Articles

[Clinical application of anterior thoracoscopically assisted surgery with posterior one-stage total en block spondylectomy for thoracic spinal tumor].

[Clinical application of anterior thoracoscopically assisted surgery with posterior one-stage total en block spondylectomy for thoracic spinal tumor].

Zhongguo Gu Shang. 2017 Sep 25;30(9):857-860

Authors: Xue W, Guan XL, Wang ZP, Hao ZY, Liu L, Qian YW

Summary
OBJECTIVE: To research the clincial results and feasibility of anterior thoracoscopically assisted surgical procedure (TAS) with posterior one-stage whole en block spondylectomy(TES) for thoracic spinal tumour.
METHODS: From October 2014 to January 2016, Four sufferers with thoracic spinal tumour had been handled by anterior thoracoscopically assisted surgical procedure with posterior one-stage whole en block spondylectomy. There have been 2 males and a couple of females, aged 16, 35, 46, 60 years. Programs of illness had been 1, Four, 6, 9 months. The tumor occurred at T?, T?, T??? phase in 1 case respectively, at double T7/T8 segments in 1 case. Preoperative visible analogue scores(VAS) had been Four, 5, 6, Eight factors. Frankel grade of neurologic operate was grade B in 2, D in 1, and E in 1. SF-36 high quality of life scores had been 38, 65, 35, 29 factors, together with 2 instances of main spinal tumors, 2 instances of metastatic spinal tumors. In response to the classification of Tomita, 1 case was kind III, 2 instances had been kind IV, 1 case was kind VI. And in keeping with the WBB staging, Four-9/ABCD was in 2 instances, 5-Eight/ABC compliated with 1-Three was in 1 case, 6-7/ABC was in 1 case. Surgical process: With lateral place, the thoracoscope channel was inserted. The concerned intervertebral vessels and corresponding intercostal vessels had been ligated, whereas the prevertebral giant vessels had been utterly separated and guarded. The entrance halves of superior and inferior concerned vertebral discs had been eliminated. Then the sufferers had been modified to inclined place, posterior one-stage whole en block spondylectomy, titanium cage bone graft (allograft bone), pedicle screw fixation had been carried out.
RESULTS: The entire operations had been profitable and the sufferers had been adopted up for 34, 10, 11, 12 months. Pleural effusion occurred in 1 case after operation, and pleural closed drainage was performed. All incisions acquired main therapeutic; and all sufferers confirmed vital ache reduction (P<zero.005), with the VAS rating reducing to 2(2 instances) and three(2 instances) scores, 2 months after surgical procedure. No nerve purposeful damage aggravated. SF-36 high quality of life rating clearly improved with postoperative scores for 88, 92, 71, 80 at Three months after operation. No recurrent vertebral tumor, inside fixation lossening or breakage was discovered at follow-up factors of three, 6, 12 months. One affected person with lung most cancers died of a number of organ failure at 11 months after operation.
CONCLUSIONS: With anterior TAS, vertebral anterior vessels, intervertebral blood vessels, intercostal vessels had been efficiently separated or ligated, intraoperative bleeding was successfully managed, lung and esophagus had been successfully protected, and the tumor obtained broad excision. Anterior TAS and one-stage posterior TES might considerably scale back the surgical trauma and the danger of surgical procedure.

PMID: 29455490 [PubMed – in process]

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2022-06-08

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2022-06-06

Sciatica My mother was in absolute agony for more than 3 months due to sciatica. It just came out of nowhere and took her out of action. From working full time she went straight to being bed bound and unable to carry out simplest of actions.The pain was 9/10 and she was bed bound for those three months. Multiple trips to A&E and GP and they wouldn't class it as an emergency therefore they wouldn't do anything about it other than upgrading the painkillers which did next to nothing for my mother. I couldn't bear to watch my mother sleeping on A&E bench in pain for 7 hours, just to be told by doctors that she wouldn't be kept in. I remember her joining her hands and begging the doctors to stop the pain which broke my heart. I then started doing research on google and London spine unit came up with Dr Mo AKMAL's profile and review. First meeting with Dr AKMAL was via ZOOM as my mother was bed bound. Dr AKMAL spoke to me and my mom and told us that this is nothing to worry about and that the pain would be 100% gone.Dr AKMAL assured us to visit the hospital so he could physically inspect my mother and give us the best solution. One trip to the london spine unit and Dr AKMAL advised us that the best solution would be to carry out Minimally invasive disectomy. Dr AKMAL advised that due to my mother being bed bound for a while, steroid injection might not give the result that my mother wishes. Dr AKMAL was very confident and showed us some videos from other patients who had gone through the same ordeal. The biggest thing i noticed between before and after was the smile on the patients face. Dr AKMAL was constantly assuring my mother throughout the meeting that he would take care of her pain and gave her 100% confidence that the result would be delivered.He promised her that she would be walking pain free the same day after the operation. Before the operation Dr GURUNG was consulted multiple times and he also was very helpful. Right after the surgery, as Dr AKMAL promised, my mother was walking and the biggest thing was that the pain was gone. My mother had forgotten to smile for three months and there i saw her smiling again. Dr AKMAL and Dr GURUNG gave us brilliant aftercare and informed us that just give them a ring if there was any issue. Its been several weeks now and my mother is heading towards complete recovery without any issues. The pain is completely gone and anyone who is reading this going through the same horrible sciatica pain you must come and see Dr AKMAL. Thank you Dr AKMAL and your whole team for helping my mom achieve this pain free life.

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2022-05-18

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2022-05-18

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2022-04-22

I had a massive bulging disk on my back… I had a massive bulging disk on my back compressing my nerve for three years. It caused me excruciating pain and almost left me disabled. I was on both crutches and completely homebound due to the severity of pain and mobility limitations. I had my lumber surgery two weeks ago and walked out of hospital within a few hours pain free on my right leg that was almost paralysing prior to surgery. The disk was shaved off releasing the nerve completely. Two days after surgery I had excruciating pain on my head that is unexplained as I had CT scan and MRI which were all fine. Dr Akmal has suggested it could be from the anaesthetic. I am extremely grateful to Dr Akmal and his very welcoming and cari g team. I would highly recommend his clinic as I have had excellent recovery.

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2022-04-02

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2022-03-22

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2022-03-17

Great service and painless procedure Great service and painless procedure. Definitely alleviated the pain

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Clinical application of anterior thoracoscopically assisted surgery with posterior one-stage total en block spondylectomy for thoracic spinal tumor | Best physiotherapy for frozen shoulder