Anesthesia for Anterior/Posterior Spine Surgery

2018 ◽  
Author(s):  
Thomas N. Pajewski
Keyword(s):  
Anesthetic Management ◽  
Surgical Techniques ◽  
Spinal Column ◽  
Structural Instability ◽  
Neurological Dysfunction ◽  
Surgical Approaches ◽  
Surgical Patient ◽  
Surgical Interventions ◽  
Spine Pathology ◽  
Posterior Spine Surgery

Surgical approaches to correct spine pathology are based on anatomical considerations along with a surgeon’s experience and preference. Beyond consideration of the actual anatomic level being addressed, the different areas of the spinal column, cervical, thoracic, lumbar, and sacral coccygeal regions are in proximity of a range of structures that must be appreciated during surgery. These considerations impact the anesthetic management of the surgical patient. Historically, spine pathology was initially approached posteriorly, but, since the mid-twentieth century, the anterior approach has been more frequently used, especially at the cervical level. Advances in surgical techniques, coupled with advances in anesthesia and postoperative care, have allowed an increasing patient population to benefit from surgical interventions that address various forms of spinal pathology, including neurological dysfunction, deformity (either hereditary or acquired), structural instability, pathologic lesions (including tumor and infections), and pain.

scholarly journals Surgical Approaches in Management of Spinal Tuberculosis

2021 ◽  
Author(s):  
Vishal Kumar ◽  
Amit Kumar Salaria ◽  
Aditya Aggarwal ◽  
Sarvdeep Singh Dhatt
Keyword(s):  
Literature Review ◽  
Spinal Tuberculosis ◽  
Surgical Techniques ◽  
Surgical Approaches ◽  
Surgical Interventions ◽  
The Subject

AbstractAlthough the management of spinal tuberculosis (TB) is mainly medical, there are select surgical interventions for the same, especially in the event of complications. However, with multiple choices with regard to approaches and surgical techniques, one is often left with too many options. We, therefore, performed a literature review on the subject with respect to the surgical approaches to control spinal TB. Our aim is to enable the reader to understand the rationale behind various surgical approaches and techniques involved in managing spinal TB.

scholarly journals Complications associated with talectomy in paediatric patients: a comparative retrospective study of two surgical techniques

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Thamer S. Alhussainan ◽  
Omar A. Al-Mohrej ◽  
Abdullah Y. Almarshad ◽  
William J. Wade
Keyword(s):  
Surgical Techniques ◽  
Surgical Approaches ◽  
Foot Deformities ◽  
Recurrence Rates ◽  
Surgical Interventions ◽  
Group A ◽  
Baseline Characteristics ◽  
Group B ◽  
Operative Findings ◽  
Better Than

Abstract Background Studies describing the surgical approaches utilized for talectomy and their associated complications are scarce. We aimed to compare the surgical techniques and associated procedures from two groups of patients who underwent talectomy using two approaches. The main purpose of this study was to describe the complications and recurrence rates associated with each technique. Methods Between January 2004 and December 2019, 62 talectomies were performed in 48 pediatric patients with different pathologies. All patient data were reviewed retrospectively, and data of 31 patients were included in the study. The patients were divided into two groups based on the surgical technique used, and the baseline characteristics, along with the post-operative findings, and the intervention types in relation to complications were analyzed. Results In the terms of hindfoot varus, midfoot adductus, forefoot supination, and dorsal bunions, the prevalence of these deformities was higher in group (A). Group (B) patients tolerated braces (88.9 %) better than group (A) patients (84.0 %). More adjunct procedures were required in group (A) than group (B) Furthermore, the frequency and types of complications, as well as the need for further surgeries were also higher in group (A). There was a higher rate of recurrence in group A than group B. Conclusions Talectomy is an effective procedure for the treatment of persistent foot deformities despite associated complications. Surgical details and addressing associated deformities with adjunct surgical interventions should be considered.

scholarly journals OBESITY - AS A RISK OF COMPLICATIONS IN EMERGENCY SURGERY

2021 ◽  
pp. 144-149
Author(s):  
S.A. Zhidkov ◽  
◽  
A.S. Zhidkov ◽  
A.A. Peteko ◽  
D.S. Boiba ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Surgical Techniques ◽  
Surgical Approaches ◽  
Obese Patients ◽  
Actual Number ◽  
Obese People ◽  
Surgical Interventions ◽  
Organ Specific ◽  
The Impact ◽  
Emergency Abdominal Surgery

In recent years, both the actual number of overweight and obese people and their share in the population have been steadily increasing worldwide. Obese patients can no longer be considered as a small group, and they deserve special attention in relation to their surgical treatment. The results of this treatment are often difficult to combine due to differences between surgical interventions, surgical approaches, organ-specific complications, surgical techniques, and classifications of complications. This review aims to provide results on the impact of obesity on the frequency and types of complications after emergency abdominal surgery based on recent publications.

