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minimally invasive spine

Yad Ram Yadav, Shailendra Ratre, Vijay Parihar, Amitesh Dubey, Mashoo N Dubey
Symptomatic ventral cervical cord compressions have been treated by anterior discectomy with fusion, anterior corpectomy and fusion, discectomy with an artificial disc, and minimally invasive techniques. There are complications associated with the fusion procedure, especially when a long segment fusion is undertaken. Partial removal of the vertebral body without fusion could help in avoiding fusion and its associated complications. We are describing the detailed surgical technique, indications, limitations, and early results of endoscopic partially corpectomy...
March 2018: Neurology India
P Stefan, M Pfandler, P Wucherer, S Habert, J Fürmetz, S Weidert, E Euler, U Eck, M Lazarovici, M Weigl, N Navab
Surgical simulators are being increasingly used as an attractive alternative to clinical training in addition to conventional animal models and human specimens. Typically, surgical simulation technology is designed for the purpose of teaching technical surgical skills (so-called task trainers). Simulator training in surgery is therefore in general limited to the individual training of the surgeon and disregards the participation of the rest of the surgical team. The objective of the project Assessment and Training of Medical Experts based on Objective Standards (ATMEOS) is to develop an immersive simulated operating room environment that enables the training and assessment of multidisciplinary surgical teams under various conditions...
March 15, 2018: Der Unfallchirurg
Ahilan Sivaganesan, Brandon Hirsch, Frank M Phillips, Matthew J McGirt
Here, we systematically review clinical studies that report morbidity and outcomes data for cervical and lumbar surgeries performed in ambulatory surgery centers (ASCs). We focus on anterior cervical discectomy and fusion (ACDF), posterior cervical foraminotomy, cervical arthroplasty, lumbar microdiscectomy, lumbar laminectomy, and minimally invasive transforaminal interbody fusion (TLIF) and lateral lumbar interbody fusion, as these are prevalent and surgical spine procedures that are becoming more commonly performed in ASC settings...
March 12, 2018: Neurosurgery
Fahed Zairi, Camille Troux, Tarek Sunna, Mélodie-Anne Karnoub, Ghassan Boubez, Daniel Shedid
OBJECTIVES: The surgical management of dumbbell tumors of the lumbar spine remains controversial, because of their large volume and complex location, involving both the spinal canal and the retro peritoneum. While sporadically reported, our study aims to confirm the value of minimally invasive posterior access for the complete resection of large lumbar dumbbell tumors. PATIENTS AND METHODS: In this prospective study, we included all consecutive patients who underwent the resection of a voluminous dumbbell tumor at the lumbar spine through a minimally invasive approach, between March 2015 and August 2017...
March 5, 2018: Clinical Neurology and Neurosurgery
J Juanos Cabanas, H Jennart, G Leclercq, D Zorman
Acromioclavicular dislocation is a frequent pathology commonly encountered in traumatology. Therefore, its management is generally standardized, guided by clinical and radiological evaluation. This can range from conservative treatment by limb immobilization and functional rehabilitation, to surgical treatment by using minimally invasive techniques. We present the particular case of a 74-year-old patient with an acromioclavicular dislocation associated with a non-displaced fracture of the coracoid process as well as of the spine of the scapula...
2018: Revue Médicale de Bruxelles
A Guiroy, A Sícoli, N Gonzalez Masanés, A Morales Ciancio, M Gagliardi, A Falavigna
Background: The paraspinal, posterolateral, or Wiltse approach is an old technique that observes the principles of an MIS procedure. The aim of this study was to provide a step-by-step description from the literature of the Wiltse paraspinal approach and analyze its main advantages and limitations. Methods: Here, we provide a step-by-step description of the Wiltse approach. Utilizing PubMed and Lilacs and the Mesh terms "Wiltse approach," "paraspinal approach," "muscle sparing approach," and "lumbar spine," we identified 10 papers...
2018: Surgical Neurology International
Xinxin Miao, Dingwen He, Tianlong Wu, Xigao Cheng
BACKGROUND: Percutaneous endoscopic technique via interlaminar approach is one of the prevalent minimal invasive procedures in the treatment of lumbar disc herniation even lumbar spinal stenosis. The aim of this report is to perform complete decompressions for the cases with thoracic ossification of the ligamentum flavum using percutaneous endoscopic technique. CASE DESCRIPTION: We experienced surgical decompressions of two patients with thoracic myelopathy caused by OLF using percutaneous endoscopic surgery via interlaminar approach...
