Showing 7 results for Posterior
Farzan M, Mostafavi A,
Volume 59, Issue 1 (4-2001)
Abstract
Between 1371 to 1379, of 10 patients with radial tunnel syndrome, 9 patients were treated by decompression of the posterior interosseous nerve. 8 patients were followed up more than 10 months. One patient improved without surgery. Half of the patients suffered from pain and all of them had variable degrees of paralysis in muscles innervated by deep branch of the radial nerve. The syndrome was diagnosed after an average of 26 months after onset of symptoms. 3 patients had associated endocrine disease and 2 patients suffered from another accompanied compression neuropathy. 8 patients performed strenuous, repetitive upper extremity tasks. EMG confirmed the diagnosis in all patients. The source of nerve entrapment was identified as the arcade of Frohse in 4 patients. Malignant soft tissue tumor was responsible for nerve compression in one patient. More than one pathologic site was responsible for nerve entrapment in another 4 patients. Of 8 patients with enough follow-up after operation, pain was improved in all, but paralysis was improved in only half of them. According to ritts criteria, results were good in 50% of patients and in 50% of patients results were bad. All bad results were due to persistence of paralysis in affected muscles. One of four patients who had no improvement in paralysis, was satisfied with surgical result because tendon transfer was performed at the time of nerve decompression. It is recommended that all possible sites of nerve compression in the radial tunnel be explored and released.
Behtash H, Ganjavian M, Shahre Babaki B, Fereshtehnejad S.m, Akbarnia B,
Volume 64, Issue 10 (10-2006)
Abstract
Background: The currently accepted treatment of scoliosis are bracing and surgery. Two-stage anterior and posterior spinal fusion is used to correct scoliosis. It seems that the application of a longitudinal force to the axis of the spinal column as a means of stabilizing by halo traction, may increase the correction of the curve. The aim of this study was to evaluate the effect of halo traction used between the two stages of corrective surgery, anterior and posterior spinal fusion, on the correction of scoliosis curvature.
Methods: In this randomized clinical trial twelve scoliotic patients, aged from 12-19 years old, were treated by two-stage anterior spinal release and fusion (ASF) and posterior spinal fusion (PSF). The patients were divided in two groups: 6 scoliotic patients without any traction between ASF and PSF surgeries (group A), and 6 scoliotic patients were undergone halo traction for one week between ASF and PSF surgeries (group B). Major curve angle was measured before surgery, one week after ASF and one year after PSF surgeries. Data were collected and analyzed using SPSS v.13.5.
Results: The mean baseline curve angles were 90° (SD=18.70) and 94.17°(SD=28.18) in groups A and B, respectively. Whereas, the mean final curve angles (one year after PSF) were 51.17°(SD=29.59) and 39.17°(23.11) in groups A and B, respectively. Final angle improvement was 46.58% (SD=20.31) in patients without traction and 61.32% (SD=14.02) in patients with halo traction. The major curve angles showed significantly better correction in patients with traction one week after ASF [38.67°(SD=7.86) vs. 25°(SD=6.28), P=0.012]. This difference persisted at the end of the first year after operation. [55°(SD=8.94) vs. 38.83°(SD=11.65), P=0.022].
Conclusion: Application of halo traction between ASF and PSF surgeries may lead to better improvement of the scoliotic curvature and short time application of halo traction decreases possible complications.
Behtash H, Ameri E, Ganjavian M.s, Kabirian Dehkordi N, Fereshtehnejad S.m, Akbarnia B,
Volume 65, Issue 8 (11-2007)
Abstract
Background: Congenital scoliosis is a developmental disorder defined as a lateral curvature of the spine. Its progressive trend and complications, such as cosmetic problems, pain and pulmonary symptoms, have put scoliosis as an important skeletal deformity that should be corrected. One of the currently accepted methods of treatment is posterior spinal fusion (PSF) that may be performed with or without instrumentation. However, the use of implants in conjunction with PSF in congenital spine deformity has been debated over the past three decades primarily because of increased risk of neurological deficit and implant displacement. The aim of this study was to compare short-term and long-term outcomes of spinal fusion with and without posterior instrumentation in congenital scoliosis.
