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Results for “Decompression, Surgical”

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At least 127 records · Page 7Linked to original sources

PubMed1988

Suprasellar tuberculoma developing during treatment of tuberculous meningitis requiring urgent surgical decompression.

An adult patient on treatment for tuberculous meningitis developed visual failure due to a tuberculoma compressing both optic nerves and chiasm. Although continued anti-tuberculous chemotherapy is the treatment of choice for intracranial tuberculoma, the rapid deterioration in vision necessitated urgent surgical decompression, which resulted in complete recovery of vision.

Adult↗

PubMedDate not supplied

[Surgical decompression of the fornix humeri, comparison of 2 procedures: resection of the ligament and Neer's method of anterior acromioplasty].

The impingement-syndrome is caused by a conflict between the humeral head, the rotator cuff and the coracoacromial arch. Degenerative changes in the rotator cuff appear to be the cause when conservative treatment fails, surgical decompression may be resorted to. The two methods commonly applied are the resection of the coracoacromial ligament and Neer's anterior acromioplasty. In this retrospective study 52 patients were followed up of whom 31 had ligament resection and 21 had acromioplasty. The average follow up time was 10 months. Excellent and good results were achieved by ligament resection in 16 patients (52%) and by acromioplasty in 12 patients (57%). Satisfactory results had 10 (32%) patients after ligament resection and 8 patients (38%) after acromioplasty. In 5 cases (16%) unsatisfactory results were achieved by ligament resection and in 1 case (5%) after acromioplasty. Statistically the results did not differ at the 5% level of error. Both methods retain the length of the acromion which is important as it is the attachment of the deltoid muscle and determines the functional lever arm of this muscle. The superior results of acromioplasty in cases with rotator tears suggest that this procedure could be beneficial as a routine decompression in these cases. Theoretically the acromioplasty creates more space for the reconstructed cuff.

Acromion↗

PubMed1996

[Surgical decompression of the orbit in a case of post-traumatic retrobulbar hematoma].

The authors present a case of 34-years-old man with retrobulbar hematoma caused by blunt injury accompanied by partial palsy of the oculomotor nerve and ischemia of the optic nerve and retina. Fractures of the orbit were excluded using computer tomography. Surgical decompression of the orbit was performed. The authors obtained quick and marked improvement with normal visual acuity and limitation of adduction.

Adult↗

PubMed1986

Surgical decompression of the facial nerve in the treatment of chronic cluster headache.

The nervus intermedius (NI) appears to be the main conduit for the associated symptoms of cluster headache (CH) and perhaps for the pain as well. Subtle injury of the facial nerve and NI might initiate mechanisms responsible for CH. Five patients with chronic CH unresponsive to medication underwent surgical decompression of the root exit-entry zone of the facial nerve, and in two patients the trigeminal nerve root was also decompressed. In two patients, the pain syndrome was markedly relieved for as long as two years. In one patient, initial improvement was obscured by narcotic addiction. In two patients, the operation was a failure. The NI was identified as a separate bundle in only one of five patients and decompressions may not have affected that component of the facial nerve.

Adult↗

PubMedDate not supplied

[Functional sequelae of surgical decompression of the lumbar spine--a biomechanical study in vitro].

PURPOSE: Dorsal decompression has become accepted as the standard surgical treatment for spinal stenosis. However, no consensus has been reached to date concerning the extent of resectioning required or the ensuing functional impairment of the segment. As a result, a discussion is now underway on the necessity of employing various additional methods for instrumented stabilisation. The aim of this biomechanical in vitro study is to objectify the functional impact of various defined decompression techniques. METHODS: With the aid of a universal spine tester, the increasing defect situations following left hemifacetectomy, bilateral hemifacetectomy, left hemilaminotomy and laminectomy of the functional spinal unit L4/5 were assessed. A three-dimensional motion analysis was performed on six human lumbar spine specimens under the loading conditions flexion/extension, left/right bending and right/left rotation. RESULTS: The results showed an increase in both the neutral zone and the range of motion under all the loading components. No significant differences were observed in coupled motions following decompression. CONCLUSIONS: Laminectomy leads to a distinct instability and the question arises of how much additive stability achieved by instrumented stabilization will be adequate.

Adult↗

PubMedDate not supplied

Current status of surgical decompression and drainage procedures upon the endolymphatic system.

