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https://www.readbyqxmd.com/read/28735464/radiation-dose-reduction-in-thoracic-and-lumbar-spine-instrumentation-using-navigation-based-on-an-intraoperative-cone-beam-ct-imaging-system-a-prospective-randomized-clinical-trial
#1
Nathalie Pireau, Virginie Cordemans, Xavier Banse, Nadia Irda, Sébastien Lichtherte, Ludovic Kaminski
PURPOSE: Spine surgery still remains a challenge for every spine surgeon, aware of the potential serious outcomes of misplaced instrumentation. Though many studies have highlighted that using intraoperative cone beam CT imaging and navigation systems provides higher accuracy than conventional freehand methods for placement of pedicle screws in spine surgery, few studies are concerned about how to reduce radiation exposure for patients with the use of such technology. One of the main focuses of this study is based on the ALARA principle (as low as reasonably achievable)...
July 22, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28728206/-subaxial-cervical-spine-injuries-treatment-recommendations-of-the-german-orthopedic-and-trauma-society
#2
Philipp Schleicher, Matti Scholz, Frank Kandziora, Andreas Badke, Florian Hans Brakopp, Helmut Klaus Friedrich Ekkerlein, Erol Gercek, Rene Hartensuer, Philipp Hartung, Jan-Sven Gilbert Jarvers, Philipp Kobbe, Stefan Matschke, Robert Morrison, Christian W Müller, Miguel Pishnamaz, Maximilian Reinhold, Klaus John Schnake, Gregor Schmeiser, Gregor Stein, Bernhard Ullrich, Thomas Weiß, Volker Zimmermann
In a consensus process during four sessions in 2016, the working group "lower cervical spine" of the German Society for Orthopedic and Trauma Surgery (DGOU), formulated "Therapeutic Recommendations for the Lower Cervical Spine", taking into consideration the current literature. Therapeutic goals are a permanently stable, painless cervical spine and the protection against secondary neurologic damage while retaining the greatest possible amount of motion and spinal profile. Due to its ease of use and its proven good reliability, the AOSpine classification for subaxial cervical injuries should be used...
July 20, 2017: Zeitschrift Für Orthopädie und Unfallchirurgie
https://www.readbyqxmd.com/read/28715331/the-importance-of-haptics-in-generating-exoskeleton-gait-trajectory-using-alternate-motor-inputs
#3
Kiran K Karunakaran, Kevin M Abbruzzese, Hao Xu, Richard A Foulds
Human gait requires both haptic and visual feedback to generate and control rhythmic movements, and navigate environmental obstacles. Current lower extremity wearable exoskeletons that restore gait to individuals with paraplegia due to spinal cord injury rely completely on visual feedback to generate limited pre-programmed gait-variations, and generally provide little control by the user over the gait cycle. As an alternative to this limitation, we propose user control of gait in real time using healthy upper extremities...
July 13, 2017: IEEE Transactions on Neural Systems and Rehabilitation Engineering
https://www.readbyqxmd.com/read/28710046/image-guidance-to-aid-pedicle-screw-fixation-of-a-lumbar-fracture-dislocation-injury-in-a-toddler
#4
John K Houten, Jonathan Nahkla, Shashank Ghandi
BACKGROUND: Pedicle screw fixation of the lumbar spine in children less than two years of age is particularly challenging, as successful cannulation of the small pedicle dimensions require a high level of precision and there are no implants specifically designed for the infantile spine. Image-guided navigation is commonly used in adult spinal surgery and may be particularly helpful for placement of spinal screws where the bony anatomy is small and/or anatomically complex as in the upper cervical area...
July 11, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28710043/minimally-invasive-computer-navigation-assisted-endoscopic-transforaminal-interbody-fusion-with-bilateral-decompression-via-a-unilateral-approach-initial-clinical-experience-at-one-year-follow-up
#5
Yaqing Zhang, Chuang Xu, Yue Zhou, Bo Huang
OBJECTIVE: The purpose of this study was to assess the feasibility of minimally invasive transforaminal lumbar interbody fusion (TLIF) and bilateral decompression via a unilateral approach that was performed with a novel working retractor with an endoscopic system for degenerative lumbar spondylolisthesis associated with spinal stenosis, to minimize surgical trauma without compromising the quality of the treatment outcome. METHODS: In this case series, the procedure was performed in 17 patients...
