- Three-column reconstruction through the posterior approach alone for the treatment of a severe lumbar burst fracture: a case report
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Woo Seok Kim, Tae Seok Jeong, Woo Kyung Kim
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J Trauma Inj. 2023;36(3):290-294. Published online June 9, 2023
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DOI: https://doi.org/10.20408/jti.2022.0075
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Abstract
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- Generally, patients with severe burst fractures, instability, or neurological deficits require surgical treatment. In most cases, circumferential reconstruction is performed. Surgical methods for three-column reconstruction include anterior, lateral, and posterior approaches. In cases involving an anterior or lateral approach, collaboration with general or thoracic surgeons may be necessary because the adjacent anatomical structures are unfamiliar to spinal surgeons. Risks include vascular or lumbar plexus injuries and cage displacement, and in most cases, additional posterior fusion surgery is required. However, the posterior approach is the most common and anatomically familiar approach for surgeons performing spinal surgery. We present a case in which three-column reconstruction was performed using only the posterior approach to treat a patient with a severe lumbar burst fracture.
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Summary
- Cranioplasty Results after the Use of a Polyester Urethane Dural Substitute (Neuro-Patch®) as an Adhesion Prevention Material in Traumatic Decompressive Craniectomy
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Tae Seok Jeong, Woo Kyung Kim, Myung Jin Jang
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J Trauma Inj. 2019;32(4):195-201. Published online December 30, 2019
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DOI: https://doi.org/10.20408/jti.2019.030
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Abstract
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Purpose
This study was conducted to investigate the usefulness of a polyester urethane dural substitute (Neuro-Patch®, B. Braun, Boulogne, France) as an anti-adhesion agent in subsequent cranioplasty by analyzing the use of Neuro-Patch® during decompressive craniectomy in traumatic brain injury patients.
Methods
We retrospectively analyzed patients with traumatic brain injury who underwent decompressive craniectomy followed by cranioplasty from January 2015 to December 2018. Patients were analyzed according to whether they received treatment with Neuro-Patch® or not (Neuro-Patch® group, n=71; control group, n=55). Patients’ baseline characteristics were analyzed to identify factors that could affect cranioplasty results, including age, sex, hypertension, diabetes mellitus, use of antiplatelet agents or anticoagulant medication, the interval between craniectomy and cranioplasty, and the type of bone used in cranioplasty. The cranioplasty results were analyzed according to the following factors: operation time, blood loss, postoperative hospitalization period, surgical site infection, and revision surgery due to extra-axial hematoma.
Results
No significant difference was found between the two groups regarding patients’ baseline characteristics. For the cranioplasty procedures, the operation time (155 vs. 190 minutes, p=0.003), intraoperative blood loss (350 vs. 450 mL, p=0.012), and number of surgical site infections (4 vs. 11 cases, p=0.024) were significantly lower in the Neuro-Patch® group than in the control group.
Conclusions
The use of Neuro-Patch® was associated with a shorter operation time, less blood loss, and a lower number of surgical site infections in subsequent cranioplasties. These results may provide a rationale for prospective studies investigating the efficacy of Neuro-Patch®.
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- Efficacy and safety of decompressive craniectomy with non-suture duraplasty in patients with traumatic brain injury
Tae Seok Jeong, Gi Taek Yee, Tae Gyu Lim, Woo Kyung Kim, Chan Jong Yoo, Giovanni Grasso PLOS ONE.2020; 15(10): e0232561. CrossRef
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