Journal of spinal disorders & techniques
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J Spinal Disord Tech · Aug 2005
Utility of computerized isocentric fluoroscopy for minimally invasive spinal surgical techniques.
The purpose of this study was to prospectively evaluate the clinical utility and accuracy of intraoperative three-dimensional fluoroscopy as an adjunct for the placement of a complex spinal instrumentation. ⋯ Use of intraoperative three-dimensional fluoroscopy for image guidance in minimally invasive complex spinal instrumentation procedures is feasible and safe. This technique provides excellent visualization of three-dimensional relationships. This potentially results in improved accuracy of screw positioning and the ability to detect misplaced screws prior to wound closure. This technique also potentially results in a significant reduction in radiation exposure for both the patient and the staff.
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J Spinal Disord Tech · Aug 2005
Case ReportsAnterior lumbar interbody fusion in patients with a previous discectomy: minimum 2-year follow-up.
A retrospective review was conducted to determine the availability of anterior lumbar interbody fusion (ALIF) in selected patients who presented with recurrent lumbar disc herniation. ⋯ The authors found ALIF to be an effective procedure with satisfactory clinical results in selected patients with a recurrent disc herniation in the lumbar spine.
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J Spinal Disord Tech · Aug 2005
Transforaminal lumbar interbody fusion: clinical and radiographic results and complications in 100 consecutive patients.
We retrospectively reviewed the results of 100 consecutive transforaminal lumbar interbody fusions (TLIFs) performed at one institution. The preoperative diagnoses included degenerative disk disease (55), spondylolisthesis (41; 22 isthmic, 19 degenerative), and degenerative adult scoliosis (4). There were 64 single-level, 33 two-level, 2 three-level, and 1 four-level TLIF (140 levels). ⋯ We conclude that TLIF is a safe and effective method of achieving lumbar fusion with a 93% radiographic fusion success and a nearly 80% rate of overall patient satisfaction but frequently results in incomplete relief of symptoms. Complications resulting from the procedure are uncommon and generally minor and transient.
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J Spinal Disord Tech · Jun 2005
Multishot diffusion-weighted imaging features in spinal cord infarction.
The purpose of this study was to use a multishot, navigator-corrected, echo-planar (EP) pulse sequence to perform clinical diffusion-weighted imaging (DWI), analyze the DWI findings in ischemic spinal cord lesions, and discuss the value of DW magnetic resonance imaging (MRI) in distinguishing infarction (especially in the subacute stage) from inflammatory diseases and tumors of the spinal cord. ⋯ MRI is useful in detecting spinal cord infarction. DWI (especially multishot DWI) of the spinal cord may provide additional information for the assessment of ischemic changes and help improve in differentiating diagnosis.
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J Spinal Disord Tech · Jun 2005
The thoracolumbar injury severity score: a proposed treatment algorithm.
Significant controversy exists regarding the optimal management of thoracolumbar injuries. This is in part due to the lack of understanding of the natural history of various injury subtypes and the absence of a universally accepted classification scheme that facilitates communication among care providers and assists in directing treatment. The Spine Trauma Study Group has developed an injury severity score based on three major variables: the mechanism of injury determined by radiographic appearance, the integrity of the posterior ligamentous complex, and the neurologic status of the patient. By systematically assigning specific point values within each category based on the severity of injury, a final severity score may be generated that can be used to help direct treatment. The goal of this work is to present a proposal of a detailed treatment algorithm to assist in the nonoperative or operative management of thoracolumbar injuries. ⋯ The proposed treatment algorithm is an attempt to assist physicians using best-evidence medicine in managing thoracolumbar spinal injuries. The final point flow chart with graduated treatment recommendations is only preliminary and needs to be validated through prospective cohort analysis. In addition, the importance of the chosen variables determining spinal stability must also be verified.