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Lumbar epidural

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https://www.readbyqxmd.com/read/28526462/-sudden-motor-and-sensorial-loss-due-to-retroperitoneal-hematoma-during-postoperative-periods-a-case-report
#1
Pelin Şen, Havva Gül Gültekin, İsmail Caymaz, Ömer Özel, Ayda Türköz
A 68 year-old male patient was hospitalized for radical prostatectomy. He had no abnormal medical history including neurological deficit before the operation. Prior to general anesthesia, an epidural catheter was inserted in the L3-4 interspace for intraoperative and postoperative analgesia. After surgery for nine hours, he developed confusion and flaccid paralysis of bilateral lower extremities occurred. No pathology was detected from cranial computed tomography and diffusion magnetic resonance imaging no pathology was detected...
May 16, 2017: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/28524751/pseudogout-of-the-cervical-and-thoracic-spine-mimicking-infection-after-lumbar-fusion-case-report
#2
Kelly J Bridges, Carli L Bullis, Ajay Wanchu, Khoi D Than
Pseudogout is a form of acute calcium pyrophosphate deposition (CPPD) disease that typically afflicts the elderly. CPPD commonly involves larger joints, such as the knees, wrists, shoulders, and hips, and has been known to involve the spine. The authors report the case of a 66-year-old woman with a recent history of lumbar laminectomy and fusion who presented 5 weeks postprocedure with a clinical and radiographic picture consistent with multilevel skip lesions involving the cervical and thoracic spine, thoracic discitis, and epidural abscess...
May 19, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28504775/efficacy-of-epidural-blood-patches-for-spontaneous-low-pressure-headaches-a-case-series
#3
S Ansel, A Rae, A Tyagi
Patients with a spontaneous cerebrospinal fluid leak, normally at a spinal level, typically present with low-pressure headache. In refractory cases, an epidural blood patch may be attempted. We aimed to assess the efficacy of lumbar epidural blood patching in spontaneous, low-pressure headaches. Methods We retrospectively analysed notes of patients who had an epidural blood patch performed for spontaneous low-pressure headaches in a single centre. Information regarding demographics, radiology and clinic follow-up was extracted from an electronic patient record system...
December 2016: Journal of the Royal College of Physicians of Edinburgh
https://www.readbyqxmd.com/read/28504548/the-lumbar-neural-foramen-and-transforaminal-epidural-steroid-injections-an-anatomic-review-with-key-safety-considerations-in-planning-the-percutaneous-approach
#4
Jacob C Mandell, Gregory J Czuczman, Glenn C Gaviola, Varand Ghazikhanian, Charles H Cho
OBJECTIVE: The purpose of this article is to review the anatomy of the lumbar neural foramen and to describe techniques of transforaminal epidural steroid injections with emphasis on safety. Rare cases of paraplegia have been reported. CONCLUSION: Although no consensus currently exists about which approach is the safest, knowledge of the foraminal anatomy is a key consideration when choosing a needle approach for transforaminal epidural steroid injections.
May 15, 2017: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/28504498/-pediatric-case-report-spinal-epidural-abscess
#5
Mauricio Pons, Leila Pérez, Facundo Juárez
Spinal epidural abscess is an uncommon pathology. It has an incidence of one case per 100 000 individuals. An increase is observed due to the raise of risk factors such as diabetes mellitus, spinal abnormalities, tattoos, acupuncture, epidural analgesia, and a greater availability of imaging methods. It is a purulent collection located between the dura and the medullary canal. The most common germs are Staphylococcus aureus and Gram-negative bacteria. Without timely treatment, it evolves to medullary compression and permanent neurological sequelae...
