PubMed Health⌕ Search

Biomedical subjects

I Hovorka

Publications and source records attributed to I Hovorka.

12 recordsLinked to original sources
PubMed2001

[Videoscopic retropleural and retroperitoneal approach to the thoracolumbar junction of the spine].

PURPOSE OF THE STUDY: A minimally invasive anterior approach has been developed for the thoracolumbar junction of the spine. The aim of this study was to evaluate the possibilities of videoscopic treatment of fractures and malunions of the thoracolumbar junction and to report the first results obtained with this technique. MATERIAL AND METHODS: Video-assisted surgery was performed in eleven patients using costal resection and a retropleural and retroperitoneal approach. Anterior arthrodesis was performed in all cases, four with anterior instrumentation. The indications were trauma for six patients and malunion for five. RESULTS: Mean follow-up was 17.4 months. For malunion patients, the mean angular gain was 22.4 degrees. Radiological anterior fusion was achieved in all cases except one. The mean angular loss was 5.7 degrees. DISCUSSION: The surgeon can control the procedures by direct vision, while the assistant follows the operation on the video display screen. The upper par of L1 can be reached via a supradiaphragmatic retropleural approach, while a larger exposure is possible if the insertions of the diaphragm are released and the retroperitoneal space is opened. The crus does not have to be sectioned to expose the lateral part of the thoracolumbar vertebrae. Possible complications are similar to those which can be observed with open procedures. CONCLUSION: The videoscopic approach enables the exposure of throacolumbar junction with a smaller parietal lesion than with open procedures. It enables arthrodesis procedures with corporectomay, angular correction and anterior osteosynthesis.

Adolescent↗
PubMed2000

Five years' experience of the retroperitoneal lumbar and thoracolumbar surgery.

Retroperitoneal videoscopic spine surgery has been developed in our department since 1994. It has been used not only at the lumbar, but also at the thoracolumbar and lumbosacral level. Thirty-eight patients have been operated on. We have performed 12 thoracolumbar approaches, 23 lumbar approaches, and 3 retroperitoneal lumbosacral approaches. In every case, a video-assisted technique has been employed. These techniques have been used for anterior grafting in 18 cases of fracture, for corporectomy and grafting with or without anterior osteosynthesis in 6 cases of malunion, for cage implantation or isolated grafting in 10 cases of degenerative disc disease, and for the treatment of 4 cases of spondylodiscitis. Results were satisfactory for every type of pathology. The complications related to the approach were the same as those seen with open surgery; however, the videoscopic approach seems to us less invasive, with cosmetic benefit, less blood loss, and more rapid recovery. A video-assisted technique appears to be a good compromise between videoscopic technique and open surgery. With the development of these techniques, few indications remain for open anterior surgery on the lumbar spine in our opinion.

Adolescent↗
PubMed2000

Traumatic rotatory displacement of the lower cervical spine.

The authors describe the classification for traumatic rotary injuries of the cervical spine. The classification is based on a review of 306 severe lower cervical spine injuries observed in 255 patients between 1980 and 1994. Traumatic rotatory displacements (TRD) represented 39% of the 306 severe injuries. Three different lesions were observed: unilateral facet fractures, fracture-separation of the articular pillars, and unilateral facet dislocations.

Cervical Vertebrae↗
PubMed1999

[Retroperitoneoscopic anterior approach to the L2, L3, L4 vertebral bodies].

PURPOSE OF THE STUDY: We present a technique of retroperitoneal video assisted anterior approach of vertebral bodies and adjacent discs on L2-L3-L4 levels without CO2 insufflation. MATERIALS: A videosurgical material is required as well as fluoroscopic control. Ordinary anesthesia methods can be used. The patient is placed in right lateral decubitus. Ay. A3 cm incision is targeted moderately anteriorly at the level of the vertebra. Dissection of the retroperitoneal space is begun by blunt finger dissection and completed by a balloon. A camera is inserted. CO2 insufflation is not used for this open video-assisted technique. METHODS: We have performed 12 arthrodeses with this technique, 11 of them without corporectomy. In one case, a corporectomy with peroneal graft was used. RESULTS: Eleven arthrodesis fused. The possible complications are the same as with a full open procedure. DISCUSSION: Extension of this approach is limited cranially by the 12th rib and caudally by the iliac crest. CONCLUSION: Although this is an easy to perform mini open technique, a learning curve is necessary. Conservation to a full open procedure is possible at any point in the procedure.

