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https://www.readbyqxmd.com/read/28927210/navigation-and-image-injection-for-control-of-bone-removal-and-osteotomy-planes-in-spine-surgery
#1
Michael Kosterhon, Angelika Gutenberg, Sven Rainer Kantelhardt, Elefterios Archavlis, Alf Giese
BACKGROUND AND IMPORTANCE: In contrast to cranial interventions, neuronavigation in spinal surgery is used in few applications, not tapping into its full technological potential. We have developed a method to preoperatively create virtual resection planes and volumes for spinal osteotomies and export 3-D operation plans to a navigation system controlling intraoperative visualization using a surgical microscope's head-up display. The method was developed using a Sawbone ® model of the lumbar spine, demonstrating feasibility with high precision...
April 1, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/28927206/preoperative-magnetic-resonance-and-intraoperative-computed-tomography-fusion-for-real-time-neuronavigation-in-intramedullary-lesion-surgery
#2
Francesco Costa, Alessandro Ortolina, Andrea Cardia, Marco Riva, Martina Revay, Guido Pecchioli, Carla Daniela Anania, Francesco Asteggiano, Maurizio Fornari
BACKGROUND: Image-guided surgery techniques in spinal surgery are usually based upon fluoroscopy or computed tomography (CT) scan, which allow for a real-time navigation of bony structures, though not of neural structures and soft tissue remains. OBJECTIVE: To verify the effectiveness and efficacy of a novel technique of imaging merging between preoperative magnetic resonance imaging (MRI) and intraoperative CT scan during removal of intramedullary lesions. METHODS: Ten consecutive patients were treated for intramedullary lesions using a navigation system aid...
April 1, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/28922280/time-demand-and-radiation-dose-in-3d-fluoroscopy-based-navigation-assisted-3d-fluoroscopy-controlled-pedicle-screw-instrumentations
#3
Horst Balling
STUDY DESIGN: Prospective single-center cohort study to record additional time requirements and radiation dose in navigation-assisted O-arm-controlled pedicle screw (PS) instrumentations. OBJECTIVE: To evaluate amount of extra-time and radiation dose for navigation-assisted PS instrumentations of the thoracolumbosacral spine using O-arm 3D-real-time-navigation (O3DN) compared to non-navigated spinal procedures (NNSP) with a single C-arm and postoperative computed tomography (CT) scan for controlling PS positions...
September 15, 2017: Spine
https://www.readbyqxmd.com/read/28917286/intraoperative-3d-computed-tomography-spine-surgery
#4
REVIEW
Stephanie E Adamczak, Frank J Bova, Daniel J Hoh
Spinal instrumentation often involves placing implants without direct visualization of their trajectory or proximity to adjacent neurovascular structures. Two-dimensional fluoroscopy is commonly used to navigate implant placement, but with the advent of computed tomography, followed by the invention of a mobile scanner with an open gantry, three-dimensional (3D) navigation is now widely used. This article critically appraises the available literature to assess the influence of 3D navigation on radiation exposure, accuracy of instrumentation, operative time, and patient outcomes...
October 2017: Neurosurgery Clinics of North America
https://www.readbyqxmd.com/read/28917280/a-novel-use-of-the-intraoperative-mri-for-metastatic-spine-tumors-laser-interstitial-thermal-therapy-for-percutaneous-treatment-of-epidural-metastatic-spine-disease
#5
REVIEW
Jonathan G Thomas, Wajd N Al-Holou, Dhiego Chaves de Almeida Bastos, Amol J Ghia, Jing Li, Andrew J Bishop, Behrang Amini, Laurence D Rhines, Claudio E Tatsui
Spinal laser interstitial thermal therapy (LITT) appears to be a promising novel modality for treatment of epidural metastatic spine disease in patients who are poor candidates for larger-scale oncologic spinal surgery and can act synergetically with spinal stereotactic radiosurgery to maximize local control and palliate pain. This technique is ideally suited for the intraoperative MRI suite to monitor the extent of the ablation in the epidural space. As percutaneous navigation, imaging, and LITT technology improve, broader applicability of this minimally invasive technique in spinal oncology is foreseen...
