Biomedical subjects

A Baikousis

Publications and source records attributed to A Baikousis.

22 records · Page 2Linked to original sources

PubMed1997

Transthoracic disc excision with interbody fusion. 12 patients with symptomatic disc herniation followed for 2-8 years.

Thoracic disc herniation is a rare and slowly progressing disease, commonest at the lower thoracic spine. We performed transthoracic discectomy and interbody fusion in 12 patients with an average age of 46 years suffering from symptomatic herniated thoracic disc. Pain and neurologic impairment were the commonest symptoms at admission. The outcome at a mean follow-up of 4 (2-8) years concerning pain were excellent or good in 10 patients, fair in 1 and unchanged in 1 patient. There were no approach-related complications. All 7 patients with incomplete neurologic impairment preoperatively improved postoperatively at least 1 Frankel grade. Posterior complementary fusion at the thoracolumbar junction was necessary in 2 patients because of increasing symptomatic local kyphosis. Although the number of patients is small, due to the rarity of the disease, it seems that the transthoracic approach for anterior discectomy and fusion is an appropriate treatment for symptomatic thoracic disc herniation. Proper patient selection, preoperative planning and surgical technique resulted in good pain relief, neurologic recovery in cases associated with incomplete neurologic impairment and restoration of the sagittal profile of the thoracolumbar spine.

Adult↗

PubMed1996

Simultaneous three-level disc herniation in a patient with multiple sclerosis.

A rare case is presented of symptomatic simultaneous multilevel disc herniation in the cervical, thoracic and lumbar spine of a 38-year-old man, which were operated on at three different timepoints. Following the third operation, the patient was diagnosed with multiple sclerosis, based on pathological visual evoked potentials and cerebrospinal fluid examination. Spinal surgeons should be aware of the uncommon simultaneous presence of symptomatic disc herniations at different spinal levels, and of the possibility that such multilevel disc herniations may coexist with demyelinating diseases and may confuse the diagnosis.

Adult↗

PubMed1996

Vertical transmission of the hip rolls due to wearing of TLSO for scoliosis.

Cosmesis is important in the treatment of adolescent patients with idiopathic scoliosis. It has been shown that although bracing reduces the rib hump, it induces several complications. The aim of this study was to describe a new disturbing complication due to wearing a thoracolumbosacral orthosis (TLSO) for adolescent idiopathic scoliosis: the vertical transmission of the hip rolls (trochanteric lipomatosis) in girls and its pathogenetic mechanisms. Trochanteric lipomatosis is common in the female population, particularly after adolescence, and is responsible for the characteristic appearance of the hip rolls. No data have been reported concerning vertical transmission of normal trochanteric lipomatosis with subsequent disturbance of aesthetic appearance while wearing the TLSO. In this prospective study, 300 consecutive adolescent girls who were treated with the TLSO for progressive idiopathic scoliosis were followed and evaluated for development of any vertical transmission of the hip rolls after application of the brace for an average of 2.5 years after termination of the treatment. Almost simultaneously, 290 age-matched, randomly selected adolescent girls served as controls and were examined by two unbiased observers during the school screening program to estimate the prevalence of trochanteric lipomatosis in female adolescents of the same geographic area. In this series, bracing reduced the thoracic scoliosis from 34.4 +/- 5 degrees to 18.5 +/- 6 degrees and the lumbar scoliosis from 29.4 +/- 4 degrees to 16.7 +/- 4 degrees 6 months after initiation of brace wearing. The average prevalence of normal trochanteric lipomatosis in girls in the control group was 26% (range, 12.2-68.4%) for the ages 9-14 years and was increasing with the age and weight. No correlation was found between amount of reduction of scoliosis and prevalence of the complication. Vertical transmission of the hip rolls was observed in 69 (23%) of the girls with scoliosis 6 months after initiation of brace wearing and was positively correlated with the rigidity of the scoliotic curvature (p < 0.05) and the amount of reduction of the curvature (p < 0.05). Seven (8.8%) girls discontinued brace wearing because of psychological distress related to the deformity around the hip rolls, whereas 51 (73%) additional girls underwent suction lipoplasty during or after the termination of the brace wearing, because of persistent and disturbing lipomatosis. Recurrence of significant lipomatosis was observed in 3 (5.8%) of the girls who underwent lipoplasty. Physicians who are involved with treatment of scoliosis with bracing should be aware of this aesthetic complication. Brace wearing should not attempt maximum correction of scoliosis, thus avoiding excessive force on the body, and should be ordered only in patients with immature spines, curves of > 25 degrees, and radiologically justified progression. Suction lipoplasty seems to be a safe method of treatment and should be advised in cases with unaesthetic vertical transmission of the hip rolls.

Adipose Tissue↗

PubMed1996

Relapsing pancreatitis after combined anterior and posterior instrumentation for neuropathic scoliosis.

We report a case of pancreatitis in a 28-year-old woman who underwent a combined anterior Zielke procedure followed by Luque-TSRH (Texas Scottish Rite Hospital) operation in the same session for severe polioscoliosis. To our knowledge, only one case of a child with acute pancreatitis after posterior instrumentation for spondylolisthesis has been reported. In the early postoperative period, the patient developed acute pancreatitis that was diagnosed by a marked increase in plasma amylase and was confirmed by ultrasonography. The symptoms of pancreatitis in this patient temporarily resolved a few weeks after conservative treatment (diet, infusions, antibiotics). Six, 16, and 32 months after the combined operation, there were repeated relapsing episodes of pancreatitis with elevated amylase levels and concomitant symptoms. In the last follow-up evaluation in December 1995, the patient was well and the amylase levels were within normal limits. Although the etiology of pancreatitis in this case is obscure, we believe that the correction of the severe biplane spinal deformity, achieved by the two major operations on the spine in the same session, may have contributed to the pathogenesis of the disease. This observation suggests that pancreatitis after major scoliosis surgery should be suspected when abdominal symptoms persist associated with elevated serum amylase levels. Some cases of acute pancreatitis, such as this case, can persist in chronic-relapsing form for long periods postoperatively.

Abdominal Pain↗