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https://www.readbyqxmd.com/read/28806217/the-effect-of-ondansetron-on-acute-opioid-tolerance-in-patients-receiving-intrathecal-opioids-prior-to-cesarean-delivery
#1
Kevin C Greer, Abdullah S Terkawi, Siny Tsang, Priyanka Singla, Marcel E Durieux, Mohamed Tiouririne
BACKGROUND: Multiple animal studies suggest that ondansetron ameliorates opioid-induced hyperalgesia and tolerance. In this study, we aimed to determine if the administration of ondansetron prior to spinal anesthesia would have an effect on intrathecal opioid-induced acute opioid tolerance, postoperative pain, and analgesic requirements in patients undergoing cesarean delivery with spinal anesthesia. METHODS: Eighty-six patients undergoing elective cesarean delivery were recruited and randomly allocated to receive either 8 mg intravenous ondansetron (n = 44) or placebo (n = 42) in a prospective, double-blind design...
August 11, 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28805781/-surgical-treatment-of-hip-subluxation-and-luxation-in-children-with-spinal-hernia-consequences
#2
S V Ivanov, A G Baindurashvili, V M Kenis
AIM: To determine surgical tactics for hip subluxation and luxation in children with spinal hernia consequences. MATERIAL AND METHODS: The study included 134 patients with hip subluxation and luxation with consequences of cerebrospinal hernias who were examined at the Turner Research Institute for Children's Orthopedics in 2006-2016. The main group consisted of 69 patients who received surgical treatment with hip joint stabilization. The control group included 65 children without surgery...
2017: Khirurgiia
https://www.readbyqxmd.com/read/28803177/clusterin-a-new-cerebrospinal-fluid-biomarker-in-severe-subarachnoid-haemorrhage-a-pilot-study
#3
Norbert Wąsik, Bartosz Sokół, Marcin Hołysz, Witold Mańko, Robert Juszkat, Piotr Paweł Jagodziński, Roman Jankowski
BACKGROUND: Inflammation following subarachnoid haemorrhage (SAH) employs numerous mediators with biomarker properties. Preliminary studies indicated that clusterin, a multifunctional chaperon protein, was a potential biomarker in SAH. We aim to clarify the status of clusterin in SAH. METHOD: 47 CSF samples were collected on post-SAH days 0-3, 5-7, and 10-14 from 27 patients with severe SAH. Control CSF was collected from 25 age- and sex- matched healthy patients undergoing spinal anaesthesia for minor surgery...
August 9, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28803172/influence-of-obesity-on-complications-clinical-outcome-and-subsidence-following-anterior-lumbar-interbody-fusion-alif-prospective-observational-study
#4
Kevin Phan, Priya Rogers, Prashanth J Rao, Ralph J Mobbs
BACKGROUND: The complications associated with obesity have been well described for posterior lumbar spinal surgery. However, the influence of obesity on anterior lumbar interbody fusion (ALIF) is not well established. We aimed to compare complication risks, functional outcomes and subsidence rates in normal, overweight and obese patients who underwent ALIF. METHODS: 137 consecutive patients undergoing ALIF surgery from 2012-2014 were prospectively followed. Patients were categorized into 3 groups according to their body mass index (BMI)...
August 9, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28803171/open-versus-minimally-invasive-surgery-for-extraforaminal-lumbar-disk-herniation-a-systematic-review-and-meta-analysis
#5
REVIEW
Oluwaseun O Akinduro, Panagiotis Kerezoudis, Mohammed Ali Alvi, Jangwon Yoon, Jamachi Eluchie, Hasan M Murad, Zhen Wang, Selby G Chen, Mohamad Bydon
INTRODUCTION: Extraforaminal disk herniation (EDH) accounts for 3-11% of all disk herniations. Despite the heterogeneity of spinal procedures, there is a paucity of literature comparing the outcomes from different surgical approaches. METHODS: We performed a systematic review and meta-analysis of available literature on EDHs. We compared patients undergoing open surgery (OS) with those undergoing minimally invasive surgery (MIS) approaches, including tubular microscopic, percutaneous endoscopic, and micro-endoscopic...
