OBJECTIVE: To investigate the current status of kinesiophobia after lumbar fusion surgery in patients with lumbar disc herniation (LDH) and to analyze its influencing factors. METHODS: A total of 489 LDH patients who underwent lumbar fusion surgery in our hospital from January 2021 to December 2022 and effectively filled out the tampa scale for kinesiophobia (TSK) and other questionnaires on the first day after surgery were collected as the study subjects, the current status of kinesiophobia in LDH patients after lumbar fusion surgery were investigated using the TSK. The LDH patients were grouped into a kinesiophobia group (n=221) and a non kinesiophobia group (n=268) based on whether there was kinesiophobia after lumbar fusion surgery. The self-designed general data questionnaires were used to collect data, and Logistic regression was applied to analyze independent risk factors for kinesiophobia after lumbar fusion surgery in the LDH patients. RESULTS: In the study, 221 out of the 489 LDH patients (45.19%) had kinesiophobia after lumbar fusion surgery. Univariate analysis showed that there were statistically significant differences between the phobic group and the non phobic group in terms of gender, education level, course of disease, whether there was hypoproteinemia, pain level, self-efficacy, social support, whether there was anxiety, and whether there was depression (P < 0.05). There were no statistically significant differences in terms of age, body mass index, monthly family income, marital status, residence, medical expense payment form, whether there was hypertension, whether there was diabetes, whether there was cardiovascular and cerebrovascular disease, whether there was respiratory disease, whether there was surgery experience, whether there was anemia, work conditions, and responsibility segments (P>0.05). Male (95%CI: 3.289-10.586, P < 0.001), education level below undergraduate level (95%CI: 6.533-45.162, P < 0.001), severe pain (95%CI: 10.348-72.025, P < 0.001), moderate pain (95%CI: 6.247-37.787, P < 0.001), low self-efficacy (95%CI: 4.238-15.095, P < 0.001), and medium self-efficacy (95%CI: 2.804-8.643, P < 0.001) were influencing factors for kinesiophobia after lumbar fusion surgery in the patients with LDH (P < 0.05). CONCLUSION The incidence of kinesiophobia after lumbar fusion surgery in patients with LDH is high, and its influencing factors include gender, education level, pain level, and self-efficacy.
Humans ; Spinal Fusion/psychology* ; Intervertebral Disc Displacement/psychology* ; Lumbar Vertebrae/surgery* ; Male ; Female ; Middle Aged ; Phobic Disorders/etiology* ; Surveys and Questionnaires ; Adult ; Risk Factors ; Aged ; Fear ; Kinesiophobia

The Natrelle(TM) 410 (Allergan Inc., Irvine, CA, USA) shaped, form-stable silicone gel implant was introduced in Europe in 1993. Its "form stability" relates to increased cohesiveness or stiffness of the gel filler, allowing the implant to maintain its shape in the upright position. The anatomical form-stable implant is helpful for reducing ripples and provides more natural looking due to less upper pole fullness, so it has some benefits for the thin patients. And it provides more expansion to the lower pole, it has also benefits for the ptotic breasts or constricted breasts. I have experienced 69 cases with anatomical form-stable implants (52 Polytech Replicon(R) (POLYTECH Health & Aesthetics, Dieburg, Germany) implants, 85 Natrelle(TM) 410 implants) from February to December of 2012. The most common used implants are MF295 g of Natrelle(TM) 410 and high profile 315 g of Polytech Replicon(R). I did reoperations for 2 breasts of 2 patients. One was due to hematoma and the other was due to displacement. Both cases are my early experiences of shaped implants. There is no other complication yet. I need longer follow-up period for the appropriate evaluation. In my early experiences, the results of anatomical form-stable implants seem to make less fullness of upper pole, less ripples, more tightness, and similar recovery periods in contrast with the results of round textured implants.
Breast ; Breast Implants ; Displacement (Psychology) ; Esthetics ; Europe ; Female ; Follow-Up Studies ; Hematoma ; Humans ; Mammaplasty ; Models, Anatomic ; Silicone Gels

