Relevant bibliographies by topics / Epidural adhesion

Academic literature on the topic 'Epidural adhesion'

Author: Grafiati
Published: 10 December 2022
Last updated: 29 January 2023

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Journal articles on the topic "Epidural adhesion"

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Zhivotenko, A. P., V. A. Sorokovikov, and Z. V. Koshkareva. "Formation of Adhesive Arachnoiditis with Epidural Fibrosis as a Cause of Repeated Surgical Interventions (Clinical Case)." Acta Biomedica Scientifica 5, no. 3 (July 13, 2020): 54–61. http://dx.doi.org/10.29413/abs.2020-5.3.8.

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The work presents a rare clinical case of adhesive arachnoiditis, which developed against the background of epidural fibrosis during repeated surgical interventions. The cicatricial adhesion in the epidural space is formed in 100% of cases after surgery and is a frequent cause of intraoperative complications during repeated surgical interventions (bleeding, damage to the spinal cord and the dura mater with subsequent outflow of cerebrospinal fluid) and, therefore, an unsatisfactory result of surgical treatment with the formation of constant pain of various intensity, pseudomeningocele, commissural arachnoiditis, etc. The cicatricial adhesion in the epidural space is the main reason for the development of failed back surgery syndrome (FBSS), which today is an important and unresolved problem in spinal surgery. The epidural, as well as the subdural and subarachnoid space of the operated spinal motor segment of the spinal canal can be involved in the cicatricial adhesion, as it is shown in our clinical example. In this regard, it is important to prevent the development of the cicatricial adhesion in the epidural space during primary spinal surgeries, since with the increase in life expectancy of the population and increase in surgical activity during spinal surgeries, the patient can be operated repeatedly. Consequently, the question arises of preventing the formation of the cicatricial adhesion in 100% of cases with each surgical intervention, since the formed cicatricial adhesion in the epidural space does not have effective methods of conservative and surgical treatment and worsens favorable and satisfactory forecasts of surgical treatment for repeated surgical interventions.
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Shin, Dong Ah. "Finite Element Analysis of the Effect of Epidural Adhesions." July 2016 5;19, no. 5;19 (July 14, 2016): E787—E793. http://dx.doi.org/10.36076/ppj/2016.19.e787.

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Background: It is well documented that epidural adhesion is associated with spinal pain. However, the underlying mechanism of spinal pain generation by epidural adhesion has not yet been elucidated. Objectives: To elucidate the underlying mechanism of spinal pain generation by epidural adhesion using a two-dimensional (2D) non-linear finite element (FE) analysis. Study design: A finite element analysis. Setting: A two-dimensional nonlinear FE model of the herniated lumbar disc on L4/5 with epidural adhesion. Methods: A two-dimensional nonlinear FE model of the lumbar spine was developed, consisting of intervertebral discs, dura, spinal nerve, and lamina. The annulus fibrosus and nucleus pulpous were modeled as hyperelastic using the Mooney-Rivlin equation. The FE mesh was generated and analyzed using Abaqus (ABAQUS 6.13.; Hibbitt, Karlsson & Sorenson, Inc., Providence, RI, USA). Epidural adhesion was simulated as rough contact, in which no slip occurred once two surfaces were in contact, between the dura mater and posterior annulus fibrosus. Results: The FE model of adhesion showed significant stress concentration in the spinal nerves, especially on the dorsal root ganglion (DRG). The stress concentration was caused by the lack of adaptive displacement between the dura mater and posterior annulus fibrosus. The peak von Mises stress was higher in the epidural adhesion model (Adhesion, 0.67 vs. Control, 0.46). In the control model, adaptive displacement was observed with decreased stress in the spinal nerve and DRG (with adhesion, 2.59 vs. without adhesion, 3.58, P < 0.00). Limitations: This study used a 2D non-linear FE model, which simplifies the 3D nature of the human intervertebral disc. In addition, this 2D non-linear FE model has not yet been validated. Conclusion: The current study clearly demonstrated that epidural adhesion causes significantly increased stress in the spinal nerves, especially at the DRG. We believe that the increased stress on the spinal nerve might elicit more pain under similar magnitudes of lumbar disc protrusion. Key words: Finite element, epidural adhesion, spinal pain, adhesiolysis
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Hyun, Dong-Min, Chan-Hye Park, Yujin Kim, and Seong-Soo Choi. "Successful electrode insertion for spinal cord stimulation after balloon adhesiolysis in a patient with epidural adhesion - A case report -." Anesthesia and Pain Medicine 16, no. 2 (April 30, 2021): 191–95. http://dx.doi.org/10.17085/apm.20084.

