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David Altschul, Andrew Kobets, Jonathan Nakhla, Ajit Jada, Rani Nasser, Merritt D Kinon, Reza Yassari, John Houten
OBJECTIVE Postoperative urinary retention (POUR) is a common problem leading to morbidity and an increased hospital stay. There are limited data regarding its baseline incidence in patients undergoing spinal surgery and the risk factors with which it may be associated. The purpose of this study was to evaluate the incidence of POUR in elective spine surgery patients and determine the factors associated with its occurrence. METHODS The authors retrospectively reviewed the records of patients who had undergone elective spine surgery and had been prospectively monitored for POUR during an 18-month period...
October 21, 2016: Journal of Neurosurgery. Spine
Marcos Augusto Bastos Dias, Rosa Maria Soares Madeira Domingues, Arthur Orlando Corrêa Schilithz, Marcos Nakamura-Pereira, Maria do Carmo Leal
BACKGROUND: The rate of cesarean delivery (CD) in Brazil has increased over the past 40 years. The CD rate in public services is three times above the World Health Organization recommended values. Among strategies to reduce CD, the most important is reduction of primary cesarean. This study aimed to describe factors associated with CD during labor in primiparous women with a single cephalic pregnancy assisted in the Brazilian Public Health System (SUS). METHODS: This study is part of the Birth in Brazil survey, a national hospital-based study of 23,894 postpartum women and their newborns...
October 17, 2016: Reproductive Health
Miki Katzir, Svetlana Tov, Ayelet Eran, Gill E Sviri
Intracranial hypotension can be a complication of epidural anaesthesia. Pure clinical spinal hypotension manifesting as acute transient quadriplegia following epidural anaesthesia is a severe, life-threatening complication that have not been described before. This complication can be solved with an epidural blood patch; thus, it should be familiar to doctors across all specialities.
October 21, 2016: British Journal of Neurosurgery
Joseph M Blankush, Robbie Freeman, Joy McIlvaine, Trung Tran, Stephen Nassani, I Michael Leitman
Modified Early Warning Scores (MEWS) provide real-time vital sign (VS) trending and reduce ICU admissions in post-operative patients. These early warning calculations classically incorporate oxygen saturation, heart rate, respiratory rate, systolic blood pressure, and temperature but have not previously included end-tidal CO2 (EtCO2), more recently identified as an independent predictor of critical illness. These systems may be subject to failure when physiologic data is incorrectly measured, leading to false alarms and increased workload...
October 20, 2016: Journal of Clinical Monitoring and Computing
Marco Braga, Nicolò Pecorelli, Marco Scatizzi, Felice Borghi, Giancarlo Missana, Danilo Radrizzani
BACKGROUND: Enhanced recovery after surgery (ERAS) pathways represent the optimal approach for patients undergoing colorectal surgery. Elderly or low physical status patients have been often excluded from ERAS pathways because considered at high risk. The aim of this study is to assess the adherence to ERAS protocol and its impact on short-term postoperative outcome in patients with different surgical risk undergoing elective colorectal resection. METHODS: Prospectively collected data entered in an electronic Italian registry specifically designed for ERAS were reviewed...
October 20, 2016: World Journal of Surgery
Joseph S Hudson, Kingsley Abode-Iyamah, Yasunori Nagahama, Chandan G Reddy
BACKGROUND: Ionic contrast, if accidentally injected into the intrathecal space during routine imaging studies or interventional procedures, may significantly interfere with neuronal activity, potentially causing ascending tonic-clonic seizure syndrome and even death. As a result, ionic contrast is strictly contraindicated for intrathecal use. Rapid recognition of the condition followed by prompt management, typically involving aggressive cerebrospinal fluid (CSF) drainage, is critical to improving patient outcome...
