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https://www.readbyqxmd.com/read/28540126/neurological-complications-of-lumbar-and-cervical-dural-punctures-with-a-focus-on-epidural-injections
#1
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/28538591/intrathecal-morphine-and-oral-analgesics-provide-safe-and-effective-pain-control-after-posterior-spinal-fusion-for-adolescent-idiopathic-scoliosis
#2
Ying Li, Rebecca A Hong, Christopher B Robbins, Kathleen M Gibbons, Ashlee E Holman, Michelle S Caird, Frances A Farley, Matthew D Abbott, Michelle C Burke
STUDY DESIGN: Retrospective comparative study. OBJECTIVE: To demonstrate that intrathecal morphine (ITM) and oral analgesics provide effective pain control after posterior spinal fusion (PSF) for adolescent idiopathic scoliosis (AIS), and this protocol has a low complication rate so patients can be admitted to a general care floor. SUMMARY OF BACKGROUND DATA: Previous studies have shown that ITM combined with intravenous patient-controlled analgesia or epidural infusion (EPI) provides effective pain control after PSF for AIS...
May 23, 2017: Spine
https://www.readbyqxmd.com/read/28535567/radiation-dose-and-procedure-time-for-994-ct-guided-spine-pain-control-procedures
#3
Matthew S Lazarus, Rebecca B Forman, Alan L Brook, Todd S Miller
BACKGROUND: Image guidance for spine pain control procedures, including epidural steroid injection, nerve root block, and facet block, can be performed with either computed tomography (CT) or conventional fluoroscopy. CT has the advantage of improved anatomic localization and use of air for contrast; however, there are concerns that CT leads to higher radiation dose and longer procedure time. OBJECTIVE: To evaluate procedure time and radiation dose for multiple types of spine pain control procedures performed under CT guidance...
May 2017: Pain Physician
https://www.readbyqxmd.com/read/28535546/cost-utility-analysis-of-lumbar-interlaminar-epidural-injections-in-the-treatment-of-lumbar-disc-herniation-central-spinal-stenosis-and-axial-or-discogenic-low-back-pain
#4
Laxmaiah Manchikanti, Vidyasagar Pampati, Ramsin M Benyamin, Joshua A Hirsch
BACKGROUND: Cost utility or cost effective analysis continues to take center stage in the United States for defining and measuring the value of treatments in interventional pain management. Appropriate cost utility analysis has been performed for caudal epidural injections, percutaneous adhesiolysis, and spinal cord stimulation. However, the literature pertaining to lumbar interlaminar epidural injections is lacking, specifically in reference to cost utility analysis derived from randomized controlled trials (RCTs) with a pragmatic approach in a practical setting...
May 2017: Pain Physician
https://www.readbyqxmd.com/read/28532963/fully-endoscopic-interlaminar-and-transforaminal-lumbar-discectomy-analysis-of-47-complications-encountered-in-a-series-of-835-patients
#5
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/28526487/ultrasound-guided-thoracic-paravertebral-injection-in-dogs-a-cadaveric-study
#6
Diego A Portela, Luis Campoy, Pablo E Otero, Manuel Martin-Flores, Robin D Gleed
OBJECTIVE: To describe ultrasound-visualized anatomy and the spread characteristics of a dye injected in the thoracic paravertebral (TPV) space under ultrasound guidance. STUDY DESIGN: Anatomic cadaver study. ANIMALS: Seven dog cadavers. METHODS: One cadaver was used to observe, identify, and describe the relevant TPV anatomy. In the remaining six, the left fifth TPV space was randomly assigned to be injected with either a low volume (LV; 0...