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Background: Spinal cord stimulation (SCS) can be successfully performed using highly developed implantation techniques. However, anatomical barriers, such as epidural adhesion, may impede placing the electrode for SCS in an adequate position.Case: A 60-year-old woman who had SCS with an electrode at the T9-10 level removed because she had a wound infection at the back incision site. After the wound infection was completely resolved, we tried to re-insert the SCS electrode. However, it was difficult to advance it up to the T11 level due to epidural adhesion. We performed a combined epidural adhesiolysis using balloon decompression with an inflatable balloon catheter. After that, the SCS lead was successfully placed up to the T11 level, and implantation of SCS was performed.Conclusions: When a patient has epidural adhesion, an epidural adhesiolysis with an inflatable balloon catheter may help the insertion of the SCS electrode in the epidural space.
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Welch, William C., Kevin A. Thomas, G. Bryan Cornwall, Peter C. Gerszten, Jeffrey M. Toth, Edwin M. Nemoto, and A. Simon Turner. "Use of polylactide resorbable film as an adhesion barrier." Journal of Neurosurgery: Spine 97, no. 4 (November 2002): 413–22. http://dx.doi.org/10.3171/spi.2002.97.4.0413.

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Object. The present investigation evaluates two thicknesses of a resorbable polylactic acid (PLA) barrier film as an adhesion barrier to posterior spinal scar formation. Methods. A readily contourable, thin film was placed directly over the dura. The thick film was placed above the lamina defect to act as a physical barrier inhibiting the prolapse of soft tissue into the epidural space. Through a combination of gross dissection with and without scar scores, quantitative analysis of collagen adjacent to the scar site, and histological evaluation, the resorbable adhesion barrier membranes were found to be effective treatment for reduction of posterior adhesions. Conclusions. The gross dissection demonstrated that both thicknesses of resorbable PLA barrier films created a controlled dissection plane, facilitated access to the epidural space, and provided a reduction in the tissue adherent to the dura.
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Preul, Mark C., Patrick K. Campbell, David S. Garlick, and Robert F. Spetzler. "Application of a new hydrogel dural sealant that reduces epidural adhesion formation: evaluation in a large animal laminectomy model." Journal of Neurosurgery: Spine 12, no. 4 (April 2010): 381–90. http://dx.doi.org/10.3171/2009.10.spine09537.

