Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Decompression”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 829 records · Page 46Linked to original sources
PubMed2002

The use of the impingement test as a predictor of outcome following subacromial decompression for rotator cuff tendinosis.

PURPOSE: To evaluate the use of the impingement test as a predictor of outcome following subacromial decompression for patients with rotator cuff tendinosis. TYPE OF STUDY: Observational study. METHODS: An impingement test was administered to each patient immediately before surgery. Patients underwent a subacromial decompression and were assessed postoperatively at 3 and 6 months. The primary outcome measure was the Western Ontario Rotator Cuff Index (WORC). RESULTS: Thirty patients (mean age, 47.0 years; range, 29.4 to 71.2 years) took part in this study. There was no significant correlation between the classic impingement test (Neer's impingement sign before and after subacromial injection of local anesthetic) and the change in WORC score (r = -.174, P =.358). Similar results were obtained for the aggregate impingement test (pain at rest plus Neer's impingement sign plus Hawkins sign plus resisted abduction) before and after subacromial injection of local anesthetic (r = -.208, P =.270). When divided into categories of improvement following the classic impingement test (worse 0%-25%, 26%-50%, 51%-75%, 76%-100% better), there was no significant difference between groups for outcome as indicated by WORC score (P =.203). Results were similar for the aggregate impingement test (P =.271). CONCLUSIONS: The impingement test is a poor tool for predicting the success of subacromial decompression. There are 6 assumptions discussed that must hold true in order for the impingement test to be a useful predictor of outcome following subacromial decompression. If one or more of these assumptions are not met, or are only partially met, the impingement test would be rendered invalid as a predictor of outcome, as this study suggests.

Adult↗
PubMed1995

[The MR tomography of avascular necrosis of bone: the primary findings and the follow-up observations after core decompression].

PURPOSE: To assess the signal changes of avascular bone necrosis after core decompression. PATIENTS AND METHODS: 17 patients with avascular epiphyseal necrosis were examined by MRI using T1-weighted spin echo sequences before and after gadopentetate dimeglumine application, T2-weighted spin echo sequences and in some patients with fat-saturated 2D gradient echo sequences up to 22 months after core decompression. RESULTS: All patients but one recovered from symptoms after core decompression. Although the signal morphology of the necrotic area remained unchanged in the majority of the cases, a decrease of the joint effusion was observed as well as an ongoing signal increase after gadopentetate dimeglumine application. The last examinations displayed similar signal characteristics as on the preoperative scans; however, a reduction of the necrotic zone became evident. CONCLUSIONS: The decrease of joint effusion indicates successful core decompression, while a persistent signal increase after gadopentetate dimeglumine application reflects the viability of the necrotic area as well as an ongoing healing process.

Adult↗
PubMed1984

[Ophthalmo-rhinosurgical decompression operation in malignant endocrine exophthalmus].

The thyroid metabolism has to be treated first. If this is not followed by regression of the exophthalmos, treatment with prednisone over a period of several weeks is indicated. If this does not result in permanent improvement, surgical decompression of the orbit is indicated, especially if the exposition of the cornea or compression of the optic nerve represent an imminent danger. In such cases surgical decompression is preferable to multiple series of prednisone or radiation treatment (Wright 1981, Trokel 1982). Both the Krönlein-Berke operation for resection of the lateral orbital wall as well as neurosurgical resection of the orbital roof have proved to be excellent for removal of correspondingly located orbital tumors; effective decompression of the orbit in malignant endocrine exophthalmos, however, cannot be achieved this way, as the temporal muscle and the brain, respectively, prevent protrusion of the swollen orbital tissues through these apertures. Resection of the orbital floor is somewhat more effective. The mucosa of the maxillary sinus can easily be moved by the protruding orbital tissues, resulting in a reduction in the size of the maxillary sinus. This decompression, however, is effective only in the anterior two-thirds of the orbit, while the optic nerve must be relieved from the pressure of the swollen muscles in particular in the posterior one-third of the orbit. The only effective way is to remove the medical orbital wall up to the tip of the orbit. Surgical techniques for this purpose have already been recommended, but appeared unsatisfactory from a rhinological point of view.(ABSTRACT TRUNCATED AT 250 WORDS)

Graves Disease↗
PubMed2001

Results of orbital decompression in Taiwan.

