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Hideo Yasunaga - One of the best experts on this subject based on the ideXlab platform.

  • spinal Epidural Hematoma and abscess after neuraxial anesthesia a historical cohort study using the japanese diagnosis procedure combination database
    Canadian Journal of Anaesthesia-journal Canadien D Anesthesie, 2021
    Co-Authors: Kanako Makito, Hideyuki Mouri, Hiroki Matsui, Nobuaki Michihata, Kiyohide Fushimi, Hideo Yasunaga
    Abstract:

    Spinal Epidural Hematoma and abscess are rare complications of neuraxial anesthesia but can cause severe neurologic deficits. The incidence of these complications vary widely in existing studies and the risk factors remain uncertain. We estimated the incidence of these complications and explored associations using a national inpatient database in Japan. Using Japanese Diagnosis Procedure Combination data on surgical inpatients who underwent neuraxial anesthesia from July 2010 to March 2017, we identified patients with spinal Epidural Hematoma and/or abscess. We investigated age, sex, Charlson comorbidity index, antithrombotic therapy, type of surgery, admission, and hospital for association with these complications. The incidences of spinal Epidural Hematoma and abscess were estimated separately, and a nested case-control study was performed to examine factors associated with these complications. We identified 139 patients with spinal Epidural Hematoma and/or abscess among 3,833,620 surgical patients undergoing neuraxial anesthesia. The incidences of spinal Epidural Hematoma and abscess were 27 (95% confidence interval [CI], 22 to 32) and 10 (7 to 13) per one million patients, respectively. Spinal anesthesia was associated with significantly fewer complications compared with Epidural or combined spinal Epidural anesthesia (odds ratio, 0.15; 95% CI, 0.08 to 0.32). Antiplatelet agent (odds ratio, 0.49; 95% CI, 0.06 to 3.91) and anticoagulants (odds ratio, 1.65; 95% CI, 0.95 to 2.85) were not significantly associated with these complications. This analysis identified the incidences of spinal Epidural Hematoma and/or abscess after neuraxial anesthesia. Additional large-scale studies are warranted to examine the incidences and factors associated with these complications.

  • spinal Epidural Hematoma and abscess after neuraxial anesthesia a historical cohort study using the japanese diagnosis procedure combination database
    Canadian Journal of Anaesthesia-journal Canadien D Anesthesie, 2020
    Co-Authors: Kanako Makito, Hideyuki Mouri, Hiroki Matsui, Nobuaki Michihata, Kiyohide Fushimi, Hideo Yasunaga
    Abstract:

    BACKGROUND Spinal Epidural Hematoma and abscess are rare complications of neuraxial anesthesia but can cause severe neurologic deficits. The incidence of these complications vary widely in existing studies and the risk factors remain uncertain. We estimated the incidence of these complications and explored associations using a national inpatient database in Japan. METHODS Using Japanese Diagnosis Procedure Combination data on surgical inpatients who underwent neuraxial anesthesia from July 2010 to March 2017, we identified patients with spinal Epidural Hematoma and/or abscess. We investigated age, sex, Charlson comorbidity index, antithrombotic therapy, type of surgery, admission, and hospital for association with these complications. The incidences of spinal Epidural Hematoma and abscess were estimated separately, and a nested case-control study was performed to examine factors associated with these complications. RESULTS We identified 139 patients with spinal Epidural Hematoma and/or abscess among 3,833,620 surgical patients undergoing neuraxial anesthesia. The incidences of spinal Epidural Hematoma and abscess were 27 (95% confidence interval [CI], 22 to 32) and 10 (7 to 13) per one million patients, respectively. Spinal anesthesia was associated with significantly fewer complications compared with Epidural or combined spinal Epidural anesthesia (odds ratio, 0.15; 95% CI, 0.08 to 0.32). Antiplatelet agent (odds ratio, 0.49; 95% CI, 0.06 to 3.91) and anticoagulants (odds ratio, 1.65; 95% CI, 0.95 to 2.85) were not significantly associated with these complications. CONCLUSIONS This analysis identified the incidences of spinal Epidural Hematoma and/or abscess after neuraxial anesthesia. Additional large-scale studies are warranted to examine the incidences and factors associated with these complications.

Oystein P Nygaard - One of the best experts on this subject based on the ideXlab platform.

  • lumbar Epidural Hematoma after chiropractic manipulation for lower back pain case report
    Neurosurgery, 2008
    Co-Authors: Ole Solheim, Jan V Jorgensen, Oystein P Nygaard
    Abstract:

    OBJECTIVE Spinal manipulation therapy is widely used for the treatment of lower-back pain. Serious complications to spinal manipulation are most often seen in the cervical region. We report the first case of a lumbar Epidural Hematoma after chiropractic manipulation. CLINICAL PRESENTATION A 77-year-old man with a long history of lower-back pain underwent chiropractic manipulation of the lower spine. He was receiving anticoagulation therapy as a result of chronic atrial fibrillation. After a manipulation session, he developed partial cauda equina syndrome with lower extremity paresis and urinary retention. Computed tomographic and magnetic resonance imaging scans showed an Epidural Hematoma at the L3 level. INTERVENTION AND TECHNIQUE We performed surgical evacuation of the Hematoma through laminectomy of L3 and L4. During the follow-up period, his motor deficits improved, but the bladder dysfunction remained. CONCLUSION This is the first case report of a lumbar Epidural Hematoma after chiropractic manipulation. Even rare complications after chiropractic manipulation of the spine should be weighed against potential benefits of such treatment. Caution should be shown in patients receiving antithrombotic therapy.

