Publications by authors named "Michal Filip"

13 Publications

  • Page 1 of 1

Long-Term Outcome After Midline Lumbar Fusion for the Treatment of Lumbar Spine Instability Due to Degenerative Disease.

World Neurosurg 2021 Jul 29. Epub 2021 Jul 29.

Department of Neurosurgery, Tomas Bata Regional Hospital, Zlin, Czech Republic. Electronic address:

Background: Midline lumbar fusion (MIDLF) is one promising new surgical technique that has been developed to minimize perioperative damage to the paravertebral stabilizing musculotendinous system. The aim of this study was to assess long-term clinical and radiological effects of MIDLF.

Methods: This prospective cohort study evaluated patients who underwent MIDLF for degenerative spinal instability. Clinical and radiological examinations were performed before and after surgery. Perioperative and postoperative complications were recorded. Follow-up was 2 years. P ≤ 0.05 was considered statistically significant.

Results: The study included 64 patients (mean age 58.9 ± 10.7 years; 41 women [64.1%]). The most frequent indication for MIDLF was degenerative spondylolisthesis grade I (28 cases [43.8%]); the prevalent spinal segment to be fused was L4-L5 (35 cases [54.7%]). Mean duration of surgery was 148.2 ± 28.9 minutes. Relief of low back pain and leg pain was significant and stable in the postoperative period as assessed by visual analog scale (P < 0.001). Of patients, 86.9% reported fair, good, or excellent outcomes in terms of pain relief based on MacNab score 2 years after surgery. Patients' level of function in activities of daily living improved significantly based on Oswestry Disability Index score: from 66.8 ± 9.8 before surgery to 33.9 ± 16.5 2 years after surgery (P < 0.001). X-rays and computed tomography at 12 months showed interbody fusion in 46 cases (73.4%), inconclusive results in 13 cases (20.3%), and no fusion in 4 cases (6.3%). No damage to neural or vascular structures and no failure of hardware or screw loosening were recorded.

Conclusions: MIDLF is a safe, efficient method for surgical treatment of lumbar spine instability. Its limited invasiveness contributes to better preservation of paravertebral muscles and enhanced postoperative spinal stability.
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http://dx.doi.org/10.1016/j.wneu.2021.07.108DOI Listing
July 2021

Effect of ionizing radiation on the female reproductive system.

Ann Agric Environ Med 2019 Dec 12;26(4):606-616. Epub 2019 Nov 12.

Diagnostic Techniques Unit, Faculty of Health Sciences, Medical University, Lublin, Poland.

Introduction And Objective: The tendency towards postponement of maternity implies a greater exposure of female germ cells to damaging environmental effects, including ionizing radiation (IR). Progress in paediatric oncology, based on the use of radiotherapy, also implies the occurrence of gonadal dysfunctions and subsequent female fertility disorders. Therefore, it seems justifiable to systematize the state of knowledge concerning the effect of IR on the female reproductive system.

Brief Description Of The State Of Knowledge: A considerable part of studies concerning the effect of IR on female germ cells have been conducted on animals. Their extrapolation to humans is hindered because in animal studies high acute exposures are applied, which do not reflect human environmental exposures characterized by chronic low dose exposure. Studies on animals provide a heterogenous image, which hinders the formulation of unequivocal conclusions and indicates that radiosensitivity depends, i.a. on IR dose, stage of development of oocytes, the applied marker of the effects of IR, or on the species. LD50 of human oocytes is estimated to be below 2 Gy. The effect of IR depends, i.a. on the dose fractionation and the age (older women are more radiosensitive). In females, the effective sterilizing dose is: at birth 20.3 Gy, at 10 years 18.4 Gy, at 20 years 16.5 Gy, whereas at 30 years 14.3 Gy, which is associated with the available pool of ovarian follicles.

Conclusions: Within the range of low doses received as a result of environmental exposure to IR, there is no evidence for the occurrence of either adverse pregnancy outcomes, nor fertility disorders in females. These effects may be related to the cancer radiotherapy, or exposure to high IR doses during nuclear accidents.
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http://dx.doi.org/10.26444/aaem/112837DOI Listing
December 2019

Successful surgical excision of cerebral abscess caused by Fonsecaea monophora in an immunocompetent patient and review of literature.

Folia Microbiol (Praha) 2019 May 27;64(3):383-388. Epub 2018 Oct 27.

Department of Botany, Faculty of Science, Charles University, Prague, Czech Republic.

