Minimally invasive transforaminal lumbar interbody fusion with percutaneous bilateral pedicle screw fixation for lumbosacral spine degenerative diseases. a retrospective database of 40 consecutive treated cases and literature review.

Millimaggi, Daniele Francesco; Norcia, Valerio Di; Luzzi, Sabino; Alfiero, Tommaso; Galzio, Renato; Ricci, Alessandro

doi:10.5137/1019-5149.jtn.19479-16.0

Cited by 15 publications

(12 citation statements)

References 13 publications

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“…Similarly, the higher prevalence of BE underlines the importance of having an early arterial blood gas and to remember in its interpretation that the rise in BE correlates with the development trauma coagulopathy. It would certainly be interesting to further investigate, from a pathophysiological point of view, this correlation that we found and have shown to be significant, because understanding the underlying mechanism would allow better management of trauma coagulopathy and especially trauma in general [1,28,[48][49][50][51][52][53][54][55][56][57][58][59][60][61][62][63][64]. In both cases, this is reflected in a greater seriousness that leads to the need for hospital treatment.…”

Section: Discussionmentioning

confidence: 89%

Trauma Coagulopathy and Its Outcomes

et al. 2020

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Background and Objectives: Trauma coagulopathy begins at the moment of trauma. This study investigated whether coagulopathy upon arrival in the emergency room (ER) is correlated with increased hemotransfusion requirement, more hemodynamic instability, more severe anatomical damage, a greater need for hospitalization, and hospitalization in the intensive care unit (ICU). We also analyzed whether trauma coagulopathy is correlated with unfavorable indices, such as acidemia, lactate increase, and base excess (BE) increase. Material and Methods: We conducted a prospective, monocentric, observational study of all patients (n = 503) referred to the Department of Emergency and Acceptance, IRCCS Fondazione Policlinico San Matteo, Pavia, for major trauma from 1 January 2018 to 30 January 2019. Results: Of the 503 patients, 204 had trauma coagulopathy (group 1), whereas 299 patients (group 2) did not. Group 1 had a higher hemotransfusion rate than group 2. In group 1, 15% of patients showed hemodynamic instability compared with only 8% of group 2. The shock index (SI) distribution was worse in group 1 than in group 2. Group 1 was more often hypotensive, tachycardic, and with low oxygen saturation, and had a more severe injury severity score than group 2. In addition, 47% of group 1 had three or more body districts involved compared with 23% of group 2. The hospitalization rate was higher in group 1 than in group 2 (76% vs. 58%). The length of hospitalization was >10 days for 45% of group 1 compared with 28% of group 2. The hospitalization rate in the ICU was higher in group 1 than in group 2 (22% vs. 14.8%). The average duration of ICU hospitalization was longer in group 1 than in group 2 (12.5 vs. 9.78 days). Mortality was higher in group 1 than in group 2 (3.92% vs. 0.98%). Group 1 more often had acidemia and high lactates than group 2. Group 1 also more often had BE <−6. Conclusions: Trauma coagulopathy patients, upon arrival in the ER, have greater hemotransfusion (p = 0.016) requirements and need hospitalization (p = 0.032) more frequently than patients without trauma coagulopathy. Trauma coagulopathy seems to be more present in patients with a higher injury severity score (ISS) (p = 0.000) and a greater number of anatomical districts involved (p = 0.000). Head trauma (p = 0.000) and abdominal trauma (p = 0.057) seem related to the development of trauma coagulopathy. Males seem more exposed than females in developing trauma coagulopathy (p = 0.018). Upon arrival in the ER, the presence of tachycardia or alteration of SI and its derivatives can allow early detection of patients with trauma coagulopathy.