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Object The aim of this study was to evaluate the application and effects of a novel, nonswelling, polyethylene glycol-based hydrogel adhesion barrier and sealant in a canine laminectomy model of CSF leakage and adhesion formation. Methods After full-width L-2 and L-5 laminectomies, 1-cm midline durotomies were created and sutured closed, except for the last 1–2 mm on the cranial end to create spontaneous CSF leakage. All 5 control animals received no further treatment. Experimental animals received hydrogel at both durotomy sites via either the Dual Liquid applicator (5 animals) or MicroMyst gas-assisted sprayer (5 animals). Sealing of the CSF leak was confirmed by Valsalva maneuver. At 2 months, 2 animals from each group were killed to evaluate dural healing and epidural adhesion formation. The remaining animals were similarly evaluated 4 months after surgery. One animal died at 66 days due to a cause unrelated to hydrogel treatment. Results In hydrogel-treated animals, all leaking durotomies were sealed intraoperatively. All animals recovered uneventfully. There were no treatment-related health effects. MicroMyst hydrogel application was more controlled, slower, and significantly less thick (p = 0.0094) than Dual Liquid application. All 5 control animals developed subcutaneous CSF accumulations under the incision within days of surgery, compared with only 1 of 10 hydrogel-treated animals (p = 0.002). At 2 and 4 months, control laminectomy sites showed extensive, dense epidural adhesions blending with neodura, compared with hydrogel-treated sites (p < 0.0001 and p = 0.0234, respectively). At 2 months in hydrogel-treated animals, gel filled the epidural space and no epidural adhesions were noted (p < 0.0001 relative to controls). At 4 months, the hydrogel was absorbed. The hydrogel space was filled with scant, loosely organized connective tissue. Conclusions Hydrogel prevented CSF leakage and mitigated epidural scarring without affecting healing of the dura or laminectomy site. The safety profile of the hydrogel appears favorable due to its synthetic composition, polyethylene glycol chemistry, minimal local tissue response, and lack of neurological deficits. Controlled application of such hydrogel materials may reduce the incidence of postoperative leaks, prevent adhesion formation and thus improve recovery from spinal surgery, and improve identification of tissue planes for reoperations.
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Birkenmaier, Christof. "A Biomechanical Evaluation of the Epidural Neurolysis Procedure." Pain Physician 1;15, no. 1;1 (January 14, 2012): E89—E97. http://dx.doi.org/10.36076/ppj.2012/15/e89.

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Background: The epidural lysis of adhesions (ELOA) procedure supposedly has a biomechanical component in addition to the targeted injection of medications into the epidural space. It is assumed that the catheters used for the ELOA procedure can release epidural scars and adhesions. Objectives: To evaluate the possible biomechanical effects of the typically used catheters and to put these effects into clinical perspective. Study Design: Experimental study. Setting: The biomechanical laboratory of an academic orthopedic surgery department. Methods: Experimental setups were devised that allow for the measurement of the 3 main forces that can be exerted by manipulating a catheter in the epidural space or by injecting fluids through such a catheter: axial forces, torsional forces, and hydraulic effects. Results: The maximum axial forces measured under extremely tight catheter guidance were 7 newton (N), whereas the maximum forces under conditions that more likely reflect a real treatment situation were between 1 and 2 N. The maximum torsional forces measured were 0.3 N under extremely tight catheter guidance and 0.01 N under more realistic conditions. The maximum flow that could be achieved through the typical catheter using normal saline and the maximum possible thumb pressure onto a 5 mL or a 10 mL Luer-Lock syringe was 0.48 mL/ s. Given these results and other data available to us, it appears impossible that the ELOA procedure with typically used catheters has any relevant mechanical effect. Limitations: Like with any experimental study, the realities of an in vivo situation can only be modeled to a limited degree. The main limitation of our study is that we cannot calculate, measure, or simulate neither the flow resistance between an epidural adhesion pocket and the open, local epidural space nor the flow resistance between the open, local epidural space and the larger epidural space as well as the retroperitoneal space. Conclusions: According to our findings and arguments, the ELOA procedure is predominantly a method for the highly targeted application of epidural medications and possibly also has a lavage effect. A mechanical lysis of scars or adhesions appears unlikely. Key words: epidural lysis of adhesions, epidural neurolysis, epidural neuroplasty, biomechanical, experimental, epidural, catheter, back pain, sciatica
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Liu, Song, Jean Pierre Boutrand, Jacques Bittoun, and Marc Tadie. "A collagen-based sealant to prevent in vivo reformation of epidural scar adhesions in an adult rat laminectomy model." Journal of Neurosurgery: Spine 97, no. 1 (July 2002): 69–74. http://dx.doi.org/10.3171/spi.2002.97.1.0069.

