( ) * 止血 * フロシールゼラチントトロンビン 90 97%, フロールゼラチン, ゼラチンフロシール 6-8, フロシール ( ) 4 7 7フロシール群シトロンビン含ゼラチンスポンジ ( ) 群 0 6 0oozing flowingspurting 止血効果 ( 初回病

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1 SPINAL SURGERY 5mL 0mL

2 ( ) * 止血 * フロシールゼラチントトロンビン 90 97%, フロールゼラチン, ゼラチンフロシール 6-8, フロシール ( ) 4 7 7フロシール群シトロンビン含ゼラチンスポンジ ( ) 群 0 6 0oozing flowingspurting 止血効果 ( 初回病変 ) PPS 解析集団 6% 7% 86% 5% 97% 7% 99% 87% 99% 90% 0~ 分 ~ 分 ~ 分 ~6 分 6~0 分フロシール群トロンビン含有ゼラチンスポンジ群

SPINAL SURGERY Transforaminal and Posterior Lumbar Interbody Fusion TLIF, PLIF With the neurologic elements accounted for, the posterolateral annulus can be accessed through the

significant bleeding can be encountered at this stage, and the use of cottonoids in conjunction with hemostatic agents such as Gelfoam, Floseal, or Surgiflo can be helpful. Mitchell F.

This was controlled effectively with Floseal (Baxter Biosurgery, Deerfield, Il).

the posterior vertebral body wall or floor of the spinal canal.

al (Baxter U.S., Deerfield, IL), Gelfoam (Pharmacia, Kalamazoo, MI), and cottonoids. Lawrence G.

com Treatment is primarily preventive, with careful dissection and vessel coagulation; but there are sometimes real venous lakes that cannot be coagulated.

If there is no tear, oxygenated water is useful. As

Blamoutier, Orthopaedics & Traumatology: Surgery & Research (0) 99S, S87-S96 - When bleeding from the epidural venous plexus is encountered, it can be managed by the use of hemostatic

Frank Grochulla, Manual of Spine Surgery, P75-P79, Springer, 0 C lateral Mass-C Pedicle Screws If the epidural plexus is disturbed, the surgeon should be prepared to encounter brisk

3 SPINAL SURGERY Transforaminal and Posterior Lumbar Interbody Fusion TLIF, PLIF With the neurologic elements accounted for, the posterolateral annulus can be accessed through the previously described triangular working zone by carefully coagulating and dividing the obstructing epidural veins using bipolar cautery.significant bleeding can be encountered at this stage, and the use of cottonoids in conjunction with hemostatic agents such as Gelfoam, Floseal, or Surgiflo can be helpful. Mitchell F. Reiter and Saad B. Chaudhary, Operative Techniques in Spine Surgery, P9-P40, Lippincott Williams & Wilkins, 0 During the corpectomy bleeding was noted through multiple small vessels. This was controlled effectively with Floseal (Baxter Biosurgery, Deerfield, Il). Alok K Sharan, Spine Surgery (Mastering Orthopedic Techniques), P49-P6, Jaypee Brothers Medical Pub, 0 Vertebral Column Resection VCR The last part of the vertebral resection will be the posterior vertebral body wall or floor of the spinal canal. Here it will be essential to control epidural bleeding with the judicious use of bipolar cauterization, topical hemostatic agents such as FloSeal (Baxter U.S., Deerfield, IL), Gelfoam (Pharmacia, Kalamazoo, MI), and cottonoids. Lawrence G. Lenke, Surgical Technique: Vertebral Column Resection (VCR) for Severe Pediatric and Adult Spinal Deformity, http: spinal-deformity-surgeon.com Treatment is primarily preventive, with careful dissection and vessel coagulation; but there are sometimes real venous lakes that cannot be coagulated. In case of severe hemorrhage, the hernia and sequestra should be removed while using hemostatic compresses (Surgicel ) with or without Patti sponges, sometimes for several minutes. If there is no tear, oxygenated water is useful. As the compresses cannot be left in place, a local hemostatic (Surgiflow, Floseal ) may be useful. A. Blamoutier, Orthopaedics & Traumatology: Surgery & Research (0) 99S, S87-S96 - When bleeding from the epidural venous plexus is encountered, it can be managed by the use of hemostatic agents such as Floseal (Baxter). Frank Grochulla, Manual of Spine Surgery, P75-P79, Springer, 0 C lateral Mass-C Pedicle Screws If the epidural plexus is disturbed, the surgeon should be prepared to encounter brisk venous bleeding; this can be controlled using a thrombin-soaked absorbable gelatin sponge, cottonoid patty, and FloSeal hemostatic matrix (Tips from the Masters -). HE Smith, SD Daffner, AR Vacaro, Best Evidence for Spine Surgery, P5-P, Saunders, 0 Bleeding cancellous bone can be controlled with FloSeal (Baxter International, Inc, Deerfield, IL) or thrombin-soaked Gelfoam. Carmina f. Angels, Jon Park, Core Techniques in Operative, Neurosurgery - Expert Consult Online, Elsevier Health Sciences, 0 The lateral epidural gutters can be packed with hemostatic agents like Gelfoam (Upjohn, Kalamazoo, MI, USA) or Floseal (Baxter, Deerfield, IL, USA) before the dural edges are retracted, usually with stitches. Paolo Perrini et al., Cavernous Malformations of the Brain and Spinal Cord, P88-P9, Thieme, 007 Bleeding from decompression is readily controlled with thrombotic agents such as thrombin Gelfoam (Pharmacia & Upjohn, Kalamazoo, MI) and matrix hemostatic sealant (FloSeal; Baxter Corp., Freemont, CA). Jeremy C. Wang et al., J Neurosurg (Spine ) :87 98, 004

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8 600BZX Floseal ) ) 99. Renkens Jr K.L. et al. A Multicenter, prospective, randomized trial evaluating a new hemostatic agent for spinal surgery. Spine 00; 6: Solimeno LP, Casadei C, Pasta G, et al. Blood-sparing knee surgery in patients with haemophilia: use of a novel haemostatic matrix. European Musculoskeletal Review. 008;():-6. Oz MC, Rondinone JF, Shargill NS. FLOSEAL matrix: new generation topical hemostatic sealant. J Card Surg. 00;8: [ ] ( Baxter Floseal R50047 FLO

MISS Voice 4 MISt QOL (PPS) MISt MISt MISS Voice Theme #.1 Minimally Invasive Spine Stabilization: MISt 2005 MISt ADL QOL MISt MIS

Vol.4 MISt (Minimally Invasive Spine Stabilization: MISt ) MISt MISS Voice 4 MISt QOL (PPS) MISt MISt http://mist.umin.jp MISS Voice Theme #.1 Minimally Invasive Spine Stabilization: MISt 2005 MISt ADL

( ) * 止血 * フロシール ゼラチン トトロンビン 90 97%, フロー ル ゼラチン, ゼラチン フロシール 6-8, フロシール ( ) 4 7 7フロシール群 シ トロンビン 含 ゼラチンスポンジ ( ) 群 0 6 0oozing flowingspurting 止血効果 ( 初回病

( ) * 止血 * フロシールゼラチントトロンビン 90 97%, フロールゼラチン, ゼラチンフロシール 6-8, フロシール ( ) 4 7 7フロシール群シトロンビン含ゼラチンスポンジ ( ) 群 0 6 0oozing flowingspurting 止血効果 ( 初回病