Surgery Commons^™

Finite Element Analysis Comparing A Peek Posterior Fixation Device Versus Pedicle Screws For Lumbar Fusion, Robert Eastlack, Pierce Nunley, Kornelis Poelstra, Alex Vaccaro, Marcus Stone, Larry Miller, Pierre Legay, Julien Clin, Aakash Agarwal

Department of Orthopaedic Surgery Faculty Papers

BACKGROUND: Pedicle screw loosening and breakage are common causes of revision surgery after lumbar fusion. Thus, there remains a continued need for supplemental fixation options that offer immediate stability without the associated failure modes. This finite element analysis compared the biomechanical properties of a novel cortico-pedicular posterior fixation (CPPF) device with those of a conventional pedicle screw system (PSS).

METHODS: The CPPF device is a polyetheretherketone strap providing circumferential cortical fixation for lumbar fusion procedures via an arcuate tunnel. Using a validated finite element model, we compared the stability and load transfer characteristics of CPPF to intact conditions under a …

How Does The Severity Of Neuroforaminal Compression In Cervical Radiculopathy Affect Outcomes Of Anterior Cervical Discectomy And Fusion, Mark J. Lambrechts, Tariq Z. Issa, Yunsoo Lee, Khoa S. Tran, Jeremy Heard, Caroline Purtill, Tristan B. Fried, Samuel Oh, Erin Kim, John J. Mangan, Jose A. Canseco, I. David Kaye, Jeffrey A. Rihn, Alan S. Hilibrand, Alex R. Vaccaro, Christopher K. Kepler, Gregory D. Schroeder

Rothman Institute Faculty Papers

STUDY DESIGN: This study is a retrospective cohort study.

PURPOSE: This study aims to determine whether preoperative neuroforaminal stenosis (FS) severity is associated with motor function patient-reported outcome measures (PROMs) following anterior cervical discectomy and fusion (ACDF).

OVERVIEW OF LITERATURE: Cervical FS can significantly contribute to patient symptoms. While magnetic resonance imaging (MRI) has been used to classify FS, there has been limited research into the impact of FS severity on patient outcomes.

METHODS: Patients undergoing primary, elective 1-3 level ACDF for radiculopathy at a single academic center between 2015 and 2021 were identified retrospectively. Cervical FS was evaluated using …

Surgical Evacuation For Chronic Subdural Hematoma: Predictors Of Reoperation And Functional Outcomes, Georgios S. Sioutas, Ahmad Sweid, Md, Ching-Jen Chen, Andrea Becerril Gaitán, Fadi Al-Saiegh, Kareem El Naamani, Rawad Abbas, Abdelaziz Amllay, Lyena Birkenstock, Rachel E. Cain, Ramon L. Ruiz, Michael Buxbaum, David Nauheim, Bryan Renslo, Jonathan Bassig, Michael Reid Gooch, Nabeel Herial, Pascal Jabbour, Robert H. Rosenwasswer, Stavropoula I. Tjoumakaris

Department of Neurosurgery Faculty Papers

Background

Although chronic subdural hematoma (CSDH) incidence has increased, there is limited evidence to guide patient management after surgical evacuation.

Objective

To identify predictors of reoperation and functional outcome after CSDH surgical evacuation.

Methods

We identified all patients with CSDH between 2010 and 2018. Clinical and radiographic variables were collected from the medical records. Outcomes included reoperation within 90 days and poor (3–6) modified Rankin Scale score at 3 months.

