The risk of intraoperative and postoperative complications after spinal surgery still remains in the hospital-acquired conditions of any hospital. The methods for performing spinal surgery in children and adults are developing and constantly improving. A significant number of constructions for performing spinal surgery are created by leading manufacturers. The frequency of local and systemic surgical complications has not decreased. Knowing the rate and structure spinal surgery complications can expand the ability to predict and prevent them, which is important for medical science and practice. The presented review of literature addressed the current state of knowledge on spinal surgery complications.
Introduction: The problem of diagnostics and treatment of oncological diseases is one of the most urgent challenges of the public health system. Despite successful achievements over the past years, surgical treatment of spinal tumors is becoming more demanded due to the increasing number of cases with complexities and long duration of the disease. The research found out developing compression of the spinal cord at 10% of patients with spinal spread. Still, the patients suffering spinal tumors are associated with high mortality rates. Aim: To analyze the results of clinical treatment of spinal tumors at patients who have received specialized orthopedic aid. Methods and materials: From 2014 to 2019, patients with spinal neoformations (N=240) received surgical treatment at Traumatology Unit of North-Western State Medical University named after I.I. Mechnikov. We assessed categories of sex, age, histologic type and location of tumors, pain severity (BAIII), neurologic status (Frankel scale), life span (from operation to death or the latest check-up). Results: The choice of the treatment method depended on the pathology of the spinal tumor. Analysis of the material found: spinal lesion is caused by secondary tumors, mainly; spinal spread results in chest lesions. Positive dynamics of the neurologic status was observed at patients of B,C,D,E groups (Frankel scale) after the surgery. All the patients, having received puncture vertebroplasty, experienced the regression of pain severity. Conclusion: Vertebroplasty is an efficient treatment of pain severity at patients with symptomatic and aggressive haemangeoma and pathologic fractures of vertebral bodies during the neoplastic process. We should apply surgical treatment for patients with spinal cord compression as earlier as possible to prevent from the development of sever neurologic disorders and pain management. The main method of treatment is decompressing and stabilizing interventions from the posterior approach.
1707 Total Hip and Knee Arthroplasty had been retrospectively analyzed for the research. All patients’ data (non-complicated post- Hip and Knee Arthroplasty (1st group - 1579 patients) and post- Hip and Knee Arthroplasty with surgical site infection in 12 months (2nd group - 128 patients)) had been used as an educational matrix for a mathematic forecast and as a construction of a prevention algorithm for septic complications in primary THA and TKA. The study had shown 14 significant criteria which can influence the occurrence of surgical site infection in THA and TKA. 12-month testing period of the software in prospective research (467 cases) had shown a significant decrease rate of surgical site infection in comparison to retrospective research (decrease of 7.5% in the prospective cases and 4.1% - in retrospective).
Эндопротезирование коленных суставов (ЭКС) в последние годы занимает особое место среди достижений травматологии и ортопедии [3, 7, 10]. Вместе с тем, эта операция не всегда позволяет добиваться положительных результатов. Осложнения артропластики коленного сустава составляют от 2 до 27% среди всех случаев ЭКС [3, 5, 10, 11]. Структура негативных последствий артропластики коленного сустава (КС) неоднородна [5, 9, 11]. Значительную их часть составляют гнойно-воспалительные осложнения ЭКС [3, 7, 8].В современной отечественной и зарубежной литературе и на научных форумах разного уровня проводятся оживленные дискуссии по вопросам, касающимся улучшения результатов ЭКС. Вместе с тем, данные о возможностях прогнозирования и профилактики гнойно-воспалительных осложнений при артропластике суставов и данные о результатах оказания медицинской помощи при наличии инфекции области хирургического вмешательства (ИОХВ) после эндопротезирования суставов остаются противоречивыми [2, 4, 6]. В связи с этим, изучение вопросов прогнозирования и профилактики ИОХВ при эндопротезировании коленного сустава является актуальной темой медицинских научных исследований.Сохраняющийся риск развития гнойно-воспалительных осложнений при артропластике коленного сустава может быть расценен как побудительный мотив к разработке методик предоперационного планирования и подготовки, вариантов проведения хирургического вмешательства, а также способов ведения послеоперационного периода при эндопротезировании коленного сустава.ЦельНа основании определения факторов риска развития гнойных осложнений в зоне операции и выявления среди больных группы риска, а также разработки и применения алгоритма прогнозирования и профилактики инфекции области хирургического вмешательства улучшить результаты эндопротезирования коленных суставов
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