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Designing for Upper Torso and Arm Anatomy
Published in Karen L. LaBat, Karen S. Ryan, Human Body, 2019
Severe spinal cord damage anywhere in the thoracic region produces paraplegia, paralysis of the torso and legs (loss of muscle control), plus loss of sensation. Thoracic level spinal cord injury also impairs the sympathetic and parasympathetic nervous system components of the autonomic nervous system including bladder, bowel, and sexual/reproductive functions, further discussed in Chapter 5, Lower Torso and Legs.
Trends in Robotic Systems for Lower Limb Rehabilitation
Published in IETE Technical Review, 2023
M. H. Pérez-Bahena, P. A. Niño-Suarez, Oscar F. Avilés Sánchez, Rubén Hernández Beleño, Oscar I. Caldas, O.I. Pellico-Sánchez
Rupal et al. classify robotic systems into medical and non-medical applications, which can be grouped into industrial and service robotics. Medical applications focused on paraplegia, rehabilitation, amputation, or compensation. Non-medical applications for military, industrial, elderly, and general purpose [6].
A contemporary systematic review of the complications associated with SURGICEL
Published in Expert Review of Medical Devices, 2023
Matthew Masoudi, Jacob Wiseman, Sam M. Wiseman
In the product insert information provided with SURGICEL, the manufacturer states that ‘it must always be removed from the site of its application when used in, around, or in the proximity to foramina in bone, areas of bony confinement, the spinal cord, and/or the optic nerve and chiasm regardless of the type of surgical procedure because SURGICEL hemostat, by swelling, may exert pressure resulting in paralysis and/or nerve damage’ [69]. However, a common practice among neurosurgeons and others is to leave the material in situ, as removing it may reinitiate bleeding [70]. Bessette and Mesfin reported a case of a patient who underwent a lumbar microdiscectomy, with preexisting motor deficits, and the postoperative course was complicated by an acute decline in neurological function [10]. The findings at the time of reoperation confirmed compression in the spinal canal due to SURGICEL, and symptoms partially improved after reoperation. The first report of a ‘Surgiceloma’ manifesting as cauda equina syndrome was in 1998 by Banerjee and Goldschmidt. Their patient was a 28-year-old man who needed urgent decompression because of development of cauda equina syndrome 36 hours after an operation performed for treatment of disk degeneration and spinal stenosis. At re-exploration, swollen blood-soaked SURGICEL was found to be the only cause of compression [9]. Additionally, the product insert information from the manufacturer describes unconfirmed reports of migration of SURGICEL into the spinal canal after laminectomy or decompressive thoracotomy [21]. An example of this rare but devastating complication was reported by Henry and colleagues where they described the case of paraplegia in a child after the resection of a mediastinal neuroblastoma. In this case, the paraplegia was caused by spinal cord compression after migration of oxidized cellulose into the spinal canal [21]. Therefore, although SURGICEL is advertised as being absorbable and safe for internal use, groups studying this product often advise surgeons to minimize the amount of SURGICEL used, and once bleeding is controlled to remove the hemostat whenever possible. The manufacturer instructions that accompany the product do not specify a recommended threshold for the volume of SURGICEL that can be safely left inside a patient [69].