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https://www.readbyqxmd.com/read/28927205/rare-neurosurgical-complications-of-epidural-injections-an-8-yr-single-institution-experience
#1
Gabriel A Smith, Jonathan Pace, Madeleine Strohl, Anand Kaul, Salim Hayek, Jonathan P Miller
BACKGROUND: Neurosurgical complications from epidural injections have rarely been reported. OBJECTIVE: To define the spectrum of complications from these procedures in order to identify risk factors and strategies for prevention. METHODS: A prospectively maintained database of 14 247 neurosurgical admissions over 8 yr was screened to identify patients who had suffered procedural complications associated with 1182 cervical and 4617 lumbar interlaminar epidural injection procedures performed at a single institution...
April 1, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/28913385/closed-internal-degloving-of-the-flank
#2
Lindsay F Remy, Jacob Azurdia, Ashraf Fansa, Nabil A Ebraheim
Originally described in 1853 by Dr. Morel-Lavellee, closed internal degloving injuries represent an important, although uncommon, source of morbidity in trauma patients. These injuries are typically the result of a shearing or crushing force that traumatically separates the skin and subcutaneous tissue from the underlying fat. This results in disruption of perforating blood vessels and lymphatics, leading to hematoma/seroma formation. We describe two cases in which industrial crush injuries resulted in lumbar transverse process fracture...
July 2017: Archives of Bone and Joint Surgery
https://www.readbyqxmd.com/read/28884560/retroperitoneal-hematoma-after-minimally-invasive-lumbar-discectomy-is-the-percutaneous-endoscopic-approach-really-safe
#3
Giorgio Gioffre', Antonio Impusino, Leonello Tacconi
No abstract text is available yet for this article.
September 7, 2017: Journal of Neurosurgical Sciences
https://www.readbyqxmd.com/read/28876572/haemoperitoneum-secondary-to-snake-bite
#4
S Rahim
BACKGROUND: Literature supports that very rarely the venom of "Hemotoxic Snake" (Russell's Vipers) affect haemostasis by secreting thrombin-like enzyme which promotes formation of unstable clots. Such clots could lead to fibrin deposition in micro circulation that in turn consume platelets and coagulation factors (consumption coagulopathy). Clinical presentation is mainly spontaneous bleeding and coagulopathy. In this case the significant effects of altered coagulation were observed in retropetitoneum and the patient presented in casuality as acute abdomen...
September 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28826919/surgical-treatment-for-spinal-dural-arteriovenous-fistulas-outcome-complications-and-prognostic-factors
#5
Jakub Wojciechowski, Przemysław Kunert, Arkadiusz Nowak, Tomasz Dziedzic, Tomasz Czernicki, Katarzyna Wójtowicz, Kamil Leśniewski, Andrzej Marchel
BACKGROUND AND PURPOSE: Spinal dural arteriovenous fistulas (SDAVFs) are rare, acquired pathology and they inevitably lead to severe disability if untreated. The aim of this study is to present the outcome and complications, and to find factors that may affect the outcome after surgical treatment. METHODS: Seventeen consecutive patients (men - 14, women - 3, age: 41-79) were retrospectively analyzed. The patients presented with paraparesis (88%), bladder symptoms (71%) and/or sensory disturbances (65%)...
July 10, 2017: Neurologia i Neurochirurgia Polska
https://www.readbyqxmd.com/read/28818570/prevalence-and-risk-factors-of-deep-vein-thrombosis-in-patients-undergoing-lumbar-spine-surgery
#6
Koji Yamasaki, Masahiro Hoshino, Keita Omori, Hidetoshi Igarashi, Takashi Tsuruta, Hiroyuki Miyakata, Yasuhiro Nemoto, Hiromi Matsuzaki, Takanori Iriuchishima
BACKGROUND: Spinal surgery is classified as a moderate risk for DVT. The occurrence of DVT after various spinal surgical procedures was reviewed retrospectively, and the perioperative risk factors in the high-risk group were identified. In addition, the administration of the factor Xa inhibitor to DVT subjects with unstable thrombosis was evaluated to reveal its effectiveness in the prevention of PTE and postoperative complications. METHODS: This study included 588 subjects who underwent lumbar spine surgery...
August 14, 2017: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
https://www.readbyqxmd.com/read/28708040/anterior-lumbar-discectomy-and-fusion-for-acute-cauda-equina-syndrome-caused-by-recurrent-disc-prolapse-report-of-3-cases
#7
Kimberly-Anne Tan, Mathew D Sewell, Yma Markmann, Andrew J Clarke, Oliver M Stokes, Daniel Chan
There is a lack of information and consensus regarding the optimal treatment for recurrent disc herniation previously treated by posterior discectomy, and no reports have described an anterior approach for recurrent disc herniation causing cauda equina syndrome (CES). Revision posterior decompression, irrespective of the presence of CES, has been reported to be associated with significantly higher rates of dural tears, hematomas, and iatrogenic nerve root damage. The authors describe treatment and outcomes in 3 consecutive cases of patients who underwent anterior lumbar discectomy and fusion (ALDF) for CES caused by recurrent disc herniations that had been previously treated with posterior discectomy...
