International journal of clinical and experimental medicine
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Balloon kyphoplasty has been shown to be safe in treatment of vertebral compression fractures refractory to conservative management. However, few reports have focused on lateral wedging of cemented vertebra after kyphoplasty. A 72-year-old woman with a T12 osteoporotic compression fracture underwent kyphoplasty using polymethylmethacrylate (PMMA) via a bipedicular approach. ⋯ Twelve months later, lateral wedging of the cemented vertebra was detected in plain radiographs. In the kyphoplasty procedure, symmetric cement filling should be achieved to avoid lateral wedging of the cemented vertebra. Postoperative anti-osteoporotic medication treatment is also very important.
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Wire-reinforced endotracheal tubes are used to prevent obstruction. Risk factors related to reinforced endotracheal tube obstruction were believed to be repeatedly used tube and in presence of N2O. In our case, even in free of these risk factors, a delayed tube obstruction occurred with the progress of surgical duration. This delay suggests that the obstruction was caused by diffusion of warm air/oxygen into an initially small defect, especially as the duration of surgery progresses.
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Postoperative nausea and vomiting (PONV) is a frequent complication in postoperative period. The aim of the current meta-analysis was to assess the efficacy of dexmedetomidine on PONV. ⋯ The present meta-analysis indicates that dexmedetomidine shows superiority to placebo, but not to all other anesthetic agents on PONV. And this efficacy may be related to a reduced consumption of intraoperative opioids.
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Vasospasm is one of the most common complications after aneurysmal subarachnoid hemorrhage. Statins have been proven to be effective to reduce the incidence of vasospasm both in experimental subarachnoid hemorrhage and several clinical trials before. This meta-analysis aimed to investigate the efficacy of statins for patients with aneurysmal subarachnoid hemorrhage. ⋯ There were in total 1031 patients in six RCTs with 504 patients received statins and 527 patients in placebo group. 561 patients with statins compared with 1579 patients in no statin-use group were finally included in 8 observational studies. Outcomes included in this meta-analysis (cerebral vasospasm, DIC and poor outcome) all indicated no statistical significance between two groups both in RCTs and observational studies. No benefits of statins-use for patients with aneurysmal subarachnoid hemorrhage were observed in both RCTs and observational studies, which was quite different from the results of several previous meta-analysis.
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Vertebral artery injury (VAI) is a rare but serious complication of cervical spine surgery. Instrumented posterior surgery of the upper cervical spine places the vertebral artery at the highest risk of injury. However, VAI during removal of cervical internal fixation is really rare and unexpected. ⋯ An interventional vertebral artery embolism was performed and the patient suffered a sudden cerebral infarction one day after interventional vertebral artery embolism. From this case, removal of upper cervical pedicle screws of malposition is not recommended if it is not really necessary for some other reasons. Interventional vertebral artery embolism is an effective and less invasive procedure than open ligation surgery in the treatment of haemorrhage resulted from VAI but potential risk of cerebral infarction should not be ignored.