An abdominal advancement flap (AAF) is a flap that pulls the elevated abdominal skin up and creates the shape of the inferior portion of the breast by making a neo-inframammary fold. Seven patients underwent remodeling using an AAF or a method combining an AAF with other volume displacement techniques after partial mastectomy. The excision volume ranged from 15% to 35%. AAF with only mobilization of the gland flaps was performed in two cases, with lateral mammoplasty in one case, with the round block technique (RBT) in one case, with a modified RBT in one case, and with medial mammoplasty in two cases. Although one patient treated with a RBT had a partial blood-flow insufficiency of the nipple-areola complex, it improved with conservative treatment. The cosmetic results were found to be excellent in three cases, good in three, and fair in one case.
Breast ; Cosmetics ; Displacement (Psychology) ; Female ; Humans ; Mammaplasty ; Mastectomy, Segmental ; Skin ; Surgical Procedures, Operative

Schwannomas are well-differentiated solitary benign tumors that originate from the schwann cells of the nerve sheath. They can readily occur in the head and neck regions, but the schwannoma originating from the infraorbital nerve is extremely rare and usually painless, slow-growing, and without specific symptoms. The author experienced a rare case of infraorbital schwannoma, which was completely removed through the intraoral approach. A 20-year-old woman was admitted to our hospital for a painless, solid and circular mass located on the right infraorbital region. The eyeball movement and visual field were normal. There was no globe displacement or proptosis. Preoperative computed tomography demonstrated 13x10x5 mm-sized soft tissue mass. On March 2011, the mass was removed through an intraoral approach. On histopathological examination, the gross specimen consisted of a smooth, well-encapsulated and light yellowish solid mass, measuring 12x7x5 mm. Microscopically, it presented a typical manifestation of schwannoma with Antoni A area with Verocay body, and Antoni B area on H&E stain. The result of the immunohistochemical staining was positive for the S-100 protein. The patient had hypoesthesia of the nasal septum and vestibule in the postoperative period, and this finding confirmed that the internal nasal branch of infraorbital nerve was the nerve in which the schwannoma originated. Infraorbital schwannomas are very rare and must be included in the differential diagnosis of the orbital masses inferior to the eyeball. In the case of early diagnosis, the small-sized infraorbital schwannomas can be completely removed without any scar through an intraoral approach.
Cicatrix ; Diagnosis, Differential ; Displacement (Psychology) ; Early Diagnosis ; Exophthalmos ; Female ; Head ; Humans ; Hypesthesia ; Light ; Nasal Septum ; Neck ; Neurilemmoma ; Orbit ; Orbital Neoplasms ; Postoperative Period ; S100 Proteins ; Schwann Cells ; Visual Fields

Schmorl nodes represent displacement of intervertebral disc tissue into the vertebral body and have been considered as an asymptomatic incidental radiological finding on plain radiographs, computed tomography and magnetic resonance imaging (MRI). Although uncommon, acute symptomatic Schmorl nodes causing severe back pain do occur. We report here an unusual case of acute painful Schmorl node in a young healthy woman, with no previous trauma, presenting with a sudden significant localized back pain within hours accompanied by characteristic findings on a MRI scan. We reviewed all reports of symptomatic Schmorl nodes known in the literature, focusing mainly on MRI findings, and recent treatment options.
Acute Pain ; Back Pain ; Displacement (Psychology) ; Female ; Humans ; Intervertebral Disc ; Magnetic Resonance Imaging

