The Experts below are selected from a list of 138 Experts worldwide ranked by ideXlab platform
Koichi Sairyo - One of the best experts on this subject based on the ideXlab platform.
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The reduction and direct repair of isthmic spondylolisthesis using the smiley face rod method in adolescent athlete: Technical note.
The journal of medical investigation : JMI, 2017Co-Authors: Kazuta Yamashita, Kosaku Higashino, Toshinori Sakai, Yoichiro Takata, Fumio Hayashi, Fumitake Tezuka, Masatoshi Morimoto, Akihiro Nagamachi, Koichi SairyoAbstract:Presently, lumbar spondylolisthesis did not have the indication of direct repair surgery because of the difficulty to reduce the slippage. In this report, we presented a case and described a minimally invasive direct repair surgery to reduce and repair the pars interarticularis defects of lumbar spondylolisthesis. First, curettage and removal of the synovium of the pars interarticularis and Decompression of Nerve root are conducted. Next, cancellous bone is harvested from the iliac crest. And then the Percutaneous Pedicle Screws are inserted bilaterally. A rod is bended and placed just caudal to the spinous process. We can make reposition of slipped vertebra and stabilize the loose lamina more firmly using a reduction tool and a rod pusher. Finally, bone grafts are implanted onto the pars defects. The Smiley face rod method is very useful to reduce the slippage and repair the pars defects in the lumbar spondylolisthesis especially in adolescent athletes. J. Med. Invest. 64: 168-172, February, 2017.
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A new endoscopic technique to decompress lumbar Nerve roots affected by spondylolysis. Technical note.
Journal of neurosurgery, 2003Co-Authors: Koichi Sairyo, Shinsuke Katoh, Tadanori Sakamaki, Shinji Komatsubara, Natsuo YasuiAbstract:The authors describe a new endoscopic technique to decompress lumbar Nerve roots affected by spondylolysis. Short-term clinical outcome was evaluated. Surgery-related indications were: 1) radiculopathy without low-back pain; 2) no spinal instability demonstrated on dynamic radiographs; and 3) age older than 40 years. Seven patients, four men and three women, fulfilled these criteria and underwent endoscopic decompressive surgery. Their mean age was 60.9 years (range 42-70 years). No subluxation was present in four patients, whereas Meyerding Grade I slippage was demonstrated in three. For endoscopic Decompression, a skin incision of 16 to 18 mm in length was made, and fenestration was performed to identify the affected Nerve root. The proximal stump of the ragged edge of the spondylotic lesion, and the fibrocartilaginous mass compressing the Nerve root were removed. The follow-up period ranged from 6 to 22 months (mean 11.7 months). Clinical outcome was evaluated using Gill criteria; in three patients the outcome was excellent, and in four it was good. This new endoscopic technique was useful in the Decompression of Nerve roots affected by spondylolysis, the technique was minimally invasive, and the clinical results were acceptable.
Natsuo Yasui - One of the best experts on this subject based on the ideXlab platform.
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A new endoscopic technique to decompress lumbar Nerve roots affected by spondylolysis. Technical note.
Journal of neurosurgery, 2003Co-Authors: Koichi Sairyo, Shinsuke Katoh, Tadanori Sakamaki, Shinji Komatsubara, Natsuo YasuiAbstract:The authors describe a new endoscopic technique to decompress lumbar Nerve roots affected by spondylolysis. Short-term clinical outcome was evaluated. Surgery-related indications were: 1) radiculopathy without low-back pain; 2) no spinal instability demonstrated on dynamic radiographs; and 3) age older than 40 years. Seven patients, four men and three women, fulfilled these criteria and underwent endoscopic decompressive surgery. Their mean age was 60.9 years (range 42-70 years). No subluxation was present in four patients, whereas Meyerding Grade I slippage was demonstrated in three. For endoscopic Decompression, a skin incision of 16 to 18 mm in length was made, and fenestration was performed to identify the affected Nerve root. The proximal stump of the ragged edge of the spondylotic lesion, and the fibrocartilaginous mass compressing the Nerve root were removed. The follow-up period ranged from 6 to 22 months (mean 11.7 months). Clinical outcome was evaluated using Gill criteria; in three patients the outcome was excellent, and in four it was good. This new endoscopic technique was useful in the Decompression of Nerve roots affected by spondylolysis, the technique was minimally invasive, and the clinical results were acceptable.
