Impact of general anaesthesia on parameters of bulbocavernosus reflex

2021 ◽  
pp. 37-40
Author(s):  
D. E. Malyshok ◽  
A. Yu. Orlov ◽  
M. V. Aleksandrov
Keyword(s):  
Spinal Cord ◽  
Current Strength ◽  
Total Intravenous Anesthesia ◽  
Neurophysiological Monitoring ◽  
Spinal Cord Tumors ◽  
Intravenous Anesthesia ◽  
Intramedullary Tumors ◽  
Inhalation Anesthesia ◽  
Bulbocavernosus Reflex ◽  
Intradural Extramedullary

Dysfunction of the pelvic organs in tumor lesions of the spinal cord is up to 20%. Registration of the bulbocavernosus reflex is performed to assess the integrity of the segmental apparatus of the spinal cord. Polymodal neurophysiological monitoring includes registration of the bulbocavernosus reflex during surgery of spinal cord tumors. The effect of the components of general anesthesia on the parameters of the bulbocavernosus reflex varies significantly according to various medical sources. The aim of the work was to compare the effect of inhalation anesthesia (sevoflurane) and total intravenous anesthesia (propofol) on the parameters of the bulbocavernosus reflex in the surgical treatment of spinal cord tumors. Thirty patients with intradural extramedullary and intramedullary tumors of the spinal cord at the level of Th11–S2 vertebrae were included in the study. The amplitude-frequency parameters of the bulbocavernosus reflex and the threshold intensity of stimulation were assessed in the study. The results of the study demonstrate that intraoperative registration of the bulbocavernosus reflex during resection of tumors of the distal spinal cord can be performed both with inhalation and total intravenous anesthesia. A sustained motor response of the bulbocavernosus reflex requires a higher intensity of stimulation with inhalation anesthesia with sevoflurane than with total intravenous anesthesia. If during the operation the depth of propofol's anesthesia increases by 1 mg/kg/h, then it is necessary to increase the current strength during stimulation by 10–11 mA. 

scholarly journals “No performance in surgery more interesting and satisfactory”: Harvey Cushing and his experience with spinal cord tumors at the Johns Hopkins Hospital

2011 ◽  
Vol 14 (3) ◽  
pp. 412-420 ◽  
Author(s):  
Hormuzdiyar H. Dasenbrock ◽  
Courtney Pendleton ◽  
Aaron A. Cohen-Gadol ◽  
Jean-Paul Wolinsky ◽  
Ziya L. Gokaslan ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Correct Diagnosis ◽  
Adult Patients ◽  
Johns Hopkins Hospital ◽  
Spinal Cord Tumors ◽  
Intramedullary Tumors ◽  
Pathological Lesions ◽  
Harvey Cushing ◽  
Intradural Extramedullary ◽  
Spine Surgeon

Although Harvey Cushing was a neurosurgical pioneer, his work on the spine remains largely unknown. In fact, other than his own publications, Cushing's patients with pathological lesions of the spine who were treated while he was at the Johns Hopkins Hospital, including those with spinal cord tumors, have never been previously described. The authors report on 7 patients with spinal cord tumors that Cushing treated surgically between 1898 and 1911: 2 extradural, 3 intradural extramedullary, and 2 intramedullary tumors. The authors also describe 10 patients in whom Cushing performed an “exploratory laminectomy” expecting to find a tumor, but in whom no oncological pathological entity was found. Cushing's spine surgeries were limited by challenges in making the correct diagnosis, lack of surgical precedent, and difficulty in achieving adequate intraoperative hemostasis. Other than briefly mentioning 2 of the 4 adult patients in his landmark monograph on meningiomas, these cases—both those involving tumors and those in which he performed exploratory laminectomies—have never been published before. Moreover, these cases illustrate the evolution that Harvey Cushing underwent as a spine surgeon.

scholarly journals Intradural Spinal Cord Tumors Surgical Experience with Modified Sheehan Technique