Orbital decompression was performed on 116 orbits with Graves' ophthalmopathy. The indications for decompression were dysthyroid optic neuropathy (DON), recalcitrant corneal exposure (EXP) and disfiguring exophthalmos (COS). All cases but one (in the DON group) had improved or unchanged vision. The average retinal sensitivity improvement in the DON group was 6.7 +/- 6.1 dB and 85% had a significant retinal sensitivity improvement (>5 dB). The average retroplacement effect was 4.4 +/- 2.1 mm and only five cases (7%) had postoperative asymmetry of more than 2 mm by Hertel's exophthalmometry. The most frequent sequela was diplopia, which tended to occur in more severely myopathic eyes. In our series, 21% (10/48 cases without preoperative diplopia) developed diplopia after decompressive surgery. Hypoglobus is another complication, noted in two cases, which was successfully repositioned. In conclusion, decompressive surgery is a safe and effective procedure to restore vision and reduce exophthalmos in Graves' ophthalmopathy. Careful evaluation of clinical parameters, individualization of surgical goals and intraoperative titration of the retroplacement effect are the key to optimal results.

Journal Article↗
PubMed2026

Minimizing decompression and warming during deep seawater collection increases abundance and activity of autochthonous bacteria and archaea.

The deep ocean hosts autochthonous pressure-adapted microorganisms that are unique to this environment, as well as allochthonous pressure-sensitive members transported from shallow depths by vertical advection and particle-sinking. However, conventional sampling instruments decompress and warm deep-sea samples during retrieval, potentially altering microbial properties when studied ex situ. Here, we assess this potential sampling bias by comparing seawater microbial communities collected with or without measures aimed at minimizing pressure and temperature effects. When compared to samples collected under pressurized conditions, conventional sampling (using Niskin bottles) was found to affect prokaryotic cells retrieved by reducing their total numbers, diminishing protein synthesis activity (>10%), and also causing overall shifts in the community composition. The most significant compositional change was a >20% decrease in metagenomic archaeal representation (TACK-group/Thaumarchaeota/Nitrososphaerota). Deep-sea bacterial groups had mixed responses to preserving pressure during retrieval, with some groups exhibiting higher representation when samples were maintained pressurized (e.g. members of the family Pelagibacteraceae, unclassified Thiotricales, Thioglobaceae, and Chitinophagaceae), whereas others increased their representation when decompressed (e.g. Burkholderiaceae, Comamonadaceae, and Oxalobacteraceae). This study reveals the existence of bias introduced by the complete decompression of samples retrieved with traditional instrumentation, as well as a decrease in overall bacterial activity when samples are completely decompressed during retrieval. Additionally, incubations lasting for >24 h were shown to transform the original prokaryotic community composition. Precautions addressing these effects are necessary to enhance the reliability of ex situ measurements and improve our understanding of deep-sea microbial ecology and biogeochemistry.

Seawater↗
PubMed1987

Percutaneous endoscopic gastrostomy for gastrointestinal decompression.

From September 1980 to April 1986, 185 percutaneous endoscopic gastrostomies were performed at University Hospitals of Cleveland. Of these, nine (5%) were done for chronic gastrointestinal decompression and form the basis of this report. Patients ranged in age from 21-73 years (mean: 51 years) and all had prolonged, complex hospitalizations extending 25-122 days (mean: 63 days). The only complication associated with the procedure was the identification of transhepatic placement of the catheter, which caused no adverse effects. Two of the nine patients died during hospitalization of causes unrelated to the gastrostomy construction. The goals of gastric decompression and elimination of nasogastric intubation were achieved in all patients. In one patient with gastric intestinal disconnection, the percutaneous gastrostomy was effective as the sole means for elimination of swallowed saliva and gastric output. Three patients continued to use the gastrostomies for chronic decompression after discharge for the remainder of their lives (2 months, 6 months, and 2 years, respectively). Percutaneous endoscopic gastrostomy may provide a safe, secure, and comfortable method of long-term gastric decompression in a select group of high-risk patients with complex intra-abdominal processes.