Cerebral abscesses caused by dark-pigmented Fonsecaea fungi are rare, especially in otherwise healthy individuals. In this case report, we present a 61-year-old man from Moldova, living in the Czech Republic, who had worked as a locksmith on oil platforms in Turkmenistan, Kazakhstan, Sudan, and Iraq since 1999, and was admitted to a neurology ward for a sudden motion disorder of the right leg, dysarthria, and hypomimia. Imaging revealed presence of expansive focus around the left lateral ventricle of the brain and a pronounced peripheral edema. The intracranial infectious focus was excised under intraoperative SonoWand guidance. Tissue samples were histologically positive for dark-pigmented hyphae, suggesting dematiaceous fungi. Therefore, liposomal amphotericin B therapy was initiated immediately. Fonsecaea monophora was provisionally identified using ITS rDNA region sequencing directly from brain tissue. The identification was subsequently confirmed by cultivation and DNA sequencing from culture. The strain exhibited in vitro sensitive to voriconazole (MIC = 0.016 μg/mL) and resistance to amphotericin B (MIC = 4 μg/mL); therefore, the amphotericin B was replaced with voriconazole. Postoperatively, a significant clinical improvement was observed and no additional surgery was required. Based on the literature review, this is the third documented case of cerebral infection due to this pathogen in patients without underlying conditions and the first such case in Europe.
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http://dx.doi.org/10.1007/s12223-018-0661-9DOI Listing
May 2019

Complete diagnostics and clinical approach for a female patient with unusual glioblastoma: A case study.

Mol Clin Oncol 2016 Jul 10;5(1):161-164. Epub 2016 May 10.

Institute of Medical Biochemistry and Laboratory Diagnostics, First Faculty of Medicine, Charles University and General University Hospital, 128 08 Prague 2, Czech Republic.

The present study reports a case of a 44-year-old female patient with a large frontal lobe tumor who underwent surgery using a modern navigation system SonoWand that combines the advantages of a non-frame navigation system with intraoperative real-time ultrasound imaging. The right frontal lobe tumor consisted of two morphologically different sections. A diffuse astrocytoma grade II and a glioblastoma grade IV were identified. These tumors were relatively substantially separated. A 17 p deletion, including , was detected in a diffuse astrocytoma but not in a glioblastoma. and amplifications were detected only in a glioblastoma. Detection of these amplifications is typical for primary glioblastomas. These findings support our assumption of two independent tumors. The , and gene mutations were also detected in a glioblastoma. Such an accumulation of molecular mutations is rare in one tumor. Following oncological treatment the patient was cared for in the oncological center and survived for 15 months after the surgery without any signs of a disease. This is an unusual case, and to the best of our knowledge, is not frequently published in literature.
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http://dx.doi.org/10.3892/mco.2016.891DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4906621PMC
July 2016

Comparison of biochemical response between the minimally invasive and standard open posterior lumbar interbody fusion.

Neurol Neurochir Pol 2016 6;50(1):16-23. Epub 2015 Nov 6.

Institute of Biostatistics and Analyses, Masaryk University, Brno, Czech Republic.

Background: The mini-invasive open posterior lumbar fusion procedure (mini PLIF) procedure is an alternative to standard open procedure (open PLIF) and is intended to reduce surgery-related trauma. The measuring of suitable biochemical factors enables objective comparison of the invasiveness of spinal surgery procedures.

Methods: Prospectively collected data on myoglobin, creatine kinase, interleukin-6, C-reactive protein levels and intensity of low back pain and radicular pain in one-level mini PLIF and open PLIF procedures were analysed. The mini PLIF and the open PLIF groups included 27 and 23 patients, respectively. The collection of blood samples and clinical data were performed preoperatively and on postoperative days 1, 3 and 7. The non-paired t-test was used for statistical evaluation.

Results: We did not found any statistically significant differences of myoglobin and creatine kinase levels between the groups. In the open PLIF group the IL-6 levels were significantly higher than in the mini PLIF group on postoperative day 3. CRP levels showed significant lower stress response in favour of the mini PLIF group on postoperative days 3 and 7. Levels of post-op low back pain on day 3 were significantly lower in mini PLIF group. Also intensity of radicular pain on day 1 and 3 were lower also mini PLIF group.

