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https://www.readbyqxmd.com/read/29340585/spinal-tuberculosis-clinicoradiological-findings-in-274-patients
#1
Suzaan Marais, Izanne Roos, Ayesha Mitha, Sepelong J Mabusha, Vinod Patel, Ahmed I Bhigjee
Background: Mycobacterium tuberculosis is a major cause of myelopathy and radiculopathy in high TB/HIV prevalent settings. However, a paucity of publications exists on the spectrum of neurological and magnetic resonance imaging (MRI) findings of spinal tuberculosis in these populations. Methods: A retrospective study of adults with spinal tuberculosis conducted at a referral center for patients with spinal disease without bony involvement on plain film radiography in South Africa...
January 11, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/29339580/advantages-of-soft-subdural-implants-for-the-delivery-of-electrochemical-neuromodulation-therapies-to-the-spinal-cord
#2
Marco Capogrosso, Jérôme Gandar, Nathan Greiner, Eduardo Martin Moraud, Nikolaus Wenger, Polina Shkorbatova, Pavel E Мusienko, Ivan Minev, Stephanie P Lacour, Gregoire Courtine
We recently developed soft neural interfaces enabling the delivery of electrical and chemical stimulation to the spinal cord. These stimulations restored locomotion in animal models of paralysis. Soft interfaces can be placed either below or above the dura mater. Theoretically, the subdural location combines many advantages, including increased selectivity of electrical stimulation, lower stimulation thresholds, and targeted chemical stimulation through local drug delivery. However, these advantages have not been documented, nor have their functional impact been studied in-silico or in a relevant animal model of neurological disorders using a multimodal neural interface...
January 17, 2018: Journal of Neural Engineering
https://www.readbyqxmd.com/read/29338142/patient-controlled-epidural-analgesia-with-and-without-basal-infusion-using-ropivacaine-0-15-and-fentanyl-2%C3%AE-ml-for-labour-analgesia-a-prospective-comparative-randomised-trial
#3
Paraskevi K Matsota, Kalliopi H Drachtidi, Chrysanthi Z Batistaki, Agathi V Karakosta, Ioanna C Koukopoulou, Eugenia I Koursoumi, Georgia G Kostopanagiotou
BACKGROUND: Patient-Controlled Epidural Analgesia (PCEA) is a common practice for labour pain relief. This study aimed to compare two different settings of a PCEA device using the same solution to obtain labour analgesia. METHODS: Fifty two parturients were randomly allocated to receive ropivacaine 0.15% and fentanyl 2γ/mL via a PCEA device either as a background infusion of 5mL/h plus 5mL demand bolus doses with 10 min lockout (group B/D, n=26) or as only demand bolus doses of 5mL with 10 min lockout (group D, n=26)...
January 16, 2018: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29336785/the-erector-spinae-plane-block-in-4-cases-of-video-assisted-thoracic-surgery
#4
J C Luis-Navarro, M Seda-Guzmán, C Luis-Moreno, J L López-Romero
Multimodal anaesthesia, combining epidural catheter and general anaesthesia, is a common technique in thoracic surgery, however, epidural catheter placement is not always possible. Recently, erector spinae plane block has been described, which provides analgesia like that of the epidural block, although unilateral, and which has been used in various procedures at thoracic level. At present, there are no studies comparing the efficacy or safety of this block with those commonly used in thoracic surgery. However, its safety profile and contraindications seem different from those of the epidural catheter, since its placement is done under ultrasound view, the needle introduction is done in plane and the ultrasound target, the transverse process, is easily identifiable and is relatively remote from major neural or vascular structures and the pleura...
January 11, 2018: Revista Española de Anestesiología y Reanimación
https://www.readbyqxmd.com/read/29333355/bilateral-peripheral-nerve-field-stimulation-for-intractable-coccygeal-pain-a-case-study-using-dual-lead-intercommunication
#5
Michelle Granville, Patrick T Brennan, Robert E Jacobson
Coccygeal pain is a difficult chronic pain problem with mixed response to various treatments. This is a report of a case of coccygeal pain that after failing various conservative and interventional procedures over five years was evaluated with a temporary peripheral sacral fascial lead followed by implantation of bilateral sacral paramedian leads for peripheral nerve field stimulation (PNFS). This resulted in marked pain control and resumption of full activity. The visual analog scale (VAS) pain score improved from eight pre-implant to one after implant and has remained at that level in follow-up...