July 14, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28689621/intrathecal-hematoma-and-arachnoiditis-mimicking-bacterial-meningitis-after-an-epidural-blood-patch
#8
F Roy-Gash, N Engrand, E Lecarpentier, M P Bonnet
We present a case of arachnoiditis and an intrathecal hematoma after an epidural blood patch. A 24-year-old parturient underwent an epidural blood patch three days after an accidental dural puncture during epidural labor analgesia. Four days later, the patient developed severe lower back pain, bilateral leg pain, persistent headache and fever. Bacterial meningitis was initially suspected and antibiotics started. Lumbar magnetic resonance imaging was performed and showed an intrathecal hematoma, with no blood in the epidural space...
June 1, 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/28623115/association-of-cerebral-venous-thrombosis-and-intracranial-hypotension-review-of-3-cases
#9
Leen Sinnaeve, Ludo Vanopdenbosch, Koen Paemeleire
Cerebral venous thrombosis is a rare complication of intracranial hypotension. We describe 3 cases in which this phenomenon occurred, as a result of a lumbar puncture or due to a spontaneous cerebrospinal fluid leak. We emphasize the importance of early detection of the intracranial hypotension syndrome, the most common clinical manifestation being orthostatic headache. It is not an innocent condition as it is associated with other potential complications such as subdural hygroma/hematoma, cranial nerve palsies, cerebellar tonsillar descent, and even brainstem manifestations...
June 13, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28614233/discordant-lumbar-epidural-hematoma-after-caudal-steroid-injection-a-case-report-care-compliant
#10
Jung Ju Choi, Young Jin Chang, Wol Seon Jung, Kyung Cheon Lee, Ju Ho Kim, Youn Yi Jo
RATIONALE: Caudal epidural injection is one of the conventional treatments of chronic back pain. Even though spinal epidural hematoma after caudal epidural injection is rare but it can cause serious neurologic complication. PATIENT CONCERNS: An 83-year-old woman taking cilostazol received caudal epidural steroid injection because of her chronic back pain. Six hours later, she experienced an acute hip pain which worsened with time. DIAGNOSIS: Magnetic resonance image showed acute cord compression due to a spinal epidural hematoma at L2-S1 level with concomitant central canal compromise at L2/3, L3/4 level...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28597302/the-impact-of-hypertension-on-the-occurrence-of-postoperative-spinal-epidural-hematoma-following-single-level-microscopic-posterior-lumbar-decompression-surgery-in-a-single-institute
#11
Yasushi Fujiwara, Hideki Manabe, Bunichiro Izumi, Takahiro Harada, Kazuyoshi Nakanishi, Nobuhiro Tanaka, Nobuo Adachi
PURPOSE: Postoperative spinal epidural hematoma (PSEH) is one of the most hazardous complications after spine surgery. A recent study has reported that a ≥50 mmHg increase in systolic blood pressure after extubation was a significant risk factor for symptomatic PSEH. In this paper, the impact of hypertension on PSEH occurrence was investigated. METHODS: Among a total of 2468 patients who underwent single level microscopic posterior decompression surgery for lumbar spinal stenosis in a single institute, 15 (0...
June 9, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28574329/spinal-epidural-hematomas-personal-experience-and-literature-review-of-more-than-1000-cases
#12
REVIEW
Maurizio Domenicucci, Cristina Mancarella, Giorgio Santoro, Demo Eugenio Dugoni, Alessandro Ramieri, Maria Felice Arezzo, Paolo Missori
OBJECTIVE The goal of this study was to identify factors that contribute to the formation of acute spinal epidural hematoma (SEH) by correlating etiology, age, site, clinical status, and treatment with immediate results and long-term outcomes. METHODS The authors reviewed their series of 15 patients who had been treated for SEH between 1996 and 2012. In addition, the authors reviewed the relevant international literature from 1869 (when SEH was first described) to 2012, collecting a total of 1010 cases. Statistical analysis was performed in 959 (95%) cases that were considered valid for assessing the incidence of age, sex, site, and clinical status at admission, correlating each of these parameters with the treatment results...
August 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28567220/should-we-check-the-routine-postoperative-mri-for-hematoma-in-spinal-decompression-surgery
#13
Hun-Kyu Shin, Hwa-Jae Jeong, Eugene Kim, Jai Hyung Park, Se-Jin Park, Yongun Cho
BACKGROUND: A postoperative magnetic resonance imaging (MRI) is performed as a routine to assess decompression of the spinal cord as well as to evaluate postoperative complications. The purpose of this study is to analyze the efficacy of postoperative MRI for hematoma in spinal decompression surgery. METHODS: Between January 1, 2008 and January 31, 2015, 185 patients who underwent postoperative MRI after spinal decompression surgery were included in this study. We checked the history of the use of an anticoagulant or antiplatelet agent, withdrawal period, blood platelet count, and prothrombin time (international normalized ratio [INR])...
