Ureteral double J stent displaced into vena cava and management with laparoscopy: A case report and review of the literature

We reported displacement of a ureteral double J stent into the vena cava and laparoscopic management in a 69-year-old patient with a history of ureteral stent placement. Preoperative computed tomography and plain X-rays showed malpositioning of the double J stent and displacement into the inferior vena cava. The characteristics of stent misplacement precluded endovascular procedures and explorative laparoscopic surgery was performed. The intra- and postoperative periods were uneventful. Postoperative imaging demonstrated that the new double J stent was in the right position. The patient was discharged 7 d after the operation and was symptom free at the 4-mo follow-up.     

螺纹克氏针内固定治疗移位性锁骨骨折

目的探讨螺纹克氏针内固定治疗移位性锁骨骨折的临床效果。方法将48例锁骨移位性骨折患者行切开复位螺纹克氏针内固定。结果按疗效评定标准,31例得到随访病人疗效均达到优。结论螺纹克氏针内固定除具有普通克氏针内固定的优点外,还克服了普通克氏针内固定的缺点,值得临床推广应用。     

早期多元化护理在鼻中隔偏曲位移修复术中的应用

目的 探讨早期多元化护理在鼻中隔偏曲位移修复术中的应用。方法 选取山东健康集团枣庄中 心医院2020年3月-2023年3月收治的86例行鼻中隔偏曲位移修复患者为研究对象，采取随机数字表法分为 参照组和研究组，每组43例。参照组实施常规护理，研究组实施早期多元化护理，比较两组舒适度、焦 虑情况、睡眠质量及并发症发生情况。结果 研究组护理后舒适度评分高于参照组（P＜0.05）；研究组焦 虑评分低于参照组，睡眠质量评分低于参照组（P＜0.05）；研究组并发症发生率为2.33%，低于参照组的 18.60%（P＜0.05）。结论 在鼻中隔偏曲位移修复术中对患者实施早期多元化护理，可有效提升护理舒适 度及护理质量，缓解患者焦虑，进一步提高患者睡眠质量，以及减少相关并发症发生。     

Prevention of Bone Cement Displacement in Kümmell Disease without Neurological Deficits through Treatment with a Novel Hollow Pedicle Screw Combined with Kyphoplasty

Objective

Displacement of bone cement following percutaneous vertebral augmentation for Kümmell disease (KD) presents a significant concern, resulting in increasing back pain and compromising daily activities. Unfortunately, current literature does not yet establish a validated and minimally invasive surgical intervention for this issue. This study aims to investigate the effects of a novel hollow pedicle screw combined with kyphoplasty (HPS-KP) in preventing bone cement displacement following simply percutaneous kyphoplasty for the management of KD.

Methods

A total of 22 patients (six males, 16 females, averagely aged 77.18 ± 7.63 years) with KD without neurological deficits treated by HPS-KP at the hospital between March 2021 and June 2022 were hereby selected, among which, there were three stage I KD cases, 12 stage II KD cases, and seven stage III KD cases according to Li's classification. Bone mineral density (BMD), spinal X-ray, computed tomography (CT), and magnetic resonance imaging (MRI) were examined before the operation. The operation time, intraoperative blood loss, and postoperative complications were all recorded. The follow-up focused on visual analog scale (VAS) score, Oswestry dysfunction index (ODI), anterior vertebral height (AVH), middle vertebral height (MVH), posterior vertebral height (PVH), wedge-shape affected vertebral Cobb angle (WCA), and bisegmental Cobb angle (BCA). One-way analysis of variance (ANOVA) followed by Bonferroni post-hoc test was employed for performing multiple comparisons in the present study.

Results

All patients having received the operation successfully were followed up for more than 8 months (ranging from 8 to 18 months). The operation time, intraoperative blood loss, and BMD (T-score) were 39.09 ± 5.64 min, 14.09 ± 3.98 ml, and − 3.30 ± 0.90 g/cm³, respectively. Statistically significant differences were observed in the VAS score, ODI, AVH, MVH, and WCA (All p < 0.05), but there was no statistically significant difference in PVH and BCA at different time points (All p > 0.05). During follow-up, five patients suffered from bone cement leakage, and one presented an adjacent vertebral fracture and no bone cement displacement.

Conclusion

HPS-KP could be safe and effective in the treatment of KD without neurological deficits, effectively relieving the symptoms of patients, restoring partial vertebral height, and preventing the occurrence of bone cement displacement.     

Endoscopic Resection and Decompression for Lateral Displacement of Cage after Oblique Lumbar Interbody Fusion: A Case Report from a Single Center

Background

Lateral displacement of cage is a rarely seen complication of oblique lumbar interbody fusion (OLIF). To the best of our knowledge, this complication has always been revised with posterior open surgery. However, open surgery often associates with large trauma and long period of recovery.

Case Presentation

In the case presented, a 64-year-old male patient with lateral displacement of cage which consequently caused neurological symptoms after OLIF, was reported and surgically revised with an endoscopic resection and decompression technique. The surgery was performed through a posterolateral approach which was similar to transforaminal approach, with estimated blood loss of 45mL and whole operation time of 70 min. Neurological symptoms were disappeared after operation immediately and the patient was discharged 2 days later. He reported no symptoms other than mild weakness of the lower back at the last follow-up of 12 months.

Conclusion

Endoscopic decompression technique may be an effective alternative to surgically treat lateral displacement of cage after OLIF with advantages of minimal invasion and quick recovery.