Respiratory Arrest due to Tension Pneumoperitoneum and Pneumomediastinum without Pneumothorax: Complication of the Lumbar Spinal Surgery

The authors present a case of respiration arrest after posterior lumbar interbody fusion. This rare complication occurred because of the tension pneumoperitoneum and pneumomediastinum. We report the pathophysiology and treatments.

Clinical Results of Radiofrequency Dorsal Root Entry Zone Coagulation for Paraplegic Pain

OBJECTIVE: Dorsal root entry zone(DREZ) operation has been the most common surgical treatment for paraplegic pain in the past, but the results differ according to the patients. In this study, we attempt to analyze the results from the patients by the different patterns of the pain before the surgery. METHODS: A total of twelve paraplegic patients have undergone a total of thirteen radiofrequency DREZ coagulation procedures between April 1994, and March 2003. The patients were divided depending on patients' subjective description on the character, frequency, and range of pain. RESULTS: The patients were divided into the two groups, postoperatively: improvement of more than 75% of pain was defined as treatment success, and any level less than 75% of improvement was defined as treatment failure. Eight of the ten mechanical pain group cases were regarded as treatment success, and remaining two cases with thermal type of pain as treatment failure. Also, one case with combined pain failed to obtain any favorable outcome. Intermittent pain group (6 of 7 cases), continuous pain group (2 of 6 cases), and localized pain group (7 of 11 cases) showed treatment success, respectively. However, diffuse pain group (1 of 2 cases) resulted in poor outcome. CONCLUSION: Radiofrequency DREZ coagulation is more effective in managing intermittent and/or mechanical pain than continuous and/or thermal pain in the paraplegic patients following spinal cord injury.