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Biomedical subjects

Panayiotis J Papagelopoulos

Publications and source records attributed to Panayiotis J Papagelopoulos.

At least 37 records · Page 2Linked to original sources
PubMed2005

Minimally invasive techniques in orthopedic oncology: radiofrequency and laser thermal ablation.

Image-guided percutaneous thermal ablation is a safe and effective method to reduce pain in patients with painful bone tumors. Computed tomography-guided radiofrequency or laser ablation is the modality of choice for most osteoid osteomas. Radiofrequency or laser thermal ablation also offers an alternative method for palliation of localized, painful osteolytic metastatic lesions. Pain can be reduced and neural damage prevented, improving the quality of life for patients with cancer who often have multimorbid conditions and limited life expectancy. A multidisciplinary approach that includes orthopedic surgeons, neurosurgeons, medical and radiation oncologists, and interventional radiologists is essential to manage these patients.

Bone Neoplasms↗
PubMed2005

Coracoclavicular screw fixation for unstable distal clavicle fractures.

Fifteen patients with Neer type II distal clavicle fracture were treated surgically. Operative treatment included open reduction and fixation of the proximal clavicular fragment to the coracoid process using a 6.5-mm cancellous screw and repair of the coracoclavicular ligaments. Fracture union occurred at a mean of 7 weeks postoperatively without any serious complications. All patients returned to the pre-injury level of activity with no residual pain or dysfunction.

Adolescent↗
PubMed2005

Percutaneous Harlow Wood needle biopsy of the spine: a retrospective analysis of 238 spine lesions.

This retrospective study assessed the diagnostic accuracy and clinical usefulness of the Harlow Wood needle biopsy for spinal lesions. The medical records of 238 patients (138 men and 100 women) who underwent closed spine biopsy from 1987 through 1997 were reviewed. Patient age ranged from 21 to 83 years. Lesions involved the thoracic vertebrae in 127 patients, the lumbar vertebrae in 99 patients, and the sacrum in 12 patients. Cultures of the biopsy specimens were examined histopathologically and cytologically. One hundred twenty-four patients were diagnosed with a spinal infection, and 68 patients were diagnosed with a tumor. In the remaining 46 patients, the biopsy specimens were negative for infection or neoplasia in 20 patients and not diagnostic in 26 (10.9%) patients. There were no major complications. The Harlow Wood needle biopsy is a simple, repeatable procedure with satisfactory diagnostic accuracy (89.1%) and can be performed on an outpatient basis.

Adult↗
PubMed2004

Factors associated with good outcome using lateral mass plate fixation.

The immediate and long-term outcomes of 70 consecutive patients who underwent subaxial lateral mass fixation between June 1996 and June 2001 were reviewed. Intraoperative fluoroscopy and somatosensory evoked potential (SEP) monitoring were used in all patients. Immediate postoperative computed tomography (CT) was performed to determine screw trajectory and placement. Follow-up ranged from 2 to 7 years. Postoperative CT showed 206 (58%) of 356 screws had unicorticate and 42% bicorticate purchase. Furthermore, 96 (27%) screws had suboptimal trajectory, but only 5 of these screws minimally penetrated the foramen transversarium without resultant vascular or neurological sequelae. A sudden unilateral intraoperative SEP amplitude decrease during screw placement in 2 patients resolved with screw removal and alteration of screw trajectory. The overall fusion success rate was 91.5% and screw pull-out developed in 2 patients. The recommended drilling technique and trajectory (15 degrees - 25 degrees rostral in the sagittal plane, 20 degrees - 30 degrees lateral in the axial plane), supplemented bone grafting, and intraoperative SEP monitoring are all associated with good screw placement, fusion, and neurological outcome and are recommended for all lateral mass fusion procedures.

Adult↗
PubMed2004

Surgical decompression for cervical spondylotic myelopathy: correlation between operative outcomes and MRI of the spinal cord.

Forty-two patients who underwent decompressive surgery for cervical spondylotic myelopathy were studied. The pre- and postoperative magnetic resonance imaging (MRI) findings and the Japanese Orthopedic Association score were analyzed to evaluate whether the different appearances of intramedullary high-signal intensity on T2-weighted MRI are related to the surgical prognosis. Magnetic resonance imaging signal intensities were classified as type 0 if no intramedullary high-signal intensity on T2-weighted images was noted, type 1 if high-signal intensity involved only one segment, and type 2 if high-signal intensity extended over two segments. Statistical analyses of the recovery ratio showed that type 0 and type 1 intramedullary high-signal intensity indicates better prognosis than type 2.

Adult↗
PubMed2004

Multiple fractures of the axis.

Multiple fractures of the axis are not common lesions. A retrospective study was performed to identify the different fracture patterns and to analyze the incidence of these injuries and their long-term behavior. The medical records of 674 consecutive patients with fractures of the cervical spine were reviewed. Nine (1%) of 674 patients (6 men and 3 women) had multiple fractures of the axis. Mean patient age was 48 years. The most common lesion was a combination of traumatic spondylolisthesis with either an odontoid process or a teardrop fracture of the axis body. All patients were treated conservatively with an excellent or good outcome at mean 12-year follow-up (range: 2-18 years). Computed tomography was the imaging modality of choice for the correct diagnosis of these rare lesions.

Adult↗
PubMed2003

Bone marrow edema syndrome of the knee: a case report and review of the literature.

The authors present a 45-year-old man with bone marrow edema syndrome (BMES) of the medial condyle of the knee. Early diagnosis of BMES was based upon clinical, bone scintigraphy and magnetic resonance (MRI) findings. After failure of the conservative treatment, core decompression was performed. Histological examination showed no evidence of osteoporosis or osteonecrosis. Within 2 months after the operation, the patient was pain-free and he resumed his previous activities. At 1-year follow-up examination, MRI showed complete resolution of all signal abnormalities; at 3-year follow-up the patient remained symptom-free and with no functional limitations.

Bone Marrow Diseases↗
PubMed2003

Foot malignancies: a multidisciplinary approach.

Malignant osseous and soft tissue tumors of the foot are rare and should be considered in patients who have foot-related symptoms. Most sarcomas affect patients who are older than 55 years; however, many young patients who are otherwise healthy, may present with malignant foot and ankle lesions. In addition to benign and malignant neoplasms, pseudotumorous conditions mimic neoplastic lesions and should be differentiated before any treatment is undertaken. Invasiveness is a characteristic of sarcomas. The foot is a terminal anatomic structure, with closed and tight compartments and well-vascularized tissues, that predispose it to hematogenous and lymphatic metastases. Patients who have a malignant foot tumor should be referred to an orthopedic oncologist for further evaluation and treatment. The goals of treatment include local tumor control, restoration of function and stability during standing and walking, long-term survival, and improved quality of life. In most cases, wide surgical margins require a ray, Syme, midtarsal, or below-the-knee amputation. Recent advances in chemotherapy and radiotherapy have allowed limb salvage procedures with wide tumor resections. Because overall survival is greatly improved in these patients, the reconstruction of skeletal defects needs to be more functional and durable. After tumor resection, reconstruction of the skeletal and soft tissue defects is possible by using bone allografts or vascularized autografts, arthrodesis, and free vascularized musculocutaneous flaps.

Bone Neoplasms↗