Current Strategies in the Management of Spinal Metastatic Disease

Swiss Surgery ◽  
2003 ◽  
Vol 9 (2) ◽  
pp. 55-62 ◽  
Author(s):  
Bartanusz ◽  
Porchet
Keyword(s):  
Spinal Cord ◽  
Surgical Techniques ◽  
Cord Compression ◽  
Treatment Modalities ◽  
Surgical Approaches ◽  
Spinal Stabilization ◽  
Management Algorithm ◽  
Specific Manner ◽  
Extensive Surgery ◽  
Selection Of

The treatment of metastatic spinal cord compression is complex. The three treatment modalities that are currently applied (in a histologically non-specific manner) are surgery, radiotherapy and the administration of steroids. The development of new spinal instrumentations and surgical approaches considerably changed the extent of therapeutic options in this field. These new surgical techniques have made it possible to resect these tumours totally, with subsequent vertebral reconstruction and spinal stabilization. In this respect, it is important to clearly identify those patients who can benefit from such an extensive surgery. We present our management algorithm to help select patients for surgery and at the same time identifying those for whom primary non-surgical therapy would be indicated. The retrospective review of surgically treated patients in our department in the last four years reveals a meagre application of conventional guidelines for the selection of the appropriate operative approach in the surgical management of these patients. The reasons for this discrepancy are discussed.

scholarly journals The concept of “Four Walls, Two Poles” in the lesions of the thalamus and ganglion regions: case report and literature review

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Haiyang Yang ◽  
Gang Bai ◽  
Yongli Zhang ◽  
Guolong Chen ◽  
Lei Duan ◽  
...  
Keyword(s):  
Basal Ganglia ◽  
Literature Review ◽  
Surgical Resection ◽  
Three Dimensional ◽  
Surgical Techniques ◽  
Surgical Approaches ◽  
Surgical Results ◽  
Case Presentation ◽  
Operation Process ◽  
Thalamic Glioma

Abstract Background There are few articles about the surgical techniques of thalamic glioma and the lesions in the basal ganglia area. According to three existing cases and the literature review (Twelve articles were summarized which mainly described the surgical techniques), we discuss the surgical characteristics of lesions of the thalamus and basal ganglia area and summarize the relevant surgical skills. Case presentation Of the three cases, two were thalamic gliomas and one was brain abscess in basal ganglia. According to the three-dimensional concept of the “Four Walls, Two Poles”, lesions of the thalamus and basal ganglia were surgically removed, and the operative effect was analysed by relevant surgical techniques. Surgical resection of the lesions of the thalamus and basal ganglia area according to the three-dimensional concept of the “Four Walls, Two Poles” has achieved good surgical results. Relevant surgical techniques, such as the use of retractors, the use of aspirators, the choice of surgical approaches, and the haemostasis strategy, also played an important role in the operation process. Conclusions In the presented three cases the three-dimensional concept of the “Four Walls, Two Poles” allowed for safe surgical resection of lesions of the thalamus and basal ganglia.

scholarly journals Primary Malignant Orbital Tumors

2021 ◽  
Vol 82 (01) ◽  
pp. 081-090
Author(s):  
Jacquelyn Laplant ◽  
Kimberly Cockerham
Keyword(s):  
Multimodal Therapy ◽  
Surgical Techniques ◽  
Surgical Approaches ◽  
Imaging Features ◽  
Orbital Surgery ◽  
Diagnosis And Management ◽  
Microsurgical Techniques ◽  
Invasive Techniques ◽  
Traditional Approaches ◽  
Orbital Imaging

