Abstract：
BACKGROUND:Although postoperative spinal epidural hematoma (SEH) is not uncommon, hematomas that require surgery are rare. Cauda equina syndrome (CES) may be associated with postoperative SEH. In these cases, early recognition and emergency decompression can prevent further damage and better neurologic recovery. CASE DESCRIPTION:A 41-year-old man underwent two-level discectomy with insertion of an interspinous spacer at L3-4 and L4-5 because of low back pain and radiculopathy. Eight hours after the operation, the patient developed CES. MRI revealed SEH compressing posteriorly at the L3-4 level. On emergency decompression and hematoma evacuation, the interspinous spacer had obstructed the laminotomy site at L3-4 completely, blocking drainage to the drain. The patient experienced complete neurologic recovery by 2 months followup. LITERATURE REVIEW:Many studies report risk factors for SEH. However, postoperative SEH can also be encountered in patients without these risks. One study reported a critical ratio (preoperative versus postoperative cross-sectional area) correlated with postoperative symptoms, especially in those with CES. The propensity to develop CES is likely dependent on a number of patient-specific factors. CLINICAL RELEVANCE:Surgeons should be aware that patients without risk factors may develop acute CES. Wider laminotomy (larger than half of the device size) may help to prevent this complication when one uses the compressible type of device, especially in patients with relatively small lamina.
journal_name
Clin Orthop Relat Resjournal_title
Clinical orthopaedics and related researchauthors
Limthongkul W,Yingsakmongkol Wdoi
10.1007/s11999-011-2031-7subject
Has Abstractpub_date
2012-06-01 00:00:00pages
1668-72issue
6eissn
0009-921Xissn
1528-1132journal_volume
470pub_type
杂志文章abstract：:Gunshot injuries to the hand and upper extremity have been studied during military conflicts and in urban settings. Treatment concepts include identification of injured structures, aggressive surgical wound care, and reconstruction of important functional structures. There are various types of missile injuries. For si...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,评审
doi：10.1097/00003086-200303000-00016
更新日期：2003-03-01 00:00:00
abstract：BACKGROUND:Although use of nonsteroidal antiinflammatory drugs and low-dose irradiation has demonstrated efficacy in preventing heterotopic ossification (HO) after THA and surgical treatment of acetabular fractures, these modalities have not been assessed after traumatic blast amputations where HO is a common complicat...
journal_title：Clinical orthopaedics and related research
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更新日期：2019-03-01 00:00:00
abstract：:A test for knee posterolateral instability, which is a modification of the standard posterolateral rotatory instability test, is described. In this test, the patient lies supine on the examination table with hips and knees flexed to 90 degrees. The examiner grasps both feet and attempts to maximally externally rotate ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1991-03-01 00:00:00
abstract：:A human osteosarcoma cell line, HuO9, was established from a tumor that was heterotransplanted into athymic nude mice. Antiserum against nude mouse spleen cells was added to the early passage cultures to eliminate the host fibroblastic cells. The cell line retained a high activity of liver/bone/kidney-type alkaline ph...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1990-10-01 00:00:00
abstract：:An analysis of the patellofemoral joint based on experimental determinations of pressure distributions on the patellar cartilage and vectorial calculations is presented. The extension torque of all quadriceps muscles is similar. The force transmitted to the patella by the retinacula is small in all knee positions. Bec...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1990-09-01 00:00:00
abstract：:A new method of geometrical analysis is capable of determining bone deformity from routine anteroposterior (AP) and lateral roentgenograms. The maximum angulation may occur in a plane other than the AP or lateral roentgenogram planes. Therefore, the maximum angulation may exceed the apparent angulation seen on routine...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1987-05-01 00:00:00
abstract：:A 27-year-old manual laborer presented with dislocation of the right elbow, complete separation of the radial head at the neck level, and avulsion of the coronoid process. Closed reduction of the elbow resulted in ulnohumeral instability. As an alternative to silastic implant, the radial head was reduced, internally f...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1992-03-01 00:00:00
abstract：:Intraoperative femoral fracture is a well-recognized technical complication of cementless total hip arthroplasty. This study was designed to establish an in vitro model for initiation and propagation of fractures of the proximal femur in cementless THA and to assess the effect of fracture fixation in the form of cercl...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1991-11-01 00:00:00
abstract：BACKGROUND:Unloader braces are a nonsurgical approach for predominantly unicompartmental knee arthritis. Although noninvasive, braces are expensive and it is unclear whether clinical factors, if any, will predict regular brace use. QUESTIONS/PURPOSES:We asked: (1) Do patients continue to use the unloader brace more th...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-013-2814-0
更新日期：2013-06-01 00:00:00
abstract：:Specialty boards serve the function of defining qualifications and issuing credentials to assure the public of the specialist's preparation and skill. Over the past 72 years, 23 such boards have been approved and now issue 31 different types of general specialty certificates and 57 types of subspecialty credentials. F...
