Symptomatic Tarlov (perineural cysts) are uncommon. In the following hemodialysis case, cauda equina syndrome was not detected after combined spinal-epidural anesthesia untilthe patient reported a lack of sensation in the perianal area 14 days postoperatively. She had normal motor function of her extremities. A laminectomy and cyst irrigation was performed. After the operation, her sphincter disturbance subsided gradually and her symptoms had disappeared.
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http://dx.doi.org/10.4184/asj.2013.7.3.232 | DOI Listing |
Eur Spine J
January 2025
Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan.
Purpose: Spinal epidural abscesses are rare yet serious conditions, often necessitating emergency surgical intervention. Holospinal epidural abscesses (HEA) extending from the cervical to the lumbosacral spine are even rarer and present significant challenges in management. This report aims to describe a case of HEA with both ventrally-located cervical and dorsally-located thoracolumbar epidural abscesses treated with a combination of anterior keyhole decompression and posterior skip decompression surgeries.
View Article and Find Full Text PDFOrthop Surg
January 2025
Department of Orthopedics, Ningbo No. 6 Hospital, Ningbo, Zhejiang, China.
Background: Postoperative spinal epidural hematoma (SEH) is a rare but serious complication following lumbar surgery, with cauda equina syndrome (CES) being one of its most devastating outcomes. While CES typically presents with a combination of bladder and/or bowel dysfunction, diminished sensation in the saddle area, and motor or sensory changes in the lower limbs, atypical cases with isolated urinary symptoms are less recognized and pose significant diagnostic challenges.
Case Presentation: We report the case of a 46-year-old male who developed CES following lumbar microdiscectomy, presenting solely with urinary retention, without the classic signs of lower limb weakness or perineal sensory loss.
Best Pract Res Clin Anaesthesiol
September 2024
Department of Anaesthesiology, GZA Hospitals, Antwerp, Belgium.
Labour analgesia is a crucial aspect of obstetric anaesthesia, aiming to alleviate pain during childbirth while ensuring maternal and foetal safety. Over the past decade, advancements in labour analgesia techniques have evolved, impacting initiation, maintenance, and outcomes. We emphasize the longstanding importance of epidural analgesia while recognizing the growing significance of combined spinal-epidural and dural puncture epidural techniques for labour initiation.
View Article and Find Full Text PDFAnesth Analg
December 2024
From the Department of Anaesthesiology, Pain Medicine, and Critical Care, All India Institute of Medical Sciences (AIIMS), New Delhi, India.
Background: A systematic review and meta-analysis was conducted to compare phenylephrine boluses versus prophylactic infusion in parturients undergoing cesarean delivery under spinal or combined spinal-epidural anesthesia on feto-maternal outcomes.
Methods: Medline, Embase, Cochrane, and US Clinical registry databases were searched. Studies comparing phenylephrine boluses (both therapeutic and prophylactic) with infusion (both fixed- and variable-rate) assessing various feto-maternal outcomes were included.
Proc (Bayl Univ Med Cent)
October 2024
Department of Anesthesiology, Baylor Scott & White Medical Center - Temple, Temple, Texas, USA.
Background: We hypothesized that patients who received a lower dose of intrathecal morphine (ITM) would have higher postoperative opioid consumption following cesarean delivery.
Methods: Patients who had cesarean deliveries from February 15, 2022, through February 14, 2024 at Baylor Scott & White Medical Center - Temple with single injection spinal or combined spinal epidural anesthesia who did not have labor epidural anesthesia were included. Morphine milligram equivalent (MME) opioid consumption in the first 24 postoperative hours was recorded along with patient demographic, physical, and clinical characteristics.
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