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Spine anesthesia

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https://www.readbyqxmd.com/read/28339551/anticoagulant-and-antiplatelet-management-for-spinal-procedures-a-prospective-descriptive-study-and-interpretation-of-guidelines
#1
Bradly S Goodman, L McLean House, Sridhar Vallabhaneni, Srinivas Mallempati, Matthew R Willey, Matthew Thomas Smith
Setting.:  Epidural hematoma rarely complicates interventional spine procedures. While anticoagulant and antiplatelet drugs increase bleeding risk, cessation may precipitate serious thromboembolic events. The Spine Intervention Society (SIS) and American Society of Regional Anesthesia and Pain Medicine (ASRA) put forth guidelines that dissent with regard to management of hemostatically active agents during commonly performed spinal injections. Objective.:  To validate an antiplatelet/anticoagulant management table based on modifications of the SIS 2013 and ASRA 2015 guidelines...
October 6, 2016: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28321993/metatropic-dysplasia-a-skeletal-dysplasia-with-challenging-airway-and-other-anesthetic-concerns
#2
Mary C Theroux, Martha Lopez, Patricia J Olszewsky, Sabina DiCindio, Lynda Arai, Colleen Ditro, Michael B Bober, Olubukola Opeyemi Olla, Tetsu Uejima, David W West, William G Mackenzie
BACKGROUND: Metatropic dysplasia is a rare form of skeletal dysplasia requiring multiple anesthetics for surgical and imaging procedures, most of which are orthopedic procedures. We provide centralized care to patients with skeletal dysplasia at our tertiary care pediatric hospital, and we were able to collect the largest number of metatropic dysplasia patients reported to date. AIM: The aim of this retrospective study was to describe and characterize the anesthetic difficulties in this high-risk population...
March 21, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28320029/morphometric-changes-of-the-lumbar-intervertebral-foramen-after-percutaneous-endoscopic-foraminoplasty-under-local-anesthesia
#3
Tatsuhiko Henmi, Tomoya Terai, Akihiro Nagamachi, Koichi Sairyo
Background Percutaneous endoscopic diskectomy (PED) for the lumbar spine is a relatively new technique that is becoming more common due to its relatively less invasive nature. However, one possible serious complication is an exiting nerve injury when the cannula of the endoscope is inserted into the neural canal through the intervertebral foramen. A technique to enlarge the intervertebral foramen, called foraminoplasty, was recently established to insert the cannula safely into an appropriate position in the neural canal...
March 20, 2017: Journal of Neurological Surgery. Part A, Central European Neurosurgery
https://www.readbyqxmd.com/read/28315990/model-based-registration-of-preprocedure-mr-and-intraprocedure-us-of-the-lumbar-spine
#4
Delaram Behnami, Alireza Sedghi, Emran Mohammad Abu Anas, Abtin Rasoulian, Alexander Seitel, Victoria Lessoway, Tamas Ungi, David Yen, Jill Osborn, Parvin Mousavi, Robert Rohling, Purang Abolmaesumi
PURPOSE: Epidural and spinal needle insertions, as well as facet joint denervation and injections are widely performed procedures on the lumbar spine for delivering anesthesia and analgesia. Ultrasound (US)-based approaches have gained popularity for accurate needle placement, as they use a non-ionizing, inexpensive and accessible modality for guiding these procedures. However, due to the inherent difficulties in interpreting spinal US, they yet to become the clinical standard-of-care...
March 18, 2017: International Journal of Computer Assisted Radiology and Surgery
https://www.readbyqxmd.com/read/28301408/k-cl-cotransporter-2-mediated-cl-extrusion-determines-developmental-stage-dependent-impact-of-propofol-anesthesia-on-dendritic-spines
#5
Martin Puskarjov, Hubert Fiumelli, Adrian Briner, Timea Bodogan, Kornel Demeter, Claudia-Marvine Lacoh, Martina Mavrovic, Peter Blaesse, Kai Kaila, Laszlo Vutskits
BACKGROUND: General anesthetics potentiating γ-aminobutyric acid (GABA)-mediated signaling are known to induce a persistent decrement in excitatory synapse number in the cerebral cortex when applied during early postnatal development, while an opposite action is produced at later stages. Here, the authors test the hypothesis that the effect of general anesthetics on synaptogenesis depends upon the efficacy of GABA receptor type A (GABAA)-mediated inhibition controlled by the developmental up-regulation of the potassium-chloride (K-Cl) cotransporter 2 (KCC2)...