At the present time, neither the etiologic factors nor the pathophysiologic mechanisms that lead to the development of endolymphatic hydrops or Ménière's disease are known; however, the anatomic-pathologic alterations in the labyrinth that are produced by the disease are well-documented. Undoubtedly, what is not known is responsible for the controversial status and questionable benefit that surgical decompression and drainage procedures have upon the endolymphatic system.

Animals↗

PubMed2000

Surgical decompression and radiation therapy in epidural metastasis from cervical cancer.

Spinal cord compression by epidural metastasis is considered an exceptional complication in patients with cervical carcinoma. We report three patients treated for a cervical carcinoma who developed epidural metastasis with spinal cord compression at 9, 25 and 48 months after primary treatment of the uterine malignancy. All patients had poorly-differentiated adenocarcinomas with lymphovascular space invasion, and two had lymph node metastasis. All patients underwent emergency decompressive laminectomy followed by radiotherapy and a partial recovery of the neurological function was achieved. In two patients the spinal cord was the only site of recurrent disease, whereas the other had lung and brain metastasis at the time of epidural involvement diagnosis. All three patients, however, died of disseminated disease. Surgical decompression followed by radiation therapy may result in a complete preservation of the neurologic functions in patients with spinal cord compression secondary to metastatic carcinoma of the uterine cervix. Considering the propensity for disseminated disease, long term survival might be achieved only with the use of effective chemotherapy.

Adenocarcinoma↗

PubMed1993

[Surgical decompression for the C-1 and C-2 sensory roots and upper cervical cord in a case with cervical myelopathy and occipital neuralgia due to bilateral fenestration of vertebral artery: a case report].

A case of bilateral fenestration of the vertebral artery at the level of the atlas in a patient who had occipital neuralgia and cervical myelopathy is presented. MRI and vertebral angiogram demonstrated the fenestrated vertebral artery compressing the upper cervical cord. Surgical decompression for the C-1 and C-2 sensory roots and the upper cervical cord was performed. Fenestration of the vertebral artery is mostly of no clinical significance. However, considering the pathway of the fenestrated vertebral artery, it is quite possible that the fenestrated vertebral artery might compress the neural structures, resulting in some clinical problems. Although occipital neuralgia may result from a variety of causes, this case was caused by the fenestrated vertebral artery compressing the C-1 and C-2 sensory roots. The authors wish to emphasize that microsurgical vascular decompression may be the only effective treatment in such cases as well as in facial spasm and trigeminal neuralgia.

Aged↗

PubMed1993

Surgical decompression of impingement in the weightbearing shoulder.

Shoulder pain is a common affliction, posing particular limitations on the spinal cord injured person. Abnormalities of the rotator cuff mechanism are a common cause of shoulder injury in the general population and it has recently been observed that a large percentage of persons with paraplegia suffer from chronic shoulder pain. This report describes six cases of impingement syndrome in four spinal cord injured persons who depend on upper extremity function for the execution of activities of daily living and mobility. All had failed prolonged trials of conservative therapy and subsequently underwent anterior acromioplasty and when indicated, repair of the supraspinatus tendon. In each case, functional capacity that approached or equalled premorbid levels was achieved. Pain complaints also markedly decreased from preoperative levels. It is suggested that surgical decompression of shoulder impingement and rotator cuff repair may be beneficial in spinal cord injured persons who have failed conservative therapy. Further study is required to determine the long-term efficacy of surgical intervention in this population.

Chronic Disease↗

PubMed1988

Lateral lumbar spinal canal stenosis: classification, pathologic anatomy and surgical decompression.

The lateral region of the lumbar spinal canal is subject to pathologic alterations which encroach upon the neural structures located within. In order to further understanding and facilitate communication among specialists in diverse disciplines, a subdivision of the lateral region is proposed to comprise three zones: entrance zone, mid-zone and exit zone. The anatomical boundaries of these zones are defined and the pathologic conditions of each are described, and serve as the basis for techniques of surgical decompression when clinically required.

Humans↗

PubMed2004

Carpal tunnel syndrome in elderly patients: results of surgical decompression.

