Spine
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The present report describes treatment of enlarged lumbar epidural veins in a patient with Budd-Chiari syndrome presenting with intractable radicular and low back pain. ⋯ Inferior vena cava stenosis related to hypertrophied caudate lobe producing lumbar epidural venous engorgements should be considered as one of the causes of radicular and low back pain. We could obtain a favorable clinical outcome by handling the primary cause of the venous engorgement.
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Review Case Reports
Intradural cement leakage: a devastatingly rare complication of vertebroplasty.
The aim of this case report is to examine the devastating complication that may follow vertebroplasty. ⋯ Percutaneous vertebroplasty with polymethyl methacrylate is relatively safe, but it still should be proceeded under careful safeguard. The needle tip should not cross the medial border of the pedicle on the anteroposterior view before it has crossed the posterior cortex of the vertebral body on the lateral view. Good quality of image monitoring and clear visualization of cement should be helpful to prevent complications.
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: Literature review. ⋯ : While many advances in the basic science of spinal cord injury provide optimism for future treatments, clinical science lags. At present, there are no pharmacologic strategies of proven benefit. Although steroids continue to be given to patients with spinal cord injury in many institutions, evidence of deleterious effects continues to accumulate. Current standard of care management includes support of arterial oxygenation and spinal cord perfusion pressure.
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Literature review and expert opinion. ⋯ The application of MIS techniques to spinal trauma is theoretically sound. However, the indications and technology are currently in evolution. Although very limited information is available, the results of current MIS techniques for the management of TL trauma are encouraging.
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Evidence-based literature review. ⋯ There are currently no standards regarding the role and timing of decompression in acute SCI. We recommend urgent decompression of bilateral locked facets in a patient with incomplete tetraplegia or in a patient with SCI with neurologic deterioration. Urgent decompression in acute cervical SCI remains a reasonable practice option and can be performed safely. There is emerging evidence that surgery within 24 hours may reduce length of intensive care unit stay and reduce post-injury medical complications.