November 9, 2017: Curēus
https://www.readbyqxmd.com/read/29332332/a-study-on-cellular-immune-function-of-patients-treated-with-radical-resection-of-pulmonary-carcinoma-with-two-different-methods-of-anesthesia-and-analgesia
#6
Jie Chen, Feng Luo, Min Lei, Zhoumiao Chen
PURPOSE: To compare the influence on the immune system of two different methods of anesthesia and analgesia in patients treated with radical resection of pulmonary carcinoma. METHODS: Thirty-four patients treated with radical resection of pulmonary carcinoma were randomly divided into two groups (group A and group B, 17 cases in each group). Patients in group A were administered total intravenous anesthesia (TIVA) without inhaled hypnotics and intravenous analgesia while patients in group B were administered TIVA combined with epidural anesthesia and epidural analgesia...
November 2017: Journal of B.U.ON.: Official Journal of the Balkan Union of Oncology
https://www.readbyqxmd.com/read/29332115/ultrasound-guided-transversus-abdominis-plane-block-postoperative-analgesia-in-children-with-spinal-dysraphism
#7
Eralp Çevikkalp, Koray Erbüyün, Serpil Erbüyün, Gülay Ok
Pediatric regional anesthesia is widely used to relieve postoperative pain after abdominal surgery. Commonly used techniques of regional anesthesia include lumbar epidural and caudal block. However, the use of central neuraxial blockade has limitations. It is contraindicated in patients with clotting abnormalities, spinal dysraphism with tethered cord syndrome, meningomyelocele, and following spinal surgery with instrumentation. Ultrasound guided transversus abdominis plane block is a new method of regional anesthesia that can be used in settings where central neuraxial blockade is contraindicated...
January 2018: Saudi Medical Journal
https://www.readbyqxmd.com/read/29330854/combined-spinal-epidural-vs-spinal-anaesthesia-for-caesarean-section-meta-analysis-and-trial-sequential-analysis
#8
REVIEW
M Klimek, R Rossaint, M van de Velde, M Heesen
Combined spinal-epidural and single-shot spinal anaesthesia are both used for caesarean section. It has been claimed in individual trials that combined spinal-epidural is associated with higher sensory spread and greater cardiovascular stability. We set out to gather all available evidence. We performed: a systematic literature search to identify randomised controlled trials comparing combined spinal-epidural with spinal anaesthesia for caesarean section: conventional meta-analysis; trial-sequential analysis; and assessment of trial quality using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system...
January 13, 2018: Anaesthesia
https://www.readbyqxmd.com/read/29330575/a-new-technique-for-minimal-invasive-complete-spinal-cord-injury-in-minipigs
#9
Elena E Foditsch, Gratian Miclaus, Irina Patras, Ioan Hutu, Karin Roider, Sophina Bauer, Günter Janetschek, Ludwig Aigner, Reinhold Zimmermann
BACKGROUND: The aim of this study was to develop a minimal invasive complete spinal cord injury (SCI) minipig model for future research applications. The minipig is considered a translationally relevant model for SCI research. However, a standardized minimal invasive complete SCI model for pigs has not yet been established. METHODS: Adult Göttingen minipigs were anesthetized and placed in extended prone position. After initial computed tomography (CT) scan, the skin was incised, a needle placed in the epidural fatty tissue...
January 12, 2018: Acta Neurochirurgica
https://www.readbyqxmd.com/read/29327462/propensity-score-matched-outcomes-after-thoracic-epidural-or-paravertebral-analgesia-for-thoracotomy
#10
W J Blackshaw, A Bhawnani, S H Pennefather, O Al-Rawi, S Agarwal, M Shaw
It is not known which regional analgesic technique is most effective or safest after open lung resection. We retrospectively examined outcomes in 828 patients who received thoracic epidural analgesia and 791 patients who received paravertebral block after lung resection between 2008 and 2012. We analysed outcomes for 648 patients, 324 who had each analgesic technique, matched by propensity scores generated with peri-operative data. There were 22 out of 324 (7%) postoperative respiratory complications after thoracic epidural and 23 out of 324 (7%) after paravertebral block, p = 0...
