The spine journal : official journal of the North American Spine Society
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Low-dose aspirin for the prevention of cardiovascular disease is recommended to be discontinued at least 7 days before spinal surgery. ⋯ The intraoperative blood loss during spinal fusion surgery was similar in both groups. However, the blood drainage after surgery was significantly higher in the aspirin group despite stopping aspirin 7 days before surgery. Hence, surgeons should pay careful attention to postoperative blood loss and complications related to hemorrhage in patients who have been taking low-dose aspirin.
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Image navigation has improved the safety and ability to perform complex spinal procedures where visibility is not optimal or anatomic deformity is present. Numerous published studies are available demonstrating its effectiveness in improved pedicle screw placement in complex multiplanar deformities. Studies have also demonstrated image navigation technology versatility; however, stabilization of the lumbopelvic junction with navigated iliac bolt fixation has not been reported. ⋯ Image-navigated iliac fixation allows for safe and accurate placement of bilateral iliac bolts without PSIS percutaneous reference frame interference. Image guidance eliminates fluoroscopic radiation exposure and extensive soft-tissue dissection and facilitates both traditional and anatomic iliac bolt placement techniques.
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Minimally invasive approaches to the lumbar spine allow for pedicle screw placement through a muscle-splitting paraspinal approach. These techniques are highly dependent on fluoroscopy and do not allow for direct visualization of anatomic landmarks. The effect of this on the accuracy of pedicle screw placement is not well described. The purpose of this study was to evaluate the rate of violation of the superior segment facet joint and rates of cortical violation after minimally invasive pedicle screw placement. ⋯ This study revealed a low rate of superior segment facet violation and cortical violation after minimally invasive pedicle screw placement. This rate of superior-level facet involvement is significantly lower than previously reported after open procedures. The rate of cortical violation is similar to previous reports in the literature with a low revision rate.
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Comparative Study
Biomechanical analysis of occipitocervical stability afforded by three fixation techniques.
Occipital condyle screws appear to be a novel technique that demands biomechanical consideration. It has the potential to achieve fixation anterior to the axis of rotation while offering a point of fixation in line with the C1/C2 screws. ⋯ With instrumentation across the mobile OC junction, our results indicate that similar stability can be achieved with occipital condyle screws/eyelet screws compared with the standard occipitocervical plate/rod system.