Conclusion: The extent of myonecrosis was comparable in both techniques. The analysis of the IL-6 and CRP levels showed significantly lower systemic inflammatory response in mini PLIF technique. The mini PLIF technique provides transiently lower postoperative pain levels.
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http://dx.doi.org/10.1016/j.pjnns.2015.10.008DOI Listing
June 2016

Comparison of Biochemical Markers of Muscle Damage and Inflammatory Response Between the Open Discectomy, Microsurgical Discectomy, and Microsurgical Discectomy Using Tubular Retractor.

J Neurol Surg A Cent Eur Neurosurg 2015 Sep 29;76(5):384-91. Epub 2015 May 29.

Institute of Biostatistics and Analyses, Masaryk University Brno, Brno, Czech Republic.

Background: One of the methods to compare the invasiveness of different surgical techniques objectively is to measure the levels of biochemical markers of systemic inflammatory response and muscle damage.

Methods: A total of 120 patients undergoing surgery for symptomatic disc herniation at L4-L5 and L5-S1 were enrolled in the study. Patients were operated on using open discectomy (OD), microsurgical discectomy (MD), or microsurgical discectomy with tubular retractor (MD-TUB). Myoglobin (MYO) and creatine kinase (CK) levels were used as indicators of muscle damage, and interleukin-6 (IL-6) and C-reactive protein (CRP) levels were used as indicators of systemic inflammatory response. Sampling and analysis of samples were performed preoperatively and on postoperative days 1, 3, and 7. Levels of postoperative low back pain and radicular pain were recorded on a 10-grade visual analog scale. Statistical evaluation was performed using the analysis of variance test.

Results: MYO concentrations in the MD-TUB group on postoperative day 1 were significantly lower than in the MD and OD groups. CK values on postoperative day 1 were significantly lower in microsurgical techniques (MD and MD-TUB) than in the OD group. The lowest IL-6 levels were found in the MD-TUB group, followed by the MD and OD groups. Differences in the IL-6 levels were significant between the groups on postoperative day 1. On all postoperative days that were monitored, values of CRP in the MD-TUB group were significantly lower compared with the MD and OD groups. Lower values in the MD group versus OD group were not statistically significant.

Conclusion: All studied techniques showed similar efficacy in reducing radicular pain. The microsurgical diskectomy using a retractor in comparison with MD and OD is friendlier toward the paraspinal muscles, but the difference is significant only for the MYO levels. The total stress inflammatory response exhibited by patients undergoing the MD-TUB technique is significantly lower compared with the MD and OD techniques.
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http://dx.doi.org/10.1055/s-0034-1393929DOI Listing
September 2015

Application of transcranial color-coded sonography in severe brain injury.

Acta Neurochir Suppl 2013 ;118:265-7

Department of Anaesthesiology, T. Bata Regional Hospital, Zlín, Czech Republic.

Transcranial color-coded sonography (TCCS) monitoring of severe brain injury patients may reveal various pathological hemodynamic changes. According to changes in flow velocities in basal brain arteries, the presence of brain hyperemia, vasospasms, and oligemia can be detected. The study included a group of 20 patients with severe brain injury. TCCS measured flow velocities and ICP values were monitored on a daily basis in the course of a week after injury. In nearly 50 % of patients significant hemodynamic changes occurred. The most frequent pathological finding was hyperemia (31.8 %), followed by vasospasm (10.9 %) and oligemia (9.1 %). In 42.7 % of patients increased flow velocities were registered and only 9.1 % of records were within the normal range of values. The most substantial elevation in time-averaged mean velocity occurred from the second to the sixth day after injury. In a subgroup of patients with raised intracranial pressure 41.6 % of flow velocity (FV) measuring met the TCCS criteria for hyperemia compared with 26 % in a subgroup of patients without intracranial pressure (ICP) elevation. The study showed that hemodynamic changes after severe brain injury are relatively common findings and that TCCS is a useful bed-side tool for the monitoring of intracranial hemodynamic changes.
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http://dx.doi.org/10.1007/978-3-7091-1434-6_50DOI Listing
August 2013

Detection of intracranial arterial stenosis using transcranial color-coded duplex sonography, computed tomographic angiography, and digital subtraction angiography.

J Ultrasound Med 2011 Aug;30(8):1069-75

Department of Neurology, Ostrava Medical School and University Hospital, Ostrava, Czech Republic.

Objectives: The aim of this retrospective study was to compare intracranial arterial stenosis in patients with stroke using 3 different methods: transcranial color-coded duplex sonography, computed tomographic (CT) angiography, and digital subtraction angiography in a common clinical practice.