January 12, 2018: Anaesthesia
https://www.readbyqxmd.com/read/29326813/surgical-treatment-of-aggressive-vertebral-hemangioma-causing-progressive-paraparesis
#11
M Dobran, F Mancini, D Nasi, M Gladi, S Sisti, M Scerrati
Vertebral hemangioma is a benign vascular lesion that may onset with neurologic symptoms due to spinal cord compression by epidural extension. Surgical procedure, embolization and radiotherapy are the gold standard for the treatment of this disease. We present a case of a 84 years old woman admitted at our department with worsening paraparesis and urinary retention. Her magnetic resonance images (MRI) showed a lesion involving both anterior and posterior vertebral element of D5, with extension into epidural space and spinal cord compression...
January 2018: Annals of Medicine and Surgery
https://www.readbyqxmd.com/read/29326765/pneumocephalus-following-combined-spinal-epidural-anaesthesia-for-total-knee-arthroplasty-a-case-report
#12
Y W Chew, V K Suppan, S R Ashutosh, M M Tew, J H Jimmy-Tan
The authors describe a case of pneumocephalus following epidural anaesthesia for total knee arthroplasty. Multiple attempts in locating the epidural space for the anaesthesia and the use of loss of resistance to air (LORA) technique were identified as the source of air entry. Supportive management was given including high flow oxygenation therapy and spontaneous reabsorption of air was noted five days after surgery. The presence of pneumocephalus should be kept in mind if patient develops neurological complications postoperatively following epidural anaesthesia...
November 2017: Malaysian Orthopaedic Journal
https://www.readbyqxmd.com/read/29326182/variations-in-childbirth-interventions-in-high-income-countries-protocol-for-a-multinational-cross-sectional-study
#13
Anna Seijmonsbergen-Schermers, Ank de Jonge, Thomas van den Akker, Katrien Beeckman, Annick Bogaerts, Monalisa Barros, Patricia Janssen, Lorena Binfa, Eva Rydahl, Lucy Frith, Mechthild Gross, Berglind Hálfdánsdóttir, Deirdre Daly, Jean Calleja-Agius, Patricia Gillen, Anne Britt Vika Nilsen, Eugene Declercq
INTRODUCTION: There are growing concerns about the increase in rates of commonly used childbirth interventions. When indicated, childbirth interventions are crucial for preventing maternal and perinatal morbidity and mortality, but their routine use in healthy women and children leads to avoidable maternal and neonatal harm. Establishing ideal rates of interventions can be challenging. This study aims to describe the range of variations in the use of commonly used childbirth interventions in high-income countries around the world, and in outcomes in nulliparous and multiparous women...
January 10, 2018: BMJ Open
https://www.readbyqxmd.com/read/29325956/rapid-onset-thoracic-myelopathy-due-to-an-epidural-sarcoid-like-lesion-in-a-pediatric-patient
#14
Michael A Galgano, Carlos R Goulart, Karen Chisholm, Melissa Hazen, Scellig Stone
Isolated intraspinal neurosarcoidosis is a rare clinical entity, with most reports describing intramedullary involvement in adults. We detail the case of a nine-year-old girl with rapid onset compressive myelopathy secondary to a thoracic epidural lesion. Although pathological diagnosis was challenging, a presumptive diagnosis of isolated extradural neurosarcoidosis was made in light of the patient's investigations and dramatic response to corticosteroids. Though less likely than neoplasia, rheumatologic processes such as inflammatory granulomatous disease warrant consideration in similar cases...
January 8, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29325950/a-novel-technique-for-cervical-laminoplasty-fusion-clpf-simultaneously-enhancing-stabilization-and-decompression-in-various-cervical-myelopathies-a-technical-note-and-outcomes
#15
Il Sup Kim, Jae Taek Hong, Jung Jae Lee, Jong Bum Lee, Chul Bum Cho, Seung Ho Yang, Jae Hoon Sung
PURPOSE: Cervical laminectomy has two major disadvantages: post-laminectomy adhesion of dural membrane and the lack of a fusion bed. The objective of this study was to determine whether simultaneous laminoplasty with fusion (CLPF) might overcome these unwanted outcomes. METHODS: Cases of CLPF for treating various cervical myelopathy with instability who were followed up for at least 12 months were enrolled. Preoperative and postoperative Neck Disability Index (NDI), Japanese Orthopedic Association (JOA) scores before and after surgeries, recovery rates (RRs), C2-7 lordosis, and fusion success rates were evaluated...