journal_title：Clinical orthopaedics and related research
pub_type： 历史文章,杂志文章
doi：
更新日期：1990-08-01 00:00:00
abstract：:Of 2023 patients treated for acute spinal injuries, 729 sustained acute injuries in thoracic and lumbar regions; 295 surgically treated patients were reviewed for evidence of postoperative neurological complications. Of the 295 patients, 150 were intraoperatively monitored using somatosensory-evoked potentials (SSEP)....
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1988-12-01 00:00:00
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journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1982-10-01 00:00:00
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journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1982-01-01 00:00:00
abstract：:The annual wear rate in polyethylene articulations should be 0.1 mm or less to avoid future osteolysis. Highly cross-linked polyethylene shows an 80 to 90% wear reduction in hip simulator testing, but the clinical documentation of this new polyethylene is still inadequate. We evaluated the highly cross-linked polyethy...
journal_title：Clinical orthopaedics and related research
pub_type： 临床试验,杂志文章,随机对照试验,评审
doi：
更新日期：2004-12-01 00:00:00
abstract：:Maduromycosis is a rare fungal infection in the northern United States, most frequently caused by Allescheria boydii, usually in debilitated or immunosuppressed patients. An 18-year-old Mexican-American, in excellent health, developed multiple draining sinuses at the sites of insertion of Ender nails for a closed tibi...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1981-01-01 00:00:00
abstract：:Intramedullary nailing after reaming of the medullary cavity according to Küntscher, provides a rigid fixation and makes early mobilization possible, and is even applicable to infected non-unions. Experience with 150 cases of fresh femoral fractures and more than 80 cases of non-union of the femur, the tibia, the hume...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1976-03-01 00:00:00
abstract：BACKGROUND:The ability of injection of corticosteroids into the subacromial space to relieve pain ascribed to rotator cuff tendinosis is debated. The number of patients who have an injection before one gets relief beyond what a placebo provides is uncertain. QUESTIONS/PURPOSES:We asked: (1) Do corticosteroid injection...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,meta分析,评审
doi：10.1007/s11999-016-5002-1
更新日期：2017-01-01 00:00:00
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journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1987-12-01 00:00:00
abstract：BACKGROUND:Minimally invasive surgery (MIS) approaches have the potential to reduce procedure-related morbidity when compared with traditional approaches. However, the magnitude of radiographic correction and degree of clinical improvement with MIS techniques for adult spinal deformity remain undefined. QUESTION/PURPO...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,评审
doi：10.1007/s11999-013-3441-5
更新日期：2014-06-01 00:00:00
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更新日期：2011-04-01 00:00:00
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journal_title：Clinical orthopaedics and related research
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journal_title：Clinical orthopaedics and related research
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更新日期：1992-07-01 00:00:00
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journal_title：Clinical orthopaedics and related research
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doi：
更新日期：1991-02-01 00:00:00
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journal_title：Clinical orthopaedics and related research
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更新日期：1991-07-01 00:00:00
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journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1988-08-01 00:00:00
abstract：:The acute effects of immobilization on cortical and trabecular bone formation were studied in juvenile male rhesus monkeys (Macaca mulatta). Four animals were immobilized for two weeks by application of total body casts. Two control monkeys were housed in separate metabolic cages under similar environmental and dietar...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1983-12-01 00:00:00
abstract：:The treatment of nonunion of the tibia in 40 patients by constant direct current was evaluated in a prospective survey. The method was simple to apply and the complication rate was low, but considerable cooperation is required on the part of patients. The success rate was 85%. When two patients who had significant fra...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1983-09-01 00:00:00
abstract：BACKGROUND:With cerebral palsy (CP), an equinus deformity may lead to genu recurvatum. Botulinum toxin A (BtA) injection into the calf muscles is a well-accepted treatment for dynamic equinus deformity. QUESTIONS/PURPOSES:The purpose of this study was to determine whether BtA injections into the calf muscles to decrea...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-013-2897-7
更新日期：2013-07-01 00:00:00
abstract：:Six patients with systemic lupus erythematosus and avascular necrosis of the femoral head were treated by total hip arthroplasty (THA). The primary indication for surgery was persistent hip pain despite conservative therapy. Postoperatively, pain was relieved with corresponding improvement in range of motion in all si...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1981-11-01 00:00:00
