European journal of trauma and emergency surgery : official publication of the European Trauma Society
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Eur J Trauma Emerg Surg · Oct 2014
Posterior only versus combined posterior and anterior approaches in surgical management of lumbosacral tuberculosis with paraspinal abscess in adults.
To compare single-stage posterior transforaminal lumbar interbody fusion, debridement, posterior instrumentation, and postural drainage (posterior-only surgery) with a combined posterior-anterior surgical approach for treatment of adults with lumbosacral spinal tuberculosis (STB) with paraspinal abscess and to determine the clinical feasibility and effectiveness of posterior-only surgical treatment. ⋯ Posterior-only surgery is feasible and effective, resulting in better clinical outcomes than combined posterior-anterior surgeries, especially in surgical time, blood loss, hospital stay, and complications.
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Delay in the diagnosis of acute compartment syndrome (ACS) has serious and sometimes catastrophic consequences for the outcome of injury, and has been recognised as one of the primary causes of a poor outcome. This article reviews the evidence for the use of clinical findings and intra-compartmental pressure (ICP) monitoring in making a prompt diagnosis of ACS. ⋯ Patients at risk of ACS or at risk of a delayed diagnosis are defined, and it is recommended that these patients undergo ICP monitoring. It is recommended that decompression is carried out primarily on the basis of the differential pressure being less than 30 mmHg for more than 2 h as this results in a reduced time to definitive treatment when compared to waiting for the development of clinical symptoms and signs.