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Day: October 27, 2017

Transforaminal approach in thoracal disc pathologies: transforaminal microdiscectomy technique.

By wp_zaman

Transforaminal approach in thoracal disc pathologies: transforaminal microdiscectomy technique.

Minim Invasive Surg. 2014;2014:301945

Authors: Dalbayrak S, Yaman O, Oztürk K, Yılmaz M, Gökdağ M, Ayten M

Abstract
Objective. Many surgical approaches have been defined and implemented in the last few decades for thoracic disc herniations. The endoscopic foraminal approach in foraminal, lateral, and far lateral disc hernias is a contemporary minimal invasive approach. This study was performed to show that the approach is possible using the microscope without an endoscope, and even the intervention on the discs within the spinal canal is possible by having access through the foramen. Methods. Forty-two cases with disc hernias in the medial of the pedicle were included in this study; surgeries were performed with transforaminal approach and microsurgically. Extraforaminal disc hernias were not included in the study. Access was made through the Kambin triangle, foramen was enlarged, and spinal canal was entered. Results. The procedure took 65 minutes in the average, and the mean bleeding amount was about 100cc. They were mobilized within the same day postoperatively. No complications were seen. Follow-up periods range between 5 and 84 months, and the mean follow-up period is 30.2 months. Conclusion. Transforaminal microdiscectomy is a method that can be performed in any clinic with standard spinal surgery equipment. It does not require additional equipment or high costs.

PMID: 24839557 [PubMed]

[Effectiveness analysis of Vertex rod-screw system in cervical expansive open-door laminoplasty].

By wp_zaman

Related Articles [Effectiveness analysis of Vertex rod-screw system in cervical expansive open-door laminoplasty]. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2011 Dec;25(12):1440-4 Authors: Xu N, Xu R, Ma W, Liang B Abstract OBJECTIVE: To evaluate the clinical application value and short-term results of Vertex rod-screw system in cervical expansive open-door laminoplasty. METHODS: Between…

Postoperative fever discharge guidelines increase hospital charges associated with spine surgery.

By wp_zaman

Postoperative fever discharge guidelines increase hospital charges associated with spine surgery.

Neurosurgery. 2011 Apr;68(4):945-9; discussion 949

Authors: Walid MS, Sahiner G, Robinson C, Robinson JS, Ajjan M, Robinson JS

Postoperative fever is a common sequel of spine surgery. In the presence of rigid nationally mandated clinical guidelines, fever management may consume more health care resources than is reasonably appropriate.

PMID: 21242842 [PubMed – in process]

Secondary spread of caudal block as assessed by ultrasonography.

By wp_zaman
Related Articles

Secondary spread of caudal block as assessed by ultrasonography.

Br J Anaesth. 2012 Apr;108(4):675-81

Authors: Lundblad M, Eksborg S, Lönnqvist PA

Abstract
BACKGROUND: Redistribution and secondary spread after the initial injection of local anaesthetics (LAs) are important factors that contribute to the final spread of caudal block in children. However, to date, these phenomena have yet not been studied in detail. Thus, the aim of this observational study was to define patterns of secondary spread and redistribution of a caudal block by means of real-time ultrasonography scanning and cutaneous testing.
METHODS: Ultrasound assessment of LA spread within the caudal-epidural space and epidural pressure was followed during 15 min after initial injection (1.5 ml kg(-1), ropivacaine 0.2%) in 16 infants. At 15 min post-injection, cutaneous testing was also performed to assess the cranial dermatomal level of the block (at end-tidal sevoflurane 2.5%).
RESULTS: The median ultrasound-assessed cranial spread was Th10 and Th8 at 0 and 15 min, respectively, and the sensory level at 15 min was Th4. The caudal injection was initially found to compress the terminal part of the dural sac, later followed by a partial re-expansion as epidural pressure was returning towards pre-injection values. An intrasegmental redistribution from the dorsal to the ventral compartment of the epidural space was also observed.
CONCLUSIONS: Two separate patterns of secondary spread of caudal block could be observed, being horizontal intrasegmental redistribution and longitudinal cranial spread. The observed bi-directional movement of cerebrospinal fluid (coined ‘the CSF rebound mechanism’) does explain a major part of the difference between the initial ultrasound-assessed cranial level and the final level determined by cutaneous testing.

PMID: 22315327 [PubMed – indexed for MEDLINE]