Spine
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A morphologic study of the anterior part of the iliac crest was performed. ⋯ The region around the iliac tubercle is suitable for harvesting bicortical or tricortical bone graft.
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Comparative Study Clinical Trial Controlled Clinical Trial
Reduction of blood loss during spinal surgery by epidural blockade under normotensive general anesthesia.
This study consisted of a comparison of intraoperative blood loss during posterior spins surgery under normotensive general anesthesia with and without epidural blockade, and a hemodynamic study after epidural injection. ⋯ The epidural blockade reduces intraoperative bleeding, even under normotensive conditions, and it takes effect in the lumbar spine, but not in the upper thoracic or cervical spine. This effect appears to be due chiefly to venous hypotension in the lumbar spine, which may be created by sympathetic blockade, with arteriolar dilatation and venous pooling in the lower limbs and reactive vasoconstriction in the lumbar vertebrae.
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A cross-sectional study. ⋯ When the appropriate technique is used, medial branch blocks are target specific. To guard against false-negative responses due to intravenous up-take, contrast medium must be used before the injection of local anaesthetic.
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Morphometric, radiographic, and computed tomographic evaluation of the pedicle of the first sacral vertebra was performed, and the pedicle's spatial relation with the posterior surface of the ilium was defined. ⋯ This study suggests that placement of one screw through the S1 pedicle into the vertebral body is safer, and routine placement of two sacral pedicular screws may be difficult. The optimal starting point for placement of single iliosacral screw is 3 to 3.5 cm anterior to the posterior border of the iliac bone in the sagittal plans, and 3.5 to 4 cm cephalad to the greater sciatic notch. The screw should be directed perpendicular to the outer surface of the table from this entry point. The safe length of the iliosacral pedicular screw is up to 80 mm.
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A case report is presented of a 31-year-old man who visited the authors' neurosurgical department in 1993, complaining of neurogenic claudication. History revealed a gunshot incident 11 years ago, with a bullet left in situ. ⋯ It is argued that with regard to a retained bullet in the vicinity of the spinal canal, the presence or absence of neurologic symptoms should be the guide for further diagnostic procedures. Only if a neurologic deficit develops, which is possible after many years, should surgical intervention be considered, depending on the severity and type of the deficit, as presented in this case report.