Spinal stenoses

A 77-year-old woman was found dead in her bathtub. She had a history of depression, liver disease, spinal stenosis, and diabetes mellitus. An empty bottle of triazolam was found in the bin. At autopsy there was no injury or evidence of drowning. There was triazolam 0.12 mg/1 in the heart blood. 

Bupivacaine has recently been implicated in two cases of cauda equina syndrome (213). One patient was given 3.6 ml of a hyperbaric 0.5% solution, and the other, 3.5 ml of plain bupivacaine. Spinal stenosis was felt to have contributed to the first case, while the cause of the second was unclear. 

A 66-year-old woman with unrecognized spinal stenosis had six spinal anesthetics over 3 years. The first five were with hdocaine 2%. After 24—48 hours, she developed pain in the back, hips, buttocks, and thighs, which lasted for 2-3 days. On the sixth occasion she had a spinal anesthetic with 1.5% mepivacaine 4 ml and the next day again had severe back pain radiating bilaterally to the hips and thighs. 

Some medical conditions require the extended presence of a corticoid at the site of inflammation. One treatment for the pain from spinal stenosis or degenerative disk disease comprises epidural injection of a long-lasting corticoid. Depo Medrol , a solution of 6a-prednisolone (9-1) in a special vehicle, is one of the drugs often used for that purpose. Once injected, the solution forms a depot at the site of administration the drug slowly diffuses from that depot, leading to the sustained presence of the anti-inflammatory compound. 

Dennis LN, Rogers LF (1989) Superior mediastinal widening from spine fractures mimicking aortic rupture on chest radiographs. AJR Am J Roentgenol 152 27-30 Epstein NE, Epstein JA, Mauri T (1989) Treatment of fractures of the vertebral limbus and spinal stenosis in five adolescents and five adults. Neurosurgery 24 595-604 Ferguson RL, Allen BL Jr (1984) A mechanistic classification of thoracolumbar spine fractures. Clin Orthop Relat Res 77-88... 

The treatment of sickle cell priapism requires more disease-specific treatment, including oxygenation, hydration, alkalinization, exercise, analgesia and exchange transfusion. Anecdotal evidence supports the use of oral therapy with hydroxyurea and hydralazine (Al Jam a and Al Dabbous 1998). Etilefrine is an oral a-adrenoreceptor agonist that in the form of maintenance therapy may help prevent further attacks, with little effect on systemic blood pressure (Virag et al. 1996). Surgical spinal decompression has been recommended to alleviate priapism associated with lumbar spinal stenosis. 

Al Jam a AH, Al Dabbous lA (1998) Hydroxyurea in the treatment of sickle cell associated priapism. J Urol 159 1642 Baba H, Maezawa Y, Furusawa N, et al. (1995) Lumbar spinal stenosis causing intermittent priapism. Paraplegia... 

Conventional Irnnbar myelography showing high grade, degenerative spinal stenosis, coronary and transversal MPR... 

Engelhorn T, Rennert J, Richter G et al. (2007) Myelography using flat panel volumetric computed tomography a comparative study in patients with lumbar spinal stenosis. Spine 15 32 E523-527... 

Non-approved uses include treatment of pediatric osteoporosis and treatment of osteogenesis imperfecta. It has also been used to treat refractory pain of lumbar degenerative spinal stenosis. 

Spinal stenosis refers to a narrowing of the spinal canal. A variety of causes exists for stenosing the canal. These include ... 

Turner JA, Ersek M, Herron L, Deyo R. Surgery for lumbar spinal stenosis. Attempted meta-analysis of the literature. Spine 1992 January 17( 1) 1-8. 

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