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https://www.readbyqxmd.com/read/29098646/failed-back-surgery-syndrome-a-new-strategy-by-the-epidural-injection-of-mesna
#1
M Carassiti, A Di Martino, A Centonze, C C Quattrocchi, A Caldaria, F Agrò, V Denaro
PURPOSE: Evaluate the efficacy and safety of MESNA (sodium 2-mercaptoethanesulfonate) injection into the epidural space in the FBSS. METHODS: We designed a prospective phase II longitudinal study. Six consecutive patients were enrolled. Patients underwent one peridural injection per week for 3 weeks. NRS and ODI were investigated before and 48 h after injections, and at 1 week, 1 month and 2 months after the last procedures. Opioids intake is investigated before procedures and 1 week, 1 month and 3 months after the last procedures...
November 2, 2017: Musculoskeletal Surgery
https://www.readbyqxmd.com/read/28744777/-recent-standards-in-management-of-obstetric-anesthesia
#2
REVIEW
Maximiliaan van Erp, Clemens Ortner, Stefan Jochberger, Klaus Ulrich Klein
The following article contains information not only for the clinical working anaesthesiologist, but also for other specialists involved in obstetric affairs. Besides a synopsis of a German translation of the current "Practice Guidelines for Obstetric Anaesthesia 2016" [1], written by the American Society of Anesthesiologists, the authors provide personal information regarding major topics of obstetric anaesthesia including pre-anaesthesia patient evaluation, equipment and staff at the delivery room, use of general anaesthesia, peridural analgesia, spinal anaesthesia, combined spinal-epidural anaesthesia, single shot spinal anaesthesia, and programmed intermittent epidural bolus...
November 2017: Wiener Medizinische Wochenschrift
https://www.readbyqxmd.com/read/28641358/-pain-treatment-after-thoracic-surgery
#3
Holger Hendrix, Vladimir Kamlak, Georgi Prisadov, Katrin Welcker
The treatment of pain after thoracic surgery is a challenge and takes place in the individual clinics mostly according to clinic internal standards. It exists no currently valid S3 guideline for the treatment of acute perioperative and posttraumatic pain. For an effective pain treatment as well individual pain experience as the pain intensity of the various thoracic surgical procedures must be considered. Regular pain assessment with appropriate methods and their documentation form the basis for adequate and adapted pain therapy...
June 2017: Zentralblatt Für Chirurgie
https://www.readbyqxmd.com/read/28532673/-neuraxial-anesthesia-in-patients-with-multiple-sclerosis-a-systematic-review
#4
Helmar Bornemann-Cimenti, Nikki Sivro, Frederike Toft, Larissa Halb, Andreas Sandner-Kiesling
BACKGROUND AND OBJECTIVES: Current guidelines for neuraxial analgesia in patients with multiple sclerosis are ambiguous and offer the clinician only a limited basis for decision making. This systematic review examines the number of cases in which multiple sclerosis has been exacerbated after central neuraxial analgesia in order to rationally evaluate the safety of these procedures. METHODS: A systematic literature search with the keywords "anesthesia or analgesia" and "epidural, peridural, caudal, spinal, subarachnoid or intrathecal" in combination with "multiple sclerosis" was performed in the databases PubMed and Embase, looking for clinical data on the effect of central neuraxial analgesia on the course of multiple sclerosis...
July 2017: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/28323713/efficacy-of-poly-d-l-lactic-acid-co-glycolic-acid-poly-ethylene-glycol-poly-d-l-lactic-acid-co-glycolic-acid-thermogel-as-a-barrier-to-prevent-spinal-epidural-fibrosis-in-a-postlaminectomy-rat-model
#5
Xiangqian Li, Lin Chen, Hong Lin, Luping Cao, Ji'an Cheng, Jian Dong, Lin Yu, Jiandong Ding
STUDY DESIGN: Experimental animal study. OBJECTIVE: The authors conducted a study to determine the efficacy and safety of the poly(D,L-lactic acid-co-glycolic acid)-poly(ethylene glycol)-poly(D,L-lactic acid-co-glycolic acid) (PLGA-PEG-PLGA) thermogel to prevent peridural fibrosis in an adult rat laminectomy model. SUMMARY OF BACKGROUND DATA: Peridural fibrosis often occurs after spinal laminectomy. It might cause persistent back and/or leg pain postoperatively and make a reoperation more difficult and dangerous...