Results

We identified 461 surgically treated CSDH cases (396 patients). The mean age was 70.1 years, 29.7 % were females, 298 (64.6 %) underwent burr hole evacuation, 152 (33.0 %) …

Current Medical Therapy And Revascularization In Peripheral Artery Disease Of The Lower Limbs: Impacts On Subclinical Chronic Inflammation, Andrea Leonardo Cecchini, Federico Biscetti, Matteo Manzato, Lorenzo Lo Sasso, Maria Margherita Rando, Maria Anna Nicolazzi, Enrica Rossini, Luis Eraso, Paul Dimuzio, Massimo Massetti, Antonio Gasbarrini, Andrea Flex

Department of Surgery Faculty Papers

Peripheral artery disease (PAD), coronary artery disease (CAD), and cerebrovascular disease (CeVD) are characterized by atherosclerosis and inflammation as their underlying mechanisms. This paper aims to conduct a literature review on pharmacotherapy for PAD, specifically focusing on how different drug classes target pro-inflammatory pathways. The goal is to enhance the choice of therapeutic plans by considering their impact on the chronic subclinical inflammation that is associated with PAD development and progression. We conducted a comprehensive review of currently published original articles, narratives, systematic reviews, and meta-analyses. The aim was to explore the relationship between PAD and inflammation and evaluate the …

Endovascular Embolization For Epistaxis: A Single Center Experience And Meta-Analysis, Kareem El Naamani, Charles Morse, Marc Ghanem, Julie Barbera, Abdelaziz Amllay, Grace Severance, Ramon Ruiz, Ahmad Sweid, Michael Gooch, Nabeel Herial, Pascal Jabbour, Robert Rosenwasswer, Gurston Nyquist, Stavropoula Tjoumakaris

Department of Neurosurgery Faculty Papers

The optimal treatment for intractable epistaxis is still controversial. Various studies have demonstrated high success rates and low complication rates for endovascular embolization. Herein, the authors report an institutional experience and meta-analysis in terms of efficacy and safety of endovascular embolization of intractable epistaxis. This was a retrospective observational study of 35 patients with epistaxis who underwent 40 embolization procedures between 2010 and 2023. The primary outcome was immediate success defined by immediate cessation of epistaxis at the end of the procedure. Immediate success was achieved in most of the procedures (39, 97.5%). During follow-up, three (7.5%) patients experienced a …

Utilization And Short-Term Outcomes Of Percutaneous Left Atrial Appendage Occlusion In Patients With Cancer, Yaqi Zhang, Zhuoran Yang, Muhammad Usman Almani, Raquel Soon-Shiong, Bolun Liu

Einstein Health Papers

Background

Percutaneous left atrial appendage occlusion (LAAO) has been rapidly evolving since FDA’s approval in 2015 and has become more of a same-day-discharge procedure. Cancer patient with atrial fibrillation/flutter (AF) population can benefit from the procedure but the in-hospital outcomes and readmission data were rarely studied.

Objectives

We investigated the utilization, in-hospital and readmission outcomes in cancer patients with AF who underwent LAAO.

Methods

Data were derived from the National Inpatient Sample and National Readmissions Database from 2016 to 2019. Patients with primary diagnosis of AF admitted for LAAO (ICD-10 code 02L73DK) were grouped by cancer as a secondary diagnosis. …

Informed Consent In Surgical Practice With Patients’ Experiences: A Cross-Sectional Study, Seda Kumru, Pakize Yiğit, Meryem Demirtaş, Hüseyin Fındık

Patient Experience Journal

This study aims to evaluate patients' experiences and perspectives regarding informed consent in surgical practice. Data for this cross-sectional study were collected from 276 patients using a questionnaire developed by Falagas et al. Descriptive statistics were employed for all questions. Statistical tests such as the Mann-Whitney U test, Kruskal-Wallis test, and Spearman's rank correlation analysis were performed, and Cohen's effect sizes were reported. IBM SPSS 23.0 was used for all analyses, and p<0.05 was considered statistically significant. A high score on both The Delivered Information Index and The Patient-Physician Index represents a positive informed consent process. Among the participants, 65.2% indicated that they understood all parts of the consent form. Of all patients, 92.8% reported that information about the specific surgical procedure was provided by physicians. However, 47.5% of the patients reported that they did not feel comfortable with their surgeons. The mean score of the Delivered Information Index was 5.63 (2.38). The mean patient-physician relationship score was 14.38 (3.31). There was a moderate positive correlation between the delivered information index and the patient-physician relationship (r=0.50; p<0.001). In addition, there was a moderate positive correlation between the delivered information index and the time spent on the informed consent process, as well as between the patient-physician relationship and the time spent on the informed consent process (r=0.52; r=0.40, respectively). The study emphasized the lack of communication between patients and physicians, the limitation of information on treatment risks, adverse effects, and alternative treatment options.

