The preoperative MR findings in 11 patients, all of whom had developed recurrent low back pain after surgery for herniated lumbar intervertebral disk, were correlated with the surgical findings to determine possible criteria for distinguishing recurrent disk herniation from postoperative scar (extradural fibrosis). The preoperative MR findings agreed with the surgical findings in seven of eight...

Objective: To determine the correlation of skull fracture with extradural hematoma in head injury patients presenting to a tertiary care hospital in Pakistan. Patients and Methods: This descriptive study was carried out at Shifa International Hospital, Islamabad from January 2002 to January 2007. All patients who were operated for extradural hematoma during the study period were included in the...

Conventional extradural analgesia during labour with 0.25-0.375% bupivacaine may induce motor weakness and subjective sensory deficit, reducing maternal satisfaction. Even in a regimen for ambulatory extradural analgesia (0.1% bupivacaine-fentanyl 2 micrograms ml-1), a potential for proprioreception impairment exists, which may impair safe ambulation. We have combined fentanyl with clonidine fo...

An extradural spinal tumor was diagnosed in a 12-year-old Labrador retriever that was presented with a one-week history of paraparesis. Myelography indicated a deviation of the spinal cord to the right side at the level of the second lumbar (L2) vertebra. The difference in length measuring the left and right sides of the L2 vertebra suggested a fracture of the vertebral body. Severe bone remode...

The case histories are reported of one patient who developed evidence of extradural infection 16 days postpartum, and another who spontaneously developed an extradural haematoma. Several points of interest and concern raised by these case histories are discussed.

Sir,—Morris has suggested [1] that removal of a fixed extradural catheter may be facilitated by placing the patient in the original insertion position. I recently experienced a case where this recommendation was unhelpful. I was asked to assess a 73-yr-old patient who appeared to have an obstructed extradural catheter after a total hip replacement. The extradural space had been identified earli...

collection, the patient was started on intravenous cefotaxime and transferred back to Torbay for further care. He received a total of three weeks of intravenous antibiotics and, at follow up five weeks following surgery, his computed tomogram had returned to normal and he was symptom free. During his recovery, he recalled an incident two years previously when he had been struck on the head whil...

In order to test if the rate of onset of sensation of warmth in the legs after the injection of 0.5% bupivacaine might discriminate between subarachnoid and extradural injection, 150 urological patients were allocated randomly to receive either spinal anaesthesia with isobaric (IS) or hyperbaric (HS) 0.5% bupivacaine, or extradural anaesthesia with isobaric 0.5% bupivacaine. The volume of the l...

The effect of lumbar extradural analgesia on intervillous blood flow (IBF) during labour was studied in 26 healthy parturients using an i.v. bolus injection of xenon-133. There was a 19% decrease (n.s.) in mean IBF in six parturients (non-extradural control group). Mean IBF increased by 37.5% when 0.25% bupivacaine 10 ml was used and by 35.2% when 2% 2-chloroprocaine 10 ml was used (n.s.). When...

We have undertaken a prospective, randomized double-blind study to compare extradural bupivacaine infusions with i.v. morphine infusions for postoperative analgesia in 32 infants younger than 4 yr undergoing abdominal surgery. "Sham" extradural or i.v. catheters were used to maintain the blinded nature of the study. Both techniques provided adequate analgesia for most of the 36-h postoperative ...