dorsal column stimulator for shingles pain

#DORSAL COLUMN STIMULATOR FOR SHINGLES PAIN GENERATOR#
#DORSAL COLUMN STIMULATOR FOR SHINGLES PAIN SKIN#
#DORSAL COLUMN STIMULATOR FOR SHINGLES PAIN FREE#

Skin was then reapproximated using 2-0 Vicryl for the subcutaneous tissues and 5-0 Monocryl for the skin. The bone flap was then replaced and held in place using multiple K LS fixation devices.

Additional meticulous hemostasis was then obtained. This opening was primarily closed using 4-0 Nurolon. A small opening was then made in the dura to ensure that there was not an underlying blood clot. This was carefully and thoroughly coagulated using bipolar cauterization. A bleeding point was found in the region of the middle meningeal artery. Directly beneath the bone flap was a large well-formed clot which delivered itself from the epidural space. This was removed from the immediate operative field.

#DORSAL COLUMN STIMULATOR FOR SHINGLES PAIN FREE#

Multiple burr holes were then placed and connected using the high-speed drill to create a large free bone flap. The resulting musculocutaneous flap was then reflected anteriorly. A curvilinear incision was made beginning just anterior to the left ear, curving posteriorly, then upward and anteriorly, to and at the hair line just off the midline. PROCEDURE/TECHNIQUES/DESCRIPTION OF FINDINGS/CONDITION OF PATIENT: The patient was brought to the operating room and after induction of adequate general anesthesia, was prepped and draped in the usual sterile fashion for a left frontotemporal parietal craniotomy. An urgent CT scan revealed a large epidural hematoma and the patient was taken emergently to the operating room for evacuation. He presented to the emergency department neurologically intact. PREOPERATIVE DIAGNOSIS: Acute epidural hematoma POSTOPERATIVE DIAGNOSIS: As above ANESTHETIC AGENT: General Endotracheal OPERATION: Left craniotomy for evacuation of epidural hematoma (emergent) INDICATIONS: The patient presented with a history of a motor vehicle accident. What are the CPT® and ICD-10-CM codes reported? All final needle arid sponge counts were correct. The patient was aroused from sedation and taken to the recovery area in good condition. The wound was irrigated copiously and closed in layers using interrupted 0 and 3-0 Vicryl sutures followed by Mastisol and Steri-Strips to reapproximate the skin.

#DORSAL COLUMN STIMULATOR FOR SHINGLES PAIN GENERATOR#

The generator was implanted and secured to the fascia using 0 Ethibond suture. An impedance test was performed, which yielded acceptable results.

The leads were disconnected from the old generator and connected to the new generator in the same orientation. This was explanted and a new prime advanced generator was prepared. The pouch housing the existing generator was entered. A wide area of the right lateral flank region surrounding her existing scar was prepped and draped in standard fashion and infiltrated with 0.5% Marcaine with 1:200,000 epinephrine. Sedation was induced and a dose of IV antibiotics was administered. The patient was brought to the operating room and positioned on the table in the left lateral decubitus position. PROCEDURE IN BRIEF: After extensive preoperative counseling, informed consent was obtained. On this basis, revision of the device was offered and accepted. The device was interrogated approximately a week prior to this procedure and no telemetry was obtained, indicating a breakdown of the battery. Her current device has a complication in which it began malfunctioning approximately a month prior to this procedure and she has gradually noticed declining effectiveness. INDICATIONS: This woman has a dorsal column stimulator in place and has benefited from the therapy. IMPLANTS: Medtronics prime advanced nonreconstructable generator. ESTIMATED BLOOD LOSS: Less than 5 ml SPECIMENS: None. ATTENDING: John Smith, MD ANESTHESIA: Monitored anesthetic coverage with local. PROCEDURE PERFORMED: Replacement of dorsal column stimulator generator. POSTOPERATIVE DIAGNOSIS: Dorsal column stimulator generator malfunction. PREOPERATIVE DIAGNOSIS: Dorsal column stimulator generator malfunction.

Dorsal column stimulator for shingles pain