-
Case Reports
Dural Traction A Possible Cause Of Hemodynamic Changes During Single Level Transforaminal Lumbar Interbody Fusion.
- Jonathan M Weimer, Martin Marinov, and Rafi Avitsian.
- Department of Internal Medicine, Cleveland Clinic, Cleveland, Ohio, USA.
- World Neurosurg. 2017 Jan 1; 97: 761.e1-761.e3.
BackgroundLumbar spinal surgery may be associated with electrophysiologic and hemodynamic abnormalities during the procedure.Case DescriptionA 58-year-old man with grade II L4-5 spondylolisthesis and degenerative changes underwent single-level transforaminal lumbar interbody fusion. During decompression of the L4 foramina, distraction of the disc space, and placement of the interbody cage and pedicle screws, episodes of extreme bradycardia with up to 5 seconds of asystole were detected on electrocardiogram and invasive hemodynamic monitoring. The events correlated with and possibly could have been a result of traction on the dura mater.ConclusionsAnesthesia providers should be aware of electrophysiologic and hemodynamic abnormalities during lumbar spinal surgery and the need to respond appropriately with sympathomimetic or vagolytic interventions.Copyright © 2016 Elsevier Inc. All rights reserved.
Notes
Knowledge, pearl, summary or comment to share?You can also include formatting, links, images and footnotes in your notes
- Simple formatting can be added to notes, such as
*italics*,_underline_or**bold**. - Superscript can be denoted by
<sup>text</sup>and subscript<sub>text</sub>. - Numbered or bulleted lists can be created using either numbered lines
1. 2. 3., hyphens-or asterisks*. - Links can be included with:
[my link to pubmed](http://pubmed.com) - Images can be included with:
 - For footnotes use
[^1](This is a footnote.)inline. - Or use an inline reference
[^1]to refer to a longer footnote elseweher in the document[^1]: This is a long footnote..