Adult↗
PubMed1995

Treatment of hyperesthetic neuropathic pain in diabetics. Decompression of the tarsal tunnel.

OBJECTIVE: The authors evaluated the causal relationship between entrapment of the posterior tibial nerve and neuropathic pain and describe the results of nerve decompression in a selected group of patients with intractable pain. SUMMARY BACKGROUND DATA: Painful metabolic neuropathy has, until recently, been thought to be an irreversible and essentially untreatable complication of diabetes. Recent studies have shown that metabolic deterioration is only one component of the disease process. METHODS: A group of patients with intractable painful neuropathy and a positive percussion sign underwent posterior tibial nerve decompression. RESULTS: Nerve decompression relieved the pain in the majority of treated patients. Return of other sensory function also was noted. CONCLUSIONS: Painful diabetic neuropathy of the lower extremities is potentially reversible. It appears to be caused partially by nerve entrapment and can be reversed by decompression.

Adult↗
PubMed1990

Hypoglobus following orbital decompression for dysthyroid ophthalmopathy.

Hypoglobus following orbital decompression is not a rare complication. Hypoglobus requiring surgery to elevate the globe following orbital decompression is considered clinically significant hypoglobus. A retrospective analysis of 157 consecutive patients who had their orbits expanded by removing the medial wall and floor of the orbit found seven patients (4.5%) who required further surgery to elevate the globe. The seven patients who developed clinically significant hypoglobus following orbital decompression all developed a set of distinct clinical signs. These included a "setting sun" appearance of the globe, eyelid malposition, orbital volume loss, and strabismus. These clinical signs can be explained by the inferior movement of the globe and the orbital contents following the loss of support structures on the orbital floor. A two-wall orbital decompression performed on a cadaver reproduced the physical signs of hypoglobus. The dissection suggested that the periorbita is the most important structure supporting the globe in the orbit.

Exophthalmos↗
PubMed1995

Does decompression diminish the discomfort of severe dysthyroid orbitopathy?

We assessed whether patients perceived that surgical decompression had reduced the discomfort of dysthyroid orbitopathy. Standard pain instruments were administered to 13 consecutive patients of a university-based oculoplastic practice who had undergone two-wall orbital decompression for dysthyroid optic neuropathy. We used visual analog scale (VAS) ratings of pre- and postoperative orbital discomfort. On a 0 to 10 scale, relief of discomfort after decompression was rated as moderate or better (VAS > 9.0) in 13 of 13 patients (mean VAS = 9.22, SD = 0.91) and complete (VAS = 10.0) in 8 of 13. Patients perceived that surgical decompression was associated with a clinically and statistically significant (p < 0.001) reduction of discomfort.

Adult↗
PubMed1996

Is immediate decompression of high voltage electrical injuries to the upper extremity always necessary?

OBJECTIVE: To determine if immediate decompression is required for all high voltage injuries to the upper extremity. DESIGN: Retrospective review. MATERIALS AND METHODS: Charts reviewed of 62 patients who had upper extremity contact with >1,000 volts of electricity over a 10-year period. MAIN RESULTS: One hundred upper extremities were treated. Twenty-two percent were decompressed within 24 hours because of progressive nerve dysfunction, clinical compartment syndrome, or failure of resuscitation. This group required a mean of 4.2 operations with an amputation rate of 45%, similar to other series. Thirty-five percent of burned extremities had their first operative procedure delayed until resuscitation was complete. This group required a mean of 2.1 operations with no amputations. Forty-three percent of extremities did not require operations to achieve healing. Overall results show a 10.0% amputation rate and mean hospital stay of 27 days. CONCLUSIONS: We conclude that the need for amputation and multiple operations is determined by the injury itself and that immediate decompression is only required for the usual clinical signs of compartment syndrome. Selective decompression may actually preserve tissue and decrease the need for eventual amputation because fasciotomy can lead to soft tissue dessication by exposing viable tissue.