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Object. The authors investigated the effect of a collagen-based sealant, Gel Amidon Oxydé (GAO), in preventing the reformation of epidural scar adhesions in an adult rat model of laminectomy. Methods. Thirty-two adult Sprague—Dawley rats underwent a complete L5–6 laminectomy, after which the dura mater was exposed and the left adjacent L-4 and L-5 nerve roots were exposed. The surgical wound was then closed; 1 month later it was reopened. The epidural scar adhesions that developed were observed and carefully removed, leaving clean dura and nerve roots reexposed. In 16 experimental rats, GAO was placed onto the reexposed dura and around the nerve roots before it polymerized. No treatment was performed in 16 control rats. Postoperatively, all rats were healthy and without neurological deficit. The incisions healed within 1 week regardless of the treatment with the GAO. Three months after reoperation, magnetic resonance imaging revealed that important epidural adhesions were present in the control rats but not in the experimental rats. These findings were then confirmed by gross anatomical examination in which a white tissue layer was found over the dura without adhesions in the experimental animals, whereas significant epidural scar adhesions were demonstrated in the controls. Histological evaluation of the laminectomy site also showed that the peridural space in the experimental rats was larger than that in the controls. Conclusions. The authors found that GAO may be a safe and effective antiscarring adhesion biomaterial in vivo. When placed into the laminectomy site, GAO may prove beneficial in preventing the formation and reformation of epidural scar adhesions in humans.
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Liu, Song, Jean Pierre Boutrand, and Marc Tadie. "Use of a collagen-based sealant to prevent in vivo epidural adhesions in an adult rat laminectomy model." Journal of Neurosurgery: Spine 94, no. 1 (January 2001): 61–67. http://dx.doi.org/10.3171/spi.2001.94.1.0061.

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Object. The authors investigated the effect of a collagen-based sealant, Gel Amidon Oxydé (GAO), in the prevention of epidural scar adhesions in an adult rat model of laminectomy. Methods. Seventy-two adult Sprague—Dawley rats underwent an L5–6 laminectomy, after which the dura mater and the left L-4 and L-5 nerve roots were exposed. In the 36 animals that received GAO, the sealant was applied over the dura and around the nerve roots, and it was used to fill the laminectomy cavity before it polymerized. In 36 control animals, the same surgical treatment was performed, but the rats did not receive GAO. During the early postoperative period, a significant decrease in the occurrence of epidural hematoma was found in the GAO-treated rats. In contrast to findings in control rats, a thin white connective tissue layer was found between the dura and surrounding muscles after GAO had degraded and been absorbed. One month posttreatment, no epidural scar adhesion was found between the tissue layer and the dura in the GAO-treated animals. Three months postoperatively, both gross inspection and histological examination further confirmed that formation of epidural adhesions was significantly inhibited in the rats treated with GAO. No special inflammatory reaction was observed, and the healing of skin and muscle lesions was not affected by either treatment. Conclusions. The data obtained in this study suggest that the GAO collagen—based sealant may be an effective biomaterial to prevent epidural adhesions in vivo after laminectomy.
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Fishchenko, Ya, D. Zavodovskyi, T. Matvienko, D. Nozdrenko, and O. Motuzyuk. "Structural changes of spinal cord fibrosis due to epidural application of mixture of longidaza and diprospa." Bulletin of Taras Shevchenko National University of Kyiv. Series: Problems of Physiological Functions Regulation 20, no. 1 (2016): 49–53. http://dx.doi.org/10.17721/2616_6410.2016.20.49-53.

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Changes in structure of fibrosis of rat spinal cord induced using intervertebral disc rupture fibers method due to application longidaza and diprospan mixture. Simultanious epidural application of hyaluronidase and betamethasone in preparation of diprospan and longidasa had high synergistic effect and antifibrosis activity. Through anti-inflammatory effect and ability to reduce epidural scars adhesion this complex, to our opinion, has perspective in therapy of epidural spinal cord fibrosis.
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Lee, Jin-Yul, Werner Stenzel, Heinrich Ebel, Christoph Wedekind, Ralf-Ingo Ernestus, and Norfrid Klug. "Mitomycin C in preventing spinal epidural fibrosis in a laminectomy model in rats." Journal of Neurosurgery: Spine 100, no. 1 (January 2004): 52–55. http://dx.doi.org/10.3171/spi.2004.100.1.0052.

