ABSTRACT
OBJECTIVE: In the treatment of degenerative lumbar stenosis, facet-sparing laminectomy with instrumented fusion (FSL) was recently almost totally replaced by less invasive, allegedly equally effective surgical techniques. We performed a long-term comparison between outcomes after Young laminoplasty (YL) as a representative of the less invasive technique and FSL. METHODS: From December 4, 2000, to March 11, 2005, 56 patients with a history of neurogenic claudication and radiologically verified absolute lumbar stenosis were surgically treated. After applying inclusion and exclusion criteria, 44 patients were enrolled. RESULTS: Using the Oswestry Disability Index scale, significant improvement on 1-year and 8-year follow-up examinations was noticed in the FSL and YL groups. The Oswestry Disability Index was significantly better in the FSL group compared with the YL group at the 8-year follow-up (27.82 ± 1.918 vs. 40.74 ± 2.163). CONCLUSIONS: FSL is a more invasive and more expensive surgical technique than YL. In a short-term and long-term follow-up comparison, FSL is a more successful operative technique, and the difference increases over time in favor of FSL.
Subject(s)
Intervertebral Disc Degeneration/surgery , Laminectomy , Laminoplasty , Spinal Fusion , Spinal Stenosis/surgery , Aged , Disability Evaluation , Female , Follow-Up Studies , Humans , Intervertebral Disc Degeneration/diagnostic imaging , Intervertebral Disc Degeneration/pathology , Laminectomy/methods , Male , Middle Aged , Minimally Invasive Surgical Procedures , Spinal Fusion/methods , Spinal Stenosis/diagnostic imaging , Spinal Stenosis/pathology , Time Factors , Treatment OutcomeABSTRACT
Awake brain surgery has been approved as a safe and efficaceous operative procedure with the goal of maximal tumor resection and preservation of neurological function. This case report presents the first full awake primary brain tumor surgical procedure performed in Croatia.
Subject(s)
Brain Neoplasms/surgery , Monitoring, Intraoperative , Wakefulness , Craniotomy , Croatia , Evoked Potentials, Somatosensory , Humans , Male , Middle AgedABSTRACT
The matrix metalloproteinases (MMPs) comprise a family of zinc-dependent endopeptidases that are secreted as inactive precursors, which are activated by cleavage of an N-terminal pro-peptide. Their basic mechanisms of action include cancer cell growth, differentiation, apoptosis, migration and invasion, and the regulation of tumour angiogenesis and immune surveillance. The expression of MMP2 and MMP9 has been associated with high potential of metastasis in several human carcinomas including breast cancer. The 29 female patients, 9 premenopausal and 20 postmenopausal, aged from 37 to 79 years were included in this study. Tissue samples were examined in 29 primary and 48 recurrent carcinomas using the tissue microarrays which included 102 cores of primary breast carcinomas and 96 of recurrent breast carcinomas. Immunohistochemistry determined a pattern of expression for MMP9. The staining was diffuse cytoplasmic, strong, moderate, faint/weak and negative. The majority of the breast carcinomas stained homogenously for MMP9 on tumor cells. Statistically significant correlation was found for the expression of MMP9 between primary and recurrent breast carcinomas in general (p < 0.001) and in tumors that were grouped as recurrence before (p = 0.039) and after 24 months (p < 0.001). Strong expression of MMP9 was observed in primary tumors that recurred after 24 months, median: 162.5 (score range 0-300) and those tumors that recurred before 24 months of the initial diagnosis, median: 102.5 (score range 0-250) (p = 0.026).
