35 research outputs found

    Małoinwazyjne (przezskórne) techniki stabilizacji przeznasadowej jako postępowanie z wyboru w złamaniach kręgosłupa piersiowego i lędźwiowego

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    Introduction. Minimally invasive techniques of transpedicular fusion have become very common and seem to displace classical open techniques. Pedicle screws fusion is the procedure of choice in unstable traumatic lumbar and thoracic spine fractures of.Aim. The aim of the study was to answer whether open techniques are still used in injuries or whether they have been completely replaced by MISS.Material and Methods. The manuscript presents an analysis of patients treated in 2017ÔÇô2021 in the Department of Neurosurgery, Neurotraumatology and Pediatric Neurosurgery of Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University.Results. Based on the analysis of medical documentation, it was found that every case of traumatic thoracolumbar spine fracture in 2017ÔÇô2021 was treated using minimally invasive techniques. According to the documentation, the last case of using open surgical technique in the case of trauma was in 2016. It was noted that percutaneous techniques dominated the surgical treatment of thoracolumbar spine fractures and replaced the classic techniques in our department, which are used only, in some cases, in treatment of non-traumatic spondylolisthesis.Conclusions. Therefore, percutaneous techniques are currently the procedure of choice in spine injuries fusion in our hospital. The use of percutaneous techniques reduces the surgical traumatization of tissues (it is important to avoid additional traumatization and blood loss in traumatic patients). It has been pointed out that these procedures are performed by neurosurgeons who, in teaching process, used percutaneous techniques often and now prefer this method. The use of percutaneous techniques has important aspect in the field of neurosurgical nursing, because care of the operated area consists in observing few (4ÔÇô16) smaller wounds, not one long wound (as in classic techniques), and these wounds are located directly above the titanium screw tips, which must under neurosurgical nurse care. (JNNN 2022;11(1):3ÔÇô7)Wst─Öp. Techniki minimalnie inwazyjne stabilizacji przeznasadowej sta┼éy si─Ö bardzo powszechne i wydaj─ů si─Ö wypiera─ç klasyczne techniki otwarte. Stabilizacja ┼Ťrubami przeznasadowymi jest post─Öpowaniem z wyboru w przypadku niestabilnych z┼éama┼ä pourazowych kr─Ögos┼éupa l─Öd┼║wiowego i piersiowego.Cel. Celem badania by┼éa odpowied┼║, czy techniki otwarte s─ů nadal stosowane w kontuzjach, czy te┼╝ zosta┼éy ca┼ékowicie zast─ůpione przez MISS.Materia┼é i metody. W pracy przedstawiona zosta┼éa analiza chorych leczonych w latach 2017ÔÇô2021 w Klinice Neurochirurgii, Neurotraumatologii i Neurochirurgii Dzieci─Öcej w Collegium Medicum w Bydgoszczy Uniwersytetu Miko┼éaja Kopernika.Wyniki. Na podstawie dokumentacji medycznej stwierdzono, ┼╝e w ka┼╝dym przypadku z┼éamania urazowego w tym okresie zastosowano system ma┼éoinwazyjny. Wed┼éug dokumentacji, ostatni przypadek zastosowania otwartej, klastycznej techniki operacyjnej w przypadku urazu mia┼é miejsce w 2016 r. Zwr├│cono uwag─Ö, ┼╝e techniki przezsk├│rne zdominowa┼éy leczenie operacyjne z┼éama┼ä kr─Ögos┼éupa piersiowo-l─Öd┼║wiowego i wypar┼éy w naszym o┼Ťrodku techniki klasyczne, kt├│re stosowane s─ů jedynie, w niekt├│rych przypadkach w leczeniu nieurazowych kr─Ögozmyk├│w.Wnioski. Techniki przezsk├│rne s─ů wi─Öc obecnie post─Öpowaniem z wyboru w stabilizacji uraz├│w kr─Ögos┼éupa w naszym o┼Ťrodku. Zastosowanie technik przezsk├│rnych zmniejsza chirurgiczn─ů traumatyzacj─Ö tkanek (a jest to istotne aby nie powodowa─ç dodatkowej traumatyzacji i utraty krwi u chorych po urazach). Zwr├│cono uwag─Ö, ┼╝e zabiegi te wykonywane s─ů przez neurochirurg├│w, kt├│rzy w procesie swojego nauczania stykali si─Ö cz─Ö┼Ťciej z technikami przezsk├│rnymi i obecnie preferuj─ů t─ů metod─Ö. Zastosowanie technik przezsk├│rnych w urazach kr─Ögos┼éupa ma istotny aspekt w zakresie piel─Ögniarstwa neurochirurgicznego, poniewa┼╝ piel─Ögnacja sk├│ry okolicy operowanej polega na obserwacji kilku mniejszych ran (4ÔÇô16), a nie jednej d┼éugiej rany (tak jak w technikach klasycznych), za┼Ť rany te po┼éo┼╝one s─ů bezpo┼Ťrednio nad tytanowymi wierzcho┼ékami ┼Ťrub, co musi budzi czujno┼Ť─ç z punktu widzenia piel─Ögniarstwa neurochirurgicznego. (PNN 2022;11(1):3ÔÇô7

