Patients are generally placed in a supine position with the head in an extended position. As noted above, Gardner-Wells tongs can be used for additional cervical traction. The hands can also be tied downward to increase the operative exposure. Once the surgical site is properly prepared with cleansing material, the appropriate surgical level is identified with intraoperative radiographs. A scalpel is used to make a linear longitudinal incision just medial to the body of the sternocleidomastoid muscle. The incision is made long enough to include at least 2 vertebral levels if a 1-level discectomy is being performed. Alternatively, transverse skin incisions over the targeted vertebral level can also be performed. The platysmal muscle is identified and incised. The platysmal incision can be extended if a multilevel decompression is the surgical aim. Extensive subplatysmal dissection is performed to reduce retraction injury.

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About Us Contact Disclaimer Get Published! Follow Us Epomedicine Medical Students Clinical Discussion Cases Emergencies Blog Medical Mnemonics Clinical Skills Search Subjects Clinical examination Gastrointestinal system Internal medicine Updated on January 31, 2017 Percussion of Spleen Traube’s semilunar space Borders: Superiorly: Left 6th rib superiorly Laterally: Left midaxillary line or Left anterior axillary line Inferiorly: Left costal margin Method: Patient’s position: supine with left arm slightly abducted. Percuss: from medial to lateral Interpretation: Resonance (Normal) and Dullness (Splenomegaly) Also: Pleural effusion or mass in stomach may cause dullness in Traube’s space.

Epidural hematoma (EDH) is a traumatic accumulation of blood between the inner table of the skull and the stripped-off dural membrane. EDH results from traumatic head injury, usually with an associated skull fracture and arterial laceration.The inciting event often is a focused blow to the head, such as that produced by a hammer or baseball bat. In 85-95% of patients, this type of trauma results in an overlying fracture of the skull. Blood vessels in close proximity to the fracture are the sources of the hemorrhage in the formation of an epidural hematoma. Because the underlying brain has usually been minimally injured, prognosis is excellent if treated aggressively. Outcome from surgical decompression and repair is related directly to patient's preoperative neurologic condition. [1]

Craniectomy is neurosurgical procedure that involves removing a portion of the skull in order to relieve pressure on the underlying brain. This procedure is typically done in cases where a patient has experienced a very severe brain injury that involves significant amounts of bleeding around the brain or excessive swelling of the brain.

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In as many as 80% of cases, doctors don’t find the exact reason for a curved spine. Scoliosis without a known cause is what doctors call “idiopathic.” Some kinds of scoliosis do have clear causes. Doctors divide those curves into two types -- structural and nonstructural. In nonstructural scoliosis, the spine works normally, but looks curved. Why does this happen? There are a number of reasons, such as one leg’s being longer than the other, muscle spasms, and inflammations like appendicitis. When these problems are treated, this type of scoliosis often goes away.

A pacemaker insertion is the implantation of a small electronic device that is usually placed in the chest (just below the collarbone) to help regulate slow electrical problems with the heart.

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