The triangle formed between the apex of the sacral hiatus and the superolateral sacral crests was found to have the features of an equilateral triangle. The sacrum and sacral hiatus are variable anatomical structures. However, the equilateral triangle located between the apex of the sacral hiatus and superolateral sacral crests will certainly be of use in determining the location of the sacral hiatus during CEB.

Elevated maternal serum levels of hs-CRP, TNF- alpha, IL-6 and homocysteine in preeclamptic women correlate with fetal birth weight in the early third trimester.

ObjectiveFailed back surgery syndrome is characterized by the presence of intractable pain and varying degrees of functional incapacity after lumbar spine surgery. Because the mechanisms that cause pain are variable, treatment of this syndrome is quite difficult, and one of the most common methods that is used for treatment nowadays is epidural injection. This research evaluates the analgesic efficacy of addition of oral gabapentin treatment to epidural corticosteroid application in patients with failed back surgery syndromes.MethodsForty-two patients, including 23 females and 19 males, with failed back surgery syndrome who had been previously operated on at least twice due to lumbar disc herniation were randomly divided into two groups. Following epidural application of a single dose of methylprednisolone in the first group of patients (Group K), an oral medical treatment containing naproxen sodium, tizanidine, and vitamin B and C complex, was devised to be applied for one month. For the second group, oral gabapentin was added to the same treatment regime (Group G). Pain levels were evaluated by a visual analog scale for straight leg raise before, during, and after treatment, as well as in the first and third months.ResultsThere was no demographically significant difference between the patients (P > 0.05). After the beginning of treatment, it was observed that the pain level in Group G patients regressed earlier and that it progressed at a significantly lower level (both in the first and third month controls).ConclusionIt was concluded that addition of oral gabapentin to epidural corticosteroid application in patients with failed back surgery syndromes was effective in ameliorating pain at an early stage without significant side effects.

In this paper, we report a case of vertebral hemangioma during pregnancy in a 21-year-old woman presenting with paraparesis of rapid onset. An emergency MRI scan of the dorsal spine showed a lesion of the ninth thoracic vertebra with extradural extension and marked spinal cord compression. A cesarean section was done, and this was followed by emergent laminectomy. Her symptoms and neurologic deficits quickly improved. The etiopathogenesis, clinical, radiological features, and treatment modalities are discussed in the light of the literature.

Background:Even if carried out under optimal conditions, postdural puncture headache is still a frustrating and unpleasant complication in spinal anesthesia. This syndrome has an estimated incidence from less than 1% to about 5% of patients undergoing spinal anesthesia, even in the highest risk subset, the young, female, and pregnant population.Case presentation:In our two female cases, headaches started following spinal anesthesia on the 11th and 14th hours, respectively. No response was obtained from patients diagnosed with postdural puncture headache with classical treatments such as bed rest, hydration, oral analgesic, and caffeine combination as well as intravenous theophylline application. The treatment of oral pregablin, commonly used for cases that rejected epidural blood patch, caused a significant decrease in headache severity. Later, the two cases whose headaches were completely resolved were discharged from the hospital on the post-operative 7th day.Conclusion:Postdural puncture headache is one of the most common complications of spinal anesthesia. Cerebral spinal fluid leakage into the epidural space has been proposed as the main mechanism responsible for this syndrome. Multiple methods of treatment have been applied with wide-ranging results. We detected that oral pregabalin application caused a significant decrease in the difficult and severe postdural puncture headaches of both our cases who did not respond to conventional treatments.