Studies in health technology and informatics
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A surgical classification of pediatric lumbosacral spondylolisthesis has been proposed recently. In this classification involving 8 distinct types of spondylolisthesis, the patient is classified according to: 1) the slip grade (low- vs. high-grade), 2) the degree of dysplasia (low- vs. high-dysplastic), and 3) the sagittal spinopelvic balance. The objective of this preliminary study is to assess the reliability of the classification. ⋯ The proposed classification could be used to better evaluate and compare available surgical techniques, and to develop a treatment algorithm for spondylolisthesis. This new classification results in good intra- and inter-observer agreement. Further studies with observers not involved in the design of the classification are however needed in order to confirm the relevance of the classification.
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Stud Health Technol Inform · Jan 2006
Zero-dose fluoroscopy-based close reduction and osteosynthesis of diaphyseal fracture of femurs.
This paper presents a novel technique to create a computerized fluoroscopy with zero-dose image updates for computer-assisted fluoroscopy-based close reduction and osteosynthesis of diaphyseal fracture of femurs. With the novel technique, repositioning of bone fragments during close fracture reduction will lead to image updates in each acquired imaging plane, which is equivalent to using several fluoroscopes simultaneously from different directions but without any X-ray radiation. Its application facilitates the whole fracture reduction and osteosynthesis procedure when combining with the existing leg length and antetorsion restoration methods and may result in great reduction of the X-ray radiation to the patient and to the surgical team. In this paper, we present the approach for achieving such a technique and the experimental results with plastic bones.
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Stud Health Technol Inform · Jan 2006
Timing of osteotomy for thoracolumabar or lumbar kyphosis secondary to ankylosing spondylitis.
Ankylosing spondylitis may lead to a rigid thoracolumbar kyphotic deformity. Several authors have reported the results of patients treated by a lumbar osteotomy, but there is no consensus on the level of the osteotomy and on timing of osteotomy. The purpose of this study is to explore timing of osteotomy for thoracolumabar or lumbar kyphosis secondary to ankylosing spondylitis by analyzing the natural history of 78 AS patients. ⋯ Lumbar pain arrests for more than 6 months (exclusive of mechanical pain of lumbar), normal blood sedimentation rate continues for two times, and reactive protein is negative. These factors must be considered in timing of osteotomy for thoracolumabar or lumbar kyphosis secondary to ankylosing spondylitis.
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Stud Health Technol Inform · Jan 2006
Variations of the position of the cerebellar tonsil in adolescent idiopathic scoliosis with severe curves: a MRI study.
This study is an investigation into the position of the cerebellar tonsils in AIS with severe curves and any relationship it has with age, sex, curve severity and curve pattern. Sagittal magnetic resonance imaging (MRI) of hindbrain was performed on both of 205 AIS patients with a Cobb angle greater than 40 degrees and 86 healthy controls. The position of the cerebellar tonsil relative to the line connecting the basion and opisthion (BO line) was measured. ⋯ However, a significant lower incidence of tonsillar ectopia (p=0.049) was found in patients with lumbar curves when compared to those with thoracic or thoracolumbar curves. In conclusion, there was a relatively lower position of the cerebellar tonsil together with a significant higher incidence of tonsil ectopia in AIS patients. There was a trend that tonsillar ectopia was more often in thoracic or thoraco-lumbar curves, suggesting that a lower position of the cerebellar tonsil may play an important role in the etiopathogenesis of AIS.
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Stud Health Technol Inform · Jan 2006
Artificial neural network versus subjective scoring in predicting mortality in trauma patients.
Current methods of trauma outcome prediction rely on clinical knowledge and experience. This makes the system a subjective score, because of intra-rater variability. This project aims to develop a neural network for predicting survival of trauma patients using standard, measured, physiological variables, and compare its predictive power with that obtained from current trauma scores. ⋯ An ANN developed using pre-hospital physiological variables without using subjective scores resulted in good mortality prediction when applied to a test set. Its performance was too sensitive and requires refinement.