Symptomatic Thromboembolism as an Uncommon Postoperative Complication in Young Patients with Spinal Deformity

Background/Purpose: Thromboembolism continues to be one of the most appalling postoperative complications. We aim to extend the findings of earlier authors on clinically symptomatic thromboembolic complications in young patients (<30 years old) operated due to major spinal deformity. Methods: We retrospectively studied 297 patients (98 males and 199 females), with a mean age of 17.8 ± 4.2 years (range, 1.8–29.8 years) and a mean follow-up period of 12.3 ± 5.9 months (range, 6–84 months), who had been operated due to major spinal deformity from August 2005 to December 2012. A complete clinical examination was performed in all patients throughout the postoperative period to find out any symptomatic thromboembolism. Results: We found three (1.01%) and two (0.67%) cases with symptomatic thromboembolism and extensive pulmonary embolism, respectively. All of them had a positive history of anterior spine surgery, and one of them had been placed in a poor posture for a long time to improve the inflammation of a surgical wound. Conclusion: Despite the rarity of thromboembolism after surgery for major spinal deformities in young patients, the possibility still exists, and patients with a positive history of anterior spinal surgery or poor posturing are probably more susceptible

Effectiveness of eye movement exercise and diaphragmatic breathing with jogging in reducing migraine symptoms: A preliminary, randomized comparison trial

Abstract Background Migraine is a multifactorial headache disorder. Maladaptive functional networks or altered circuit‐related connectivity in the brain with migraine appear to perturb the effects of usual treatments. Objectives In the present preliminary trial, we aim to study the effectiveness of performing pieces of body–mind, cognitive, or network reconstruction‐based training (i.e., eye movement exercise plus jogging; EME+J and diaphragmatic breathing plus jogging; DB+J) in decreasing migraine symptoms. Methods We used a three‐arm, triple‐blind, non‐inferiority randomized comparison design with pre‐test, post‐test, and follow‐up measurements to assess the effectiveness of EME+J and DB+J in the brain with migraine. Participants were randomly assigned to one of the study groups to perform either 12 consecutive weeks of EME+J (n = 22), DB+J (n = 19), or receiving, treatment as usual, TAU (n = 22). Results The primary outcome statistical analysis through a linear mixed model showed a significant decrease in the frequency (p = .0001), duration (p = .003), and intensity (p = .007) of migraine attacks among the interventions and measurement times. The pairwise comparisons of simple effects showed that EME+J and DB+J effectively reduced migraine symptoms at the post‐test and follow‐up (p < .05). Cochran's tests showed that interventions decreased the number of menses‐related migraine attacks. EME+J and DB+J effectively decreased over‐the‐counter (OTC) drug use, refreshed wake‐up mode, and improved sleep and water drinking patterns. These are the secondary outcomes that Cochran's tests showed in the interventional groups after the interventions and at 12 months of follow‐up. Conclusion EME+J or DB+J can be an effective and safe method with no adverse effects to decrease the symptoms of migraine attacks. Moreover, a reduction in the frequency of menstrual cycle‐related attacks, OTC drug use, and improved quality of sleep and drinking water were the secondary outcomes of the post‐test and a 12‐month follow‐up

Identifying predisposing factors for recurrence after successful surgical treatment of lumbar disc herniation

Background: Recurrent lumbar disc herniation (rLDH) comprises one of the most common complications of lumbar discectomy occurring in about 1-21% of the operated patients. Aim: This study aims to elucidate the role of predisposing factors in producing rLDH in the patients with previous successful lumbar discectomy. Materials and Methods: In this retrospective study, we reviewed 213 patients (133 male; 62%) who underwent simple primary lumbar discectomy in our Orthopedic Department from August 2009 to January 2014. Mean age and follow-up period were 38.1 ± 9.8 years and 48.2 ± 7.3 months, respectively. The term of rLDH referred to those cases who have suffered a relapsed sciatalgia after a primary pain improvement period. We repeated magnetic resonance imaging (MRI) scanning only in those cases with recurrent complaints. Chi-square, Fisher, and Student's t-tests were used for statistics. Results: Recurrent sciatalgia occurred in 39 patients (18.3%), while true rLDH on MRI scanning was detected in 32 patients (15%). Younger age, heavier smoking, and less severity of herniation on primary MRI scanning (protrusion vs. sequestration) play as predisposing roles in creating rLDH, while gender, level or side of LDH, the presence of Modic changes, or body mass index (BMI) have no significant effect. The most common sites of rLDH were same level same side, different level, and same level contra-lateral side, respectively. Conclusion: In the patients who had been successfully treated by simple primary lumbar discectomy, younger age, heavier smoking state, and less protrusion of the herniated disc at the time of the index surgery, were all correlated with more probability of the future rLDH, while BMI, Modic change, sex, level, and side of LDH had no significant role

SPSS file with a part of the research data.

(SAV)</p

Socio-demographic characteristics of the study participants.

Socio-demographic characteristics of the study participants.</p

Univariate analyses and logistic regression of barriers to the utilization of ante natal care services.

Univariate analyses and logistic regression of barriers to the utilization of ante natal care services.</p

Questionnaire used for the research.

(DOCX)</p

ANC-related and other variables in study participants.

ANC-related and other variables in study participants.</p