Methods: In this historical cohort study, 41 patients with congenital scoliosis were recruited. All patients underwent PSF surgery between 1977 and 1996. They were divided into two groups according to the use of instrumentation: 22 congenital scoliotic patients who were treated by PSF without any instrumentation (group A), and 19 instrumented PSF patients (group B). Instrumentation was mostly performed using the Harrington rod. The major curve angle was measured before surgery, two weeks and one year after PSF surgery and at the end of the follow-up period.
Results: The mean baseline curve angles were 66.3° and 69.1° in groups A and B, respectively. The mean Cobb angles one year after PSF were 43.1° and 38.4° in groups A and B, respectively. The mean follow-up period was 8 years (SD=3) and, at the end of this period, the final Cobb angles were 47.3° and 39.4° in groups A and B, respectively. Therefore, the final angle correction was 28.7% in patients without instrumentation and 43% in patients with instrumentation. The mean loss of correction was 5.5% and 4.3% in groups A and B, respectively. The final curve angles was significantly more corrected for those patients in whom instrumentation was used than those without instrumentation (p<0.05).
Conclusion: The treatment of congenital scoliosis can be very challenging despite the benefits of modern surgeries and instrumentation methods. The results of our study demonstrate that the application of an implant with PSF surgery may lead to increased improvement of the scoliotic curvature in the short-term and long-term periods, as well as a decrease in the loss of correction and the rate of reoperation. In addition, the low incidence of complications in our study indicates the safety of the posterior instrumentation for the treatment of congenital scoliosis.
Mohammadzadeh R, Kamal Hedayat D, Mohagheghi A, Tabatabaie A H, Darehzereshki A,
Volume 66, Issue 3 (6-2008)
Abstract
Background: For the purpose of ascertaining myocardial infarction (MI) and ischemia, the sensitivity of the initial 12-lead ECG is inadequate. It is risky to diagnose posterior MI using only precordial reciprocal changes, since the other leads may be more optimally positioned for the identification of electrocardiographic changes. In this study, we evaluated the relationship between electrocardiography changes and wall motion abnormalities in patients with posterior MI for earlier and better diagnosis of posterior MI.
Methods: In this prospective cross-sectional study, we enrolled patients with posterior MI who had come to the Emergency Department of Shariati Hospital with their first episode of chest pain. A 12-lead surface electrocardiogram using posterior leads (V7-V9) was performed for all participants. Patients with ST elevation >0.05 mV or pathologic Q wave in the posterior leads, as well as those with specific changes indicating posterior MI in V1-V2, were evaluated by echocardiography in terms of wall motion abnormalities. All data were analyzed using SPSS and p<0.05 were considered statistically significant.
Results: Of a total 79 patients enrolled, 48 (60.8%) were men, and the mean age was 57.35±8.22 years. Smoking (54.4%) and diabetes (48%) were the most prevalent risk factors. In the echocardiographic evaluation, all patients had wall motion abnormalities in the left ventricle and 19 patients (24.1%) had wall motion abnormalities in the right ventricle. The most frequent segment with motion abnormality among the all patients was the mid-posterior. The posterior leads showed better positive predictive value than the anterior leads for posterior wall motion abnormality.
Conclusion: Electrocardiography of the posterior leads in patients with acute chest pain can help in earlier diagnosis and in time treatment of posterior MI.
Ghanbari Z, Eftekhar T, Goodarzi Sh, Haj Baratali B, Bashiri Sa, Shariat M,
Volume 67, Issue 3 (6-2009)
Abstract
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Background: The abdominal sacrocolpopexy is the gold standard method of vaginal prolapse
correction and posterior intra- vaginal slingplasty (posterior IVS) is a newer procedure with minimal invasion.
This study is going to compare the effectiveness and complications of these two
surgical methods.
Methods: In this study, 51 patients with prolapse
admitted to vali-e-asr Hospital
of Tehran University of
medical science were evaluated during years 2001-2004. 26 patients were operated
by posterior IVS method (the first
group) and 25 of them had
undertaken sacrocolpo-pexy (the second group). Data were primarily gathered
from patients' folder and further complimentary information were achieved by
two years follow-up and inviting patients to interview or exam.
