111 research outputs found
Intraoperative Myelography in Minimally Invasive Decompression for Degenerative Lumbar Spinal Stenosis
No full textsj-pdf-1-imr-10.1177_03000605221085405 - Supplemental material for <i>Salmonella</i> spondylodiscitis and epidural abscess successfully treated with unilateral biportal endoscopic discectomy and debridement: a rare case report
No full textSupplemental material, sj-pdf-1-imr-10.1177_03000605221085405 for Salmonella spondylodiscitis and epidural abscess successfully treated with unilateral biportal endoscopic discectomy and debridement: a rare case report by Ta-Li Hsu, Chia-Jui Yang and Jwo-Luen Pao in Journal of International Medical Research</p
Above-Knee Amputation after Recurrent Dislocations of Total Knee Arthroplasty
No full textAmputation after total knee arthroplasty (TKA) is an extremely rare but disastrous complication. Most of the reported cases resulted from refractory deep joint sepsis or perioperative vascular complications. We present a case of above-knee amputation resulting from vascular complications after recurrent dislocations of a TKA in a patient with underlying end-stage renal disease. The possible association between certain metabolic diseases and instability of TKA is discussed. In contrast to the high incidence of vascular complications after traumatic knee dislocation, popliteal artery injury after TKA dislocation is seldom encountered. The importance of careful evaluation and serial physical examinations to exclude the possibility cannot be overemphasized, however. When compromise of the circulation was recognized, emergent exploration of the popliteal fossa for repair of the vascular injury presented the best chance to save the limb. Copyright 2003, Elsevier Science (USA). All rights reserved
Retrograde Intramedullary Nailing for Nonunions of Supracondylar Femur Fracture of Osteoporotic Bones
No full textNonunion of supracondylar femur fracture remains a challenging problem because of limited treatment options. The situation is more complex when it occurs in elderly patients with osteoporotic bones. We report the treatment of 3 elderly patients with supracondylar femur fracture nonunion after open reduction and internal fixation with various plate-screw internal fixation systems. Two of these patients had traumatic fractures and the third had a periprosthetic fracture after primary total knee arthroplasty (TKA). After revision surgeries using retrograde nailing techniques, all fractures united eventually. When combined with indirect reduction, these techniques provide superior biomechanical properties and reduce the need for soft tissue dissection
Clinical Outcomes of Microendoscopic Decompressive Laminotomy for Degenerative Lumbar Spinal Stenosis
No full textThe goal of surgical treatment for degenerative lumbar spinal stenosis ( LSS) is to effectively relieve the neural structures by various decompressive techniques. Microendoscopic decompressive laminotomy (MEDL) is an attractive option because of its minimally invasive nature. The aim of prospective study was to investigate the effectiveness of MEDL by evaluating the clinical outcomes with patient-oriented scoring systems. Sixty consecutive patients receiving MEDL between December 2005 and April 2007 were enrolled. The indications of surgery were moderate to severe stenosis, persistent neurological symptoms, and failure of conservative treatment. The patients with mechanical back pain, more than grade I spondylolisthesis, or radiographic signs of instability were not included. A total of 53 patients (36 women and 17 men, mean age 62.0) were included . Forty-five patients (84.9%) were satisfied with the treatment result after a follow-up period of 15.7 months (12-24). The clinical outcomes were evaluated with the Oswestry disability index (ODI) and the Japanese Orthopedic Association (JOA) score. Of the 50 patients providing sufficient data for analysis, the ODI improved from 64.3 +/- A 20.0 to 16. 7 +/- A 20.0. The JOA score improved from 9.4 +/- A 6.1 to 24.2 +/- A 6.0. The improvement rate was 73.9 +/- A 30.7% and 40 patients (80%) had good or excellent results. There were 11 surgical complications: dural tear in 5, wrong level operation in 2, and transient neuralgia in 4 patients. No wound-related complication was noted. Although the prevalence of pre- operative comorbidities was very high (69.8%), there was no serious medical complication. There was no post-operative instability at the operated segment as evaluated with dynamic radiographs at final follow-up. We concluded that MEDL is a safe and very effective minimally invasive technique for degenerative LSS. With an appropriate patient selection, the risk of post-operative instability is minimal
Staged Reimplantation of Total Knee Arthroplasty after Candida Infection
