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ABSTRACT: Anatomical variability of sacral bone as well as its diverse interpretations a surgical field prompted the authors to modify surgical technique in such manner to allow unequivocal identification of a starting point for introduction of transpedicular screws into the first sacral vertebra. The starting point is not located, as described in previous publications, inferiorly and laterally to the S1 articular process, but goes through a precisely defined place in the dorsal ridge of superior articular process following its partial resection.
Chirurgia narzadow ruchu i ortopedia polska 01/2013; 78:101-4.
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ABSTRACT: The objective of this study was to discuss the variables influencing alignment mechanisms of the spine, with particular consideration of post-surgical alignment in adolescent idiopathic scoliosis. The analysis is based on information currently available in the literature, and on the authors' own experience, which includes surgical material from over 2200 cases of idiopathic scoliosis. Over 50% of cases of adolescent idiopathic scoliosis are decompensated before surgical treatment. Spinal alignment is most significantly influenced by the position of the pelvis. Surgical restoration of lumbar lordosis is more important than attempting to restore thoracic kyphosis in the sagittal plane. The sagittal profile has an essential impact on spinal alignment. The same curves in the coronal plane can have various 3-dimensional configurations. Clinical difficulties in the assessment of thoracic kyphosis and lumbar lordosis result from the fact that they undergo constant change with age. Thoracic hypokyphosis diagnosed before surgery is a very frequent symptom of curve progression. The presence of proximal (thoraco-thoracic) and distal (thoraco-lumbar) junctional kyphosis is very important for planning the scope of spondylodesis. The natural tendency of the spine for alignment (compensation) after surgery nowadays occurs more naturally by applying derotational forces through pedicle screws, compared to the distraction devices (eg, Harrington rod) used in the past.
Medical science monitor: international medical journal of experimental and clinical research 12/2012; 18(12):RA181-187. · 1.70 Impact Factor
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ABSTRACT: The number of body injuries keeps growing and that is mostly due to increasing number of car accidents. How to prevent thrombosis in such cases is still under discussion with the biggest issue being the proper timing. Most of the input to such discussion usually comes from extrapolating data from other studies, which is hardly of help for treatment of such group of patients. The authors focus on collection and analysis of most recent data and recommendations that are available in literature. They show that low-molecular-weight heparins are by far the most common, if not sole pharmacologic means of thromboembolism prevention in patients with numerous body injuries.
Ortopedia, traumatologia, rehabilitacja. 06/2011; 13(3):229-40.
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ABSTRACT: The aim of this prospective study was to assess the walking ability in patients with osteoarthritis of the knee before and after opening-wedge high tibial osteotomy with use of OSTEO+ system. From 2002 to 2005 thirty medial opening-wedge tibial osteotomies were performed in thirty patients. Patients with varus knee deformity and moderate degenerative changes of the knee were chosen for the procedure. A medial transverse osteotomy was performed proximal to the tibial tuberosity. The medial side of the osteotomy site was opened to the desired angle of correction. The opened osteotomy site was fixed with OSTEO+ system with no bone graft used. The goal was to achieve a final standing alignment of 5 degrees of anatomical valgus angulation. We assessed the patients with The Knee Score and The Functional Score before and after the procedure. The average follow-up was 2 years. All patients had pain relief and improvement in walking ability after the osteotomy. There were no cases of recurrence of varus deformity.
Chirurgia narzadow ruchu i ortopedia polska 02/2006; 71(6):427-9.
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ABSTRACT: The number of ACL injuries noted during diagnostic arthroscopy is steadily increasing. This has lead us to assess an optimal method for ACL reconstruction. 563 patients with post-trauma disfunction of the knee were treated at LORO between january 2000 and december 2001. In this group 79 cases of incomplete ACL injuries and 43 complete ACL injuries were noted. 17 arthroscopic ACL reconstructions were performed, using semitendinous and gracilis tendons. After surgery patients underwent a rehabilitation protocol and were followed-up on a regular basis. In 11 (65%) a very good results was achieved 6 months after surgery (according to the IKCD scale), and in further 3 cases (17.5%) 12 months post surgery. No instability was noted in any of the treated patients.
Chirurgia narzadow ruchu i ortopedia polska 02/2005; 70(1):9-12.
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ABSTRACT: The aim of this prospective study was to assess the usefulness of OSTEO+ (Implants Industrie) system in opening-wedge tibial valgus osteotomy in patients with osteoarthritis of the knee. From 2002 to 2003 ten medial opening-wedge tibial osteotomies were performed in ten patients. Patients with varus knee deformity and mild or moderate degenerative changes of the knee were chosen for the procedure. A medial transverse osteotomy was performed proximal to the tibial tuberosity. The medial side of the osteotomy site was opened to the desired angle of correction. The opened osteotomy site was fixed with OSTEO+ system with no bone graft used. The goal was to achieve a final standing alignment of 0 to 5 degrees of anatomical valgus angulation. The average duration of clinical and radiological follow-up was 6 months (range, four to eight months). All patients had paro relief and improvement in walking ability after the osteotomy. There were no cases of recurrence of varus deformity.
Chirurgia narzadow ruchu i ortopedia polska 02/2004; 69(2):97-9.