Methods: Sixty-seven patients (47 male and 20 female; age range, 23-79 years; mean age ± SD, 62.0 ± 9.5 years) were enrolled in this study over 40 months. All patients underwent examinations of the intracranial arteries using transcranial color-coded sonography, CT angiography, and digital subtraction angiography. Findings were divided into 4 groups: normal, mild stenosis (<50%), severe stenosis (50%-99%), and occlusion.

Results: Because of technical reasons or an insufficient bone window, 465 of 536 arterial segments in 67 patients were evaluated; 12 stenotic and 15 occluded segments were detected using digital subtraction angiography. The sensitivity, specificity, positive predictive value, and negative predictive value of transcranial color-coded sonography and CT angiography in comparison with digital subtraction angiography as a reference standard were 88.9%, 94.8%, 51.1%, and 99.3% and 81.5%, 98.7%, 78.6%, and 98.6%, respectively. The agreement between transcranial color-coded sonography and CT angiography was 93.8% (κ = 0.559); between transcranial color-coded sonography and digital subtraction angiography, it was 93.9% (κ = 0.588); and between CT angiography and digital subtraction angiography, it was 96.6% (κ = 0.697).

Conclusions: Moderate agreement was found between CT angiography, transcranial color-coded sonography, and digital subtraction angiography in the evaluation of intracranial stenosis. Computed tomographic angiography and digital subtraction angiography are sufficient for assessment of the diagnosis.
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http://dx.doi.org/10.7863/jum.2011.30.8.1069DOI Listing
August 2011

Medical consultations and the sharing of medical images involving spinal injury over mobile phone networks.

Am J Emerg Med 2012 Jul 27;30(6):961-5. Epub 2011 Jul 27.

Department of Neurosurgery, Bata Hospital, CZ-76001, Zlín, Czech Republic.

Background: The transmission of medical images and other data over mobile phone networks may facilitate remote medical consultations between neurosurgeons and regional hospitals treating spinal injury patients. The aim of this study was to compare the efficacy of mobile phone consultations with standard hospital workstation consultations in spinal injury patients.

Methods: The images were exported over the Internet from surrounding local hospitals through the Picture Archiving and Communication System, in DICOM III format, to the central hospital server. The xVision browser was used to view the acquired images on a standard workstation. The data were also exported to the secured hospital Web server IIS60 and converted to JPEG format to enable remote physician access and consultation. The remote consulting physician connected to this server by mobile phone using the phone's Internet browser. A second physician, blind to the mobile phone results, evaluated the same images at a workstation in the hospital. The results of the mobile phone consultations were compared with the results from standard workstation consultations.

Results: There was no difference in the quality of spinal computed tomographic/magnetic resonance images viewed on the phone screen compared with on the workstation. More importantly, the final diagnoses made by mobile phone did not differ from those made by workstation consultations. A transfer to the department of neurosurgery was required after consultation in 11 patients.

Conclusion: Mobile phone consultations for patients with spinal injuries was as effective as workstation consultations. Mobile phone consultations can increase the expertise available to regional hospitals, which are often the first responders to medical emergencies.
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http://dx.doi.org/10.1016/j.ajem.2011.05.007DOI Listing
July 2012

Decompressive surgery for malignant supratentorial infarction remains underutilized after guideline publication.

J Neurol 2011 Sep 24;258(9):1689-94. Epub 2011 Mar 24.

Department of Neurology, Faculty Hospital Ostrava, Tr. 17. Listopadu 1790, 708 52 Ostrava, Czech Republic.

Decompressive surgery <48 h from stroke onset reduces the prevalence of mortality and morbidity from malignant supratentorial infarction. We investigated if utilization of decompressive surgery changed in the Czech Republic (CZ) after the release of new guidelines regarding treatment of malignant brain infarction. The volume of decompressive surgery in 2009 in all centers in the CZ was assessed using the same methodology as in 2006. All neurosurgery departments in the CZ were asked to complete a questionnaire and asked to identify all cases of decompressive surgery for malignant brain infarction through a combination of discharge codes for "brain infarction" and "decompressive surgery" from electronic hospital charts. Data for 56 patients were obtained from 15 of the 16 neurosurgery departments in the CZ. The average age was 53 ± 13; number of males 20; median time to surgery was 48 h (range 24-62); median NIHSS score was 25 (IQR, 20-30); median infarct volume was 300 cm(3) [interquartile (IQR, 250-350)]; mean shift on CT was 10.6 ± 3.6 mm and size of hemicraniectomy was 125 cm(2) (IQR, 110-154). A favorable outcome was achieved in 45% of the patients. The number of procedures increased from 39 in 2,006 to 2,056 in 2009. Based on data from one stroke center, 10% suffered from malignant supratentorial infarction and 2.3% met the criteria for decompressive surgery. In 2009, as compared to 2006, the volume of decompressive surgery carried out moderately increased. However, procedures remained underutilized because only ~10% of those who needed decompressive surgery underwent surgery.
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http://dx.doi.org/10.1007/s00415-011-6003-3DOI Listing
September 2011