    Injuries related to taekwondo training - short report based on experiences from Primary School No. 31 with sports championship classes in Bydgoszcz (Poland)

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    Taekwondo has become a very popular sport in Poland and around the world, and training in this martial art begins with young children. Taekwondo trainings are organized in kindergartens and schools, clubs and master classes are organized in sports schools, and children take part in competitions. Taekwondo, like any martial art, carries a potential risk of injury. According to the literature, lower limb injuries are the most common, as in taekwondo the lower limbs are mainly used. Head and spine injuries as a result of falls are also described. The author emphasizes that despite the injuries described in the literature and the frequency of occurrence defined as about 2.5 - 8%, injuries in the sports school in Bydgoszcz are significantly less frequent. The author also points out that there are also injuries (fractures) of the upper limbs, which are ignored by numerous international publications. Despite this, it should be emphasized that taekwondo is a safe sport discipline. Its prevalence among school children is a favorable phenomenon

    Neurosurgical departments functioning during the COVID-19 pandemic - report

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    We present a short article on the actual state of functioning of neurosurgical departments, performing neurosurgical procedures during the COVID-19 pandemic on the example of our department - Department of Neurosurgery, Neurotraumatology and Pediatric Neurosurgery of Ludwik Rydygier Collegium Medicum of Nicolaus Copernicus University. The pandemic disrupted so far, proper work of neurosurgical departments and put neurosurgeons in a new reality. Despite the widespread exacerbation of spine diseases, they were pushed to the background. Many neurosurgical departments have been converted into COVID-19 isolation departments. We present a brief report on the actual state of the work of neurosurgeons and that a year after the pandemic began, the work of neurosurgical departments is still disrupted and the prospect of performing non-urgent neurosurgical procedures is uncertain

    Neurosurgery education of medical students in Nicolaus Copernicus University during the COVID-19 pandemic

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    We present a short article on the actual state of education and didactics in the Department of Neurosurgery during the COVID-19 pandemic. The pandemic disrupted the education of students in the 2019/2020 and 2020/2020 academic years. From March 2020, there are no traditional classes with students and they have been deprived the possibility of patients examining and participating in surgical procedures. Only on-line classes are conducted by the use of Microsoft Teams and by e-mail contact. We emphasize that this is unprecedented situation in history of clinical medicine education. We also affirm difficulty of surgical medical specializations training by e-learning. Due to the practical nature of neurosurgery, we provide numerous neuroimaging and videos of surgical procedures using Microsoft Teams. The effects of on-line education of surgical sciences, including neurosurgery, can be assessed after a longer period of time. Currently, in the new reality that surprised unexpectedly medical academics in 2020, we are unable to interpret it

    Insidious enemy - phaeochromocytoma. Can diabetes be cured?

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    We present the case of a 54-year-old patient with long-term type 2 diabetes, treated with intensive insulin therapy, who was considered to be ordinary diabetes. In a random imaging examination it turned out to be a phaeochromocytoma. The patient underwent surgical treatment. It turned out that after the surgery, the diabetes resolved. It is a casuistic curiosity that the patient was "cured" of the disease after diagnosis and treatment for pheochromocytoma, and on the second day after the surgery. It is also a valuable guide when looking for all possible causes of "secondary" diabetes

    Cranioplasty as neurosurgical procedure with potential risk of legal claims

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    We present the current state of affairs regarding the legal claims of patients after cranioplasty operations who are dissatisfied with the treatment effect and have claims that the perioperative course is unfavorable. In the period of 11 years (2010-2020), 2 legal claims were submitted in our neurosurgical center after cranioplasty. Both are civil claims. One of them about purulent infection of the bone prosthesis was found by the judgment to be unfounded. The second one concerning the alleged general condition deterioration as a consequence of cranioplasty has been declared obsolete. A cranioplasty is a surgical procedure used to correct a defect in a bone of the skull. It is not urgent sugery and is performed in patients who had been previously in serious condition. The same medical staff who previously saved the live of patients by performing brain decompression may be subject of legal claims in the case of cranioplasty. Thus, according to authors, claims of patients regarding the alleged negative effects of cranioplasty is an interesting psychological phenomenon.  Authors epmhasized that cranioplasty should be considered as a procedure of increased risk of potential legal claims for medical staff