Adolescent↗
PubMed1990

Surgical decompression without transposition for ulnar neuropathy: factors determining outcome.

Fifty-one surgical decompressions without nerve transposition for ulnar neuropathy were performed in 46 patients. All of the patients were men with an average age of 59 years at the time of surgery. The follow-up range was between 5 and 32 months (average, 17.8 months). The disease involved the nondominant arm in 24 patients (52%) and was bilateral in 5 (11%). In 23 cases (50%), no predisposing condition could be identified, whereas 15 patients (33%) abused alcohol and 8 patients (17%) had diabetes mellitus. Fifty-seven percent of the patients helped by surgery had symptoms for less than 1 year, whereas only 30% of patients with symptoms for more than 1 year had symptomatic improvement. The relative magnitude of the slowing of ulnar nerve conduction velocity across the elbow was not significantly correlated with the success of decompression in relieving symptoms. Ulnar nerve conduction velocities across the elbow were 36.13 +/- 11.76 m/s in those responding to surgery and 38.97 +/- 13.91 m/s in those not responding (c = 0.06, dF = 50, P less than 0.3). A total of 37 patients showed symptomatic improvement after decompression. Simple decompression of the ulnar nerve was performed under local anesthesia without transposition of the nerve. In all of these cases, compression of the nerve occurred predominantly in the epicondylar groove. Narrowing of the nerve in the groove was present in 28 cases (55%); scar tissue was found adhering to the nerve in 21 cases (41%); and two pseudoneuromas were found (4%). Forty-one operations (80%) resulted in symptomatic improvement, typically noted by the patient within the first month postoperatively.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1998

Occipital remodeling and suboccipital decompression in severe craniosynostosis associated with tonsillar herniation.

OBJECTIVE: The goal was to describe a surgical technique allowing occipital vault remodeling and suboccipital decompression in patients affected by multiple-suture synostosis presenting severe occipital flattening and chronic tonsillar herniation (CTH). METHODS: Four patients (two with Crouzon's syndrome, one with Kleeblattschädel, and one with complex craniosynostosis) presenting multiple-suture synostosis with severe occipital flattening, posterior fingerprint impressions, and CTH were operated on in the prone position. For three patients, occipital vault remodeling and suboccipital decompression without dural opening were performed; for one patient affected by Kleeblattschädel, an upper cervical laminectomy and dural opening were performed. All patients were studied with magnetic resonance imaging pre- and postoperatively. RESULTS: No complications were observed. In all cases, postoperative magnetic resonance imaging revealed good decompression of the craniocervical junction, with resolution of brain stem displacement. In one case, CTH recurred 15 months after surgery, although in a less severe form. CONCLUSION: In selected cases of complex or syndromic craniosynostosis with predominant posterior deformity and CTH, this technique was safe and useful in the management of cranial reconstruction, allowing posterior vault remodeling and prophylactic suboccipital decompression. After validation with a larger number of patients, it could prove to be a useful option in all cases of complex craniosynostosis with CTH in which a staged repair of the craniosynostosis is to be considered.

Cerebellar Diseases↗
PubMedDate not supplied

Experimental study on changes of the spinal-evoked potential and circulatory dynamics following spinal cord compression and decompression.

In an attempt to elucidate the pathogenesis of spinal cord injury, the authors investigated the changes in spinal-evoked potential (SEP) and serial fluorescein angiography during compression and after decompression of the thoracolumbar cord in dogs. The degree of compression was correlated well with the changes in SEP during compression and after decompression. The findings of serial fluorescein angiography immediately after decompression indicated hyperemia and extravasation of the fluorescein dye, especially in the group weighted with 36 and 60 g. Poor filling of the arteries and veins with fluorescein dye, and prolongation of the regional circulation time were observed at between 30 and 120 minutes after decompression in the group weighted with 36 and 60 g. These findings suggest that secondary circulatory disturbance plays an important role in the pathogenesis of spinal cord injury. The relation between changes of SEP and the circulation are also discussed.