August 9, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28799527/recent-advances-in-technique-and-clinical-outcomes-of-minimally-invasive-spine-surgery-in-adult-scoliosis
#6
REVIEW
Gang Liu, Sen Liu, Yu-Zhi Zuo, Qi-Yi Li, Zhi-Hong Wu, Nan Wu, Ke-Yi Yu, Gui-Xing Qiu
OBJECTIVE: Conventional open spinal surgery of adult scoliosis can be performed from anterior, posterior, or combined approach. Minimally invasive spine surgery (MISS) was developed for the purpose of reducing the undesirable effects and complications. This review aimed to make a brief summary of recent studies of the approach and clinical outcomes of MISS in adult scoliosis. DATA SOURCES: We conducted a systematic search from PubMed, Medline, EMBASE, and other literature databases to collect reports of surgical methods and clinical outcomes of MISS in treatment of adult scoliosis...
August 9, 2017: Chinese Medical Journal
https://www.readbyqxmd.com/read/28799195/sacral-nerve-stimulation-for-constipation-and-fecal-incontinence-in-children-long-term-outcomes-patient-benefit-and-parent-satisfaction
#7
P L Lu, I J N Koppen, D K Orsagh-Yentis, K Leonhart, E J Ambeba, K J Deans, P C Minneci, S Teich, K A Diefenbach, S A Alpert, M A Benninga, D Yacob, C Di Lorenzo
OBJECTIVE: To evaluate the long-term efficacy of sacral nerve stimulation (SNS) in children with constipation and describe patient benefit and parent satisfaction. METHODS: Using a prospective patient registry, we identified patients <21 years old with constipation treated with SNS for >2 years. We compared symptoms, medical treatment, PedsQL Gastrointestinal Symptom Scale (GSS), Fecal Incontinence Quality of Life Scale (FIQL), and Fecal Incontinence Severity Index (FISI) before SNS and at follow-up...
August 10, 2017: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
https://www.readbyqxmd.com/read/28798984/midlife-changes-of-health-related-quality-of-life-in-adolescent-idiopathic-scoliosis-patients-who-underwent-spinal-fusion-during-adolescence
#8
Tsutomu Akazawa, Toshiaki Kotani, Tsuyoshi Sakuma, Shohei Minami, Yoshiaki Torii, Sumihisa Orita, Kazuhide Inage, Kazuki Fujimoto, Yasuhiro Shiga, Gen Inoue, Masayuki Miyagi, Wataru Saito, Seiji Ohtori, Hisateru Niki
PURPOSE: Our previous study reported a good health-related quality of life (HRQOL) in adolescent idiopathic scoliosis (AIS) patients 21 years or more after surgery. The purpose of this study is to investigate midlife changes in HRQOL among AIS patients who passed further 5 years from the previous survey. METHODS: Subjects were 252 individuals who underwent spinal fusion for AIS between 1968 and 1988. The survey was administered twice-in 2009 and in 2014 using Scoliosis Research Society Patient Questionnaire (SRS-22)...
August 10, 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/28797980/can-fan-beam-ict-accurately-predict-indirect-decompression-in-miss-fusion-procedures
#9
Insa Janssen, Gernot Lang, Rodrigo Navarro-Ramirez, Ajit Jada, Connor Berlin, Aaron Hilis, Micaella Zubkov, Lena Gandevia, Roger Härtl
BACKGROUND: Recently, a novel mobile intraoperative fan-beam CT (iFBCT) was introduced, allowing for real time navigation and immediate intraoperative evaluation of neural decompression in spine surgery. This study sought to investigate whether intraoperatively assessed neural decompression during minimally invasive spine surgery (MISS) has a predictive value for clinical and radiographic outcome. METHODS: A retrospective study of patients undergoing iCT-guided extreme lateral interbody fusion (XLIF) or transforaminal lumbar interbody fusion (TLIF) was conducted...
