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Query: UMLS:C0149871 (deep vein thrombosis)
 12,364 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A new technique for interbody lumbar spondylodesis using a new cancellous metal, plug-shaped construct was performed in 35 cases with spondylolisthesis or lumbar instability. All of these patients have had severe low-back pain for years, some with radicular symptoms and had been treated unsuccessfully for years. In a follow-up study, 28 of these patients were examined after a time-period of 4 to 24 months. According to objective criteria, the clinical results were good in 19 cases, moderate in five cases and poor in one case. The patients' own judgement about the success of the operation was somewhat different: 17 patients judged their condition as good, six as moderate and two as poor. For three patients the follow-up examination was so close to surgery that no judgement can be made. We saw postoperative complications in two cases: one was a fracture of the implant, the other was a deep vein thrombosis. Since the first reports about ventral spondylodesis by CAPENER [4] and BURNS [2] in the years 1932 and 1933 this surgical technique has been under discussion worldwide. This discussion even increased after HORMON [10] published some reports about his experience with this operative treatment in 1948. Since that time, many techniques for the intercorporal fusion of the spine have been reported. These include tibial or iliac bone grafts, sometimes fixed with screws or plates [6, 9, 12, 17, 20]. This article now describes the new surgical technique for ventral spondylodesis, using a new implant for the interbody fusion of the lumbar and sacral spine. In addition, we describe the indications for ventral spondylodesis and report the results of a rather small follow-up study.
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PMID:Ventral interbody spondylodesis using a new plug-shaped implant. 213 20

Pulmonary embolism following postoperative deep venous thrombosis is a very serious complication with a high mortality rate. Though this disorder has been thought to be rare in Japanese, its occurrence seems to be increasing recently because of changes in eating habits, increase of average age and the frequent practice of venous catheterization. Two cases of the pulmonary embolism following deep venous thrombosis after surgery are reported, and possible causes of the deep venous thrombosis are discussed. Case 1: A 48 year-old obese female was operated on for a posterior fossa dural arteriovenous malformation. On the 4th postoperative day, she developed a pain and swelling in the left leg and low back pain. On the 18th postoperative day, she fell into a state of shock following the sudden onset of a severe back pain and respiratory distress. After diagnosis of the pulmonary embolism, she was immediately treated with urokinase, warfarin and aspirin. Her obesity was considered to be one of the risk factors of the postoperative deep venous thrombosis. Case 2: A 62 year-old female with a ruptured cerebral aneurysm could not get out of bed because of postoperative mental disturbance. A central venous pressure catheter was inserted into the right femoral vein for two weeks postoperatively. One month after surgery, she complained of swelling and a dull pain in the right leg without cardiorespiratory symptoms. Lung perfusion scintigraphy showed asymptomatic pulmonary embolism. She was treated immediately. Both long bed rest and femoral venous catheterization were considered as risk factors possibly leading to deep venous thrombosis.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Postoperative pulmonary embolism in neurosurgical practice: report of two cases]. 321 Dec 80

Between 1986 and 1992, 32 thoracolumbar fractures in 32 patients were treated nonoperatively with 4-6 weeks on a rotorest bed followed by bracing with a thoracolumbosacral orthosis for a total of 3-6 months. The fractures were classified as 20 burst, six fracture dislocations, five severe compression fractures, and one gunshot wound. There were 12 multilevel fractures. Nine patients had incomplete neurological injuries and three had complete neurological injuries. The average age was 36.8 years (range 17-63) and the average follow-up was 22.3 months (range 12-60). Fifty three percent (17/32) of these had multisystem injuries including visceral trauma and long extremity fractures. There were only two complications; a deep vein thrombosis and a heel ulcer. Neither of these complications extended the patients' hospital stay. All nine of those with incomplete neurological injuries improved at least one Frankel grade. Fifteen of 24 patients who were employed returned to their previous jobs, and only nine patients had persistent back pain requiring medication. Surgical treatment of thoracolumbar fractures is often favored over conservative treatment in the multitrauma and neurologically injured patient because of complications related to bedrest. However, by using a rotorest bed and aggressive physical therapy, conservative treatment may actually result in lower morbidity.
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PMID:Non-operative treatment of thoracolumbar fractures. 775 71