This study prospectively compared preoperative and postoperative (6 months after surgical release) clinical and electrophysiological evaluation and self-administered Boston questionnaire (BQ) findings of a series of elderly carpal tunnel syndrome (CTS) patients with those of young and adult patients. Three hundred twenty three consecutive hands (282 patients) underwent surgery between 1997 and 2000. Patients were divided into four age groups: group 1 (20-40 years), 49 hands; group 2 (41-54 years), 96 hands; group 3 (55-69 years), 106 hands; and group 4 (70-90 years), 72 hands. Sex ratio, education, duration and bilaterality of CTS, history of wrist and hand trauma, connective tissue and thyroid diseases, diabetes, polyneuropathy, renal failure, and other nerve entrapment syndromes were recorded. The elderly group (group 4) only had more cases of diabetes than groups 1 and 2 (young and adult patients). Before surgery, elderly patients showed more severe clinical objective and electrophysiological findings than young and adult patients. Preoperative subjective findings (BQ scores) were similar in all four groups. Although their absolute postoperative BQ scores and clinical objective and electrophysiological stages improved, elderly patients showed less improvement in all findings than the 20-54 age groups, presumably due to greater preoperative damage and less repair capacity of the compressed nerve. This, however, is not a contraindication for surgical release in elderly patients.

Adult↗

PubMed1984

Rattlesnake bites and surgical decompression: results using a laboratory model.

Studies were performed on the hind limbs of dogs and their anterolateral compartments to evaluate the effect of fasciotomy on tissue pressure and necrosis following pit viper envenomation. Venom from the southern Pacific rattlesnake, Crotalus viridis helleri, was injected into either the subcutaneous tissues, the intact anterolateral compartment or the anterolateral compartment following fasciectomy. Interstitial fluid pressure measurements, as well as limb girth and surface temperatures, were obtained over the first 48 hr following venom injection, after which time the compartment contents were examined microscopically. The results demonstrated intracompartment tissue pressure elevations only following intracompartment injections. Fasciectomy prior to injection did not prevent muscle necrosis, though it did reduce maximum compartment pressures. Clinically the limbs in each group could not be differentiated. Intracompartment pressure measurements were able to distinguish between muscle and subcutaneous envenomations by the differences in compartment pressures. These results demonstrate the value of tissue pressure measurements in the evaluation of patients envenomated by rattlesnakes. They also indicate the objectivity necessary to determine the need for surgical decompression.

Animals↗

PubMed2005

Acute traumatic central cord syndrome--experience using surgical decompression with open-door expansile cervical laminoplasty.

BACKGROUND: Open-door expansile cervical laminoplasty (ODECL) is an effective surgical technique in the treatment of multilevel cervical spondylotic myelopathy. In the present study, we reviewed the safety and short-term neurological outcome after expansile cervical laminoplasty in the treatment of acute central cord syndrome. METHODS: We retrospectively reviewed our database over a 3-year period (January 1997-January 2001) and identified 69 surgically treated cervical spinal cord injuries, including 29 cases of acute traumatic central cord syndrome (ATCCS). Fifteen of these patients underwent expansile cervical laminoplasty, whereas 14 did not because of radiographic evidence of sagittal instability. We collected data on the preoperative and the immediate postoperative and 3-month neurological examinations. Neurological function was assessed using the Asia Spinal Injury Association (ASIA) grading system. We also reviewed the occurrence of complications and short-term radiological stability after the index procedure. RESULTS: The median age was 56 years. All patients had hyperextension injuries with underlying cervical spondylosis and stenosis in the absence of overt fracture or instability. The average delay from injury to surgery was 3 days. The preoperative ASIA grade scale was grade C, 8 patients, and grade D, 7 patients. There were no cases of immediate postoperative deterioration or at 3 months follow-up. Neurological outcome: 71.4% (10/14) of patients improved 1 ASIA grade when examined 3 months post injury. CONCLUSIONS: Surgical intervention consisting of ODECL can be safely applied in the subset of patients with ATCCS without instability who have significant cervical spondylosis/stenosis. Open-door expansile cervical laminoplasty is a safe, low-morbidity, decompressive procedure, and in our patients did not produce neurological deterioration.

Acute Disease↗

PubMed2001

Cysts of the atlantoaxial joint: excellent long-term outcome after posterolateral surgical decompression. Report of two cases.

Articular cysts of the atlantoaxial joint are infrequently described and probably an underreported cause of upper cervical spinal cord compression. The authors report on two patients with cysts located posteriorly of the dens in whom a C-1 and partial C-2 hemilaminectomy with subtotal resection of the cyst provided adequate and stable decompression 1 year postoperatively. The clinical and magnetic resonance imaging features and the surgical approach are discussed after a review of the literature.

