Management of herniated intervertebral disks during saturation dives: a case report

Rubicon Research Repository/Manakin Repository

Management of herniated intervertebral disks during saturation dives: a case report

Show full item record


Title: Management of herniated intervertebral disks during saturation dives: a case report
Author: Stevens, DM; Caras, BG; Flynn, ET; Dutka, AJ; Thorp, JW; Thalmann, ED
Abstract: During research saturation dives at 5.0 and 5.5 atm abs, 2 divers developed an acute herniation of the nucleus pulposus of the L5-S1 intervertebral disk. In both cases the pain was severe enough to require intravenous morphine or intramuscular meperidine. Although the symptoms presented by these divers are frequently considered to be an indication for immediate surgical consultation, we decided that emergency decompression posed an unacceptable risk that decompression sickness (DCS) would develop in the region of acute inflammation. In both cases strict bedrest and medical therapy were performed at depth. In the first case, 12 h was spent at depth before initiating a standard U.S. Navy saturation decompression schedule with the chamber partial pressure of oxygen elevated to 0.50 atm abs. In the second case, a conservative He-N2-O2 trimix decompression schedule was followed to the surface. In both cases, no initial upward excursion was performed. The required decompression time was 57 h 24 min from 5.5 atm abs and 55 h 38 min from 5.0 atm abs. During the course of decompression, the first diver's neurologic exam improved and he required decreasing amounts of intravenous narcotic; we considered both to be evidence against DCS. The second diver continued to have pain and muscle spasm throughout decompression, however he did not develop motor, reflex, or sphincter abnormalities. Both divers have responded well to nonsurgical therapy.
Description: Undersea and Hyperbaric Medical Society, Inc. (http://www.uhms.org )
URI: PMID: 1534427
http://archive.rubicon-foundation.org/2624
Date: 1992

Files in this item

Files Size Format View
1534427.pdf 1.237Mb PDF View/Open

This item appears in the following Collection(s)

  • Undersea Biomedical Research Journal
    The Undersea Baromedical Research journal was published by the Undersea Medical Society, Inc. (now the Undersea and Hyperbaric Medical Society) quarterly from 1974 to 1992 when the name changed to the Undersea and Hyperbaric Medicine Journal.

Show full item record

Browse

My Account