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Biomedical subjects

B A Huizenga

Publications and source records attributed to B A Huizenga.

5 recordsLinked to original sources
PubMed1992

Acute normovolemic hemodilution combined with hypotensive anesthesia and other techniques to avoid homologous transfusion in spinal fusion surgery.

To avoid homologous transfusion in spinal fusion surgery, acute normovolemic hemodilution was combined with controlled hypotensive anesthesia. Patients were kept hemodiluted, not only during surgery, but also after surgery by delaying transfusion until the next morning or later. Transfusion decisions were made by clinical judgment rather than by preset value (ie, 10 g/dl). Other techniques used in this protocol were preoperative autologous blood donation and intraoperative salvage of shed blood. Only 4 of 119 patients (3.4%) required homologous blood, compared to 25 of 29 patients (86%) in 1982, at which time none of these techniques were used. The average hemoglobin on the seventh postoperative day was similar in both groups; 11.5 g/dl in the current series compared to 11.1 g/dl in the 1982 series.

Adolescent↗
PubMed1991

Predictability of adequacy of spinal root decompression using evoked potentials.

Dermatomal evoked potentials are being used to obtain accurate information concerning the viability of specific nerve root pathways and the quality and extent of nerve root decompression. Twelve patients with quantifiable weakness were selected and tested before, during, and after surgery. Nine patients showed dramatic intraoperative electrical improvement, including decreased latencies and/or increased amplitudes; all had postoperative relief of pain and motor return. Three patients showed variable intraoperative electrical responses with complete pain relief but no motor improvement. No patients had false-negative findings. Intraoperative monitoring of dermatomal evoked potentials appears to be of value in predicting the quality of spinal decompression. Similar monitoring of somatosensory evoked potentials alone cannot provide the specificity for individual root levels that is available by monitoring individual dermatomes.

Adult↗
PubMed1991

Pudendal nerve evoked potential monitoring in procedures involving low sacral fixation.

Pudendal nerve evoked potentials were used in orthopaedic surgical procedures involving fixation below the S1 level. Pudendal nerve stimulation was used to monitor 154 patients. Eleven patients (7.14%) had responses that were either difficult or impossible to interpret in that they were not consistently replicable. In one case (0.65%), responses were lost during surgery, and there were no subsequent neurologic sequelae (false-positive response). No patients had postoperative deficit to the sacral roots or to the global cord. Although it is possible to obtain definitive dermatomal responses down to S1, the use of pudendal nerve stimulation was found to provide additional means of monitoring lower sacral roots. Since the pudendal nerve is intimately associated with bowel, bladder, and sexual dysfunction, easily obtainable routine monitoring of this nerve can provide significant safety that the conventional somatosensory and dermatomal responses give to higher spinal levels.

Adolescent↗
PubMed1988

Dermatomal monitoring for surgical correction of spondylolisthesis. A case report.

The operative treatment for high-grade spondylolisthesis carries with it an inherently high morbidity due primarily to the probability of significant stretch or other injury to nerve roots. Routine somatosensory monitoring of evoked potentials does not give the same specificity to nerve roots as may be desirable to accurately detect changes during surgical correction. We report our experience with the use of dermatomal monitoring to track changes in conduction characteristics of specific nerves and root entry levels.

Child↗