Pub Date : 2021-12-31DOI: 10.47363/jsar/2021(2)135
C. Hmidi, A. Khairi, S. Mazouz, N. Gharib, A. Abbassi
{"title":"Surgical Treatment of Rhinophyma : About a Case and Literature Review","authors":"C. Hmidi, A. Khairi, S. Mazouz, N. Gharib, A. Abbassi","doi":"10.47363/jsar/2021(2)135","DOIUrl":"https://doi.org/10.47363/jsar/2021(2)135","url":null,"abstract":"","PeriodicalId":198093,"journal":{"name":"Journal of Surgery & Anesthesia Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115074761","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-09-30DOI: 10.47363/jsar/2021(2)130
S. Kumari
Traumatic diaphragmatic injury (TDI) is a fairly uncommon with incidence of 0.8 and 1.6 %, commonest fallowing blunt trauma abdomen. Right-side have higher mortality rate compared to left side and penetrating injuries. It present as occult to obvious. Laparoscopy offers diagnostic and therapeutic tool of care. Lack of awareness of the condition may delay in diagnosis, results life threatening complications. Missed hernia is a known complication of blunt trauma as acute diagnosis can be difficult to ascertain. An early diagnosis and treatment lead to better outcome. In present study CECT revealed acute diaphragmatic hernia, bilateral pleural effusion and hair line fracture of right tibia on skiagram limb. Because of uncertainty in diagnosis of acute diaphragmatic hernia or rupture surgeons faces challenges for the management, high suspicion index required to diagnose the cases. An early diagnosis and treatment lead to better outcome
{"title":"Traumatic Diaphragmatic Hernia: Management and Review","authors":"S. Kumari","doi":"10.47363/jsar/2021(2)130","DOIUrl":"https://doi.org/10.47363/jsar/2021(2)130","url":null,"abstract":"Traumatic diaphragmatic injury (TDI) is a fairly uncommon with incidence of 0.8 and 1.6 %, commonest fallowing blunt trauma abdomen. Right-side have higher mortality rate compared to left side and penetrating injuries. It present as occult to obvious. Laparoscopy offers diagnostic and therapeutic tool of care. Lack of awareness of the condition may delay in diagnosis, results life threatening complications. Missed hernia is a known complication of blunt trauma as acute diagnosis can be difficult to ascertain. An early diagnosis and treatment lead to better outcome. In present study CECT revealed acute diaphragmatic hernia, bilateral pleural effusion and hair line fracture of right tibia on skiagram limb. Because of uncertainty in diagnosis of acute diaphragmatic hernia or rupture surgeons faces challenges for the management, high suspicion index required to diagnose the cases. An early diagnosis and treatment lead to better outcome","PeriodicalId":198093,"journal":{"name":"Journal of Surgery & Anesthesia Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133150519","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-09-30DOI: 10.47363/jsar/2021(2)132
M. Haridas, Venkata Jaya Divya Tenneti, Divya Poduri
Anal necrosis is an extremely rare and uncommon disease. It has a rich collateral blood supply. The most common etiology of anal necrosis in the elderly is ischemic secondary to atherosclerosis but anal necrosis in young with no predisposing factor is infrequent thus impeling the authors to write a report. A young middle aged male presented to our emergency department with pain and foul smelling discharge from the anal canal. There was prior history of anal fistula and a recent treatment with herbal medication. The patient underwent computed tomography and magnetic resonance imaging confirming anal canal necrosis with infection. The patient was in septic shock. Antibiotics and supportive volume resuscitation was carried out for managing sepsis. He also underwent prompt debridement with defunctioning loop colostomy. Early reconstruction of the anal canal spinchters and flap construction of the skin and subcutaneous tissue was done to prevent loss of anal canal spinchters control and further morbidity.
