How did the endoscopic spine surgery influencied the scenario?5 answersEndoscopic spine surgery has revolutionized the surgical treatment of spinal diseases, providing distinct advantages over open or microscopic techniques. It has become a popular technique due to its proven safety and efficacy in surgery of the degenerative spine. The introduction of endoscopic surgery has allowed spine surgeons to overcome issues associated with traditional open surgery, such as longer operative time, high morbidity, and prolonged disabilities. The advancements in endoscopic resolution and surgical instruments have expanded the surgical indications for endoscopic spine surgery, allowing surgeons to perform surgeries for pathologies once considered contraindications. The future of endoscopic spine surgery looks promising, with Indian surgeons showing expertise in various techniques and technological innovations being made. Overall, endoscopic spine surgery has had a significant impact on the field, offering a viable alternative to traditional surgical techniques and improving patient outcomes.
When does a patient with sciatic syndrome need surgery?5 answersPatients with sciatic syndrome may need surgery in certain situations. Surgery is often recommended for patients who do not improve after receiving conservative treatment for 6 weeks. Surgical discectomy may be considered in selected patients with sciatica due to lumbar disc herniations that fail to resolve with conservative management for at least 6-8 weeks. In cases of refractory sciatica despite appropriate conservative treatments, surgery can be a good treatment option. The optimal timing of surgery for sciatica is not known, but it may be performed in patients who have sciatica that does not resolve within 6 weeks.
Is posterior clinoidectomy useful in the management of basilar apex aneurysm, especially during asubtemporal approach?5 answersPosterior clinoidectomy is a useful maneuver in the management of basilar apex aneurysms, particularly during a subtemporal approach. It allows for improved visualization and access to low-lying aneurysms in this challenging location. The expansion maneuvers performed during a pretemporal transcavernous approach (PTA) also involve posterior clinoidectomy, which extends the exposure to the basilar artery. Additionally, the addition of a posterior clinoidectomy can enhance access to the basilar artery and improve exposure during a frontotemporal approach. The need for posterior clinoidectomy depends on the patient's anatomical characteristics and the specific surgical approach being used. Overall, posterior clinoidectomy is a valuable technique that can be employed to optimize visualization and access to the basilar artery during the management of basilar apex aneurysms, including during a subtemporal approach.
What is the impact of CLABSI in critically ill children and neonates?5 answersCentral line-associated bloodstream infection (CLABSI) has a significant impact on critically ill children and neonates. It is one of the most common healthcare-associated infections (HAIs) in pediatric intensive care units (PICUs) and can lead to increased morbidity, mortality, length of hospital stay, and cost. The incidence of CLABSI in Western countries ranges from 6.1% to 15.1%, while in India, it is between 10.5% and 19.5%. Risk factors for CLABSI include the total number of central line accesses, acute behavioral health needs, and prolonged central venous catheter (CVC) duration. Implementing interventions targeting these risk factors can help reduce CLABSI in high-risk populations. It is crucial to focus on strict asepsis, hand hygiene practices, surveillance of infections, antibiotic stewardship, and adherence to bundled care to prevent CLABSI and improve patient outcomes.
What is the difference between CLACS and sclerotherapy?2 answersCryo-Laser & Cryo-Sclerotherapy (CLaCS) is a technique that combines thermal sclerotherapy and injection sclerotherapy. It involves targeting telangiectasias and small varicosities with a transdermal laser, followed by injection sclerotherapy. During the procedure, a cooling device blows cold air onto the skin to prevent skin burn. Sclerotherapy, on the other hand, is a targeted elimination of small vessels, varicose veins, and vascular anomalies by the injection of a sclerosant. The aim of sclerotherapy is to damage the vessel wall and transform it into fibrous tissue. Therefore, the main difference between CLaCS and sclerotherapy is that CLaCS combines thermal and injection sclerotherapy with the use of a transdermal laser and a cooling device, while sclerotherapy focuses on the injection of a sclerosant to eliminate vascular anomalies.
What are the advantages and disadvantages of posterior longitudinal ligament resection in acdf?1 answers事实证明,在宫颈前路椎间盘切除术和融合术(ACDF)手术中切除后纵韧带(PLL)有几个优点。它可以帮助去除隐藏在下面的压缩结构,防止极端运动时神经根撞击。研究表明,锁相环切除术作为ACDF手术的常规步骤可以显著改善轴向和神经根疼痛。此外,切除锁相环似乎不会增加显著的手术风险,并且会对手术结果产生积极影响。另一方面,锁相环切除术可能有一些缺点。尽管并发症相对罕见,但也可能发生。但是,总体而言,锁相环切除术在ACDF手术中的益处似乎大于潜在的风险,因此建议将此步骤视为手术的常规部分。