Publications (2)4.6 Total impact
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Article: Spinal epidural abscess.
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ABSTRACT: Spinal epidural abscess is an uncommon disease with a relatively high rate of associated morbidity and mortality. The most important determinant of outcome is early diagnosis and initiation of appropriate treatment. We aim to highlight the clinical manifestations, describe the early diagnostic evaluation, and outline the treatment principles for spinal epidural abscess in the adult. Spinal epidural abscess should be suspected in the patient presenting with complaints of back pain or a neurologic deficit in conjunction with fever or an elevated erythrocyte sedimentation rate. Gadolinium-enhanced magnetic resonance imaging is the diagnostic modality of choice to confirm the presence and determine the location of the abscess. Emergent surgical decompression and debridement (with or without spinal stabilization) followed by long-term antimicrobial therapy remains the treatment of choice. In select cases, non-operative management can be cautiously considered when the risk of neurologic complications is determined to be low. Patients with a spinal epidural abscess often present first in the emergency department setting. It is imperative for the emergency physician to be familiar with the clinical features, diagnostic work-up, and basic management principles of spinal epidural abscess.Journal of Emergency Medicine 09/2010; 39(3):384-90. · 1.31 Impact Factor -
Article: Posterolateral intertransverse lumbar arthrodesis in the New Zealand White rabbit model: I. Surgical anatomy.
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ABSTRACT: The New Zealand White rabbit model for posterolateral lumbar fusion is commonly used for spinal fusion research. However, the high rate of animal morbidity and mortality associated with the model makes experimentation inefficient and can lead to faulty data analysis. Operative complications are in part the result of inadequate knowledge of normal rabbit lumbar spine anatomy. To describe the lumbar spine anatomy of the New Zealand White rabbit as it pertains to the surgical technique of posterolateral intertransverse arthrodesis. This is a descriptive anatomical study of the lumbar spine (and related structures) of the New Zealand White rabbit spinal fusion model. The study was performed at a university research facility. The lumbar spine and associated soft tissue structures of 16 previously sacrificed, skeletally mature New Zealand White rabbits were dissected and examined. The musculoskeletal and neurologic structures relevant to posterolateral lumbar fusion in the New Zealand White rabbit are described. Specific knowledge of rabbit lumbar spine anatomy allows the researcher to more rapidly acquire expertise in the surgical technique of posterolateral arthrodesis. Improved technical execution of the procedure should lower the complication rate, reduce the costs of experimentation and lead to more reliable and reproducible results.The Spine Journal 4(3):287-92. · 3.29 Impact Factor
