Single-level Posterolateral Fusion (PLF) Alone and Posterior Interbody Fusion (PLIF/TLIF) Alone Lead to a Decreased Risk of Short-term Complications Compared to Combined PLF With PLIF/TLIF Procedures: A Matched Analysis

Study Design. Retrospective review of a database cohort. Objective. To compare short-term outcome measures and complications between single-level posterolateral fusion (PLF), single-level posterior interbody fusion (PLIF/TLIF), and combined single-level PLF+PLIF/TLIF. Summary of Background Data. Both PLF and interbody fusion are well-established procedures for degenerative spinal disease. However, there is lack of consensus as to the ideal surgical approach for specific applications. Additionally, the difference in risk of complications with traditional PLF, interbody fusion with posterior approach, and circumferential fusion is still contested. Methods. The ACS NSQIP database was used to identify 24,228 patients who underwent either a single-level PLF, single-level PLIF/TLIF, or combined single-level PLF+PLIF/TLIF between 2014 and 2017. To control for potential confounding variables, exact matching was used to pair individuals from each treatment group based on several factors, including sex, age, body mass index, various comorbidities, and American Society of Anesthesiologists classification. After appropriate matching, the rate of various short-term outcome measures and complications were compared between the three treatment groups. Results. After exact matching, 13,251 patients were included in the final analysis. The rates of non-home discharge, overall surgical complications, and bleeding requiring transfusion were significantly lower in the PLF group and ...
Source: Spine - Category: Orthopaedics Tags: CLINICAL CASE SERIES Source Type: research

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Conclusion: This investigation can offer a reliable basis for the effectiveness and safety of IFB in treating the PELD pain. Trial registration: This study protocol is registered in Research Registry (researchregistry5985).
Source: Medicine - Category: Internal Medicine Tags: Research Article: Study Protocol Clinical Trial Source Type: research
We report a case of vaginal paraganglioma in a 15-yr-old adolescent girl who presented with irregular heavy menses and anemic symptoms. Examination under anesthesia revealed a polypoid mass of 3 cm size in the left anterior vaginal wall, which was resected piecemeal. Histology showed a circumscribed nodular tumor with typical nested morphology of paraganglioma and no significant nuclear atypia. Immunohistochemically the tumor cells were diffusely positive for synaptophysin and chromogranin while being negative for cytokeratin, accompanied by S100-positive sustentacular cells. SDHB immunohistochemistry demonstrated t...
Source: International Journal of Gynecological Pathology - Category: Pathology Tags: PATHOLOGY OF THE LOWER TRACT: CASE REPORTS Source Type: research
(American Society of Anesthesiologists) Researchers have identified genetic mutations that appear to protect women from severe bleeding after childbirth, a leading cause of maternal death. A preliminary study of the findings is being presented at the ANESTHESIOLOGY ® 2020 annual meeting.
Source: EurekAlert! - Social and Behavioral Science - Category: International Medicine & Public Health Source Type: news
Organ transplantation represents one of the major accomplishments of modern medicine over the last 50 years with liver transplantation progressing during that time from experimental therapy to standard of care with excellent outcomes. Advances in anesthesia and critical care during the operative and early postoperative period have played a major role in this success, along with the more obvious improvements in patient selection and immunosuppression. Management of even heavy intraoperative bleeding is now routine for most anesthesia teams and is perhaps only limited by early recognition.
Source: American Journal of Surgery - Category: Surgery Authors: Tags: Invited Commentary Source Type: research
Publication date: Available online 1 October 2020Source: Anaesthesia Critical Care &Pain MedicineAuthor(s): François M. Carrier, André Y. Denault, Anna Nozza, Benjamin Rioux-Massé, André Roy, Luc Massicotte
Source: Anaesthesia, Critical Care and Pain Medicine - Category: Anesthesiology Source Type: research
This article reports the case of a 29-year-old female Jehovah's Witness with severe anemia after intrauterine fetal death in the 25th week of gestation, complicated by vaginal bleeding, acute renal failure and hemolysis. Due to her religious beliefs the patient categorically refused blood transfusions. Despite adhering to the recommendations for patient blood management, the hemoglobin (Hb) level gradually decreased to 1.9 g/dl on day 10, when she fainted and had to be sedated and invasively ventilated. Inhalative isoflurane was chosen for sedation because of its potential organ-protective effects and because i...
Source: Der Anaesthesist - Category: Anesthesiology Authors: Tags: Anaesthesist Source Type: research
Extracorporeal membrane oxygenation (ECMO) could theoretically be useful in patients with high-risk pulmonary embolism (PE). Current European Society of Cardiology give a low-grade recommendation for ECMO implantation in patients with circulatory collapse or cardiac arrest, reporting that it may be considered (class IIb – level of evidence C) in combination with surgical embolectomy or catheter-based treatment.1 Caution is given regarding the use of ECMO in combination with systemic thrombolysis or as a stand-alone technique due to excessive risk of bleeding in one case and controversial efficacy in the other.
Source: Journal of Cardiothoracic and Vascular Anesthesia - Category: Anesthesiology Authors: Tags: Letter to the Editor Source Type: research
(London School of Hygiene&Tropical Medicine) A life-saving treatment for bleeding trauma victims, tranexamic acid (TXA), can now be given by a simple injection at the scene of the injury, according to a new study in British Journal of Anaesthesia.
Source: EurekAlert! - Social and Behavioral Science - Category: International Medicine & Public Health Source Type: news
Abstract Puerperal inversion of the uterus is a rare but life-threatening obstetric complication. Unrecognized, it can lead to severe bleeding and shock and even maternal death. Manual replacement under general anesthesia is usually successful. If the manual replacement fails, surgical replacement by laparotomy needs to be performed. In any case, mortality and morbidity can be reduced by rapid recognition and immediate replacement. Therefore, regular practical exercises for the detection and treatment of acute uterine inversion as well as other obstetric emergencies should be performed as part of medical training....
Source: Zeitschrift fur Geburtshilfe und Neonatologie - Category: Perinatology & Neonatology Authors: Tags: Z Geburtshilfe Neonatol Source Type: research
Conclusion: IRE was essentially safe, however further studies on tumor ablation using several different animal models are needed.
Source: Journal of Cancer Research and Therapeutics - Category: Cancer & Oncology Authors: Source Type: research
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