Hazem Ahmed, Frank Gosse`
Iliac screws are a biomechanically sound method for deformity correction and stabilization of a long multi-segment lumbar constructs, which are instrumented down to S1. There is disagreement about complications and the effect on the fusion rate. The aim of the study is to analyse the safety and outcome of iliac screws.
Maleho M. Maku*, Mandela Johnson Motsoari and MV Ngcelwane
DOI: 10.37421/ 2165-7939.22.11.529
Introduction: Venous Thromboembolism (VTE) can result in significant morbidity and mortality. Data indicate no significant change to the overall incidence and mortality from VTE. Incidence of Deep Venous Thrombosis (DVT) varies, it is as high as 80% in patients sustaining lower extremity trauma where prophylaxis is not used. All patients with delayed (>24 hours) presentation of an acute hip or femur fracture undergo preoperative Doppler ultrasound to rule out DVT. Preoperative DVT is shown to occur in as high as 9% to 62% of patients receiving prophylaxis. Despite all the attention given to preventing VTE in hospitalized trauma patients, still there are no strong evidence-based recommendations to guide the treating surgeon. The purpose of the present study was to establish the incidence of DVT in patients with delayed presentation after sustains long bone, pelvic and spine fractures.
Methods: A prospective observational study was performed over an 18-month period between November 2019 to May 2021. Data collected from patient’s hospital records. A chi square test with 4 degrees of freedom with a medium effect 0.30, an error probability α=0.10, and a power of 1- β=0.80, a sample size of 108 was required.
Results: A total of 90 patients were identified. Included in the study were 39 patients on whom Doppler studies were done, of these 22 were females (54%) and 17 were males (46%). Mean age of 76 years (30-90 yrs.). Low energy falls accounted for 30/39 (76.9%) with neck of femur fractures being the most common type at 25/39 (64.1%) followed by intertrochanteric fracture 8 (20.5%), One of the intertrochanteric fractures was a high energy fracture 1/39 (2.6%) and the other high energy fractures included the tibia fractures 4/39 (10.2%). None of these patients had a previous history of DVT. There were 4 patients (9.7%) diagnosed positive with a thrombus of which 2/4 (50%) were pre-operative DVT. Of the 4 positives with thrombus, 3/4 (75%) was in female patients, 1/4 (25%) was in a male patient. Mortality in this study was 2/39 (5.1%).
Conclusion: The incidence of deep venous thrombosis was identified as 10.6% in our population study group. Routine ultrasound screening in patients with delayed presentation to exclude deep venous thrombosis in asymptomatic patients may be deemed necessary.
DOI: 10.37421/ 2165-7939.22.11.538
DOI: 10.37421/ 2165-7939.22.11.539
DOI: 10.37421/ 2165-7939.22.11.540
Ebrahim Ghayem Hassankhani*, Golnaz Ghayyem Hassankhani and Solmaz Ghayyem Hassankhani
DOI: 10.37421/2165-7939.2023.12.574
Background: In spine surgery postoperative closed suction drainage is used to decrease the potential risks of wound hematoma formation, reduces the risk of infection, cord compression and neurologic deficit. However, the efficacy of drains used for this purpose in adolescent idiopathic scoliosis is controversial. The purpose of this study is to evaluate outcomes of patients after posterior spinal fusion with instrumentation for adolescent idiopathic scoliosis without wound suction drainage.
Methods: A total of 66 patients who underwent posterior spinal fusion and instrumentation for the correction of adolescent idiopathic scoliosis without use of drain from January 2012 to January 2021 were included. Wound dehiscence, wound hematoma, infection, preoperative and postoperative hemoglobin levels and need for transfusion were described as frequency and mean values.
Results: The average age was 15.06 years. Hospital stay was 2.2 days. Patients were followed-up over 50.21 months. There was no deep infection, wound hematoma. The difference between just postoperative and three days after operation hemoglobin levels was not signi icant and no need for transfusion. Only 3 (4.5%) cases with super icial skin infection and 4 (6%) cases with skin and wound dehiscence were treated with dressing and antibiotics with full recovery.
