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S Dudeney

Publications and source records attributed to S Dudeney.

9 recordsLinked to original sources
PubMed2002

Kyphoplasty in the treatment of osteolytic vertebral compression fractures as a result of multiple myeloma.

PURPOSE: We prospectively evaluated the safety and efficacy of kyphoplasty in the treatment of osteolytic vertebral compression fractures resulting from multiple myeloma. The principle symptoms in multiple myeloma result from bone destruction, especially the spine. Kyphoplasty is a new technique that involves the introduction of inflatable bone tamps (IBT) into the vertebral body. The purpose of the IBT is to restore the vertebral body back toward its original height, while creating a cavity that can be filled with highly viscous bone cement. PATIENTS AND METHODS: Fifty-five consecutive kyphoplasty procedures were performed in 18 patients with osteolytic vertebral compression fractures resulting from multiple myeloma. Cement leakage and any complications were recorded. Early objective analysis was made by comparing preoperative and latest Short Form 36 Health Survey scores. Height restoration was estimated by measuring vertebral height on lateral radiographs. RESULTS: The mean age of patients was 63.5 years, mean duration of symptoms was 11 months, and mean follow-up was 7.4 months. There were no major complications related directly to use of this technique. On average, 34% of height lost at the time of fracture was restored. Asymptomatic cement leakage occurred at two (4%) of 55 levels. Significant improvement in SF36 scores occurred for Bodily Pain (23.2 to 55.4, P =.0008), Physical Function (21.3 to 50.6, P =.0010), Vitality (31.3 to 47.5, P =.010), and Social Functioning (40.6 to 64.8, P =.014). CONCLUSION: Kyphoplasty was efficacious in the treatment of osteolytic vertebral compression fractures resulting from multiple myeloma. Kyphoplasty is associated with early clinical improvement of pain and function as well as some restoration of vertebral body height.

Aged↗
PubMed2001

Initial outcome and efficacy of "kyphoplasty" in the treatment of painful osteoporotic vertebral compression fractures.

STUDY DESIGN: An Institutional Review Board-approved Phase I efficacy study of inflatable bone tamp usage in the treatment of symptomatic osteoporotic compression fractures. OBJECTIVES: To evaluate the safety and efficacy of inflatable bone tamp reduction and cement augmentation, "kyphoplasty," in the treatment of painful osteoporotic vertebral compression fractures. SUMMARY OF BACKGROUND DATA: Osteoporotic compression fractures can result in progressive kyphosis and chronic pain. Traditional treatment for these patients includes bed rest, analgesics, and bracing. Augmentation of vertebral compression fractures with polymethylmethacrylate, "vertebroplasty," has been used to treat pain. This technique, however, makes no attempt to restore the height of the collapsed vertebral body. Kyphoplasty is a new technique that involves the introduction of inflatable bone tamps into the vertebral body. Once inflated, the bone tamps restore the vertebral body back toward its original height while creating a cavity that can be filled with bone cement. PATIENTS AND METHODS: Seventy consecutive kyphoplasty procedures were performed in 30 patients. The indications included painful primary or secondary osteoporotic vertebral compression fractures. Mean duration of symptoms was 5.9 months. Symptomatic levels were identified by correlating the clinical data with MRI findings. Perioperative variables and bone tamp complications or issues were recorded and analyzed. Preoperative and postoperative radiographs were compared to calculate the percentage height restored. Outcome data were obtained by comparing preoperative and latest postoperative SF-36 data. RESULTS: At the completion of the Phase I study there were no major complications related directly to use of this technique or use of the inflatable bone tamp. In 70% of the vertebral bodies kyphoplasty restored 47% of the lost height. Cement leakage occurred at six levels (8.6%).SF-36 scores for Bodily Pain 11.6-58.7, (P = 0.0001) and Physical Function 11.7-47.4, (P = 0.002) were among those that showed significant improvement. CONCLUSIONS: The inflatable bone tamp was efficacious in the treatment of osteoporotic vertebral compression fractures. Kyphoplasty is associated with early clinical improvement of pain and function as well as restoration of vertebral body height in the treatment of painful osteoporotic compression fractures.

Aged↗
PubMed1998

Extraspinal causes of sciatica. A case report.

STUDY DESIGN: A case of intrapelvic aneurysm is reported. It is as an example of one of the many extraspinal causes of sciatica. OBJECTIVE: To demonstrate the importance of clinical examination in the assessment of patients with sciatic, despite continuing improvements in methods for imaging the spine. SUMMARY OF BACKGROUND DATA: Extraspinal conditions cause sciatic in a rare but recognized group of patients. Their clinical symptoms can be very similar to those of patients with sciatic from lumbar disc protrusion. METHODS: The clinical appearance, investigation, and treatment of a patient with an internal iliac artery aneurysm causing sciatic are discussed. RESULTS: Surgical treatment of the patient's aneurysm resulted in relief of the symptoms of sciatica. CONCLUSIONS: Although these cases are unusual in isolation, together they represent an important group. When a patient has sciatica, the clinician looks first to the spine for the origin of symptoms. Extraspinal causes are often not considered in the differential diagnosis. This oversight may be compounded by observation of asymptomatic disc protrusions on computed tomographic and magnetic resonance studies. The importance of clinical history and examination in the diagnosis of these lesions cannot be overemphasized.

Aneurysm↗
PubMedDate not supplied

Epidural abscess causing cauda equina syndrome.

BACKGROUND: Spinal epidural abscesses are uncommon but are well documented in the literature as a serious causes of mortality and long-term neurological morbidity. AIM: We describe a case of a 57-year-old female who presented to Accident and Emergency with an acute exacerbation of long standing mild lower back pain with symptoms of cauda equina syndrome and a systemic infective process. CONCLUSION: The diagnosis of this condition requires a high index of suspicion. This report demonstrates that with adequate decompression and appropriate antimicrobial treatment a good outcome is achievable.

Acute Disease↗
PubMedDate not supplied

CT guided radiofrequency ablation of intra-articular osteoid osteoma of the hip.

BACKGROUND: Osteoid osteoma is a painful benign bone tumour. Previously the standard therapy was surgical excision. Image guided radiofrequency ablation can be clinically applied to ablate the tumour in a minimally invasive manner. AIMS: We present a case of an 18-year-old boy who presented with features of chronic left hip arthropathy secondary to intra-articular osteoid osteoma, subsequently successfully treated by percutaneous CT guided radiofrequency ablation. RESULTS: The CT guided radiofrequency ablation was technically successful as a day case procedure without complication. The patient returned to normal function within one week. No recurrence occurred in the three-year follow-up period. CONCLUSION: Radiofrequency ablation is a safe, minimally invasive and effective technique for treatment of osteoid osteoma.

Adolescent↗
PubMedDate not supplied

Foot deformities in children with cerebral palsy.

Clinical observation suggests that deformities of the foot and ankle are common in children with cerebral palsy. Two hundred children with cerebral palsy attending the Central Remedial Clinic were examined and photographed. The children had no previous surgical intervention and were between 1.5 and 19 years of age. Deformities were assessed and related to the type of cerebral palsy and mobility status.

Adolescent↗