Abstract:
Tethered cord syndrome results from adherence of the conus medullaris to the sacrum and may be associated with high complication rates from neuraxial anesthesia. We present the case of a 32-year-old gravida 2 para 0 patient with a history of lipomyelomeningocele (one of several types of spina bifida) and tethered cord status post repair, residual low-lying conus medullaris, supermorbid obesity (body mass index of 58), and Mallampati IV airway, who underwent successful fluoroscopically guided epidural catheter placement for vaginal delivery. Risks and benefits of epidural catheter utilization and methods of placement are reviewed.
摘要:
脊髓栓系综合征是由于脊髓圆锥与骶骨的粘附而引起的,并且可能与神经轴麻醉的高并发症发生率有关。我们介绍了一例32岁的gravida2para0患者,有脂肪脊髓膜膨出(几种类型的脊柱裂之一)和脊髓栓系状态修复后的病史,残余的低洼圆锥延髓,超病态肥胖(体重指数为58),还有MallampatiIV气道,成功行透视引导硬膜外导管放置阴道分娩的患者。回顾了硬膜外导管使用的风险和收益以及放置方法。