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The Use of Extracoporeal Membrane Oxygention (ECMO) Support During an Emergent Evacuation of a Thoracic Epidural Abscess.
MedLine Citation:
PMID:  23609206     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
: Study Design: Case ReportObjective: To present the first reported case of utilizing ECMO support in an emergent decompression and evacuation of a thoracic epidural abscess.Summary of Background Data: Thoracic epidural abscesses with neurological deficits require surgical evaluation and intervention in most cases. We present a case of a 35 year old patient with an acute onset of paraplegia diagnosed with a thoracic epidural abscess. The patient was emergently taken to the OR and was unable to tolerate prone positioning secondary to cardiopulmonary collapse. ECMO was initiated for cardiopulmonary support to complete the case.Methods: Retrospective chart review of patient case.Results: The patient was stabilized with ECMO support and tolerated a T4-T8 laminectomy and decompression. The source of the patients abscess was hematogenous and at 6 months of clinical follow-up, the patient has no motor or sensory function of his bilateral lower extremities.Conclusion: The use of ECMO support in adult spinal surgery has not been previously reported in the literature. Therefore we describe the first reported use of ECMO to maintain cardiopulmonary support in a patient unable to tolerate prone positioning during spine surgery. ECMO support can be a viable option in adult patients who need emergent spinal surgery but are unable to tolerate prone positioning secondary to cardiopulmonary complications.
Authors:
Aakash Chauhan; Robert J Moraca; Daniel T Altman
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-4-19
Journal Detail:
Title:  Spine     Volume:  -     ISSN:  1528-1159     ISO Abbreviation:  Spine     Publication Date:  2013 Apr 
Date Detail:
Created Date:  2013-4-23     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7610646     Medline TA:  Spine (Phila Pa 1976)     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
1Department of Orthopaedics, Allegheny General Hospital, 1307 Federal North Street, Floor 2, Pittsburgh, PA 15212 2Department of Thoracic and Cardiovascular Surgery, Allegheny General Hospital, 320 E. North Avenue, Pittsburgh, PA 15212.
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