The incidence of a spinal epidural abscess (SEA), which can cause serious neurological complications, is low; however, the incidence of SEA caused by Streptococcus is even lower, most of which are reported in the thoracolumbar spine and lumbosacral segment. We reported a case of cervical SEA caused by Streptococcus constellatus infection, resulting in paralysis of the patient. The acute onset of SEA in a 44-year-old male led to decreased upper limb muscle strength, lower limb paralysis, and loss of bowel and bladder function, and imaging and blood tests suggested pyogenic spondylitis. Emergency decompression surgery and antibiotic therapy were given, the patient gradually recovered, and the muscle strength of the lower limbs gradually improved. This case report suggests the importance of early decompressive surgery and effective antibiotic therapy.
With the development of medicine and chemistry, an increasing number of plant‐derived medicines have been shown to exert beneficial therapeutic on the treatment of various physical and psychological diseases. In particular, by using physical chemistry methods, we are able to examine the chemical components of plants and the effects of these substances on the human body. Muscle atrophy (MA) is characterized by decreased muscle mass and function, is caused by multiple factors and severely affects the quality of life of patients. The multifactorial and complex pathogenesis of MA hinders drug research and disease treatment. However, phytotherapy has achieved significant results in the treatment of MA. We searched PubMed and the Web of Science for articles related to plant‐derived substances and muscle atrophy. After applying exclusion and inclusion criteria, 166 and 79 articles met the inclusion criteria, respectively. A total of 173 articles were included in the study after excluding duplicates. The important role of phytoactives such as curcumin, resveratrol, and ginsenosides in the treatment of MA (e.g., maintaining a positive nitrogen balance in muscles and exerting anti‐inflammatory and antioxidant effects) has been extensively studied. Unfortunately, MA dose not have to a single cause, and each cause has its own unique mechanism of injury. This review focuses on the therapeutic mechanisms of active plant components in MA and provides insights into the personalized treatment of MA.
Lateral shoulder imbalance (LSI) is reflected radiologically by the clavicle angle (CA). How to achieve postoperative lateral shoulder balance (LSB) after scoliosis correction surgery remains unclear. In the current study, by using the preoperative upper instrumented vertebra (UIV) tilt, the CA, the flexibility between T1 and the UIV, and the ideal postoperative UIV tilt was predicted based on the following formula: ideal postoperative UIV tilt = preoperative UIV tilt—the flexibility between T1 and UIV—preoperative CA. The reliability of the formula was verified through a retrospective analysis, and 76 scoliosis patients were enrolled. The feasibility of this method was verified through a prospective analysis, and 13 scoliosis patients were enrolled. In the retrospective study, there was a significant correlation between the difference in the actual and ideal postoperative UIV tilt values and the postoperative CA, with correlation coefficients in the whole, LSI, and LSB groups of 0.981, 0.982, and 0.953, respectively (p < 0.001). In the prospective study, all patients achieved satisfactory LSB. Using the formula preoperatively to predict an ideal postoperative UIV tilt and controlling the intraoperative UIV tilt with the improved crossbar technique may be an effective digital method for achieving postoperative LSB and has important clinical significance.
Unilateral biportal endoscopic spinal surgery (UBE) is a rapidly growing surgical method and has attracted much interest recently. The most common complication of this technique is cerebrospinal fluid (CSF) leakage due to intraoperative dural tears. There have been no reports of bacterial meningitis due to dural tears in UBE surgery and its treatment and prevention. We reported a 47 year-old man with CSF due to an intraoperative dural tear. A drainage tube was routinely placed and removed on the fourth day after surgery, resulting in fever and headache on the fifith postoperative day. Blood and CSF cultures showed Klebsiella pneumoniae infection, and with lumbar drainage and appropriate antibiotics based on sensitivity tests, the patient's fever and headache were effectively relieved. This case report suggests the importance of prolonged drainage tube placement, adequate drainage, careful intraoperative separation to avoid dural tears, and effective sensitive antibiotic therapy.
Background: Lateral shoulder imbalance (LSI) is reflected radiologically by the clavicle angle (CA). How to achieve postoperative lateral shoulder balance (LSB) after scoliosis correction surgery remains unclear.Methods: In the current study, by using the preoperative upper instrumented vertebra (UIV) tilt, CA, the flexibility between T1 and the UIV, the ideal postoperative UIV tilt was predicted based on the following formula: ideal postoperative UIV tilt = preoperative UIV tilt – the flexibility between T1 and UIV – preoperative CA. The reliability of the formula was verified through a retrospective analysis, and 76 scoliosis patients were enrolled and divided into three groups based on the postoperative shoulder balance: 1) the whole group (n = 76); 2) the LSI group (n = 26); and 3) the LSB group (n = 50). The pre- and postoperative CA, UIV tilt, T1 tilt, flexibility between T1 and the UIV, and ideal UIV tilt were measured or calculated using the formula mentioned above. The feasibility of this method in achieving LSB by establishing the predicted ideal UIV tilt intraoperatively using the improved crossbar technique was verified through a prospective analysis, and 13 scoliosis patients were enrolled. Results: In the retrospective study, there was a significant correlation between the difference in the actual and ideal postoperative UIV tilt values and the postoperative CA, with correlation coefficients in the whole, LSI and LSB groups of 0.981, 0.982 and 0.953, respectively (p < 0.001). In the prospective study, all patients achieved satisfactory LSB, with a correlation coefficient between the difference in the actual and ideal postoperative UIV tilt values and the postoperative CA of 0.939 (p < 0.001).Conclusions: Using the formula preoperatively to predict an ideal postoperative UIV tilt and controlling the intraoperative UIV tilt with the improved crossbar technique may be an effective digital method for achieving postoperative LSB and has important clinical significance.