Use of implants and spinal fusion is always associated with a risk of complications and is frequently independent of the surgeon. 2. In order to reduce the rate of revision surgeries, it is important to perform complete decompression and select an adequate surgical technique.

STRESZCZENIEAwulsyjne uszkodzenie splotu ramiennego ze złamaniem kłykcia potylicznego należy do bardzo rzadkich urazów i najczęściej jest skutkiem wypadków komunikacyjnych. W pracy przedstawiono analizę przypadku 24-letniego pacjenta, u którego w wyniku wypadku samochodowego wystąpiły obydwa powyższe uszkodzenia. Badanie tomografii komputerowej uwidoczniło złamanie kłykcia potylicznego prawego, natomiast badanie rezonansu magnetycznego przerwanie ciągłości nerwów rdzeniowych na poziomie C3-C7 po stronie lewej. U chorego zastosowane leczenie zachowawcze.Słowa kluczowe: uszkodzenie splotu ramiennego, złamania kłykcia potylicznego, rezonans magnetyczny SUMMARYAvulsion injuries of the brachial plexus with occipital condyle fractures are very rare and usually result from motor vehicle accidents. This paper presents an analysis of the case of a 24-year-old male patient who sustained both these injuries in a car accident. Computed tomography revealed a fracture of the right occipital condyle and a magnetic resonance scan showed spinal nerve disruption at the C3-C7 level on the left. The patient underwent conservative treatment. MEDSPORTPRESS, 2016; 4(6); Vol. 18, 359-365 DOI: 10.5604/15093492.1220827 Key words: brachial plexus injuries , occipital condyle fractures, magnetic resonance imaging STUDIUM PRZYPADKU / CASE STUDYO O r r t t o o p p e e d d i i a a Traumatologia Rehabilitacja © WSTĘPUszko dze nie splo tu ra mien ne go na stę pu je naj czę -ściej w wy ni ku ura zu, tj. wy pad ku ko mu ni ka cyj ne go z udzia łem po jaz dów po ru sza ją cych się z du żą pręd -ko ścią, upad ku z wy so ko ści, kon tu zji spor to wych oraz dłu go trwa łe go uci sku na splot ra mien ny np. pod czas snu. Spo śród wszyst kich wy pad ków ko mu ni ka cyj nych tyl ko 0,67% pro wa dzi do uszko dze nia splo tu ra mienne go. Naj czę ściej pro blem do ty czy gru py mło dych mę żczyzn po wy pad kach mo to cy klo wych [1,2]. Uraz o du żej in ten syw no ści w cza sie wy pad ku, po wo du ją -cy przy gię cie gło wy i szyi do bar ku, jest przy czy ną wy rwa nia ko rze ni ner wów rdze nio wych z rdze nia krę go we go stro ny prze ciw nej.Kon se kwen cją nad mier nej trak cji splo tu mo że być je go uszko dze nie przed zwo jo we lub po za zwo jowe. Uszko dze nie przed zwo jo we ozna cza uszko dzenie włó kien ner wo wych przed zwo jem rdze nio wym, w ka na le krę go wym lub w otwo rze mię dzy krę gowym [2][3][4]. Uszko dze nie to nie po wo du je de ge ne racji ty pu Wal le ria na i nie two rzą się ner wia ki, po nieważ ak son po zo sta je w cią gło ści z cia łem ko mór ki w zwo ju. Uszko dze nie po za zwo jo we okre śla uszkodze nie włó kien ner wo wych dy stal nie od zwo ju rdzenio we go i fi zjo lo gicz nie po dob ne jest do uszko dzenia ner wów ob wo do wych.Awul sja ko rze ni ner wów rdze nio wych pro wa dzi do po ra że nia splo tu ra mien ne go i jest spo wo do wa na wy so ko ener ge tycz nym na prę że niem włó kien nerwo wych. Zer wa ne włók na są nie zdol ne do re ge ne racji i nie pod da ją się le cze niu chi rur gicz ne mu, a de ficy ty...

IntroductionInfections after spinal surgery are sporadic and depend on the patient's condition and the type and extent of surgery. The incidence of surgical site infections in European centers ranges from 0% to 18%. The aim of the study was to determine the frequency of infections in patients after spinal surgery.Material and methodsThe analysis covered 6067 patients who underwent spinal surgery in the Department of Neuroorthopedics between 2015-2019, taking into account the number of microbiological tests and the number of detected infections, the number of surgical procedures and the rate of SSI infections, the number of readmissions and reoperations, and the use of antibiotics. The analysis was based on retrospective data of patients hospitalized in the analyzed period.ResultsThe number of operated patients remained at a similar level in the analyzed annual periods, from 1136 to 1269 patients, while the infection rate of the operated site ranged from 0,33% to 1,04%, and the percentage of infections was between 0,58% and 3,29 %. In turn, the analysis of reoperations performed due to infection of the operated site in 2018 and 2019 was 0,56% and 0,07%, respectively, which places the center in the leading position in the European ranking. During the analyzed five years, the use of antibiotics was reduced by 2/3.ConclusionsThe analysis of infections in patients after spinal surgery over a 5-year period showed that the SSI rate did not exceed 1,04%, which is comparable with data from recognized European centers. Infections caused by alarm pathogens have been detected occasionally.

Background: A positive experience of childbirth, as outlined by the WHO, consists of giving birth to a healthy child, and meeting the expectations of the woman based on her beliefs, previous experiences, and cultural conditions. Aim of the study: To evaluate the mother’s satisfaction with childbirth, satisfaction with the expectations of giving birth, and the care received during and after birth. Material and methods: This study used a questionnaire for data collection that was validated by a panel of experts using the Delphi method. The Chi-square, Mann-Whitney U and Kruskal-Wallis rank tests with post-hoc comparisons were used for the analysis. Correlations were examined using the Spearman’s R test. Results: For the whole study group (n = 444), the mean score for satisfaction with childbirth was 3.83 (± 1.25), and the assessment of care during childbirth (n = 444) and care in the maternity unit (n = 427) were 4.11 (± 1.12) and 3.60 (± 1.22), respectively. Satisfaction with childbirth in the whole study group was significantly correlated with emotional support (r = 0.55, p < 0.001) and communication with staff (r = 0.53, p < 0.001) during delivery, provision of intimacy (r = 0.44, p < 0.001), pain relief (r = 0.43, p < 0.001), contact with the newborn after birth (r = 0.43, p < 0.001), support for breastfeeding (r = 0.37, p < 0.001), and accommodation and sanitary conditions during delivery (r = 0.37, p < 0.001). The largest statistically significant differences regarding fulfillment of the women’s expectations were observed between groups describing their childbirth as frightening and painful, and groups describing their childbirth as expected, positive and pleasant. Conclusions: Women had a worse opinion of care after childbirth compared to care during childbirth, which may be due to the lack of expectations concerning emotional support and assistance in breastfeeding that were reported by the respondents.

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