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12. Angiotensin-II type-1 receptor blockade decreased T2 signal intensity in spinal cord compression in symptomatic cervical spondylotic myelopathy
Cervical spondylosis may lead to spinal cord compression, poor vascular perfusion, and ultimately cervical myelopathy. The process whereby chronic compression may cause spinal cord damage has not been fully understood. However, multiple mechanisms such as inflammation, apoptosis, and vascular variations, are thought to be responsible for the neuronal loss, axonal degeneration, and myelin impairment seen in cervical spondylotic myelopathy (CSM). Studies reported a beneficial effect of renin-angiotensin system (RAS) blockers in the central nervous system, particularly in brain inflammation and stroke, but data on their influ...
Source: The Spine Journal - August 23, 2019 Category: Orthopaedics Authors: Alexander Perdomo-Pantoja, Alejandro Chara, Joshua Casaos, Samuel Kalb, Corinna Zygourakis, Zach Pennington, Ethan Cottrill, Amir Manbachi, Timothy F. Witham, Nicholas Theodore Source Type: research

Cerebral Oxygenation in the Sitting Position Is Not Compromised During Spontaneous or Positive-Pressure Ventilation
ConclusionsThere were no signs of inadequate brain perfusion during general anesthesia using paralytic agents. Positive-pressure ventilation with moderate hypotension in the sitting position does not endanger patients, in the context of moderate hypercapnia and hemodynamic support using ephedrine or epinephrine.
Source: HSS Journal - November 9, 2018 Category: Orthopaedics Source Type: research

What Adverse Events and Injuries Are Cited in Anesthesia Malpractice Claims for Nonspine Orthopaedic Surgery?
CONCLUSIONS: Nonspine orthopaedic anesthesia malpractice claims more frequently cited nerve injury and events arising from the use of regional anesthesia than other surgical anesthesia malpractice claims. This may reflect the frequency of regional anesthesia in orthopaedic cases rather than increased risk of injury associated with regional techniques. When neuraxial procedures and anticoagulation regimens are used concurrently, care pathways should emphasize clear lines of responsibility for coordination of care and early investigation of any unusual neurologic findings that might indicate neuraxial hematoma. We do not hav...
Source: Clinical Orthopaedics and Related Research - March 1, 2017 Category: Orthopaedics Authors: Kent CD, Stephens LS, Posner KL, Domino KB Tags: Clin Orthop Relat Res Source Type: research