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https://www.readbyqxmd.com/read/28913395/simultaneous-bilateral-total-hip-arthroplasty-in-morquio-syndrome
#1
Imran Ilyas, Syed Kashif, Samar Rabbani, Husam A Alrumaih
A 16-year-old girl who had Morquio syndrome presented with severe bilateral hip pain and limited mobility because of bilateral hip osteoarthritis and fixed flexion deformities. She was wheelchair bound for the previous 6 months. Cervical spine flexion-extension views showed mild subluxation (<3 mm), and there was thoracolumbar spine kyphosis. Magnetic resonance imaging of the cervical and thoracolumbar spine showed hypoplasia of the odontoid and vertebral bodies, but no spinal cord compression. Bilateral cemented total hip arthroplasty was performed through a posterior approach under general anesthesia with fiberoptic intubation...
September 2017: Arthroplasty Today
https://www.readbyqxmd.com/read/28882353/neurophysiological-monitoring-in-radiofrequency-ablation-of-spinal-osteoid-osteoma-with-a-progressive-time-and-temperature-protocol-in-children
#2
Mariano A Nöel, Martin J Segura, Sergio Sierre, Ida A Francheri Wilson, Carlos A Tello, Eduardo Galaretto, Rodrigo G Remondino, María E Talarico, Ernesto S Bersusky, Lucas Piantoni
STUDY DESIGN: Retrospective. Level IV Evidence. OBJECTIVE: To assess the utility of intraoperative neurophysiological monitoring (IONM) to detect and eventually prevent impending neurovascular damage during computed tomography (CT)-guided radiofrequency ablation (RFA) of spinal osteoid osteoma (OO) in children. SUMMARY AND BACKGROUND DATA: To our knowledge, this is the first case series of spinal OO in pediatric patients treated at a single center employing IONM during RFA...
September 2017: Spine Deformity
https://www.readbyqxmd.com/read/28869902/acute-effects-of-anesthetic-lumbar-spine-injections-on-temporal-spatial-parameters-of-gait-in-individuals-with-chronic-low-back-pain-a-pilot-study
#3
Carl L Herndon, MaryBeth Horodyski, Heather K Vincent
This study examined whether epidural injection-induced anesthesia acutely and positively affected temporal spatial parameters of gait in patients with chronic low back pain (LBP) due to lumbar spinal stenosis. Twenty-five patients (61.7±13.6years) who were obtaining lumbar epidural injections for stenosis-related LBP participated. Oswestry Disability Index (ODI) scores, Medical Outcomes Short Form (SF-36) scores, 11-point Numerical pain rating (NRSpain) scores, and temporal spatial parameters of walking gait were obtained prior to, and 11-point Numerical pain rating (NRSpain) scores, and temporal spatial parameters of walking gait were obtained after the injection...
August 31, 2017: Gait & Posture
https://www.readbyqxmd.com/read/28856576/changes-in-transcranial-motor-evoked-potentials-during-hemorrhage-are-associated-with-increased-serum-propofol-concentrations
#4
Jeremy A Lieberman, John Feiner, Mark Rollins, Russ Lyon
Transcranial motor evoked potentials (TcMEPs) monitor the integrity of the spinal cord during spine surgery. Propofol-based anesthesia is favored in order to enhance TcMEP quality. During intraoperative hemorrhage, TcMEP amplitudes may be reduced. The serum concentration of propofol may increase during hemorrhage. No study has determined whether changes in TcMEPs due to hemorrhage are related to changes in propofol blood levels. We monitored TcMEPs, mean arterial pressure (MAP), and cardiac output (CO) and hemoglobin in pigs (n = 6) undergoing controlled progressive hemorrhage during a standardized anesthetic with infusions of propofol, ketamine, and fentanyl...
August 30, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/28853117/a-randomized-comparison-between-neurostimulation-and-ultrasound-guided-lateral-femoral-cutaneous-nerve-block
#5
Gaurav Gupta, Mohan Radhakrishna, Isaac Tamblyn, D Q Tran, Markus Besemann, Atikun Thonnagith, Maria Francisca Elgueta, Marie Eve Robitaille, Roderick J Finlayson
BACKGROUND: This prospective, randomized trial compared neurostimulation (NS) and ultrasound (US) guided lateral femoral cutaneous nerve (LFCN) block. We hypothesized that US would result in a shorter total anesthesia-related time (sum of performance and onset times). METHODS: Twenty-one volunteers were enrolled. The right lower limb was randomized to an NS- or US-guided LFCN block. The alternate technique was employed for the left lower limb. With NS, paresthesias were sought in the lateral thigh at a stimulatory threshold of 0...