    Analysis of patient with cervical discopathy treated surgically on the own material of neurosurgical department

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    Cervical discopathy is an important medical problem widespread in society. Symptoms are often upper limbs radicular pain, local pain in the cervical spine, and vetrebrobasilar cerebrovascular insufficiency. In the case of ineffective conservative treatment and severe pressure on nerve structures, surgical treatment is indicated. Cervical discopathy is most common at the age of 30 - 60 with a predominance of women. The authors of this manuscript analyzed the medical data of patients operated on due to cervical discopathy on their own material. Cervical discopathy was found to be more common in women, which is consistent with world references. A relationship was found between cervical myelopathy and critical spinal canal stenosis and C4-C5 stenosis. Stenosis on C3-C4 has also been rare in female patients and more common in men. Obtained data on own material are generally consistent with reports from world literature and constitute its complement in reference to the region of the Kuyavian-Pomeranian Voivodeship

    Overload pain but root differentiation discomfort in the lumbar spine

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    Lumbar pain syndromes of the spine can also be referred to as the pain of the cross. These ailments have now become epidemics of our time. In literature, these pain are referred to as localized ailments that are located in the lumbar, lumbosacral, and cross-iliac areas. Cross pains are a very general term because there are a multitude of factors that cause lumbar disc herniation. This problem poses great diagnostic difficulties. [4]. The nature of these ailments is often difficult to pinpoint by the patient, but it can be the pain that describes patients from blunt, piercing, biting, baking, to those that are termed cold feeling. Keep in mind that the location of the lumbar pain symptoms varies. Patients report pain that is located throughout the lumbar-sacral area or only on one side of the spine, or occurs only in the area of the hip joints. These complaints often radiate along the lower limb. They are often the result of a lack of proper spine prevention: they contribute to this poor body posture, improper sleep positioning, as well as lack of coping skills, as well as a bad diet. In daily life, it is important to remember to do your daily activities in the correct position as well as to use prevention to avoid pain in the lumbar area

    Vacuum ÔÇô assisted closure in neurosurgery as treatment option for purulent wounds after spinal implants procedures ÔÇô short preliminary report

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    We present a short preliminary report about the use of vacuum - assisted closure in infected and purulent wounds treatment after neurosurgical spinal procedures. Our report is based on the currently treated patients and points out to other neurosurgeons this therapeutic possibility. We are currently treating two severely injured patients in bad functional state. These patients had severe spine injuries and were therefore treated surgically by decompression and fusion. Patient No. 1 had C5 burst fracture treated by anterior and posterior stabilization, while patient No. 2 had Th4 burst fracture treated with posterior transpedicular stabilization. The patients developed purulent surgical site infection. Revision and wounds irrigation were ineffective. Desire to leave titanium implants in patientÔÇÖs spines (which is important for future rehabilitation), it was decided to use V.A.C┬« in wounds healing. We find that vacuum - assisted closure appears to be of significant benefit in such treatment. It is a good therapeutic option in the management of such patients; however, this issue requires more extensive research in the future

    Neurochirurgiczne implanty kręgosłupowe u chorych w wieku podeszłym leczonych operacyjnie z powodu stenozy lędźwiowej