April 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28291642/chitosan-dextran-gel-as-an-anti-adhesion-agent-in-a-postlaminectomy-spinal-sheep-model
#6
Sukanya Rajiv, Amanda Drilling, Ahmed Bassiouni, Marguerite Harding, Craig James, Simon Robinson, Steve Moratti, Peter-John Wormald
INTRODUCTION: Post-operative peridural adhesions increase morbidity after neurosurgical procedures. Aim of this study is to assess safety and efficacy of Chitosan-Dextran (CD) gel as an anti-adhesion agent in a spinal laminectomy sheep model. METHODS: Eighteen sheep were used in this study with 6 animals in each treatment arm (namely, CD gel, Gelfoam paste and normal saline control). Posterior lumbar laminectomy was performed in all animals and the dura was exposed intact...
March 10, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28246047/is-the-use-of-hemostatic-matrix-floseal-and-alkylene-oxide-copolymer-ostene-safe-in-spinal-laminectomies-peridural-fibrosis-assessment
#7
Oktay Gurcan, Ahmet Gurhan Gurcay, Atilla Kazanci, Evrim Onder, Salim Senturk, Murad Bavbek
OBJECTIVE: Failed Back Syndrome (FBS) is unacceptable relief of pain or recurrence of symptoms in patients after spinal surgery, such as laminectomy. One possible cause of FBS is peridural fibrosis (PF). PF is the overproduction of scar tissue adjacent to the dura mater. Bleeding can cause PF after laminectomy. Ostene is an alkylene oxide copolymer material used to stop bleeding from bony surfaces. Floseal is a gelatin thrombin matrix sealant used to assist fibrin formation and to promote coagulation...
February 25, 2017: Acta Orthopaedica et Traumatologica Turcica
https://www.readbyqxmd.com/read/28168635/imaging-of-post-surgical-treatment-and-of-related-complications-in-spinal-trauma
#8
REVIEW
F Caranci, G Leone, L Ugga, E Cesarano, R Capasso, S Schipani, A Bianco, P Fonio, F Briganti, L Brunese
Spinal trauma is a devastating event with a high morbidity and mortality. The rationale of imaging is to diagnose the traumatic abnormalities and characterize the type of injury, to estimate the severity of the lesions, to evaluate the potential spinal instability. In case of spinal instability, the goals of operative treatment are decompression of the spinal cord canal and stabilization of the disrupted vertebral column. Particularly, diagnostic imaging, mainly by CT and MR, has a main role in the post-treatment evaluation...
March 2017: Musculoskeletal Surgery
https://www.readbyqxmd.com/read/28115269/stretching-of-roots-contributes-to-the-pathophysiology-of-radiculopathies
#9
Jean-Marie Berthelot, Jean-Denis Laredo, Christelle Darrieutort-Laffite, Yves Maugars
PURPOSE: To perform a synthesis of articles addressing the role of stretching on roots in the pathophysiology of radiculopathy. METHODS: Review of relevant articles on this topic available in the PubMed database. RESULTS: An intraoperative microscopy study of patients with sciatica showed that in all patients the hernia was adherent to the dura mater of nerve roots. During the SLR (Lasègue's) test, the limitation of nerve root movement occurs by periradicular adhesive tissue, and temporary ischemic changes in the nerve root induced by the root stretching cause transient conduction disturbances...
January 20, 2017: Joint, Bone, Spine: Revue du Rhumatisme
https://www.readbyqxmd.com/read/27848124/reversible-cerebral-vasoconstriction-syndrome-and-posterior-reversible-encephalopathy-syndrome-associated-with-intracranial-hypotension
#10
Katharina Feil, Robert Forbrig, Franziska S Thaler, Julian Conrad, Suzette Heck, Franziska Dorn, Hans-Walter Pfister, Andreas Straube
BACKGROUND: Reversible cerebral vasoconstriction syndrome (RCVS) and posterior reversible encephalopathy syndrome (PRES) are both rare disorders. The pathophysiology of both diseases is not yet fully understood. METHODS: We report the unique case of a 19-year-old comatose woman who was brought to the ER after a series of generalized tonic-clonic seizures 6 days post peridural anesthesia for cesarean section. Vital signs and initial laboratory testing including urine analysis and drug screening were unremarkable...