July 2017: U.S. Army Medical Department Journal
https://www.readbyqxmd.com/read/28837906/comparison-of-visual-evoked-potential-monitoring-during-spine-surgeries-under-total-intravenous-anesthesia-versus-balanced-general-anesthesia
#6
Alberto A Uribe, Ehud Mendel, Zoe A Peters, Bassel F Shneker, Mahmoud Abdel-Rasoul, Sergio D Bergese
OBJECTIVE: To determine the comparison of its clinical utility and safety profile for visual evoked potential (VEP) monitoring during prone spine surgeries under total intravenous anesthesia (TIVA) versus balanced general anesthesia using the SightSaver™ visual stimulator. METHODS: The protocol was designed asa pilot, single center, prospective, randomized, and double-arm study. Subjects were randomized to receive either TIVA or balanced general anesthesia. Following induction and intubation, 8 electrodes were placed subcutaneously to collect VEP recordings...
October 2017: Clinical Neurophysiology: Official Journal of the International Federation of Clinical Neurophysiology
https://www.readbyqxmd.com/read/28836257/-efficacy-comparison-of-the-laparoscopic-total-extraperitoneal-prosthetic-and-the-lichtenstein-herniorrhaphy-for-inguinal-hernia
#7
Yiliang Li, Zhi Wang, Lemu Ke, Fuzeng Su, Cheng Zhang, Huiling Li, Zhi Du, Zhikai Zhu, Song Li
OBJECTIVE: To compare the efficacy and safety between laparoscopic total extraperitoneal prosthetic (TEP) and Lichtenstein herniorrhaphy in the treatment of inguinal hernia (IH). METHODS: Clinical data of 158 IH patients at our hospital from October 2015 to October 2016 were retrospectively analyzed. Among 158 patients, 85 patients underwent TEP (TEP group), and 73 underwent Lichtenstein herniorrhaphy(Lichtenstein group). Patients of TEP group received general anesthesia...
August 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28809679/automatic-localization-of-the-needle-target-for-ultrasound-guided-epidural-injections
#8
Mehran Pesteie, Victoria Lessoway, Purang Abolmaesumi, Robert N Rohling
Accurate identification of the needle target is crucial for effective epidural anesthesia. Currently, epidural needle placement is administered by a manual technique, relying on the sense of feel, which has a significant failure rate. Moreover, misleading the needle may lead to inadequate anesthesia, post dural puncture headaches and other potential complications. Ultrasound offers guidance to the physician for identification of the needle target, but accurate interpretation and localization remain challenges...
August 11, 2017: IEEE Transactions on Medical Imaging
https://www.readbyqxmd.com/read/28795472/does-ultrasound-guidance-add-accuracy-to-continuous-caudal-epidural-catheter-placements-in-neonates-and-infants
#9
Vrushali C Ponde, Vinit V Bedekar, Ankit P Desai, Kiran A Puranik
BACKGROUND: Caudo-lumbar and caudo-thoracic epidural anesthesia is an established technique that carries a low risk of dural puncture or spinal cord trauma in infants. Traditionally catheter advancement is based on external measurements. However, malpositioning of catheters are known to occur. We hypothesized that caudal-epidural catheters inserted under real-time ultrasound guidance may be more accurate than the accuracy of the measurements traditionally used for their placement. METHODS: We studied 25 patients, aged 2 days to 5 months, posted for abdominal or thoracic surgery, receiving general anesthesia followed by caudo-epidural continuous block...
October 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28776686/contralateral-r1-and-r2-components-of-the-laryngeal-adductor-reflex-in-humans-under-general-anesthesia
#10
Catherine F Sinclair, Maria J Téllez, Oscar R Tapia, Sedat Ulkatan
OBJECTIVES: To demonstrate that under total intravenous general anesthesia (TIVA), the contralateral R1 (cRI) and contralateral R2 (cR2) components of the laryngeal adductor reflex (LAR) can be reliably elicited; to determine effects of topical anesthesia and inhalational anesthesia on the LAR; and to discuss how this technique may be utilized to continuously monitor the vagus nerve reflex arc. STUDY DESIGN: Case series. METHODS: Vocal fold mucosa was electrically stimulated via endotracheal tube surface-based electrodes to elicit a LAR...