January 8, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29325946/skip-hemilaminectomy-for-large-multilevel-spinal-epidural-haematomas-report-of-a-series-of-11-patients
#16
Alessandro Di Rienzo, Denise Brunozzi, Mauro Dobran, Maurizio Iacoangeli, Roberto Colasanti, Rikin Trivedi, Massimo Scerrati
OBJECTIVE: We present our experience with a modification of the conventional techniques for the removal of large Spinal Epidural Haematomas (SEHs), based on multilevel "skip hemilaminectomies". METHODS: Eleven patients with SEHs extending over 5 or more spinal segments were treated at our institution using a modified hemilaminectomy technique from 2008 to 2014. This procedure, that we called "skip hemilaminectomy" consists in performing consecutive, alternating, unilateral laminar decompressions at two to three levels, followed by sublaminar undercutting, ipsi- and contralateral flavectomy, plus haematoma removal...
January 8, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29325937/histopathological-analysis-of-tamoxifen-on-epidural-fibrosis
#17
Yasar Ozturk, Ismail Bozkurt, Mesut Emre Yaman, Yahya Guvenc, Tolga Tolunay, Deniz Billur, Fatma Kubra Erbay, Salim Senturk, Gokhan Bozkurt
BACKGROUND: Epidural fibrosis is a challenging topic in spinal surgery. This phenomenon constitutes one of the the main reasons behind "post-laminectomy syndrome" or "failed-back surgery syndrome", which leads to persistent back and leg pain in association with compression and/or stretching the nerve root or the dura. The exact mechanism of action in epidural fibrosis is complex and remains uncertain. Excessive deposition of collagen, fibronectin, and dermatan sulfate known as "extracellular matrix", and decrease of tissue cellularity results in epidural fibrosis...
January 8, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29325336/-dose-response-relationship-of-ropivacaine-for-epidural-block-in-early-herpes-zoster-guided-by-ct
#18
K Y Xie, J B Ma, Q Xu, B Huang, M Yao, H D Ni, J J Deng, G D Chen
Objective: To determine the dose-response relationship of ropivacaine for epidural block in early herpes zoster by CT guided. Methods: From January 2015 to February 2017, according to the principle of completely random digital table, 80 patients with early herpes zoster who were prepared for epidural block were divided into 4 groups(each group 20 patients): in group A the concentration of ropivacaine was 0.08%, in group B was 0.10%, in group C was 0.12% and in group D was 0.14%.Under CT guidance, epidural puncture was performed in the relevant section, mixing liquid 5...
December 26, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/29324600/reassessing-the-duration-of-the-second-stage-of-labor-in-relation-to-maternal-and-neonatal-morbidity
#19
Katherine L Grantz, Rajeshwari Sundaram, Ling Ma, Stefanie Hinkle, Vincenzo Berghella, Matthew K Hoffman, Uma M Reddy
OBJECTIVE: To assess the morbidity associated with continuing the second-stage duration of labor, weighing the probability of spontaneous vaginal birth without morbidity compared with birth with serious maternal or neonatal complications. METHODS: In a retrospective cohort, we analyzed singleton, vertex births at 36 weeks of gestation or greater without prior cesarean delivery (n=43,810 nulliparous and 59,605 multiparous women). We calculated rates of spontaneous vaginal birth and composite serious maternal or neonatal complications...
January 9, 2018: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29323741/stainless-steel-wear-debris-of-a-scoliotic-growth-guidance-system-has-little-local-and-systemic-effect-in-an-animal-model
#20
Vaneet Singh, Jeremy Rawlinson, Nadim Hallab
Options to treat early-onset scoliosis include guided-growth systems with sliding action between rods and pedicle screws. The wear was previously measured in an in vitro test, and in this in vivo rabbit model, we evaluated the local and systemic biological response to the stainless steel debris. Compared to the previous study, a relatively higher volume of representative wear particles with a median particle size of 0.84 µm were generated. Bolus dosages were injected into the epidural space at L4-L5 for a minimum of 36 rabbits across three treatment groups (negative control, 1...
January 11, 2018: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
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