March 7, 2018: World Neurosurgery
Jae-Kwang Kim, Bong Ju Moon, Sang-Deok Kim, Jung-Kil Lee
RATIONALE: In the treatment of noncontiguous lumbar burst fractures, there still remains controversy over proper surgical procedures. PATIENT CONCERNS: A 19-year-old female patient visited our hospital after fall down from 3 m high. DIAGNOSES: Initial neurologic examination revealed an incomplete spinal cord injury characterized by hypoesthesia and motor grade of 2 below the L2 segment. Lumbar computed tomography and magnetic resonance imaging demonstrated L2 and L5 burst fractures severely obliterating the spinal canal...
March 2018: Medicine (Baltimore)
F Gilbert, T M Heintel, M G Jakubietz, H Köstler, C Sebald, R H Meffert, A M Weng
BACKGROUND: Minimally invasive pedicle screw fixation has less approach-related morbidity than open screw placement and is allegedly less traumatizing on paravertebral muscles, as there is no requirement to mobilize and retract the adjacent muscle portion. The approach-related long-term effects to the morphology of the paravertebral muscles are unknown. The purpose of this study was to compare the long-term amount of fatty degeneration of the multifidus muscle in patients treated with a classical open or a minimally invasive approach...
March 7, 2018: BMC Musculoskeletal Disorders
Cosmas Mwikirize, John L Nosher, Ilker Hacihaliloglu
PURPOSE: We propose a framework for automatic and accurate detection of steeply inserted needles in 2D ultrasound data using convolution neural networks. We demonstrate its application in needle trajectory estimation and tip localization. METHODS: Our approach consists of a unified network, comprising a fully convolutional network (FCN) and a fast region-based convolutional neural network (R-CNN). The FCN proposes candidate regions, which are then fed to a fast R-CNN for finer needle detection...
March 6, 2018: International Journal of Computer Assisted Radiology and Surgery
Miguel Pishnamaz, Ulrike Schemmann, Christian Herren, Klemens Horst, Philipp Lichte, Frank Hildebrand, Hans-Christoph Pape, Philipp Kobbe
PURPOSE: This review addressed the question of whether minimally invasive surgery after traumatic thoracolumbar spine fractures can reduce paraspinal muscle injury, limit changes in muscular structure and function, and lead to better functional outcome. Special emphasis was given to studies using imaging techniques or electromyography to evaluate the lumbar multifidus muscle structure and function. METHODS: The authors searched the literature in the PubMed/Medline, EMBASE, by cross-referencing and additional hand search...
March 1, 2018: Journal of Musculoskeletal & Neuronal Interactions
Dirk H Alander, Shari Cui
Percutaneous pedicle screw fixation has evolved as a useful tool in the management of spinal trauma. As a minimally invasive approach, it provides the stability of open instrumentation while limiting blood loss, avoiding excessive muscle/soft-tissue insult, and improving postoperative pain and mobilization. Muscle-dilating techniques also preserve greater paraspinal muscle volume and strength compared with open midline approaches. In patients with spinal trauma, the use of percutaneous instrumentation and indirect reduction can theoretically preserve the fracture hematoma and its osteogenic inflammatory factors...
March 1, 2018: Journal of the American Academy of Orthopaedic Surgeons
Andrea Zanirato, Marco Damilano, Matteo Formica, Andrea Piazzolla, Alessio Lovi, Jorge Hugo Villafañe, Pedro Berjano
PURPOSE: To review the incidence of perioperative and late complications of surgery for spinal deformity (ASD). METHODS: Review of the literature. We reviewed recent literature in English to investigate the incidence of complications in ASD surgery in the perioperative (≤ 3 months post-operative) and late (> 3 months post-operative) periods. Randomized-controlled trials, non-randomized trials, cohort studies, case-control studies, and case series published in 2005 or later were included...