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    Introduction. The incidence of degenerative lumbar spine stenosis increases with age. While young people tend tohave simple disc herniations with root compression, older people develop degenerative stenosis: facet joint hypertrophy,osteophytes, and ligamentum flavum hypertrophy. A typical for senility is neurogenic claudication caused by lumbarforaminal stenosis. Its symptoms decrease in spine flexion.Aim. The study consisted of a retrospective evaluation of medical data: analysis of the patientÔÇÖs age, description ofthe surgical procedure and a list of spine implants.Material and Methods. The analysis included patients treated surgically for lumbar stenosis in 2020 in NeurosurgicalDepartment of Collegium Medicum in Nicolaus Copernicus University (Bydgoszcz, Poland).Results. The perioperative risk increases with the age of patients, therefore procedures in elderly patients shouldusually be less invasive, ephemeral, and even under local anesthesia. Therefore, neurosurgeons tend to insert spinalimplants in senility to support the surgical effect and optimize the time of the procedure. Interspinous spacers areimplants for neurogenic claudication. Interspinous spacers causes foraminal distraction and thus can theoreticallyinduce nerve roots decompression in indirect mechanism, less invasive, with less tissue damage. We notice significantlymore frequent use of interspinous spacers in patients over seventy.Conclusions. This observation requires further research and analysis; however, it is consistent with the availableliterature and the actual state of clinical practice. This has potentially important implications for neurosurgicalnursing ÔÇö in geriatric patients after lumbar spine surgery, implants are significantly more common ÔÇö interspinousspacers, which should be considered in nursing perioperative recommendations. (JNNN 2021;10(3):91ÔÇô95)Wst─Öp. Cz─Östo┼Ť─ç wyst─Öpowania stenozy zwyrodnieniowej kr─Ögos┼éupa l─Öd┼║wiowego wzrasta wraz z wiekiem. O ileu chorych m┼éodszych kompresj─Ö struktur nerwowych wywo┼éuj─ů przepukliny dyskowe, o tyle w wieku podesz┼éym przyczyn─ů stenozy s─ů zmiany zwyrodnieniowe: przerost staw├│w mi─Ödzykr─Ögowych, wi─Özade┼é ┼╝├│┼étych i osteofity. Jednostk─ů chorobow─ů, typow─ů dla os├│b w wieku podesz┼éym i spowodowan─ů stenoz─ů kana┼éu kr─Ögowego i otwor├│w mi─Ödzykr─Ögowych jest chromanie neurogenne, za┼Ť objawy chromania ulegaj─ů remisji w pozycji zgi─Öcia kr─Ögos┼éupa, co jest jednym z wa┼╝nych objaw├│w je r├│┼╝nicuj─ůcych.Cel. Badanie polega┼éo na retrospektywnej ocenie danych medycznych: analizie wieku pacjenta, opisie zabiegu chirurgicznego oraz wykazie implant├│w kr─Ögos┼éupa.Materia┼é i metody. Analiz─ů obj─Öto pacjent├│w leczonych operacyjnie z powodu zw─Ö┼╝enia odcinka l─Öd┼║wiowego w 2020 r.w Klinice Neurochirurgii Collegium Medicum UMK (Bydgoszcz).Wyniki. Ryzyko oko┼éooperacyjne wzrasta wraz z wiekiem chorych, dlatego zabiegi w zakresie kr─Ögos┼éupa w podesz┼éymwieku powinny by─ç zwykle mniej inwazyjne, mniej obci─ů┼╝aj─ůce, a nawet w miar─Ö mo┼╝liwo┼Ťci przeprowadzone w znieczuleniu miejscowym. Maj─ůc na wzgl─Ödzie specyfik─Ö chorych w wieku podesz┼éym, zakwalifikowanych do leczenia operacyjnego kr─Ögos┼éupa l─Öd┼║wiowego, neurochirurdzy maj─ů tendencj─Ö do wszczepiania implant├│w aby wesprze─ç efekt leczenia i skr├│ci─ç czas zabiegu. Dystraktory mi─Ödzykolcowe to implanty dedykowane dla chorych z chromaniem neurogennym. Powoduj─ů one potencjaln─ů dystrakcj─Ö otwor├│w mi─Ödzykr─Ögowych i tym samym mog─ů teoretycznie przyczynia─ç si─Ö do dekompresji zawartych w nich korzeni nerwowych w mechanizmie po┼Ťrednim, mniej inwazyjnym, z mniejszym uszkodzeniem tkankowym. Zauwa┼╝amy istotnie cz─Östsze stosowanie dystraktor├│w mi─Ödzykolcowych u pacjent├│w po siedemdziesi─ůtym roku ┼╝ycia.Wnioski. Obserwacja ta wymaga dalszych bada┼ä i analiz, jednak naszym zdaniem jest zgodna z dost─Öpn─ů literatur─ůi stanem praktyki klinicznej. Fakt, ┼╝e u chorych w wieku podesz┼éym po operacjach kr─Ögos┼éupa wyst─Öpuj─ů cz─Ö┼Ťciej implanty ma potencjalnie istotne implikacje kliniczne z punktu widzenia piel─Ögniarstwa neurochirurgicznego i zalece┼äpiel─Ögniarskich. (PNN 2021;10(3):91ÔÇô95)S┼éowa kluczowe: pacjenci w podesz┼éym wieku, implanty kr─Ögos┼éupowe, operacja kr─Ögos┼éup
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