No full textProsthetic joint infection with Candida is uncommon. Only 28 cases have been reported in the English literature. Successful reimplantation after eradication of Candida infection has been reported in 3 hip joints and only 1 knee. We present the case of a 68-year-old woman with chronic Candida parapsilosis infection of a prosthetic knee joint. Removal of the prosthesis, thorough debridement. and antifungal therapy treated the infection successfully. Antifungal therapy included 6 weeks of parenteral administration of fluconazole followed by 4 weeks of oral fluconazole. The involved knee joint was reimplanted 3 months after initial treatment. The prosthetic joint was pain free and functioned satisfactorily during the ensuing 4 years. No recurrence of infection was noted. The principle in treating Candida prosthetic infection generally has been the same as that of bacterial prosthetic infection. In chronic cases, removal of implants, thorough debridement, and effective antifungal therapy are mandatory for the eradication of infection. Reimplantation of the prosthesis can be performed successfully in a staged surgical procedure with the interval between the 2 stages shortened to 3 months
Preliminary Clinical and Radiological Outcomes of the “No-Punch” Decompression Techniques for Unilateral Biportal Endoscopic Spine Surgery
Get PDFObjective To avoid the most offending surgical instrument for dural tears, we develop a “no-punch” decompression technique for unilateral biportal endoscopic (UBE) spine surgery. Methods This retrospective study enrolled 68 consecutive patients with degenerative lumbar spinal stenosis segments. The treatment results were evaluated using the visual analogue scale (VAS) for low back and leg pain, the Japanese Orthopaedic Association (JOA) scores, and the Oswestry Disability Index (ODI). Radiological outcomes were evaluated using the preoperative and postoperative magnetic resonance imaging. Results This study included 36 male and 32 female patients who received 109 segments of decompression, with an average age of 68.7 (37–90 years). The average operation time was 52.2 minutes. The average hospital stay was 3.1 days. There were no dural tears but 3 minor surgical complications, all treated conservatively. The VAS for low back and leg pain improved from 4.6 and 7.0 to 0.8 and 1.2. The JOA score improved from 16.2 to 26.8, with an improvement rate of 82.0%. The ODI improved from 50.1 to 18.7. All these improvements were statistically significant. The cross-sectional dural area improved from 61.1 to 151.3 mm2, with an average increase of 90.2 mm2 and 205.3%. 87.1% of the ipsilateral facet joints and 84.7% of the contralateral facet joints were preserved. In 61% of the decompressed segments, the ipsilateral facet joints were preserved better than the contralateral facet joints. Conclusion The UBE “no-punch” decompression technique effectively avoids the dural tears. It provides effective neural decompression, excellent facet joint preservation, and good treatment outcomes
First person – Bao-Luen Chang
No full textFirst Person is a series of interviews with the first authors of a selection of papers published in Disease Models & Mechanisms (DMM), helping early-career researchers promote themselves alongside their papers. Bao-Luen Chang is first author on ‘Semiology, clustering, periodicity and natural history of seizures in an experimental occipital epilepsy model’, published in DMM. Bao-Luen conducted the research described in this article while a PhD student in Professor Stephanie Schorge's lab at Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology (IoN), Queen Square, London, WC1N 3BG, UK. He is now a neurologist consultant and physician scientist in the lab of Professor Stephanie Schorge at No.5, Fuxing St., Guishan District, Taoyuan City 333, Taiwan, investigating mechanisms of epileptogenesis, epilepsy and pathophysiology of pharmacoresistant epilepsy
Rezension: "American Born Chinese" von Gene Luen Yang, übersetzt von Matthias Wieland
Get PDFDer amerikanische Autor und Zeichner Gene Luen Yang verkörpert, wovon er in seiner preisgekrönten Graphic Novel American Born Chinese erzählt: Er ist der Sohn von asiatischen Immigrant*innen, wobei sein Vater aus Taiwan stammt, seine Mutter aus Hongkong. Von Matthias Wieland jüngst ins Deutsche übersetzt, erzählt Gene Luen Yang mit kunstvoll ineinander vermengten Geschichten, deren Zusammengehörigkeit sich erst im Laufe der Zeit offenbart, vom Prozess einer schwierigen Immigration. Letztlich, so seine Botschaft, geht es um Identität, die nicht von außen und von anderen bestimmt wird.American author and illustrator Gene Luen Yang embodies what he tells in his award-winning graphic novel American Born Chinese: he is the son of Asian immigrants, his father from Taiwan and his mother from Hong Kong. Recently translated into German by Matthias Wieland, Gene Luen Yang tells stories about the difficult process of immigration, artfully interwoven with each other and with connections that only become apparent over time. Ultimately, his message is about an identity that is not determined from outside and by others
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