{"title":"Anal Necrosis - A Rare Entity Following Treatment with Herbal Supplements and Herbal Injections","authors":"M. Haridas, Venkata Jaya Divya Tenneti, Divya Poduri","doi":"10.47363/jsar/2021(2)132","DOIUrl":"https://doi.org/10.47363/jsar/2021(2)132","url":null,"abstract":"Anal necrosis is an extremely rare and uncommon disease. It has a rich collateral blood supply. The most common etiology of anal necrosis in the elderly is ischemic secondary to atherosclerosis but anal necrosis in young with no predisposing factor is infrequent thus impeling the authors to write a report. A young middle aged male presented to our emergency department with pain and foul smelling discharge from the anal canal. There was prior history of anal fistula and a recent treatment with herbal medication. The patient underwent computed tomography and magnetic resonance imaging confirming anal canal necrosis with infection. The patient was in septic shock. Antibiotics and supportive volume resuscitation was carried out for managing sepsis. He also underwent prompt debridement with defunctioning loop colostomy. Early reconstruction of the anal canal spinchters and flap construction of the skin and subcutaneous tissue was done to prevent loss of anal canal spinchters control and further morbidity.","PeriodicalId":198093,"journal":{"name":"Journal of Surgery & Anesthesia Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124089488","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-09-30DOI: 10.47363/jsar/2021(2)133
M. Haridas, Venkata Jaya Divya Tenneti
{"title":"Repair of Large Lateral Abdominal Wall Defect Post Resection of Abdominal Wall Sarcoma: A Paradigm","authors":"M. Haridas, Venkata Jaya Divya Tenneti","doi":"10.47363/jsar/2021(2)133","DOIUrl":"https://doi.org/10.47363/jsar/2021(2)133","url":null,"abstract":"","PeriodicalId":198093,"journal":{"name":"Journal of Surgery & Anesthesia Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116599624","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Juvenile polyps (JP) are rare but important causes of acute gastrointestinal symptoms in children. They are a recognized cause of painless rectal bleeding in preschool age children and also the most common intraluminal disorder of the colon in children They are often solitary, pedunculated and small in size but may occasionally grow to large sizes or occur in great numbers, as in juvenile polyposis syndrome. Histologically juvenile polyps are similar to inflammatory polyps with irregular dilated glands, lamina propria expansion and granulation tissue expansion. Sporadic juvenile polyps of the colon occur in up to 2 percent of children under the age of 10 years, are usually solitary, and are not associated with an increased cancer risk. The etiology, diagnosis, clinical presentation, and management of these intestinal polyps depend on the type of polyp or polyposis syndrome. A change in bowel habits, abdominal pain, rectal bleeding, rectal prolapse, and even intussusception may be the initial presentation in children. In addition to a careful history, including a detailed family history, a physical examination, contrast studies, and endoscopic examination are vital diagnostic tools. Juvenile polyps may also present with prolapse of the polyp from the anus, abdominal pain due to intussusception or may even be asymptomatic. All such polyps should be removed by colonoscopy or transanal resection
{"title":"Solitary Juvenile Polyp at a Rural Ugandan Hospital Presenting with Recurrent Rectal Bleeding","authors":"Gideon Kurigamba, V. Akello, Asaph Owamukama, Irene Nanyanga, Racheal J Ayikoru","doi":"10.47363/jsar/2021(2)134","DOIUrl":"https://doi.org/10.47363/jsar/2021(2)134","url":null,"abstract":"Juvenile polyps (JP) are rare but important causes of acute gastrointestinal symptoms in children. They are a recognized cause of painless rectal bleeding in preschool age children and also the most common intraluminal disorder of the colon in children They are often solitary, pedunculated and small in size but may occasionally grow to large sizes or occur in great numbers, as in juvenile polyposis syndrome. Histologically juvenile polyps are similar to inflammatory polyps with irregular dilated glands, lamina propria expansion and granulation tissue expansion. Sporadic juvenile polyps of the colon occur in up to 2 percent of children under the age of 10 years, are usually solitary, and are not associated with an increased cancer risk. The etiology, diagnosis, clinical presentation, and management of these intestinal polyps depend on the type of polyp or polyposis syndrome. A change in bowel habits, abdominal pain, rectal bleeding, rectal prolapse, and even intussusception may be the initial presentation in children. In addition to a careful history, including a detailed family history, a physical examination, contrast studies, and endoscopic examination are vital diagnostic tools. Juvenile polyps may also present with prolapse of the polyp from the anus, abdominal pain due to intussusception or may even be asymptomatic. All such polyps should be removed by colonoscopy or transanal resection","PeriodicalId":198093,"journal":{"name":"Journal of Surgery & Anesthesia Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133597214","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-09-30DOI: 10.47363/jsar/2021(2)129
Gargadi S I, R. Seljul, Ogunjobi Allen A
Introduction: Albumin is a single polypeptide chain of 585 amino acids synthesized by the liver which accounts for 75-80% Osmotic pressure. Hypo albuminemia in burns occurs due to loss from damage tissues, reduction in hepatic blood and due to inhibitory tissue factor such as Necrotic tissue factor, interleukin 1 and 6 released at burn sites. Method: The information about the 73 patients in our study was from our unit records and the hospital records. We Used the Cobas C III system, colorimetric assay method to carry out the serum albumin and total protein investigations. Result: We had 11 burn mortality out of the 73 patients, and based on the serum albumin at the time of death, those with serum albumin of < 25g/L have burn mortality sensitivity of 90.9% and specificity of 83.3%. Discussion: Amongst all the prognostic factors we evaluated such as type, size of burns, age of patients, inhalational injury, co-morbid factors, we found that serum albumin of < 25g/L to be a more useful prognostic factor in burn mortality. Conclusion: We used serum albumin of < 25g/L in our patients to prognosticate burn mortality and to use this knowledge to optimize their serum albumin to avert death.
