The Journal of neuroscience nursing : journal of the American Association of Neuroscience Nurses
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Comparative Study
The multiple benefits of minimally invasive spinal surgery: results comparing transforaminal lumbar interbody fusion and posterior lumbar fusion.
Minimally invasive transforaminal lumbar interbody fusion (TLIF) offers equivalent postoperative fusion rates compared to posterior lumbar fusion (PLF) and minimizes the amount of iatrogenic injury to the spinal muscles. The objective of this study was to examine the difference in pain perception, stress, mood disturbance, quality of life, and immunological indices throughout the perioperative course among patients undergoing TLIF and PLF. A prospective, nonrandomized descriptive design was used to evaluate these measures among patients undergoing TLIF (n = 17) or PLF (n = 18) at 1 week prior to surgery (T1), the day of surgery (T2), 24 hours postoperatively (T3), and 6 weeks postoperatively (T4). ⋯ The TLIF group also demonstrated significantly higher levels (near baseline) of CD8 cells at T4 than the PLF group. Interleukin-6 levels were significantly higher in the TLIF group as well, which may be an indicator of ongoing nerve regeneration and healing. Knowledge concerning the effect of pain and the psychological experience on immunity among individuals undergoing spinal fusion can help nurses tailor interventions to improve outcomes, regardless of the approach used.
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Comparative Study
The impact of brain temperature and core temperature on intracranial pressure and cerebral perfusion pressure.
Hyperthermia has been demonstrated to increase neuronal injury when present during or after an acute brain injury. The assumption that core temperature equals brain temperature exists. If the temperature of an injured brain is higher than core temperature, episodes of neural hyperthermia may go undetected. ⋯ There was no significant difference found between hyperthermic ICP or CPP and normothermic ICP or CPP determined by brain or core temperature. No significant correlation was found between temperature and intracranial dynamics. Future research is needed with prospectively collected data of adequate sample size to continue to investigate the impact of core and brain temperature on the intracranial dynamics of ICP and CPP.
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More than 700,000 people have a stroke each year in the United States. A diagnosis of stroke formerly elicited a nihilistic approach, but this has substantially changed in the last decade. ⋯ Evolving protocols, management, and nursing care all have important implications during the acute phase of ischemic stroke. Patient and family education on risk reduction must also be addressed by the entire healthcare team.
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A technical grasp of a medical condition does not always give a person a sense of the emotions behind the disease. Medical professionals, of course, cannot afford to be emotionally invested in every illness they see. ⋯ However, emotional or psychological struggles are a large component of a patient's suffering. If these realities are ignored, a medical professional will be much less effective on any level.
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Spinal surgery is one of the most frequently performed surgeries in the United States. In 2003, almost 450,000 cases were performed for problems related to lumbar herniated disks, stenosis, and degenerative changes. It has been reported that patient expectations play a role in perceived quality of life (QOL). ⋯ A sample of 57 patients completed questionnaires designed to measure perceived QOL, expectations, and optimism before lumbar spinal surgery and 3 months after surgery. The major findings of the study are as follows: (a) patients with higher degrees of optimism reported better perceived QOL; (b) increased fulfillment of expectations was associated with better postoperative QOL; and (c) both expectations and level of optimism were significant predictors of postoperative QOL. These findings will help nurses better understand how patients' expectations can affect their perceived QOL while recovering from lumbar spinal surgery.