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Section: Discussionmentioning

confidence: 89%

Trauma Coagulopathy and Its Outcomes

et al. 2020

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“…In that document, as well as in other reports,[ 9 ] it was also suggested that advanced age was one of the factors in mortality, along with some other pathological processes predisposing to unfavorable outcomes and with diagnoses according to the mechanism, anatomical, and hemodynamic criteria. [ 10 11 12 13 14 15 16 17 18 ]…”

Section: Discussionmentioning

confidence: 99%

Major Trauma in Elderly Patients

Savioli

Ceresa

Macedonio

et al. 2021

Journal of Emergencies, Trauma, and Shock

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Introduction: Major trauma is the leading cause of mortality in the world in patients younger than 40 years. However, the proportion of elderly people who suffer trauma has increased significantly. The purpose of this study is to assess the correlation of old age with mortality and other unfavorable outcomes. Methods: We assessed on one hand, anatomical criteria such as ISS values and the number of body regions affected, on the other hand, hemodynamic instability criteria, various shock indices, and Glasgow Coma Scale. Finally, we also evaluated biochemical parameters, such as lactate, BE, and pH values. We conducted a prospective and monocentric observational study of all the patients referred to the Emergency Department of the IRCCS Fondazione Policlinico S. Matteo in Pavia for major trauma in 13 consecutive months: January 1, 2018–January 30, 2019. We compared the elderly population (>75 years) and the younger population (≤75). Results: We included 501 patients, among which 10% were over the age of 75 years. The mortality rate was higher among the older patients than among the younger (4% vs. 1.33%; P = 0.050). Hemodynamic instability was more common in the older patients than in the younger (26% vs. 9%; P < 0.001). More older patients (44%) had an ISS >16, in comparison with 32% of younger patients (P = 0.01). Conclusions: The elderly showed worse outcomes in terms of mortality, hospitalization rate, hemodynamic instability criteria, and anatomical and biochemical parameters.

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“…All the aforementioned aspects make piezosurgery a very good tool for most of the complex skull and spinal neurosurgical approaches [47][48][49][50][51][52][53][54][55][56][57][58][59].…”

Section: Discussionmentioning

confidence: 99%

Minimal Invasive Piezoelectric Osteotomy in Neurosurgery: Technic, Applications, and Clinical Outcomes of a Retrospective Case Series

Crovace

Luzzi

Lacitignola

et al. 2020

Veterinary Sciences

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Objective: To report the physical and technical principles, clinical applications, and outcomes of the minimal invasive piezoelectric osteotomy in a consecutive veterinary neurosurgical series. Methods: A series of 292 dogs and 32 cats underwent an osteotomy because a neurosurgical pathology performed with a Mectron Piezosurgery® bone scalpel (Mectron Medical Technology, Genoa, Italy) was retrospectively reviewed. Efficacy, precision, safety, and blood loss were evaluated intraoperatively by two different surgeons, on a case-by-case basis. Postoperative Rx and CT scans were used to assess the selectivity and precision of the osteotomy. A histological study on bony specimens at the osteotomized surface was carried out to evaluate the effects of piezoelectric cutting on the osteocytes and osteoblasts. All the patients underwent a six-months follow-up. A series of illustrative cases was reported. Results: All the osteotomies were clear-cut and precise. A complete sparing of soft and nervous tissues and vasculature was observed. The operative field was blood- and heat-free in all cases. A range of inserts, largely different in shape and length, were allowed to treat deep and difficult-to-reach sites. Two mechanical complications occurred. Average blood loss in dogs’ group was 52, 47, and 56 mL for traumatic, degenerative, and neoplastic lesions, respectively, whereas it was 25 mL for traumatized cats. A fast recovery of functions was observed in most of the treated cases, early on, at the first sixth-month evaluation. Histology on bone flaps showed the presence of live osteocytes and osteoblasts at the osteotomized surface in 92% of cases. Conclusions: Piezosurgery is based on the physical principle of the indirect piezo effect. Piezoelectric osteotomy is selective, effective, and safe in bone cutting during neurosurgical veterinary procedures. It can be considered a minimal invasive technique, as it is able to spare the neighboring soft tissues and neurovascular structures.

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Minimally invasive transforaminal lumbar interbody fusion with percutaneous bilateral pedicle screw fixation for lumbosacral spine degenerative diseases. a retrospective database of 40 consecutive treated cases and literature review.

Cited by 15 publications

References 13 publications

Trauma Coagulopathy and Its Outcomes

Trauma Coagulopathy and Its Outcomes

Major Trauma in Elderly Patients

Minimal Invasive Piezoelectric Osteotomy in Neurosurgery: Technic, Applications, and Clinical Outcomes of a Retrospective Case Series

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