follow-up. Limitations: Patients were placed into the control group, NSM, if they did not meet inclusion criteria for sacroplasty. However, the baseline characteristics of the sacroplasty versus NSM group were not statistically different. Additionally, the control group was only followed through 2 years and was not contacted at the 10-year follow-up. Conclusions: Our results and those reported in previous studies establish that sacroplasty allows for decreased use of medications and results in pain relief, greater patient mobility, and improved patient satisfaction. In addition to the published body of literature, our results show strong evidence in support of sacroplasty as a safe and efficacious treatment of SIFs. Key words: Sacroplasty, sacral fracture, fracture, osteoporosis, insufficiency, radiology

2015 ◽  
Vol 2 (2) ◽  
Author(s):  
Sheida Jabalameli ◽  
Hamid Taher Neshat Doost ◽  
Mohammad Bagher Kajbaf ◽  
Hossein Molavi

Generalized Anxiety Disorder (GAD) is one of the most common anxiety disorders. It has been reported that psychological treatments like Cognitive-Behavioral Therapy (CBT) is effective for patients with GAD. The purpose of the present research was to investigate the effectiveness of CBT on Quality of Life (QOL) and worry in patients with GAD. A sample of 30 patients with GAD who had been referred to psychiatry offices in Isfahan, Iran were selected and assigned into an experimental group (n=15) and a control group (n=15) randomly.  The experimental group received CBT in 8 weekly sessions. All participants completed the World Health Organization Quality Of Life-Brief (WHOQOL-BREF) questionnaire and the Penn State Worry Questionnaire (PSWQ) at pretest, posttest and follow up. The results of MANCOVA showed that the mean scores of QOL in the experimental group was significantly higher than the control group at the posttest and follow up (P<0.05) and the mean scores of worry in the experimental group was significantly lower than the control group at the posttest and follow up (P<0.05) It is concluded that CBT can be applied for the patients with GAD as a useful psychological treatment. In general, CBT can improve QOL and decrease worry in patients with GAD.


2020 ◽  
Author(s):  
Lucas Matias Felix ◽  
Marcela Mansur Alves ◽  
Mariana Teles ◽  
Laura Jamison ◽  
Hudson Golino

This paper reports the results from a three-years follow-up study to access the long-term efficacy of a cognitive training for healthy older adults and investigates the effects of booster sessions on the cognitive performance of the participants using an innovative analytical approach from information theory. Design: semi-randomized quasi-experimental controlled design. Participants: 50 healthy older adults, (M = 73.3, SD = 7.77) were assigned into an experimental (N = 25; Mean age = 73.9; SD = 8.62) and a passive control group (N = 25; mean age = 72.9; SD = 6.97). Instruments: six subtests of WAIS and two episodic memory tasks. Procedures: the participants were assessed in four occasions: after the end of the original intervention, pre-booster sessions (three years after the original intervention), immediately after the booster sessions and three months after the booster sessions. Results: the repeated measures ANOVA showed that two gains reported in the original intervention were identified in the follow-up: Coding (F(1, 44) = 11.79, MSE = 0.77, p = .001, ηˆG2 = .084) and Picture Completion (F(1, 47) = 10.01, MSE = 0.73, p = .003, ηˆG2 = .060). After the booster sessions, all variables presented a significant interaction between group and time favorable to the experimental group (moderate to high effect sizes). To compare the level of cohesion of the cognitive variables between the groups, an entropy-based metric was used. The experimental group presented a lower level of cohesion in three of the four measurement occasions, suggesting a differential impact of the intervention with immediate and short-term effects, but without long-term effects.


2020 ◽  
Vol 28 (2) ◽  
pp. 230949902092316
Author(s):  
Deuk-Soo Hwang ◽  
Chan Kang ◽  
Jeong-Kil Lee ◽  
Jae-Young Park ◽  
Long Zheng ◽  
...  