Animals↗
PubMed1989

Clinical study of dissociated motor weakness following anterior cervical decompression surgery.

C5 segment motor loss (deltoid muscle) after a cervical spinal operation, either anterior decompression or posterior decompression, has rarely been reported. However, most such cases are diagnosed immediately after surgery, and they appear to be due to inadequate surgical technique or insufficient decompression. Recently, the authors have experienced three cases in which weakness of the deltoid muscle started several days following anterior cervical decompression surgery. On the basis of postoperative plain films, myelography, and computed tomography (CT) myelography, the cause of the motor weakness was considered to be C5 root disturbance due to postoperative malalignment of the cervical spine, which gradually increased. The malalignment of the cervical spine seemed to be due to weakness of iliac bone grafts, inadequate design of the bone graft and recipient site, and insufficient postoperative fixation. To prevent this malalignment, eg, lateral inclination of the bone graft to axial rotation deformity, adequate bone graft design is required. The authors have been performing internal fixation using sapphire screws on cases in which fusion extending over four vertebral bodies is required.

Adult↗
PubMed1993

Early stabilization and decompression for incomplete paraplegia due to a thoracic-level spinal cord injury.

All patients treated between 1985 and 1990 for acute incomplete spinal cord injury between T2 and T11 were retrospectively studied. This level was chosen for study because by excluding cervical cord, conus, and cauda equina injuries, neurologic improvement could be attributed to improvement of spinal cord function. Only 14 patients with incomplete thoracic level paraplegia were identified, representing 1.2% of all spinal injuries. All 14 patients were treated by early operative reduction, stabilization, or decompression. Twelve patients had surgery within 24 hours of neurologic injury, one at 36 hours, and one at 5 days. Twelve patients had initial posterior instrumentation and fusion, one of whom subsequently had an anterior decompression. Two patients had initial anterior decompression and fusion. Both later had posterior instrumentation and fusion to treat progressive deformity. Follow-up averaged 20 months (range, 9-65 months). Neural function before surgery and at follow-up was given a Frankel grade and lower extremity motor index score. Of 13 surviving patients, seven were initially Frankel B and six Frankel C. Of the seven patients initially Frankel B, four recovered to Frankel E, two improved to Frankel D, and one remained Frankel B. Of the six patients originally Frankel C, five recovered to Frankel E and one improved to Frankel D. Average neurologic improvement was 2.2 Frankel grades per patient, lower extremity motor index improved from an average of 7 to 44. Early surgical reduction, stabilization, and decompression is safe and improves neurologic recovery in comparison to historical controls treated by postural reduction or late surgical intervention.

Adult↗
PubMed1995

Transoral anterior decompression and fusion of chronic irreducible atlantoaxial dislocation with spinal cord compression.

STUDY DESIGN: In this study, 10 patients with chronic irreducible atlantoaxial dislocation were treated by transoral anterior decompression and fusion. OBJECTIVES: To examine the benefits of the transoral approach, the patients treated with this procedure were compared with the historical control subjects after 2 years of follow-up. SUMMARY AND BACKGROUND DATA: Chronic irreducible atlantoaxial dislocation with cord compression is difficult to treat because the cord is compressed posteriorly by the posterior arch of the atlas as well as anteriorly by the posterior-superior portion of the axial body and nonunited dens. Its irreducibility, as a result of the bony scarring between the dens and the anterior body of the axis, and the locking of the lateral joints of C1-C2, makes reduction more complex. Posterior surgical approaches have been associated with high morbidity and mortality. METHODS: Ten patients were diagnosed and followed up by clinical symptoms, radiography, pantopaque myelography, and computed tomography. They were treated surgically by transoral decompression and fusion. During the surgery the nonunited dens as well as callus, granulation, and scar tissue were removed; the cartilage of the articular surfaces of the atlantoaxial joint was excised. Postoperative treatment included skull-cervical biaxial traction, tracheostomy care, nasal feeding, and Minerva cast. RESULTS: The 2- to 6-year follow-up showed that four out of 10 patients recovered completely and returned to work, three recovered to a great degree and ambulated, two partially recovered, and one recovered poorly. CONCLUSION: Transoral decompression and fusion offered satisfactory results in a series of patients with chronic irreducible atlantoaxial dislocation. None of the patients showed serious complications of stability, even though only one had a secondary posterior fusion. Therefore, anterior decompression associated with subtotal obliteration of the atlantoaxial joints without bone grafts is a feasible therapy for irreducible atlantoaxial dislocation using a multifunctional bed and biaxial traction.