March 16, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28291143/the-role-of-multimodal-analgesia-in-spine-surgery
#6
Mark F Kurd, Tyler Kreitz, Gregory Schroeder, Alexander R Vaccaro
Optimal postoperative pain control allows for faster recovery, reduced complications, and improved patient satisfaction. Historically, pain management after spine surgery relied heavily on opioid medications. Multimodal regimens were developed to reduce opioid consumption and associated adverse effects. Multimodal approaches used in orthopaedic surgery of the lower extremity, especially joint arthroplasty, have been well described and studies have shown reduced opioid consumption, improved pain and function, and decreased length of stay...
April 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/28263243/use-of-3-dimensional-printing-to-create-patient-specific-thoracic-spine-models-as-task-trainers
#7
Jelliffe Jeganathan, Yanick Baribeau, Jeffrey Bortman, Feroze Mahmood, Marc Shnider, Muneeb Ahmed, Azad Mashari, Rabia Amir, Yannis Amador, Robina Matyal
BACKGROUND AND OBJECTIVES: Thoracic epidural anesthesia is a technically challenging procedure with a high failure rate of 24% to 32% nationwide. Residents in anesthesiology have limited opportunities to practice this technique adequately, and there are no training tools available for this purpose. Our objective was to build a low-cost patient-specific thoracic epidural training model. METHODS: We obtained thoracic computed tomography scan data from patients with normal and kyphotic spine...
March 3, 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28248542/two-photon-laser-scanning-microscopy-for-single-and-repetitive-imaging-of-dorsal-and-lateral-spinal-white-matter-in-vivo
#8
F Nadrigny, K Le Meur, H Steffens, E D Schomburg, S Safavi-Abbasi, P Dibaj
We developed appropriate surgical procedures for single and repetitive multi-photon imaging of spinal cord in vivo. By intravenous anesthesia, artificial ventilation and laminectomy, acute experiments were performed in the dorsal and lateral white matter. By volatile anesthesia and minimal-invasive surgery, chronic repetitive imaging up to 8 months were performed in the dorsal column through the window between two adjacent spines. Transgenic mouse technology enabled simultaneous imaging of labeled axons, astrocytes and microglia...
February 28, 2017: Physiological Research
https://www.readbyqxmd.com/read/28243379/preemptive-caudal-ropivacaine-an-effective-analgesic-during-degenerative-lumbar-spine-surgery
#9
Shashwat Kumar, Jagannath Manickam Palaniappan, Anantha Kishan
STUDY DESIGN: This was a prospective, randomized, controlled trial comprising 60 patients undergoing lumbosacral spine (noninstrumentation/nonfusion) surgery. PURPOSE: The purpose of this study was to evaluate the efficacy of 0.2% ropivacaine (20 mL) administered alone as a single, preoperative, caudal epidural block injection versus that of intravenous analgesics in providing effective postoperative analgesia to patients undergoing lumbosacral spine surgery. OVERVIEW OF LITERATURE: Various studies have shown the effectiveness of a caudal epidural injection (bupivacaine or ropivacaine) in providing postoperative analgesia in combination with steroids or other analgesics...
February 2017: Asian Spine Journal
https://www.readbyqxmd.com/read/28240718/a-peripherally-inserted-central-catheter-line-inserted-the-day-before-surgery-decreases-the-time-from-induction-to-incision-for-spinal-deformity-surgery-and-safely-provides-central-venous-access-during-surgery-a-pilot-study
#10
Anne E Stuedemann, Richard M Schwend, Valorie K Thomas, Julia M Leamon, Tammy S Lightner
Pediatric patients undergoing surgery for spinal deformity may benefit from central venous access to provide intraoperative monitoring and fluid resuscitation. For pediatric surgical patients requiring central access, we hypothesized that placing a peripherally inserted central catheter (PICC) line preoperatively should decrease time from induction of anesthesia to incision and result in improved patient safety and decreased operating room charges. This was a retrospective, nonrandomized, and case comparison study...