Purpose: We measured the width of the acetabular labra in, and the clinical outcomes of, patients with borderline hip dysplasia (HD) who underwent arthroscopy. Methods: A total of 1436 patients who underwent hip arthroscopy to treat symptomatic, acetabular labral tears were enrolled. From this cohort, we extracted a borderline HD group (162 cases). Lateral labral widths were evaluated using preoperative magnetic resonance imaging scans. Clinical data including the modified Harris hip score (mHHS), non-arthritic hip score (NAHS), hip outcome score–activity of daily living (HOS-ADL) score, visual analog scale (VAS) pain score, and Tönnis grade were collected. In addition, patient satisfaction with arthroscopy outcomes was rated. All complications and reoperations were noted. Results: The mean follow-up time was 87.4 months. The lateral labral width was 7.64 mm in those with normal hips and 7.73 mm in borderline HD patients, respectively ( p = 0.870). The Tönnis grade progressed mildly from 0.46 to 0.76 ( p = 0.227). At the last follow-up, clinical outcome scores (mHHS, NAHS, and HOS-ADL scores) and the VAS score were improved ( p < 0.001). The mean patient satisfaction was scored at 8.2. The reoperation rate was higher in those who underwent labral debridement (25.6%) than labral repair (4.1%). Conclusions: The lateral labral width did not differ significantly between the borderline HD group and the nondysplastic control group. Arthroscopy relieved the symptoms of painful borderline HD and did not accelerate osteoarthritis. Therefore, if such patients do not respond to conservative treatment, hip arthroscopy can be considered for further treatment.


1998 ◽  
Vol 10 (4) ◽  
pp. 366-377 ◽  
Author(s):  
François Trudeau ◽  
Louis Laurencelle ◽  
Janie Tremblay ◽  
Mirjana Rajic ◽  
Roy J. Shephard

The purpose of this project was to undertake a long-term follow-up of participants in the Trois-Rivières Growth and Development Study. Some 20 years after their initial involvement in the program, two groups were compared: experimental subjects (n =150) who had received 5 one-hour sessions of specialized physical education per week throughout their 6 years of primary school, and the original control group (n = 103). All subjects completed a questionnaire regarding current patterns of physical activity (PA), attitudes and beliefs about PA, and perceived barriers to PA. Principal results indicate: (a) More experimental than control women exercise 3 times or more per week, (b) experimental subjects more commonly perceived their health to be very good to excellent, (c) control subjects in general felt less psychological dependency on exercise, and (d) women in the experimental group had a lower relative risk of back problems.


2020 ◽  
pp. bjophthalmol-2020-316146
Author(s):  
Natasa Mihailovic ◽  
Alina Friederike Blumberg ◽  
Friederike Rosenberger ◽  
Viktoria Constanze Brücher ◽  
Larissa Lahme ◽  
...  

Background/AimDacryocystorhinostomy (DCR) remains the gold standard therapy for nasolacrimal duct obstruction (NLDO), but is invasive and does not maintain the physiology of the lacrimal pathway. With transcanlicular microdrill dacryoplasty (MDP), there is a minimally invasive alternative surgical approach. This study aimed to present this modern lacrimal duct surgery technique and to evaluate its long-term success rate in a large study population.MethodsThe medical records of 1010 patients with acquired NLDO were retrospectively reviewed. Adult patients who had undergone transcanalicular MDP were included. The evaluation included the following parameters: age, gender, success rate, complication rate, obstruction grade and patient satisfaction. Long-term results regarding patient satisfaction and success rate were evaluated by a telephone survey. Only a complete resolution of symptoms was defined as success.Results793 eyes of 576 patients after transcanalicular MDP could be included in the study. The mean follow-up time was 8.7±0.9 years. Initial surgical success rate was 84.0%. At the time of the follow-up, 57.5% (n=229) still had full resolution of symptoms. The mean patient satisfaction with the procedure was 6.9±3.2 out of 10 points. Heavy bleeding occurred in two cases only (0.25%).ConclusionThis is the first study to show the success rate of microendoscopic lacrimal duct surgery after such a long follow-up period and in such a large study population. Transcanalicular MDP is a minimally invasive technique with a very low complication rate and can be used as an alternative procedure before performing more invasive lacrimal duct surgery such as DCR.