{"title":"Low Serum Albumin is A Significant Prognostic Factor in Burn Mortality; A Retrospective Study from January 2016 – November 2020 in Buth Jos Nigeria","authors":"Gargadi S I, R. Seljul, Ogunjobi Allen A","doi":"10.47363/jsar/2021(2)129","DOIUrl":"https://doi.org/10.47363/jsar/2021(2)129","url":null,"abstract":"Introduction: Albumin is a single polypeptide chain of 585 amino acids synthesized by the liver which accounts for 75-80% Osmotic pressure. Hypo albuminemia in burns occurs due to loss from damage tissues, reduction in hepatic blood and due to inhibitory tissue factor such as Necrotic tissue factor, interleukin 1 and 6 released at burn sites. Method: The information about the 73 patients in our study was from our unit records and the hospital records. We Used the Cobas C III system, colorimetric assay method to carry out the serum albumin and total protein investigations. Result: We had 11 burn mortality out of the 73 patients, and based on the serum albumin at the time of death, those with serum albumin of < 25g/L have burn mortality sensitivity of 90.9% and specificity of 83.3%. Discussion: Amongst all the prognostic factors we evaluated such as type, size of burns, age of patients, inhalational injury, co-morbid factors, we found that serum albumin of < 25g/L to be a more useful prognostic factor in burn mortality. Conclusion: We used serum albumin of < 25g/L in our patients to prognosticate burn mortality and to use this knowledge to optimize their serum albumin to avert death.","PeriodicalId":198093,"journal":{"name":"Journal of Surgery & Anesthesia Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124279335","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-09-30DOI: 10.47363/jsar/2021(2)128
Barrett S. Boody, Jad Khalil Khalil, Betsy H. Grunch, Michael J. Musacchio, Amir Vokshoor, R. Wilson, R. Sasso
Anterior cervical discectomy and fusion (ACDF) has been widely utilized as the workhorse approach for the surgical treatment of cervical degenerative pathology. Minimal high-level evidence data exists on the efficacy and safety of integrated cage-screw implants. A prospective, non-randomized clinical study utilizing STALIF C-Ti® integrated cage-screw implants was performed in 145 patients. 12-month outcome scores demonstrated significant improvements in all patient reported outcome scores collected (p<0.05 for all), including NDI, VAS neck, VAS left arm, and VAS right arm. Patients receiving STALIF C-Ti integrated cage-screw implants demonstrated significant improvements in clinical outcome scores with minimal overall complication rate
{"title":"Preliminary 12-Month Safety and Efficacy Outcomes for the Treatment of Cervical Radiculopathy and Myelopathy with the Stalif-C Integrated Interbody Fusion Device","authors":"Barrett S. Boody, Jad Khalil Khalil, Betsy H. Grunch, Michael J. Musacchio, Amir Vokshoor, R. Wilson, R. Sasso","doi":"10.47363/jsar/2021(2)128","DOIUrl":"https://doi.org/10.47363/jsar/2021(2)128","url":null,"abstract":"Anterior cervical discectomy and fusion (ACDF) has been widely utilized as the workhorse approach for the surgical treatment of cervical degenerative pathology. Minimal high-level evidence data exists on the efficacy and safety of integrated cage-screw implants. A prospective, non-randomized clinical study utilizing STALIF C-Ti® integrated cage-screw implants was performed in 145 patients. 12-month outcome scores demonstrated significant improvements in all patient reported outcome scores collected (p<0.05 for all), including NDI, VAS neck, VAS left arm, and VAS right arm. Patients receiving STALIF C-Ti integrated cage-screw implants demonstrated significant improvements in clinical outcome scores with minimal overall complication rate","PeriodicalId":198093,"journal":{"name":"Journal of Surgery & Anesthesia Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122579158","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-09-30DOI: 10.47363/jsar/2021(2)131
W. Rahman, Habibullah Sarkar, S. K. Talukder, J. Abedin, P. K. Ghosh
Introduction: Dog bites in humans are a major public health problem. Globally, millions of people are bitten by dogs but most of the fatal cases occur in children. Dog bites in human are a serious public health problem and have been well documented worldwide. As rabies is not a notifiable disease in Bangladesh and most deaths occur in rural areas where surveillance is poor. Objectives: To determine the pattern of dog bite injuries and associated health problems among children. Methods: The study was an observational retrospective study carried out at the Dept. of General Surgery, Chuadanga Sadar Hospital, Chuadanga, Bangladesh. The study reviewed the clinical data of patients managed for dog bite related injuries and rabies over a four and half year period between January 2016 and June 2020. A proforma was designed to extract relevant clinical data from the case records. Information extracted included the age, sex of the victims, site of the bite, time of presentation in the hospital, pre-hospital treatment, hospital treatment including post-exposure prophylaxis and complication. Results: In all, 200 cases of dog bite injuries were managed constituting 0.89% of the total consultations; 5 (2.5%) had rabies. Most of the victims were aged 6-12 years (55.0%) and majority (67.0%) was boys. Eighty two percent of the victims presented within 24hrs of the injury. 