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Resumen Presentamos el caso clínico de un paciente que manifestó un anudamiento en la porción distal de una sonda nasogástrica, sin complicaciones, y realizamos una breve revisión de las posibles complicaciones asociadas al uso de este tipo de dispositivos.
Abstract We report the case of a patient who presented a knot in the distal portion of a nasogastric tube, without transcendence, and perform a brief review of the possible complications associated with the use of this type of devices.
Resumo Apresentamos o caso de um paciente que apresentou um nó na porção distal da sonda nasogástrica sem complicações. Realizamos uma breve revisão das possíveis complicações associadas ao uso deste tipo de dispositivos.
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Objective To discuss the clinical effect and safety of the unilateral C2 pedicle screw-plate(C2PSP)combined with contralateral C2 laminar screw-rod(C2LSR)for atlanto-axial joint and occipital cervical fixation.Methods 11 patients were treated by internal fixation with pedicle screw plate system combined with contralateral C2 laminar screw rod system.The cause of atlantoaxial instability was fresh type Ⅱ odontoid fracture in 5 patients,old odontoid fracture in 3 patients,occipitalization mal-formation in 2 patients,atlantoaxial instability in 2 patients.6 patients had small pedicle of the vertebral arch,2 patients had a high-riding vertebral artery(VA),2 patients had an asymmetrical VA,1 patient re-ceived a revision operation.9 patients performed C1-2 fixation,2 patients performed occipito-cervical fixa-tion.1 patient of irreducible atlantoaxial dislocation also performed anterior atlantoaxial joint release before posterior Fixation.All patients performed bone grafting to achieve a further occipito-cervical fusion or at-lantoaxial fusion.Before and after the operation,the neurologic function was scored according JOA scale. The X-ray and CT-scan also performed at regular intervals to evaluate cervical alignment and the fusion. Results All cases were complete reposition without vertebral artery,spinal cord or never root injuried.All patients were followed up for 6-32 months ( mean 16 months ),clinical symptom were improved visibly. The mean postoperative JOA scores was 14.9(13-16).The postoperative JOA score improvement rate was 76%-92%,and its mean value was 83%.All patients achieved bone fusion approved by CT scan after six months of operation.The reduction maintained well and the internal fixation was well positioned.Conclu-sion It will be an effective and safe way to achieve atlantoaxial fusion by posterior unilateral C2 pedicle screwing combined with contralateral C2 laminar screwing,but this study had not including clinical com-parative study.
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PURPOSE: To evaluate the effectiveness of iliosacral screw fixation with anterior plating in the management of an unstable pelvic ring injury. MATERIALS AND METHODS: Nineteen patients with an unstable pelvic ring injury were enrolled in this retrospective study. All patients were followed up for at least 1 year. The mean age of the patients was 43 years. According to the AO-OTA classification, there were five B2 injuries, 11 C1 injuries, and 3 C2 injuries. After anterior fixation by plating, ilio-sacral screw fixation was performed percutaneously under the C-arm guide. RESULTS: All cases united except for 1 case of nonunion at the pubic ramus. The radiology results showed 9, 7, 2 and 1 case of anatomic, nearly anatomic, moderate and poor reduction, respectively. Sixteen out of 19 patients had a good or excellent functional result. Two moderate and one poor result were from an unsatisfactory reduction in a type C injury with the residual neurological signs. Screw misplacement with neurological compromise occurred in one patient but there were no adverse sequelae after its removal. Regarding the complications, there were two cases of screw loosening, two cases of anterior metal failures, and 1 case of a deep infection. CONCLUSION: Percutaneous ilio-sacral screwing with anterior plating may be a useful method for treating unstable pelvic ring injuries, and the reduction quality and neurological signs are important.
Assuntos
Humanos , Classificação , Estudos RetrospectivosRESUMO
STUDY DESIGN: Eighteen patients undergoing bone cement augmentation of pedicular screwing for osteoporotic lumbar spine were reviewed retropectively. OBJECTIVES: To assess the effectiveness of bone cement augmentation of pedicular screwing for osteoporotic lumbar spine. SUMMARY OF LITERATURE REVIEW: For the technical limit obtaining the dynamic stability in the bone-screw interface for osteoporotic lumbar spine, the additional device to enhance pedicular screw fixation strength needs. MATERIALS AND METHODS: We reviewed 18 cases undergoing pedicular screwing and fusion for the osteoporotic (Jikei grade I, II, III/III) lumbar spine from Feb. 2000 to Mar. 2001 with an average follow-up of 1.5 years. Mean age was 69.5 years with 6 male and 12 female. Inclusion criteria was 9 degenerative spinal stenosis, 5 spinal stenosis associated with compression fracture, 2 Kummel's disease, 1 spondylolisthesis and 1 internal disc disruption. We performed bone cement injection around the screws showing significantly low insertion torque, screw pullout or cut-up during surgery. We asssessed the radiographic results of sagittal angle correction (SAC) of the fused segment and disc height restoration (DHR) on the preoperative, postoperative and last follow up lumbar lateral views. Clinical results were evaluated according to the Kumano's criteria. RESULTS: Mean sagittal angle at preoperative, postoperative and last follow-up was 11.6-21.6-19.6 degrees with mean SAC gain 10 degrees (p0.05). Mean disc height of each period was 33.3-49.8-43.5% with mean DHR gain 16.5% (p0.05). The clinical result was analyzed as 14 good, 3 fair and 1 poor. Fusion success was achieved in all. There were 2 perioperative complications of 1 superficial surgical site infection and 1 incomplete L4 root injury, and 6 complications during follow up of 3 compression fractures above fused segment, 1 screw pullout, 1 screw cut-up, and 1 bone cement extrava-sation into canal. CONCLUSIONS: The bone cement augmentation of pedicular screwing for osteoporotic lumbar spine can be an alternative to enhance screw fixation strength.