2017 ◽  
Vol 22 (6) ◽  
pp. 343-349 ◽  
Author(s):  
Dong-Kee Kim ◽  
Jung Mee  Park ◽  
Jung Ju Han ◽  
Yun Min Chung ◽  
Jung Min Kim ◽  
...  

Objective: To evaluate the therapeutic effects of middle ear tendon resection (METR) on middle ear myoclonic tinnitus (MEMT) and to investigate its long-term effects on hearing and hyperacusis. Materials and Methods: Thirty-seven patients with MEMT with a mean age of 33.2 ± 11.8 years were included in this study. METR was performed on all 37 MEMT patients (41 ears) between November 2004 and August 2016. The mean follow-up period was 16.1 months. We examined changes in tinnitus and accompanying stress and depression in patients after surgery, and examined the hearing changes and the occurrence of complications including hyperacusis. Results: After surgery, 34 (91.9%) patients exhibited complete resolution of MEMT during their follow-up period, and 3 patients showed a partial response. The mean Visual Analog Scale (VAS) scores for tinnitus severity, the Tinnitus Handicap Inventory (THI), and stress index decreased significantly after surgery (p < 0.05, paired t test). No patient developed hearing loss or hyperacusis following surgery. Preexisting hyperacusis even improved in most of the patients with intractable MEMT after surgery. Recurrence of the symptom occurred in only 1 patient, who underwent revision surgery with improvement. We observed 1 case of postoperative delayed facial palsy with complete recovery in 2 weeks. Conclusions: METR seems to be an effective and safe treatment option for intractable MEMT, considering its high control rate of tinnitus and no long-term harmful effects on hearing and hyperacusis.


2020 ◽  
Author(s):  
Kirsti Uusi-Rasi ◽  
Saija Karinkanta ◽  
Pekka Kannus ◽  
Kari Tokola ◽  
Harri Sievänen

Abstract Background : Exercise interventions focused on balance and strength training have been shown to be effective for falls prevention. The aim of this 20-year register-based follow-up was to examine whether long-term participation in recreational female gymnastics is associated with a lower risk of medically-attended injurious falls. Methods : Health care register data of 187 women (103 recreational gymnasts and 84 sedentary controls) from the original cohort of 243 women were assessed. The mean age (sd) at baseline was 62.8 (5.4) years and the mean follow-up time was 19.4 (2.7) years (range from 5.6 to 21.0 years). Injurious falls were scrutinized from medical records. An injurious fall was defined as an event in which falling was mentioned as a reason for making contact with the health-care professionals. Negative binomial regression was used to estimate incidence rate ratios (IRR) for injurious falls, and Cox-regression models for calculating hazard ratios (HR) for injured fallers with the control group as reference. Results Recreational gymnasts had about 30% less injurious falls compared to controls, the mean IRR (95% CI) being 0.71 (0.51 to 0.96). Regarding injured fallers, the HR was 0.73 (0.52 to 1.02) favoring the recreational gymnasts. There were no statistically significant between-group differences for fractures. Conclusion s: Long-term recreational gymnastics appears to reduce the risk of injurious falls in old age.


Author(s):  
Serdar Kabataş ◽  
Erdinç Civelek ◽  
Erek Öztürk ◽  
Eyüp Can Savrunlu ◽  
Murat Kahraman ◽  
...  