October 17, 2016: World Neurosurgery
Gregory G Billy, Ji Lin, Mengzhao Gao, Mosuk X Chow
STUDY DESIGN: Retrospective clinical outcome analysis. OBJECTIVE: To evaluate and determine whether demographic, comorbid factors, or physical examination findings may predict the outcome of caudal epidural steroid injections in managing patients with chronic low back pain and radiculopathy SUMMARY OF BACKGROUND DATA:: The caudal epidural approach is commonly utilized with patients who are on anticoagulation or who have had prior lumbar surgery to treat L5 or S1 radiculopathies...
October 19, 2016: Clinical Spine Surgery
Chris Durkin, Travis Schisler, Jens Lohser
PURPOSE OF REVIEW: Despite marked improvements in perioperative outcomes, esophagectomy continues to be a high-risk operation associated with significant morbidity and mortality. Progress has been achieved through evidence-based changes in preoperative optimization, intraoperative ventilation strategies, fluid therapy, and analgesia, as well as expedited postoperative recovery pathways. This review will summarize the recent literature on the anesthetic management of patients undergoing esophageal resection...
October 18, 2016: Current Opinion in Anaesthesiology
Ruyi Huang, Serapio M Baca, Jason W Worrell, Xingquan Liu, Yeji Seo, James C Leiter, Daniel C Lu
Respiration is produced and controlled by well-characterized brainstem nuclei, but the contributions of spinal circuits to respiratory control and modulation remain under investigation. Many respiratory studies are conducted in in vitro preparations (e.g., brainstem slice) obtained from neonatal rodents. While informative, these studies do not fully recapitulate the complex afferent and efferent neural circuits that are likely to be involved in eupnea (i.e., quiet breathing). To begin to investigate spinal contributions to respiration, we electrically stimulated the cervical spinal cord during unassisted respiration in anesthetized, intact mice...
October 7, 2016: Journal of Applied Physiology
Marie-Pascale Côté, Marion Murray, Michel A Lemay
Body-weight supported locomotor training (BWST) promotes recovery of load-bearing stepping in lower mammals, but its efficacy in individuals with a spinal cord injury (SCI) is limited and highly dependent on injury severity. While animal models with complete spinal transections recover stepping with step-training, motor complete SCI individuals do not, despite similarly intensive training. In this review, we examine the significant differences between humans and animal models that may explain this discrepancy in the results obtained with BWST...
October 20, 2016: Journal of Neurotrauma
Nilesh Balu Sonawane, J Balavenkatasubramanian, P Gurumoorthi, Poonam Ashok Jadhav
No abstract text is available yet for this article.
October 2016: Indian Journal of Anaesthesia
Anand Kaul, Sunil Manjila, Jonathan P Miller
: Isadore Max Tarlov (1905-1977) is primarily remembered for his 1938 description of the eponymous perineural "Tarlov cyst." However, during his long career as a neurosurgeon and researcher, he was responsible for many other observations and inventions that influenced the development of neurosurgery in the 20th century. While studying at Johns Hopkins Medical School he was acquainted with Walter Dandy, and he became the first resident to study under Wilder Penfield at the newly formed Montreal Neurological Institute...
November 2016: Neurosurgery
Saul Wilson, Kingsley O Abode-Iyamah, John W Miller, Chandan G Reddy, Sina Safayi, Douglas C Fredericks, Nicholas D Jeffery, Nicole A DeVries-Watson, Sara K Shivapour, Stephanus Viljoen, Brian D Dalm, Katherine N Gibson-Corley, Michael D Johnson, George T Gillies, Matthew A Howard
OBJECTIVE: To develop a large animal model of spinal cord injury (SCI), for use in translational studies of spinal cord stimulation (SCS) in the treatment of spasticity. We seek to establish thresholds for the SCS parameters associated with reduction of post-SCI spasticity in the pelvic limbs, with implications for patients. STUDY DESIGN: The weight-drop method was used to create a moderate SCI in adult sheep, leading to mild spasticity in the pelvic limbs. Electrodes for electromyography (EMG) and an epidural spinal cord stimulator were then implanted...
