Anterior Segmental Decompression and Interbody Fusion for Multi-segmental Cervical Spondylotic Myelopathy in the Elderly
Guowei Zhang,
Zhengbin Cai,
Qiuling Liu,
Zhisheng Ji,
Yuhao Yang,
Hongsheng Lin
Issue:
Volume 5, Issue 4, August 2017
Pages:
58-61
Received:
25 May 2017
Accepted:
5 June 2017
Published:
21 July 2017
Abstract: To explore the clinical effect of anterior segmental decompression and interbody fusion in treatment of elderly patients with complex cervical spondylotic myelopathy of three segments or more, 50 patients, with titanium plate internal fixation bone fusion underwent anterior cervical decompression and multi segmental cervical spondylosis, were collected. Parameters of operation time, intraoperative blood loss, JOA score 1 week before and after, 12 months after operation, cervical X-ray, CT and MRI before and after operation were measured. Clinical symptoms and the improvement of JOA, internal fixation and bone grafting fusion, cervical standard sagittal Cobb angle, lateral fusion segment of vertebral body height (height of anterior border, HAB) and posterior height (height of posterior border, HPB), were observed. Operation time was 90 ~ 150 minutes, average 120 minutes. The amount of bleeding 150 ~ 450 ml, average 325.5 ml. Mean follow-up time was 15.1 months. 2 weeks after operation, sympathetic symptoms were improved obviously, lower limb muscle strength was increased, physical activity was significantly improved, and anesthesia of double upper limbs disappeared. Except for the 3 cases who had serious cervical spinal cord injury showed no obvious recovery, the other 47 patients showed significant improved neurological recovery. X-ray results of 12 months after operation showed that 50 cases of fused intervertebral, intervertebral height and lordosis maintained good. In general, anterior segmental decompression and bone graft fusion and titanium plate internal fixation operation is a safe and effective operation for treating the three section and above cervical spondylotic myelopathy, worth recommending.
Abstract: To explore the clinical effect of anterior segmental decompression and interbody fusion in treatment of elderly patients with complex cervical spondylotic myelopathy of three segments or more, 50 patients, with titanium plate internal fixation bone fusion underwent anterior cervical decompression and multi segmental cervical spondylosis, were colle...
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Compound Elevated Skull Fracture: A Report of Two Cases and Literature Review
Sale Danjuma,
Kache Stephen Akau,
Obadaki Abubakar Michael,
Johnson Ameh,
Aghadi Ifeanyi Kene
Issue:
Volume 5, Issue 4, August 2017
Pages:
68-71
Received:
23 May 2017
Accepted:
12 June 2017
Published:
23 August 2017
Abstract: Elevated skull fracture unlike depressed skull fracture is rare with few cases reported in the literature. Some cases have been reported from the South-western part of Nigeria. The aim of this report is to present an unusual aetiology for compound elevated skull fracture and to highlight the need for proper imaging and careful examination under anaesthesia to identify any dura tear and institute appropriate care. This is a report of 2 cases with compound elevated skull fractures. The first patient is a 2 year old boy who sustained injury following contact with a rotating ceiling fan blade while he was being lifted up by his uncle. Whereas the other patient, a 45 year old man, had his injury inflicted following assault. Examination findings in both patients revealed scalp laceration. The first patient had no focal neurological deficit but the second patient had significant focal neurological deficit. CT scan in both patients showed elevated skull fracture and evidence of dura tear. Both patients were worked up for surgery and had craniotomy, wound debridement, duroplasty and primary wound closure. They have been doing well since discharge. In conclusion, a rotating fan blade making contact with the head with downward pull produced elevated skull fracture in young children. Early recognition and treatment of this type of fracture would reduce the morbidity and mortality and improve outcome.
Abstract: Elevated skull fracture unlike depressed skull fracture is rare with few cases reported in the literature. Some cases have been reported from the South-western part of Nigeria. The aim of this report is to present an unusual aetiology for compound elevated skull fracture and to highlight the need for proper imaging and careful examination under ana...
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