February 24, 2017: Journal of Pediatric Orthopedics. Part B
https://www.readbyqxmd.com/read/28236012/application-of-a-computer-assisted-flexible-endoscope-system-for-transoral-surgery-of-the-hypopharynx-and-upper-esophagus
#11
Daniel T Friedrich, M O Scheithauer, J Greve, N Rotter, J Doescher, T K Hoffmann, P J Schuler
Zenker's diverticulum is a common pathology in the transition zone of the posterior hypopharynx and esophagus. Surgical treatment is routinely performed by ENT and general surgeons. Besides the traditional open transcervical diverticulectomy, the introduction of transoral rigid treatment led to a paradigm change and is now the preferred treatment option for patients who are fit for general anesthesia. The implementation of interventional flexible endoscopy has opened another new micro-invasive approach for patients with high morbidity...
February 24, 2017: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/28217398/comparison-of-intubation-success-and-glottic-visualization-using-king-vision-and-c-mac-videolaryngoscopes-in-patients-with-cervical-spine-injuries-with-cervical-immobilization-a-randomized-clinical-trial
#12
Dhanyasi Shravanalakshmi, Prasanna U Bidkar, K Narmadalakshmi, Suman Lata, Sandeep K Mishra, S Adinarayanan
BACKGROUND: Glottic visualization can be difficult with cervical immobilization in patients with cervical spine injury. Indirect laryngoscopes may provide better glottic visualization in these groups of patients. Hence, we compared King Vision videolaryngoscope, C-MAC videolaryngoscope for endotracheal intubation in patients with proven/suspected cervical spine injury. METHODS: After standard induction of anesthesia, 135 patients were randomized into three groups: group C (conventional C-MAC videolaryngoscope), group K (King Vision videolaryngoscope), and group D (D blade C-MAC videolaryngoscope)...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28186470/image-guidance-based-on-mri-for-spinal-interstitial-laser-thermotherapy-technical-aspects-and-accuracy
#13
Claudio E Tatsui, Clarissa N G Nascimento, Dima Suki, Behrang Amini, Jing Li, Amol J Ghia, Jonathan G Thomas, R Jason Stafford, Laurence D Rhines, Juan P Cata, Ashok J Kumar, Ganesh Rao
OBJECTIVE Image guidance for spinal procedures is based on 3D-fluoroscopy or CT, which provide poor visualization of soft tissues, including the spinal cord. To overcome this limitation, the authors developed a method to register intraoperative MRI (iMRI) of the spine into a neuronavigation system, allowing excellent visualization of the spinal cord. This novel technique improved the accuracy in the deployment of laser interstitial thermal therapy probes for the treatment of metastatic spinal cord compression...
February 10, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28183582/use-of-ultrasound-for-spinal-anesthesia-in-a-super-morbidly-obese-patient
#14
Yasuhiro Morimoto, Yoichiro Ihara, Yoko Shimamoto, Hiroko Shiramoto
We report the application of ultrasound prescans for spinal anesthesia to morbid obesity patient. A 38-year-old woman with a body mass index (BMI) of 50 (weight: 110 kg; height: 148 cm) was scheduled to undergo pilonidal cyst resection at the bottom of the tailbone. Spinal anesthesia was selected for the procedure, because the patient's position during the surgery was prone and the patient had morbid obesity. To determine the spinal needle insertion point and the distance between the skin and dura, we planned to use ultrasound...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28156208/image-guided-intrathecal-baclofen-pump-catheter-implantation-a-technical-note-and-case-series
#15
Shenandoah Robinson, Faith C Robertson, Hormuzdiyar H Dasenbrock, Cormac P O'Brien, Charles Berde, Horacio Padua
OBJECTIVE Medically refractory spasticity and dystonia are often alleviated with intrathecal baclofen (ITB) administration through an indwelling catheter inserted in the lumbar spine. In patients with cerebral palsy, however, there is a high incidence of concomitant neuromuscular scoliosis. ITB placement may be technically challenging in those who have severe spinal deformity or who have undergone prior instrumented thoracolumbar fusion. Although prior reports have described drilling through the lumbar fusion mass with a high-speed bur, as well as IT catheter implantation at the foramen magnum or cervical spine, these approaches have notable limitations...
