Cases reported "Spinal Cord Injuries"

Filter by keywords:



Filtering documents. Please wait...

1/117. Special problems associated with abdominal aneurysmectomy in spinal cord injury patients.

    There were 8 patients with spinal cord injury in the last 100 consecutive patients with abdominal aortic aneurysm resected at the Long Beach veterans Administration Hospital. Emphasis is placed upon the problems in management not found in individuals without spinal cord injury. A successful outcome is dependent upon: (a) aggressive control of foci of infection, (b) early diagnosis and planned surgical intervention, (c) continuous intraoperative arterial and central venous pressure monitoring and (d) alertness to the prevention of postoperative complications, with emphasis upon careful tracheal toilet and anticipation of delayed wound healing.
- - - - - - - - - -
ranking = 1
keywords = operative
(Clic here for more details about this article)

2/117. The efficacy of single-stage surgical management of multiple pressure sores in spinal cord-injured patients.

    The practice of multiple-stage management in the treatment of patients with multiple pressure ulcers has long represented the standard of care in many specialty centers. The authors have observed that an aggressive surgical approach has proved necessary for control of this devastating problem in these patients. Their experience with one-stage reconstruction of multiple pressure sores over a 10-year period (between 1986 and 1996) in 120 spinal cord-injured patients has revealed certain advantages of this comprehensive method of surgical management. Although cumulative operating time and intraoperative blood loss were somewhat increased, the number of anesthetic episodes and the hospital stay were less than that seen in patients managed in multiple stages. Accordingly, rehabilitation and societal reintegration can be initiated earlier, and overall hospital cost may be better contained.
- - - - - - - - - -
ranking = 0.5
keywords = operative
(Clic here for more details about this article)

3/117. Diagnosis and treatment of acute central cervical cord injury.

    OBJECTIVE: To clarify the diagnosis and management of acute central cervical cord injury. methods: Eighty-nine patients with acute cervical central cord injury were retrospectively reviewed. Sixty-three patients were treated conservatively and 26 were treated surgically. There were two acute deaths. Eighty-seven patients were followed up for 3 months to 15 years. RESULTS: Their average neurological score (asia) was increased from 41.7 at admission to 83.1 at follow-up. CONCLUSIONS: Acute central cervical cord injury should be differentiated from complete spinal cord injury, cervical myelopathy, cruciate paralysis and C8 nerve root injury. When compression of nerve tissue or cervical instability is identified, operative intervention should be indicated. The prognosis is less optimistic in the patients with severe primary injury and at old age.
- - - - - - - - - -
ranking = 0.5
keywords = operative
(Clic here for more details about this article)

4/117. Ascending myelopathy in the early stage of spinal cord injury.

    A 30-year-old healthy woman was involved in a road traffic accident. She sustained a fracture dislocation of T11/12 with a complete Frankel A paraplegia below T11. She had no associated injuries. High Dose methylprednisolone was administered according to the NASCIS III protocol (48 h) together with low molecular weight heparin and gastroprotected medication. Complete transection of the spinal cord and an anterior haematoma from T11 to T12 were confirmed on X rays, CT's and MRI scans. Posterior surgical stabilisation was performed using Isola instrumentation, starting 8 h post injury. Her post surgical period was uneventful except for some episodes of low blood pressure (85/60 mmHg) from which she had no symptoms. On the 12th post operative day, while in the physiotherapy department, she complained of right scapular pain. This occurred every time she was sat up and was associated with paraesthesia of both upper limbs. Two days later she deteriorated neurologically and her level ascended initially to T8 and then to T3. MRI of the spine with and without gadolinium showed spinal cord oedema between C3 and T1. There was no evidence of haemorrhage or syringomyelia. The authors discussed this case making different hypotheses. They are mainly the following: (1) Gradually ascending ischaemia due to a vascular disorder; (2) Double spinal trauma; (3) Ischaemia related to repeated hypotensive episodes; (4) Low grade intramedullary tumour; and (5) Thrombus of the Radicularis Magna artery. The case has been recognised as being very rare and interesting. In the conclusions, the presenting author stresses the importance of adopting MRI-compatible instrumentation for the surgical stabilisation of the spine, and careful monitoring of blood pressure during the acute phase of spinal cord injury. Dr Aito agrees with Mr El Masry about the opportunity of forming a group of clinicians in order to discuss protocols to cope with this devastating complication.
- - - - - - - - - -
ranking = 0.5
keywords = operative
(Clic here for more details about this article)

5/117. 'Shared spinal cord' scenario: paraplegia following abdominal aortic surgery under combined general and epidural anaesthesia.

    Serious neurological complications of abdominal aortic vascular surgery are rare but devastating for all involved. When epidural blockade is part of the anaesthetic technique such complications may be attributed to needles, catheters or drugs. We present a patient who developed paraplegia following an elective abdominal aortic aneurysm repair. Continuous epidural blockade was part of the anaesthetic technique and postoperative analgesia. In this case the spinal cord damage was explained by ischaemia caused by the aortic surgery. This event has made us aware of a rare complication associated with abdominal aortic surgery and highlighted safety aspects of epidural anaesthesia in such patients.
- - - - - - - - - -
ranking = 0.5
keywords = operative
(Clic here for more details about this article)

6/117. Delayed presentation of spinal stab wound: case report and review of the literature.

