Severe Blount’s disease results in progressive multiplanar deformity of the lower limb.
Blount’s disease management should be tailored individually.
Step Cut “V” Osteotomy developed by our institution in order to have more predictable result.
Step Cut “V” Osteotomy provide accurate and safe correction even in severe deformity.
Background:The development of full endoscopic procedures enables surgeons to visualize the operative field very clearly. Posterior foraminotomy using endoscopy was developed as a minimally invasive procedure to reduce the complication of the anterior cervical approach and to preserve the segmental motion without decreasing the effectiveness of nerve decompression. Our aim is to evaluate the result of full endoscopic posterior cervical foraminotomy in our center. Methods: This is a prospective single-arm study of 65 foraminal disc herniation and foraminal stenosis patients that underwent full endoscopic posterior foraminotomy procedures. All patients were routinely observed for 12-months duration to evaluate Visual Analog Score (VAS) of the neck, arm, and modified Macnab criteria. Results: Arm pain VAS decreased significantly compared with the pre-operation state (p < 0.001, 0.034, 0.001 on immediate post-operative, 6-months follow-up, and 12-months follow-up, respectively) even though 6.15% of patients had hypesthesia on follow-up. There was no neck pain observed during 1 year follow-up, and modified Macnab criteria showed a good outcome following full endoscopic posterior foraminotomy. Conclusion: Full endoscopic posterior foraminotomy provides good nerve decompression with all the benefits of endoscopic spine procedure.
Background:Until recently, open decompression was considered the gold standard for the management of spinal stenosis, but the evolution of minimally invasive spine instruments has brought a new dimension to the management of spinal stenosis. Full endoscopic surgery has a lot of advantages in terms of minimal soft tissue damage, less bleeding, shorter hospital length of stay, and earlier return to work. Our aim was to evaluate the efficacy of full endoscopic lumbar decompression for degenerative lumbar canal stenosis compared with classic open decompression surgery.Methods: This is a retrospective cohort study of degenerative lumbar spinal stenosis without instability, consisting of 132 open decompression and 163 full endoscopic decompression patients. We evaluated the clinical result of the pre-and postoperative visual analog scale (VAS) of leg pain, back pain, and Oswestry Disability Index (ODI). We observed the patients until 1 year after the operation.Results: The postoperative ODI scores and VAS scores for back pain and leg pain were better than the preoperative scores. The ODI scores and VAS scores for leg pain were significantly better in both groups (P = 0.033 and 0.04, respectively). The main difference between open and full endoscopic decompression was the VAS back pain and amount of bleeding. In the full endoscopic group, the mean VAS back pain was 1.6 and the amount of bleeding was minimal. In the open decompression surgery, the mean VAS back pain was 3.5 and the amount of bleeding was around 84 mL. The length of hospital stay was shorter in the full endoscopic group, which was 1.5 days compared with 3.4 days in open decompression (P = 0.034).Conclusion: Full endoscopic decompression showed better early results compared with the conventional group, but a long-term study is still needed for further evaluation of the clinical results. The use of the full endoscopic technique is very promising in the management of spinal stenosis.Clinical Relevance: This study provides a comparison of the efficacy of open decompression and full endoscopic decompression in degenerative lumbar canal stenosis.
Elbow joint stiffness is relatively common following injury to the elbow.
This case is very devastating due to loss of overall arm function due to traumatic elbow stiffness.
We managed to restore ROM of elbow joint to the functional level after traumatic stiffness.
This combination technique of surgery provides excellent outcome for the patient.
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