2021 ◽  
Vol 5 (7) ◽  
Author(s):  
Ramadan Shamseldein
Keyword(s):  
Magnetic Resonance Imaging ◽  
Spinal Cord ◽  
Magnetic Resonance ◽  
Spinal Injury ◽  
Resonance Imaging ◽  
Spinal Cord Tumors ◽  
Radiological Investigation ◽  
Intramedullary Tumors ◽  
Period Range ◽  
Intradural Extramedullary

Background: Primary spinal cord tumors are rare neoplasms that lead to significant morbidities. They representing about 2–4% of all tumors that affect the central nervous system. According to their relation to the dura, and spinal cord they are classified into extradural, intradural extramedullary and intradural intramedullary tumors. Magnetic resonance imaging is the radiological investigation of choice for the diagnosis of intradural tumors both intra and extramedullary. Surgical excision is the best treatment modality in the majority of patients. Patients and Methods: This is a retrospective study of thirty patients, fifteen males, and fifteen females suffering spinal cord tumors. Median age at diagnosis 41years. Follow up period range from 6months to 43 months with average 24 months. Neurological assessment of the patients carried out by ASIA (American spinal injury association) scoring. Radiological evaluation occurs through MRI (magnetic resonance imaging) with contrast. Of the studied group seven cases were intradural intramedullary and twenty-three cases were intradural extramedullary. The utilized surgical approach was modified Sheehan technique and all the cases were operated by a single surgeon to avoid the inter surgeon variability. Histopathological assessment was done for the excised specimen for all patients. Results: Thoracic region most affected 53.3%, followed by cervical 23.4%, then lumbar (20%) regions. 76.7% intradural extramedullary, and 23.3% intradural intramedullary. Schwannoma 43.3% and Meningioma (20%) were the most pathology. ASIA group C decreased from 40% to 6.7%, and ASIA group D decreased from 60% to 26.7%, and we got a new ASIA group E 66.7% didn’t exist before surgery. Conclusion: The utilized surgical technique is very effective and safe as we get wide corridor for tumor excision, so increasing the effectiveness of operative microscopy and other operative tools, and improve the surgical outcome as noticed in postoperative neurological status.

Mucinous oligodendroglioma of the spinal cord in a dog

1995 ◽  
Vol 31 (1) ◽  
pp. 26-28 ◽  
Author(s):  
RB Wilson ◽  
SL Beckman
Keyword(s):  
Spinal Cord ◽  
Dura Mater ◽  
Subdural Space ◽  
Pathological Findings ◽  
Spinal Cord Tumors ◽  
Intramedullary Tumors ◽  
Intradural Extramedullary

Intraspinal neoplasia in the dog is relatively rare and may be classified according to the location of the tumor. Extradural tumors are situated outside the dura mater. Intradural tumors may be subdivided into two classes, depending upon whether the tumor is located outside the spinal cord in the subdural space (intradural extramedullary) or within the spinal cord substance (intramedullary). Intramedullary tumors are the least commonly reported spinal cord tumors; most primary intramedullary tumors are astrocytomas, ependymomas, or oligodendrogliomas. Reported here are the clinical, radiographic, and pathological findings associated with a spinal cord oligodendroglioma in a dog.

scholarly journals LONG-TERM RESULTS OF SURGICAL TREATMENT IN PATIENTS WITH INTRADURAL SPINAL TUMORS

2018 ◽  
Vol 73 (2) ◽  
pp. 88-95 ◽  
Author(s):  
V. A. Byvaltsev ◽  
I. A. Stepanov ◽  
E. G. Belykh ◽  
M. A. Aliyev
Keyword(s):  
Spinal Cord ◽  
Surgical Treatment ◽  
Long Term Results ◽  
Neurophysiological Monitoring ◽  
Spinal Cord Tumors ◽  
Intramedullary Tumors ◽  
Neurological Outcomes ◽  
Factors Influencing ◽  
Significant Difference

