Search results for "Epidural"
showing 10 items of 45 documents
Nerve Root and Types of Needles Used in Transforaminal Injections
2014
The use of transforaminal epidural injections of steroids is common practice in pain medicine, in patients with radicular pain resistant to conventional treatments such as physiotherapy or anti-inflammatory medications. The goal of these injections is to deposit steroids in the proximity of nerve roots, using the epidural or the transforaminal route. The procedure is performed using a translaminar, caudal, or transforaminal approach.
Emergency surgery in a patient with large spontaneous spinal epidural hematoma determining excellent neurological recovery: Review of the literature
2014
Study design: Case report. Objectives: We report a case of a 75-year-old woman suffering from voluminous idiopathic spontaneous spinal epidural hematoma (SSEH) that was rapidly diagnosed and successfully treated. Methods: Clinical presentation was characterized by sudden and intense back pain that rapidly evolved into plegia of the right leg and severe paresis of the left leg. Hypoesthesia below T6 and urinary retention were also present. Magnetic resonance imaging showed a significant posterior spinal compression from T6 through L3 caused by an epidural hematoma that involved 10 metameric levels, extending for ∼20 cm, with a maximum thickness of 1.6 cm from T12 to L1. Results: Within 12 h,…
Combined epidural morphine and bupivacaine in the treatment of lumbosacral radicular neuropathic pain: a noncontrolled prospective study
2016
Simone Vigneri,1,2 Gianfranco Sindaco,2 Marco La Grua,2 Matteo Zanella,2 Laura Ravaioli,2 Valentina Paci,2 Gilberto Pari2 1Department of Experimental Biomedicine and Clinical Neurosciences, University of Palermo, Palermo, 2Advanced Algology Research and Pain Medicine Unit, Santa Maria Maddalena Hospital, Occhiobello, RO, Italy Objective: The aim of this study was to investigate the therapeutic effectiveness of epidural morphine and bupivacaine in patients with chronic lumbosacral radicular neuropathic pain after the cessation of treatment.Methods: Twenty-two patients with chronic lumbosacral pain with neuropathic features were enrolled. An indwelling catheter was placed into the epidural sp…
Hirayama disease – Early MRI diagnosis of subacute medullary ischemia: A case report
2020
Background: Hirayama disease (HD) is a rare, benign, and self-limiting motor neuron disorder that results in selective motor impairment of the C7-T1 myotomes. It is characterized by progressive, unilateral, or bilateral asymmetric muscle atrophy of the distal upper extremities and myelopathy. Case Description: A 23-year-old male presented with bilateral atrophy of the thenar/hypothenar eminences/ interosseous muscles, plus left-hand weakness. The cervical MRI documented subacute ischemic damage of the distal cervical cord. To rule out a tumor and reduce questionable cord compression, the patient underwent a C5–C6 anterior cervical discectomy and fusion (ACDF) immediately followed by a lami…
A new approach using high volume blood patch for prevention of post-dural puncture headache following intrathecal catheter pump exchange.
2015
Background: In an observational study, complications of intrathecal catheter pumps necessitating surgical exchange were analyzed. Also the use of a high-volume prophylactic epidural blood patch (EBP) during surgery for preventing post-dural puncture headache (PDPH) with a follow-up for 1 year is described. Materials and Methods: In 22 patients with refractory chronic pain of cancer/noncancer origin or severe spasticity, who were receiving intrathecal morphine including adjuvants or baclofen for symptom relief, catheter exchange with or without pump was performed. In patients with documented symptoms of PDPH following initial intrathecal catheter implantation, a prophylactic EBP with a high …
Spontaneous anterior cervicothoracic spinal epidural hematoma extending to clivus in SARS-CoV-2 infection
2021
Background: The treatment of spontaneous spinal epidural hematomas (SSEHs), depending on the lesion size and myeloradicular involvement, can be surgical or conservative. Here, we present a 55-year-old patient who sustained a SSEH several months following a systemic SARS-CoV-2 infection. Case Description: A 55-year-old immunocompromised female (i.e., history 17 years ago of Hodgkin’s lymphoma, nodular sclerosis variant) recently developed a SARS-CoV-2 infection treated with nonsteroidal anti-inflammatory agents. She then reported the sudden onset of cervicodorsalgia after a slight cervical flexion/extension maneuver. The brain and cervicothoracic spine MRI studies documented a clival anteri…
Role of ozone Disc Nucleolysis in Herniated intervertebral Disc : The Indian experience [abstract]
2018
Aim: To study the role of ozone disc Nucleolysis in herniated intervertebral disc 
 Materials: We retrospectively analysed consecutives patients undergoing ozone disc nucleolysis. There were Total of 5265 patients with 2740 males and 2525 females .their Age was ranging from 17yrs to 84 years. Patients weight was ranging from 36 to 138 kilograms. All the patients had failed conservative management for at least 3weeks. 
 Methods: All the patients were clinically evaluated as per inclusion and exclusion criterions. Pre-treatment Visual Analogue scale (VAS)and Oswestry Disability Index (ODI).All the patients undergone Pre-treatments work up of MRI of the spine.256 patients were underg…
Combined Epidural and General Anesthesia Prevents Excessive Oxygen Consumption Postoperatively
1994
In the postoperative period patients are at risk of excessive oxygen consumption (VO2). However, patients suffering from cardiovascular disease may be unable to increase their oxygen transport capacity sufficiently and may be especially vulnerable to tissue hypoxia as part of the reaction to intraoperative stress. During the last 10 years contradictory results concerning the benefits of a combined epidural and light general anesthesia have been published. Some of the results indicate that postoperative catabolism maybe depressed and that the neuroendocrine response to stress may be inhibited by such a combined technique1,2. We studied the effect of a combined epidural and light general anes…
Interventional treatment for neuropathic pain due to combined cervical radiculopathy and carpal tunnel syndrome: a case report
2017
Key Clinical Message The coexistence of median and cervical nerve root damage might hide a complex pathophysiology. Here, we describe and discuss the case of a patient suffering from numbness and painful tingling of the hand, whose symptoms were effectively treated with pulsed radiofrequency and epidural administration of bupivacaine and morphine.
Discordancia clínico-radiológica y resolución espontánea de un hematoma postcateterización epidural
2008
Neuraxial techniques are considered safe if certain guidelines are followed, but they are not risk free. We report the case of an 81-year-old woman with an invasive bladder tumor who underwent radical cystectomy with a Bricker-type procedure. General anesthesia was used and epidural analgesia was also provided for surgical and postoperative pain management. Late in the postoperative recovery period a large epidural hematoma was diagnosed based on radiologic signs of spinal cord compression, in the absence of symptoms other than mild and progressive back pain that developed after extubation. The surgeon decided against emergency surgery to reduce compression. Symptoms resolved gradually, and…