August 4, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28763433/injury-and-liability-associated-with-spine-surgery
#11
Rachel Kutteruf, Deva Wells, Linda Stephens, Karen L Posner, Lorri A Lee, Karen B Domino
BACKGROUND: Although spine surgery is associated with significant morbidity, the anesthesia liability profile for spine surgery is not known. We examined claims for spine procedures in the Anesthesia Closed Claims Project database to evaluate patterns of injury and liability. MATERIALS AND METHODS: A retrospective cohort study was performed. Inclusion criteria were anesthesia claims provided for surgical procedures in 2000 to 2014. We compared mechanisms of injury for cervical spine to thoracic or lumbar spine procedures using χ and the Fisher exact test...
July 31, 2017: Journal of Neurosurgical Anesthesiology
https://www.readbyqxmd.com/read/28727707/continuing-anti-thrombotic-medication-during-low-to-intermediate-risk-spinal-procedures-a-retrospective-evaluation
#12
Noud van Helmond, Wesley Day, Kenneth B Chapman
BACKGROUND: The current American Society of Regional Anesthesia (ASRA) guidelines recommend discontinuing anti-thrombotic therapy prior to any interventional spine procedures to decrease the incidence of bleeding complications. However, discontinuing anti-thrombotics may pose considerable danger in terms of cerebrovascular and cardiovascular events. Recent evidence suggests that some spinal interventions may still be performed safely with anti-thrombotics on board and some practitioners thus elect to continue certain anti-thrombotics for these procedures...
July 2017: Pain Physician
https://www.readbyqxmd.com/read/28716031/a-rare-case-of-intradural-and-extramedullary-epidermoid-cyst-after-repetitive-epidural-anesthesia-case-report-and-review-of-the-literature
#13
Haruki Funao, Norihiro Isogai, Kenshi Daimon, Yuichiro Mima, Hitoshi Sugiura, Takahiro Koyanagi, Masaya Nakamura, Morio Matsumoto, Ken Ishii
BACKGROUND: Spinal epidermoid cysts are benign tumors, which are rarely seen as an intradural extramedullary spinal cord tumor in the conus medullaris region. Acquired spinal epidermoid cysts are mostly caused by iatrogenic procedures, such as lumbar puncture, and the majority of acquired spinal epidermoid cysts have been reported below the L1 level, because lumbar puncture is usually performed around the iliac crest. Here, we report an extremely rare case of an epidermoid cyst that occurred as an intradural and extramedullary spinal cord tumor attached to the conus medullaris after repetitive epidural anesthesia...
July 17, 2017: World Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28696044/practice-patterns-of-palliative-radiation-therapy-in-pediatric-oncology-patients-in-an-international-pediatric-research-consortium
#14
Avani Dholakia Rao, Qinyu Chen, Ralph P Ermoian, Sara R Alcorn, Maria Luisa S Figueiredo, Michael J Chen, Karin Dieckmann, Shannon M MacDonald, Matthew M Ladra, Daria Kobyzeva, Alexey V Nechesnyuk, Kristina Nilsson, Eric C Ford, Brian A Winey, Rosangela C Villar, Stephanie A Terezakis
BACKGROUND/OBJECTIVES: The practice of palliative radiation therapy (RT) is based on extrapolation from adult literature. We evaluated patterns of pediatric palliative RT to describe regimens used to identify opportunity for future pediatric-specific clinical trials. DESIGN/METHODS: Six international institutions with pediatric expertise completed a 122-item survey evaluating patterns of palliative RT for patients ≤21 years old from 2010 to 2015. Two institutions use proton RT...
November 2017: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/28683067/early-postnatal-exposure-to-isoflurane-causes-cognitive-deficits-and-disrupts-development-of-newborn-hippocampal-neurons-via-activation-of-the-mtor-pathway
#15
Eunchai Kang, Danye Jiang, Yun Kyoung Ryu, Sanghee Lim, Minhye Kwak, Christy D Gray, Michael Xu, Jun H Choi, Sue Junn, Jieun Kim, Jing Xu, Michele Schaefer, Roger A Johns, Hongjun Song, Guo-Li Ming, C David Mintz
Clinical and preclinical studies indicate that early postnatal exposure to anesthetics can lead to lasting deficits in learning and other cognitive processes. The mechanism underlying this phenomenon has not been clarified and there is no treatment currently available. Recent evidence suggests that anesthetics might cause persistent deficits in cognitive function by disrupting key events in brain development. The hippocampus, a brain region that is critical for learning and memory, contains a large number of neurons that develop in the early postnatal period, which are thus vulnerable to perturbation by anesthetic exposure...
