Anesthetic Challenges of an Adolescent Patient with Epidermolysis Bullosa and Gitelman's Syndrome Undergoing Posterior Spinal Fusion Surgery

2020 ◽  
Author(s):  
Edgar E. Kiss ◽  
Neethu Chandran ◽  
Gijo Alex ◽  
Patrick Olomu
Keyword(s):  
Spinal Fusion ◽  
Epidermolysis Bullosa ◽  
Posterior Spinal Fusion ◽  
Epidermolysis Bullosa Simplex ◽  
Spinal Fusion Surgery ◽  
Gitelman's Syndrome ◽  
Intraoperative Management ◽  
Anesthetic Considerations ◽  
Perioperative Planning

AbstractSurgical correction for scoliosis is undertaken to avoid progression to cardiopulmonary compromise as well as improve the patient's overall quality of life. In this case report, we presented a case of a 14-year-old girl with epidermolysis bullosa simplex and Gitelman's syndrome who underwent posterior spinal fusion for scoliosis. The perioperative planning and intraoperative management of a patient with this unique combination of comorbidities undergoing a complex, high-risk surgical procedure were not previously chronicled in the literature. We detailed the steps undertaken to optimize the patient prior to surgery and the unique intraoperative surgical and anesthetic considerations that led to a successful completion of the surgery and recovery.

Fatal pulmonary fat embolism after posterior spinal fusion surgery

2006 ◽  
Vol 11 (2) ◽  
pp. 217-220 ◽  
Author(s):  
Yoshimasa Takahashi ◽  
Ken’ichiro Narusawa ◽  
Kenji Shimizu ◽  
Masakazu Takata ◽  
Toshitaka Nakamura
Keyword(s):  
Spinal Fusion ◽  
Posterior Spinal Fusion ◽  
Fat Embolism ◽  
Fusion Surgery ◽  
Spinal Fusion Surgery ◽  
Pulmonary Fat Embolism

scholarly journals Intranasal Premedication Combined with Erector Spinae Plane Block during Spinal Surgery for a Paediatric Patient: A Case Report

2021 ◽  
Vol 8 (1) ◽  
Author(s):  
Bao L ◽  
◽  
Qu M ◽  
Jing S ◽  
◽  
...  
Keyword(s):  
Spinal Fusion ◽  
Spinal Surgery ◽  
Congenital Scoliosis ◽  
Posterior Spinal Fusion ◽  
Erector Spinae ◽  
Surgical Trauma ◽  
Fusion Surgery ◽  
Perioperative Analgesia ◽  
Spinal Fusion Surgery ◽  
Erector Spinae Plane Block

Posterior spinal fusion surgery for congenital scoliosis may cause substantial surgical trauma. Erector Spinae Plane Block (ESPB) can alleviate pain in adults who undergo spinal surgery; however, reports regarding its use in paediatric patients are limited. Here, we report the case of a 2-year-old girl who underwent posterior spinal fusion for congenital scoliosis. The patient initially experienced severe sadness upon separation from her parents; however, after performing various interactive activities, premedication using intranasal dexmedetomidine and midazolam was administered to sedate the patient. Ultrasound-guided bilateral ESPB was applied for perioperative analgesia. The anaesthesiologist identified mild-to-moderate pain during the first 6 days after surgery using the visual analogue scale for pain and Face, Legs, Activity, Cry, and Consolability scale. Therefore, ESPB may provide a satisfactory analgesic effect and help reduce postoperative opioid consumption in children who require spinal fusion surgery.

scholarly journals The role of femoral obliquity angle and T1 pelvic angle in predicting quality of life after spinal surgery in adult spinal deformities

2021 ◽  
Vol 22 (S2) ◽  
Author(s):  
Andrea Perna ◽  
Luca Proietti ◽  
Amarildo Smakaj ◽  
Calogero Velluto ◽  
Maria Concetta Meluzio ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Spinal Fusion ◽  
Strong Correlation ◽  
Spinal Surgery ◽  
Functional Outcomes ◽  
Rank Correlation ◽  
Posterior Spinal Fusion ◽  
Spinal Deformities ◽  
Spinopelvic Parameters

Abstract Background Adult spinal deformities (ASD) represent a growing clinical condition related to chronic pain, disability and reduction in quality of life (QoL). A strong correlation among spinal alignment, spinopelvic parameters and QoL after spinal fusion surgery in ASD patients was thoroughly investigated over the last decade, However, only few studies focused on the relationship between lumbo-pelvic-femoral parameters - such as Femoral Obliquity Angle (FOA), T1 Pelvic Angle (TPA) and QoL. Methods Radiological and clinical data from 43 patients surgically treated with thoracolumbar posterior spinal fusion for ASD between 2015 and 2018 were retrospectively analyzed. The primary outcomes were the correlation between preoperative spino-pelvic-femoral parameters and postoperative clinical, functional outcomes and QoL. Secondary outcomes were: changes in sagittal radiographic parameters spino-pelvic-femoral, clinical and functional outcomes and the rate of complications after surgery. Results Using Spearman’s rank correlation coefficients, spinopelvic femoral parameters (FOA, TPA, pre and post-operative) are directly statistically correlated to the quality of life (ODI, SRS-22, pre and post-operative; > 0,6 strong correlation, p <  0.05). Stratifying the patients according pre preoperative FOA value (High FOA ≥ 10 and Normal/Low FOA <  10), those belonging to the first group showed worse clinical (VAS: 5.2 +/− 1.4 vs 2.9 +/− 0.8) and functional outcomes (ODI: 35.6+/− 6.8 vs 23.2 +/− 6.5) after 2 years of follow-up and a greater number of mechanical complications (57.9% vs 8.3% p <  0.0021). Conclusion Based on our results, preoperative FOA and TPA could be important prognostic parameters for predicting disability and quality of life after spinal surgery in ASD patients and early indicators of possible spinal sagittal malalignment. FOA and TPA, like other and better known spinopelvic parameters, should always be considered when planning corrective surgery in ASD patients.

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