Imaging changes in spinal-pelvic sagittal alignment in sitting and standing positions in degenerative lumbar spondylolisthesis patients / 中国组织工程研究

BACKGROUND: Spinal-pelvic sagittal alignment is important for the diagnosis and treatment of degenerative lumbar spondylolisthesis. However, the current study of the spine-pelvic sagittal alignment in patients with degenerative lumbar spondylolisthesis is limited to the standing position. There is no relevant report on the spine-pelvic sagittal alignment under the sitting position. OBJECTIVE: To analyze imaging data of sitting-standing spine-pelvic sagittal alignment in patients with degenerative lumbar spondylolisthesis, and to determine the sagittal alignment of spine change in degenerative lumbar spondylolisthesis patients from standing position to sitting position. METHODS: Totally 44 patients with degenerative lumbar spondylolisthesis (12 males, 32 females; age, 50-84 years) were enrolled from Tianjin Hospital from March to September 2019. All patients took X-rays of the spine in standing and sitting positions. Through the hospital image archiving and communication system, spinal and pelvic parameters were measured, including pelvic incidence, pelvic tilt, sacral slope, lumbar lordosis, thoracic kyphosis, and sagittal vertical axis. The parameters were compared between standing posture and sitting posture. By using Pearson’s correlation test, differences of relationship between spinal and pelvic parameters in standing versus sitting position were discussed. This study was approved by the Ethics Committee of Tianjin Hospital. RESULTS AND CONCLUSION: (1) When moving from standing to sitting position, in 44 degenerative lumbar spondylolisthesis patients, pelvic tilt increased [(21.3±10.1)°, (34.0±10.4)°, P 0.05). (2) Whether standing or sitting position, lumbar lordosis was correlated with other parameters (P 0.05), but lumbar lordosis was also correlated with sagittal vertical axis (P < 0.05). (3) When the degenerative lumbar spondylolisthesis patients change from standing position to sitting position, the sagittal configuration of spine pelvis shows that the pelvis rotates back around the bilateral femoral heads; the pelvis shows a backward leaning state; the physiological curvature of lumbar spine becomes shallow; and the sagittal balance axis of spine moves forward.

The effect of body posture change on the catheter tip position of totally implantable venous access port / 介入放射学杂志

Objective To discuss the effect of body posture change on the catheter tip position of totally implantable venous access port (TIVAP).Methods Under ultrasound guidance,implantation of TIVAP was carried out through bedside puncturing of internal jugular vein or subclavian vein.After the implantation of TIVAP,X-ray chest films of both erect position and supine position were taken to check the catheter tip position.The distance from the upper edge of the first thoracic vertebra to the catheter tip was separately measured on the erect position and supine position chest films.The shift of the catheter tip position was judged by the difference in the distance measured on chest films as well as by the comparison with the bony anatomic marks.Results Successful implantation of TIVAP was accomplished in 86 patients.When the patients changed from erect position to supine position,the catheter tip of TIVAP moved caudally in 71 patients,with the mean displace distance being (12.29±7.48) mm;the catheter tip of TIVAP moved cephalad in 31 patients,with the mean displace distance being (5.00±3.79) mm;and the catheter tip of TIVAP remained in the same position in 2 patients.When the patients changed from erect position to supine position,the catheter tip of TIVAP had a tendency to move toward the foot side,the average displace distance was (-9.32±9.36) mm,the difference in catheter tip location between two photographic positions was statistically significant (P＜0.000 1).No statistically significant correlation existed between the changes of catheter tip position and the sex,age,height,weight as well as body mass index (P＞0.05).Conclusion After the implantation of TIVAP,the position of catheter tip will change with patient's body posture.When patient's posture changes from erect position to supine position the tip of the catheter tends to shift towards the atrium.

Comparison of the Level and Side Effects of Spinal Anesthesia with Hyperbaric Bupivacaine in the Supine, Lateral, and Prone Positions

PURPOSE: This study attempted to test whether there are differences in the level and hemodynamic side effects (blood pressure, heart rate, O2 saturation), and nausea & vomiting of spinal anesthesia using hyperbaric bupivacaine according to position (supine, lateral, and prone positions) in orthopedic surgery patients who received podiatric surgery under spinal anesthesia. METHODS: This study was conducted with 53 patients who had received orthopedic surgery under spinal anesthesia at I General Hospital. Data were analyzed using SPSS 20.0 through repeated-measures ANOVA, post-hoc test, Chi-test, and Fisher's exact test. RESULTS: The change of position after spinal anesthesia with hyperbaric bupivacaine caused a change in the level of spinal anesthesia (F=12.768, p<.001). However, no difference of blood pressure, heart rate, O2 saturation and nausea and vomiting caused by the change in anesthesia level was observed, and in prone position, drug was administered for the correction of side effects. CONCLUSION: As expected, recognizing that there can be a change in the level of spinal anesthesia after the change of position in surgical patients, nurse anesthetists should monitor their conditions carefully and continuously.