A case of bilateral lower extremity deep venous thrombosis and pulmonary embolism as a complication of bed rest prescribed for an acute low back pain episode is presented. A 29-year-old woman with low back pain was prescribed more than 2 weeks of bed rest, during which she developed progressive bilateral lower extremity complaints that were ascribed to nerve root irritation. Her symptoms were initially treated with physical therapy and epidural steroid injections. A Doppler examination and ventilation-perfusion scan revealed extensive deep venous thromboses and mismatches consistent with pulmonary embolism. This case illustrates an unusual extraspinal source of lower extremity symptoms associated with low back pain and further supports the role of early mobilization in the treatment of back pain.
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PMID:Deep venous thrombosis and pulmonary embolism as a complication of bed rest for low back pain. 1063 88

The objective of this prospective case-control study was to identify and quantify demographic and clinical risk factors for venous ulcer disease, with special emphasis on heredity and physical activity. Patients presenting to a participating vascular surgery department between January and December 1997 with a first open venous ulcer served as cases. Controls were sampled among patients with subacute conditions such as skin problems, back pain, cold, headache/migraine, sore throat, and mild ear infections and were matched on referral physician, age (+/-5 years), and gender. Subjects were eligible if they were 18 years or older and were excluded if they had nonpalpable pedal pulse or any chronic active diseases such as cancer or AIDS. Cases' and controls' statuses were ascertained by the participating physicians. Data on risk factors were collected with an interviewer-administered questionnaire and were self-reported by patients. The mean age of participants was 61 years for cases (n = 102) and 59 years for controls (n = 200). Family history of maternal venous insufficiency (odds ratio (OR) = 6.8, 95% confidence interval (CI) = [1.9, 24.3]95%), vigorous exercise (OR = 8.9, CI = [1.1, 72.0]95%), and history of deep vein thrombosis (DVT) (OR = 17.6, CI = [2.9, 106.8]95%) were found to be significant predictors of venous ulcers in matched multivariate logistic regression analysis; number of pregnancies was also a significant risk factor in women (OR = 1.2, Cl = [1.0, 1.5]95%). Our study suggests that knowledge of family history of venous insufficiency and monitoring of physical activity will lead to ulcer prevention. Although physical activity is recommended for patients with venous insufficiency, vigorous exercise increases the likelihood of ulcerations.
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PMID:Risk factors for the first-time development of venous ulcers of the lower limbs: the influence of heredity and physical activity. 1246 17

The paper describes an 18-year-old woman with vena cava inferior atresia. She was hospitalised with deep venous thrombosis after she had taken contraceptives for two months and had been confined to bed for three weeks because of back pain. Anticoagulant treatment was successful. Vena cava inferior atresia is a rare condition, but it must be suspected in younger people with proximal bilateral deep vein thrombosis.
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PMID:[Vena cava inferior atresia as the cause of deep venous thrombosis]. 1277 99

A 38-year-old male was initially admitted for left leg swelling. He was diagnosed as having deep vein thrombosis (DVT) in the left leg and a pulmonary thromboembolism by contrast-enhanced chest computed tomography (CT) with delayed lower extremity CT. The DVT was treated by thrombolysis and a venous stent. Four hours later, he complained of severe back pain and a sensation of separation of his body and lower extremities; he experienced paraplegia early in the morning of the following day. Magnetic resonance imaging showed a spinal epidural hematoma between T11 and L2, which decompressed following surgery. We, therefore, report a case of a spinal epidural hematoma after thrombolysis in a case of DVT with a pulmonary thromboembolism.
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PMID:Spinal epidural hematoma after thrombolysis for deep vein thrombosis with subsequent pulmonary thromboembolism: a case report. 1605 67