July 11, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28673199/accuracy-of-pedicle-screw-placement-based-on-preoperative-computed-tomography-versus-intraoperative-data-set-acquisition-for-spinal-navigation-system
#6
Hao Liu, Weikai Chen, Tao Liu, Bin Meng, Huilin Yang
AIM: To investigate the accuracy of pedicle screw placement based on preoperative computed tomography in comparison with intraoperative data set acquisition for spinal navigation system. METHODS: The PubMed (MEDLINE), EMBASE, and Web of Science were systematically searched for the literature published up to September 2015. This review followed the Preferred Reporting Items for Systematic Reviews and Meta-analysis guidelines. Statistical analysis was performed using the Review Manager 5...
May 2017: Journal of Orthopaedic Surgery
https://www.readbyqxmd.com/read/28656505/videoexoscopic-real-time-intraoperative-navigation-for-spinal-neurosurgery-a-novel-co-adaptation-of-two-existing-technology-platforms-technical-note
#7
Meng Huang, Sean Michael Barber, William James Steele, Zain Boghani, Viren Rajendrakumar Desai, Gavin Wayne Britz, George Alexander West, Todd Wilson Trask, Paul Joseph Holman
Image-guided approaches to spinal instrumentation and interbody fusion have been widely popularized in the last decade [1-5]. Navigated pedicle screws are significantly less likely to breach [2, 3, 5, 6]. Navigation otherwise remains a point reference tool because the projection is off-axis to the surgeon's inline loupe or microscope view. The Synaptive robotic brightmatter drive videoexoscope monitor system represents a new paradigm for off-axis high-definition (HD) surgical visualization. It has many advantages over the traditional microscope and loupes, which have already been demonstrated in a cadaveric study [7]...
June 27, 2017: Journal of Robotic Surgery
https://www.readbyqxmd.com/read/28634552/inherited-paediatric-motor-neuron-disorders-beyond-spinal-muscular-atrophy
#8
REVIEW
Hooi Ling Teoh, Kate Carey, Hugo Sampaio, David Mowat, Tony Roscioli, Michelle Farrar
Paediatric motor neuron diseases encompass a group of neurodegenerative diseases characterised by the onset of muscle weakness and atrophy before the age of 18 years, attributable to motor neuron loss across various neuronal networks in the brain and spinal cord. While the genetic underpinnings are diverse, advances in next generation sequencing have transformed diagnostic paradigms. This has reinforced the clinical phenotyping and molecular genetic expertise required to navigate the complexities of such diagnoses...
2017: Neural Plasticity
https://www.readbyqxmd.com/read/28627291/early-complications-morbidity-and-mortality-in-octo-and-nonagenarians-undergoing-posterior-intraoperative-spinal-navigation-based-c1-2-fusion-for-type-ii-odontoid-process-fractures
#9
Basem Ishak, Till Schneider, Valerie Gimmy, Andreas W Unterberg, Karl L Kiening
Type II odontoid fractures represent the most common cervical spine injury in the elderly. The decision for surgical treatment is still controversial, particularly with regard to the elevated perioperative risk attributed to frequent comorbidities and poor bone quality. Purpose of this study was to assess both short-term mortality and mid-term clinical and radiological outcome in the elderly. Between January 2007 and December 2015, 35 patients with type II odontoid process fractures who underwent posterior atlanto-axial instrumentation using a modified Goel-Harms technique were retrospectively analyzed and prospectively examined clinically and radiologically...
June 18, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/28602642/precision-and-accuracy-of-consumer-grade-motion-tracking-system-for-pedicle-screw-placement-in-pediatric-spinal-fusion-surgery
#10
Andrew Chan, Janelle Aguillon, Doug Hill, Edmond Lou
Adolescent idiopathic scoliosis (AIS) is a 3-dimensional spinal deformity involving lateral curvature and axial rotation. Surgical intervention involves insertion of pedicle screws into the spine, requiring accuracies of 1mm and 5° in translation and rotation to prevent neural and vascular complications. While commercial CT-navigation is available, the significant cost, bulk and radiation dose hinders their use in AIS surgery. The objective of this study was to evaluate a commercial-grade Optitrack Prime 13W motion capture cameras to determine if they can achieve adequate accuracy for screw insertion guidance in AIS...