Experience Framework

This article is associated with the Policy & Measurement lens of The Beryl Institute Experience Framework (https://theberylinstitute.org/experience-framework/).

• Access other PXJ articles related to …

Slow Surgical Correction Affects More Than Just The Bowels, Emilia M. Clementi

Clinical Research in Practice: The Journal of Team Hippocrates

Reflection on how delayed colostomy reversal affects a patient's mental and physical well-being.

Phenytoin-Induced Cerebellar Atrophy: A Case For Reversibility Of Neurological Decline, Edwin Mogere, Davis Cheruiyot, Manakhe Nassiuma

General Surgery, East Africa

This case serves as a reminder of the infrequent, yet consequential occurrence of cerebellar degeneration linked to phenytoin usage. Whilst emphasizes the importance of monitoring patients on long-term phenytoin therapy, and it further suggests considering employing bedside imaging tools such as Ultrasound fusion imaging for follow-up of patients at risk of this type of disorder. We present a case study involving a 23-year-old woman who experienced significant neurological impairment resulting in severe cerebellar atrophy while undergoing phenytoin treatment. On cessation of phenytoin, the patient exhibited improvement with enhanced cerebellar function.

Resilience Of Patients Undergoing Knee And Shoulder Arthroscopy Procedures, Jillian Mazzocca, Natalie Lowenstein, Connor Crutchfield, Jamie Collins, Elizabeth Matzkin

Student Papers, Posters & Projects

INTRODUCTION: Resilience is a person's capacity to overcome adversity. The purpose was to determine what patient factors correlate with resilience using the Brief Resilience Score. We hypothesize that characteristics of female sex, younger age, Workers' Compensation status, and preoperative opioid use are predictors of a lower preoperative resilience score and that patients with positive psychosocial factors would have higher resilience scores.

METHODS: Eight hundred nine patients undergoing knee or shoulder arthroscopy were preoperatively categorized into low, normal, and high-resilience groups. Preoperative patient-reported outcome measures (PROMs) and demographics were assessed. Statistical analyses evaluated differences in demographics and PROMs between resilience groups. …

Maternal And Perinatal Outcomes Of Women With Vaginal Birth After Cesarean Section Compared To Repeat Cesarean Birth In Select South Asian And Latin American Settings Of The Global Network For Women's And Children's Health Research, Lester Figueroa, Margo Harrison, Manolo Mazariegos, Shivaprasad Gouda, Avinash Kavi, Richard Derman, Archana Patel, Prabir Das, Sarah Saleem, Farnaz Naqvi

Community Health Sciences

Objective: Our objective was to analyze a prospective population-based registry including five sites in four low- and middle-income countries to observe characteristics associated with vaginal birth after cesarean versus repeat cesarean birth, as well as maternal and newborn outcomes associated with the mode of birth among women with a history of prior cesarean.
Hypothesis: Maternal and perinatal outcomes among vaginal birth after cesarean section will be similar to those among recurrent cesarean birth.
Methods: A prospective population-based study, including home and facility births among women enrolled from 2017 to 2020, was performed in communities in Guatemala, India (Belagavi and Nagpur), …

Subungual Squamous Cell Carcinoma Leading To Arm Amputation, Ovidiu V. Fabian, Emilia Maria Pătruţ, Mădălina Șteţca, Radu Mircea Galasiu, Vlad Zolog, Adriana Zolog, Iacob Domşa, Ioan Șimon, Anca Mihailov, Olga Hilda Orăşan, Flaviu Mureşan

