European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society
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Instrumentation using the intraoperative O-arm navigation technique appears safer than its predecessor techniques. However, only a handful of surgeons often used navigation during spinal surgeries. Too many operative glitches and unreliable navigation accuracy were the important reasons cited even by experienced surgeons for not using spinal navigation. We have studied the accuracy of pedicle screw placement during the learning curve and beyond it. We have also discussed in detail the intricacies of the technique and solutions to the difficulties encountered using spinal navigation. ⋯ Surgeons should learn the correct principles of the technique of O-arm navigation to prevent the loss of accuracy and place pedicle screws with high accuracy. There is a learning curve of around 30-35 surgeries or 200 pedicle screw placements to acclimatize with the technique of O-arm navigation and learn its principles.
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To develop a deep learning (DL) model for epidural spinal cord compression (ESCC) on CT, which will aid earlier ESCC diagnosis for less experienced clinicians. ⋯ A deep learning model for the objective assessment of ESCC on CT had comparable or superior performance to radiologists and spine surgeons. Earlier diagnosis of ESCC on CT could reduce treatment delays, which are associated with poor outcomes, increased costs, and reduced survival.
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This study investigated the vertebral bone quality (VBQ) score as a potential tool for opportunistic osteoporosis screening and its correlation with dual-energy X-ray absorptiometry (DXA) values. ⋯ The study highlighted the potential of VBQ as a diagnostic tool for osteoporosis with high intra- and inter-observer reliability. The optimal VBQ threshold of 2.7 can aid in ruling out osteoporosis and identifying individuals for further evaluation.
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The decision to instrument to L5 or ilium, in NMS, is usually based on radiologic factors, including pelvic obliquity (PO) > 15°, apex of curvature < L3, and Cobb angle > 60°. Since scoliosis in these patients is caused by a neurologic disease, we based our decision to stop at L5 on the presence of spasticity or flaccidity. ⋯ The decision on instrumentation length should take flexibility and disease into consideration. If the trunk is centred over the pelvis, deterioration will not occur in absence of spasticity.
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The study aims to assess if the angle of trunk rotation (ATR) in combination with other readily measurable clinical parameters allows for effective non-invasive scoliosis screening. ⋯ Machine-learning-based classification models have the potential to effectively improve the non-invasive screening for AIS. The results of the study constitute the basis for the development of easy-to-use tools enabling physicians to decide whether to prescribe radiographic imaging.