June 2017: Clinics in Orthopedic Surgery
https://www.readbyqxmd.com/read/28560607/femoral-nerve-and-lumbar-plexus-injury-after-minimally-invasive-lateral-retroperitoneal-transpsoas-approach-electrodiagnostic-prognostic-indicators-and-a-roadmap-to-recovery
#14
Naomi A Abel, Jacob Januszewski, Andrew C Vivas, Juan S Uribe
Injury to the lumbosacral (LS) plexus is a well-described complication after lateral retroperitoneal transpsoas approaches to the spine. The prognosis for functional recovery after lumbosacral plexopathy or femoral/obturator neuropathy is unclear. We designed a retrospective case-control study with patients undergoing one-level lateral retroperitoneal transpsoas lumbar interbody fusion (LLIF) between January 2011 and June 2016 to correlate electrodiagnostic assessments (EDX) to physiologic concepts of nerve injury and reinnervation, and attempt to build a timeline for patient evaluation and recovery...
May 30, 2017: Neurosurgical Review
https://www.readbyqxmd.com/read/28547573/results-of-lumbar-spondylodeses-using-different-bone-grafting-materials-after-transforaminal-lumbar-interbody-fusion-tlif
#15
Nicolas Heinz vonderHoeh, Anna Voelker, Christoph-Eckhard Heyde
PURPOSE: Can a mixture of hydroxyapatite (HA) and autologous bone from decompression sites produce similar results when used for transforaminal lumbar interbody fusion (TLIF)? In the current literature, autologous iliac crest bone grafts (ICBGs) have been reported the gold standard for this procedure. Indeed, to date, no clinical data have confirmed that a mixture of equal volumes of HA and local autologous bone produce similar results in term of fusion as the same volume of autologous ICBG alone...
May 25, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28540132/more-risks-and-complications-for-elective-spine-surgery-in-morbidly-obese-patients
#16
REVIEW
Nancy E Epstein
BACKGROUND: The vast majority of studies emphasize the greater morbidity/mortality for elective spine surgery in morbidly obese patients. METHODS: This review focuses on the increased morbidity/mortality of performing elective spinal operations in morbidly obese patients. There are two definitions of morbid obesity; a body mass index (BMI) of equal to or greater than 35 plus two major comorbid factors (e.g., hypertension, diabetes, etc.) or a BMI (morbidly obese III) of =≥40 kg/m(2)...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28540126/neurological-complications-of-lumbar-and-cervical-dural-punctures-with-a-focus-on-epidural-injections
#17
Nancy E Epstein
BACKGROUND: Various types of lumbar dural punctures may contribute to neurological injury. The etiologies of dural injury include; inadvertent dural punctures due to epidurals placed for labor anesthesia, epidural steroid injections (ESI/transforaminal TESI; approximately 9 million ESI performed in the US per year), deliberate placement of intradural pain devices, and spontaneous cerebrospinal fluid (CSF) fistulas. Resulting neurological complications may include; spinal headaches/intracranial hypotension, subdural hematomas, and 6(th) nerve cranial palsies...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28532963/fully-endoscopic-interlaminar-and-transforaminal-lumbar-discectomy-analysis-of-47-complications-encountered-in-a-series-of-835-patients
#18
Ali Güven Yörükoğlu, Burcu Göker, Alican Tahta, Mehmet Osman Akçakaya, Aydın Aydoseli, Pulat Akın Sabancı, Yavuz Aras, Görkem Alkır, Altay Sencer, Murat Imer, Nail Izgi, Ali Tuncay Canbolat
OBJECTIVE: To report perioperative complications in fully endoscopic lumbar discectomy (FELD). METHODS: From September 2010 to November 2016, 835 patients underwent FELD. In total, 865 disc levels were operated on. Of the 835 patients, the transforaminal (TF) approach was used in 174 patients, while 691 patients were operated on using the interlaminar (IL) approach. Surgical complications occurred in 47 patients, which were retrospectively analyzed. RESULTS: Neurological deficits occurred in six patients...
May 19, 2017: Neurocirugía
https://www.readbyqxmd.com/read/28532910/impact-of-elderly-age-on-complications-and-clinical-outcomes-following-anterior-lumbar-interbody-fusion-surgery
#19
Kevin Phan, Vignesh Ramachandran, Tommy Tran, Steven Phan, Prashanth J Rao, Ralph J Mobbs
BACKGROUND: Anterior lumbar interbody fusion (ALIF) is a surgical technique used to treat patients with a variety of lumbar pathologies. Identification of risk factors leading to complication following ALIF surgery may allow surgeons to better judge candidacy and optimize care for high-risk patients. METHODS: A retrospective analysis was conducted on a prospectively collected database of 137 patients who all underwent ALIF surgery by a single primary spine surgeon...
September 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28526462/-sudden-motor-and-sensorial-loss-due-to-retroperitoneal-hematoma-during-postoperative-periods-a-case-report
#20
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
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