PURPOSE: Posteroanterior screw fixation is biomechanically stronger than anteroposterior screw fixation. However, there are few literature about the correlation between clinical results and more strength by posteroanterior fixation. This study was performed to evaluate the clinical outcomes of the accelerated rehabilitation following anterior open reduction and posterior percutaneous screw fixation for displaced talar neck fractures. MATERIALS AND METHODS: Eighteen cases were followed up for more than 1 year after posteroanterior fixation using headless compression screw for talar neck fractures. The clinical evaluation was performed according to American Orthopaedic Foot and Ankle Society (AOFAS) score and Hawkins criteria. As radiographic evaluation, the degree of fracture displacement, period to union, and occurrence rate of complications such as avascular necrosis through MRI were measured. RESULTS: The AOFAS score was average 90.4 points at the last follow-up. There were 7 excellent, 9 good, and 2 fair results according to the Hawkins criteria. Therefore, 16 cases(88.8%) achieved satisfactory results. The degree of fracture displacement had improved significantly from preoperative average 5.6 mm to 1.2 mm immediate postoperatively, and maintained to 1.1mm at the last follow-up. All cases achieved bone union, and the period to union was average 12.4 weeks. There were 3 cases of avascular necrosis of talar body and 2 cases of post-traumatic arthritis. CONCLUSION: Anterior open reduction and posterior percutaneous headless screw fixation seems to be an effective surgical method for displaced talar neck fractures, because of the possibility of accurate restoration of articular surface, fixation strength enough to early rehabilitation, and needlessness of hardware removal.
Animals ; Ankle ; Bone Screws ; Displacement (Psychology) ; Follow-Up Studies ; Foot ; Neck ; Necrosis ; Talus

PURPOSE: To present radiographic characteristics and report the clinical results of the operative treatment of Muller-Weiss disease. MATERIALS AND METHODS: This is a retrospective study including 13 patients, 14 feet who had been operated for Muller-Weiss disease between April 2006 and December 2011. Osteoarthritis of the peri-navicular joints were radiographically evaluated. Various range of peri-navicular fusion and joint-preserving surgeries according to patients' symptoms and radiographic findings were done. The clinical results were evaluated by American Orthopaedics Foot and Ankle Society (AOFAS) midfoot scale and visual analogue scale (VAS). RESULTS: On radiographs, osteoarthritic changes were presented at talonavicular joint in 11 cases, calcaneocuboid joint in 7 cases, subtalar joint in 6 cases, naviculo-cuneiform joint in 1 case. The mean anteroposterior talocalcaneal angle was 16.6 degrees. On hindfoot alignment view, 6 cases were varus, 5 cases were neutral and 3 cases were valgus alignment. Fusion comprised 6 cases in triple fusion, 1 case in talonavicular-cuneiform fusion, 2 cases in talonavicualr fusion and 1 case in talonavicular & calcaneocuboid fusion. Joint-preserving surgeries were bony fragment excision of the lateral part of navicular & medial displacement calcaneal osteotomy in 1 case, bony spur excision of talonavicular joint in 1 case and medial displacement calcaneal osteotomy in 2 cases. The postoperative AOFAS and VAS score were improved significantly (p=0.000, p=0.000). CONCLUSION: In cases of Muller-Weiss disease without osteoarthritic changes at peri-navicular joints, fragment excision of navicular, bony spur excision with or without medial displacement calcaneal osteotomy were effective operative treatments.
Animals ; Ankle ; Displacement (Psychology) ; Foot ; Humans ; Joints ; Osteoarthritis ; Osteotomy ; Retrospective Studies ; Subtalar Joint