Effects of Transient Prone Position on Vault and Anterior Chamber Angle in ICL Implanted Patients

PURPOSE: To evaluate the effects of transient prone position on vault and anterior chamber angle parameters in ICL implanted patients. METHODS: 40 eyes of 20 ICL implanted patients with at least 1 month of follow-up were included in the present study. The central ICL vault and anterior chamber parameters including angle opening distance at 500 (AOD500) were measured with the Visante anterior segment optical coherence tomography (OCT) (Carl Zeiss, Dublin, CA) in both the sitting and prone positions by tilting the OCT 90 degrees in the vertical axis and having the patient fixate downwards towards the floor. RESULTS: The mean central vault was 0.55 +/- 0.21 mm (SD) and 0.59 +/- 0.21 mm (SD) in the sitting and prone positions, respectively (p < 0.0001). The nasal and temporal AOD500 were 0.26 +/- 0.11 mm and 0.28 +/- 0.08 mm, respectively in the sitting position, which decreased to 0.24 +/- 0.10 mm and 0.26 +/- 0.08 mm in the prone position, however, both were not statistically significant (p = 0.08, p = 0.09). AOD500 was inversely correlated with vault (r = -0.47; p = 0.0024). There were no significant correlations between increase of vault and anterior chamber depth or white to white nor ICL vault. CONCLUSIONS: Transient prone positioning of ICL implanted patients can induce a significant increase in ICL vault.

Cardiac arrest after position change in a morbidly obese patient: A case report / 대한마취과학회지

Morbid obesity presents many clinical problems. Especially, morbid obesity has a significant effect on airway management and pulmonary function. We experienced a cardiac arrest of a morbidly obese (Body Mass Index of about 62 kg/m2). 21-year-old male patient that necessitated cardiopulmonary resuscitation (CPR). The patient was scheduled for an emergency cystoscopy under local anesthesia. After change to supine position in the operation room, dyspnea, tachypnea, agitation, and, subsequently, cardiac arrest developed.

The Effect of 30degree laterally Inclined Position Change on the Pressure Sores of Patients in Intensive Care Unit / 성인간호학회지

The purpose of this study was to test the effects of position change with 30degree laterally inclined position on pressure sores prevention. This study was designed as a Nonequivalent Control Group Quasi-experiment study. The subjects were collected with convenience sample of 30 patients who were hospitalized at ICU(Intensive Care Unit) of C university hospital in Seoul from March 1 to October 31, 1997. The patients were not able to change of position without help. The 15 patients were assigned to the control group and the other 15 patients to the experimental group. The both group were done position change every 2 hours and were observed whether pressure sores was developed for 2 weeks. For the experimental group, two positioning methods were alternatively used : 30degree right lateral, 30degree left lateral. For the control group, 90degree right and left lateral position were applied instead of 30degree lateral position. New Pressure Risk Assessment Scale was utilized to assess pressure sore risk. It is consists of 8 subscales which reflect sensory perception, skin moisture, activity, mobility, friction and shear, nutritional status, body temperature, and amount of medications(analgesics and sedatives). The results of this study are as follows ; 1. The incidence of pressure sores in total sample was 13 cases(43.3%) : 10 cases(76.9%) in control group, 3 cases(23.1%) in experimental group. the incidence rate of pressure sores in experimental group was significant lower than control group. 2. The sites of pressure scores development were 5 cases in trochanteric region, 4 cases in hip region, 2 cases in flank region, 1 cases in sacral region and 1 case in occipital region. Trochanteric region sores were not developed in experimental group. 3. The mean hospitalized period before pressure sores development were 7.3 day in experimental group and 4.1 day in control group. According to the results from this study, suggestions are as follows ; 1. Development of device which enable to keep 30degree laterally inclined position for 2 hours is needed. 2. It is necessary to study variously and objectively usefulness of 30degree laterally inclined position change which is applied to the other pressure risk assessment scale.