ABSTRACT
AIM: The intention of this retrospective analysis with follow-up was to assess results after decompressive or additional stabilising operations in the clinical setting of degenerative lumbar spinal stenosis. METHOD: 74 patients, operated upon from 1995 to 2001, were investigated clinically, radiologically and with questionnaire score 1 to 8 years (mean 2.5) postoperatively. All data were compared and evaluated with the preoperative findings. The results of the group with decompressive operations were compared with those for the group with additional stabilising operations. RESULTS: The patients with stabilising operations showed an improvement of 78.3% on the visual analogue scale and of 76.1% on the Oswestry score. The patients with decompressive operations showed an improvement of 91.7% on the visual analogue scale and of 75.0% on the Oswestry score. The difference between the two groups was not significant. There was a poorer outcome for previously operated patients or patients with a prolonged course of disease. CONCLUSION: The choice of the operative treatment with regard to spinal stenosis requires a differentiated preoperative diagnostic procedure in accord with the respective living situation and age of the patients. Instability in terms of degenerative spondylolisthesis, lumbar scoliosis as well as intraoperatively recognised or generated instability has to be additionally stabilised with an instrumented fusion in regard to the functional aspect of the stenosis.
Subject(s)
Decompression, Surgical , Lumbar Vertebrae/surgery , Postoperative Complications/etiology , Spinal Cord Compression/surgery , Spinal Fusion , Spinal Osteophytosis/surgery , Spinal Stenosis/surgery , Adult , Aged , Combined Modality Therapy , Female , Humans , Lumbar Vertebrae/pathology , Magnetic Resonance Imaging , Male , Middle Aged , Pain Measurement , Postoperative Complications/diagnosis , Reoperation , Retrospective Studies , Spinal Cord Compression/diagnosis , Spinal Osteophytosis/diagnosis , Spinal Stenosis/diagnosis , Tomography, X-Ray ComputedSubject(s)
Diskectomy, Percutaneous , Diskectomy , Intervertebral Disc Displacement/surgery , Lumbar Vertebrae/surgery , Microsurgery , Postoperative Complications/etiology , Adult , Female , Humans , Intervertebral Disc Displacement/diagnosis , Magnetic Resonance Imaging , Male , Middle Aged , Neurologic Examination , Outcome and Process Assessment, Health Care , Postoperative Complications/diagnosis , Retrospective Studies , Spinal Cord Compression/diagnosis , Spinal Cord Compression/surgeryABSTRACT
A case report demonstrates the complication of pericardial tamponade during the installation of a central venous catheter via the subclavian vein. To reduce the high mortality of this rare complication, quickly applicable diagnostic measures and adequate therapy of pericardiocentesis are indicated. Prompt recognition and treatment of pericardial tamponade are imperative if a disastrous outcome is to be prevented.