    Stab wounds to the spinal cord are relatively uncommon in north america, but even rarer is the presentation of such an injury in a delayed fashion. We report a case of a 31-year-old male who presented with neurologic deficit 4 weeks after a stab wound injury to the spine. Because of worsening neurologic deficit, the retained knife fragment was operatively removed, and the patient had an uneventful recovery. The management of such an injury is discussed, with a review of the literature.
- - - - - - - - - -
ranking = 0.5
keywords = operative
(Clic here for more details about this article)

7/117. Laparoscopic bladder auto-augmentation in an incomplete traumatic spinal cord injury.

    OBJECTIVES: To assess the urodynamic and clinical outcome of a laparoscopic auto-augmentated bladder. methods: Laparoscopic bladder autoaugmentation in a 27-year-old woman with an incomplete spinal cord injury at T12 level with urge incontinence caused by a hyperreflexic bladder. RESULTS: Six months later the patient voids by Valsalva's manoeuvre every 3 h and remains dry day and night. The radio-urodynamic study, performed 2 months later, revealed an intact bladder with a diverticulum of anterior wall and a capacity of 510 ml with filling rate of 100 ml/min without evidence of leakage of infusion water. CONCLUSION: Laparoscopic retropubic auto-augmentation allows a brief hospital stay and minor postoperative discomfort. Moreover the laparoscopic approach should not complicate or preclude subsequent enterocystoplasty if necessary.
- - - - - - - - - -
ranking = 0.5
keywords = operative
(Clic here for more details about this article)

8/117. Lobectomy for destroyed lung in quadriplegic patients.

    BACKGROUND: Sixty-seven percent of quadriplegic patients after spinal cord injury (SCI) develop respiratory complications, which leads to death in one third. Preventive measures may fail to avoid parenchymal destruction and possible septic complications. methods: Three quadriplegic patients (C3-C6 level), with destroyed lower lobes and incontrollable septic symptoms, were subjected to lobectomy. RESULTS: Neither operative morbidity nor mortality was observed. All patients were discharged home without ventilatory assistance, and were symptom-free. CONCLUSIONS: When the endobronchial chronic infection calls for repeated fiberoptic bronchoscopies to clear the bronchial tree, the parenchymal destruction is limited to one lobe of the lung, and there is evidence of impending septic complications, lobectomy may be indicated in quadriplegics to eradicate the source of infection.
- - - - - - - - - -
ranking = 0.5
keywords = operative
(Clic here for more details about this article)

9/117. Bilateral S3 nerve stimulation, a minimally invasive alternative treatment for postoperative stress incontinence after implantation of an anterior root stimulator with posterior rhizotomy: a preliminary observation.

    STUDY DESIGN: A preliminary report. OBJECTIVES: Urinary stress incontinence following implantation of an anterior root stimulator and a posterior rhizotomy is a rare complication which is difficult to treat. It is seen in patients with an open bladder neck (T9-L2 lesion). An artificial urinary sphincter is a possible treatment for this condition but has a higher failure rate in patients with neurogenic bladder disease and could complicate micturition. SETTING: Ghent, belgium. methods: A male paraplegic patient (T9, complete lesion) aged 36 was suffering from severe urinary incontinence due to detrusor hyperreflexia. Preoperatively the bladder neck was closed on cystography. Following implantation (6/95) of an intradural anterior root stimulator with posterior rhizotomy, severe urinary stress incontinence presented. Bilateral S3 foramen leads were implanted and connected to a pulse generator. RESULTS: The patient has been continent with continuous stimulation of both S3 roots for 4 years, and no fatigue of the levator muscles has been seen. Preoperative urodynamics are compared to results 3 years postoperatively. CONCLUSION: Bilateral S3 stimulation is a feasible and minimally invasive treatment of urinary stress incontinence following implantation of an anterior root stimulator.
- - - - - - - - - -
ranking = 3.5
keywords = operative
(Clic here for more details about this article)

10/117. osteonecrosis after treatment for heterotopic ossification in spinal cord injury with the combination of surgery, irradiation, and an NSAID.

    STUDY DESIGN: Case report. OBJECTIVE: Heterotopic ossification (HO) is a frequent complication in spinal cord injury (SCI) that is often difficult to treat. Although surgery may become necessary, operative resection has been associated with complications and poor outcome due to a high recurrence rate. Additional methods of treatment to reduce the recurrence rate have been developed, including post operative irradiation and NSAIDs. This article presents three patients, who developed an osteonecrosis of the femoral head after the combined treatment for HO of surgery, irradiation, and an NSAID.
- - - - - - - - - -
ranking = 1
keywords = operative
(Clic here for more details about this article)
| Next ->


Leave a message about 'Spinal Cord Injuries'


We do not evaluate or guarantee the accuracy of any content in this site. Click here for the full disclaimer.