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Background@#Rotator cuff tears cause pathologies of the long head of the biceps tendon (LHBT). One of the surgical treatments for such a tear is LHBT tenodesis to the humerus. This study aims to compare simultaneous rotator cuff repair and LHBT tenodesis with or without detachment of the proximal end of the LHBT (PELHBT) from its site of adhesion to the glenoid. @*Methods@#This retrospective study involved patients affected by LHBT pathology with rotator cuff tear. The patients were divided into two groups, with or without PELHBT detachment from the glenoid. Therapeutic outcomes were investigated by evaluation of patient satisfaction, pain based on visual analog scale, shoulder function based on Constant score and simple shoulder test, and biceps muscle strength based on the manual muscle testing grading system before surgery, at 6 months, and at the final visit after surgery. @*Results@#Groups 1 and 2 comprised 23 and 26 patients, respectively, who showed no significant differences in demographic characteristics (p>0.05). Shoulder function, biceps muscle strength, pain, and satisfaction rate improved over time (p0.05). No post-surgical complication was found in either group. @*Conclusions@#There was no difference in final outcomes of tenodesis with or without detachment of the PELHBT from the supraglenoid tubercle. Such tendon detachment is not necessary.
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Background@#Several therapeutic methods have been proposed for frozen shoulder syndrome. These include suprascapular nerve block, a simple and cost-effective technique that eliminates the need for nonsteroidal anti-inflammatory drug therapy. @*Methods@#This was a clinical trial that included patients with unilateral shoulder joint stiffness. Patients were divided into three groups: those treated with isolated physiotherapy for 12 weeks (PT group), those treated with a single dose intra-articular injection of corticosteroid together with physiotherapy (IACI group), and those treated with a suprascapular nerve block performed with a single indirect injection of 8-mL lidocaine HCL 1% and 2 mL (80 mg) methylprednisolone acetate together with physiotherapy (SSNB group). The variables assessed were age, sex, side of involvement, dominant limb, presence of diabetes, physical examination findings including erythema, swelling, and muscle wasting; palpation and movement findings; shoulder pain and disability index (SPADI) score; and the visual analog scale (VAS) score pre-intervention and at 2-, 4-, 6-, and 12-week post-intervention. @*Results@#Ninety-seven patients were included in this survey (34 cases in the PT group, 32 cases in the IACI group, and 31 cases in the SSNB group). Mean age was 48.55±11.06 years. Fifty-seven cases were female (58.8%) and 40 were male (41.2%). Sixty-eight patients had a history of diabetes (70.1%). VAS and SPADI scores and range of mototion degrees dramatically improved in all cases (p<0.001). Results were best in the SSNB group (p<0.001), and the IACI group showed better results than the PT group (p<0.001). @*Conclusions@#Suprascapular nerve block is an effective therapy with long-term pain relief and increased mobility of the shoulder joint in patients with adhesive capsulitis.
ABSTRACT
Background and Aim: the purpose of this study was to evaluate and compare the pain of patients with spondylolisthesis who had undergone either of the surgery techniques: posterolateral fusion [PLF] or posterior lumbar interbody fusion [PLIF]
Methods and Materials/Patients: in a prospective observational study, 102 surgical candidates with low grade degenerative and isthmic spondylolisthesis were enrolled from 2012 to 2014. The observed patients were into two groups: PLF and PLIF. Assessing of pain has been done by a questionnaire using Visual Analogue Scale [VAS] scores. The questionnaire was completed by all patients before surgery, the day after surgery, after six months and after one year
Results: there were no statistically significant differences in terms of age and sex distribution, type of spondylolisthesis and pre-operation pain between groups [p>0.05]. Comparison of the mean VAS scores of two groups over the whole study period showed a significant statistical difference [p-value<0.05], although comparison of VAS at three points in time showed a mixed result. VAS scores showed no significant differences between two groups before surgery, the day after surgery and one year after surgery [p>0.05], but the difference of mean VAS scores between groups 6 months after surgery was statistically significant [p<0.05]. Analyzing the course of VAS scores over the study period showed a descending pattern for either of the groups [p<0.0001]
Conclusion: both surgical fusion techniques [PLF and PLIF] showed to be effective in treating low grade degenerative and isthmic spondylolisthesis, but PLIF was related to better outcome with respect to pain control