Journal of Mind and Medical Sciences

Although rare, subungual carcinoma is the most common malignant nail tumor. The symptomatology is not characteristic, being very similar to that of other nail and periungual diseases. For this reason, early diagnosis is usually established by performing a biopsy. With appropriate treatment, subungual carcinoma usually has a favorable prognosis. Metastatic cases are rarely encountered, but they usually have a poor therapeutic result. This article presents the case of a patient with subungual carcinoma (diagnosed by histopathological exam), initially treated by amputation of the distal and middle phalanges of the fourth finger. Two years after the operation, a recurrence in the …

Giant Renal Cell Carcinoma In A Patient With Ipsilateral Lower Limb Hypertrophic Lichen Planus; Case Report And Literature Review, Silvia Popescu, Dumitru Peța, Zoltan Janos Kövér, Dumitru Toma, Ioan-Teodor Cristea, Mihaela Anca Popescu, Oana-Denisa Bălălău, Romina-Marina Sima, Gabriel-Petre Gorecki, Călin Giurcăneanu

Journal of Mind and Medical Sciences

Renal cell carcinoma is the most common type of primary urogenital cancer, usually resistant to radiotherapy and chemotherapy. Hypertrophic lichen planus is an inflammatory dermatosis characterized by the presence of papulosquamous and intensely pruritic lesions. The association of these two conditions is unusual, being reported in the specialized literature only in a few rare cases with the onset of lichenoid lesions after patients have undergone various forms of treatment. The case of a 62-year-old male patient who was admitted for severe abdominal pain due to a giant renal tumor associated with a hypertrophic plaque located on the anterior part of …

Is Open Surgery Still Part Of The Current Treatment Of Inguinal Hernias?, Dan Bratu, Alin Mihetiu, Alexandra Sandu, Crenguta Serboiu, Corneliu Tudor, Laurentiu Simion, Dragos Cretoiu, Florin Bobirca, Dragos Davitoiu, Bogdan Serban, Claudiu Eduard Nistor

Journal of Mind and Medical Sciences

Inguinal hernia repair represents one of the most frequent pathologies with surgical addressability. From the multitude of surgical procedures, a limited number still keep their indication in the current treatment of hernias. Open surgery, the exclusive repair method until recently, is associated with laparoscopic techniques with benefits that are at least superposable on those in open repair. We conducted a study, analyzing several types of procedures in open surgery and comparing them to each other, but also with the TAPP approach, which is still at the beginning in our service. The non-mesh procedures scored poorly in terms of recurrence, the …

Revascularization Impact: Quality Of Life Enhancement In Chronic Limb-Threatening Ischemia, Cristian Traian Paius, Vlad Denis Constantin, Alexandru Carap, Andrei Tarus, Grigore Tinica

Journal of Mind and Medical Sciences

Introduction. Globally, over 230 million people have peripheral artery disease, often undiagnosed, leading to chronic limb-threatening ischemia. Revascularization is vital for preventing amputation and improving quality of life. While specific questionnaires for severe ischemia are lacking, the SF-36 questionnaire is widely used to assess quality of life, with variations like SF-12 and SF-8 for larger cohorts. Objectives. Our aim was to assess how different lower limb revascularization methods affect the postoperative quality of life in patients with chronic limb-threatening ischemia. Methods. This study was conducted at the St. Pantelimon Emergency Hospital of Bucharest, Romania. It included 166 adult patients with …

Follow-Up Care After Metabolic Surgery – A Prospective Study In The North-Eastern Region Of Romania, Sorina Boariu, Ana Maria Scutariu, Adrian Cureniuc, Anamaria Meuca, Roxana Adriana Stoica, Anca Mihaela Pantea Stoian, Delia Reurean Pintilei

