Journal of spinal disorders & techniques
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J Spinal Disord Tech · Jun 2011
Comparative StudyRadiation exposure to the surgeon during percutaneous pedicle screw placement.
In-vitro radiation exposure study. ⋯ On the basis of this data, percutaneous pedicle screw placement seems to be safe. A surgeon would exceed occupational exposure limit for the eyes and extremities by placing 4854 and 6396 screws percutaneously, respectively. Lead protected against radiation exposure during screw placement. The "hands-off" technique used in this study is recommended to minimize radiation exposure. Lead aprons, thyroid shields, and leaded glasses are recommended for this procedure.
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J Spinal Disord Tech · Jun 2011
Comparative StudyAnalysis of measured D-dimer levels for detection of deep venous thrombosis and pulmonary embolism after spinal surgery.
A retrospective clinical study. ⋯ The D-dimer assay was useful in predicting DVT development. A D-dimer level of ≥10 μg/mL is considered to be a risk factor for thromboembolic disease after spinal surgery. False-positive cases of thromboembolic disease preclude the use of this assay as a stand-alone test for DVT diagnosis. CT venography and CT pulmonary angiography are recommended to confirm thromboembolic disease.
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J Spinal Disord Tech · Jun 2011
Comparative StudyDoes preoperative DVT chemoprophylaxis in spinal surgery affect the incidence of thromboembolic complications and spinal epidural hematomas?
Deep venous thrombosis (DVT) and pulmonary embolus (PE) remain common surgical complications, often affecting patients without any prior warning. Postoperative spinal epidural hematomas (SEH) may have a devastating impact on a patient's recovery from a routine procedure. The effect of preoperative DVT prophylaxis administration on elective spinal patients has not previously been studied. ⋯ Preoperative DVT prophylaxis does not influence the rate of postoperative DVT or PE among elective spinal patients. It probably does not influence SEH rate, and it is noted that SEH may present quite late, in contrast to currently accepted time courses.
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J Spinal Disord Tech · May 2011
Trajectory of transsacral iliac screw for lumbopelvic fixation: a 3-dimensional computed tomography study.
A 3-dimensional multi detector computed tomography study. ⋯ The TSIS could be safely inserted without increasing the general risk of conventional iliac screw. On the basis of the result of this study, we consider the TSIS technique a useful option for lumbopelvic fixation to overcome disadvantages of iliac screw.
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J Spinal Disord Tech · May 2011
Case ReportsTranspedicular drainage of presacral abscess and posterior decompression of acute cauda equina syndrome in caries spine: a case series of 3 patients.
We describe 3 patients with lumbosacral tuberculosis with epidural and presacral abscess who presented to us with acute cauda equina syndrome. A novel technique of draining the abscess and its results are described. ⋯ The transpedicular approach to the presacral region is a safer option compared with other approaches to reach this region. It simultaneously allows decompression of cauda equina nerve roots by laminotomy without changing the position of the patient in the theater. The key to success with this approach is early diagnosis and early treatment.