Surgical Complications Functional Outcome

The feared complication after intraspinal and, in particular, intramedullary tumor surgery is paralysis. The incidence of this occurrence is related to the pre-operative functional status. Patients who have no or minimal pre-operative motor deficits have less than 3% incidence for this complication. On the other hand, patients who already have a significant motor deficit are more likely to deteriorate post-operatively [9].

While complete resection of extramedullary tumors should be attempted and is possible in almost all cases, the resection radicality in intramedullary surgery is lower. In fact, complete removal, particularly of the last fragments of tumor tissue, has a high risk of resulting in major neurological deficits. In the senior author's experience of intramedullary tumors, a gross total resection was feasible in about 70-80% of cases and a subtotal (80-97%) in the remainder. There was no surgical mortality. The short-term deterioration of motor function is significant. One-third of patients experience a transient motor deficit, which resolves within hours to days [8]. The long-term functional motor outcome is much better and directly related to the pre-operative neurological function [9]. Therefore, it is advisable that patients with intramedullary tumors undergo surgery before the development of significant neurological deficits.

Impaired joint position sense may be a serious functional disability and is more commonly seen after ependymoma rather than astrocytoma resection. Patients who have impaired proprioception may require extensive physical therapy to learn to compensate for this deficit. In addition, patients may experience a variety of pain syndromes, autonomic symptoms and decreased strength for prolonged physical activity.

Cure Your Yeast Infection For Good

Cure Your Yeast Infection For Good

The term vaginitis is one that is applied to any inflammation or infection of the vagina, and there are many different conditions that are categorized together under this ‘broad’ heading, including bacterial vaginosis, trichomoniasis and non-infectious vaginitis.

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