October 2017: Neurosurgery Clinics of North America
https://www.readbyqxmd.com/read/28912022/when-does-intraoperative-3d-imaging-play-a-role-in-transpedicular-c2-screw-placement
#6
Cornelius Jacobs, Philip P Roessler, Sebastian Scheidt, Milena M Plöger, Collin Jacobs, Alexander C Disch, Klaus D Schaser, Tony Hartwig
INTRODUCTION: The stabilization of an atlantoaxial (C1-C2) instability is demanding due to a complex atlantoaxial anatomy with proximity to the spinal cord, a variable run of the vertebral artery (VA) and narrow C2 pedicles. We perfomed the Goel & Harms fusion in combination with an intraoperative 3D imaging to ensure correct screw placement in the C2 pedicle. We hypothesized, that narrow C2 pedicles lead to a higher malposition rate of screws by perforation of the pedicle wall. The purpose of this study was to describe a certain pedicle size, under which the perforation rate rises...
September 8, 2017: Injury
https://www.readbyqxmd.com/read/28890028/a-novel-technique-for-placement-of-sacro-alar-iliac-s2ai-screws-by-k-wire-insertion-using-intraoperative-navigation
#7
Kevin Phan, Julian Li, Gloria Giang, Ian Teng, Steven Phan, Nicholas Chang, Ralph Mobbs
Sacral-iliac fixation techniques may be indicated in the management of various lumbosacral pathologies including spinal degeneration, infection, tumour resection, fracture, pseudarthrosis, correction of spinal deformities involving long fusion constructs to the sacrum and cases with poor sacral fixation. There are a number of options for lumbosacral fixation each with their own advantages and disadvantages. Though S2-alar-iliac (S2AI) have demonstrated promising advantages over alternatives, the complex anatomy of the spinopelvic region demands precise insertion of the screws to create a biomechanically robust construct safely...
September 7, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28876566/a-survey-of-selected-key-areas-of-management-of-south-african-neurosurgical-patients
#8
C H Daniel, M D du Trevou
BACKGROUND: Previous surveys of neurosurgical patient management, including a South African (SA) survey conducted in 2001, confirmed the existence of significant dissimilarities in management on national and international levels. This survey aimed to determine current SA neurosurgical patient management and to compare this with international trends. METHOD: Questionnaires in multiple choice question (MCQ) and free text entry format covering key areas of neurosurgical practice were emailed to SA neurosurgeons following ethics approval...
September 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28870824/spine-navigation-based-on-three-dimensional-robotic-fluoroscopy-for-accurate-percutaneous-pedicle-screw-placement-a-prospective-study-of-66-consecutive-cases
#9
Edward Fomekong, Salah Edine Safi, Christian Raftopoulos
BACKGROUND: Minimally invasive spine surgery is associated with obstructed visibility of anatomical landmarks and increased radiation exposure, leading to higher incidence of pedicle screw mispositioning. To address these drawbacks, intraoperative three-dimensional fluoroscopy (io3DF) and navigation are being increasingly used. We aimed to present our dedicated multifunctional hybrid operating room (HyOR) setup and evaluate the accuracy and safety of io3DF image-guided spinal navigation in transforaminal lumbar interbody fusion with percutaneous pedicle screw (PPS) placement...
September 1, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28826707/modified-posterior-c1-lateral-mass-screw-insertion-for-type-ii-odontoid-process-fractures-using-intraoperative-ct-based-spinal-navigation-to-minimize-postoperative-occipital-neuralgia
#10
Basem Ishak, Till Schneider, R Shane Tubbs, Valerie Gimmy, Alexander Younsi, Andreas W Unterberg, Karl L Kiening
No abstract text is available yet for this article.
