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spinal navigation

Jane Halliday, Ian Kamaly
BACKGROUND: Neuronavigation, the ability to perform real-time intra-operative guidance during cranial and/or spinal surgery, has increased both accuracy and safety in neurosurgery [2]. Cranial navigation of existing surgical instruments using Brainlab requires the use of an instrument adapter and clamp, which in our experience renders an endoscope 'top-heavy', difficult to manipulate, and the process of registration of the adapter quite time-consuming. METHODS: A Brainlab Disposable Stylet was used to navigate fenestration of an entrapped temporal horn in a pediatric case...
October 14, 2016: Acta Neurochirurgica
Olaf Suess, Markus Schomacher
Aim. Transpedicular screw fixation is widely used in spinal surgery. But the insertion of pedicle screws can sometimes be challenging because of the variability in pedicle size and the proximity of nerve roots. Methods. We detected intraoperatively the sensitivity for iatrogenic pedicel perforation with a hand-held electronic conductivity measurement device (ECD) that measures electrical conductivity of tissue-medium surrounding the instrument tip. ECD was used to guide the placement of 84 pedicle screws in 15 patients undergoing surgery for tumor or degenerative spinal disease at various spinal levels from T8 to L5...
2016: Advances in Medicine
M Lefranc, J Peltier
The ROSA® robot (Medtech, Montpellier, France) is a new medical device designed to assist the surgeon during minimally invasive spine procedures. The device comprises a patient-side cart (bearing the robotic arm and a workstation) and an optical navigation camera. The ROSA® Spine robot enables accurate pedicle screw placement. Thanks to its robotic arm and navigation abilities, the robot monitors movements of the spine throughout the entire surgical procedure and thus enables accurate, safe arthrodesis for the treatment of degenerative lumbar disc diseases, exactly as planned by the surgeon...
October 2016: Expert Review of Medical Devices
O Gonschorek, S Hauck, V Bühren
BACKGROUND: Intraoperative imaging during spinal interventions has experienced significant developments over the last two decades. By the introduction of flat screen detectors, 3D imaging has been made possible and easier and by developing compact and mobile systems computed tomography can even be used in the operating theater. OBJECTIVE: Presentation of modern intraoperative 3D imaging and navigation in spinal surgery. MATERIAL AND METHODS: The techniques of intraoperative 3D imaging and navigation during spinal procedures are presented based on the currently available literature and own experiences at a German national spine and trauma center...
October 2016: Der Unfallchirurg
Guoxin Fan, Ruoshuang Han, Xin Gu, Hailong Zhang, Xiaofei Guan, Yunshan Fan, Teng Wang, Shisheng He
PURPOSE: Beginners usually need increased punctures and dozens of fluoroscopy in learning transforamimal percutaneous endoscopic lumbar discectomy (tPELD). Navigator-assisted spinal surgery (NASS) is a novel technique that could induce a definite trajectory. The retrospective study aimed to investigate the impact of a definite trajectory on the learning curve of tPELD. METHODS: A total of 120 patients with symptomatic lumbar disc herniation who received tPELD between 2012 and 2014...
September 3, 2016: International Orthopaedics
Megumi Nakao, Shota Endo, Shinichi Nakao, Munehito Yoshida, Tetsuya Matsuda
In microendoscopic discectomy for spinal disorders, bone cutting procedures are performed in tight spaces while observing a small portion of the target structures. Although optical tracking systems are able to measure the tip of the surgical tool during surgery, the poor shape information available during surgery makes accurate cutting difficult, even if preoperative computed tomography and magnetic resonance images are used for reference. Shape estimation and visualization of the target structures are essential for accurate cutting...
2016: PloS One
R Schniepp, M Wuehr, F Schöberl, A Zwergal
BACKGROUND: Difficulties of walking and deficits of cognitive functions appear to be associated in the elderly. Thus, clinical assessment in geriatry and neurology should focus on: (1) diagnostic approaches covering both domains of everyday functioning; (2) therapeutic interventions that take into account possible interactions and synergies of both domains. DISCUSSION: In order to assess the capability for motor-cognitive interactions in the elderly it is recommended to investigate walking patterns during dual-tasks (e...