June 1, 2017: Archivos Argentinos de Pediatría
https://www.readbyqxmd.com/read/28490942/comparison-of-incidences-of-intravascular-injection-between-medial-and-lateral-side-approaches-during-traditional-s1-transforaminal-epidural-steroid-injection
#6
Sang Jun Park, Shin Hyung Kim, Seon Ju Kim, Duck Mi Yoon, Kyung Bong Yoon
Purpose. Intravascular injection rates are higher during traditional S1 transforaminal epidural steroid injection (TFESI) compared with lumbar transforaminal injection. We compared the incidences of intravascular injection between the medial and lateral approaches to the S1 foramen during S1 TFESI. Materials and Methods. A total of 139 patients underwent one or more TFESIs (170 total injections). The patients received S1 TFESI by either medial or lateral side of S1 foramen under fluoroscopic anteroposterior view using digital subtraction method...
2017: Pain Research & Management: the Journal of the Canadian Pain Society
https://www.readbyqxmd.com/read/28489779/epidural-hematoma-after-total-hip-arthroplasty-in-ankylosing-spondylitis-patient-a-case-report-and-review-of-the-literature
#7
Jia Li, Ke Qi, Yongjin Zhang, Chenchen Xue, Weidong Xu
RATIONALE: Ankylosing spondylitis (AS) can affect the hip joint, causing deformity and disability. Total hip arthroplasty can obviously relieve the pain of the hip joint, and reconstruct the function of hip joint. Epidural anesthesia in this patient population has high risk of epidural hematoma, but the reason is unclear. PATIENT CONCERNS: A 44-year-old man diagnosed with AS underwent total hip arthroplasty. DIAGNOSES: Six days after operation, he was diagnosed epidural hematoma...
May 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28486232/osthole-a-coumadin-analog-from-cnidium-monnieri-l-cusson-ameliorates-nucleus-pulposus-induced-radicular-inflammatory-pain-by-inhibiting-the-activation-of-extracellular-signal-regulated-kinase-in-rats
#8
Hai-Xuan Wu, Yi-Min Wang, Hui Xu, Ming Wei, Qiu-Lan He, Mei-Na Li, Lai-Bao Sun, Ming-Hui Cao
AIM: This study was aimed at assessing the role of extracellular signal regulated kinase (ERK) in mechanical allodynia resulting from lumbar disc herniation (LDH) and exploring the osthole's anti-nociceptive effect on ERK activation. METHODS: Radicular pain was generated by applying nucleus pulposus (NP) to the L5 dorsal root ganglion (DRG). Allodynia was measured using Von Frey filaments to calculate the mechanical pain threshold. Phosphorylated ERK and total ERK protein in the lumbar spinal dorsal horn was detected by using the Western blot technique...
May 10, 2017: Pharmacology
https://www.readbyqxmd.com/read/28485773/curcumin-alleviates-lumbar-radiculopathy-by-reducing-neuroinflammation-oxidative-stress-and-nociceptive-factors
#9
L Xiao, M Ding, A Fernandez, P Zhao, L Jin, X Li
Current non-surgical treatments for lumbar radiculopathy [e.g. epidural steroids and Tumour necrosis factor-α (TNF-α) antagonists] are neither effective nor safe. As a non-toxic natural product, curcumin possesses an exceptional anti-inflammatory profile. We hypothesised that curcumin alleviates lumbar radiculopathy by attenuating neuroinflammation, oxidative stress and nociceptive factors. In a dorsal root ganglion (DRG) culture, curcumin effectively inhibited TNF-α-induced neuroinflammation, in a dose-dependent manner, as shown by mRNA and protein expression of IL-6 and COX-2...
May 9, 2017: European Cells & Materials
https://www.readbyqxmd.com/read/28482336/spinal-subdural-abscess-following-repeat-lumbar-microdiscectomy-a-case-report-of-imaging-findings-for-a-rare-infection
#10
Shao Z Chen, Adam L Shimer, Nicholas C Nacey
Spinal subdural abscess is a rare central nervous system infection with just over a hundred cases reported. It is much less common than spinal epidural abscess. While most case reports have focused on route of infection and treatment options, there have not been any reports that focused on the unique MRI findings of spinal subdural abscess. We describe a case of spinal subdural abscess diagnosed by MRI in a 33-year-old male who presented with headaches after undergoing a microdiscectomy procedure, and review the underlying anatomic features of the spinal meninges which produce the appearance of a spinal subdural abscess...
