Intraoperative pulmonary fat and bone-marrow embolism is a serious complication of bone and joint surgery. We have investigated the occurrence and incidence of intraoperative embolism in patients undergoing elective lumbar spinal surgery with or without instrumentation. Sixty adult patients with lumbar degenerative disease were examined by intraoperative transoesophageal echocardiography while undergoing posterior lumbar surgery. Of these, 40 underwent surgery with instrumentation and 20 without. Moderate to severe (grade 2 or 3 according to the grading scale of Pitto et al) embolic events were seen in 80% of the instrumented patients but in none of the non-instrumented patients (p < 0.001). The insertion of pedicle screws was particularly associated with large numbers of pulmonary emboli, while the surgical approach, laminectomy, disc removal and bone harvesting were associated with small numbers of emboli. We consider that, as in arthroplasty and intramedullary fixation of fractures, these embolic events are relevant to the development of potentially fatal fat embolism during spinal surgery.

A 72-year-old woman who presented with a unilateral oculomotor nerve palsy was shown to have a very rare condition: multiple dural arteriovenous fistulae (DAVF) involving the cavernous and sphenoparietal sinuses. The sphenoparietal DAVF was cured completely by transarterial embolisation. Symptomatic relief was accomplished by this procedure. The cavernous sinus DAVF progressed to acquire cortical venous drainage, and was obliterated completely by transvenous embolisation.

Sinus pericranii has been reported to be situated usually along the midline. Two cases of laterally situated sinus pericranii are presented. Venous blood was obtained of contrast medium into the tumors demonstrated a communication between the tumors and the intracranial venous sinuses through marked diploic veins.

IMS (injection molded solder) is an advanced solder bumping technology with solder alloy flexibility even at very fine pitch and small size. One of key materials for successful fine pitch bumping by IMS is a photoresist material. The photoresist material must be stable at high temperature during the IMS process and be perfectly stripped after the IMS process without any residue on the surface of the substrate. In this study, negative tone liquid photoresist materials were prepared to investigate effects of thermal cure of photoresist on IMS process and stripping performance. With appropriate cure conditions, successful bumping without any film damages at IMS process and any residue at stripping was achieved. Fine pitch bumping down to 40 μm pitch with 20 μm diameter was demonstrated with a Sn-3.0Ag-0.5Cu solder. Also physical and electrical connections for the solder joints of IMS bumps to Ni/Au pads were confirmed using a 80 μm pitch test vehicle.

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