  • lumbar Epidural Hematoma after chiropractic manipulation for lower back pain case report commentary
    Neurosurgery, 2007
    Co-Authors: Ole Solheim, Jan V Jorgensen, Oystein P Nygaard, Volker K H Sonntag, Martin B Camins, Paul Khoueir, Michael Wang
    Abstract:

    OBJECTIVE: Spinal manipulation therapy is widely used for the treatment of lower-back pain. Serious complications to spinal manipulation are most often seen in the cervical region. We report the first case of a lumbar Epidural Hematoma after chiropractic manipulation. CLINICAL PRESENTATION: A 77-year-old man with a long history of lower-back pain underwent chiropractic manipulation of the lower spine. He was receiving anticoagulation therapy as a result of chronic atrial fibrillation. After a manipulation session, he developed partial cauda equina syndrome with lower extremity paresis and urinary retention. Computed tomographic and magnetic resonance imaging scans showed an Epidural Hematoma at the L3 level. INTERVENTION AND TECHNIQUE: We performed surgical evacuation of the Hematoma through laminectomy of L3 and L4. During the follow-up period, his motor deficits improved, but the bladder dysfunction remained. CONCLUSION: This is the first case report of a lumbar Epidural Hematoma after chiropractic manipulation. Even rare complications after chiropractic manipulation of the spine should be weighed against potential benefits of such treatment. Caution should be shown in patients receiving antithrombotic therapy.

Kanako Makito - One of the best experts on this subject based on the ideXlab platform.

  • spinal Epidural Hematoma and abscess after neuraxial anesthesia a historical cohort study using the japanese diagnosis procedure combination database
    Canadian Journal of Anaesthesia-journal Canadien D Anesthesie, 2021
    Co-Authors: Kanako Makito, Hideyuki Mouri, Hiroki Matsui, Nobuaki Michihata, Kiyohide Fushimi, Hideo Yasunaga
    Abstract:

    Spinal Epidural Hematoma and abscess are rare complications of neuraxial anesthesia but can cause severe neurologic deficits. The incidence of these complications vary widely in existing studies and the risk factors remain uncertain. We estimated the incidence of these complications and explored associations using a national inpatient database in Japan. Using Japanese Diagnosis Procedure Combination data on surgical inpatients who underwent neuraxial anesthesia from July 2010 to March 2017, we identified patients with spinal Epidural Hematoma and/or abscess. We investigated age, sex, Charlson comorbidity index, antithrombotic therapy, type of surgery, admission, and hospital for association with these complications. The incidences of spinal Epidural Hematoma and abscess were estimated separately, and a nested case-control study was performed to examine factors associated with these complications. We identified 139 patients with spinal Epidural Hematoma and/or abscess among 3,833,620 surgical patients undergoing neuraxial anesthesia. The incidences of spinal Epidural Hematoma and abscess were 27 (95% confidence interval [CI], 22 to 32) and 10 (7 to 13) per one million patients, respectively. Spinal anesthesia was associated with significantly fewer complications compared with Epidural or combined spinal Epidural anesthesia (odds ratio, 0.15; 95% CI, 0.08 to 0.32). Antiplatelet agent (odds ratio, 0.49; 95% CI, 0.06 to 3.91) and anticoagulants (odds ratio, 1.65; 95% CI, 0.95 to 2.85) were not significantly associated with these complications. This analysis identified the incidences of spinal Epidural Hematoma and/or abscess after neuraxial anesthesia. Additional large-scale studies are warranted to examine the incidences and factors associated with these complications.

  • spinal Epidural Hematoma and abscess after neuraxial anesthesia a historical cohort study using the japanese diagnosis procedure combination database
    Canadian Journal of Anaesthesia-journal Canadien D Anesthesie, 2020
    Co-Authors: Kanako Makito, Hideyuki Mouri, Hiroki Matsui, Nobuaki Michihata, Kiyohide Fushimi, Hideo Yasunaga
    Abstract:

    BACKGROUND Spinal Epidural Hematoma and abscess are rare complications of neuraxial anesthesia but can cause severe neurologic deficits. The incidence of these complications vary widely in existing studies and the risk factors remain uncertain. We estimated the incidence of these complications and explored associations using a national inpatient database in Japan. METHODS Using Japanese Diagnosis Procedure Combination data on surgical inpatients who underwent neuraxial anesthesia from July 2010 to March 2017, we identified patients with spinal Epidural Hematoma and/or abscess. We investigated age, sex, Charlson comorbidity index, antithrombotic therapy, type of surgery, admission, and hospital for association with these complications. The incidences of spinal Epidural Hematoma and abscess were estimated separately, and a nested case-control study was performed to examine factors associated with these complications. RESULTS We identified 139 patients with spinal Epidural Hematoma and/or abscess among 3,833,620 surgical patients undergoing neuraxial anesthesia. The incidences of spinal Epidural Hematoma and abscess were 27 (95% confidence interval [CI], 22 to 32) and 10 (7 to 13) per one million patients, respectively. Spinal anesthesia was associated with significantly fewer complications compared with Epidural or combined spinal Epidural anesthesia (odds ratio, 0.15; 95% CI, 0.08 to 0.32). Antiplatelet agent (odds ratio, 0.49; 95% CI, 0.06 to 3.91) and anticoagulants (odds ratio, 1.65; 95% CI, 0.95 to 2.85) were not significantly associated with these complications. CONCLUSIONS This analysis identified the incidences of spinal Epidural Hematoma and/or abscess after neuraxial anesthesia. Additional large-scale studies are warranted to examine the incidences and factors associated with these complications.

Ole Solheim - One of the best experts on this subject based on the ideXlab platform.

  • lumbar Epidural Hematoma after chiropractic manipulation for lower back pain case report
    Neurosurgery, 2008
    Co-Authors: Ole Solheim, Jan V Jorgensen, Oystein P Nygaard
    Abstract:

    OBJECTIVE Spinal manipulation therapy is widely used for the treatment of lower-back pain. Serious complications to spinal manipulation are most often seen in the cervical region. We report the first case of a lumbar Epidural Hematoma after chiropractic manipulation. CLINICAL PRESENTATION A 77-year-old man with a long history of lower-back pain underwent chiropractic manipulation of the lower spine. He was receiving anticoagulation therapy as a result of chronic atrial fibrillation. After a manipulation session, he developed partial cauda equina syndrome with lower extremity paresis and urinary retention. Computed tomographic and magnetic resonance imaging scans showed an Epidural Hematoma at the L3 level. INTERVENTION AND TECHNIQUE We performed surgical evacuation of the Hematoma through laminectomy of L3 and L4. During the follow-up period, his motor deficits improved, but the bladder dysfunction remained. CONCLUSION This is the first case report of a lumbar Epidural Hematoma after chiropractic manipulation. Even rare complications after chiropractic manipulation of the spine should be weighed against potential benefits of such treatment. Caution should be shown in patients receiving antithrombotic therapy.

  • lumbar Epidural Hematoma after chiropractic manipulation for lower back pain case report commentary
    Neurosurgery, 2007
    Co-Authors: Ole Solheim, Jan V Jorgensen, Oystein P Nygaard, Volker K H Sonntag, Martin B Camins, Paul Khoueir, Michael Wang
    Abstract:

    OBJECTIVE: Spinal manipulation therapy is widely used for the treatment of lower-back pain. Serious complications to spinal manipulation are most often seen in the cervical region. We report the first case of a lumbar Epidural Hematoma after chiropractic manipulation. CLINICAL PRESENTATION: A 77-year-old man with a long history of lower-back pain underwent chiropractic manipulation of the lower spine. He was receiving anticoagulation therapy as a result of chronic atrial fibrillation. After a manipulation session, he developed partial cauda equina syndrome with lower extremity paresis and urinary retention. Computed tomographic and magnetic resonance imaging scans showed an Epidural Hematoma at the L3 level. INTERVENTION AND TECHNIQUE: We performed surgical evacuation of the Hematoma through laminectomy of L3 and L4. During the follow-up period, his motor deficits improved, but the bladder dysfunction remained. CONCLUSION: This is the first case report of a lumbar Epidural Hematoma after chiropractic manipulation. Even rare complications after chiropractic manipulation of the spine should be weighed against potential benefits of such treatment. Caution should be shown in patients receiving antithrombotic therapy.

Reinaldo Acosta - One of the best experts on this subject based on the ideXlab platform.

  • spontaneous spinal Epidural Hematoma in pregnancy associated with using low molecular weight heparin
    Obstetrics & Gynecology, 2009
    Co-Authors: Evan Forsnes, Amy Occhino, Reinaldo Acosta
    Abstract:

    BACKGROUND Spontaneous Epidural Hematoma of the spine occurring in pregnancy is uncommon and may result in permanent damage if not promptly treated. The use of low molecular weight heparin may be a risk factor for this condition. CASE We describe the case of a woman who presented at 27 weeks of gestation with progressive back pain and leg weakness while being treated with low molecular weight heparin. A magnetic resonance imaging (MRI) examination of the spine revealed an Epidural Hematoma, which was surgically treated. A cesarean delivery was performed at 36 weeks of gestation. CONCLUSION Spontaneous Epidural Hematoma of the spine may present in pregnant patients using low molecular weight heparin. The onset of neurologic symptoms and pain in these gravidas should be evaluated with MRI. Expeditious surgery is almost always the best treatment option.