Journal of Mind and Medical Sciences

Background. Anti-obesity therapeutic strategies are continuously evolving. Bariatric procedures or metabolic surgery are among the most effective and long-lasting therapies for obesity and its complications. Our objective was to investigate the clinical and biological evolution after metabolic surgery in a group of patients from North-Eastern Romania and to evaluate a nutritional intervention plan for this population. Materials and Methods. Our clinic surveyed 50 patients who received nutritional counselling before and after bariatric surgery. The patient's weight loss, metabolic markers, and lifestyle changes from January to December 2021 were recorded. SPSS Statistics v.18 was used for statistical analyses. Results and Discussions. …

Best Therapeutic Practices In The Management Of Obstetric Sepsis, Gabriel Petre Gorecki, Oana Denisa Balalau, Diana Elena Comandasu, Anca Daniela Stanescu, Dana Rodica Tomescu

Journal of Mind and Medical Sciences

Background. Physiological changes that occur during pregnancy make maternal sepsis a difficult condition to diagnose and treat, still having a fairly high mortality rate. Consequently, an early diagnosis and prompt therapeutic management of sepsis can significantly decrease mortality. The purpose of this study is to review literature data that present current practices in the management of obstetric sepsis. Methods. To collect the data required for the study, we performed a search of published articles in the PubMed and Google Scholar databases related to obstetric sepsis. Research paper articles from the period 2012-2022 were included in the analysis. In addition, 145 …

Endoscopic Approach To Recurrent Inguinal Hernia After Previous Open Surgery, Doru Moga, Dragos Serban, Bogdan Geavlete, Crenguta Serboiu, Bogdan Serban, Ana Maria Dascalu, Valentin Oprea

Journal of Mind and Medical Sciences

Background. The management of a recurrent inguinal hernia varies depending on multiple factors. In the case of recurrent inguinal hernias after open anterior repair, the laparoscopic approach is recommended. TEP and TAPP procedures are considered to have similar results. The purpose of the study is to evaluate on our sample if there are differences between primary inguinal hernia cases and recurrent hernia after laparoscopic TAPP and TEP procedures. Materials and Methods. We retrospectively reviewed the medical records of 300 patients who underwent laparoscopic inguinal hernia repairs at our hospital from March 2013 to March 2023. Results. Of the 300 patients, …

Sentinel Node Biopsy For Personalized Breast Cancer Management; Advances And Controversies, Rahim Al Moushaly, Daniel Ion, Octavian Andronic, Bogdan Socea, Alexandru Cosmin Palcau, Dan Nicolae Paduraru

Journal of Mind and Medical Sciences

Sentinel lymph node biopsy (SLNB) has become the gold standard for axillary lymph node staging, providing valuable prognostic information while minimizing complications compared to axillary lymph node dissection. However, there are ongoing debates and controversies surrounding SLNB in specific cases. Studies have explored the use of SLNB in neoadjuvant chemotherapy, emphasizing the need for customized therapy decisions. Factors such as age, tumor characteristics, and treatment response influence the selection of SLNB or axillary lymph node dissection. Additionally, the presence of extranodal extension, micrometastases, and isolated tumor cells has been evaluated to determine the need for lymphadenectomy. The importance of accurate …

Diabetes Mellitus: Interdisciplinary Medical, Surgical And Psychological Therapeutic Approach, Bogdan Socea, Adrian Silaghi, Laura Florentina Rebegea, Daniela Gabriela Balan, Cristian Balalau, Tiberiu Ștefăniță Tenea-Cojan, Doina Andrada Mihai, Ioana Paunica

Journal of Mind and Medical Sciences

Diabetes mellitus is a complex and widespread metabolic disease, having extremely complex implications (biological, psychological, social) for patients. Understanding the pathophysiology of diabetes (majorly influenced by various factors such as genetic predisposition, age, lifestyle choices, etc.) is essential for the prevention of this condition and the establishment of effective treatment strategies. The latest and relevant literature data related to the epidemiology, pathophysiology, and treatment of diabetes are presented, after an exhaustive review of the articles published on this topic and indexed in the WOS, PubMed, Scopus and Google Scholar databases. Preventing or delaying the onset of diabetes can be achieved …