ABSTRACT
From January 2016 to June 2017, 68 patients with thoracic osteoporotic compression fractures were treated with percutaneous kyphoplasty, including 31 cases with ultrasound-guided thoracic paravertebral nerve block (group A) and 37 cases with local anesthesia (group B). The duration of analgesia in group A was longer than that in group B (P<0.05). The satisfaction of anesthesia in group A was higher than that in group B (90% vs. 68%, P<0.05). There was no significant difference in length of hospital stay and cost between the two groups (P>0.05). The post-operative VAS scores was significantly lower than those of pre-operation in both groups (P<0.05). The intraoperative VAS score of group A was lower than that of group B (P<0.05). There was no significant difference between the two groups in mean arterial pressure and heart rate (P>0.05). No cardiovascular and cerebrovascular adverse reactions occurred in both groups. Ultrasound-guided thoracic paravertebral nerve block is a safe and effective method used in percutaneous kyphoplasty.
ABSTRACT
A 28-year-old man was admitted with severe thoracic pain, a body temperature of 37.20, paraplegia and sphincter disturbances. MRI revealed an epidural abscess T5T8. A decompressive laminectomy T5T8 was performed and the abscess was removed. A methicillin-resistent Staphylococcus aureus was cultured. Vancomycin was administered. Six months later muscle testing showed values from 3/5 to 4/5. MRI is the first choice diagnostic tool. Laminectomy, drainage and intravenous antibiotics constitute the basic treatment. Antibiotics alone can be sufficient in case of whole spine involvement, lumbosacral localization without neurological symptoms, fixed neurological deficit, complete paralysis for more than 72 hours, or severe concomitant medical problems.