June 9, 2017: Medical Engineering & Physics
https://www.readbyqxmd.com/read/28598291/spinal-navigation-for-posterior-instrumentation-of-c1-2-instability-using-a-mobile-intraoperative-ct-scanner
#11
Marcus Czabanka, Julien Haemmerli, Nils Hecht, Bettina Foehre, Klaus Arden, Thomas Liebig, Johannes Woitzik, Peter Vajkoczy
OBJECTIVE Spinal navigation techniques for surgical fixation of unstable C1-2 pathologies are challenged by complex osseous and neurovascular anatomy, instability of the pathology, and unreliable preoperative registration techniques. An intraoperative CT scanner with autoregistration of C-1 and C-2 promises sufficient accuracy of spinal navigation without the need for further registration procedures. The aim of this study was to analyze the accuracy and reliability of posterior C1-2 fixation using intraoperative mobile CT scanner-guided navigation...
June 9, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28594523/congenital-scoliosis-a-case-based-approach
#12
Frances A Farley, Laurel C Blakemore
Congenital scoliosis is lateral curvature of the spine caused by vertebral anomalies. Congenital scoliosis is associated with congenital anomalies of other organ systems. Traditionally, treatment options for patients with congenital scoliosis focused on posterior spinal fusion. Current surgical treatment options for young children include growing rods, vertical expandable prosthetic titanium ribs, and, most recently, magnetic rods. Hemivertebrae resection is an important early treatment option for patients who have a hemivertebra...
February 15, 2017: Instructional Course Lectures
https://www.readbyqxmd.com/read/28591055/stereoelectroencephalography-based-on-the-leksell-stereotactic-frame-and-neurotech-operation-planning-software
#13
Guangming Zhang, Guoqiang Chen, Dawei Meng, Yanwu Liu, Jianwei Chen, Lanmei Shu, Wenbo Liu
This study aimed to introduce a new stereoelectroencephalography (SEEG) system based on Leksell stereotactic frame (L-SEEG) as well as Neurotech operation planning software, and to investigate its safety, applicability, and reliability.L-SEEG, without the help of navigation, includes SEEG operation planning software (Neurotech), Leksell stereotactic frame, and corresponding surgical instruments. Neurotech operation planning software can be used to display three-dimensional images of the cortex and cortical vessels and to plan the intracranial electrode implantation...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28585080/visuo-locomotor-control-in-persons-with-spinal-cord-injury-in-a-manual-or-power-wheelchair-for-direction-change-and-obstacle-circumvention
#14
Caroline Charette, François Routhier, Bradford J McFadyen
Many individuals, such as persons with spinal cord injury (SCI), rely on wheeled locomotion involving manual (MWC) or power (PWC) wheelchairs to navigate their environments. Yet, visuo-locomotor control underlying WC navigation in experienced users is not well understood. The objective of this study was to compare the visuo-locomotor control between MWC and PWC in individuals with SCI while changing direction and circumventing an obstacle. Participants with SCI using a MWC (n = 12, 38.5 ± 10.7 years) or a PWC (n = 10, 47...
June 5, 2017: Experimental Brain Research. Experimentelle Hirnforschung. Expérimentation Cérébrale
https://www.readbyqxmd.com/read/28566019/using-evidence-to-inform-practice-and-policy-to-enhance-the-quality-of-care-for-persons-with-traumatic-spinal-cord-injury
#15
Michael G Fehlings, Christiana L Cheng, Elaine Chan, Nancy P Thorogood, Vanessa K Noonan, Henry Ahn, Christopher Bailey, Anoushka Singh, Marcel F Dvorak
In today's economic climate there is a need to demonstrate a return on investment for healthcare spending and for clinical practice and policy to be informed by evidence. Navigating this process is difficult for decision-makers, clinicians and researchers alike. This article will describe how a knowledge translation framework and an evidence-based policy-making process were integrated to clarify the problem, frame options, and plan implementation, to impact clinical practice and policy in the area of traumatic spinal cord injury (tSCI)...
