Severe hypotension related to high negative pressure suction drainage on a thoracic epidural drain during multilevel spinal fixation.

Hypotension or bradycardia or both related to intracranial hypotension after craniotomy has been reported in the literature. However, such reports are uncommon with thoracic epidural drains. We describe a case in which application of high negative pressure suction to a thoracic epidural drain caused a sudden decrease in arterial blood pressure.

Challenges in the surgical management of spine trauma in the morbidly obese patient: a case series.

Object: The treatment of morbidly obese individuals with spine trauma presents unique challenges to spine surgeons and trauma staff. This study aims to increase awareness of current limitations in the surgical management of spine trauma in morbidly obese individuals, and to illustrate practical solutions.

Methods: Six morbidly obese patients were treated surgically for spine trauma over a 2-year period at a single trauma center in Australia.