February 16, 2017: Veterinary Anaesthesia and Analgesia
https://www.readbyqxmd.com/read/28514779/low-back-pain-in-pregnancy-investigations-management-and-role-of-neuraxial-analgesia-and-anaesthesia-a-systematic-review
#7
Herman Sehmbi, Rohan D'Souza, Anuj Bhatia
BACKGROUND: Low back pain (LBP) is commonly experienced during pregnancy and is often poorly managed. There is much ambiguity in diagnostic work-up, appropriate management and decision-making regarding the use of neuraxial analgesia and anaesthesia during labour and delivery in these patients. This systematic review summarises the evidence regarding investigations, management strategies and considerations around performing neuraxial blocks for pregnant women with LBP. METHODS: We searched 3 databases and reviewed literature concerning LBP in pregnancy with regards to diagnostic modalities, management strategies and use of neuraxial techniques for facilitating labour and delivery...
May 18, 2017: Gynecologic and Obstetric Investigation
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
#8
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/28498138/epidural-injection-of-platelet-rich-plasma-for-postlumbar-puncture-headaches
#9
Adnan I Qureshi, Asad Ahrar, Vikram Jadhav, Shawn S Wallery
No abstract text is available yet for this article.
May 11, 2017: Journal of Neurosurgical Anesthesiology
https://www.readbyqxmd.com/read/28492440/diskitis-osteomyelitis-spinal-epidural-abscess-meningitis-and-endocarditis-following-sacroiliac-joint-injection-for-the-treatment-of-low-back-pain-in-a-patient-on-therapy-for-hepatitis-c-virus
#10
Geeta Nagpal, John P Flaherty, Honorio T Benzon
OBJECTIVE: Sacroiliac joint injections are frequently performed procedures in the management of acute and chronic low-back pain, including patients with various immunocompromised states. Infectious complications following these procedures along with other spinal injections are rarely reported, but the true incidence is unknown. The purpose of this report is to highlight the devastating neurologic sequela that can occur, and to discuss potential future management strategies. CASE REPORT: We present a patient who developed diskitis, osteomyelitis, spinal epidural abscess, meningitis, and endocarditis from Staphylococcus aureus, all of which developed shortly after a sacroiliac joint injection...
May 10, 2017: Regional Anesthesia and Pain Medicine
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
#11
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/28485773/curcumin-alleviates-lumbar-radiculopathy-by-reducing-neuroinflammation-oxidative-stress-and-nociceptive-factors
#12
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/28483686/persistent-hiccups-after-an-epidural-steroid-injection-successfully-treated-with-baclofen-a-case-report
#13
Berdale Colorado, Gregory Decker
Persistent hiccups are an established adverse reaction to epidural steroid injections. Although oral baclofen has been used to treat hiccups in various clinical settings, none of the previously reported studies that used baclofen were related to hiccups occurring after spinal injections/procedures. We report a case of a man who developed persistent hiccups after a transforaminal epidural steroid injection that was treated successfully with oral baclofen. LEVEL OF EVIDENCE: To be determined...
May 5, 2017: PM & R: the Journal of Injury, Function, and Rehabilitation
https://www.readbyqxmd.com/read/28482062/cervical-epidural-depth-correlation-between-cervical-mri-measurements-of-the-skin-to-cervical-epidural-space-and-the-actual-needle-depth-during-interlaminar-cervical-epidural-injections
#14
Haitham Algrain, Alison Liu, Sarabdeep Singh, To-Nhu Vu, Steven P Cohen
Objective. : The purpose of this study was to assess the correlation between skin-to-epidural space depth, as measured on cervical magnetic resonance imaging (MRI), and actual needle depth, as measured by Tuohy needle markings during cervical epidural steroid injections. Methods. : We conducted a retrospective review of cervical MRI images to determine estimated depth from skin to epidural space. Of the 121 reviewed patients who underwent cervical epidural steroid injections, 81 met inclusion criteria and were retained for data analysis...
May 8, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28479104/behavioral-study-of-a-rat-model-of-migraine-induced-by-cgrp
#15
Gang Yao, Qian Huang, Min Wang, Chun-Li Yang, Cai-Fen Liu, Ting-Min Yu
Migraine is a debilitating disorder characterized by recurrent headache arising from neurovascular dysfunction. Despite recent progress in migraine research, the exact mechanisms underpinning migraine are poorly understood. Furthermore, it is difficult to develop an animal model of migraine that resembles all symptoms of patients. In this study, we established a novel animal model of migraine induced by epidural injection of calcitonin gene-related peptide (CGRP), and examined climbing hutch behavior, facial-grooming behavior, body-grooming behavior, freezing behavior, resting behavior, and ipsilateral hindpaw facial grooming behavior of rats following CGRP injection...