Abstract Objective Primary orbital malignancy is rare. Awareness of the characteristic clinical and imaging features is imperative for timely identification and management. Surgery remains an important diagnostic and treatment modality for primary orbital malignancy, but determining the optimal surgical approach can be challenging. The purpose of this article is to explore recent advances in the diagnosis, management, and surgical approaches for primary orbital malignancies. Design In this review, the clinical presentation, imaging features, and medical and surgical management of primary orbital malignancies with representative cases will be discussed. Setting Outpatient and inpatient hospital settings. Participants Patients with diagnosed primary orbital malignancies. Main Outcome Measures Descriptive outcomes. Results Advancements in orbital imaging, microsurgical techniques, and multimodal therapy have improved the diagnosis and management of primary orbital malignancies. Special considerations for biopsy or resection are made based on the tumor's location, characteristics, nearby orbital structures, and goals of surgery. Minimally invasive techniques are supplanting traditional approaches to orbital surgery with less morbidity. Conclusions Advances in imaging technologies and surgical techniques have facilitated the diagnosis and management of primary orbital malignancies. Evolution toward less invasive orbital surgery with focus on preservation and restoration of function is underway.

scholarly journals Trends in surgical and catheter interventions for isolated congenital shunt lesions in the UK and Ireland

Heart ◽  
2019 ◽  
Vol 105 (14) ◽  
pp. 1103-1108 ◽  
Author(s):  
Mehreen Farooqi ◽  
John Stickley ◽  
Rami Dhillon ◽  
David J Barron ◽  
Oliver Stumper ◽  
...  
Keyword(s):  
Ventricular Septal Defect ◽  
Patent Foramen Ovale ◽  
Septal Defect ◽  
Surgical Techniques ◽  
Foramen Ovale ◽  
Patient Age ◽  
Surgical Interventions ◽  
Patient Âgé ◽  
Duct Ligation ◽  
The Uk

ObjectiveTo evaluate time trends in the use of catheter and surgical procedures, and associated survival in isolated congenital shunt lesions.MethodsNationwide, retrospective observational study of the UK National Congenital Heart Disease Audit database from 2000 to 2016. Patients undergoing surgical or catheter procedures for atrial septal defect (including sinus venosus defect), patent foramen ovale, ventricular septal defect and patent arterial duct were included. Temporal changes in the frequency of procedures, and survival at 30 days and 1 year were determined.Results40 911 procedures were performed, 16 604 surgical operations and 24 307 catheter-based interventions. Transcatheter procedures increased over time, overtaking surgical repair in 2003–2004, while the number of operations remained stable. Trends in interventions differed according to defect type and patient age. Catheter closure of atrial septal defects is now more common in children and adults, although surgical interventions have also increased. Patent foramen ovale closure in adults peaked in 2009–2010 before falling significantly since. Surgery remains the mainstay for ventricular septal defect in infants and children. Duct ligation is most common in neonates and infants, while transcatheter intervention is predominant in older children. Excluding duct ligation, survival following surgery was 99.4% and ≈98.7%, and following catheter interventions was 99.7% and ≈99.2%, at 30 days and 1 year, respectively.ConclusionsTrends in catheter and surgical techniques for isolated congenital shunt lesions plot the evolution of the specialty over the last 16 years, reflecting changes in clinical guidelines, technology, expertise and reimbursement, with distinct patterns according to lesion and patient age.

scholarly journals Minimum Invasive Stabilizing and Decompressive-Stabilizing Methods of Surgical Treatment for Degenerative-Dystrophic Lesions of Spine

2011 ◽  
Vol 18 (4) ◽  
pp. 3-10
Author(s):  
A V Krut'ko ◽  
Shamil' Al'firovich Akhmet'yanov ◽  
D M Kozlov ◽  
A V Peleganchuk ◽  
A V Bulatov ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Lumbar Spine ◽  
Surgical Techniques ◽  
Pain Syndrome ◽  
Early Postoperative Period ◽  
Main Group ◽  
Control Group ◽  
Surgical Interventions ◽  
Comparative Group ◽  
Operative Wound