February 2017: Neurocritical Care
https://www.readbyqxmd.com/read/27811494/successful-treatment-of-persistent-pain-after-pectus-excavatum-repair-using-paravertebral-nerve-radiofrequency-thermoablation
#11
Hannah Noemi Ladenhauf, Ottokar Stundner, Rudolf Likar, Jörg Schnöll, Roman P Metzger
We present a case of a 25-year-old male patient suffering from severe prolonged pain after uneventful pectus excavatum repair that could be treated successfully by paravertebral nerve radiofrequency thermoablation. The patient was scheduled for a minimally invasive Nuss pectus excavatum repair. Surgical correction was performed under general anesthesia in combination with a thoracic peridural catheter. The immediate postoperative course was uneventful; however, the patient developed severe prolonged bilateral chest wall pain across segments T8 and T9...
January 1, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/27666613/knowledge-based-iterative-model-reconstruction-technique-in-computed-tomography-of-lumbar-spine-lowers-radiation-dose-and-improves-tissue-differentiation-for-patients-with-lower-back-pain
#12
Cheng Hui Yang, Tung-Hsin Wu, Chung-Jung Lin, Yi-You Chiou, Ying-Chou Chen, Ming-Huei Sheu, Wan-Yuo Guo, Chen Fen Chiu
PURPOSE: To evaluate the image quality and diagnostic confidence of reduced-dose computed tomography (CT) of the lumbar spine (L-spine) reconstructed with knowledge-based iterative model reconstruction (IMR). MATERIALS AND METHODS: Prospectively, group A consisted of 55 patients imaged with standard acquisition reconstructed with filtered back-projection. Group B consisted of 58 patients imaged with half tube current, reconstructed with hybrid iterative reconstruction (iDose(4)) in Group B1 and knowledge-based IMR in Group B2...
October 2016: European Journal of Radiology
https://www.readbyqxmd.com/read/27631406/risk-factors-for-emergency-caesarean-section-in-planned-vaginal-breech-delivery
#13
Tamara K Parissenti, Gundula Hebisch, Wieland Sell, Patricia E Staedele, Volker Viereck, Mathias K Fehr
PURPOSE: To identify risk factors for emergency caesarean section in women attempting a vaginal breech delivery at term. METHODS: Data from 1092 breech deliveries performed between 1998 and 2013 at a Swiss cantonal hospital were extracted from an electronic database. Of the 866 women with a singleton, full term pregnancy, 464 planned a vaginal breech delivery. Fifty-seven percent (265/464) were successful in delivering vaginally. Multivariate regression analyses of risk factors were performed, and neonatal and maternal complications were compared...
January 2017: Archives of Gynecology and Obstetrics
https://www.readbyqxmd.com/read/27593819/effects-of-topical-cova%C3%A2-tisseel%C3%A2-and-adcon%C3%A2-gel-application-on-the-development-of-spinal-peridural-fibrosis-an-experimental-study-in-rats
#14
Nuri Eralp Cetinalp, Serdar Baki Albayrak, Ozgur Ismailoglu, Nail Caglar Temiz, Ilker Solmaz, Gamze Tanriover, Necdet Demir
AIM: Leptomeningeal adhesions and fibrosis in the spinal peridural space are the most common causes of post-laminectomy syndrome. Fibrin sealant agents and membrane barriers are commonly used for hemostasis and sealing purposes in spinal surgery. Peridural fibrosis may be a risk of the usage of these topical agents. In this study, we aimed to compare the effects of Cova ™, Tisseel® and Adcon ® Gel on the development of spinal peridural fibrosis in the experimental rat model. MATERIAL AND METHODS: Thirty-two Sprague Dawley female rats were randomly divided into 4 groups...
2017: Turkish Neurosurgery
https://www.readbyqxmd.com/read/27593811/postlaminectomy-bone-and-scar-formations-in-presence-of-ankaferd-blood-stopper-and-bitter-melon-momordica-charantia-an-experimental-study
#15
Enis Kuruoglu, Mehmet Emin Onger, Abdullah Hilmi Marangoz, Suleyman Emre Kocacan, Cengiz Cokluk, Suleyman Kaplan
AIM: In the present study, a quantitative model of post-laminectomy in rats was designed. Concurrently, the effects of Momordica charantia (MC) and Ankaferd blood stopper (ABS) were evaluated. MATERIAL AND METHODS: Eighteen adult Wistar albino rats underwent lumbar laminectomy at L2-L3 vertebral levels, and were randomly assigned to one of three groups of six rats each. The treatment group received MC and ABS treatment and the Control group was untreated. Rats were sacrificed 4 weeks after treatment...
