Articles: trauma.
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The authors report their experience with 42 patients in whom anterior lumbar fusion was performed using titanium cages as a versatile adjunct to treat a wide variety of spinal deformity and pathological conditions. These conditions included congenital, degenerative, iatrogenic, infectious, traumatic, and malignant disorders of the thoracolumbar spine. Fusion rates and complications are compared with data previously reported in the literature. ⋯ The complication rate mirrors the low morbidity rate associated with the anterior approach. A detailed study of clinical outcomes is in progress. Patient selection and strategies for avoiding complication are discussed.
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Chin. J. Traumatol. · Nov 1999
Balloon occlusion test and therapeutic occlusion on traumatic carotid cavernous fistulas.
To evaluate the safety of the balloon occlusion test(BOT) and therapeutic occlusion of the internal carotid artery(ICA). ⋯ BOT of ICA is safe and economical. The reliability of the results is almost the same compared with that of other more complicated methods of assessing therapeutic occlusion of ICA. And it is easy to treat TICCF with therapeutic occlusion of ICA.
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This prospective study was designed to determine the prevalence of lumbar facet joint pain in a consecutive series of patients with chronic low back pain treated at an interventional, multidisciplinary private pain management practice utilizing double diagnostic blocks, to determine the prevalence of false positive rate of uncontrolled facet joint blocks, and to determine the relationship of clinical features of responders and non-responders to double diagnostic blocks. One hundred and twenty patients with low back pain with or without lower extremity pain were selected. The procedure consisted of diagnostic blocks using lidocaine and bupivacaine on separate occasions, usually two weeks apart. ⋯ However, history of previous surgery showed a negative correlation as only 29% of the patients after previous surgery were positive in contrast to 51% of the nonsurgical population. The results of this study echo previous concerns of reliability of uncontrolled single blocks, history, and clinical features. This study demonstrated that the facet joint is a source of pain in 45% of the patients suffering with chronic low back pain in an interventional pain management setting in a private practice.
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Neurological complications following the administration of a local anaesthetic can be alarming. By reading reports of such incidents, dentists who find themselves in similar situations will be able to reassure their patients and act accordingly. ⋯ Examples of complications covered are facial nerve palsy, transient amaurosis, post-injection paraesthesia, Horner's syndrome, transient paralysis of combined cranial nerves III, IV and VI, sudden unilateral deafness and abducens nerve palsy. A thorough knowledge of the relevant anatomy pertinent to the various injections used in dental surgery is essential and is highlighted in the text.
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To review the pathophysiology and management of patients with clinical manifestations of fat embolism. ⋯ Fat embolism occurs in many traumatic and atraumatic conditions and is largely asymptomatic. Preventative measures include early immobilization of fractures and methods to reduce intramedullary pressure during surgical manoeuvres. Treatment is largely symptomatic with therapy for respiratory failure similar to that used in management of acute respiratory distress syndrome. Corticosteroids have not been found to be of significant benefit.