March 1, 2018: European Spine Journal
Ori Barzilai, Charles G Fisher, Mark H Bilsky
Treatment paradigms for patients with spine metastases have evolved significantly over the past decade. Incorporating stereotactic radiosurgery into these paradigms has been particularly transformative, offering precise delivery of tumoricidal radiation doses with sparing of adjacent tissues. Evidence supports the safety and efficacy of radiosurgery as it currently offers durable local tumor control with low complication rates even for tumors previously considered radioresistant to conventional radiation. The role for surgical intervention remains consistent, but a trend has been observed toward less aggressive, often minimally invasive, techniques...
February 22, 2018: Neurosurgery
Khalid H Kurtom, Wendy S Towers
BACKGROUND: Minimally invasive transforaminal lumbar interbody fusion (MITLIF) is a well-described procedure with excellent reported outcomes. A modification of interbody graft placement can potentially improve the ease and safety of this procedure. OBJECTIVE: To describe a modification of the MITLIF graft placement and retrospectively review our experience including intraoperative and postoperative complications. METHODS: Single surgeon, single institution, retrospective analysis of consecutive patients who underwent a modified MITLIF technique between November 2011 and December 2013...
February 16, 2018: Operative Neurosurgery (Hagerstown, Md.)
Ankur S Narain, Fady Y Hijji, Gabriel Duhancioglu, Brittany E Haws, Benjamin Khechen, Blaine T Manning, Matthew W Colman, Kern Singh
STUDY DESIGN: Prospective questionnaire. OBJECTIVE: To describe patient perceptions of minimally invasive spine (MIS) versus open surgery, and to determine which factors are most heavily considered by the patient when choosing between approaches. SUMMARY OF BACKGROUND DATA: MIS surgery has increased in popularity due to proposed advantages in the perioperative and immediate postoperative periods. However, patient preferences and understanding with regard to the differences between MIS and open surgery have not been elucidated...
February 20, 2018: Clinical Spine Surgery
K Farah, T Graillon, H Dufour, S Fuentes
INTRODUCTION: Adjacent level spondylodiscitis (ALS) after primary surgery for thoracic spondylodiscitis is a very rare condition. CASE REPORT: We report the case of a 76-year-old man with this pathology. A first posterior minimally invasive approach combined with anterior approach to the thoracic spine was safely performed for thoracic spondylodiscitis. More than a year later, exploration of recurrent symptoms with 18 FDG PET scan helped to diagnose ALS. Further surgery was performed...
February 12, 2018: Neuro-Chirurgie
Taylor E Purvis, Rafael De la Garza Ramos, Eric W Sankey, Isaac O Karikari, C Rory Goodwin, Daniel M Sciubba
Management of spine fractures among the elderly is complicated by preexisting comorbidities and increased risk of osseous nonunion. Whether operative treatment is superior for the management of thoracolumbar fractures in the aged is unknown. The purpose of this study was to investigate the rates of in-hospital medical complications after non-operative and operative treatment of thoracolumbar fractures in elderly patients. The Nationwide Inpatient Sample database from 2002 to 2011 was used to identify patients over 75 years of age with a principal discharge diagnosis of thoracolumbar fracture without spinal cord injury...
February 5, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Guillaume Racloz, Dennis Dominguez, Antonio Faundez, Romain Dayer
Adult scoliosis is a common condition. Symptoms could be very debilitating. Surgical management requires a clear assessment of the functional impact of scoliosis, the failure of conservative treatments and precise analysis of radiological investigations (full spine views, dynamic X-rays and MRI). Surgical techniques (anterior and posterior approaches, minimal invasive techniques, osteotomies, all spine instrumentation) must be tailored to each patient. The main goals of surgery are treatment of symptoms, correction of deformity in coronal and sagittal plane and achievement of a solid fusion...
February 7, 2018: Revue Médicale Suisse
Hiroshi Uei, Yasuaki Tokuhashi, Masafumi Maseda, Masahiro Nakahashi, Hirokatsu Sawada, Enshi Nakayama, Hirotoki Soma
BACKGROUND: Surgeries performed for metastatic spinal tumor are mostly palliative and are controversial for patients with short life expectancy. We investigated whether palliative posterior spinal stabilization surgery with postoperative multidisciplinary therapy results in improvement of life prognosis and activities of daily living (ADL) in patients with metastatic spinal tumor. METHODS: The subjects were 55 patients who underwent palliative posterior-only instrumentation surgery for metastatic spinal tumor at our hospital between 2012 and 2015...
February 5, 2018: Journal of Orthopaedic Surgery and Research
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