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Object. Extensive epidural fibrosis after lumbar surgery may be the underlying cause in most cases of failed—back surgery syndrome. Various materials have been used to prevent epidural fibrosis, but only moderate success has been shown. Mitomycin C, an alkylosing antibiotic substance isolated from Streptomyces caespitosus, potentially supresses fibroblast proliferation after surgery. In this study, the authors investigated the effect of mitomycin C by local application on spinal epidural fibrosis in a rat laminectomy model. Methods. Five Wistar rats underwent laminectomy at cervical, thoracic, and lumbar levels. Based on data obtained from ophthalmological studies, mitomycin C was applied to the laminectomy sites in various concentrations (0.01, 0.05, and 0.1 mg/ml). One laminectomy site in each rat was left untreated and thus served as a control. Evoked potentials were measured pre- and postoperatively, and all rats underwent clinical evaluation. Mobility status and evidence of neurological deficit were recorded. Twelve weeks later, the rats were killed, and the spinal column, including surrounding muscle tissue, was removed en bloc, decalcified, and fixed in formaldehyde. Epidural fibrosis was evaluated histologically. In all mitomycin C—treated laminectomy sites, epidural scarring was significantly reduced compared with control sites. Remarkably, dural adhesions were absent in laminectomy defects treated with mitomycin C concentrations of 0.05 and 0.1 mg/ml. Moderate to marked epidural fibrosis with adhesion to the dura mater was noted at sites receiving 0.01 mg/ml of mitomycin C. All control sites showed dense epidural fibrosis with marked dura adherence. Conclusions. In this experimental model, mitomycin C applied locally at a concentration of 0.1 mg/ml effectively reduced epidural fibrosis, completely avoided dural adherence, and induced no side effects.
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Dissertations / Theses on the topic "Epidural adhesion"

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Vediappan, Rajan Sundaresan. "Modifying Post-Surgical Wound Healing." Thesis, 2021. http://hdl.handle.net/2440/130740.

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“Surgery is a profession defined by its authority to cure by means of bodily invasion. The brutality and risks of opening a living person's body have long been apparent, the benefits only slowly and haltingly worked out”, says Atul Rawande on reviewing 200 yrs. of Surgery as a specialty in NEJM. My research focuses on working out these benefits, specifically looking at reduction of scar tissue formation in ENT, Abdominal & Spine surgery. Scar tissue formation is an outcome of healing process that can be excessive due to inflammation or infection and thereby has the ability to curtail the benefits or warrant revision surgery. Multiple strategies have been tested and employed thus far and none have given favourable results without causing additional harm or economic burden in health care costs. I propose to use a hydrogel synthesized by combining Chitosan and Dextran aldehyde -Chitin is an exoskeleton extracted polymer and Dextran Aldehyde a sugar, with added noveldrugs Deferiprone and Gallium Protoporphyrin providing additional anti scaring and antibiotic properties which could potentially augment the healing properties of the gel. I have conducted 3 types of studies. There are 2 animal studies and a Phase 1 Human clinical trial. The animal studies are an abdominal surgery rat model and a spine surgery sheep model. These studies show the safety and efficacy of this chitogel-drug combination at various dosages and illustrate the healing benefits of gel-drug combination.
Thesis (Ph.D.) -- University of Adelaide, Adelaide Medical School, 2021
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Book chapters on the topic "Epidural adhesion"

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Racz, Gabor Bela, and Gabor J. Racz. "Epidural Lysis of Adhesions." In Multidisciplinary Spine Care, 251–315. Cham: Springer International Publishing, 2022. http://dx.doi.org/10.1007/978-3-031-04990-3_12.

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Racz, Gabor B., James E. Heavner, Carl E. Noe, Adnan Al-Kaisy, Tomikichi Matsumoto, Sang Chul Lee, and Laszlo Nagy. "Epidural Lysis of Adhesions and Percutaneous Neuroplasty." In Techniques of Neurolysis, 119–43. Cham: Springer International Publishing, 2016. http://dx.doi.org/10.1007/978-3-319-27607-6_8.

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Racz, Gabor B., and Jerry T. Holubec. "Lysis of Adhesions in the Epidural Space." In Techniques of Neurolysis, 57–72. Boston, MA: Springer US, 1989. http://dx.doi.org/10.1007/978-1-4899-6721-3_6.

