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相关概念视频

Local Anesthetics: Clinical Application as Spinal Anesthesia01:11

Local Anesthetics: Clinical Application as Spinal Anesthesia

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Spinal anesthetics are given during lower abdomen and limb surgeries to block sensory and motor neurons. They are administered in the mid to low lumbar regions, primarily acting on the cauda equina's nerve roots. The blockade level depends on the local anesthetic (LA) concentration. Usually, low LA concentrations are sufficient to block sensory fibers, while only high LA concentrations block motor fibers. Other factors like injection volume and speed, the patient's posture, and the drug...
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相关实验视频

Updated: Jun 26, 2025

Spinal Hernia Repair and Cauda Equina Repositioning After Lumbar Decompression under Three-Dimensional Microscopy: A Case Report and Literature Review
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尾牙症候群:在脊柱减压后的成本负担

Darren Z Nin1, Ya-Wen Chen, Raymond W Hwang

  • 1From the Department of Orthopedic Surgery, New England Baptist Hospital (Nin, Hwang, Niu, Chang, and Kim), the Department of Surgery, Massachusetts General Hospital, Harvard Medical School (Nin, Chen, and Chang), Tufts University School of Medicine (Hwang and Kim), and the Department of Orthopedic Surgery, Tufts Medical Center, Boston, MA (Sinz).

The Journal of the American Academy of Orthopaedic Surgeons
|May 15, 2024
PubMed
概括

马尾综合征 (CES) 患者在脊柱减压手术后的第一年,短期治疗成本较高,主要是物理治疗和膀管理. 在第二年,成本变得可比.

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科学领域:

  • 神经外科 神经外科
  • 卫生经济学 卫生经济学

背景情况:

  • 马尾综合征 (CES) 是一种罕见但严重的神经疾病,对患者有重大影响.
  • 有效管理CES对于减轻长期后果至关重要.

研究的目的:

  • 为了比较后背脊减压后出现CES和没有CES的患者的2年术后治疗费用.
  • 确定导致成本差异的特定治疗类别.

主要方法:

  • 一项观察性队列研究分析了商业保险索赔数据库.
  • 包括2017年因腰椎狭窄症,骨干病变或椎间盘瘤而经历后脊椎减压的患者.
  • 治疗费用在手术后两年被跟踪,包括物理治疗,止痛药,注射,膀/肠道管理,性功能障碍和心理治疗.

主要成果:

  • 该研究包括3,140名患者;平均总治疗费用为2,996美元±6,368美元.
  • 在术后第一年,CES患者的物理治疗费用 (+115%) 和膀管理费用 (+697%) 显著增加.
  • 在第一年,CES患者的整体治疗费用显著上升 (3,022美元与1,824美元),但这一差异在第二年减少.

结论:

  • 在CES患者的第一个术后一年中,观察到治疗成本的短期增加.
  • 物理治疗和膀管理是导致CES患者成本增加的主要驱动因素.
  • 在CES和非CES患者之间,整体治疗成本在术后第二年变得相似.