Injuries of the central nervous system - mobile phone consultations.

Pol J Radiol 2010 Oct;75(4):30-3

Neurosurgery Department, KNTB, Regional Hospital of T. Ba̕a in Zlín, Zlín, Czech Republic.

Transmission of visual documentation between a neurosurgery center and a regional hospital, with a mobile phone, significantly improves consultation on a craniocerebral injury. This is one of the methods of fast consultation on image documentation (CT). We reported on one year of experience (September 2007 to September 2008) of our department with this method of image transmission in 16 patients with craniocerebral injury. The images were exported, via the Internet, from local hospitals through the PACS system [Picture Archiving and Communication System], in DICOM III format, to the server of the Regional Hospital of T. Ba̕a, (KNTB). Browsing of the acquired image documentation at particular stations was possible with the xVision browser. The data were exported to a secure hospital Web server, IIS60, to enable consultation on the images, which were changed to JPEG format. The consulting physician was connected to this server with his/her mobile phone by means of the Internet browser. After establishing the connection, it downloads and gradually displays the images on the screen of the mobile phone. The whole process takes approximately 10 minutes. After comparing the images on the screen of the mobile phone and on the workstation using the xVision browser, we verified that there was no difference in the quality of imaging of the pathological lesions recorded with CT.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3389895PMC
October 2010

18 months of experiences with the biotitanium replacement (Implaspin) used in treatment of degenerative lumbar spine diseases.

Chir Narzadow Ruchu Ortop Pol 2010 Mar-Apr;75(2):131-5

Neurosurgery Department, Regional Hospital of Tomdás Bat'a in Zlín.

Between 2007-2008 forty two patients neurosurgery department of the KNTB (Regional Hospital of T. Bat'a) Zlin underwent surgery using the bioactive replacement Implaspin. The group of 21 patient of the total of number of 42 patients was operated first time for diagnosis degenerative instability or spondylolisthesis gr I-II. In this group was the follow-up period of 18 months, the mean baseline Oswestry score was 57%. A value of 37% was achieved after 18 months during the evaluation of the clinical status using the Oswestry questionnaire. This result represented a improvement of the condition. No change of the position of the instruments occurred during the X-ray and CT, MRI controls. Therefore, the Implaspin replacement appeared to be a perfect alternative to other lumbar spine replacements combining the osteoconductive properties of the bioactive material with the rigidity of titanium.
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September 2010

Bioactive titan cage Implaspin in treatment of degenerative disease of the cervcal spine--the results from 2007 till 2008.

Chir Narzadow Ruchu Ortop Pol 2010 Jan-Feb;75(1):69-73

Neurosurgery Department, Regional Hospital of Tomás Bata, Zlín.

The authors present results of surgical treatment of cervical spine degenerative disease via Implaspin biotitanium replacement. Surgery was indicated for a group of 24 patients with symptoms of cervical spondylogenic myelopathy or the irritation decay root syndrome non-reacting to conservative treatment. Pre-surgery X-ray and MRI examinations showed spinal canal stenosis caused by the intervertebral disk osteochondrosis combined with prolapse or dorsal osteophytes. Clinical problems of the group of patients were evaluated through the JOA classification before surgery and during the 2nd, the 6th and month 12th after surgery. The surgery rate of success was evaluated in percentages during post-surgery examinations that took place in the 12th month. Based on the JOA classification, that rate of success falls into the good surgery results zone. The post-surgery X-ray examinations showed two sank replacements by 1/3 of its height into the surrounding vertebral bodies. In these cases we performed the control MRI. No signs of the new spinal compression were found and the spinal canal was free in the operated site. Based on our short-term experiences, the Implaspin bioactive replacement seems to be a suitable alternative to the other types of replacements designed for intervertebral fusion in the lower cervical spine area.
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June 2010
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