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R Tadić

Publications and source records attributed to R Tadić.

At least 19 recordsLinked to original sources
PubMed2002

Microsurgical DREZotomy for pain of spinal cord and Cauda equina injury origin: clinical characteristics of pain and implications for surgery in a series of 26 patients.

The result of the DREZotomy procedure used for the treatment of chronic intractable neuropathic pain caused by injuries at the T9-L4 spine level in 26 patients has been reported. For the purpose of identifying the most favorable pain pattern for DREZ surgery we retrospectively analyzed the effectiveness of surgical treatment on different forms of pain in the follow-up period of 13-50 months, 37 months on average. All pain forms were classified according to subjective sensory pain expression including the rhythm and topography of the pain. Three groups of pain were formed according to subjective sensory equivalents: pain of thermal quality (burning, boiling, baking, warm etc.), pain of mechanical-nonthermal quality (shooting, cutting, stabbing, sharp, incisive, cramping, constriction, distraction, throbbing etc.). The third group was the combination of the previous two. Success in pain relief has been defined as a 50% or greater reduction in pain after surgery such that pain no longer interferes with patient activities of daily living and sleeping pattern and no longer requires routine analgesic pain medication. Our results revealed that the pain of mechanical-nonthermal nature and intermittent rhythm, confined to segmental topography was the most responsive to the DREZ surgical treatment so that 90% patients suffering from this pain pattern experienced a good long-term pain relief (70% had complete long term pain relief). Neuropathic pain of thermal quality with the diffuse infralesional distribution and steady rhythm was the most resistant to the DREZ surgical treatment: neither patient had long-term relief of this pain pattern. In the group of patients suffering from pain consisting of combined mechanical and thermal sensory components with confined pain territory, 75% experienced a good long-term pain relief (50% had complete long-term pain relief). Immediate pain relief was obtained in 88% of patients and was long lasting in 69% of the total series. Our results pointed to confined territory, intermittent rhythm and mechanical nature of the pain as the most relevant predictors of the expected pain relief achieved by the DREZ surgery.

Adult↗
PubMed1999

DREZ surgery on conus medullaris (after failed implantation of vascular omental graft) for treating chronic pain due to spine (gunshot) injuries.

The results of DREZlesioning procedure used for the treatment of chronic intractable pain due to deafferentation caused by gunshot injuries at the thoracolumbar (T10-L1) spine level are reported in six patients. The specificity of these cases arises from the fact that all the patients underwent, after decompressive laminectomy, an implantation of vascularized omental graft on the injured cord segments, 4-17 months after injury. Because of the failure of this method, which did not improve spinal function nor hinder the development of pain, surgery in the DREZ was performed 2-5 years after implantation. The results of the microsurgical DREZotomy procedure in those patients, 7-12 months after the surgery were: 4 patients with complete pain relief and 2 patients with pain relieved of 80%. All the patients with well-confined segmental pain were completely cured.

Adult↗
PubMed1999

[Necrosis of the omental flap].

The aim of this research is to review the frequency of the omental flap necrosis comparing the vascularized omental flaps based on the left or right gastroepiploic vessels. The first 100 patients, with injuries of spinal cord on different levels, are included in this prospective clinical study with follow-up from 12 to 24 months. The special surgical technique was used for preparation of omental pedicled graft, for its lengthening and transposition to the level of the spinal cord injury and direct and indirect signs of the omental flap necrosis were studied. In our patients there was no necrosis of the omental grafts based on the left gastroepiploic artery. The insufficiency of the left gastroepiploic artery was not present in any patient and so it was not the reason of the omental flap necrosis. Devascularisation of the great gastric curvature until to the root of the left gastroepiploic artery, administration of the prophylactic doses of the Heparin and to put gently pressure on the omental flap do not contribute to the appearance of the omental flap necrosis. Based on our experiences and on results of this research we conclude that this way of forming the omental graft can be used for the other omentopexies.

Adolescent↗
PubMed1969

[Not Available].

Explore the source record for details and available documents.

History, Modern 1601-↗
PubMedDate not supplied

[Lateral orbitotomy in the approach to an orbital dermoid cyst].

The choice of surgical approach for the resection of orbital tumor is as a rule determined by the tumor position in the orbital space and the best choice is the most direct approach to orbital tumor. Lateral orbitotomy as the extracranial orbital approach is favorable for radical resection of the tumor, which growth is limited to the anterior, lateral and superolateral orbital segment.

Adult↗
PubMedDate not supplied

[Transnasal transsphenoidal approach to pituitary adenomas].