Gaurav Bathala - One of the best experts on this subject based on the ideXlab platform.
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proximal fibular osteochondroma causing splitting of common peroneal Nerve leading to neuropathy in an adult a rare case report
The Journal of medical research, 2016Co-Authors: Ujjwal G Wankhade, Amit Kale, Prafful Rawate, Gaurav BathalaAbstract:Osteochondroma is the most common benign primary tumor of appendicular skeleton arising from the metaphyseal or metadiaphyseal region of long bones and are most commonly seen around the knee. A proximal fibular osteochondroma may distort the normal anatomical course of Nerves and it may lead to vascular compression syndromes or peroneal Nerve paralysis. We report a case of proximal fibular osteochondroma causing splitting of common peroneal Nerve leading to neuropathy in an adult. Our article concludes that osteochondroma of proximal fibula could be responsible for common peroneal Nerve palsy due to compression or entrapment and in such cases Decompression of Nerve should not be delayed. Moreover, we also report that osteochondroma causing splitting of midsubstance of common peroneal Nerve which may surprise surgeon intraoperatively. Through this case report, we are hoping to alert surgeons that this problem may occur, and care should be taken to identify the entire common peroneal Nerve prior to removal of the osteochondroma.
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Proximal fibular osteochondroma causing splitting of common peroneal Nerve leading to neuropathy in an adult – a rare case report
The Journal of medical research, 2016Co-Authors: Ujjwal G Wankhade, Amit Kale, Prafful Rawate, Gaurav BathalaAbstract:Osteochondroma is the most common benign primary tumor of appendicular skeleton arising from the metaphyseal or metadiaphyseal region of long bones and are most commonly seen around the knee. A proximal fibular osteochondroma may distort the normal anatomical course of Nerves and it may lead to vascular compression syndromes or peroneal Nerve paralysis. We report a case of proximal fibular osteochondroma causing splitting of common peroneal Nerve leading to neuropathy in an adult. Our article concludes that osteochondroma of proximal fibula could be responsible for common peroneal Nerve palsy due to compression or entrapment and in such cases Decompression of Nerve should not be delayed. Moreover, we also report that osteochondroma causing splitting of midsubstance of common peroneal Nerve which may surprise surgeon intraoperatively. Through this case report, we are hoping to alert surgeons that this problem may occur, and care should be taken to identify the entire common peroneal Nerve prior to removal of the osteochondroma.
Gert Muhr - One of the best experts on this subject based on the ideXlab platform.
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Triangular osteosynthesis for unstable sacral fractures
Orthopaedics and Traumatology, 2014Co-Authors: Thomas A. Schildhauer, Christoph Josten, Gert MuhrAbstract:Objectives Stable internal fixation of sacral fractures after anatomic reduction of the vertical displacement. Decompression of Nerve roots. Early return to pain-free function.
