Transverse decompression technique in the surgical treatment of degenerative lumbar canal stenosis

By

Müjde, S (Mujde, Salih) ; Erel, N (Erel, Nuri) ; Ozan, F (Ozan, Firat)

 (provided by Clarivate) 

Source

ACTA ORTHOPAEDICA ET TRAUMATOLOGICA TURCICA

Volume

49

Issue

6

Page

614-619

DOI

10.3944/AOTT.2015.14.0027

Published

2015

Indexed

2015-12-30

Document Type

Article

Abstract

Objective: The aim of this study was to assess the outcomes of fusion technique via posterior instrumentation in combination with transverse decompression in the surgical treatment of degenerative lumbar canal stenosis.

Methods: Forty-five patients-39 women (86.7%) and 6 men (13.3%)-were included. Mean age was 58.68 +/- 8.63 years with mean follow-up of 51.71 +/- 20.96 months. Preoperative and postoperative clinical evaluation was performed using the Oswestry Disability Index (ODI) and Visual Analog Scale (VAS) for overall pain. Preoperative and postoperative imaging studies were used to measure the degree of spondylolisthesis and the angle of scoliosis and lumbar lordosis. The presence of preoperative facet joint arthrosis and changes in the diameter of anterior, posterior, and transverse spinal canal were assessed by computed tomography (CT). Preoperative disc degeneration, disk herniation, and spondylolisthesis were examined by magnetic resonance imaging (MRI).

Results: Mean preoperative ODI and VAS scores were 59.2% and 7.06, respectively, while postoperative ODI and VAS scores were 14.4% and 1.7%, respectively (p=0.001). Anteroposterior diameter of the central canal increased from 10.43 +/- 2.18 mm preoperatively to 19.63 +/- 2.01 mm postoperatively (p=0.0001). Mean preoperative and postoperative spondylolisthesis were 5.81 +/- 4.88 mm and 3.87 +/- 4.53 mm, respectively (p=0.0001). Mean preoperative and postoperative scoliosis angles were 5.84 degrees +/- 10.14 degrees and 2.04 degrees +/- 5.08 degrees, respectively (p=0.0002). Mean preoperative and postoperative lordosis angles were 22.47 degrees +/- 13.98 degrees and 33.73 degrees +/- 10.8 degrees, respectively (p=0.0001). Complications included pulmonary embolism in 1 patient (2.2%), superficial injury site infection in 1 patient (2.2%), and deep surgical site infection in 1 patient (2.2%). Two patients (4.4%) experienced dural tears. One patient (2.2%) had intraoperative radix damage.

Conclusion: The results of the present study suggest that the fusion technique via posterior instrumentation, in combination with transverse decompression, offers a clinical improvement in patients with lumbar canal stenosis.

Keywords

Author Keywords

Canal stenosis complication decompression instrumental fusion laminectomy surgical treatment

Surgical Treatment of Mid-Shaft Clavicle Fractures: Plate Fixation and Clinical Outcomes

By

Ozan, F (Ozan, Firat) ; Dogar, F (Dogar, Fatih) ; Altay, T (Altay, Taskin) ; Müjde, S (Mujde, Salih) ; Koyuncu, S (Koyuncu, Semmi) ; Vatansever, F (Vatansever, Fatih) ; Bulut, T (Bulut, Tugrul)

 (provided by Clarivate) 

Source

JOURNAL OF CLINICAL AND ANALYTICAL MEDICINE

Volume

6

Page

792-796

Supplement

6

DOI

10.4328/JCAM.3668

Published

DEC 2015

Indexed

2015-12-01

Document Type

Article

Abstract

In the present study, we assessed the clinical and radiographic results and complications in patients who underwent open reduction and internal fixation using a plate for clavicle fracture. A total of 42 patients were enrolled in the study, including 27 men (64.2%) and 15 women (35.7%). The mean age was 31 years (range, 19-51 years), and the mean follow-up time was 16.2 months (range, 9-26 months). Twenty-three patients (54.7%) had left clavicle fractures, and 19 patients (45.2%) had right clavicle fractures. The mean constant score was 85.2 (range, 65-96) at the end of follow-up. In the post -operative period, implant failure was detected in five patients (11.9%), and implant irritation was detected in two patients (4.74). In patients without implant failure, the mean clavicular length was measured as 164.45 mm (range, 124.78-188.19 mm) on the treated side and 165.82 mm (range, 124.17-189.94 mm) on the intact side after follow-up (p = In patients with implant failure, the mean clavicular length was measured as 161.93 mm (range, 137-172.54 mm) on the treated side and 171.05 mm (range, 149.49-181.72 mm) on the intact side (p = 0.02). We conclude that anatomical restoration using plates in displaced mid -shaft clavicle fractures with loss of cortical contact spares clavicular length and provides better functional outcomes.