Journal of spinal disorders & techniques
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J Spinal Disord Tech · Apr 2007
Controlled Clinical TrialCorrelation of spinal canal dimensions to efficacy of epidural steroid injection in spinal stenosis.
To determine a critical canal dimension in patients with spinal stenosis that predicts response to epidural steroid injections (ESI). ⋯ Spinal canal dimension is not predictive of success or failure of ESI in patients with spinal stenosis.
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J Spinal Disord Tech · Apr 2007
Comparative StudyComputer-assisted spinal navigation versus serial radiography and operative time for posterior spinal fusion at L5-S1.
To review the operative time differences between computer-assisted spinal navigation versus serial radiography. ⋯ Image-guided spinal surgery did not cause an increase in operative time. In the best scenario, image navigation saved a statistically significant (P<0.001) amount of time in the operating room. At its worst, fluoroscopy-based image-guided navigation is not significantly different from standard serial radiography.
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J Spinal Disord Tech · Apr 2007
Controlled Clinical TrialBleeding risk with ketorolac after lumbar microdiscectomy.
There is a need to improve postoperative analgesia to support the trend to shorter hospitalization after minimally invasive spine surgeries. Ketorolac Tromethamine has proven efficacy in decreasing postoperative pain but there is concern with postoperative epidural bleeding after spine procedures. We prospectively assessed the incidence of bleeding complications after microdiscectomy in patients treated with a single 30 mg intraoperative dose of Ketorolac subsequent to wound closure. ⋯ Single dose intravenous Ketorolac provided beneficial analgesia without significant increase in risk of bleeding after microdiscectomy, enabling us to consistently perform microdiscectomy as an ambulatory procedure. Meticulous hemostasis should be accomplished before closure. Prolonged postoperative use is a promising alternative to narcotics.
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J Spinal Disord Tech · Apr 2007
Three-dimensional reconstruction of the scoliotic spine and pelvis from uncalibrated biplanar x-ray images.
Current three-dimensional (3D) reconstruction methods based on explicit or implicit calibration procedure require a calibration object to generate calibrated x-rays for the 3D reconstruction of the human spine and the pelvis. However, to conduct retrospective studies where no 3D technology is available, 3D reconstruction must be performed from x-ray images where no calibration object was used. The current state of the art offers a variety of methods to obtain a personalized 3D model of a patient's spine, however, none have presented a clinically proven method which allows a 3D reconstruction using uncalibrated x-rays. ⋯ For each case, a 3D reconstruction of the spine and pelvis was obtained using both explicit and self-calibration methods, from calibrated and uncalibrated x-rays, respectively. Results show that 3D reconstructions obtained with the proposed method from uncalibrated x-ray images yield- geometrical models that exhibit insignificant differences for 2D and 3D clinical indices commonly used in the evaluation of spinal deformities. This allows a 3D clinical assessment of scoliotic deformities from standard x-rays without the need for calibration, and providing access to this technology in any clinical setup and allowing to perform retrospective studies, which were previously impossible.
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J Spinal Disord Tech · Apr 2007
Lumbar spinal osteotomy for kyphosis in ankylosing spondylitis: the significance of the whole body kyphosis angle.
Retrospective analysis of 11 consecutive patients with ankylosing spondylitis who underwent lumbar spinal osteotomy for severe kyphosis, with a mean follow up of 4 (2 to 8.5) years. The chin brow vertical angle, thigh flexion angle, and the whole body kyphosis angle (WBKA) were measured on the clinical photographs of the patient in standing. The lumbar lordosis, thoracic kyphosis, total kyphosis, sacral slope, and sagittal balance were measured on the standing radiographs. ⋯ The WBKA correlated closely with the amount of lordosis correction in lumbar spine. The intraobserver and interobserver reproducibility of the WBKA was verified by statistical analysis. In our opinion the measurement of the WBKA on the preoperative photograph is helpful in planning the lumbar osteotomy.