Adolescent↗
PubMed1995

Spinal cord expansion after decompression in cervical myelopathy. Investigation by computed tomography myelography and ultrasonography.

STUDY DESIGN: This study analyzed anatomic characteristics of 44 patients with cervical myelopathy. OBJECTIVES: This study was conducted to clarify the patterns of spinal cord expansion after decompression, their relationship to clinical recovery, and the capacity of the compressed spinal cord for restoration. SUMMARY OF BACKGROUND DATA: No previous studies have clearly assessed the relationship between morphological changes of the spinal cord and clinical improvement after posterior decompression in patients with cervical myelopathy using computerized tomography myelography and intraoperative spinal sonography. METHODS: Forty-four patients with cervical myelopathy underwent posterior decompression. The diagnosis was cervical spondylosis in 26 patients and ossification of the posterior longitudinal ligament in 18 patients. The cross-sectional area, sagittal diameter, and frontal diameter of the spinal cord at the level of maximum compression were determined by computerized tomography myelography (performed before and 1 month after decompression) and by intraoperative spinal sonography. RESULTS: Expansion of the spinal cord was defined as immediate or gradual. Of the 44 patients, 20 demonstrated gradual expansion, and their clinical recovery rate was 68.4%. In contrast, the clinical recovery rate of patients without gradual expansion was only 32.6%. Good clinical recovery was significantly related to gradual expansion. The patients were divided into four groups (A-D) based on the clinical recovery rate and compression ratio. Group A (severe compression and poor clinical recovery) showed a significantly smaller cross-sectional area of the spinal cord than Group D (severe compression, but good clinical recovery). CONCLUSIONS: Preservation of the cross-sectional area of the spinal cord, even when it is severely compressed and deformed, is an important factor in a good surgical outcome.

Adult↗
PubMed1995

"Conservative" cranio-cervical decompression in the treatment of syringomyelia-Chiari I complex. A prospective study of 20 adult cases.

STUDY DESIGN: This study was designed to investigate prospectively a series of patients with syringomyelia-Chiari I complex operated on by a minimally invasive procedure. OBJECTIVE: The objective was to determine whether a relatively simple and low-risk osteo-dural decompression would obtain as good clinico-radiological results as those observed after the commonly used, more complex posterior fossa surgery. SUMMARY OF BACKGROUND DATA: The majority of hypotheses concerning the pathogenesis of syringomyelia link it to the existence of some derangement of the cerebro-spinal fluid flow at the cranio-spinal level and, consequently, surgical procedures are directed toward decompressing the cranio-cervical junction; however, there is no clear-cut evidence that simple osteo-dural decompression should be associated with manipulation of nervous tissue for the purpose of restoring to normal an altered cerebro-spinal fluid flow dynamic. METHODS: The procedure consisted of a small suboccipital craniectomy and laminectomy of C1 (when necessary C2 as well), followed by dura mater opening. Exploration and plugging of the obex, resection of arachnoid adherences, or amputation of the amygdala(e) were never performed. Every effort was made to keep the arachnoid intact. The series included 20 patients with progressive disease treated according the above-mentioned criteria. RESULTS: Mortality and morbidity were nil and MRI controls showed shrinkage of the syrinx in all cases. At long-term follow-up (average, 2.4 years), 8 patients were considered improved, 11 stabilized, and 1 patient continued to deteriorate despite the collapse of the cord cavity. CONCLUSION: Considering that the results of this "conservative" cranio-cervical decompression are at least comparable to those obtained with other surgical procedures, this procedure, which was not associated with mortality or morbidity, currently should be considered the first option in the treatment of syringomyelia-Chiari I complex.

Adolescent↗