August 4, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28819694/thoracic-corpectomy-for-neoplastic-vertebral-bodies-using-a-navigated-lateral-extracavitary-approach-a-single-center-consecutive-case-series-technique-and-analysis
#11
Sebastian Hartmann, Christoph Wipplinger, Anja Tschugg, Pujan Kavakebi, Alexander Örley, Pierre Pascal Girod, Claudius Thomé
Thoracic myelopathy is often caused by vertebral body fractures resulting from neoplastic conditions, traumatic events, or infectious diseases. One of the preferred procedures for treating it is the lateral extracavitary approach (LECA) with single-level or multilevel decompressive corpectomy and reconstruction. The aim of this retrospective study was to analyze the thoracic lateral extracavitary approach with corpectomy using vertebral body replacement systems (VBR-S) and dorsal reconstruction. Twenty-four patients with metastatic or primary lesions of thoracic vertebrae T2-T12 underwent spinal decompression and ventral column reconstruction with correction of spinal deformity via a LECA...
August 17, 2017: Neurosurgical Review
https://www.readbyqxmd.com/read/28819344/positioning-performance-of-power-and-manual-drivers-in-posterior-spinal-fusion-procedures
#12
J Micah Prendergast, Alexander C Perry, Vikas V Patel, Emily M Lindley, Mark E Rentschler
This work presents an analysis and comparison of the efficacy of two methods for pedicle screw placement during posterior spinal fusion surgery. A total of 100 screws (64 manual and 36 power driven), all placed utilizing a surgical navigation system, were analyzed and compared. Final screw placement was compared to initial surgical plans using the navigation system, and the final screw locations were analyzed on the basis of angular deviation from these planned trajectories as well as screw translation within a critical reference plane...
2017: Applied Bionics and Biomechanics
https://www.readbyqxmd.com/read/28813969/prediction-of-user-preference-over-shared-control-paradigms-for-a-robotic-wheelchair
#13
Ahmetcan Erdogan, Brenna D Argall
The design of intelligent powered wheelchairs has traditionally focused heavily on providing effective and efficient navigation assistance. Significantly less attention has been given to the end-user's preference between different assistance paradigms. It is possible to include these subjective evaluations in the design process, for example by soliciting feedback in post-experiment questionnaires. However, constantly querying the user for feedback during real-world operation is not practical. In this paper, we present a model that correlates objective performance metrics and subjective evaluations of autonomous wheelchair control paradigms...
July 2017: IEEE ... International Conference on Rehabilitation Robotics: [proceedings]
https://www.readbyqxmd.com/read/28808622/radiation-exposure-and-reduction-in-the-operating-room-perspectives-and-future-directions-in-spine-surgery
#14
REVIEW
Ankur S Narain, Fady Y Hijji, Kelly H Yom, Krishna T Kudaravalli, Brittany E Haws, Kern Singh
Intraoperative imaging is vital for accurate placement of instrumentation in spine surgery. However, the use of biplanar fluoroscopy and other intraoperative imaging modalities is associated with the risk of significant radiation exposure in the patient, surgeon, and surgical staff. Radiation exposure in the form of ionizing radiation can lead to cellular damage via the induction of DNA lesions and the production of reactive oxygen species. These effects often result in cell death or genomic instability, leading to various radiation-associated pathologies including an increased risk of malignancy...
July 18, 2017: World Journal of Orthopedics
https://www.readbyqxmd.com/read/28797980/can-fan-beam-ict-accurately-predict-indirect-decompression-in-miss-fusion-procedures
#15
Insa Janssen, Gernot Lang, Rodrigo Navarro-Ramirez, Ajit Jada, Connor Berlin, Aaron Hilis, Micaella Zubkov, Lena Gandevia, Roger Härtl
BACKGROUND: Recently, a novel mobile intraoperative fan-beam CT (iFBCT) was introduced, allowing for real time navigation and immediate intraoperative evaluation of neural decompression in spine surgery. This study sought to investigate whether intraoperatively assessed neural decompression during minimally invasive spine surgery (MISS) has a predictive value for clinical and radiographic outcome. METHODS: A retrospective study of patients undergoing iCT-guided extreme lateral interbody fusion (XLIF) or transforaminal lumbar interbody fusion (TLIF) was conducted...