Conclusion: Without using drain for patients with idiopathic scoliosis who underwent posterior spinal fusion and instrumentation, no increase in blood loss, transfusion requirements, wound infection, skin dehiscence, and wound hematoma was observed.
DOI: 10.37421/2795-7939.2022.11.576
Phytochemicals, also known as secondary metabolites, are plant-produced substances that have been shown to have a wide range of biological activities, providing a scientific basis for the use of herbs in traditional medicine. Furthermore, the use of herbs is thought to be safer and less expensive than synthetic medicine. Herbal medicines, on the other hand, have drawbacks such as low solubility, stability, and bioavailability. Some of them can degrade physically and chemically, reducing their pharmacological activity. Nanotechnology-based herbal drug formulations have attracted attention in recent decades due to their increased activity and potential for overcoming the problems associated with herbal medicine. Approaches that use biocompatible, biodegradable nanotechnology-based delivery systems based on lipids, polymers, or Nano emulsions can improve the solubility, stability, bioavailability, and pharmacological activity of herbals. The purpose of this review article is to provide an overview of the most recent advances in the development of nanotechnology-based herbal drug formulations for increased activity, as well as a summary of the challenges that these herbal medicine delivery systems face.
DOI: 10.37421/2795-7939.2022.11.574
The first vaccine vial was developed a few centuries ago, and it has resulted in a significant reduction in infectious disease morbidity and mortality. According to the World Health Organization (WHO), the discovery of the novel virus and the disease, as well as its steady progression to a global pandemic with confirmed cases and reported deaths, was extremely catastrophic. This resulted in an unexpected need for preventative and cost-effective measures to mitigate the virus's devastating impact, followed by accelerated competition among pharmaceutical behemoths to manufacture and dispense vaccines at an exponential rate. Non-pharmaceutical medications, such as mandated face mask policies, travel restrictions, and widespread disinfectant use, were somewhat effective in mitigating the catastrophic effect.
Joel Mattias Beck*, Helena Brisby, Adad Baranto and Olof Westin
DOI: 10.37421/2165-7939.2023.12.594
Background: The lumbar spine and pelvis can be aligned in a variety of different ways. It has been demonstrated that certain lumbar morphological characteristics can affect the likelihood of developing speci ic illnesses, such as Lumbar Disc Herniation (LDH) or spondylolysis. This study's main objective was to look at the sagittal pro iles of young individuals having lumbar disc herniation surgery. Checking if a straightforward discectomy altered the sagittal features following surgery was a secondary objective.
Methods: The study comprised 16 young patients with lumbar disc herniation surgery (mean age 18.3 and 3.2 SD). Erect sagittal radiographs of the entire spine were taken prior to surgery. According to Roussouly, two experienced spinal surgeons classi ied the sagittal features. Additionally, a whole spine erect radiograph was taken three months following surgery and prospective changes in sagittal spinopelvic pro iles were assessed.
Results: The patients in the study exhibited a strong low lumbar lordosis dominance, with more than 75% of the patients having Roussouly sagittal pro iles type 1 and type 2. Examining the erect radiographs revealed that the post-operative sagittal pro ile had undergone only small, insigni icant modi ications.
Conclusion: In conclusion, this study shows that, when young patients with LDH are compared to a normal population cohort, the sagittal spinal alignment, as de ined by Roussouly, is skewed and does not appear to be changed or altered by the disc herniation condition or the surgical intervention in and of itself. The Roussouly type 1 or 2 spinal sagittal pro ile was present in the vast majority of the young LDH patients who presented for surgery, suggesting that this may be thought of as a separate risk factor for the development of LDH in this cohort.
Journal of Spine received 2022 citations as per Google Scholar report
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