August 2016: Fortschritte der Neurologie-Psychiatrie
Lorias Espinoza Daniel, Vicente González Carranza, Fernando Chico Ponce de León, Fernando Pérez Escamirosa, Arturo Minor Martinez
BACKGROUND: Navigation technology is used for training in various medical specialties, not least image-guided spinal interventions. Navigation practice is an important educational component that allows residents to understand how surgical instruments interact with complex anatomy and to learn basic surgical skills such as the tri-dimensional mental interpretation of bi-dimensional data. However, inexpensive surgical simulators for spinal surgery are lacking. We therefore designed a low-cost spinal surgery simulator (Spine MovDigSys 01) to allow 3D navigation using 2D images without altering or limiting the surgeon's natural movement...
August 12, 2016: World Neurosurgery
Aurora Pignata, Hugo Ducuing, Valérie Castellani
ASBTRACT The mechanisms governing the navigation of commissural axons during embryonic development have been extensively investigated in the past years, often using the drosophila ventral nerve cord and the spinal cord as model systems. Similarities but also specificities in the general strategies, the molecular signals as well as in the regulatory pathways controlling the response of commissural axons to the guidance cues have been found between species. Whether the Semaphorin signaling contributes to midline crossing in the fly nervous system remains unknown, while in contrast, it does play a prominent contribution in vertebrates...
August 17, 2016: Cell Adhesion & Migration
William F Sensakovic, Matthew Cody O'Dell, Ali Agha, Raymund Woo, Laura Varich
STUDY DESIGN: Retrospective Consecutive Cohort Series OBJECTIVE.: To develop a low-dose computed tomography (CT) protocol for use in robot-assisted pediatric spinal surgery. SUMMARY OF BACKGROUND DATA: CT scans are utilized preoperatively for preoperative planning, by navigation software during robot-assisted surgery, and postoperatively to assess surgical implant placement. Traditionally high radiation doses produced by CT scanning are a concern in the highly radiosensitive pediatric population...
August 10, 2016: Spine
Adrian Elmi-Terander, Halldor Skulason, Michael Söderman, John Racadio, Robert Homan, Drazenko Babic, Nijs van der Vaart, Rami Nachabe
STUDY DESIGN: Cadaveric laboratory study. OBJECTIVE: To assess the feasibility and accuracy of thoracic pedicle screw placement using augmented reality surgical navigation (ARSN). SUMMARY OF BACKGROUND DATA: Recent advances in spinal navigation have shown improved accuracy in lumbosacral pedicle screw placement but limited benefits in the thoracic spine. 3D intraoperative imaging and instrument navigation may allow improved accuracy in pedicle screw placement, without the use of X-ray fluoroscopy, and thus opens the route to image-guided minimally invasive therapy in the thoracic spine...
August 4, 2016: Spine
David César Noriega, Rubén Hernández-Ramajo, Fiona Rodríguez-Monsalve Milano, Israel Sanchez-Lite, Borja Toribio, Francisco Ardura, Ricardo Torres Cabrera, Raul Corredera, Antonio Kruger
BACKGROUND CONTEXT: Pedicle screws in spinal surgery have allowed greater biomechanical stability and higher fusion rates. However, malposition is very common and may cause neurological, vascular and visceral injuries and compromise mechanical stability. PURPOSE: The purpose of this study was to compare the malposition rate between intraoperative computed tomography scan assisted-navigation and free-hand fluoroscopy-guided techniques for placement of pedicle screw instrumentation...
August 5, 2016: Spine Journal: Official Journal of the North American Spine Society
Rani Nasser, Doniel Drazin, Jonathan Nakhla, Lutfi Al-Khouja, Earl Brien, Eli M Baron, Terrence T Kim, J Patrick Johnson, Reza Yassari
OBJECTIVE The use of intraoperative stereotactic navigation has become more available in spine surgery. The authors undertook this study to assess the utility of intraoperative CT navigation in the localization of spinal lesions and as an intraoperative tool to guide resection in patients with spinal lesions. METHODS This was a retrospective multicenter study including 50 patients from 2 different institutions who underwent biopsy and/or resection of spinal column tumors using image-guided navigation. Of the 50 cases reviewed, 4 illustrative cases are presented...
August 2016: Neurosurgical Focus
S K Verma, P K Singh, D Agrawal, S Sinha, D Gupta, G D Satyarthee, B S Sharma
INTRODUCTION: There is a relatively high incidence of screw misplacement during spinal instrumentation due to distortion of normal anatomy following spinal trauma. The O-arm is the next-generation spinal navigation tool that provides intraoperative 3-D imaging and navigation for spine surgeries. AIMS AND OBJECTIVES: To evaluate and compare the use of O-arm as compared to C-arm for spinal trauma in a Level I trauma center in India. MATERIALS AND METHODS: In this retrospective study over 3 years (July 2010-April 2013), All patients of spinal injury who underwent spinal instrumentation were divided into O-arm group and C-arm group...