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Triangular osteosynthesis for unstable sacral fractures
Orthopedics and Traumatology, 2001Co-Authors: Thomas A. Schildhauer, Christoph Josten, Gert MuhrAbstract:Objectives Stable internal fixation of sacral fractures after anatomic reduction of the vertical displacement. Decompression of Nerve roots. Early return to pain-free function. Indications All vertically unstable sacral fractures of type C pelvic ring disruptions. Sacroiliac dislocations. Contraindications Compound fractures. Soft tissue detachment of posterior pelvic ring or fractures associated with considerable soft tissue trauma constitute a contraindication limited to the immediate post-injury phase given the risk of infection and soft tissue complications. Surgical Technique Curvilinear or paravertebral posterior approach. Reduction of the fracture, stabilization between pedicle of L4 or L5 and posterior aspect of the iliac bone or the sacral wing lateral to the sacral fracture. Thereafter, iliosacral screw fixation (unilateral fractures with little displacement) or transsacral plate fixation (bilateral fractures or unilateral fractures with marked displacement). If a stabilization of the anterior pelvic ring has been performed, 1 iliosacral screw is sufficient, otherwise 2 screws should be used. Stabilization of the anterior pelvic ring is only indicated in the presence of disruption of the symphysis, marked displacement of fragments, or if associated injuries necessitate an anterior approach. Results Since April 1992, vertically unstable sacral fractures were treated with this stabilization in 48 patients (average age 34 years, range 15 to 72 years). Since 1994, the start of postoperative full weight-bearing was gradually advanced. Despite the immediate postoperative full weightbearing, a loss of reduction was not observed in properly performed triangular internal fixation. An incomplete reduction associated with an inadequate stabilization led to a loss of correction in 3 patients. Prominent heads of pedicle screws at the level of the posterior iliac crest may cause soft tissue problems. All fractures consolidated. Implant removal was performed in 23 patients, in 1 patient on account of deep infection and in 22 after consolidation of the fracture. Out of 25 patients with preoperative neurologic deficit, 4 showed a complete and 3 a partial recovery.
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Die trianguläre Osteosynthese instabiler Sakrumfrakturen
Operative Orthopädie und Traumatologie, 2001Co-Authors: Thomas A. Schildhauer, Christoph Josten, Gert MuhrAbstract:Objectives Stable internal fixation of sacral fractures after anatomic reduction of the vertical displacement. Decompression of Nerve roots. Early return to pain-free function. Indications All vertically unstable sacral fractures of type C pelvic ring disruptions. Sacroiliac dislocations. Contraindications Compound fractures. Soft tissue detachment of posterior pelvic ring or fractures associated with considerable soft tissue trauma constitute a contraindication limited to the immediate post-injury phase given the risk of infection and soft tissue complications. Surgical Technique Curvilinear or paravertebral posterior approach. Reduction of the fracture, stabilization between pedicle of L4 or L5 and posterior aspect of the iliac bone or the sacral wing lateral to the sacral fracture. Thereafter, iliosacral screw fixation (unilateral fractures with little displacement) or transsacral plate fixation (bilateral fractures or unilateral fractures with marked displacement). If a stabilization of the anterior pelvic ring has been performed, 1 iliosacral screw is sufficient, otherwise 2 screws should be used. Stabilization of the anterior pelvic ring is only indicated in the presence of disruption of the symphysis, marked displacment of fragments, or if associated injuries necessitate an anterior approach. Results Since April 1992, vertically unstable sacral fractures were treated with this stabilization in 48 patients (average age 34 years, range 15 to 72 years). Since 1994, the start of postoperative full weight-bearing was gradually advanced. Despite the immediate postoperative full weight bearing, a loss of reduction was not observed in properly performed triangular internal fixation. An imcomplete reduction associated with an inadequate stabilization led to a loss of correction in 3 patients. Prominent heads of pedicle screws at the level of the posterior iliac crest may cause soft tissue problems. All fractures consolidated. Implant removal was performed in 23 