The authors report their experience with 42 patients in whom anterior lumbar fusion was performed using titanium cages as a versatile adjunct to treat a wide variety of spinal deformity and pathological conditions. These conditions included congenital, degenerative, iatrogenic, infectious, traumatic, and malignant disorders of the thoracolumbar spine. Fusion rates and complications are compared with data previously reported in the literature. Between July 1996 and July 1999 the senior authors (C.I.S., R.P.N., and M.J.R.) treated 42 patients by means of a transabdominal extraperitoneal (13 cases) or an anterolateral extraperitoneal approach (29 cases), 51 vertebral levels were fused using titanium cages packed with autologous bone. All vertebrectomies (27 cases) were reconstructed using a Miami Moss titanium mesh cage and Kaneda instrumentation. Interbody fusion (15 cases) was performed with either the BAK titanium threaded interbody cage (in 13 patients) or a Miami Moss titanium mesh cage (in two patients). The average follow-up period was 14.3 months. Seventeen patients had sustained a thoracolumbar burst fracture, 12 patients presented with degenerative spinal disorders, six with metastatic tumor, four with spinal deformity (one congenital and three iatrogenic), and three patients presented with spinal infections. In five patients anterior lumbar interbody fusion (ALIF) was supplemented with posterior segmental fixation at the time of the initial procedure. Of the 51 vertebral levels treated, solid arthrodesis was achieved in 49, a 96% fusion rate. One case of pseudarthrosis occurred in the group treated with BAK cages; the diagnosis was made based on the patient's continued mechanical back pain after undergoing L4-5 ALIF. The patient was treated with supplemental posterior fixation, and successful fusion occurred uneventfully with resolution of her back pain. In the group in which vertebrectomy was performed there was one case of fusion failure in a patient with metastatic breast cancer who had undergone an L-3 corpectomy with placement of a mesh cage. Although her back pain was immediately resolved, she died of systemic disease 3 months after surgery and before fusion could occur. Complications related to the anterior approach included two vascular injuries (two left common iliac vein lacerations); one injury to the sympathetic plexus; one case of superficial phlebitis; two cases of prolonged ileus (greater than 48 hours postoperatively); one anterior femoral cutaneous nerve palsy; and one superficial wound infection. No deaths were directly related to the surgical procedure. There were no cases of dural laceration and no nerve root injury. There were no cases of deep venous thrombosis, pulmonary embolus, retrograde ejaculation, abdominal hernia, bowel or ureteral injury, or deep wound infection. Fusion-related complications included an iliac crest hematoma and prolonged donor-site pain in one patient. There were no complications related to placement or migration of the cages, but there was one case of screw fracture of the Kaneda device that did not require revision. The authors conclude that anterior lumbar fusion performed using titanium interbody or mesh cages, packed with autologous bone, is an effective, safe method to achieve fusion in a wide variety of pathological conditions of the thoracolumbar spine. The fusion rate of 96% compares favorably with results reported in the literature. The complication rate mirrors the low morbidity rate associated with the anterior approach. A detailed study of clinical outcomes is in progress. Patient selection and strategies for avoiding complication are discussed.
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PMID:Anterior lumbar fusion with titanium threaded and mesh interbody cages. 1691 6

This is a case of a thrombo-occlusion occurring below an inferior vena cava (IVC) filter inserted in a patient with polycythemia vera and deep vein thrombosis. The patient was a 48-year-old man with polycythemia vera and a chief complaint of swelling, redness, and bursting pain in his right leg. After admission, contrast-enhanced computed tomography scanning demonstrated a pulmonary artery thrombus and deep vein thrombosis. We inserted a Gunther tulip vena cava filter on day 1 for the prevention of pulmonary embolism (PE), and started anticoagulation therapy based on the guideline of the Japanese Circulation Society for DVT. In addition to intravenous anticoagulants, we started therapeutic phlebotomy to improve the hypercoagulability state. On day 4, our patient complained of back pain caused by thrombo-occlusion below the IVC filter, despite the anticoagulation therapy and two therapeutic phlebotomies. From this case, we concluded it is important to lower hemoglobin level and hematocrit as early as possible for IVC-filter-insertion in patients with polycythemia vera.
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PMID:Thrombo-occlusion of inferior vena cava filter in a patient with polycythemia vera. 1978 71

Vertebral hemangiomas are the most common tumours of the vertebral column. Generally, these tumours are asymptomatic but some patients complain of back pain and develop neurologic symptoms due to extraosseous extension. Vertebral hemangiomas can extend extradurally causing neurological impairment as a result of compression of the spinal cord and nerve roots. Vertebral hemangiomas may be multiple and detectable as a component of the Klippel-Trenaunay-Weber syndrome. Although this syndrome consists of deep venous thrombosis, lymphatic anomalies, cutaneous capillary malformations, and hypertrophy of soft tissue and bone on extremities, its clinical presentation may be very variable. We present a unique case of vertebral hemangioma causing spinal cord compression due to the extradural extension that also had deep venous thrombosis, hematuria, hypophyseal cyst and ventricle asymmetry, diagnosed as the Klippel-Trenaunay-Weber syndrome.
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PMID:Thoracic vertebral hemangioma causing paraplegia in Klippel-Trenaunay-Weber syndrome: case report. 2410 Dec 74


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