May 4, 2017: Neuroscience Letters
https://www.readbyqxmd.com/read/28455211/comparison-of-intratesticular-lidocaine-sacrococcygeal-epidural-lidocaine-and-intravenous-methadone-in-cats-undergoing-castration-a-prospective-randomized-investigator-blind-clinical-trial
#16
Rocio Fernandez-Parra, Luca Zilberstein, Cyril Fontaine, Chiara Adami
OBJECTIVE: The objective of this study was to compare three analgesic protocols for feline castration. STUDY DESIGN: Prospective, randomized clinical study. ANIMALS: Forty-nine client-owned cats. METHODS: Cats were injected with intramuscular (IM) dexmedetomidine (15 μg kg(-1)) and alfaxalone (3 mg kg(-1)) and assigned randomly to one of three treatment groups. Group ITL (n = 15) were administered intratesticular 2% lidocaine (0...
March 1, 2017: Veterinary Anaesthesia and Analgesia
https://www.readbyqxmd.com/read/28451389/effect-of-ephedrine-combined-with-bupivacaine-on-maternal-hemodynamic-and-spinal-nerve-block-in-cesarean-delivery
#17
Mingyue Ge, Sheng Wang, Zhigang Dai, Yan Li, Liping Xie, Xuejao Liu, Jiangwen Yin
The aim of the study was to investigate the effects of ephedrine intrathecal injection on maternal thermodynamics and spinal nerve block in cesarean section. A total of 107 patients undergoing elective cesarean section under combined spinal epidural anesthesia were randomly divided into two groups: group E: Bupivacaine (6 mg) combined with ephedrine (15 mg) and group C: Bupivacaine (6 mg). Systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), the incidence of hypotension, hypertension, tachycardia, nausea and vomiting were all recorded...
March 2017: Biomedical Reports
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
#18
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/28447976/method-of-direct-segmental-intra-hepatic-delivery-using-a-rat-liver-hilar-clamp-model
#19
Eliza W Beal, Curtis Dumond, Jung-Lye Kim, Khalid Mumtaz, Don Hayes, Ken Washburn, Bryan A Whitson, Sylvester M Black
Major hepatic surgery with inflow occlusion, and liver transplantation, necessitate a period of warm ischemia, and a period of reperfusion leading to ischemia/reperfusion (I/R) injury with myriad negative consequences. Potential I/R injury in marginal organs destined for liver transplantation contributes to the current donor shortage secondary to a decreased organ utilization rate. A significant need exists to explore hepatic I/R injury in order to mediate its impact on graft function in transplantation. Rat liver hilar clamp models are used to investigate the impact of different molecules on hepatic I/R injury...
April 2, 2017: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/28444433/boundaries-of-the-thoracic-paravertebral-space-potential-risks-and-benefits-of-the-thoracic-paravertebral-block-from-an-anatomical-perspective
#20
Esther A C Bouman, Judith M Sieben, Andrea J R Balthasar, Elbert A Joosten, Hans-Fritz Gramke, Maarten van Kleef, Arno Lataster
PURPOSE: Thoracic paravertebral block (TPVB) may be an alternative to thoracic epidural analgesia. A detailed knowledge of the anatomy of the TPV-space (TPVS), content and adnexa is essential in understanding the clinical consequences of TPVB. The exploration of the posterior TPVS accessibility in this study allows (1) determination of the anatomical boundaries, content and adnexa, (2) description of an ultrasound-guided spread of low and high viscous liquid. METHODS: In two formalin-fixed specimens, stratification of the several layers and the 3D-architecture of the TPVS were dissected, observed and photographed...
April 25, 2017: Surgical and Radiologic Anatomy: SRA
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