The practice of continuous spinal anaesthesia is not common. Though underutilised, it offers significant advantage when compared to the single-shot technique nonetheless. Time and again, it has proven its worth in patients with advanced cardiac illness, spinal deformities, and obesity. We here successfully employed this neuraxial anaesthetic technique in a sixty-two-year-old male patient with skeletal dysplasia, who presented for surgical fixation of intertrochanteric fracture of the femur. With short stature, anticipated difficult airway, and poor pulmonary status complicating the anaesthetic plan, we opted for continuous spinal anaesthesia. The procedure was carried out uneventfully with 8 mg of hyperbaric bupivacaine used in titration to anaesthetic needs. Patients with skeletal dysplasia present with wide array of clinical conditions that pose a formidable challenge to anaesthesiologists. Continuous spinal anaesthesia can be safely practiced in such patients as it provides a titratable form of neuraxial blockade with reduced dose of local anaesthesia. This, in turn, ensures a predictable block and, thus, hemodynamic stability.
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http://dx.doi.org/10.1155/2021/6644894 | DOI Listing |
Orphanet J Rare Dis
December 2024
Novartis Gene Therapies, Inc., 2275 Half Day Road, Suite 200, Bannockburn, IL, 60015, USA.
Background: Spinal muscular atrophy (SMA) is a genetic neuromuscular disease associated with progressive loss of motor function. Risdiplam, a daily oral therapy, was approved in the United States for the treatment of SMA. Risdiplam's effectiveness depends on patient adherence to the treatment regimen.
View Article and Find Full Text PDFClin Spine Surg
December 2024
Department of Orthopaedic Surgery, Rothman Orthopaedic Institute at Thomas Jefferson University Hospital, Philadelphia, PA.
Study Design: Retrospective cohort.
Objective: To analyze the annual trends in the most prevalent topics, journals, and geographic regions of the top 100 spine surgery articles, as determined by altmetric attention scores (AASs). We also describe the relationship between AAS and traditional article metrics.
J Orthop Surg Res
December 2024
Department of Spine Surgery, The First Affiliated Hospital of Xinjiang Medical University, 137 Liyushan Avenue, Xinshi District, Urumqi, 830054, Xinjiang, China.
Objectives: This study compared the clinical outcomes of minimally invasive surgery (MIS) and open surgery (OS) for patients with intraspinal tumors.
Methods: A systematic search of PubMed, Cochrane Library, EMBASE, Web of Science, China National Knowledge Infrastructure (CNKI), and Wanfang databases was conducted to identify relevant studies. Continuous variables, including estimated blood loss, surgery duration, time to mobilization, length of hospitalization, visual analog scale (VAS) score, and incision length, were reported as mean differences (MD) with 95% confidence intervals (95% CIs).
BMC Musculoskelet Disord
December 2024
Department of Orthopedics, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Taizhou, Zhejiang, 317000, China.
Background: There is controversy regarding the efficacy of intravenous combined topical tranexamic acid. We conducted this study to systematically assess the effectiveness of intravenous combined topical tranexamic acid (combined TXA) in spinal surgery to guide clinical practice.
Methods: The review process was conducted according to the PRISMA guidelines.
World Neurosurg
December 2024
Department of Orthopaedic Surgery and Spinal Surgery, The University of Tokyo, 7-3-1, Hongo, Bunkyo-Ku, Tokyo, 113-8655, Japan; University of Tokyo Spine Group (UTSG), 7-3-1, Hongo, Bunkyo-Ku, Tokyo, 113-8655, Japan.
Background: Sleep disturbances, especially those lasting more than one hour, are under-researched in patients with degenerative cervical myelopathy (DCM). This study aims to investigate the prevalence and risk factors for such disturbances in DCM patients undergoing decompression surgery and to identify factors contributing to poor postoperative improvement.
Methods: A multicenter retrospective observational study was conducted on consecutive patients diagnosed with DCM who underwent cervical decompression surgery between April 2018 and August 2022.
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