RESUMO
Postoperative infections after back operations can produce complex wounds with myonecrosis, deep dead space, and exposed orthopedic hardware, bone, and dura. Three ambulatory patients with complex postoperative back wounds that resulted from infections were treated successfully with antibiotics, debridement, irrigation, and closure of deep dead space with a superior gluteal muscle flap. Several surgical maneuvers can be performed to increase the length of the superior gluteal muscle flap. The inferior portion of the gluteus maximus was left intact to preserve gluteus maximus function. All three patients obtained healed wounds. The exposed A.O. plating system was not removed. There has not been any recurrence of infections. The superior gluteal muscle flap is a reasonable flap to fill deep dead space in the low back and has some advantages over free flaps.
Assuntos
Vértebras Lombares/cirurgia , Sacro/cirurgia , Infecção da Ferida Cirúrgica/cirurgia , Idoso , Antibacterianos/uso terapêutico , Desbridamento , Enterococcus , Feminino , Seguimentos , Infecções por Bactérias Gram-Positivas/tratamento farmacológico , Infecções por Bactérias Gram-Positivas/cirurgia , Humanos , Disco Intervertebral/cirurgia , Dor Lombar/cirurgia , Masculino , Pessoa de Meia-Idade , Músculo Esquelético/patologia , Músculo Esquelético/transplante , Necrose , Dispositivos de Fixação Ortopédica/efeitos adversos , Paralisia , Complicações Pós-Operatórias/cirurgia , Recidiva , Transplante de Pele , Fusão Vertebral/efeitos adversos , Estenose Espinal/cirurgia , Espondilolistese/cirurgia , Infecções Estreptocócicas/tratamento farmacológico , Infecções Estreptocócicas/cirurgia , Retalhos Cirúrgicos , Infecção da Ferida Cirúrgica/tratamento farmacológico , Irrigação Terapêutica , CicatrizaçãoRESUMO
The contoured anterior spinal plate (CASP) was developed for secure fixation of the anterior thoracolumbar spine. This is a report of 38 patients with various spinal pathologies treated with this system. The results were excellent regarding plate fixation and fusion. Comments on surgical technique and indications are provided.
Assuntos
Placas Ósseas , Parafusos Ósseos , Vértebras Lombares/cirurgia , Fusão Vertebral , Vértebras Torácicas/cirurgia , Adulto , Feminino , Fixação Interna de Fraturas/instrumentação , Humanos , Vértebras Lombares/lesões , Masculino , Estudos Retrospectivos , Fraturas da Coluna Vertebral/epidemiologia , Fraturas da Coluna Vertebral/cirurgia , Neoplasias da Coluna Vertebral/epidemiologia , Neoplasias da Coluna Vertebral/secundário , Neoplasias da Coluna Vertebral/cirurgia , Vértebras Torácicas/lesõesRESUMO
Surgical fusion results are presented from a retrospective study of 126 consecutive multilevel discectomy and vertebrectomy cases for spondylosis to evaluate fusion rates using autograft and allograft fibula strut graft for reconstruction. The nonunion rate was high in both groups: 27% of the autograft group and 41% of the allograft group. The nonunion rate increased with increasing numbers of motion segments fused. Age and sex were not significant factors.
Assuntos
Vértebras Cervicais/cirurgia , Fíbula/transplante , Fusão Vertebral , Osteofitose Vertebral/cirurgia , Transplante Autólogo , Transplante Homólogo , Adulto , Vértebras Cervicais/diagnóstico por imagem , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Radiografia , Estudos Retrospectivos , Osteofitose Vertebral/diagnóstico por imagemRESUMO
Lipopolysaccharide (LPS) was shown to induce tumoricidal activity in peritoneal macrophages. The optimal concentration was found to be 25 micrograms/mL. Approximately 20-h exposure to LPS was required before maximal tumor cell killing was attained. Optimal tumor killing was obtained with a ratio of tumor cell to macrophages of 1:40 with the macrophages in a confluent layer. Diphenylene iodonium (DPI) reduced the tumor cell killing in a dose dependent manner up to 1 microM. Under similar conditions DPI was shown to inhibit the superoxide production of macrophages and this supports the view that the production of oxygen radicals is important in the killing of tumor cells by macrophages and that the inhibitor DPI can be used to investigate their contribution to cytotoxicity.
Assuntos
Citotoxicidade Imunológica , Macrófagos/enzimologia , NADH NADPH Oxirredutases/fisiologia , Oniocompostos/farmacologia , Animais , Arginase/metabolismo , Linhagem Celular , Lipopolissacarídeos , Ativação de Macrófagos/efeitos dos fármacos , Macrófagos/efeitos dos fármacos , Macrófagos/imunologia , NADPH Oxidases , Ratos , Células Tumorais CultivadasRESUMO
Five children, aged 7-15 years, with brachial palsies and flail shoulders, had fusions performed. Four of the five had improved function; however, there was progressive loss of fused abduction position over time.
