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https://www.readbyqxmd.com/read/29140961/cervical-foraminal-epidural-blood-patch-for-the-targeted-treatment-of-refractory-cerebrospinal-fluid-leakage-from-a-dural-sleeve
#1
Nuj Tontisirin, Pannawit Benjhawaleemas, Sasikaan Nimmaanrat, Pornchai Sathirapanya, Teeranan Laohawiriyakamol, De Q Tran, Roderick J Finlayson
Epidural blood patches (EBPs) are routinely used to treat symptoms (eg, headaches) associated with spontaneous intracranial hypotension. Although cerebrospinal fluid leakage commonly involves the periforaminal areas of the cervical or thoracic spine, EBPs have been historically performed at the lumbar level. Recent evidence suggests that targeting the causative spinal segment may provide greater clinical benefits. While previous reports have targeted foraminal leaks with segmental thoracic or cervical injections, we present a case report detailing the novel use of a navigable epidural catheter to perform a selective EBP at the C7/T1 foramen...
November 14, 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/29130140/transforaminal-intrathecal-delivery-of-nusinersen-using-cone-beam-computed-tomography-for-children-with-spinal-muscular-atrophy-and-extensive-surgical-instrumentation-early-results-of-technical-success-and-safety
#2
John J Weaver, Niranjana Natarajan, Dennis W W Shaw, Susan D Apkon, Kevin S H Koo, Giri M Shivaram, Eric J Monroe
BACKGROUND: Nusinersen, the only treatment approved by the United States Food and Drug Administration for spinal muscular atrophy (SMA), is delivered intrathecally. Many children with SMA have extensive spinal instrumentation and deformities, often precluding the use of standard approaches for gaining intrathecal access. Furthermore the anatomical distortion that often occurs with rotoscoliosis can complicate the use of fluoroscopic guidance. Compared to fluoroscopy, CT affords superior guidance for complex needle placements...
November 13, 2017: Pediatric Radiology
https://www.readbyqxmd.com/read/29107727/severe-spinal-cord-compression-by-a-pure-giant-intradural-schwannoma-of-the-cervical-spine
#3
Javier Quillo-Olvera, Guang-Xun Lin, Jin-Sung Kim
A 73-year-old man with progressive quadriparesis, six months of evolution. Physical examination showed decreased strength at upper and lower limbs together with an increase in osteotendinous reflexes with Babinski sign. Upon radiological investigation, MRI revealed a tumor at C3-T2 with a severe ventrolateral displacement of the spinal cord (Figure 1). The patient underwent surgery for gross total resection of the lesion. Histopathologic findings reported a schwannoma. (Figure 2). Muscular strength of the limbs improved three months after surgery, and the patient was able to walk without assistance...
October 28, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29080030/progenitors-in-the-ependyma-of-the-spinal-cord-a-potential-resource-for-self-repair-after-injury
#4
Nicolás Marichal, Cecilia Reali, María Inés Rehermann, Omar Trujillo-Cenóz, Raúl E Russo
Traumatic injury of the spinal cord leads to devastating conditions that affect ~2.5 million people worldwide. This is because the mammalian spinal cord reacts to injury with only limited endogenous repair. Functional restoration requires the replacement of lost cells, the growth and navigation of regenerating axons on a permissive scaffold and axon re-myelination. The manipulation of endogenous spinal stem cells is regarded as a potential strategy to restore function. For this type of therapy it is necessary to determine the molecular and functional mechanisms regulating the proliferation, migration and differentiation of adult spinal progenitors...
2017: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/29057348/navigation-accuracy-comparing-non-covered-frame-and-use-of-plastic-sterile-drapes-to-cover-the-reference-frame-in-3d-acquisition
#5
Donald S Corenman, Eric L Strauch, Grant J Dornan, Eric Otterstrom, Lisa Zalepa King
BACKGROUND: Advancements in surgical navigation technology coupled with 3-dimensional (3D) radiographic data have significantly enhanced the accuracy and efficiency of spinal fusion implant placement. Increased usage of such technology has led to rising concerns regarding maintenance of the sterile field, as makeshift drape systems are fraught with breaches thus presenting increased risk of surgical site infections (SSIs). A clinical need exists for a sterile draping solution with these techniques...
September 2017: Journal of Spine Surgery (Hong Kong)
https://www.readbyqxmd.com/read/29054782/multi-level-spondylolysis-repair-using-the-smiley-face-technique-with-3d-intraoperative-spinal-navigation
#6
Mathew R Voisin, Christopher D Witiw, Ryan Deorajh, Daipayan Guha, Adetunji Oremakinde, Shelly Wang, Victor Yang
BACKGROUND / OBJECTIVE: Multi-level spondylolysis is a rare cause of progressive lower back pain and patients that fail conservative management are treated surgically. Direct repair methods can maintain mobility and lead to decreased morbidity compared with spinal fusion in single-level spondylolysis. In this paper, we present a patient with non-adjacent multi-level spondylolysis that underwent the 'smiley face' technique of direct multi-level repair without fusion using 3D intraoperative spinal navigation...
