Measuring outcomes in spinal decompression
Introduction In patients with spinal disorders that warrant spinal decompression, the goal of intervention is to enhance function and reduce pain. In the past, outcomes were commonly assessed based on…
Cervical and lumbar foraminotomy for the management of chronic radicular back pain
Introduction Foraminal stenosis and herniated discs are common pathologies seen in primary care and chronic pain clinics. The radicular pain caused by these anatomic abnormalities may be difficult to manage…
Discectomy: A surgical approach
Introduction Lumbar disc herniation (LDH) is the one of the most common diagnoses in spine practice for patients with lower back pain and radiculopathy, with an estimated prevalence of 2%–3%….
Surgical instruments
Introduction Surgical decompression is the main objective for many spinal procedures. Decompression may be performed in the cervical, thoracic, lumbar, or sacral spine, from a single approach or a combination…
An overview on the anatomy of the spine
Cervical spine The cervical spine is composed of seven vertebrae, with the first two vertebrae known as the atlas (C1) and axis (C2). The atlas contains a thick anterior arch…
Membrane Characteristics
Let’s now turn our attention to the membrane itself. We will explore the function of the membrane oxygenator, its limits, and how we can appraise and assess this function at…
Anticoagulation and Bleeding Management
When I am consenting a family for extracorporeal membrane oxygenation (ECMO) and discussing the risks and benefits to initiating support, bleeding and clotting are the most common risks that are…
Pharmacokinetics
Next time you are reviewing the chart for your patient, take a look at the medication administration record. Every entry represents a decision – a decision to alter the physiology…
Sweep Gas Flow Titration
Adjustments to sweep gas flow are probably the most common adjustments that you will make in the course of an extracorporeal membrane oxygenation (ECMO) run. While it is entirely feasible…
Ventilator Management on ECMO
By this point you have probably developed a healthy skepticism for the ventilator. While remaining an undeniable cornerstone in the support of critically ill patients, we have gone into the…