August 7, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28797646/spinal-epidural-abscess-a-series-of-101-cases
#10
Martin Vakili, Nancy F Crum-Cianflone
BACKGROUND: Spinal epidural abscesses are uncommon but potentially devastating infections that often elude early diagnosis. An increasing incidence has been suggested; however, few contemporary data are available regarding risk factors and epidemiologic trends over time. METHODS: A retrospective study of spinal epidural abscesses from 2004 to 2014 at a large academic hospital was conducted. Cases were identified using ICD-9 code 324.1, and a review of medical and radiographic records was performed to confirm each case...
August 7, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28797584/long-term-outcomes-of-frozen-elephant-trunk-for-type-a-aortic-dissection-in-patients-with-marfan-syndrome
#11
Wei-Guo Ma, Wei Zhang, Jun-Ming Zhu, Bulat A Ziganshin, Ai-Hua Zhi, Jun Zheng, Yong-Min Liu, John A Elefteriades, Li-Zhong Sun
OBJECTIVE: The use of the frozen elephant trunk (FET) technique for repair of type A aortic dissection (TAAD) in Marfan syndrome (MFS) is controversial. We seek to evaluate the efficacy of FET and total arch replacement (TAR) for TAAD in patients with MFS. METHODS: The early and long-term outcomes were analyzed for 106 patients with MFS (mean age, 34.5 ± 9.7 years) undergoing FET + TAR for TAAD. RESULTS: Operative mortality was 6.6% (7 of 106)...
June 16, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28796647/cauda-equina-syndrome-due-to-vigorous-back-massage-with-spinal-manipulation-in-a-patient-with-pre-existing-lumbar-disc-herniation-a-case-report-and-literature-review
#12
Si-Dong Yang, Qian Chen, Wen-Yuan Ding
Cauda equina syndrome (CES) resulting from acute lumbar disc herniation due to spinal massage is extremely rare. We present a case of CES caused by the acute worsening of a lumbar disc herniation after a vigorous back massage that included spinal manipulation. After vigorous back massage with spinal manipulation performed by a massage therapist, a 38-yr-old male patient experienced CES with severe numbness in both lower limbs, inability to walk due to weakness of bilateral lower limbs, and incontinence of urine and feces...
August 7, 2017: American Journal of Physical Medicine & Rehabilitation
https://www.readbyqxmd.com/read/28796075/muscle-gap-approach-under-a-minimally-invasive-channel-technique-for-treating-long-segmental-lumbar-spinal-stenosis-a-retrospective-study
#13
Yang Bin, Wang De Cheng, Wang Zong Wei, Li Hui
This study aimed to compare the efficacy of muscle gap approach under a minimally invasive channel surgical technique with the traditional median approach.In the Orthopedics Department of Traditional Chinese and Western Medicine Hospital, Tongzhou District, Beijing, 68 cases of lumbar spinal canal stenosis underwent surgery using the muscle gap approach under a minimally invasive channel technique and a median approach between September 2013 and February 2016. Both approaches adopted lumbar spinal canal decompression, intervertebral disk removal, cage implantation, and pedicle screw fixation...
August 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28796049/tophaceous-gout-causing-lumbar-stenosis-a-case-report
#14
Huigen Lu, Jianming Sheng, Jiaping Dai, Xuqi Hu
RATIONALE: Gout in the spine is very rare. The clinical symptoms of the spinal gout are various and lack of specificity. The authors report a case of spinal gout causing lumbar stenosis. We never find such wide-invasive spinal gouty lesion in the published studies. PATIENT CONCERNS: A 68-year-old male had low back pain radiating to bilateral lower limbs, accompanying with intermittent claudication that lasted for 3 months and aggravated 5 days ago. DIAGNOSES: Spinal gout, lumbar stenosis...
