In 100 pregnant women, identification of the epidural space was performed by a modified drip method. A saline infusion was prepared, leaving the distal 40 cm of infusion tubing full of air, and then attached to the hub of a Tuohy needle. Accurate identification of the epidural space was accomplished in less than one minute in 95% of cases. There were no unintentional dural punctures. This technique has advantages over the hanging drop and the manual loss of resistance techniques.
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Cureus
December 2024
Anesthesiology, South Brooklyn Health, Brooklyn, USA.
The efficacy of epidural blood patch (EBP) is highly variable, and often, clinicians are unable to identify the underlying reasons for treatment failure. A 36-year-old parturient underwent a "blind" epidural blood patch (EBP) without image guidance but failed to obtain relief from a postural headache related to the labor epidural. During the second EBP, an intact plica mediana dorsalis (PMD) was visualized in the anterior-posterior fluoroscopic view after injection of contrast, and autologous blood was injected on both sides of the PMD, leading to the complete resolution of headache symptoms.
View Article and Find Full Text PDFGlobal Spine J
January 2025
Department of Orthopedic Surgery, Kobe City Medical Center General Hospital, Kobe, Japan.
Study Design: Retrospective study.
Objective: To elucidate the factors influencing the identification of causative microorganisms in vertebral osteomyelitis (VO) and the effectiveness of different culture methods in increasing the identification rate.
Methods: A total of 252 patients diagnosed with and treated for VO at a single hospital were enrolled.
Quant Imaging Med Surg
January 2025
Department of Radiology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China.
The goal of this study was to summarize the radiological findings and clinical characteristics of mediastinal Ewing sarcoma/primitive neuroectodermal tumor (ES/PNET) in children. A retrospective review was conducted on the clinical and imaging data of 6 children with primary mediastinal ES/PNET that was confirmed by pathology. There were 3 girls and 3 boys in this study, aged between 2 and 11 years old.
View Article and Find Full Text PDFJ Perioper Pract
January 2025
Department of Anesthesiology, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand.
Background: This study aimed to assess the feasibility of real-time ultrasound-guided thoracic epidural placement.
Methods: A prospective observational study was conducted in 20 patients undergoing elective abdominal and thoracic surgery. The procedure, performed with patients in a lateral position, involved three sequential steps: (1) identification of the interlaminar gap, (2) advancement of the Touhy needle, and (3) identification of the epidural space.
Eur Spine J
January 2025
Department of Neurosurgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China.
Background: Spinal epidural arachnoid cysts (SEACs) are rare, non-neoplastic pathologies that can cause compressive myelopathy. Preoperative identification of the exact fistula location is crucial for minimally invasive management.
Methods: This single-center retrospective study included 27 patients with SEACs who underwent "double-needle puncture myelography" to precisely localize the fistula before minimally invasive surgery.
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