Pragmatic Approach to Neuraxial Anesthesia in Obstetric Patients With Disorders of the Vertebral Column, Spinal Cord, and Neuromuscular System

2021 ◽  
Vol 41 (4) ◽  
pp. 164-165
Author(s):  
E. Walsh ◽  
Yi. Zhang ◽  
H. Madden ◽  
J. Lehrich ◽  
L. Leffert
2020 ◽  
pp. rapm-2020-101792
Author(s):  
Elisa Walsh ◽  
Yi Zhang ◽  
Hannah Madden ◽  
James Lehrich ◽  
Lisa Leffert

Neuraxial anesthesia provides optimal labor analgesia and cesarean delivery anesthesia. Obstetric patients with disorders of the vertebral column, spinal cord and neuromuscular system present unique challenges to the anesthesiologist. Potential concerns include mechanical interference, patient injury and the need for imaging. Unfortunately, the existing literature regarding neuraxial anesthesia in these patients is largely limited to case series and rare retrospective studies. The lack of practice guidance may lead to unwarranted fear of patient harm and subsequent avoidance of neuraxial anesthesia for cesarean delivery or neuraxial analgesia for labor, with additional risks of exposure to general anesthesia. In this narrative review, we use available evidence to recommend a framework when considering neuraxial anesthesia for an obstetrical patient with neuraxial pathology.


2017 ◽  
Vol 0 (4.83) ◽  
pp. 61-77
Author(s):  
O.A. Loskutov ◽  
A.M. Strokan ◽  
O.M. Mykhalchenko ◽  
V.V. Martsyniv

2021 ◽  
Vol 26 (3) ◽  
pp. 15-19
Author(s):  
Ivona Orgonikova ◽  
Josep Brocal ◽  
Giunio Bruto Cherubini ◽  
Viktor Palus

Assessing the presence of vertebral column instability is essential in animals with vertebral fractures or luxations. Spinal instability is most commonly assessed using a three-compartment model and unstable vertebral fractures and luxations require surgical stabilisation. In cases of compression of the spinal cord (by haematoma, traumatic intervertebral disc extrusion or bone fragment), decompression surgery is necessary. Prompt surgery prevents additional spinal cord damage, but the overall condition of the patient, including any concurrent injuries, needs to be continually kept in mind. The vertebral column can be stabilised using multiple techniques, such as screws, pins, polymethylmetacrylate and plating techniques, as well as external stabilisation and spinal stapling. Complications of spinal surgeries include haemorrhage, infection, neurological deterioration, particularly in cases of spinal stabilisations, implant loosening and failure.


Development ◽  
2021 ◽  
Vol 148 (4) ◽  
pp. dev180612
Author(s):  
Filip J. Wymeersch ◽  
Valerie Wilson ◽  
Anestis Tsakiridis

ABSTRACTThe generation of the components that make up the embryonic body axis, such as the spinal cord and vertebral column, takes place in an anterior-to-posterior (head-to-tail) direction. This process is driven by the coordinated production of various cell types from a pool of posteriorly-located axial progenitors. Here, we review the key features of this process and the biology of axial progenitors, including neuromesodermal progenitors, the common precursors of the spinal cord and trunk musculature. We discuss recent developments in the in vitro production of axial progenitors and their potential implications in disease modelling and regenerative medicine.


2006 ◽  
pp. 144-144
Author(s):  
PK Sahoo ◽  
UN Panda
Keyword(s):  

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