Aged↗

PubMed2001

The postsurgical lumbosacral spine. Magnetic resonance imaging evaluation following intervertebral disk surgery, surgical decompression, intervertebral bony fusion, and spinal instrumentation.

It should be clear to those who perform and interpret medical images of the spine following one or more forms of surgical therapy that the images are often difficult to interpret in part because of the superimposition of the original disease process, alteration engendered by the surgery, or a complication of the surgical procedure. Although long-term experience in this area is helpful in regard to improving interpretive skills, certain sequela can be predicted regardless of the interpreter's background. Once the normal or expected postsurgical findings are understood, the subtle and gross changes that depart from these observations can be analyzed better. The importance of a high level of competence in the domain of post-therapeutic neurodiagnostic imaging is in the knowledge that the patient returning for restudy may be acutely in distress or even in medical danger (e.g., postoperative spondylitis). In fact, the clinical presentation posttherapeutically may well be more severe or dire than was observed pretherapeutically. An indepth appreciation of the broad range of clinicoradiologic possibilities as presented [figure: see text] here should place the medical imaging physician in an excellent position to provide an experienced diagnostic evaluation in the patient presenting with recurrent or new signs and symptoms following any one of the spectrum of possible spinal surgical procedures.

Decompression, Surgical↗

PubMed1992

[Surgical decompression of the optic nerve in intracanal injuries. Indications and results].

Fifteen patients with traumatic optic neuropathy (anatomical section excluded) underwent surgical anterior decompression of the optic nerve, via the trans ethmoid-sphenoid approach. Improvement of visual function assessed by visual acuity and visual field measurements, was obtained in 10 patients. Results remained stable for a follow-up period of at least 6 months. There was a delay of several weeks before improvement in some of the patients. Thus a long follow-up period seems recommended. Trans ethmoid-sphenoid optic nerve decompression is a reliable procedure with low morbidity, and represents a promising therapy for indirect injuries of the optic nerve.

Adolescent↗

PubMed2006

Efficacy of surgical decompression in regard to motor recovery in the setting of conus medullaris injury.

BACKGROUND/OBJECTIVE: An assessment of neurological improvement after surgical intervention in the setting of traumatic conus medullaris injury (CMI). METHODS: A retrospective evaluation of a cohort of patients with a blunt traumatic CMI from T12 to L1. The neurologic and functional outcomes were recorded from the acute hospital admission to the most recent follow-up. Data collected included age, level of injury, neurologic examination according to the Frankel grading system and motor index score, and the mechanism and timing of CMI decompression. RESULTS: A total of 24 patients with a mean age of 27 years (men, 87%) were identified. The most common level of bony injury was L1, and the most frequent mechanism of injury was a motor vehicle crash. Before surgical intervention, 16 of 24 patients (66.7%) had a complete neurological deficit below the level of injury. The median interval from injury to surgery was 6 days (range, 7 hours to 390 days). Decompression, fusion, and adjunctive internal fixation were the most common surgical procedures. Median length of follow-up was 32 months after surgery. Improvement in spinal cord and bladder function was seen in 41.6% and 63.6% of patients, respectively. Root recovery was seen in 83.3% of patients. CONCLUSIONS: In the setting of CMI, no correlation between the timing of surgical decompression and motor improvement was identified. Root recovery was more predictable than spinal cord and bladder recovery.

Adolescent↗

PubMedDate not supplied

Surgical decompression of nerves in leprosy. An attempt at prevention of deformities. A clinical, electrophysiologic, histopathologic and surgical study.

Forty-five leprosy patients were electively subjected to extraneural decompression and medial longitudinal epineurotomy in anticipation that relief from compression may favorably alter the course of the disease by retrieving reversibly damaged nerve bundles and preventing further progression of disease. Neurolysis was performed in 69 nerves, including the ulnar, median, lateral popliteal and posterior tibial. The period of follow-up was up to three years. Excellent sensory recovery was seen in most patients while motor recovery was less predictable. The recovery seen was better in those patients taking treatment early and also at the age the surgery was carried out. Motor damage appeared more severe in the 10-20 year age group. Most of the beneficial effects can be explained on the basis of increased vascularity due to relief from extraneural and intraneural compression.

Adolescent↗