Results: Eighty
percent of women with abdominal sacrocolpopexy were cured
compared to 96.2 percent with posterior IVS. Surgery complications was reported in one patient (4%) of second group while none of patients in first group experience this and
the difference was not statistically meaningful. Short-term post surgical
complications (hemorrhage-perforation fever and abdominal distention) were also
negative in first group (posterior intra vaginal slingplasty) but these
problems such as fever and abdominal distention were positive in 36% of second group (abdominal sacrocolpopexy) which
was evidently statistically meaningful (p=0.001). Long- term post surgical complication (tape and mesh disfunction) were
seen in 7.7% of first group
while none of second group patients showed these complications.
Conclusion: According
to shorter operating time, lower complications and efficient response to
therapy in posterior IVS
method, it can be an alternative in prolapse surgery it is preferred in elderly
patients with medical problems.
Bolourian Aa, Beheshti Monfared M, Gachkar L, Ghomeisi M, Shahzamani M, Foroughi M, Kazem Arabnia Mk, Ghods K, Dabbagh A,
Volume 69, Issue 1 (4-2011)
Abstract
Background: Atrial fibrillation is the most common but benign arrhythmia following cardiac surgery. Although this arrhythmia is often self-limited and vanishes in about 24 hours upon surgery a number of arrhythmias might ensue among which some might be really life-threatening. A multitude of therapeutic modalities have been proposed for the prevention of this arrhythmia and one of them is posterior pericardiotomy. This method has not been fully accepted by the peers yet and more studies are needed to prove its efficacy and benefits to the patients.
Methods: In this single-blind randomized clinical trial, done over a 2-year period from February 2009 to January 2011, the effects of posterior pericardiotomy were evaluated in 174 patients (87 the case and 87 the control groups) undergoing elective coronary artery bypass grafting (CABG). The case group underwent CABG with posterior pericardiotomy while the control group underwent CABG-only operation. The postoperative incidence of arrhythmia, especially atrial fibrillation, was assessed for a week using statistical methods.
Results: The prevalence of postoperative atrial fibrillations were fewer in the group undergoing CABG with posterior pericardiotomy compared with the CABG-only group (P<0.004).
Conclusion: Posterior pericardiotomy seems to reduce the incidence of atrial fibrillation following elective CABG therefore, its application is suggested for elective
CABGs
Leila Pourali, Atiyeh Vatanchi, Negar Ramezanpour, Sedigheh Ayati, Farzaneh Ramezani,
Volume 78, Issue 11 (2-2021)
Abstract
Background: Posterior reversible leukoencephalopathy syndrome (PRLS) is a clinical and radiological syndrome of heterogeneous etiologies that are grouped because of the similar findings on neuroimaging studies which may occur at any age. The pathogenesis of RPLS remains unclear, but it appears to be related to disordered cerebral autoregulation and endothelial dysfunction. The syndrome is more commonly seen in women, RPLS has been described in several medical conditions, with hypertensive encephalopathy, eclampsia, and the use of cytotoxic and immunosuppressant drugs being the most common conditions. Prompt recognition and treatment are important in preventing the permanent damage that can occur in this otherwise typically reversible condition. The pathogenesis of RPLS remains unclear, but it appears to be related to disordered cerebral autoregulation and endothelial dysfunction. This report aimed to introduce a case of reversible posterior leukoencephalopathy following postpartum thrombotic thrombocytopenic purpura (TTP).
Case presentation: The patient was a 30-year-old primigravid woman at 33 weeks of pregnancy who was referred to the Ghaem hospital, Mashhad University of Medical Sciences in Mashhad in July 2017 due to high blood pressure, blurred vision, headache and generalized tonic colonic seizure. She did not report in previous history of high blood pressure or seizure before pregnancy. With a diagnosis of eclampsia remote from delivery, she underwent a cesarean section. After delivery, generalized tonic colonic seizure repeated several times and a significant reduction in consciousness level happened. Renal failure also occurred, so she underwent daily plasmapheresis with a diagnosis of TTP. After 35 days, she was discharged with a good general condition.
Conclusion: In predisposing conditions, such as high blood pressure in pregnancy, in the case of clinical suspicion of posterior leukoencephalopathy, any attempt for early diagnosis and appropriate treatment are important factors in reducing the rate of morbidity and mortality.
