ABSTRACT
BACKGROUND: Lumbar spine fusion is the mainstay treatment for degenerative spine disease. Multiple potential complications of spinal fusion have been found. Acute contralateral radiculopathy postoperatively has been reported in previous literature, with unclear underlying pathology. Few articles reported the incidence of contralateral iatrogenic foraminal stenosis after lumbar fusion surgery. The aim of current article is to explore the possible causes and prevention of this complication. OBSERVATIONS: The authors present 4 cases in which patients developed acute postoperative contralateral radiculopathy requiring revision surgery. In addition, we present a fourth case in which preventive measures have been applied. The aim of this article was to explore the possible causes and prevention to this complication. LESSONS: Iatrogenic foraminal stenosis of the lumbar spine is a common complication; preoperative evaluation and middle intervertebral cage positioning are needed to prevent this complication.
ABSTRACT
Alkaptonuria is a rare metabolic disorder caused by the deficiency of homogentisic acid oxidase enzyme, which is responsible for eliminating homogentisic acid from the body through the renal system. Excessive accumulation of homogentisic acid leads to ochronosis and ochronotic arthritis. Owing to the rarity of the disease, long-term functional outcomes of joint replacements of the hips and knees in ochronosis arthropathy are unconfirmed, and only a limited number of case reports are available on this. We present a case of a 45-year-old man with ochronosis and advanced osteoarthritis of both the hips and knees. He underwent bilateral hip and knee replacements as staged procedures. At a follow-up of more than 12 years, the man had full mobility with no loosening of implants.
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INTRODUCTION: Femoral neck fracture is a common problem in elderly patients, and it is managed with either total hip arthroplasty or hemiarthroplasty with very good outcomes. However, the reported 1-year mortality rate is as high as 33%. MATERIAL AND METHODS: This study was a retrospective cohort study. The electronic patient records were searched for all physiologically old patients with displaced femoral neck fractures that were managed with either hemiarthroplasty or total hip arthroplasty. The primary aim of this study was to estimate morbidity and mortality rates at 30 days and 1 year. The secondary outcome was to determine major complications and factors influencing mortality. RESULTS: From January 2017 to December 2018, a total of 99 patients were included in the study. Of those, 57 were female patients. The mortality rate was 15.2%. The significant predictors of death included the age at the time of surgery, readmission within 30 days of initial admission, acute renal impairment, and the need for preoperative medical intervention. Patients treated with total hip arthroplasty had lower mortality rates than those treated with hemiarthroplasty (P = .017). DISCUSSION: To the best of our knowledge, this is the first study conducted in Saudi Arabia to report detailed perioperative-related complications and outcomes following neck of femur fractures. The results of our study confirm the persistently high morbidity and mortality associated with this patient group. CONCLUSION: Efforts should be aimed at optimizing preoperative medical management, which is vital to ensure early identification of medically unfit patients.
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Despite the fact that spinal surgeries for adolescent idiopathic scoliosis (AIS) result in good outcomes for most patients, they are not without complications either medically or surgically. Neurologic injury represents the most severe complication and is, as such, the most feared. Further complications include dural tears, peripheral neuropathy, surgical-site infections, implant-related issues, thromboembolic events, visual loss, pseudarthrosis, Crankshaft phenomenon, flatback phenomenon, proximal junctional kyphosis, and mortality. It is vital that all spine surgeons to be fully conversant with the possible complications and the proper responses for each of them.
ABSTRACT
Anthropometric measurements and proportions of the female body play a significant role in plastic and reconstructive surgery. This study is aimed to identify the descriptive measurements of the breast in a sample population of young nulliparous Saudi women. METHODS: Fifty-four nulliparous Saudi women of 20-25 years old, with no physical or developmental deformity, and body mass index (BMI) of 20-25 kg/m2 were recruited. The following parameters were measured: body weight, height, BMI, sternal notch-nipple length for each breast (SN), internipple distance (IND), distance from nipple to inframammary fold (IMF), distance from edge of areola to the IMF, and areolar diameter (AD). RESULTS: The mean values of age, BMI, height, and weight of the participants were 22.1 ± 1.2 years, 21.8 ± 3.1 kg/m2, 162.1 ± 5 cm, and 57.4 ± 8.6 kg, respectively. The mean values of the breast parameters were 19.8, 20.3, 7.7, 5.4, and 4.5 cm for SN, IND, distance from nipple to IMF, distance from lower end of the areola to IMF, and AD, respectively. Statistically significant difference was found only in the distance from edge of areola to IMF between the right and left breasts, with the parameter significantly higher in the left breast (P < 0.05, n = 54). A positive correlation between weight and BMI was found in SN, IND, distance from nipple to IMF, and AD. CONCLUSION: These study results will be useful for the comparison of anthropometric breast values of young Saudi women with those of women from other nationalities.
