Direct connections between the spinal epidural space and the venous circulation in humans.

Background And Objectives: Our previous studies in pigs indicate that direct connections exist between the spinal epidural space and the venous circulation. We wondered if similar connections occur in humans and have extended our investigations to human cadavers awaiting autopsy.

Methods: We studied 10 recently dead human bodies.

A macromolecular tracer indicates that the spinal epidural space connects directly to the venous circulation in pigs.

Background And Objectives: Air injected into the epidural space of the spine reaches the heart within 15 secs, suggesting easy access to the bloodstream. We wished to quantify the washout of a macromolecular tracer (albumin labeled with Evans blue) from the thoracic epidural space.

Methods: Eleven juvenile pigs were anesthetized with isoflurane and positioned on their sides.

Surgical fasciectomy of the trapezius muscle combined with neurolysis of the Spinal accessory nerve; results and long-term follow-up in 30 consecutive cases of refractory chronic whiplash syndrome.

Background: Chronic problems from whiplash trauma generally include headache, pain and neck stiffness that may prove refractory to conservative treatment modalities. As has previously been reported, such afflicted patients may experience significant temporary relief with injections of local anesthetic to painful trigger points in muscles of the shoulder and neck, or lasting symptomatic improvement through surgical excision of myofascial trigger points. In a subset of patients who present with chronic whiplash syndrome, the clinical findings suggest an affliction of the spinal accessory nerve (CN XI, SAN) by entrapment under the fascia of the trapezius muscle.

Hydrodynamics of the spinal epidural space in pigs: effects of death and exsanguinations.

Background And Objectives: We have investigated how the vascular components of the spine determine the resistance and capacitance of the spinal epidural space and determined the magnitude of the longitudinal pressure gradient in the space during fluid infusion.

Methods: Pigs were studied during isoflurane anesthesia. Tuohy needles were inserted into midthoracic spine at adjacent interspaces, one to measure pressure in the epidural space and one for fluid infusion.