Perioperative nonopioid agents for pain control in spinal surgery.

Purpose: Commonly used nonopioid analgesic agents that are incorporated into multimodal perioperative pain management protocols in spinal surgery are reviewed.

Summary: Spinal procedures constitute perhaps some of most painful surgical interventions, as they often encompass extensive muscle dissection, tissue retraction, and surgical implants, as well as prolonged operative duration. Perioperative nonopioid analgesics frequently used in multimodal protocols include gabapentin, pregabalin, acetaminophen, dexamethasone, ketamine, and nonsteroidal antiinflammatory drugs (NSAIDs).

Novel free-hand T1 pedicle screw method: Review of 44 consecutive cases.

Summary Of Background Data: Multilevel posterior cervical instrumented fusions are becoming more prevalent in current practice. Biomechanical characteristics of the cervicothoracic junction may necessitate extending the construct to upper thoracic segments. However, fixation in upper thoracic spine can be technically demanding owing to transitional anatomy while suboptimal placement facilitates vascular and neurologic complications.

Thoracolumbar instrumentation with CT-guided navigation (O-arm) in 270 consecutive patients: accuracy rates and lessons learned.

Object: Thoracolumbar instrumentation has experienced a dramatic increase in utilization over the last 2 decades. However, pedicle screw fixation remains a challenging undertaking, with suboptimal placement contributing to postoperative pain, neurological deficit, vascular complications, and return to the operating suite. Image-guided spinal surgery has substantially improved the accuracy rates for these procedures.

Sinovenous thrombosis associated with skull fracture in the setting of blunt head trauma.

Background: Emerging literature suggests that closed head injuries may be an important etiology of cerebral venous sinus thrombosis (CVST). Fractures over the dural sinuses, in particular, may predispose such patients to this secondary complication. The purpose of this study was to determine the incidence and characteristics of CVST resulting from skull fractures overlying cerebral venous sinuses at a single tertiary care center.

Effects of tribromoethanol-medetomidine combination on cycling and ovariectomized Sprague-Dawley rats.

Although commonly used to induce anesthesia in rodents, the effective dose of tribromoethanol is associated with various side effects. The authors previously found that a tribromoethanol-medetomidine combination reduced the dose of tribromoethanol necessary for effective anesthesia in male Sprague-Dawley rats, an effect reversible by atipamezole. Here, the authors focus on the effect of this anesthetic combination in female Sprague-Dawley rats, its effects on their estrous cycles, and its efficacy at low sex hormone levels.