92 (46.0%) had WHO grade 3 dog bite injury at presentation and the lower limb was the commonest (56.0%) bite site. Use of herbal preparation was the most common pre-hospital treatment 60%. Although 95.0% received anti-rabies vaccine, only 55.5% of them completed the vaccination schedule. The case fatality rate for dog bite was 5.0%. The 5 that died all presented late, had no post exposure prophylaxis and died within 24 hours of admission. Conclusion: There is need for public enlightenment on dangers associated with dog bites and also for the government to ensure vaccination for cost of post exposure prophylaxis treatment for children free of cost
{"title":"Pattern and Outcome of Dog Bite Injuries among Children-a Study in 200 Cases","authors":"W. Rahman, Habibullah Sarkar, S. K. Talukder, J. Abedin, P. K. Ghosh","doi":"10.47363/jsar/2021(2)131","DOIUrl":"https://doi.org/10.47363/jsar/2021(2)131","url":null,"abstract":"Introduction: Dog bites in humans are a major public health problem. Globally, millions of people are bitten by dogs but most of the fatal cases occur in children. Dog bites in human are a serious public health problem and have been well documented worldwide. As rabies is not a notifiable disease in Bangladesh and most deaths occur in rural areas where surveillance is poor. Objectives: To determine the pattern of dog bite injuries and associated health problems among children. Methods: The study was an observational retrospective study carried out at the Dept. of General Surgery, Chuadanga Sadar Hospital, Chuadanga, Bangladesh. The study reviewed the clinical data of patients managed for dog bite related injuries and rabies over a four and half year period between January 2016 and June 2020. A proforma was designed to extract relevant clinical data from the case records. Information extracted included the age, sex of the victims, site of the bite, time of presentation in the hospital, pre-hospital treatment, hospital treatment including post-exposure prophylaxis and complication. Results: In all, 200 cases of dog bite injuries were managed constituting 0.89% of the total consultations; 5 (2.5%) had rabies. Most of the victims were aged 6-12 years (55.0%) and majority (67.0%) was boys. Eighty two percent of the victims presented within 24hrs of the injury. 92 (46.0%) had WHO grade 3 dog bite injury at presentation and the lower limb was the commonest (56.0%) bite site. Use of herbal preparation was the most common pre-hospital treatment 60%. Although 95.0% received anti-rabies vaccine, only 55.5% of them completed the vaccination schedule. The case fatality rate for dog bite was 5.0%. The 5 that died all presented late, had no post exposure prophylaxis and died within 24 hours of admission. Conclusion: There is need for public enlightenment on dangers associated with dog bites and also for the government to ensure vaccination for cost of post exposure prophylaxis treatment for children free of cost","PeriodicalId":198093,"journal":{"name":"Journal of Surgery & Anesthesia Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125203318","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-06-30DOI: 10.47363/jsar/2021(2)127
Mohamed Ali Gliti, Houda Boudinar, S. Nitassi, Bencheikh Razika, B. Anas, A. Oujilal, L. Houssyni
Tuberculosis is an infectious disease; it has a variable degree of presentation, most often pulmonary while the extrapulmonary location is dominated by lymph node involvement, especially cervical. On the other hand, herpes zoster results from the reactivation of the virus that causes varicella. Here, we report the case of cervicofacial herpes zoster complicating ganglion-pulmonary tuberculosis in a 19-year-old female patient with a history of varicella during childhood, who presents bilateral lymphadenopathy, the diagnosis of pulmonary and lymph node tuberculosis is confirmed by histology, she has treated with anti-tuberculosis drugs and the evolution was marked by the presence of lymphadenopathy and the appearance of cervicofacial herpes zoster
