Acute traumatic intervertebral disc herniation of the thoracic spine is a rather rare injury with only a few reported cases to date. In this manuscript, we present a case of a 58-year-old male patient who sustained a car accident-related high-energy trauma, resulting in a disc herniation of the thoracic spine. Furthermore, we also discuss the possible implications of late diagnosis of such condition. The patient was initially referred from the Emergency Department as a case of head contusion with a left upper limb paresis. Due to only minimal bony trauma visible on the initial spine CT scan, the neurological deficit was attributed to the cranial trauma. The diagnosis of a traumatic disc herniation was therefore established only after the rapid onset of paraparesis, which gradually progressed into paraplegia, and a following spine MRI scan. Despite the subsequent urgent spinal decompression, the neurological functions of the lower limbs were not restored. This manuscript addresses the indications for performing MRI scans in polytrauma patients with a CT-verified spine trauma. Although it may be complicated to perform routine MRI scans in all such patients in daily practice, it can certainly help diagnose such injuries earlier and thus prevent potential permanent neurological damage to the patients. Key word: spine injury, traumatic disc herniation, thoracic spine, spine surgery.
- MeSH
- chirurgická dekomprese MeSH
- dolní končetina MeSH
- lidé středního věku MeSH
- lidé MeSH
- polytrauma * MeSH
- urgentní služby nemocnice MeSH
- výhřez meziobratlové ploténky * diagnostické zobrazování chirurgie MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- Publikační typ
- anglický abstrakt MeSH
- časopisecké články MeSH
- kazuistiky MeSH
- MeSH
- lidé MeSH
- perioperační období metody rehabilitace MeSH
- primární zdravotní péče MeSH
- totální endoprotéza kolene * metody přístrojové vybavení MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- přehledy MeSH
Tato práce popisuje technické provedení sonograficky navigovaného léčebného obstřiku sakroilického kloubu (SIK), který byl identifikován jako možný generátor nocicepce u pacientů s chronickou bolestí v kříži. V případech, kdy selhávají jiné (neinvazivní) terapeutické postupy, může cílená injekce SIK poskytnout úlevu od bolesti. Popsaný postup lze použít i s cílem provedení diagnostické blokády. U pacientů refrakterních na jinou léčbu může být identifikace SIK, jako hlavního zdroje nocicepce, významná i pro případný další postup (např. operační).
In this article, an ultrasound-guided technique for sacroiliac joint (SIJ) injection is described. The SIJ was repeatedly identified as a possible pain generator in patients with low back pain. In cases where other (noninvasive) treatment options fail, SIJ injection might provide pain relief. The described procedure can also be used to perform a diagnostic blockage. In patients refractory to other treatments, the identification of SIJ as the main source of nociception may be important for a possible further procedure (e. g., surgery).
Acta chirurgiae orthopaedicae et traumatologiae Čechoslovaca, ISSN 0001-5415 ; Vol. 88, 2021, Supplementum
49 stran : ilustrace ; 30 cm
- MeSH
- muskuloskeletální nemoci MeSH
- muskuloskeletální systém MeSH
- ultrasonografie MeSH
- Publikační typ
- sborníky MeSH
AIM: Clubfoot is a congenital deformity affecting the musculoskeletal system, resulting in contracted and stiff tissue in the medial part of the foot. Minoxidil (MXD) has an inhibitory effect on lysyl hydroxylase, which influences the quality of extracellular matrix crosslinking, and could therefore be used to reduce the stiffness and to improve the flexibility of the tissue. We assessed the in vitro antifibrotic effects of minoxidil on clubfoot-derived cells. METHODS: Cell viability and proliferation were quantified by xCELLigence, MTS, and LIVE/DEAD assays. The amount of collagen I deposited into the extracellular matrix was quantified using immunofluorescence with subsequent image segmentation analysis, hydroxyproline assay, and Second Harmonic Generation imaging. Extracellular matrix contraction was studied in a 3D model of cell-populated collagen gel lattices. RESULTS: MXD concentrations of 0.25, 0.5, and 0.75 mM inhibited the cell proliferation in a concentration-dependent manner without causing a cytotoxic effect. Exposure to ≥0.5 mM MXD resulted in a decrease in collagen type I accumulation after 8 and 21 days in culture. Changes in collagen fiber assembly were observed by immunofluorescence microscopy and nonlinear optical microscopy (second harmonic generation). MXD also inhibited the contraction of cell-populated collagen lattices (0.5 mM by 22%; 0.75 mM by 28%). CONCLUSIONS: Minoxidil exerts an in vitro inhibitory effect on the cell proliferation, collagen accumulation, and extracellular matrix contraction processes that are associated with clubfoot fibrosis. This study provides important preliminary results demonstrating the potential relevance of MXD for adjuvant pharmacological therapy in standard treatment of relapsed clubfoot.
- MeSH
- kolagen typu I MeSH
- kolagen MeSH
- konzervativní terapie MeSH
- lidé MeSH
- minoxidil farmakologie MeSH
- pes equinovarus * MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
