Eur J Trauma Emerg S
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Eur J Trauma Emerg S · Apr 2011
Accuracy of CT-assisted pedicle screw placement after CT-controlled, presurgical guide wire implantation in traumatic and pathological fractures in the thoracic spine.
The aim of this study was to evaluate the accuracy of pedicle screw placement after computed tomography (CT)-assisted positioning of guide wires and subsequent insertion of transpedicular screws in particularly narrow pedicles in the thoracic spine. Transpedicular pedicle screw placement has been commonly used for a number of decades. However, a significant number of malpositioned screws still occur, especially in the thoracic spine, potentially correlating with relevant complications, e.g., neurological deterioration. ⋯ The CT-assisted pedicle screw implantation procedure using guide wires implanted prior to surgery is an accurate, reliable, and safe method for dorsal spondylodesis in the treatment of a variety of spinal instabilities, including fractures, tumors, and infections.
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Polytrauma patients usually suffer from both life-threatening injuries, where early intervention is mandatory in order to prevent mortality from uncontrollable haemorrhage-especially during the "golden hour", and secondary injuries of lower priority which receive delayed referral or treatment. Non-life-threatening injuries can sometimes be overlooked and so remain untreated until a much later stage. The aim of this study was to investigate the incidence of eye (ocular and orbital) injuries in polytrauma (injury severity score >15) patients and describe their complexities and outcomes. ⋯ Polytrauma patients are at high risk for vision-threatening injuries, and an early multidisciplinary approach is essential for early detection and treatment.
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Eur J Trauma Emerg S · Apr 2011
Anterior column reconstruction in thoracolumbar injuries utilizing a computer-assisted navigation system.
Discectomy, corpectomy, and resection of isolated posterior wall fragments are technically demanding steps requiring maximum surgical precision during anterior reconstruction of the unstable thoracolumbar spine. ⋯ Computer-aided guidance in anterior reconstruction of the thoracolumbar spine is a technically feasible option that may aid in the performance of disc- and corpectomy, as well as the resection of isolated posterior wall fragments in cases with initial neurological compromise. However, total time for surgery is significantly prolongated by this technique. There were no differences in the precision of cage positioning between groups. However, during discectomy, the use of computer navigation may aid in the protection of adjacent endplates, as there was a trend towards fewer cases with cage subsidence in the navigated group.
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Eur J Trauma Emerg S · Apr 2011
3D-based navigation in posterior stabilisations of the cervical and thoracic spine: problems and benefits. Results of 451 screws.
Navigated procedures in spinal surgery have been established due to an increasing demand for precision. Especially, 3D C-arms connected to navigation systems are being used more often and can be utilised intraoperatively for the planning and controlling of screw positions. This prospective study analyses our experiences with 3D-based navigation in posterior stabilisations in the cervical and thoracic spine. ⋯ Intraoperative 3D imaging navigation for posterior spinal stabilisations is technically feasible and reliable in clinical use. The image quality depends on the individual bone density. With undisturbed visibility of the vertebral body, the reliability of 3D-based navigation is comparable to that of CT-based procedures. Additionally, it has the advantage of skipping the preoperative acquisition of data as well as the matching process, with reduced radiation doses.
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Eur J Trauma Emerg S · Apr 2011
Doppler ultrasound for the assessment of conservatively treated blunt splenic injuries: a prospective study.
The type and need for follow-up of non-operatively managed blunt splenic injuries remain controversial. The use of Doppler ultrasound to identify post-traumatic splenic pseudoaneurysms, considered to be the main cause of "delayed" splenic rupture, has not been well described. ⋯ Doppler ultrasound can be an effective and a safe noninvasive modality for evaluation and follow-up of patients with blunt splenic injury. The utility and cost-effectiveness of routine surveillance requires further study.