July 2017: PLoS Biology
https://www.readbyqxmd.com/read/28681191/low-back-pain-due-to-middle-cluneal-nerve-entrapment-neuropathy
#16
Kyongsong Kim, Toyohiko Isu, Juntaro Matsumoto, Kazuyoshi Yamazaki, Masanori Isobe
PURPOSE: The etiology of low back pain (LBP) is complicated and the diagnosis can be difficult. Superior cluneal nerve entrapment neuropathy (SCN-EN) is a known cause of LBP, although the middle cluneal nerve (MCN) can be implicated in the elicitation of LBP. METHODS: A 76-year-old woman with a 4-year history of severe LBP was admitted to our department in a wheelchair. She complained of bilateral LBP that was exacerbated by lumbar movement. Her pain was severe on the right side and she also suffered right leg pain and numbness...
July 5, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28680780/immediate-remote-cerebellar-hemorrhage-and-seizure-following-revision-lumbosacral-fusion
#17
Alvin Y Chan, Jeffrey P Mullin, Edward Benzel, William Bingaman
Cerebellar hemorrhage (CH) is a rare but devastating complication following spine surgery. It is associated with a compromise to dura integrity and typically has a delayed post-operative onset. Here, we describe a patient who suffered a CH that presented with a generalized tonic-clonic (GTC) seizure immediately after a revision lumbar fusion. The patient did not regain consciousness from anesthesia prior to the hemorrhage. There are no reports indicating that CHs can occur abruptly following a spine surgery...
May 30, 2017: Curēus
https://www.readbyqxmd.com/read/28663633/comparing-the-efficacy-of-caudal-with-intravenous-dexamethasone-in-the-management-of-pain-following-lumbosacral-spine-surgeries-a-randomized-double-blinded-controlled-study
#18
Sandhya Kalappa, Raghavendra Biligiri Sridhar, Saraswathi Nagappa
BACKGROUND: The challenge in providing analgesia for spine surgeries is to provide extended postoperative pain relief and simultaneously allow early neurological assessment and mobilization. Our study aimed to evaluate the analgesic efficacy of intravenous versus caudal dexamethasone in lumbosacral spine surgeries. MATERIALS AND METHODS: In this prospective double-blind study, a total of 96 patients undergoing lumbosacral spine surgery were randomized into three groups to receive 25 ml of preemptive caudal epidural injection of either injection ropivacaine 0...
April 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28663613/hemodynamic-responses-at-intubation-change-of-position-and-skin-incision-a-comparison-of-multimodal-analgesia-with-conventional-analgesic-regime
#19
Keelara Shivalingaiah Savitha, Radhika Dhanpal, M S Vikram
BACKGROUND: Lumbar spine surgery is associated with hemodynamic variations at intubation, change of position, and skin incision. A balanced anesthesia with multimodal analgesia (MMA) is necessary to attenuate these changes. AIM: To assess the relative effectiveness of preemptive MMA compared with the conventional analgesic regime in suppressing the hemodynamic response to endotracheal intubation, prone positioning, and skin incision. SETTINGS AND DESIGN: A randomized, prospective study involving 42 patients belonging to the American Society of Anesthesiologists Physical Status 1 and II scheduled to undergo elective lumbar spine surgery were allocated into two groups of 21 each...
April 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28658163/effects-of-preconditioning-of-electro-acupuncture-on-postoperative-cognitive-dysfunction-in-elderly-a-prospective-randomized-controlled-trial
#20
RANDOMIZED CONTROLLED TRIAL
Qi Zhang, Ya-Nan Li, Yang-Yang Guo, Chun-Ping Yin, Fang Gao, Xi Xin, Shu-Ping Huo, Xiu-Li Wang, Qiu-Jun Wang
Electro-acupuncture is a burgeoning treatment using the needle inserting into the body acupoints and the low-frequency pulse current being electrified by an electric acupuncture machine. This study was designed to evaluate the effects of preconditioning of electro-acupuncture on postoperative cognitive dysfunction in elderly.Ninety patients scheduled spine surgery were randomly assigned into 2 groups using a random number table: control group (group C) and electro-acupuncture group (group EA). In group EA, electro-acupuncture was applied on Baihui, Dazhui, and Zusanli acupoints 30 minutes before anesthesia...
June 2017: Medicine (Baltimore)
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