October 19, 2016: Journal of Spinal Cord Medicine
Kris Radcliff, William B Morrison, Christopher Kepler, Jeffrey Moore, Gursukhman S Sidhu, David Gendelberg, Luciano Miller, Marcos A Sonagli, Alexander R Vaccaro
STUDY DESIGN: Retrospective case series. OBJECTIVE: To identify specific magnetic resonance imaging (MRI) characteristics of epidural fluid collections associated with infection, hematoma, or cerebrospinal fluid (CSF). SUMMARY OF BACKGROUND DATA: Interpretation of postoperative MRI can be challenging after lumbar fusion. The purpose of this study was to identify specific MRI characteristics of epidural fluid collections associated with infection, hematoma, or CSF...
November 2016: Clinical Spine Surgery
Marcelo Epsztein Kanczuk, Nicholas Martin Barrett, Cristian Arzola, Kristi Downey, Xiang Y Ye, Jose C A Carvalho
BACKGROUND: Most studies that have compared programmed intermittent epidural bolus (PIEB) with continuous epidural infusion regimens have included patient-controlled epidural analgesia and/or manual bolus as rescue analgesia for breakthrough pain. Consequently, the optimal time interval between PIEB is yet to be determined. We designed a study to establish the optimal time interval between PIEB of 10 mL of bupivacaine 0.0625% with fentanyl 2 μg/mL to produce effective analgesia in 90% of women during first stage of labor without breakthrough pain...
October 11, 2016: Anesthesia and Analgesia
Sanka Amadoru, Kwang Lim, Mark Tacey, Craig Aboltins
AIMS: To explore differences in presentation and outcomes between younger and older patients with bacterial spinal infections. METHODS: Clinical, microbiological and radiological information was collected for patients at a single metropolitan hospital with spinal infections (spondylodiscitis, vertebral osteomyelitis, septic discitis, facet joint septic arthritis, and spinal epidural abscess) between January 2008 and January 2015. Patients were excluded if under 18 years of age, or if clinical and imaging findings were inconsistent with the diagnosis...
October 18, 2016: Internal Medicine Journal
Gabrielle G Tardieu, Christian Fisahn, Marios Loukas, Marc Moisi, Jens Chapman, Rod J Oskouian, R Shane Tubbs
The epidural space contains the internal vertebral venous plexus, adipose, and other connective tissues. In the anatomical literature, there are nonspecific descriptions of varying fibrous connective tissue bands in the epidural space, mainly mentioned in the lumbar region, that tether the dural sac to the posterior longitudinal ligament, the vertebral canal, and the ligamentum flavum. These ligaments have been termed as Hofmann's ligaments. This review expands on the anatomy and function of Hofmann's ligaments, increasing the awareness of their presence and serves as an impetus for further study of their histology, innervation, and function...
September 13, 2016: Curēus
Jean-Denis Laredo, Elisabeth Laemmel, Eric Vicaut
No abstract text is available yet for this article.
2016: RMD Open
Yujia Zhou, Gesheng Wang, Jialin Liu, Yong Du, Lei Wang, Xiaoyong Wang
BACKGROUND The aim of this study was to evaluate the application of medical adhesive glue for tension-reduced duraplasty in decompressive craniotomy. MATERIAL AND METHODS A total of 56 cases were enrolled for this study from Jan 2013 to May 2015. All patients underwent decompressive craniotomy and the dura was repaired in all of them with tension-reduced duraplasty using the COMPONT medical adhesive to glue artificial dura together. The postoperative complications and the healing of dura mater were observed and recorded...
October 14, 2016: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
J Willis Kiessling, Dean A Hertzler, David E M Drucker, Heather S Spader
BACKGROUND: This case report illustrates the need to evaluate the possibility of multiple arterial sources when presented with a frontal epidural hematoma associated with facial trauma. CASE DESCRIPTION: Our patient presented after being struck in the face by a baseball. Computed tomography (CT) of the brain revealed a large frontal epidural hematoma. Intraoperatively, bleeding from a frontal branch of the middle meningeal artery was encountered and cauterized, and the hematoma was removed...
October 14, 2016: World Neurosurgery
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