Oppo find clover bao nhieu tien

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Oppo find clover bao nhieu tien

Hemostasis may be achieved by compression and packing. Ifthelesionoccurred during drilling, a screw in the drill hole is a good option. The screw at the oppo- site side, if not in place, should be skipped, and a salvage Gallie procedure can be performed instead of using Magerl screws.

Pseudoaneurysm and arteriovenous fistulae are rare sequelae [61]. Stenting may be efficacious.

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Posterior Approaches to the Thoracic and Lumbar Spine Approach-related intraoperative complications are rare. Excessive bleeding can occur. The risk is reduced by adequate patient positioning and change of platelet inhibitors and anticoagulants to other drugs preoperatively. Very rarely, lesions of anterior structures occur due to direct accidental stab trauma.

Relatively rare is an accidental lesion of the dural sac or of the spinal cord during preparation of the approach. It is mandatory to use imaging to determine whether the posterior vertebral elements are intact; otherwise, preparation has to be conducted with more caution. Procedure Related Complications Decompressive Cervical and Lumbar Surgery Check preoperative X-rays for bony defects Decompressive surgery in the cervical and lumbar spine is the most frequently performed intervention but also prompts the need for revisions and surgery of the adjacent segments.

Oppo find clover bao nhieu tien

In some cases, complications can be avoided if the preop- erative radiograph is checked for bony defects. In primary cases, this precaution helps to avoid unintended dural lacerations e. Epidural Vein Bleeding The blood loss may be considerable and can substantially reduce visualization, compromising surgical success.

Epidural bleeding usually stops after wound clo- sure and turning the patient into the supine position. Reports on cauda equina syndrome caused by postoperative continued epidural bleeding are rare [52].

Severe bleeding from epidural veins occurs in 3. Wash out Floseal after epidural vein bleeding has stopped If severe bleeding occurs, it is sometimes better to continue removing the disc herniation rather than attempting to coagulate the bleeding epidural vessels.

Bleed- ing often stops after removal of the disc herniation and facilitates exploration of the bleeding vein. Compression of the vessel with a neurosponge allows the bleeding to be controlled in the vast majority of cases. Generally, bipolar cauterization may be necessary but should be limited because of postoperative scarring.

Floseal is a very efficient material to stop epidural bleeding. Usually, this agent increases its volume, so that application in the vertebral canal requires caution.

Removal of the agent by irrigation is recommended when the bleeding has stopped. Nerve Root Injuries A nerve root may be damaged by: Malpositioning of a lumbar pedicle a The axial CT scan shows that the pedicle screw has perforated the medial pedicle wall because of a far lateral recess.

The pedicle was still intact after screw hole preparation with a blunt pedicle finder 4 mm. However, the pedicle screw 7 mm perforated the pedicle cortex, which was not noticed. In questionable cases, it is recommended to again remove the screw after it has passed the pedicle and entered the vertebral body.

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However, do not completely insert the screw if you want to remove it again to probe the pedicle because of the limited bony pur- chase with screw reinsertion. Poor visualization due to bleeding, perineural fibrosis, or congenital vertebral e. The most vulnerable area for a lesion is the axilla of the nerve root.

Therefore, a good preventive principle is to stay lateral to the nerve root when removing disc material [68]. Herniating root fibers have to be reduced, and the defect has to be closed.

However, a suture of the dura is very dif- ficult and can cause stenosis. A fat or collagen pad or an artificial dura e.Create an account or log into Facebook. Connect with friends, family and other people you know.

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Oppo find clover bao nhieu tien
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