May 31, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/28551828/rate-and-mode-of-screw-misplacements-after-3d-fluoroscopy-navigation-assisted-insertion-and-3d-imaging-control-of-1547-pedicle-screws-in-spinal-levels-t10-s1-related-to-vertebrae-and-spinal-sections
#16
Horst Balling, Thomas R Blattert
PURPOSE: In the field of spinal surgery, 3D-fluoroscopy navigation-assisted pedicle screw (PS) insertion with intra-operative 3D-image control represents a modern application of contemporary navigation technology. In literature, sectional or vertebral accuracy limitations of this image-guidance approach are not profoundly specified. This observational study explicitly differentiates accuracy rates and misplacement mode between spinal sections and single vertebrae from T10 to S1 using a navigation-assisted approach...
May 27, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28498293/what-is-the-actual-3d-representation-of-the-rib-vertebra-angle-difference-mehta-s-angle
#17
Rob C Brink, Tom P C Schlösser, Marijn van Stralen, Koen L Vincken, Moyo C Kruyt, Winnie C W Chu, Jack C Y Cheng, René M Castelein
STUDY DESIGN: Cross-sectional study. OBJECTIVE: To establish the relevance of the conventional two-dimensional (2D) RVAD and the relationship with the complex three-dimensional (3D) apical morphology in scoliosis. SUMMARY OF BACKGROUND DATA: The rib vertebra angle difference (RVAD, also known as Mehta's angle) describes apical rib asymmetry on conventional radiographs and was introduced as a prognostic factor for curve severity in early onset scoliosis, and later applied to other types of scoliosis as well...
May 11, 2017: Spine
https://www.readbyqxmd.com/read/28483977/uncoupling-of-unc5c-with-polymerized-tubb3-in-microtubules-mediates-netrin-1-repulsion
#18
Qiangqiang Shao, Tao Yang, Huai Huang, Farrah Alarmanazi, Guofa Liu
Modulation of microtubule (MT) dynamics is a key event of cytoskeleton remodeling in the growth cone (GC) during axon outgrowth and pathfinding. Our previous studies have shown that the direct interaction of netrin receptor DCC and DSCAM with polymerized TUBB3, a neuron-specific MT subunit in the brain, is required for netrin-1-mediated axon outgrowth, branching, and attraction. Here, we show that uncoupling of polymerized TUBB3 with netrin-1-repulsive receptor UNC5C is involved in netrin-1-mediated axonal repulsion...
June 7, 2017: Journal of Neuroscience: the Official Journal of the Society for Neuroscience
https://www.readbyqxmd.com/read/28463612/augmented-reality-integrated-robotics-in-neurosurgery-are-we-there-yet
#19
Karthik Madhavan, John Paul G Kolcun, Lee Onn Chieng, Michael Y Wang
Surgical robots have captured the interest-if not the widespread acceptance-of spinal neurosurgeons. But successful innovation, scientific or commercial, requires the majority to adopt a new practice. "Faster, better, cheaper" products should in theory conquer the market, but often fail. The psychology of change is complex, and the "follow the leader" mentality, common in the field today, lends little trust to the process of disseminating new technology. Beyond product quality, timing has proven to be a key factor in the inception, design, and execution of new technologies...
May 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/28463610/revisions-for-screw-malposition-and-clinical-outcomes-after-robot-guided-lumbar-fusion-for-spondylolisthesis
#20
Marc L Schröder, Victor E Staartjes
OBJECTIVE The accuracy of robot-guided pedicle screw placement has been proven to be high, but little is known about the impact of such guidance on clinical outcomes such as the rate of revision surgeries for screw malposition. In addition, there are very few data about the impact of robot-guided fusion on patient-reported outcomes (PROs). Thus, the clinical benefit for the patient is unclear. In this study, the authors analyzed revision rates for screw malposition and changes in PROs following minimally invasive robot-guided pedicle screw fixation...
May 2017: Neurosurgical Focus
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