ABSTRACT
Amyotrophic lateral sclerosis is a neurodegenerative disease caused by the degeneration of upper and lower motor neurons. The disorder causes muscle weakness and atrophy throughout the body. There is an unexpected response to depolarizing or nondepolarizing muscle relaxants, and risk of perioperative respiratory failure is high. Careful monitoring and minimal doses of anesthetics are needed. We report a case of general anesthesia in a patient with amyotrophic lateral sclerosis. We used proper doses of muscle relaxant and inhalation anesthetics with neuromuscular monitoring and bispectral index. The patient early recovered from anesthesia without any respiratory complications.
Subject(s)
Humans , Amyotrophic Lateral Sclerosis , Anesthesia , Anesthesia, General , Anesthetics , Anesthetics, Inhalation , Atrophy , Motor Neurons , Muscle Weakness , Muscles , Neurodegenerative Diseases , Neuromuscular Monitoring , Respiratory InsufficiencyABSTRACT
Percutaneous vertebroplasty and balloon kyphoplasty have been accepted as effective treatment modalities for vertebral compression fractures in patients with vertebral metastasis. However, when these procedures are conducted in patients with lytic lesions of the vertebral pedicle, polymethylmethacrylate leakage through the lytic lesions that occurs during percutaneous pediculoplasty can increase the procedural risks due to the immediate vicinity of neural structures. In spite of this risk, there are not many available reports on safer methods of pediculoplasty. Here we report a case of vertebral metastasis in which the pedicle infiltration of cancer was successfully treated by pediculoplasty using a bone filler device that contained thick bone cement during a balloon kyphoplasty procedure.