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Background and Aim: spondylolisthesis is a visible deformity in lumbosacral region with vertebral slip and fracture or other deformities of pars interarticularis. This study aims at investigating the characteristics of spondylolisthesis surgery in operated patients
Methods and Materials/Patients: this is a retrospective study which included all the patients who had undergone spondylolisthesis surgery by one same surgeon from 2006 to 2011. Demographic characteristics such as age, gender, and surgery information including type of spondylolisthesis, incision site, laminectomy site, foraminotomy site, fixation site of vertebra and site of vertebral disc evacuation were collected. The data were analyzed using SPSS [Version16]
Results: 52 of 63 enrolled patients were women [82.5%] and 11 men [17.5%] with mean age of 49.6 years. Based on frequency, spondylolisthesis types were 60 degenerative [95.2%], 2 post-surgical [3.2%] and 1 post-traumatic [1.6%], respectively. 58 patients had spondylolisthesis only in one vertebra and 5 patients in two vertebrae. The total number of slipped vertebrae was 68, in which slip was seen in L3, L4 or L5 vertebrae. In 42 patients, laminectomy was performed only in one vertebra, in 19 patients in two vertebrae, in 1 patient in three vertebrae and in 1 patient in five vertebrae. The total number of vertebrae with foraminotomy was 106. The highest frequency of foraminotomy was seen in L5, L4, and S1 vertebrae, respectively. Except in one case, the rest 62 patients underwent fixation surgery in two or three vertebrae
Conclusion: based on the results, the frequency of spondylolisthesis was approximately five times in women compared to men. The most common type was degenerative spondylolisthesis. Type of surgery was fixation with pedicle screw and fusion
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Background and Aim: traumatic subdural hygroma is the accumulation of CSF [cerebrospinal fluid] in subdural space following head trauma. The mass effect of hygroma on brain can impinge on consciousness. There are still many ambiguities on indications of hygroma surgery. This is an 11-year follow-up study which involves the patients suffering traumatic subdural hygroma who underwent surgery
Methods and Materials/Patients: in this retrospective study, clinical records of 16 patients who were operated due to traumatic subdural hygroma were studied. The data from existing records in the hospital were collected and analyzed. They were then analyzed by Repeated Measures ANOVA using SPSS [Version 18]. The differences were considered statistically significant at P
Results: in this study, there were 13 men [81.3%] and 3 women [18.7%] [Mean age=62 years old]. In 87.75% of patients, hygroma was diagnosed 6 days after head injury. It wasunilateral in majority of patients [56.3%] and located in fronto-parietal area [81.3%]. The most frequent concomitant injuries were contusions [25%] and subarachnoid hemorrhage [18.8%], respectively. GCS trend on admission and at discharge was significantly different fromthat of hygroma formation [P<0.05]. One-fourth of patients had recurrence of hygroma after surgery. All patients [except one] had good outcome
Conclusion: subdural hygroma is a delayed lesion and surgical treatment improves the level of consciousness [LOC] in afflicted patients
ABSTRACT
The main question of this study is that why some patients with traumatic brain injury [TBI], suffer mental disorders even after recovery from physical problems, while others with some similar characteristics do not receive the diagnosis of any mental disorders. In this study which was performed from March to February 2010 in the Poursina Medical and Educational Center of Rasht city overall, 238 patients [43 females and 195 males] with TBI in the form of a descriptive-longitudinal study, were chosen by non-random, consecutive sampling. Each patient was evaluated by Glasgow coma scale, Glasgow outcome scale,Wechsler adult intelligence scale-revised [WAIS-R]vocabulary and picture completion subtests, Mini-Mental State Examination and General health questionnaire. After 4 months of follow-up, 65.1% [155 cases] of patients were referred to a psychiatrist to determine the nature of mental disorder due to TBI, using check list for structured clinical interview based on diagnostic and statistical manual for mental disorders-IV [DSM-IV] diagnostic criteria. The results showed that two group of patients [with and without mental disorders] were significantly different in variables such as level of consciousness [P<0.001], duration of loss of consciousness [P<0.003], duration of confined inintensive care unit [P<0.005], length of hospitalization [P<0.013] and levels of General compatibility after the trauma [P<0.0001] 4 months after TBI. Planning effective interventions, inclusion in the neurobehavioral rehabilitation processes following TBI and also monitoring and evaluation of these patients at least four months after trauma can reduce the risk of mental disorders