Relationship of Modic Changes, Disk Herniation Morphology, and Axial Location to Outcomes in Symptomatic Cervical Disk Herniation Patients Treated With High-Velocity, Low-Amplitude Spinal Manipulation: A Prospective Study

Introduction: Recurrent laryngeal nerves (RLN) are particularly prone to injury during thyroid surgeries due to its intimate relationship and proximity with the gland. Zuckerkandl’s tubercle (ZT) helps in preserving RLN intra operative. Material and Methods: A prospective study for identifying RLN in thyroid surgery using relationship with superior parathyroid gland and tubercle of Zuckerkandl was conducted on 50 thyroidectomy patients between August 2013 and February 2014. Results: In all cases ZT was identified. Temporary paralysis of RLN was seen in 3 (6%) cases and permanent paralysis in 2 (4%) of cases. Discussion: The site of greatest risk during thyroidectomy to the RLN is in the last 2-3 cm extralaryngeal course of the nerve. Relationship of recurrent laryngeal nerve with superior parathyroid gland and tubercle of Zukerkandl (ZT) is known. Conclusion: Use of ZT and superior parathyroids as a landmark allows safe dissection of RLN.

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Surgical Management of Cervical Disk Herniation

Spinal Disorders and Treatments: The NYU-HJD Comprehensive Textbook ◽

10.5005/jp/books/12544_43 ◽

2015 ◽

pp. 301-301

Author(s):

Jonathan Stieber ◽

Kseniya Slobodyanyuk

Keyword(s):

Surgical Management ◽

Disk Herniation ◽

Cervical Disk Herniation ◽

Cervical Disk

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Diagnosis: Cervical Disk Herniation

Musculoskeletal Manual Medicine ◽

10.1055/b-0034-72442 ◽

2008 ◽

Keyword(s):

Disk Herniation ◽

Cervical Disk Herniation ◽

Cervical Disk

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Accurate Placement of Central Venous Catheters Using a 16-cm Catheter

Journal of Intensive Care Medicine ◽

10.1177/088506669601100104 ◽

1996 ◽

Vol 11 (1) ◽

pp. 19-22 ◽

Cited By ~ 14

Author(s):

William T. McGee ◽

Kevin P. Moriarty

Keyword(s):

Prospective Study ◽

Teaching Hospital ◽

Subclavian Vein ◽

Standard Of Care ◽

Central Venous Catheters ◽

Central Venous ◽

A Prospective Study ◽

Relationship Of ◽

Community Teaching ◽

Central Circulation

We determine if use of 16-cm central venous catheters (CVC) minimizes dangerous intracardiac catheter placements. We conducted a prospective study in a large community teaching hospital. Consecutive patients (n = 127) who required a CVC via either the internal jugular (IJV) or the subclavian vein (SCV) were assessed using 16 (n = 102) or 20-cm (n = 25) catheters. The main outcome measurements were (1) intracardiac placement of central venous catheters, and (2) relationship of right- or left-sided internal jugular or subclavian vein insertions to intracardiac catheter placement. Use of a 20-cm CVC resulted in 14 of 25 (56%) intracardiac placements compared with 11 of 102 (11%) using a 16-cm catheter ( p < 0.0001). All intracardiac placements with the 16-cm CVC were from right-sided approaches: IJV 7 of 38 (16%), SCV 4 of 18 (18%). Use of a 16-cm CVC to access the central circulation from either the SCV or the IJV results in a significantly greater proportion of safe catheter placements than using longer CVCs, and it should become the standard of care.

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