February 5, 2016: Turkish Neurosurgery
https://www.readbyqxmd.com/read/27592463/unusual-presence-of-the-immune-evasion-gene-cluster-in-livestock-associated-mrsa-of-lineage-cc398-causing-peridural-and-psoas-abscesses-in-a-poultry-farmer
#16
Mar Olga Pérez-Moreno, María José Centelles-Serrano, Julio Nogales-López, Marie France Domenech-Spanedda, Carmen Lozano, Carmen Torres
OBJECTIVE: To characterize a methicillin-resistant Staphylococcus aureus (MRSA) isolate responsible for an aggressive infection (peridural and psoas abscess secondary to haematogenous septic arthritis) in a poultry farmer. METHODS: Molecular characterization was performed, including spa- and multilocus sequence typing of the isolate, assessment of its resistance phenotype and detection of tetracycline resistance and of virulence and immune evasion cluster (IEC) genes were performed...
August 31, 2016: Enfermedades Infecciosas y Microbiología Clínica
https://www.readbyqxmd.com/read/27579248/diep-flap-for-breast-reconstruction-using-epidural-anesthesia-with-the-patient-awake
#17
Miguel de la Parra, Marco Camacho, Jonatan de la Garza
BACKGROUND: Many articles have been published about breast reconstruction using the deep inferior epigastric perforator (DIEP) flap; however, few articles have been published in plastic/reconstructive surgery journals describing the difference between anesthetic techniques and recovery in microsurgical patients. METHODS: We analyzed 16 patients who underwent DIEP flap for breast reconstruction. Patients were divided into 2 groups: group 1: general anesthesia (n = 9); group 2: epidural block with the patient awake (n = 7)...
May 2016: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/27420146/-headhache-secondary-to-intracranial-hypotension-in-a-lumbar-spinal-stenosis-surgery
#18
Begoña Hidalgo-Mendía, Marina Angulo-Taberno, Ricardo Jaroid-Audes, Carmen Untoria-Agustín, David Rivero-Zelada
Intracraneal hypotension headache is a well known syndrome in neurosurgery practice. In most cases cerebrospinal fluid leaks are caused by medical interventions, such as lumbar puncture, peridural anesthesia and surgical interventions on the spine. Clinical symptoms tipically show orthostatic headache that resolves in supine position, and other symptoms like neck tightness, vertigo and diplopia. RMI diagnostic confirms paquimeningeal enhancement and subdural hygromas. Conservative treatment usually includes bed resting, hydratation and administration of caffeine or glucocorticoids, resolving spontaneously in one to four months...
2016: Revista de la Facultad de Ciencias Médicas
https://www.readbyqxmd.com/read/27355735/efficacy-of-poly-d-l-lactic-acid-co-glycolic-acid-poly-ethylene-glycol-poly-d-l-lactic-acid-co-glycolic-acid-thermogel-as-a-barrier-to-prevent-spinal-epidural-fibrosis-in-a-postlaminectomy-rat-model
#19
Xiangqian Li, Lin Chen, Hong Lin, Luping Cao, Ji'an Cheng, Jian Dong, Lin Yu, Jiandong Ding
STUDY DESIGN: Experimental animal study. OBJECTIVE: The authors conducted a study to determine the efficacy and safety of the PLGA-PEG-PLGA thermogel to prevent peridural fibrosis in an adult rat laminectomy model. SUMMARY OF BACKGROUND DATA: Peridural fibrosis often occurs after spinal laminectomy. It might cause persistent back and/or leg pain postoperatively and make a reoperation more difficult and dangerous. Various materials have been used to prevent epidural fibrosis, but only limited success has been achieved...
June 28, 2016: Clinical Spine Surgery
https://www.readbyqxmd.com/read/27249046/-influence-of-peridural-infiltration-therapy-on-postural-control-in-chronic-pain-of-the-lower-lumbar-spine-a-prospective-clinical-study
#20
H-G Palm, S Uhl, M Zollo, P Lang, B Friemert, H-J Riesner
Background: Postural control, balance stability, is reduced in patients with chronic low back pain, due to pain. Epidural injection therapy (EI) is an established treatment of low back pain. The objective of our study was to investigate whether EI-induced pain relief also leads to improvement in postural control, as detected by computerised dynamic posturography (CDP). Patients and Methods: In a prospective study, 32 patients underwent CDP during and after the EI series of three injections. The main objective was to measure changes in overall stability index (OSI) in a pre- and post-intervention comparison...
December 2016: Zeitschrift Für Orthopädie und Unfallchirurgie
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