July 25, 2016: British Journal of Neurosurgery
Shenghong He, Rui Zhang, Qihong Wang, Yang Chen, Tingyan Yang, Zhenghui Feng, Yuandong Zhang, Ming Shao, Yuanqing Li
The key issue of electroencephalography (EEG)- based brain switches is to detect the control and idle states in an asynchronous manner. Most existing methods rely on a threshold. However, it is often time consuming to select a satisfactory threshold, and the chosen threshold might be inappropriate over a long period of time due to the variability of the EEG signals. This paper presents a new P300-based threshold-free brain switch. Specifically, one target button and three pseudo buttons, which are intensified in a random order to produce P300 potential, are set in the graphical user interface...
July 13, 2016: IEEE Transactions on Neural Systems and Rehabilitation Engineering
Solomon Rojhani, Steven A Stiens, Albert C Recio
BACKGROUND: We are continually rediscovering how adapted recreational activity complements the rehabilitation process, enriches patients' lives and positively impacts outcome measures. Although sports for people with spinal cord injuries (SCI) has achieved spectacular visibility, participation by high cervical injuries is often restricted due to poor accessibility, safety concerns, lack of adaptability, and high costs of technology. METHODS: We endeavor to demonstrate the mechanisms, adaptability, accessibility, and benefits the sport of sailing creates in the rehabilitative process...
July 14, 2016: Journal of Spinal Cord Medicine
Tadashi Komatsubara, Takamitsu Tokioka, Yoshihisa Sugimoto, Toshifumi Ozaki
STUDY DESIGN: This is a retrospective case series. OBJECTIVE: To avoid lateral misplacement of midcervical pedicle screws, T.T., one of our authors, developed a method for minimally invasive cervical pedicle screw (MICEPS) fixation by a posterolateral approach. We reviewed our initial experience with this fixation for trauma cases. SUMMARY OF BACKGROUND DATA: Excellent clinical results with cervical screws have been reported for trauma cases...
July 11, 2016: Clinical Spine Surgery
Roy Xiao, Jacob A Miller, Navin C Sabharwal, Daniel Lubelski, Vincent J Alentado, Andrew Torre Healy, Thomas Mroz, Edward C Benzel
INTRODUCTION: The O-arm Multidimensional Surgical Imaging System provides superior accuracy of pedicle screw insertion compared with free-hand and fluoroscopic approaches. However, no studies have investigated the clinical relevance of increased accuracy. The objective of this study was to investigate the clinical outcomes following spinal fusion using O-arm navigation. We hypothesized that increased accuracy with O-arm navigation decreases the risk of reoperation compared with free-hand and fluoroscopic guidance...
August 2016: Neurosurgery
Jeffrey P Mullin, Breanna Perlmutter, Eric Schmidt, Edward Benzel, Michael P Steinmetz
OBJECTIVE In 2009, Santoni and colleagues described a novel technique of posterior instrumentation; the cortical bone trajectory (CBT) was described as a caudocephalad and medial-to-lateral trajectory. Reported indications for CBT fixation include patients with osteoporosis, single-level degenerative disease, or adjacent-segment disease (ASD). In cases of revision surgery, it is technically possible and beneficial to place a traditional pedicle screw and a CBT screw at the same spinal level and side. It remains unclear as to the feasibility of placing both a traditional and a CBT screw at all levels of the lumbar spine and with varying trajectories of the preexisting traditional pedicle screws...
July 8, 2016: Journal of Neurosurgery. Spine
J Castillo, L Cristóbal, J Alonso, R Martín, D Suárez, M A Martínez, C Cagigas, M Gómez-Ruiz, M Gómez-Fleitas, A Vázquez-Barquero
AIM: Sacral nerve stimulation (SNS) lead implantation is a straightforward procedure for individuals with intact spinal vertebrae. When sacral anomalies are present, however, the anatomical and radiological reference points used for the accurate placement of the electrode may be absent or difficult to identify. METHOD: We describe an innovative surgical procedure of percutaneous nerve evaluation for SNS in a patient with faecal incontinence secondary to a congenital imperforate anus and partial sacral agenesis using a surgical imaging platform (O-arm system) under neurophysiological control...
September 2016: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
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