Dissection↗
PubMed1999

Lung nematodes of chamois, Rupicapra rupicapra tatrica, from the Tatra National Park, Slovakia.

A larvoscopic examination of faeces collected from localities inhibited by chamois in the Tatra National Park (TANAP) in 1997 demonstrated the presence of the lung nematodes Muellerius spp. (likely to be M. tenuispiculatus and M. capillaris) and Neostrongylus linearis. The overall prevalence of lung nematodes in chamois herds in TANAP was 48.4% with prevalences of 45.6% and 11.9% for Muellerius spp. and N. linearis, respectively. No significant differences in lung nematode prevalences were observed in the biotopes of TANAP with prevalence values of 44.9% being recorded in the High Tatras and 58.5% in the Belianske Tatras. Individual species were in equal proportion in both biotopes, although N. linearis was significantly less prevalent (11.2-13.8%). The prevalence of lung nematodes in the High Tatras varied from 25.0 to 84.2% within individual localities, while in the Belianske Tatras it was more proportionate (50.0-85.7%). In the High Tatras, the prevalence of lung nematodes in the chamois herds peaked during August, declining to its lowest in October. A similar prevalence was also recorded for Muellerius species, while the minimum prevalence of N. linearis was found in July. In the Belianske Tatras, the prevalence of lung nematodes including both species of Muellerius peaked in July and gradually decreased until October. On the other hand, N. linearis was most prevalent in October. The mean L1 count per gram faeces was low (7.6 +/- 13.2 larvae g-1).

Animals↗
PubMed1996

Short device fixation and early mobilization for burst fractures of the thoracolumbar junction.

The authors present a retrospective study based on a homogeneous series of 34 patients with burst fractures of the thoracolumbar junction, fixed using Cotrel-Dubousset instrumentation. These patients underwent instrumentation using a short construct of hooks and screws gripping the two vertebrae above the lesion (2HS) and screws and hooks gripping the first vertebra below the lesion (1SH). This construct was therefore called "2HS-1SH". In order to evaluate just the material resistance after getting up, only the patients who were upright on the 4th day without a body cast and with no secondary anterior osteosynthesis were included in this study. Four patients showed some neurological symptoms on admission but recovery was so quick that they could be included in this study. Mean follow-up was 4 years 1 month (range 3 years 1 month and 6 years 2 months). Vertebral and regional kyphosis angles were measured preoperative, postoperatively and at the final follow-up. Functional recovery and complications were analyzed. Mean vertebral kyphosis was 21.2 degrees preoperatively, 3.8 degrees postoperatively and 5.3 degrees at the final follow-up. Regional kyphosis angles were respectively 19.2, 0.2, and 2.7 degrees. We had two cases of deep suppuration, one early and the other late. None of the patients required analgesics for more than 6 months after the operation. Patients returned to work after 5 months on average. The authors concluded that fixation by screw-and-hook constructs is an effective way to stabilize thoracolumbar junction burst fractures.

Adolescent↗
PubMed1996

New possibilities in L2-L5 lumbar arthrodesis using a lateral retroperitoneal approach assisted by laparoscopy: preliminary results.

Four patients underwent lumbar interbody fusion, performed via a video-assisted retroperitoneal laparoscopic approach, complementary to posterior osteosynthesis at the L2-L3, L3-L4 and/or L4-L5 level. In three cases the interventions were for lumbar fractures, and in one case for microcristalline arthritis. After surgical training on human cadavers and several porcine operative sessions, retroperitoneal lateral approaches on the left side were performed by the authors without CO2 insufflation, assisted by videoscopy. The fusion process was monitored by fluoroscopy. It is possible to perform this technique cranially above L2 or caudally below L5. Minimal blood loss was observed. Average time for these interventions was 127 min. Interbody fusion was achieved in the first, second and fourth cases; the outcome in the third case at the final check-up, 6 months after operation, was uncertain. The first patient had a complication of ureteral wound, which was certainly caused by insufficient experience with the new technique. The authors hope to extend the application of this technique to other procedures as they become more experienced.