Aim: To compare short and long term pain intensity changes and long term loss of correction rates in patients who were treated either by kyphoplasty or posterior segmentation due to their TLICS and LSC scores, therefore evaluate the specificity of these classifications. Material and Methods: Medical records of 106 patients operated due to thoracolumbar compression or burst fracture in our clinics between years 2012 to 2015 have been evaluated retrospectively. The patients were evaluated with postoperative radiography (loss of reduction) and visual analogue scale (VAS) in their follow-ups. Results: The average stay on hospital was 6.53 ± 4.51 days in kyphoplasty group. The mean preoperative cobb angle was 10.76±11.67 degrees, which improved to 10.19±10.66 degrees at postoperative 1th month. Beside this, the mean preoperative VAS score was 7.93±0.68 then improved to 4.25±0.77 and 2.75 ± 1.43 at postoperative 6th, 12th month follow-ups respectively. There were 42 patients in instrumentation group. The mean hospitalization was 13.47±10.43 days. The mean preoperative cobb angle was 15.84±10.52 and it improved to 11.86±8.15 degrees at the postoperative 1th-month follow-up. The preoperative VAS scores of the patients improved from 7.71±0.71 to 4.09±0.79 and 4.26±1.23 at 6th and 12th month follow-ups. Conclusion: In long term follow up the kyphoplasty group showed more loss of correction however lesser VAS scores comparing to the instrumentation group. Although evaluating TLICS scores to kyphoplasty patients is still based on case reports in our series it was performed to 64 patients.


2020 ◽  
Vol 20 (2) ◽  
pp. 38-48
Author(s):  
Isabel Sousa ◽  
Vânia Rocha ◽  
Catarina Samorinha ◽  
José Cunha-Machado ◽  
Henedina Antunes ◽  
...  

Implementing effective prevention programmes is critical to prevent tobacco use. Objectives. This study aims to assess the long-term effectiveness of the "SmokeOut-I" programme in the smoking prevention of school-aged adolescents, by gender. Methodology. A quasi-experimental study was conducted including a pre-test and a post-test, as well as a experimental group (N = 163) and a control group (N = 148) of adolescents attending the 6th grade at Braga schools in 2014/2015. A follow-up was conducted three years later. A self-report questionnaire was administered to both groups before and after the programme implementation, and at the follow-up. The programme was only administered to the experimental group. Results. The programme has shown long-term effectiveness in preventing smoking experimentation, and in enhancing smoking refusal skills. There was a lower prevalence of tobacco use and intention to smoke in the experimental group than in the control group, although not statistically significant. It was found that the experimental group maintained adequate knowledge about smoking over time. Conclusions. The positive effects on health and on the environment justify the broad implementation of this programme, which implies the involvement and commitment of governmental institutions.


2019 ◽  
Author(s):  
Kirsti Uusi-Rasi ◽  
Saija Karinkanta ◽  
Pekka Kannus ◽  
Kari Tokola ◽  
Harri Sievänen

Abstract Background : Exercise interventions focused on balance and strength training have been shown to be effective for falls prevention. The aim of this 20-year register-based follow-up was to examine whether long-term participation in recreational female gymnastics is associated with a lower risk of medically-attended injurious falls.Methods : Health care register data of 187 women (103 recreational gymnasts and 84 sedentary controls) from the original cohort of 243 women were assessed. The mean age (sd) at baseline was 62.8 (5.4) years and the mean follow-up time was 19.4 (2.7) years (range from 5.6 to 21.0 years). Injurious falls were scrutinized from medical records. An injurious fall was defined as an event in which falling was mentioned as a reason for making contact with the health-care professionals. Negative binomial regression was used to estimate incidence rate ratios (IRR) for injurious falls, and Cox-regression models for calculating hazard ratios (HR) for injured fallers with the control group as reference.Results Recreational gymnasts had about 30% less injurious falls compared to controls, the mean IRR (95% CI) being 0.71 (0.51 to 0.96). Regarding injured fallers, the HR was 0.73 (0.52 to 1.02) favoring the recreational gymnasts. There were no statistically significant between-group differences for fractures.Conclusions: Long-term recreational gymnastics appears to reduce the risk of injurious falls in old age.


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