Ortopedia, traumatologia, rehabilitacja
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Ortop Traumatol Rehabil · Sep 2010
Case ReportsUse of recombinant activated factor VII for reduction of perioperative blood loss during elective surgical correction of spine deformity in a Jehovah's Witness. Case report.
Planned surgical procedures at patients who refuse allogenic blood transfusion because of religious convictions are important problem, not only medical but also ethical and juristical. At the study authors report the successful use of activated recombinant factor VII (rFVIIa) for the reduction of perioperative blood loss in four years old child - Jehovah's Witness, who had planned Torode kyphectomy. Applied perioperative management together with preparing to surgery with erythropoietin allowed for reduction of blood loss and avoiding of blood transfusion. Authors state, that appropriate perioperative proceeding makes a possibility of safe surgical procedures also at patients who refuse the transfusion.
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Ortop Traumatol Rehabil · Sep 2010
ReviewClassical and modern classifications of luxations and fractures of thoracolumbar spine. Biomechanical and clinical aspects. Review of literature.
The authors present the advantages and disadvantages of the Denis and AO classifications based on a review of classical and recent literature concerning the evolution of classification of thoracolumbar spine conditions. The newest classification of fractures proposed by Vaccaro (TLICS - Thoracolumbar Injury Classification Severity Score) is discussed in detail. ⋯ The principles of modern operative treatment are briefly discussed. Short transpedicular segmental stabilization and immobilization is a commonly accepted approach in unstable fractures with neurological deficits.