Retrospective Evaluation Of Percutaneous Treated Liver Cyst Hydatic Cases

INTRODUCTION: Our aim was to evaluate percutaneous treatment of hydatid cyst cases of liver and to evaluate the efficacy, complication rate of percutaneous treatment and the reasons for failure in patients who did not respond to treatment. METHODS: Our study is a retrospective study and percutaneous treatment of hydatid cyst cases of liver was performed in our interventional radiology unit between January 2012 and November 2018 and the patients who were followed up by our clinic were included in the study. Patients were evaluated in terms of age, sex, localization of the cyst in the liver, number of cysts treated, cyst types and cyst size. Our unsuccessful treatment criteria are; increased cyst size without septation-calcification, no change in cyst stage, extravasation and recurrence. RESULTS: In our study, a total of 119 percutaneous treatment was applied to 104 patients [38 (36.5%) males and 66 (63.5%) females]. The percutaneous cysts were 4-16 cm in diameter and the average diameter was 7.8 cm. Ninety two (77%) cysts were compatible with type 1, 25 (21%) type 2 and 2 (1.6%) type 3 cyst hydatid. One hundred one treatment (85%) were successful; 18 treatment (15%) were not successful. Five (28%) of the unsuccessful treatment had cystobiliary fistulization, 2 (11%) had extravasation, 3 (17%) had inadequate medical treatment and 8 (44%) had recurrence. DISCUSSION AND CONCLUSION: Percutaneous treatment in hydatid cyst is a highly effective method because of can be applied in more than one cyst in the same session and low complication rate

Analysis of complications following posterior vertebral column resection for the treatment of severe angular kyphosis greater than 100°

Objective: The aim of this study was to evaluate the complications, efficacy and safety of posterior vertebral column resection (PVCR) in severe angular kyphosis (SAK) greater than 100°. Methods: The medical records of 17 patients (mean age 17.9 (range, 9–27) years) with SAK who underwent PVCR, were reviewed. Mean follow-up period was 32.2 (range, 24–64) months. Diagnosis of the patients included congenital kyphosis in 11 patients, post-tuberculosis kyphosis in 3 patients and neurofibromatosis in 3 patients. The sagittal plane parameters (local kyphosis angle, lumbar lordosis, sagittal vertical axis, pelvic tilt, sacral slope and pelvic incidence) were measured in the preoperative and the early postoperative periods and during the last follow-up on the lateral radiographs. Results: The mean preoperative localized kyphosis angle was 121.8° (range, 101°–149°). The mean local kyphosis angle (LKA) was 71.5° at postoperatively evaluation (p < 0.05). Complications were detected in 12 patients (70.6%) with spinal shock in 4 patients, hemothorax in 3 patients, postoperative infection in 2 patients, dural laceration in 2 patients, neurological deficit in 2 patients (1 paraplegia and 1 root injury), the shifted cage in 2 patients and rod fracture in 2 patients. Neurological events occurred in six patients (35%) with temporary neurological deficit in 5 patients and permanent neurological deficit in 1 patient. Conclusion: PVCR is an efficient and a successful technique for the correction of SAK. However, it can lead to a large number of major complications in SAK greater than 100°. Level of evidence: Level IV, therapeutic study. Keywords: Posterior vertebral column resection, Severe angular kyphosis, Complication, Neurological deficit, Neuromonitorin

Perioperative alendronate, risedronate, calcitonin and indomethacin treatment alters femoral stem fixation and periprosthetic bone mineral density in ovariectomized rats

Many factors affect implant stability and periprosthetic bone mineral density (BMD) following total joint arthroplasty. We asked whether perioperative alendronate, risedronate, calcitonin and indomethacine administration altered (1) femoral stem shear strength and periprosthetic bone mineral density BMD in ovariectomized rats and (2) whether there were differences in the effect of these drugs. Thirty overiectomized rats were divided into five groups and implanted with intramedullary mini-cortical screws in the femur. Four groups were treated with alendronate, risedronate, salmon calcitonin and indomethacin for 4 weeks preoperatively and 8 weeks postoperatively. Although alendronate and risedronate increased the periprosthetic BMD more than calcitonin, they did not alter implant fixation compared to calcitonin. Indomethacin significantly decreased the BMD around the stem and implant stability compared to all other groups. This study showed that perioperative treatment with bisphosphonates and calcitonin improved the BMD around the stems and implant stability. Although bisphosphonates increased the BMD more than calcitonin, there was no difference in implant stability. Indomethacin markedly decreased the periprosthetic BMD and implant stability. The main clinical significance of our study was the finding about the need to strictly avoid long-term use of high-dose nonsteroidal antiinflammatory drugs for patients who have major joint arthritis and a previous history of arthroplasty

Arachnoid cysts with spontaneous intracystic hemorrhage and associated subdural hematoma: Report of management and follow-up of 2 cases

Arachnoid cysts are one of the most frequently encountered intracranial space-occupying lesions in daily neurosurgery and neuroradiology practice. Majority of arachnoid cysts, particularly those of smaller sizes, have a benign uneventful lifetime course. Certain symptoms may indicate serious complications related to underlying arachnoid cysts. Hemorrhage is one of the most fearsome complications of arachnoid cysts and almost all reported cases in the literature have undergone surgical correction. In this study, we aimed to present clinical and radiologic follow-up findings in two adult cases of intracranial arachnoid cyst with spontaneous intracystic hemorrhage and associated subdural hematoma, one of which was successfully treated conservatively. In addition, we broadly summarized and discussed pertinent studies in the English literature. Keywords: Arachnoid cyst, Subdural hematoma, Intracystic hemorrhage, Headach