{"title":"Cervicofacial Herpes Zoster Complicating Ganglion-Pulmonary Tuberculosis: Case Report and Review of the Literature: A Case Report","authors":"Mohamed Ali Gliti, Houda Boudinar, S. Nitassi, Bencheikh Razika, B. Anas, A. Oujilal, L. Houssyni","doi":"10.47363/jsar/2021(2)127","DOIUrl":"https://doi.org/10.47363/jsar/2021(2)127","url":null,"abstract":"Tuberculosis is an infectious disease; it has a variable degree of presentation, most often pulmonary while the extrapulmonary location is dominated by lymph node involvement, especially cervical. On the other hand, herpes zoster results from the reactivation of the virus that causes varicella. Here, we report the case of cervicofacial herpes zoster complicating ganglion-pulmonary tuberculosis in a 19-year-old female patient with a history of varicella during childhood, who presents bilateral lymphadenopathy, the diagnosis of pulmonary and lymph node tuberculosis is confirmed by histology, she has treated with anti-tuberculosis drugs and the evolution was marked by the presence of lymphadenopathy and the appearance of cervicofacial herpes zoster","PeriodicalId":198093,"journal":{"name":"Journal of Surgery & Anesthesia Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125737422","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-06-30DOI: 10.47363/jsar/2021(2)126
Ben J. Garrido, Cristian Balcescu, Jesse Caballero, Michael J H McCarthy, Barrett S. Boody, R. Sasso
Background Context: Inflammatory arthritis of the cervical spine is common and begins early after the onset of rheumatoid arthritis. Atlantoaxial instability is the most common pattern followed by cranial settling or basilar invagination, with subaxial subluxation being least common. Vertical migration of the odontoid (basilar invagination) poses an increased risk of sudden death from compression of the brain stem. A combination of transoral decompression and posterior occipitocervical fusion has been described, although a single posterior approach stabilization may suffice and avoid the associated comorbidities with an anterior/posterior surgery in a high-risk rheumatoid patient. Purpose: To report a case of odontoid resorption and cervicomedullary angle improvement after occipitocervical fusion. Study Design: A retrospective case report. Methods: Radiographic analysis. Results: After posterior occipitocervical fusion alone for basilar invagination there was a reduction of cervicomedullary angle to 127 degrees at 3 years follow up. This was improved from an initial 115 degrees through odontoid remodeling. Conclusions: Basilar invagination treated with posterior alone occipitocervical stabilization may suffice in providing stability and long term decompression of the cervicomedullary junction through resorption and remodeling of the odontoid. This case study supports the viability of avoiding a transoral resection for an irreducible severely migrated odontoid.
{"title":"Odontoid Resorption After Posterior Occipitocervical Fusion in Rheumatoid Basilar Invagination","authors":"Ben J. Garrido, Cristian Balcescu, Jesse Caballero, Michael J H McCarthy, Barrett S. Boody, R. Sasso","doi":"10.47363/jsar/2021(2)126","DOIUrl":"https://doi.org/10.47363/jsar/2021(2)126","url":null,"abstract":"Background Context: Inflammatory arthritis of the cervical spine is common and begins early after the onset of rheumatoid arthritis. Atlantoaxial instability is the most common pattern followed by cranial settling or basilar invagination, with subaxial subluxation being least common. Vertical migration of the odontoid (basilar invagination) poses an increased risk of sudden death from compression of the brain stem. A combination of transoral decompression and posterior occipitocervical fusion has been described, although a single posterior approach stabilization may suffice and avoid the associated comorbidities with an anterior/posterior surgery in a high-risk rheumatoid patient. Purpose: To report a case of odontoid resorption and cervicomedullary angle improvement after occipitocervical fusion. Study Design: A retrospective case report. Methods: Radiographic analysis. Results: After posterior occipitocervical fusion alone for basilar invagination there was a reduction of cervicomedullary angle to 127 degrees at 3 years follow up. This was improved from an initial 115 degrees through odontoid remodeling. Conclusions: Basilar invagination treated with posterior alone occipitocervical stabilization may suffice in providing stability and long term decompression of the cervicomedullary junction through resorption and remodeling of the odontoid. This case study supports the viability of avoiding a transoral resection for an irreducible severely migrated odontoid.","PeriodicalId":198093,"journal":{"name":"Journal of Surgery & Anesthesia Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130624148","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：