Classical ballet is a demanding professional occupation, with participants who are often underserved in terms of accurate diagnosis and appropriate comprehensive medical care. The view that follows is designed to be as global and insightful as published to date. Specific rehabilitation considerations, dance mechanics, idiosyncratic differential diagnosis, and personality and equipment issues are discussed, and a rational view of dogma is presented.
Negative aspiration and allotment for passive filling is inadequate to confirm the absence of vascular injection. Spinal injection will never be risk free. The safest method is fluoroscopically guided, contrast-confirmed injection, which should be considered the current standard of care.
Refractory cancer pain may be effectively controlled by titrating intracerebroventricular (ICV) preservative-free opioid. In this case report, a continuous infusion of ICV morphine permitted our patient with lung cancer and painful spinal metastases to be discharged to home hospice with family. The approach exploits the high potency of morphine injected into cerebrospinal fluid (CSF). Sterile, injectable, preservative-free morphine is directly infused into CSF through a subcutaneous Ommaya reservoir placed under the scalp by a neurosurgeon, with an attached catheter passed through a burr hole in the skull with its tip in a cerebral ventricle. Although investigators have described home care of patients receiving intraspinal analgesics, no report describes the process of transitioning the patient receiving continuous ICV morphine infusion to the home setting.
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