August 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28795547/-multiple-vertebral-hemangiomas-treated-simultaneously-with-cyberknife%C3%A2-technology
#15
R Harkati, M Baré, A Gulyban, D Dechambre, P Berkovic, P A Coucke
Haemangioma are benign, vasoformative lesions of endothelial origin. A minority of patients with a vertebral location are symptomatic with neck or back pain. Neurological deficits due to spinal cord compression are rare and mostly observed at the thoracic and upper lumbar spine. Treatment is indicated in case of relevant symptomatology. Several invasive treatment modalities exist such as surgery and intralesional injections, but radiotherapy is the most common treatment for painful lesions. We report a case of a patient with symptomatic bifocal vertebral haemangioma (d9, l3) associated with dorsal and lumbar pain treated simultaneously using a cyberknife® vsi system, with a significant reduction of pain and a limited toxicity...
July 2017: Revue Médicale de Liège
https://www.readbyqxmd.com/read/28795472/does-ultrasound-guidance-add-accuracy-to-continuous-caudal-epidural-catheter-placements-in-neonates-and-infants
#16
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...
August 10, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28795286/diagnostic-and-therapeutic-strategies-for-patients-with-malignant-epidural-spinal-cord-compression
#17
REVIEW
Dilan A Patel, Jian L Campian
Malignant epidural spinal cord compression (MESCC) is an oncologic emergency with the potential for devastating consequences for patients if not promptly diagnosed and treated. MESCC is diagnosed by imaging. MRI is by far the most sensitive test, preferably with gadolinium. Once the diagnosis of MESCC is suspected, patients with neurologic deficits should receive prompt administration of dexamethasone with a 10-mg IV loading dose followed by 4 mg every 6 h. Quick taper is recommended once the definitive treatment is established...
August 10, 2017: Current Treatment Options in Oncology
https://www.readbyqxmd.com/read/28794836/comparing-epidural-surgical-anesthesia-and-spinal-anesthesia-following-epidural-labor-analgesia-for-intrapartum-cesarean-section-a-prospective-randomized-controlled-trial
#18
Hea-Jo Yoon, Sang-Hwan Do, Yeo Jin Yun
BACKGROUND: The conversion of epidural labor analgesia (ELA) to epidural surgical anesthesia (ESA) for intrapartum cesarean section (CS) often fails, resulting in intraoperative pain. Spinal anesthesia (SA) can provide a denser sensory block than ESA. The purpose of this prospective, non-blinded, parallel-arm, randomized trial was to compare the rate of pain-free surgery between ESA and SA following ELA for intrapartum CS. METHODS: Both groups received continuous epidural infusions for labor pain at a rate of 10 ml/h...
August 2017: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/28794528/post-operative-effectiveness-of-continuous-wound-infiltration-continuous-epidural-infusion-and-intravenous-patient-controlled-analgesia-on-post-operative-pain-management-in-patients-undergoing-spinal-surgery
#19
Anshuman Singh, Parul Jindal, Gurjeet Khurana, Ranjeet Kumar
BACKGROUND AND AIMS: Very few studies have compared continuous wound infiltration (CWI), continuous epidural infusion (CEI) and intravenous Patient Controlled Analgesia (PCA) with morphine in spine surgery. This study compared these modalities in patients undergoing microdissectomy. METHODS: This prospective, randomized control trial was conducted on 75 patients of American Society of Anesthesiologists' physical status I or II undergoing microdiscectomy. Patients in all the three groups received morphine 1 mg IV, with a lockout period of 10 min after each bolus, and the maximum allowed dose was 15 mg/5 h postoperatively...
July 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/28792087/evaluation-and-management-of-tethered-cord-syndrome-in-occult-spinal-dysraphism-recommendations-from-the-international-children-s-continence-society
#20
REVIEW
Gerald F Tuite, Dominic N P Thompson, Paul F Austin, Stuart B Bauer
AIMS: As awareness and frequency of tethered spinal cord (TSC) related to occult spinal dysraphism (OSD) has increased with magnetic resonance imaging (MRI), variability exists in its evaluation and management. Due to no published level I data, we summarize the current International Children's Continence Society (ICCS) recommendations for diagnosis and treatment of OSD. METHODS: Guidelines were formulated based on analysis of pertinent literature and consensus among authors...
August 9, 2017: Neurourology and Urodynamics
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