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Ko, Timothy Y., and Salim M. Hayek. "Epidural Lysis of Adhesions: Percutaneous and Endoscopic Techniques." In Treatment of Chronic Pain by Interventional Approaches, 195–206. New York, NY: Springer New York, 2014. http://dx.doi.org/10.1007/978-1-4939-1824-9_20.

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Ko, Timothy Y., and Salim M. Hayek. "Epidural Lysis of Adhesions: Percutaneous and Endoscopic Techniques." In Comprehensive Treatment of Chronic Pain by Medical, Interventional, and Integrative Approaches, 403–13. New York, NY: Springer New York, 2012. http://dx.doi.org/10.1007/978-1-4614-1560-2_39.

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Racz, Gabor B., Miles R. Day, James E. Heavner, and Jeffrey P. Smith. "The Racz Procedure: Lysis of Epidural Adhesions (Percutaneous Neuroplasty)." In Treatment of Chronic Pain by Interventional Approaches, 315–29. New York, NY: Springer New York, 2014. http://dx.doi.org/10.1007/978-1-4939-1824-9_31.

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Racz, Gabor B., Miles R. Day, James E. Heavner, and Jeffrey P. Smith. "The Racz Procedure: Lysis of Epidural Adhesions (Percutaneous Neuroplasty)." In Comprehensive Treatment of Chronic Pain by Medical, Interventional, and Integrative Approaches, 521–34. New York, NY: Springer New York, 2012. http://dx.doi.org/10.1007/978-1-4614-1560-2_50.

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Racz, Gabor B., Miles R. Day, James E. Heavner, and Jared Scott. "Lysis of Epidural Adhesions." In Pain Management, 1258–72. Elsevier, 2011. http://dx.doi.org/10.1016/b978-1-4377-0721-2.00169-0.

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Waldman, Steven D. "Lysis of Epidural Adhesions." In Atlas of Interventional Pain Management, 568–76. Elsevier, 2015. http://dx.doi.org/10.1016/b978-0-323-24428-2.00107-8.

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Waldman, Steven D. "Lysis of Cervical Epidural Adhesions." In Pain Management, 1138–41. Elsevier, 2011. http://dx.doi.org/10.1016/b978-1-4377-0721-2.00154-9.

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Conference papers on the topic "Epidural adhesion"

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Cavanagh, Daniel P., Asena Abay, Jessica M. Brito, Jasmine R. Joyner, Jordyn N. Nally, and Xianren Wu. "A Novel Epidural Catheter Fixation Device." In 2017 Design of Medical Devices Conference. American Society of Mechanical Engineers, 2017. http://dx.doi.org/10.1115/dmd2017-3490.

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Epidurals are a method of long-term pain relief administered by injecting and continuously delivering an anesthetic via catheter in the spine. This method of pain relief is often used for patients in the Obstetrics/Gynecology unit as well as those in pre- and post-operational care. For almost 2 million singleton vaginal deliveries across 27 states in 2008 (representing 65% of all US singleton vaginal births in 2008), 61% of patients received some form of an epidural or spinal injection [1]. Additionally, this number has been increasing. For the 18 states for which 2006 and 2008 data are available, the average of the state-level increases in epidural/spinal injections is approximately 4.2% revealing an overall increase in these injections. Just between 2000 and 2010, the use of epidural injections increased by 160% [2]. Commonly, epidural catheters are inserted into the patient’s back in the appropriate location and then secured to the body with an adhesive medical dressing. Movement and subsequent dislocation of the catheter beneath the adhesive medical dressing can result in inefficient anesthetic delivery, increased patient discomfort, and repeated administration of the epidural. Secondary migration of epidural catheters is a problem responsible for failure in approximately 6.8% of epidurals administered [3]. Requiring an anesthesiologist to repeat the procedure is also an increased cost. A solution to secondary migration of epidural catheters would ensure effective delivery of the anesthetic to the patient, reduce the need for a repeated procedure, and prevent unwanted additional healthcare expenses.
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