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Biomedical subjects

H Claude Sagi

Publications and source records attributed to H Claude Sagi.

3 recordsLinked to original sources

Contemporary management of pelvic fractures.

BACKGROUND: Pelvic fractures occur when there is high kinetic energy transfer to the patient such as would be expected in motor vehicle crashes, auto-pedestrian collisions, motorcycle crashes, falls, and crush injuries. High-force impact implies an increased risk for associated injuries to accompany the pelvic fracture, as well as significant mortality and morbidity risks. Choosing the optimum course of diagnosis and treatment for these patients can be challenging. The purpose of this review is to supply a contemporary view of the diagnosis and therapy of patients with this important group of injuries. METHODS: A comprehensive review of the medical literature, focusing on publications produced in the last 10 years, was undertaken. The principal sources were found in surgical, orthopedic, and radiographic journals. CONCLUSIONS: The central challenge for the clinician evaluating and managing a patient with a pelvic fracture is to determine the most immediate threat to life and control this threat. Treatment approaches will vary depending on whether the main threat arises from pelvic fracture hemorrhage, associated injuries, or both simultaneously. Functional outcomes in the long-term depend on the quality of the rigid fixation of the fracture, as well as associated pelvic neural and visceral injuries.

Fracture Fixation↗

Nuclear replacement strategies.

Although still a technology in its infancy, nuclear replacement promises a potential alternative to arthrodesis for patients with discogenic back pain. It is ideally suited to those patients presenting early in the degenerative cascade with minimal to no arthritic changes or disc collapse. The physical nature of the implants seeks to restore the visco-elastic, biomechanical, and fluid characteristics of the natural disc, thus reducing pain while maintaining motion and function.

Arthroplasty, Replacement↗

Airway complications associated with surgery on the anterior cervical spine.

STUDY DESIGN: Retrospective chart review of 311 anterior cervical procedures. OBJECTIVES: To assess the incidence and variables that predispose to an airway complication in a large series of anterior cervical surgical procedures. SUMMARY OF BACKGROUND DATA: A rare but potentially lethal complication after anterior cervical spine surgery is respiratory compromise and airway obstruction. Some risk factors are thought to include two-level corpectomy in myelopathic patients with a history of heavy smoking and asthma. No previous study in the literature has been directed at examining the factors specifically related to airway complications after anterior cervical spine surgery. METHODS: Each chart was examined for patient characteristics and pathology, anesthetic parameters and problems, operative procedure, and postoperative course and management. Statistical analysis was performed. RESULTS: Nineteen patients (6.1%) had an airway complication and six (1.9%) required reintubation. One patient died. Symptoms developed on average 36 hours postoperatively. All complications except for two were attributable to pharyngeal edema. Variables that were found to be statistically associated with an airway complication (P < 0.05) were exposing more than three vertebral bodies, a blood loss >300 mL, exposures involving C2, C3, or C4, and an operative time >5 hours. A history of myelopathy, spinal cord injury, pulmonary problems, smoking, anesthetic risk factors, and the absence of a drain did not correlate with an airway complication. CONCLUSIONS: Patients with prolonged procedures (i.e., >5 hours) exposing more than three vertebral levels that include C2, C3, or C4 with more than 300-mL blood loss should be watched carefully for respiratory insufficiency.

Adult↗