October 17, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29050896/intraoperative-pedicle-screw-navigation-does-not-significantly-affect-complication-rates-after-spine-surgery
#7
Scott C Wagner, Patrick B Morrissey, Ian D Kaye, Arjun Sebastian, Joseph S Butler, Christopher K Kepler
Various forms of intraoperative computer-assisted navigation technologies exist, and have consistently been shown to improve pedicle screw accuracy. However, the overall clinical effects of inaccurate pedicle screw placement have been debated. We examined the clinical effects of improved pedicle screw accuracy with computer navigation technology in reducing complication rates in patients undergoing multi-level spinal fusion. We retrospectively reviewed the ACS-NSQIP registry utilizing Current Procedural Terminology (CPT) codes 22843 + 22844 to identify patients undergoing spinal instrumentation of greater than 7 levels, as well as the CPT code 61783 to denote the use of intraoperative computer-assisted navigation...
October 16, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29019807/pedicle-screw-insertion-accuracy-using-o-arm-robotic-guidance-or-freehand-technique-a-comparative-study
#8
Pietro Aniello Laudato, Katarzyna Pierzchala, Constantin Schizas
STUDY DESIGN: Retrospective radiological study OBJECTIVE.: To evaluate the accuracy of pedicle screw insertion using O-Arm navigation, Robotic assistance or a freehand fluoroscopic technique. SUMMARY OF BACKGROUND DATA: Pedicle screw insertion using either 'O-Arm' navigation or robotic devices is gaining popularity. Although several studies are available evaluating each of those techniques separately, no direct comparison has been attempted. METHODS: 84 patients undergoing implantation of 569 lumbar and thoracic screws were divided in three groups...
October 10, 2017: Spine
https://www.readbyqxmd.com/read/29018961/accuracy-of-a-patient-specific-template-for-pedicle-screw-placement-compared-with-a-conventional-method-a-meta-analysis
#9
Yong Fan, Jin-Peng Du, Qi-Ning Wu, Jia-Nan Zhang, Ding-Jun Hao
INTRODUCTION: Accurate placement of pedicle screws in spine surgery is a challenge for surgeons. Patient-specific template techniques have the potential for improving the accuracy of screw placement. The target of this analysis was to investigate differences in terms of accuracy of pedicle screw insertion between patient-specific template assistance and the conventional free-hand method for reconstruction of spinal stability. MATERIALS: The Cochrane Library, Ovid, Web of Science, PubMed, EMBASE and CNKI database were searched until February 2017 for a systematic review, and several comparative studies were screened for comparisons of accuracies of pedicle screw insertion with patient-specific assistance and conventional methods...
October 10, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/28989844/use-of-intraoperative-ultrasound-during-spinal-surgery
#10
Viren S Vasudeva, Muhammad Abd-El-Barr, Yuri A Pompeu, Aditya Karhade, Michael W Groff, Yi Lu
STUDY DESIGN: Review and technical report. OBJECTIVE: Intraoperative ultrasound has been used by spine surgeons since the early 1980s. Since that time, more advanced modes of intraoperative imaging and navigation have become widely available. Although the use of ultrasound during spine surgery has fallen out of favor, it remains the only true real-time imaging modality that allows surgeons to visualize soft tissue anatomy instantly and continuously while operating...
October 2017: Global Spine Journal
https://www.readbyqxmd.com/read/28973529/analysis-of-intraoperative-cone-beam-computed-tomography-combined-with-image-guidance-for-lateral-lumbar-interbody-fusion
#11
Xilin Liu, Jacob R Joseph, Brandon W Smith, Yamaan Saadeh, Paul Park
BACKGROUND: Minimally invasive lateral lumbar interbody fusion (LLIF) is traditionally performed with biplanar fluoroscopy. Recent literature demonstrates that intraoperative cone-beam computed tomography combined with spinal navigation can be safely utilized for localization and cage placement in LLIF. OBJECTIVE: To evaluate the accuracy and safety of cage placement using spinal navigation in LLIF, as well as to evaluate the radiation exposure to surgeon and staff during the procedure...
August 2, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/28962027/intraoperative-spinal-navigation-for-the-removal-of-intradural-tumors-technical-notes
#12
Roberto Stefini, Stefano Peron, Jaime Mandelli, Elena Bianchini, Paolo Roccucci
BACKGROUND: In recent years, spinal surgery has incorporated the many advantages of navigation techniques to facilitate the placement of pedicle screws during osteosynthesis, mainly for degenerative diseases. However, spinal intradural tumors are not clearly visible by intraoperative fluoroscopy or computed tomography scans, thereby making navigation necessary. OBJECTIVE: To evaluate the use of spinal navigation for the removal of intradural and spinal cord tumors using spinal magnetic resonance imaging (MRI) merged with intraoperative 3-dimensional (3-D) fluoro images...
August 5, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/28951183/revision-rate-of-misplaced-pedicle-screws-of-the-thoracolumbar-spine-comparison-of-3d-fluoroscopy-navigated-with-freehand-placement-a-systematic-analysis-and-review-of-the-literature
#13
Jens Fichtner, Nicole Hofmann, Anna Rienmüller, Niels Buchmann, Jens Gempt, Jan S Kirschke, Florian Ringel, Bernhard Meyer, Yu-Mi Ryang
BACKGROUND: Recent studies could show higher accuracy rates of image-guided pedicle screw placement compared to freehand placement. However, data focusing on the impact of spinal navigation on the rate of revision surgeries due to misplaced pedicle screws (PS) are scarce. OBJECTIVE: This study is aimed at identifying the rate of revision surgeries for misplaced PS comparing 3D fluoroscopic navigation (3DFL) to freehand (FH) PS placement. METHODS: A retrospective analysis of a total of 2232 patients (mean age 65...
September 22, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28927210/navigation-and-image-injection-for-control-of-bone-removal-and-osteotomy-planes-in-spine-surgery
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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...
November 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
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