Lumbar Lordosis of Spinal Stenosis Patients during Intraoperative Prone Positioning.

Lumbar Lordosis of Spinal Stenosis Patients during Intraoperative Prone Positioning.

Clin Orthop Surg. 2016 Mar;8(1):65-70

Authors: Lee SK, Lee SH, Song KS, Park BM, Lim SY, Jang G, Lee BS, Moon SH, Lee HM

Abstract
BACKGROUND: To evaluate the effect of spondylolisthesis on lumbar lordosis on the OSI (Jackson; Orthopaedic Systems Inc.) frame. Restoration of lumbar lordosis is important for maintaining sagittal balance. Physiologic lumbar lordosis has to be gained by intraoperative prone positioning with a hip extension and posterior instrumentation technique. There are some debates about changing lumbar lordosis on the OSI frame after an intraoperative prone position. We evaluated the effect of spondylolisthesis on lumbar lordosis after an intraoperative prone position.
METHODS: Sixty-seven patients, who underwent spinal fusion at the Department of Orthopaedic Surgery of Gwangmyeong Sungae Hospital between May 2007 and February 2012, were included in this study. The study compared lumbar lordosis on preoperative upright, intraoperative prone and postoperative upright lateral X-rays between the simple stenosis (SS) group and spondylolisthesis group. The average age of patients was 67.86 years old. The average preoperative lordosis was 43.5° (± 14.9°), average intraoperative lordosis was 48.8° (± 13.2°), average postoperative lordosis was 46.5° (± 16.1°) and the average change on the frame was 5.3° (± 10.6°).
RESULTS: Among all patients, 24 patients were diagnosed with simple spinal stenosis, 43 patients with spondylolisthesis (29 degenerative spondylolisthesis and 14 isthmic spondylolisthesis). Between the SS group and spondylolisthesis group, preoperative lordosis, intraoperative lordosis and postoperative lordosis were significantly larger in the spondylolisthesis group. The ratio of patients with increased lordosis on the OSI frame compared to preoperative lordosis was significantly higher in the spondylolisthesis group. The risk of increased lordosis on frame was significantly higher in the spondylolisthesis group (odds ratio, 3.325; 95% confidence interval, 1.101 to 10.039; p = 0.033).
CONCLUSIONS: Intraoperative lumbar lordosis on the OSI frame with a prone position was larger in the SS patients than the spondylolisthesis patients, which also produced a larger postoperative lordosis angle after posterior spinal fusion surgery. An increase in lumbar lordosis on the OSI frame should be considered during posterior spinal fusion surgery, especially in spondylolisthesis patients.

PMID: 26929801 [PubMed – in process]

Development and testing of a computerized pain body map in patients with advanced cancer.

Related Articles

Development and testing of a computerized pain body map in patients with advanced cancer.

J Pain Symptom Manage. 2014 Jan;47(1):45-56

Authors: Jaatun EA, Hjermstad MJ, Gundersen OE, Oldervoll L, Kaasa S, Haugen DF, European Palliative Care Research Collaborative (EPCRC)

Abstract
CONTEXT: Pain localization is an important part of pain assessment. Development of pain tools for self-report should include expert and patient input, and patient testing in large samples.
OBJECTIVES: To develop a computerized pain body map (CPBM) for use in patients with advanced cancer.
METHODS: Three studies were conducted: 1) an international expert survey and a pilot study guiding the contents and layout of the CPBM, 2) clinical testing in an international symptom assessment study in eight countries and 17 centers (N = 533), and 3) comparing patient pain markings on computer and paper body maps (N = 92).
RESULTS: Study 1: 22 pain experts and 28 patients participated. A CPBM with anterior and posterior whole body views was developed for marking pain locations, supplemented by pain intensity ratings for each location. Study 2: 533 patients (286 male, 247 female, mean age 62 years) participated; 80% received pain medication and 81% had metastatic disease. Eighty-five percent completed CPBM as intended. Mean ± SD number of marked pain locations was 1.8 ± 1.2. Aberrant markings (15%) were mostly related to software problems. No differences were found regarding age, gender, cognitive/physical performance, or previous computer experience. Study 3: 70% of the patients had identical markings on the computer and paper maps. Only four patients had completely different markings on the two maps.
CONCLUSION: This first version of CPBM was well accepted by patients with advanced cancer. However, several areas for improvement were revealed, providing a basis for the development of the next version, which is subject to further international testing.

PMID: 23856098 [PubMed – indexed for MEDLINE]

Lyophilized Cyclamen europaeum tuber extract in the treatment of rhinosinusitis.

Lyophilized Cyclamen europaeum tuber extract in the treatment of rhinosinusitis.