Adult↗
PubMed1995

Role of small mammals in the epidemiology of toxocariasis.

Studies were conducted on the role of small mammals in maintaining toxocariasis foci in urban, rural and montane biotopes. The lowest relative density of small mammals was recorded in the urban locality and the highest in the rural and montane localities. Anti-Toxocara antibodies were most frequently detected in synanthropic and hemisynanthropic species Mus musculus, Apodemus agrarius and Micromys minutus--32.0, 30.4 and 25.0%, respectively. The highest seropositivity was found in small mammals from the urban and rural localities--22.2 and 21.6%, respectively. Toxocara canis was most prevalent in urban stray dogs (75.0%) and least prevalent in foxes from the montane locality (7.0%). The prevalence of Toxocara cati in cats at the urban, rural and montane localities was 66.2, 65.2 and 76.9%, respectively. In clinically healthy human populations, the highest seroprevalence was detected in the rural locality (14.0%). Children of the same area were 3 times more seropositive (12.9%) than those from the urban and montane localities (4.3 and 4.0%). Our studies suggest an important role for small mammals as paratenic hosts--reservoirs of Toxocara larvae--in maintaining toxocariasis foci. In this respect toxocariasis may be classified as an anthropopurgic focal zoonosis.

Adolescent↗
PubMed1994

Motorcycle petrol tanks and their role in severe pelvic injuries.

Between 1985 and 1992, nine patients who sustained severe pelvic lesions as a result of motorcycle accidents were admitted to and treated in the authors' department. In six of these nine cases the petrol tank of the motorcycle was one of the wounding agents, and all six patients had the same kind of motorcycle with an oversized petrol tank. All six patients had unstable pelvic lesions. In addition, four had subperitoneal haematomas which required multiple transfusions; five had perineal and/or genital lesions, and one had a ruptured membranous urethra. Severe pelvic injuries are rare, but can have after-effects which jeopardize the social and family life of the patients. A national epidemiological study would be useful to evaluate the frequency of such injuries and to draw conclusions leading to improved safety for motorcyclists.

Accidents, Traffic↗
PubMed1993

The vertebral foramen: a report concerning its contents.

Thirteen subjects were randomly selected and embalmed according to Winckler's technique. After removal of the vertebral column and the head in one block the specimens were frozen. Transverse transpedicular cuts were performed at C6, T1, T6, L1, L3, and L5. After enlargement photography, the surface area of the vertebral foramen and its various contents were measured on a computer using the Canvas programme and analysed using the Statview programme. The mean area of the vertebral foramen occupied by the cord was 30.5% at C6, 26.1% at T1, 21.4% at T6, 12.7% at L1, 0.08% at L3. The mean area occupied by the nerve roots was 3.9% at C6, 3.3% at T1, 1.6% at T6, 14.2% at L1, 17.5% at L3, 12.2% at L5. The mean area of all the nervous tissue was 34.4% at C6, 29.5% at T1, 23% at T6, 26.9% at L1, 18.9% at L3, 19.3% at L5. The cerebrospinal fluid occupied a mean area of 25.2% at C6, 30.7% at T1, 31.6% at T6, 43% at L1, 43.5% at L3, and 28.1% at L5. The total neural tissue did not occupy more than a third of the vertebral foramen. These facts should be considered by surgeons who perform laminectomy or decompression in cases of vertebral trauma or congenital and osteoarthritic stenoses.

Aged↗
PubMed1989

Scanning electron microscopic study on Toxascaris transfuga (Rudolphi, 1819) (Nematoda).

The authors present original observations on the species Toxascaris transfuga obtained by means of scanning electron microscopy. Attention was paid to the structure of head end, morphology of papillae of the head and abdominal end, specific morphological traits of cloacae edges and morphology of the egg surface. Presented are morphological criteria which apparently differentiate the species T. transfuga from T. leonina (Linstow, 1902). T. transfuga and T. multipapillata Kreis, 1938 seem to be conspecific.

Animals↗