Journal of spinal disorders & techniques
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J Spinal Disord Tech · Apr 2006
Accuracy over space and time of computer-assisted fluoroscopic navigation in the lumbar spine in vivo.
The integration of digital image-guided surgical navigation with C-arm fluoroscopy, known as virtual fluoroscopy (VF), has been shown to enhance the safety of spine surgery in vitro. Few clinical studies have assessed the accuracy of VF during actual spinal surgery, and no studies have investigated variations in accuracy over the course of a series of measurements obtained during operative cases. We sought to study the intraoperative accuracy of VF over time and space during lumbar pedicle screw placement in human patients. ⋯ Our results suggest that the use of VF is a reliable method of verifying the use of anatomic and/or radiographic landmarks for guidance during lumbar pedicle screw placement.
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J Spinal Disord Tech · Apr 2006
Comparative Study Controlled Clinical TrialComparison of minimally invasive and conventional open posterolateral lumbar fusion using magnetic resonance imaging and retraction pressure studies.
To determine whether minimally invasive lumbar spinal fusion results in less paraspinal muscle damage than conventional open posterior fusion. ⋯ The peak IMP generated by the minimally invasive retractor was significantly less than with the open retractor. Postoperatively, less muscle edema was demonstrated after the minimally invasive lumbar spinal fusion, with lower mean T2 and apparent diffusion coefficient measurements supporting the hypothesis that less damage occurs using a minimally invasive approach.
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J Spinal Disord Tech · Apr 2006
Clinical TrialMeasurement of the cervical spinal cord volume on MRI.
There are some reports about the relationships between the clinical manifestations and the spine morphology or spinal cord morphology in patients with myelopathy. It has also been reported that there are interindividual variations in the cross-sectional area of the spinal cord. In most of these reports, the cross-sectional area, compression ratio, and anteroposterior diameter were used as morphologic parameters of the spinal cord, but no reports have been published on the use of spinal cord volume. ⋯ We consider that the cervical spinal cord volume ratio can be used to evaluate cervical spinal cord atrophy in patients with cervical myelopathy and can be important information in looking for clinically critical points. The cervical spinal cord volume was larger in males than in the females, decreased with age, and increased with height and body weight. The cervical spinal cord volume ratio was not affected by gender, age, height, or body weight.
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J Spinal Disord Tech · Apr 2006
Comparative StudyPerioperative complications in transforaminal lumbar interbody fusion versus anterior-posterior reconstruction for lumbar disc degeneration and instability.
Multiple different approaches are used to treat lumbar degenerative disc disease and spinal instability. Both anterior-posterior (AP) reconstructive surgery and transforaminal lumbar interbody fusion (TLIF) provide a circumferential fusion and are considered reasonable surgical options. The purpose of this study was to quantitatively assess clinical parameters such as surgical blood loss, duration of the procedure, length of hospitalization, and complications for TLIF and AP reconstructive surgery for lumbar fusion. ⋯ AP lumbar interbody fusion surgery is associated with a more than two times higher complication rate, significantly increased blood loss, and longer operative and hospitalization times than both percutaneous and open TLIF for lumbar disc degeneration and instability.
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J Spinal Disord Tech · Apr 2006
Comparative StudyEfficacy of translaminar facet screw fixation in circumferential interbody fusions as compared to pedicle screw fixation.
Posterior lumbar fixation with translaminar facet screws is a minimally invasive technique with good success rates. Long-term follow-ups show reduced reoperation rates, a decrease in pain scores, and few complications compared with pedicle screw fixation devices. The purpose of this study was to compare the reoperation rate of translaminar facet screw fixation with that of pedicle screw fixation in 360 degrees anterior and posterior fusions for incapacitating low back pain due to lumbar disc degeneration unresponsive to at least 6 months of aggressive nonoperative treatment. ⋯ The success of translaminar facet screws in circumferential fusions is justified.