Results of randomized prospective study with participation of 94 patients aged from 20 to 70 years with monosegmental lumbar spine lesions are presented. Minimum invasive surgical interventions were performed in 55 patients from the main group. Control group consisted of 39 patients in whom decompressive-stabilizing operations via conventional posteromedian approach with skeletization of posterior segments of vertebral column were performed. Average size of operative wound in open interventions more than 10 times exceeded that size in minimum invasive interventions and made up 484 ± 56 and 36 ± 12 sq.cm, respectively. Mean blood loss was 326.6 ± 278.0 ml in the main group and 855.1 ± 512.0 ml in the comparative one. In the main group no one patient required substitution hemotransfusion, while in 13 patients from the comparative group donor erythrocytic mass and/or fresh-frozen plasma were used to eliminate the deficit of blood components. Intensity of pain syndrome in the zone of surgical intervention by visual analog scale in the main group was lower than in comparative group. In the main and comparative groups the duration of hospitalization made up 6.1 ± 2.7 and 9.7 ± 3.7 bed days, respectively. In no one patient from the main group complications in the zone of operative wound were noted. Three patients from the comparative group required secondary debridement and in 1 patient early deep operative wound suppuration was observed. Application of low invasive surgical techniques for the treatment of patients with degenerative lumbar spine lesions enabled to perform radical surgical treatment with minimal iatrogenic injury. The method possessed indubitable advantages over the conventional open operations especially intraoperatively and in early postoperative period.

scholarly journals Radical Dorsal Interventions in Treatment of Kyphotic Deformities (Literature Review)

2015 ◽  
Vol 22 (2) ◽  
pp. 66-75
Author(s):  
M. V Mikhailovskiy ◽  
V. V Novikov ◽  
I. G Udalov
Keyword(s):  
Clinical Practice ◽  
Literature Review ◽  
Vertebral Column ◽  
Surgical Techniques ◽  
Pedicle Subtraction Osteotomy ◽  
Treatment Results ◽  
Vertebral Column Resection ◽  
Surgical Interventions ◽  
Ponte Osteotomy ◽  
Spine Deformities

Widely used in clinical practice surgical interventions directed to the correction of severe kyphotic spine deformities, i.e. Ponte osteotomy, Smith-Peterson osteotomy, pedicle subtraction osteotomy and vertebral column resection are presented. Surgical techniques, surgery planning based on spinal and pelvic sagittal contour parameters, treatment results are described.

scholarly journals The effectiveness of spatially cross-linked polymer in the postoperative epidural fibrosis prevention: an experimental study

2021 ◽  
Vol 6 (3) ◽  
pp. 174-184
Author(s):  
K. Ts. Erdyneev ◽  
V. A. Sorokovikov ◽  
D. N. Sambuev ◽  
V. P. Saganov ◽  
B. B. Dambaev ◽  
...  
Keyword(s):  
Dura Mater ◽  
Spinal Column ◽  
Epidural Fibrosis ◽  
Barrier Methods ◽  
Surgical Interventions ◽  
Scientific Databases ◽  
Group I ◽  
Literary Sources ◽  
Male Wistar Rats ◽  
Vertebral Bodies

Introduction. Epidural fibrosis is an urgent problem in modern spinal surgery and orthopedics. The formation of connective tissue in the epidural space after performing surgical interventions on the spinal column inevitably leads to adhesion of the latter to the dura mater and compression of neural structures, followed by the formation of clinical and neurological symptoms. The  search for literary sources in domestic and foreign scientific databases has demonstrated the presence of several works studying the effectiveness of barrier methods for preventing the development of epidural fibrosis. It should be noted that the results of these studies are ambiguous and largely contradictory.The purpose was to study the effectiveness of using a spatially cross-linked polymer in the postoperative lumbar epidural fibrosis prevention in an experiment.Materials and methods. The study included 26 male Wistar rats (average body weight 338.5±9.07 g), which were divided into two groups: Group I (control, n = 12): animals underwent laminectomy at the level of vertebral bodies LVII – SI  without application of spatially crosslinked polymer; Group II (experimental, n = 14): animals underwent laminectomy at the level of vertebral bodies LVII – SI  followed by application of a spatially cross-linked polymer to the dura mater. The morphological and instrumental parameters were studied.Results. Significant differences were noted in the severity of epidural fibrosis (χ2 = 14.846, p = 0.003), the number of newly formed vessels (F = 14.371, p<0.001), the number of fibroblasts (F = 11.158, p<0.001), as well as in the severity of vertebral stenosis channe l according to multislice computed tomography (χ2 = 17.207, p=0.002) between the control and experimental groups of animals.Conclusion. Application of a spatially cross-linked polymer to the dura mater is an effective way to prevent the development of postoperative epidural fibrosis.

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