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Bloodless spine surgery

Cristian Gragnaniello, Kevin Seex
BACKGROUND: Lateral interbody cages have been proven useful in spinal fusions. Spanning both lateral cortical rims while sparing the Anterior Longitudinal Ligament, the lateral interbody cages restore and maintain disc height while adding stability prior to supplemental fixation. The standard approach for their insertion is by a 90-degree lateral transpsoas method. This is relatively bloodless compared to other techniques although has its limitations, requiring neuro-monitoring and being, at times, very difficult at L4/5 due to iliac crest obstruction or an anterior plexus position...
December 2016: Journal of Spine Surgery (Hong Kong)
Michael H Moghimi, Dana A Leonard, Charles H Cho, Andrew J Schoenfeld, Philippe Phan, Mitchel B Harris, Christopher M Bono
PURPOSE: The authors have developed a "para-midline" approach to the posterior lumbar spine using a virtually avascular surgical plane not previously described in the literature. It was their purpose to document consistent MRI presence of this plane and to prospectively evaluate its clinical use in terms of blood loss. METHODS: Fifty consecutive patients undergoing primary lumbar surgery on 1-3 levels were prospectively enrolled from September 2014 to May 2015...
March 2016: European Spine Journal
Zahra Taghipour Anvari, Nader Afshar-Fereydouniyan, Farnad Imani, Mojgan Sakhaei, Babak Alijani, Masood Mohseni
BACKGROUND: Blood loss in spine surgery is an important issue, even though it has been understudied compared with hip and knee arthroplasty. OBJECTIVES: In this study, we evaluated the effect of oral clonidine as premedication on blood loss in lumbar spine fusion surgery under anesthesia with propofol and remifentanil. PATIENTS AND METHODS: In this double-blind, randomized clinical trial, 30 patients who were undergoing lumbar spine posterior fusion surgery due to traumatic fracture were allocated randomly into 2 groups...
2012: Anesthesiology and Pain Medicine
Cristian Gragnaniello, Kevin A Seex
Lateral interbody cages have proven useful in lumbar fusion surgery. Spanning both lateral cortical rims while sparing the anterior longitudinal ligament, they restore disc height, improve coronal balance and add stability. The standard approach to their insertion is 90 degrees lateral transpsoas which is bloodless compared to other techniques of interbody cage insertion but requires neuro-monitoring and at L4/5 can be difficult because of iliac crest obstruction or an anterior plexus position. The oblique muscle-splitting approach with the patient in a lateral position, remains retroperitoneal, and on the left side enters the disc space through a window between psoas and the common iliac vein...
July 2013: Neurosurgical Focus
Nancy E Epstein
BACKGROUND: "Bloodless spinal surgery" predominantly refers to NH, a procedure that minimizes blood transfusion requirements. By limiting or eliminating allogeneic transfusions, NH reduces the risk of transmitting HIV or hepatitis, and the need for predonating autologous blood with the risks of blood bank contamination, misidentification, or the removal of coagulation factors (fresh frozen plasma, platelets). METHODS: The NH technique technically requires the controlled removal of a volume of whole blood at the beginning of surgery...
December 2008: Surgical Neurology
Paulo A S Kadri, Ossama Al-Mefty
OBJECTIVE: Although considered a basic maneuver for neurosurgical procedures, dissection of the musculature of the posterior cervical spine can be a source of complications during surgery. These complications include excessive blood loss, a loss of the plane of dissection, and injury to important structures such as the vertebral artery and nerve roots. Inappropriate closing of the muscular plane might also contribute to leakage of spinal fluid and postoperative deformation of the cervical spine...
November 2007: Neurosurgery
J C Keating
Perhaps best remembered for his contributions to B.J. Palmer's earliest developments in spinography, James F. McGinnis also pioneered in marketing methods while a straight chiropractic practitioner in Iowa. His advertising brought him to the attention of organized medicine, which sought his prosecution. Relocating to California in the early 1920s, he broadened his scope of practice and earned a naturopathic doctorate. In the 1930s he became one of the best known of several chiropractic bloodless surgeons and traveled around the nation to teach his methods...
December 1998: Chiropractic History: the Archives and Journal of the Association for the History of Chiropractic
L T Goodnough, R E Marcus
Autologous blood predeposit before elective surgery is a rapidly expanding transfusion practice. A 3-year analysis of an autologous blood predeposit program was conducted to assess its impact on orthopaedic spine surgery. It was concluded that, first, autologous blood donation has resulted in a reduction of homologous blood transfusions in patients undergoing elective spine procedures from 26% to 13% (P = .02). Second, autologous blood preoperative donation in elective spine surgery has increased significantly, so that autologous blood as an alternative to homologous blood transfusion now represents a standard of practice for elective spine surgery at the institution included in the study...
February 1992: Spine
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