April 27, 2017: Clinical Imaging
https://www.readbyqxmd.com/read/28480104/perioperative-steroids-for-lumbar-disc-surgery-a-meta-analysis-of-randomized-controlled-trials
#11
REVIEW
Muhammad Waqas, Hussain Shallwani, Muhammad S Shamim, Khabir Ahmad
BACKGROUND: Our review question was "Does perioperative steroids administration, in comparison with other treatments or placebo, improve either postoperative pain control, length of hospital stay, or return to work in patients undergoing lumbar disc surgery?" METHODS: We searched PubMed, CINAHL PLUS, and Cochrane databases for randomized control trials (RCTs) studying the role of steroids for lumbar disc surgery. Studies that compared perioperative steroids with other treatments or placebo were included...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28459053/epidural-gas-accumulation-in-connection-with-canine-degenerative-lumbosacral-disease
#12
Ditte Skytte, Hugo Schmökel
Three dogs were presented with lumbosacral hyperesthesia. Computerized tomography scans were performed in all the cases, and magnetic resonance imaging was also performed in cases 1 and 3. There was intervertebral disc (IVD) protrusion causing nerve root compression and epidural gas accumulation in all the three cases. The gas-filled cystic structures in cases 1 and 3 were within the spinal canal; in case 2, the gas was within the disc protrusion. The IVD vacuum phenomenon is relatively common in dogs, but the formation of an epidural gas accumulation in cases of a lumbar disc protrusion is rare...
2017: Frontiers in Veterinary Science
https://www.readbyqxmd.com/read/28448392/a-retrospective-study-to-evaluate-the-effect-of-concentration-of-hypertonic-saline-on-efficacy-and-safety-of-epidural-adhesiolysis
#13
Eun Joo Choi, Yong Jae Yoo, Pyung Bok Lee, Yong-Chul Kim, Sang Chul Lee, Jee Youn Moon
BACKGROUND: Percutaneous epidural adhesiolysis (PEA) is a minimally invasive procedure that is performed to relieve low back and/or lower limb pain secondary to adhesions or scarring in the epidural space that is refractory to conservative treatment. The optimal concentration of hypertonic saline might be an important factor in the safety and efficacy of PEA. We evaluated differences in the efficacy and safety of 2 concentrations of hypertonic saline (5% and 10%) used in lumbar PEA at our institutions in a retrospective study...
June 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28437262/loss-of-resistance-a-randomised-controlled-trial-assessing-four-low-fidelity-epidural-puncture-simulators
#14
Tina H Pedersen, Jonas Meuli, Eike J Plazikowski, Maximilian Buttenberg, Maren Kleine-Brueggeney, Christian Seidl, Lorenz Theiler, Robert Greif
BACKGROUND: Detecting loss of resistance (LOR) can either be taught with dedicated simulators, with a cost ranging from &OV0556;1500 to 3000, or with the 'Greengrocer's Model', requiring simply a banana. OBJECTIVES: The purpose of this study was to compare three dedicated epidural puncture training simulators and a banana in their ability to simulate LOR. Our hypothesis was that there was a difference between the four simulators when comparing the detection of LOR...
April 21, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/28428080/the-effect-of-preoperative-lumbar-epidural-corticosteroid-injection-on-post-operative-infection-rate-in-patients-undergoing-single-level-lumbar-decompression
#15
Jonathan G Seavey, George C Balazs, Theodore Steelman, Melvin Helgeson, David E Gwinn, Scott C Wagner
BACKGROUND CONTEXT: Lumbar epidural corticosteroid injections (LECI) are frequently used in the treatment of lumbar intervertebral disc herniation with radiculopathy and lumbar spinal stenosis. Although widely utilized, their effect on the outcomes and complications of subsequent surgery is unclear. Post-operative infection can be a morbid complication following spine surgery, and recent literature has suggested that the risk may be increased in patients undergoing lumbar spinal surgery who had previously received LECI...