patients, in 1 patient on account of deep infection and in 22 after consolidation of the fracture. Out of 25 patients with preoperative neurologic deficit, 4 showed a complete and 3 a partial recovery. Operationsziel Stabile Sakrumosteosynthese mit exakter, vor allem vertikaler Reposition der Fragmente; Beseitigung einer Nervenwurzelkompression sowie frühzeitige Wiederherstellung einer schmerzfreien Funktion. Indikationen Alle vertikal instabilen Sakrumfrakturen vom Typ C der Beckenringbrüche. Auch Iliosakralfugensprengungen können mit dieser Osteosynthesetechnik behandelt werden. Begleitverletzungen sollten einer frühzeitigen Vollbelastung nicht im Wege stehen, da sonst der umfangreiche Eingriff mit eigener Morbidität nicht gerechtfertigt ist. Kontraindikationen offene Frakturen, Décollement des hinteren Beckenringes oder Frakturen mit erheblicher Weichteilbeteiligung in der Akutphase wegen der Gefahr von Infektionen und Weichteildefekten. Operationstechnik Frakturreposition durch dorsalen, bogenförmigen oder paravertebralen Zugang. Vertebropelvine Abstützung zwischen Pedikel L4 oder L5 und hinterem Os ilium oder Ala sacralis lateral der Sakrumfraktur. Nachfolgende horizontale Stabilisierung durch iliosakrale Verschraubung (einseitige Frakturen mit geringer Dislokation) oder transsakrale Plattenosteosynthese (bilaterale Frakturen, einseitige Frakturen mit ausgepräger Dislokation). Bei Stabilisierung des vorderen Beckenringes reicht eine iliosakrale Schraube aus; sonst müssen zwei Iliosakralschrauben gesetzt werden. Der vordere Beckenring wird nur bei Symphysenrupturen, ausgeprägter Dislokation oder im Fall von Begleitverletzungen, die einen ventralen Zugang erfordern, angegangen. Ergebnisse Zwischen April 1992 und März 1998 wurden 48 Patienten im Durchschnittsalter von 34 (15 bis 72) Jahren mit vertikal instabilen Sakrumfrakturen auf die beschriebene Weise stabilisiert. Seit 1994 wurde eine postoperative Vollbelastung zunehmend früher erlaubt. Trotz sofortiger postoperativer Vollbelastung kam es bei korrekter triangulärer Osteosynthese zu keimen Repositionsverlust – drei Patienten mit Repositionsverlust wiesen eine unvollständige Frakturreposition und eine ungenügende operative trianguläre Stabilisierung auf. Weichteilprobleme können bei Patienten mit nicht versenkt eingebrachter Pedikelschraube im hinteren Beckenkamm auftreten. Alle Frakturen heilten ohne Pseudarthrosenbildung aus. Das Osteosynthesematerial wurde bei 23 Patienten entfernt, bei einem Patienten wegen einer tiefen Wundinfektion und bei 22 nach Ausheilen der Fraktur. Von 25 Patienten mit präoperativem neurologischen Defizit zeigten vier eine vollständige und drei eine teilweise Remission.
John W Xerogeanes - One of the best experts on this subject based on the ideXlab platform.
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endoscopically assisted fasciotomy description of technique and in vitro assessment of lower leg compartment Decompression
American Journal of Sports Medicine, 2002Co-Authors: Fraser J Leversedge, Patrick J Casey, John G Seiler, John W XerogeanesAbstract:We describe a reliable method of endoscopically assisted fasciotomy for treating chronic exertional compartment syndrome in the lower leg and for assessing compartment Decompression in an in vitro model. Endoscopically assisted fasciotomy was performed in the anterior and lateral compartments of 14 matched, fresh-frozen, through-the-knee amputation specimens using a 30 degrees endoscope. A one-incision technique used in 4 specimens failed to provide complete visualization, and a two-incision technique was then performed in 10 specimens. After Decompression, the skin and subcutaneous tissues were removed to assess adequacy of release, Nerve Decompression, anatomic course of the superficial peroneal Nerve, and potential complications. Endoscopic visualization of the fascial layer and subcutaneous neurovascular structures permitted consistent compartment Decompression. Fascial release, expressed as a percentage of length from the proximal origin of the fascia to the inferior retinaculum, was 99.8% (range, 98.4% to 100%) for the anterior compartment and 96.4% (range, 82% to 100%) for the lateral compartment. There were no retained fascial bands, unrecognized fascial defects, or neurovascular injuries. Optimal visualization with endoscopically assisted fasciotomy may improve clinical outcome through 1) reliable compartment Decompression, 2) identification of fascial defects, 3) Decompression of Nerve branches at the fascial foramen, and 4) reduction of iatrogenic risk to neurovascular and muscular structures.