The results of transnasal transsphenoidal surgery of pituitary adenomas were retrospectively analyzed in a group of 42 patients, 22 females and 20 males, aged 19-70, of average age 43 years. Histopathological examination showed null-cell adenomas in 4, growth-cell in 11, prolactin-cell in 3, adrenocorticotropin-cell in 6, plurihormonal adenomas in 6, craniopharingeoma in 1, metastasis of pulmonary carcinoma in 1, pituitary abscess in 1, and normal pituitary tissue in 9 cases, respectively. Out of 30 patients with adenomas, 21 had macro (> 1 cm) and 9 had microadenomas (< 1 cm). Cerebrospinal fluid leakage (8.7%) and meningitis (6.5%) were the most frequent postoperative complications. There was no operative mortality. Full adenoma recurrence (clinical, hormonal, and radiological) was found in 3, clinical and hormonal in 3, hormonal and radiological in 1, and radiological in 2 patients, respectively. The repeated transsphenoidal surgery was performed in 4 patients. The transnasal transsphenoidal approach is the procedure of choice for surgical treatment pituitary adenomas.

Adenoma↗
PubMedDate not supplied

[Surgical treatment of hypophyseal adenoma using the pterional approach].

The results of a retrospective study of 21 patients undergoing surgery with pterional approach to pituitary adenomas are reported. There were 7 females, and 14 males, between 20 to 68 (average 43.5) years of age. According to adenoma extension 6 patients were with type III-A (suprasellar-suprachiasmatic), 4 with type III-B (suprasellar-retrosellar), 6 with type III-C (parasellar-cavernous), and 5 with type III-D (paninvasive). According to adenoma size there was 1 patient with small (5 mm-2 cm), 11 with moderate (2-4 cm), 4 with large (4-6 cm), and 5 patients with paninvasive adenomas. Histopathological examination showed null cell in 11, growth-cell in 6, prolactin-cell in 1, and plurihormonal adenomas in 3 cases. Two patients have died. The cause of death was hypothalamic lesion or cerebral infarct.

Adenoma↗
PubMedDate not supplied

[Risk factors for the onset of vasospasm and rebleeding after spontaneous subarachnoid hemorrhage].

Retrospective study comprised 120 patients with spontaneous subarachnoid hemorrhage (SAH) and risk factors for vasospasm and rebleeding were analyzed. Rebleeding and vasospasm had the same incidence (26.7%). Vasospasm prolonged preoperative and postoperative hospital period (p > or = 0.05) and deteriorated the final treatment outcome (incidence of favorable outcome was decreased from 56.9% to 41.7%). Total rebleeding mortality rate was 62.5% and depended on the clinical state before rebleeding (p < 0.05). Risk factors for vasospasm were: poor clinical condition of a patient after the initial SAH, the period of 5-13 days after hemorrhage (p < 0.01) and aneurysm located on the anterior communicant artery (p < 0.01). Risk factors for rebleeding were: poor clinical condition of the patient after the initial SAH, the first 36 hours and the period of 8-11 days after the initial SAH, advanced age of the patient, severe arterial hypertension, vasospasm and aneurysm on the internal carotid artery.

Aneurysm, Ruptured↗
PubMedDate not supplied

[Clinical characteristics of chronic post-traumatic spinal neurogenic pain syndrome].

In order to define clinical features of chronic posttraumatic spinal neurogenic pain syndrome we have analyzed a group of 23 patients with posttraumatic neurogenic pain. Patients (21 males and 2 females) were aged from 22 to 59 years, averagely 35.8 years. Painful sensations had the character of mechanical-incisive pain in 7 (30%) patients, and thermal pain equivalents in 3 (13%) patients. In 13 (57%) patients, sensor structure of this painful state had the character of associated thermal and mechanical painful sensations. Typical posttraumatic chronic spinal syndrome in our group of patients had persistent thermal qualities, of fluctuating intensity, with periodical, intensive pain onsets of mechanical character. Level of conus and cauda equina is predilectional level of the lesion for the development of intensive pain syndrome. Posttraumatic pain syndrome can be classified as intermittent and steady pain in relation to the rhythm of its manifestation, and as diffuse and dermatomal pain in relation to extension, in which painful state of occasional rhythm and dermatomal topography is the optimal indication for operative neurosurgical treatment.

Adult↗
PubMedDate not supplied

[Omentomyelosynangiosis--a direct intraoperative observation].

The late outcome of implantation of the vascular omental pedicle on the injured spinal cord performed in 7 patients to improve functional recovery through revascularization of the injured cord tissue is reported. All the patients were reoperated at the same spinal level 2-5 years after the omental pedicle implantation for the treatment of chronic neuropathic spinal pain by employing DREZ (Dorsal Root Entry Zone lesion) surgery. From the technical standpoint it was necessary to mobilize the implanted omental pedicle from the cord surface to provide the access to dorsolateral cord sulcus for the DREZ operation. Mobilization of the omental pedicle provided unique opportunity to observe omental-cord contact surface (omentomielosinangiosis) that is believed to stimulate revascularization of the cord tissue. In our report particular attention was paid to the specificity of the omental-cord contact surface and the late tissue changes of the cord as well as omental tissue knowing the fact that the capacity of omental tissue to stimulate neoangiogenesis still represents the actual doubt in neurobiological theory and practice. Detailed analysis of the actual neurological condition of these patients compared to neurological condition assessed before the implantation of the pediculated-vascular omental graft revealed neither sensory nor motoric improvement (in the postimplantation period). The effect of DREZ surgery of the chronic neuropathic spinal pain was not a topic of this report.

Adult↗