February 3, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28141603/prevention-and-management-of-postoperative-delirium-in-elderly-patients-following-elective-spinal-surgery
#16
Alireza K Nazemi, Anirudh K Gowd, Jonathan J Carmouche, Stephen L Kates, Todd J Albert, Caleb J Behrend
STUDY DESIGN: This study is a systematic review. OBJECTIVE: Propose an evidence-based algorithm for prevention, diagnosis, and management of postoperative delirium in geriatric patients undergoing elective spine surgery. SUMMARY OF BACKGROUND DATA: Delirium is associated with longer stays after elective surgery, increased risk of readmission, and $6.9 billion annually in medical costs. Early diagnosis and treatment of delirium can reduce length of stay (LOS), in-hospital morbidity, and health care costs...
April 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28089837/direct-midline-posterior-corpectomy-and-fusion-of-a-lumbar-burst-fracture-with-retrospondyloptosis
#17
Arthur Carminucci, Rachid Assina, R Nick Hernandez, Ira M Goldstein
BACKGROUND: Traumatic burst fractures of the lumbar spine can result in significant neurologic injury and mechanical instability. The ideal surgical approach for the treatment of unstable lumbar spine burst fractures remains debatable. CASE DESCRIPTION: A 37-year-old man presented with severe neurologic injury including loss of motor function below the level of the iliopsoas muscles bilaterally, saddle anesthesia, and absent rectal tone, after a fall from 18.28 m (60 ft)...
March 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28080914/tricaine-methanesulfonate-ms-222-sedation-and-anesthesia-in-the-purple-spined-sea-urchin-arbacia-punctulata
#18
Jeffrey R Applegate, Daniel S Dombrowski, Larry Shane Christian, Meredith P Bayer, Craig A Harms, Gregory A Lewbart
The purple-spined sea urchin ( Arbacia punctulata ) is commonly found in shallow waters of the western Atlantic Ocean from the New England area of the United States to the Caribbean. Sea urchins play a major role in ocean ecology, echinoculture, and biomedical research. Additionally, sea urchins are commonly displayed in public aquaria. Baseline parameters were developed in unanesthetized urchins for righting reflex (time to regain oral recumbency) and spine response time to tactile stimulus. Tricaine methanesulfonate (MS-222) was used to sedate and anesthetize purple-spined sea urchins and assess sedation and anesthetic parameters, including adhesion to and release from a vertical surface, times to loss of response to tactile stimulus and recovery of righting reflex, and qualitative observations of induction of spawning and position of spines and pseudopodia...
December 2016: Journal of Zoo and Wildlife Medicine: Official Publication of the American Association of Zoo Veterinarians
https://www.readbyqxmd.com/read/28045856/a-multiparametric-alarm-criterion-for-motor-evoked-potential-monitoring-during-spine-deformity-surgery
#19
Martín J Segura, María E Talarico, Mariano A Noel
PURPOSE: This is a pilot study to compare changes in the amplitude, area below the curve, number of phases, duration, and latency of the intraoperative transcranial motor evoked potentials (TcMEP) for early detection of impending spinal cord injury. An empirical ratio calculated by a combination of the above-mentioned parameters was also assessed. METHODS: Intraoperative TcMEP recordings from five patients presenting with neuromuscular kyphoscoliosis, idiopathic scoliosis, achondroplasia and lumbar kyphosis, congenital kyphosis, and achondroplasia with cervical instability were reviewed...
January 2017: Journal of Clinical Neurophysiology: Official Publication of the American Electroencephalographic Society
https://www.readbyqxmd.com/read/28045758/a-virtual-reality-simulation-model-of-spinal-ultrasound-role-in-teaching-spinal-sonoanatomy
#20
Reva Ramlogan, Ahtsham U Niazi, Rongyu Jin, James Johnson, Vincent W Chan, Anahi Perlas
BACKGROUND AND OBJECTIVES: Ultrasound assessment of the lumbar spine improves the success of spinal and epidural anesthesia, especially for patients with underlying difficult anatomy. To assist with the teaching and learning of ultrasound-guided neuraxial anesthesia, we have created an online interactive educational model (http://www.usra.ca/vspine.php and http://pie.med.utoronto.ca/vspine). The aim of the current study was to determine whether the virtual spine model improved the knowledge of neuraxial anatomy and sonoanatomy...
March 2017: Regional Anesthesia and Pain Medicine
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