April 17, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28419420/reliability-of-pressure-waveform-analysis-to-determine-correct-epidural-needle-placement-in-labouring-women
#16
I Al-Aamri, S H Derzi, A Moore, M F Elgueta, M Moustafa, T Schricker, D Q Tran
Pressure waveform analysis provides a reliable confirmatory adjunct to the loss-of-resistance technique to identify the epidural space during thoracic epidural anaesthesia, but its role remains controversial in lumbar epidural analgesia during labour. We performed an observational study in 100 labouring women of the sensitivity and specificity of waveform analysis to determine the correct location of the epidural needle. After obtaining loss-of-resistance, the anaesthetist injected 5 ml saline through the epidural needle (accounting for the volume already used in the loss-of-resistance)...
April 17, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28417614/spinal-epidural-abscess-caused-by-brucella-species-a-review-of-17-cases
#17
Qin Zhang, Xiaohui Yang, Honglin Yu, Benrang Jia, Bin Meng
BACKGROUND: Spinal epidural abscess (SEA) is a rarely encountered clinical entity during the course of Brucella infection. METHODS: We reported 17 patients diagnosed with Brucellar SEA for a mean follow-up of 15 months. Spinal epidural abscess was detected by magnetic resonance imaging in all cases. Brucella diagnosis was established by serological tests. Patients were administered antibiotics for duration of 6 to 16 weeks. RESULTS: SEA was localized in lumbar region in 9 patients, thoracic in 4 patients, cervical in 3 patients, both thoracic and lumbar in 1 patient...
June 2017: Journal of Neurosurgical Sciences
https://www.readbyqxmd.com/read/28416834/-efficacy-of-transforaminal-endoscopic-nerve-root-decompression-in-the-treatment-of-degenerative-lumbar-spinal-stenosis
#18
Z R Yu, C D Li, S N Zhu, H L Sun, Y Zhao, L T Qi
OBJECTIVE: To evaluate the feasibility of transforaminal endoscopic nerve root decompression for degenerative lumbar spinal stenosis (DLSS). METHODS: From July 2011 to April 2016, 96 cases of single segment DLSS were involved. All the patients had unilateral lower extremity neurological symptoms, signs, neurogenic intermittent claudication of less than 500 m. Imaging examinations (CT or MRI) or diagnostic nerve root block confirmed single segment degeneration. The mean age was (71...
April 18, 2017: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
https://www.readbyqxmd.com/read/28413736/targeted-intraspinal-radiofrequency-ablation-for-lumbar-spinal-stenosis
#19
Robert E Jacobson, Michelle Granville, Jesse Hatgis DO
INTRODUCTION: By using a combination of magnetic resonance imaging (MRI) and computed tomography (CT) of the lumbar spine, it is possible to distinguish between spinal stenosis caused by bone compression and specific soft tissue epidural intraspinal lesions that cause localized spinal canal stenosis and neural compression. Examples include facet cysts and yellow ligament hypertrophy. Many of these patients are elderly with medical comorbidities that make open surgery problematic. MATERIALS & METHODS: This is a study of patients with predominantly soft tissue stenosis being treated with targeted intraspinal radiofrequency (RF) heat ablation...
March 10, 2017: Curēus
https://www.readbyqxmd.com/read/28413117/structure-specific-movement-patterns-in-patients-with-chronic-low-back-dysfunction-using-lumbar-combined-movement-examination
#20
Aubrey P Monie, Roger I Price, Christopher R P Lind, Kevin P Singer
OBJECTIVE: A test-retest cohort study was conducted to assess the use of a novel computer-aided, combined movement examination (CME) to measure change in low back movement after pain management intervention in 17 cases of lumbar spondylosis. Additionally we desired to use a CME normal reference range (NRR) to compare and contrast movement patterns identified from 3 specific structural pathologic conditions: intervertebral disc, facet joint, and nerve root compression. METHODS: Computer-aided CME was used before and after intervention, in a cohort study design, to record lumbar range of movement along with pain, disability, and health self-report questionnaires in 17 participants who received image-guided facet, epidural, and/or rhizotomy intervention...
April 13, 2017: Journal of Manipulative and Physiological Therapeutics
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