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ABSTRACT: The paper presents the treatment mode of metastasis to the spine. Between 2000 and 2002 5 cases (3 men and 2 women) with metastasis to the lumbar spine were treated surgically. The metastasis derived from primary foci in the prostate (3 cases), in the breast (1 case) and in the kidney (1 case). The average age of the patients was 65 years (ranging from 53 to 74 years). In all cases a vertebrectomy was performed through an anterior approach. Titanium baskets filled with bone cement were implemented. The spine was stabilized using anterior Kaneda instrumentation (3 cases) and the posterior Omega instrumentation (2 cases). This mode of treatment yielded good results. Pain relief was achieved by decompressing the neural elements, leading to better quality of life among the operated patients.
Chirurgia narzadow ruchu i ortopedia polska 02/2003; 68(1):9-11.
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ABSTRACT: Eleven patients with single compartment arthrosis of the knee were treated surgically, using the Oxford prosthesis. The age of the patients at the time of surgery ranged from 48 to 73 years. Varus deformity of the knee before surgery ranged from 0-23 degrees (average: 11 degrees). Patients with arthrosis of the medial compartment were elected for surgery. Surgery was performed only when passive correction of the varus deformity was possible and when the cruciate ligaments were intact. In all cases surgery yielded a stable knee joint.
Chirurgia narzadow ruchu i ortopedia polska 02/2003; 68(3):173-5.
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ABSTRACT: The author's present their own experiences with the Galveston technique in treatment of paralytic spine deformities. Nineteen patients (6 boys and 13 girls) were treated (between 1996 and 2002) at the Swiebodzin Spine Centre and the Special Spine Surgery Unit in Poznań. All patients were unable to sit straight without external support, due to neurologic muscle weakness and pelvic obliquity. Surgical treatment lead to a marked improvement of the spinal deformity and also allowed the patients to sit-straight, without need of any support.
Chirurgia narzadow ruchu i ortopedia polska 02/2003; 68(2):121-4.
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ABSTRACT: The purpose of this retrospective study was to compare early lower limb dysaesthesia after anterior cruciate ligament (ACL) reconstructions. The procedures were performed with ST and GR tendons using vertical or oblique harvest site incisions. In the year 2006 52 patients were treated due to total ACL rupture. In 35 we performed vertical harvest site incision and in 17 oblique incision were performed. Average follow-up was 1 month. At this time patients were asked to draw any dysaesthesia area on a knee diagram, if present. In the vertical harvest site incision 31 patients had dysaesthesia about the knee, and the average dysaesthesia area was 46.8 cm2. In the oblique harvest site incision 15 patients had dysaesthesia about the knee and the average dysaesthesia area was 44.3 cm2. The dysaesthesia areas were mostly of ellipse-like shape. There was no signigicant difference between two groups.
Chirurgia narzadow ruchu i ortopedia polska 72(4):247-8.
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ABSTRACT: Back pain is common (80-90% population), conservative treatment is usually successful. Lumbar disc herniation and sciatica are fairly common but are far less frequent than is idiopathic low back pain. Sciatica is usually due to lumbar disc herniation; the outcome is usually favorable. Surgery for lumbar disc herniation and sciatica is indicated if acute bladder and bowel impairment is present (cauda equine syndrome) or if sciatic pain is incapacitating and persistent for more than 6 to 12 weeks. Confirmation of the clinical level of disc herniation must be made by imaging (CT or MRI). With proper patient selection, surgery for lumbar disc herniation and sciatica can be expected to lead to excellent results in the majority of patients.
Chirurgia narzadow ruchu i ortopedia polska 72(2):95-7.
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ABSTRACT: Spinal stenosis is most common in elderly patients and is defined as narrowing of the spinal canal and (or) lateral nerve root canals. The underlying processes leading to spinal stenosis are degenerative changes in facet joints and intervertebral discs and buckling of the ligamentum flavum. Spinal stenosis can occur in both the cervical and the lumbar spine. Cervical stenosis mayleat to the development of radiculopathy and (or) myelopathy. The majority of patients respond to nonoperative management. Degenerative lumbar spinal stenosis presents with back and (or) leg paints of valuing severity and duration. Nonoperative treatment associated with lumbar spinal stenosis consists of restituting and avoiding those maneuvers that reproduce pain. Surgical treatment of cervical and lumbar stenosis includes decompressive lamine ctomy, often fusion and instrumentation.
Chirurgia narzadow ruchu i ortopedia polska 72(3):157-64.
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ABSTRACT: A case of revision anterior cruciate ligament (ACL) reconstruction is described. A man presented at our clinic with knee pain when walking, knee extension deficit and giving way. Primary ACL renostruction was performed 17 months earlier in another clinic. During the arthroscopy ACL graft deficiency was confirmed, tibial hardware protrusion and the lateral meniscus tear was found. Tibial hardware was removed and meniscus tear was repaired. 10 weeks later revision ACL reconstruction was performed as single-stage procedure with use of quadriceps free tendon autograft. We belive that single-stage procedure following a divergent tunnel concept could be a valuable technique in revision ACL surgery.
Chirurgia narzadow ruchu i ortopedia polska 72(3):219-21, 229-31.
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ABSTRACT: Neck pain is common. Conservative treatment is usually successful. Cervical radiculopaty is usually caused by a disc herniation. Conservative treatment is generally successful, however surgery is indicated if radicular pain is severe and persistent for more than 6 to 12 wk. Spinal cord compression and long-tract symptoms may be caused by a central cervical disc herniation, treatment is by anterior disc excision, bone grafting or metal fusion cages. Confirmation of the clinical level of disc herniation must be made by imaging (CT and (or) MRI). With proper patient selection, surgery for cervical disc herniation can be expected to lead to excellent results in the majority of patients (80-90%).
Chirurgia narzadow ruchu i ortopedia polska 72(2):85-8.