Background: Intradural spinal cord tumors include extramedullary and intramedullary tumors. The search for literature sources in the Pubmed, Medline, and E-Library databases detected a little number of researches on the long-term results of the surgical treatment of intradural spinal cord tumors. These clinical series include a small number of patients and do not consider the factors influencing clinical outcomes of surgical treatment.Aim: To evaluate the long-term results of surgical treatment in patients with intradural spinal cord tumors, to identify the main factors influencing the clinical and neurological outcomes of surgical interventions in this group of patients.Materials and methods: The study included 277 medical records of 244 patients with intradural extramedullary and 33 patients with intradural intramedullary tumors of the spinal cord. Clinical-neurological outcomes of surgical treatment in patients with intradural spinal cord tumors and factors influencing the outcomes were analyzed.Results: When comparing the degree of neurologic deficit in patients with intradural extramedullary tumors prior to surgery, no significant differences were found (p=0.241) both in the early postoperative period and 6 months after the surgery. Nevertheless, when comparing these indicators in a period of 12, 24, 36, 48, and 60 months after the surgery, statistically significant differences were revealed (p0.001). There was no statistically significant difference (p=0.437) between the scores in patients with intramedullary tumors on the modified McCormick Scale preoperatively, at the 6-month and one-year follow-up; however, comparison of the clinical and neurological indicators at 24, 26, 48, and 60 months revealed a significant difference (p0.001). The surgery outcomes in considered groups of patients were significantly influenced by the following indicators: the ASA risk level (odds ratio (OS) 2.138; 95% confidence interval (95% CI) 3.346–12.145) and intraoperative neurophysiological monitoring (OR 2.84; 95% CI 1.67–9.56).Conclusion: The study registered good and excellent long-term outcomes in most cases of intradural spinal cord tumors when the maximum possible tumor excision was performed. Analysis of the influence of various factors on the clinical and neurological outcomes in the study group of patients showed that the use of intraoperative neurophysiological monitoring and the degree of operational and anesthetic risk according to the ASA scale have a significant effect.

Diagnostic Utility of Intraoperative Neurophysiological Monitoring for Intramedullary Spinal Cord Tumors

2018 ◽  
Vol 31 (3) ◽  
pp. 112-119 ◽  
Author(s):  
Tej D. Azad ◽  
Arjun V. Pendharkar ◽  
Viet Nguyen ◽  
James Pan ◽  
Ian D. Connolly ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Intraoperative Neurophysiological Monitoring ◽  
Neurophysiological Monitoring ◽  
Diagnostic Utility ◽  
Spinal Cord Tumors ◽  
Intramedullary Spinal Cord

scholarly journals Surgical treatment of primary intramedullary spinal cord tumors in adult patients

2008 ◽  
Vol 66 (1) ◽  
pp. 59-63 ◽  
Author(s):  
Mario Augusto Taricco ◽  
Vinicius Monteiro de Paula Guirado ◽  
Ricardo Bragança de Vasconcellos Fontes ◽  
José Pindaro Pereira Plese
Keyword(s):  
Spinal Cord ◽  
Previous Treatment ◽  
Cervical Cord ◽  
Spinal Cord Tumors ◽  
Intramedullary Tumors ◽  
Treatment Protocols ◽  
Intramedullary Spinal Cord ◽  
Neurological Outcomes ◽  
Neurological Morbidity ◽  
Microsurgical Resection

BACKGROUND: Primary spinal cord intramedullary tumors are rare and present with insidious symptoms. Previous treatment protocols emphasized biopsy and radiation/chemotherapy but more aggressive protocols have emerged. OBJECTIVE: To report our experience. METHOD: Forty-eight patients were diagnosed with primary intramedullary tumors. The cervical cord was involved in 27% and thoracic in 42% of patients. Complete microsurgical removal was attempted whenever possible without added neurological morbidity. RESULTS: Complete resection was obtained in 33 (71%) patients. Neurological function remained stable or improved in 32 patients (66.7%). Ependymoma was the most frequent tumor (66.7%). CONCLUSION: Neurological outcome is superior in patients with subtle findings; aggressive microsurgical resection should be pursued with acceptable neurological outcomes.

Intradural Extramedullary and Intramedullary Spinal Cord Tumors

2012 ◽  
pp. 421-436 ◽  
Author(s):  
Michaël Bruneau ◽  
Florence Lefranc ◽  
Danielle Balériaux ◽  
Jacques Brotchi
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Tumors ◽  
Intramedullary Spinal Cord ◽  
Intradural Extramedullary
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