August 7, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28790477/pediatric-lumbar-pedicle-screw-placement-using-navigation-templates-a-cadaveric-study
#16
Xing Wang, Jun Shi, Shojie Zhang, Zhifeng Zhang, Xiaohe Li, Zhijun Li
BACKGROUND: Pedicle screw technique is commonly used treatment of adult spinal trauma, tumor, degeneration. The application of pedicle screws is very challenging in children because children have a fast growing spine and spinal pedicle morphology of children and adult has large difference. 3 D reconstruction individual navigation templates improve the success rate of pediatric pedicle screw system. This study is aimed to provide a precise method for lumbar spine pedicle screw placement in children using computer-aided design and rapid prototyping technology...
July 2017: Indian Journal of Orthopaedics
https://www.readbyqxmd.com/read/28790007/targeted-epidural-blood-patch-under-o-arm-guided-stereotactic-navigation-in-patients-with-intracranial-hypotension-associated-with-a-spinal-csf-leak-and-ventral-dural-defect
#17
Keisuke Takai, Makoto Taniguchi
OBJECTIVE: Targeted epidural blood patch (EBP) at the site of a presumed cerebrospinal fluid leak reportedly has better outcomes than non-targeted EBP; however, it is associated with a higher risk of wrong-site injection such as iatrogenic subarachnoid or intramuscular injections, which lead to reintervention due to the insufficient coverage of injected blood. METHODS: Eight patients with intracranial hypotension due to a CSF leak diagnosed by myelographic CT and thin-cut MRI received an epidural blood patch under O-arm-guided stereotactic navigation...
August 5, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28789957/mini-open-spinal-column-shortening-for-the-treatment-of-adult-tethered-cord-syndrome
#18
Michael M Safaee, Ethan A Winkler, Dean Chou
Tethered cord syndrome (TCS) is a challenging entity characterized by adhesions at the caudal spinal cord that prevent upward movement during growth and result in stretching of the cord with a concomitant constellation of neurologic symptoms. Although growth in height stops in adulthood, some patients still develop progressive symptoms; many underwent detethering as a child or adolescent, resulting in significant scar tissue and re-tethering. Recent strategies have focused on spinal column shortening to reduce tension on the spinal cord without exposing the previous de-tethering site...
October 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28766023/how-i-do-it-optimizing-radiofrequency-ablation-in-spinal-metastases-using-ict-and-navigation
#19
Pujan Kavakebi, C F Freyschlag, C Thomé
BACKGROUND: Exact positioning of the radiofrequency ablation (RFA) probe for tumor treatment under fluoroscopic guidance can be difficult because of potentially small inaccessible lesions and the radiation dose to the medical staff in RFA. In addition, vertebroplasty (VP) can be significantly high. METHOD: Description and workflow of RFA in spinal metastasis using iCT (intraoperative computed tomography) and 3D-navigation-based probe placement followed by VP. CONCLUSION: RFA and VP can be successfully combined with iCT-based navigation, which leads to a reduction of radiation to the staff and optimal probe positioning due to 3D navigation...
August 1, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28760033/minimally-invasive-guidewireless-navigated-pedicle-screw-placement-a-technical-report-and-case-series
#20
Brandon W Smith, Jacob R Joseph, Michael Kirsch, Mary Oakley Strasser, Jacob Smith, Paul Park
OBJECTIVE Percutaneous pedicle screw insertion (PPSI) is a mainstay of minimally invasive spinal surgery. Traditionally, PPSI is a fluoroscopy-guided, multistep process involving traversing the pedicle with a Jamshidi needle, placement of a Kirschner wire (K-wire), placement of a soft-tissue dilator, pedicle tract tapping, and screw insertion over the K-wire. This study evaluates the accuracy and safety of PPSI with a simplified 2-step process using a navigated awl-tap followed by navigated screw insertion without use of a K-wire or fluoroscopy...
August 2017: Neurosurgical Focus
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