Spine
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This anatomic study described robotic approaches to the posterior thoracolumbar spine in a porcine model. Ergonomics, control, and approach and technical difficulties were noted. ⋯ The da Vinci could perform the major noninstrumented procedures of the posterior spine with improved ergonomics and control. Surgeon fatigue and tremor were reduced. With some modification of prototype and commercial instruments a posterior spine surgery instrument kit can be developed. Future clinical studies can better assess patient and surgeon benefits of using the da Vinci robot for posterior spine surgeries.
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Comparative Study Clinical Trial
Comparative study of neck pain in relation to increase of cervical epidural pressure during percutaneous endoscopic lumbar discectomy.
A prospective study. ⋯ Neck pain occurring during PELD is associated with a highly increased cervical EP generated by continuous infusion.
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Case Reports
Management of traumatic cervical spondyloptosis in a neurologically intact patient: case report.
Case report. ⋯ Fractures of the posterior elements functionally decompress the spinal canal and thereby allow for cervical traction to be safely implemented in patients with spondyloptosis. Safe restoration of anatomic alignment in the neurologically intact spondyloptotic patient is crucial to minimize the extent of surgical stabilization and create a long-term stable construct of the fracture dislocation.
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Prospective cohort study of patients registered for elective surgical lumbar discectomy (ESLD) between November 1999 and December 2003 at a major tertiary care center in Vancouver. ⋯ These results provide evidence that, contrary to conventional wisdom, compensation status was not associated with longer waits for ESLD. While patients receiving compensation have elsewhere been observed to have worse outcomes after discectomy, our results suggest this is unlikely to be due to delays imposed by queuing.
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Analysis of magnetic resonance (MR) images of healthy volunteers. ⋯ MR imaging was successfully implemented as a noninvasive method for visualizing the synovial folds of the lateral atlantoaxial joints and quantifying their dimensions in healthy volunteers. The results of this study provide a basis for future studies investigating synovial fold pathology in patients with neck pain and headache.