Spine and spinal cord injuries–causes and complications.

By London Spine
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Spine and spinal cord injuries–causes and complications.

Adv Clin Exp Med. 2012 Jul-Aug;21(4):477-85

Authors: Rosińczuk-Tonderys J, Załuski R, Gdesz M, Lisowska A

Abstract
BACKGROUND: The spine as a motor organ is very often exposed to the action of forces released by an injury. The most frequent cause of spine and spinal cord injuries are traumas which are the result of accidents, and untreated osteoporosis or neoplasms as well.
OBJECTIVES: Aim of the study is an analysis of the causes of spine and spinal cord injuries as well as of the complications of these injuries.
MATERIAL AND METHODS: The material covers 130 patients hospitalized due to spine injury in 2008-2010 at the Clinical Department of Neurosurgery of Wroclaw Medical University. The data has been obtained on the basis of an analysis of medical and nursing documentation.
RESULTS: In the research group, men (64%) prevail over women (36% of the respondents). Most often, spine injuries affected patients aged over 60. Spine injuries without spinal cord injury comprised 84.6%, whereas with spinal cord injury only 15.4%. About 75% of the examined patients were admitted to the department as emergency admissions, within the time exceeding 12 hours since an injury occurrence (58.5%). The vast majority of patients (80%) were treated surgically. After completing treatment, most of the respondents were discharged (71.5%). After leaving the hospital, over half of the patients (52.3%) were not able to move on their own.
CONCLUSIONS: The most common causes of spine injuries in patients are pathologic injuries (28.5%), traffic collisions (27.7%) and falls from heights (20.0%). To the largest degrees, spine injuries concerned the thoracic segment (in 34.6%), cervical segment (32.3%) and lumbar (23.8%). Complications occurring after spine injuries included pain of a damaged spine segment (61.1%), pain in other location (36.6%) and gastroenterological complications (17.6%). In the case of complications after spine and spinal cord injuries, gastroenterological complications predominate (in 42.9% patients) along with complications of the urinary system (38.1%) and pain of the injured spine segment (38.1%).

PMID: 23240453 [PubMed – indexed for MEDLINE]

Hydronephrosis in the course of ureteropelvic junction obstruction: An underestimated problem? Current opinions on the pathogenesis, diagnosis and treatment.

By Kamruz Zaman
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Hydronephrosis in the course of ureteropelvic junction obstruction: An underestimated problem? Current opinions on the pathogenesis, diagnosis and treatment.

Adv Clin Exp Med. 2017 Aug;26(5):857-864

Authors: Krajewski W, Wojciechowska J, Dembowski J, Zdrojowy R, Szydełko T

Abstract
Ureteropelvic junction obstruction (UPJO) causes a reduction in the urine flow from the renal pelvis into the ureter. Untreated UPJO may cause hydronephrosis, chronic infection or urolithiasis and will often result in progressive deterioration of renal function. Most cases of UPJO are congenital; however, the disease can be clinically silent until adulthood. Other causes, both intrinsic and extrinsic, are acquired and include urolithiasis, post-operative/inflammatory/ischemic stricture, fibroepithelial polyps, adhesions and malignancy. In the past, the most frequent symptom of UPJO in neonates and infants was a palpable flank mass. Nowadays, thanks to the widespread use of maternal and prenatal ultrasound examinations, asymptomatic hydronephrosis is diagnosed very early. In adults and older children symptoms may include intermittent abdominal or flank pain, nausea, vomiting and hematuria. In addition to high specificity and sensitivity in detecting UPJO, modern technologically advanced equipment such as ultrasound, magnetic resonance imaging and computed tomography provides a lot of information about the function of the affected kidney and the anatomy of the surrounding tissues. Treatment options for UPJO include a wide spectrum of approaches, from active surveillance or minimally invasive endourologic techniques to open, laparoscopic or robotic pyeloplasty. The main goal of therapy is to relieve symptoms and maintain or improve renal function, but it is difficult to define treatment success after UPJO therapy.

PMID: 29068584 [PubMed – in process]