Otolaryngol Pol. 2016 Feb 29;70(1):1-9

Authors: Jurkiewicz D, Hassmann-Poznańska E, Kaźmierczak H, Składzień J, Pietruszewska W, Burduk P, Rapiejko P

Abstract
Nasal and sinus mucositis is a significant health problem associated with significant organizational and financial burden for the health care system. In recent years, several important guidelines and positions of expert groups and scientific associations have been published with regard to the diagnostics and treatment of rhinosinusitis, including European Position Paper on Rhinosinusitis and Nasal Polyps (EPOS 2012) [1] and Polish Standards for the Treatment of Rhinitis (PoSLeNN 2013) [2]. The management of viral and postviral rhinosinusitis involves systemic treatment including administration of plant origin products. The goal of this article is to present the current knowledge on the use of intranasal preparations containing natural saponin fractions from the rhizomes of Alpine cyclamen (Cyclamen europaeum). Saponins contained in the extract of Alpine cyclamen (Cyclamen europaeum) rhizomes are surface-active compounds that reduce the surface tension on the nasal mucosal cells while simultaneously stimulating the trigeminal nerve receptors leading to increased production of seromucous secretion and extensive drainage of the nasal and sinus cavities. The analysis of published studies on the efficacy and safety of intranasal products containing lyophilized extracts from Cyclamen europaeum tuber warrants the conclusion that these products are useful in the management of nasal and sinus mucositis due to their beneficial impact on the course of the treatment of acute rhinosinusitis. When used in patients with acute rhinosinusitis, an intranasal preparation containing lyophilized extracts from Cyclamen europaeum tuber efficiently reduces the symptoms, particularly the feeling of pressure and pain in the face. According to the authors of PROSINUS study, single-agent treatment using Cyclamen europaeum extracts is more efficient (in terms of the percentage of success) than other monotherapy or combination regimens.

PMID: 26926302 [PubMed – in process]

Influence of Kinesiologic Tape on Post-operative Swelling After Orthognathic Surgery.

Influence of Kinesiologic Tape on Post-operative Swelling After Orthognathic Surgery.

J Maxillofac Oral Surg. 2016 Mar;15(1):52-8

Authors: Tozzi U, Santagata M, Sellitto A, Tartaro GP

Abstract
INTRODUCTION: Orthognathic surgery involves making several osteotomies that lead to varying degrees of post-operative swelling. The use of KT may be beneficial for postoperative treatment after head and neck surgery, accelerating drainage of tissue reaction or haemorrhages. The goal of this study was to find out if the application of KT prevents or improves swelling, pain and trismus after orthognathic surgery, improving patients’ postoperative quality of life.
MATERIALS AND METHODS: In this double-blinded, randomized, control trial, 24 patients in whom bimaxillary orthognathic surgery was indicated, were included. Before surgery each patient alternatively was randomly included in the study group (treated with K-Taping(®) and corticosteroid) or in the control group (treated with corticosteroid). In the present study a MakerBot(®) Digitizer 3D™ was used to assess accurate volume measurements. All swelling measurements were expressed as total 3-D area of the landmarks (cm(2) ) in T0 pre-operative, T1 fourth day after surgery.
RESULTS: The differences T0-T1 are highly significant (p < 0.01) between group 1 or study group (treated with K-taping(®)) and group 2 (control group).
DISCUSSION: The use of KT appears promising, because it is simple to carry out, less traumatic, economical, can be performed everywhere in the world, free from side effects on the body. Even when swelling persists, KT gives patients the impression of a minor swelling detracting them from their pain and morbidity. Further studies have to be performed to find out if KT can reduce or replace the need for additional medications such as the use of steroids.

PMID: 26929553 [PubMed]

Spinal cord injury resulting from gunshot wounds: a comparative study with non-gunshot causes.

Spinal cord injury resulting from gunshot wounds: a comparative study with non-gunshot causes.

Spinal Cord. 2016 Mar 1;

Authors: Güzelküçük Ü, Demir Y, Kesikburun S, Aras B, Yavuz F, Yaşar E, Yılmaz B

Abstract
STUDY DESIGN: Retrospective, comparative 7-year study.
OBJECTIVES: To identify the clinical characteristics of patients with spinal cord injury (SCI) resulting from gunshot wound (GSW).
SETTING: Turkish Armed Forces Rehabilitation Center, Ankara, Turkey.
METHODS: The study included 1043 consecutive patients with SCI who were divided into two groups according to etiology: patients with gunshot-induced spinal cord injury (GSWSCI) constituted the study group, and randomly selected patients with non-gunshot-induced spinal cord injury (NGSWSCI) who were matched for gender and for week of admission constituted the control group. The demographic and clinical characteristics of the patients were recorded, compared and analyzed.
RESULTS: The study group included 102 patients (mean age: 26.93±9.11 years). The vast majority of the patients were aged 16-30 years (68.6%) and 90.2% were male. The majority of the lesions were at the thoracic level (58.8%) and a complete injury (60.8%). Surgical stabilization of the spine was performed in 50 patients (49%). The most prevalent associated injury was intra-abdominal injury followed by chest injury. Compared with the NGSWSCI group, the GSWSCI patients were more likely to have a complete lesion (60.8% vs 45.1%, P=0.025), had a lower rate of surgical stabilization (49 vs 88.2%, P=0.0001) and had a higher rate of associated injuries (54.9% vs 25.5%, P=0.0001). Compared with the civilian GSWSCI group, the military GSWSCI patients had a higher rate of surgical stabilization and associated injuries (60% vs 40%, P=0.049, 68.9% vs 43.9%, P=0.012, respectively).
CONCLUSION: The results revealed that GSWSCI and military GSWSCI patients may have different demographic and clinical features compared with NGSWSCI and civilian GSWSCI patients, respectively.Spinal Cord advance online publication, 1 March 2016; doi:10.1038/sc.2016.29.

PMID: 26927292 [PubMed – as supplied by publisher]