Informed consent for the neurosurgeon.
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Humans↗
Biomedical subjects
Howard Morgan
Publications and source records attributed to Howard Morgan.
Wrong disc space level surgery: medicolegal implications.
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Diskectomy↗
Abnormal coagulation studies associated with levofloxacin. Report of three cases.
Complications arising from antibiotic use are of interest to neurosurgeons because many neurosurgical patients are treated for infection. In this report, the authors describe three patients with spine disorders who developed coagulopathies after treatment with levofloxacin, an antibiotic commonly used by neurosurgical services. Three patients with spine disorders developed urinary tract infections (UTIs) for which they received a 3-day course of oral levofloxacin. Subsequently, they demonstrated prolonged prothrombin times and increased international normalized ratios. One of those patients later developed acquired von Willebrand syndrome during surgery. Coagulopathies were successfully corrected preoperatively with parenteral vitamin K. The patient with acquired von Willebrand syndrome required multiple transfusions. There seems to be an association between levofloxacin and coagulation abnormalities in neurosurgical patients treated for UTIs. Neurosurgical services prescribing this common antibiotic should be aware of this problem.
Aged↗
Titanium cage reconstruction after cervical corpectomy.
OBJECT: The authors evaluated the efficacy of titanium cage- and anterior cervical plate (ACP)-augmented fusion for reconstruction following decompressive cervical corpectomy in nontraumatic disease. METHODS: Forty-five patients ranging from 37 to 77 years of age underwent anterior cervical corpectomy followed by titanium cage-assisted reconstruction in which the cages were filled with autologous bone obtained from the resected vertebral bodies (VBs). Plates were placed in all patients. Follow-up radiographic evaluation included computerized tomography scanning and plain flexion-extension radiography. Fusion was demonstrated in all but one patient without reconstruction-related complications. The single complication involved an endplate VB fracture with pistoning of the cage into the VB. The mean follow-up period was 12.9 months. CONCLUSIONS: Autologous corpectomy bone-filled titanium cages supplemented with ACPs are an effective means of reconstruction after compressive cervical corpectomy. This technique provides a reasonable alternative to procedures involving long solid strut grafts obtained from the bone bank or from the patient.
Adult↗