BACKGROUND: Increased intra-abdominal pressure during laparoscopic surgery causes cephalad displacement of the diaphragm, resulting in the formation of atelectasis, which can be overcome by positive end-expiratory pressure (PEEP). The aim of this prospective study was to investigate the level of optimal PEEP to maintain adequate arterial oxygenation and hemodynamics during robot-assisted laparoscopic radical prostatectomy (RLRP). METHODS: One hundred patients undergoing RLRP were randomly allocated to one of five groups (n = 20) (0, 3, 5, 7 and 10 cmH2O of PEEP). Hemodynamic variables and respiratory parameters were measured at baseline with the patient in the supine position; at 30 min, 1, 2, 3 and 4 h during CO2 insufflation with the patient in the post-Trendelenburg position; and after deflation in the supine position with increasing PEEP. RESULTS: The PaO2 levels and alveolar-arterial difference in oxygen tension (AaDO2) were improved in patients with PEEPs compared with patients in whom PEEP was not used. The application of PEEP (10 cmH2O) resulted in higher PaO2 levels compared to those with lower PEEP levels, but excessive peak airway pressure (PAP) was sometimes observed. The application of a PEEP of 7 cmH2O resulted in similar PaO2 levels without causing excessive PAP. There was a significant difference in central venous pressure between the groups, but there were no significant differences in heart rate, mean arterial pressure or minute ventilation between the groups. CONCLUSIONS: A PEEP of 7 cmH2O is associated with the greater improvement of PaO2 and AaDO2 without causing excessive PAP during RLRP.
Arterial Pressure ; Central Venous Pressure ; Diaphragm ; Displacement (Psychology) ; Heart Rate ; Hemodynamics ; Humans ; Insufflation ; Laparoscopy ; Oxygen ; Positive-Pressure Respiration ; Prospective Studies ; Prostatectomy ; Pulmonary Atelectasis ; Robotics ; Supine Position ; Ventilation

PURPOSE: We evaluated the results of arthroscopic intra-articular reduction and internal fixation of tibial plateau fractures without cortical window along with any additional bone grafts. MATERIALS AND METHODS: From March 2006 to March 2009, twelve patients with arthroscopic intra-articular reduction and internal fixation of tibial plateau fractures over 5 mm in depression and displacement on the articular surface in computed tomography (CT) were enrolled in this study. We reduced or removed the depressed fracture fragment using freer without making a cortical window. Then, we accomplished internal fixation by a cannulated screw. All cases have not received bone graft. Both the postoperative clinical and radiological results were evaluated by the Rasmussen system. RESULTS: The fractures were healed completely in an average of 9 (range from 7 to 12) weeks. According to Rasmussen classification, we obtained satisfactory clinical results as excellent in 8 cases, good in 3 cases, and fair in 1 case; and radiological results were excellent in 7 cases and good in 5 cases. CONCLUSION: We consider that arthroscopic intra-articular reduction and internal fixation of tibial plateau fractures without cortical window and any additional bone grafts is are a useful methods for attaining satisfactory results.
Arthroscopy ; Depression ; Displacement (Psychology) ; Humans ; Knee Joint ; Tibia ; Tibial Fractures ; Transplants

PURPOSE: To evaluate the radiological and clinical outcomes of intrapelvic anterior plate fixations for Day Classification Type II crescent fracture-dislocations of sacroiliac joints. MATERIALS AND METHODS: Ten patients who had undertaken the surgical treatment for the sacroiliac joint from 2006 to 2012 were enrolled in this study. All cases fell into Type II by Day Classification for sacroiliac joint injuries. For surgical treatments, the plate fixation through the intra-pelvic anterior approach was first performed for all cases and anterior ring fixation was performed in 4 cases with more severely displaced anterior pelvic ring injuries. Then, radiological and clinical evaluation was implemented. RESULTS: The bone union was observed from all patients whom performed the surgical fixation. In the radiological results, 9 cases with the anatomic and nearly-anatomic reductions were observed. Out of the 10 cases which performed the rotational displacement analysis, there were 3 excellent cases, 6 good cases and 1 fair case. The 10 cases that performed the deformity index and vertical displacement analysis, less variations were observed in the anterior ring fixations after intra-pelvic anterior plate fixation group. According to the clinical results, 4 excellent cases, 3 good cases, and 3 moderate cases were observed. CONCLUSION: In the Type II crescent fracture-dislocation of sacroiliac joint, the intrapelvic anterior plate fixation achieved satisfactory anatomical reductions, radiological stabilities and clinical results.
Congenital Abnormalities ; Displacement (Psychology) ; Humans ; Sacroiliac Joint