Articles: surgery.
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J Bone Joint Surg Br · Apr 2007
Randomized Controlled TrialComputer navigation versus conventional total knee replacement: no difference in functional results at two years.
We previously compared the component alignment in total knee replacement using a computer-navigated technique with a conventional jig-based method. We randomly allocated 71 patients to undergo either computer-navigated or conventional replacement. An improved alignment was seen in the computer-navigated group. ⋯ At two years postoperatively, the frequency of mild to severe anterior pain was not significantly different (p = 0.818), varying between 44% (14) for the computer-navigated group, and 47% (14) for the conventionally-replaced group. The Bartlett Patellar score and the Oxford knee score were also not significantly different (t-test p = 0.161 and p = 0.607, respectively). The clinical outcome of the patients with a computer-navigated knee replacement appears to be no different to that of a more conventional jig-based technique at two years post-operatively, despite the better alignment achieved with computer-navigated surgery.
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Objectives. Spinal cord stimulation has been used extensively for failed back surgery syndrome, although dominant axial low back pain is difficult to treat effectively with this modality. The use of a surgically placed, double, quadripolar lead may result in better paresthesia of the low back, therefore enhancing outcomes in this difficult to treat population. Materials and Methods. Accordingly, this prospective study was designed to assess the effectiveness of placing such a lead at the T8-T10 level under general anesthesia without intraoperative testing for concordancy of paresthesia distribution. ⋯ The ability to lead a more active and social life was increased and 85% of patients said they would undergo spinal cord stimulation again. Placing the lead higher in the spinal canal (T8) resulted in a tendency for better paresthesia coverage of the low back when compared to lower lead placements. Conclusions. Placing a double quadripolar paddle lead under general anesthesia resulted in good clinical outcome similar to other implant techniques.
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J. Cardiovasc. Electrophysiol. · Apr 2007
Randomized Controlled TrialComputed tomography-fluoroscopy image integration-guided catheter ablation of atrial fibrillation.
This study examines the feasibility of atrial fibrillation (AF) ablation using registered three-dimensional computed tomography (CT) images of the left atrium with fluoroscopy. ⋯ CT-fluoroscopic-guided left atrial ablation is feasible and allows appropriate catheter manipulation in the left atrium.
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J Spinal Disord Tech · Apr 2007
Comparative StudyComputer-assisted spinal navigation versus serial radiography and operative time for posterior spinal fusion at L5-S1.
To review the operative time differences between computer-assisted spinal navigation versus serial radiography. ⋯ Image-guided spinal surgery did not cause an increase in operative time. In the best scenario, image navigation saved a statistically significant (P<0.001) amount of time in the operating room. At its worst, fluoroscopy-based image-guided navigation is not significantly different from standard serial radiography.
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Severe scoliosis in Rett syndrome is an important orthopedic, neurologic, and pediatric problem. The curve in Rett syndrome is of a neurologic type, has its highest incidence during early childhood, and shows rapid progression. In this study, the authors report the results of a 4-year follow-up of a 10-year-old Rett syndrome female patient with early onset and severe rapid progressive thoracolumbar scoliosis. ⋯ Operative treatment regimes and etiology of severe spinal deformities in Rett syndrome were discussed. The high perioperative risks in Rett syndrome patients who underwent spinal surgery may be reduced by an early cooperation between orthopedic and pediatric specialists. When considering recent data from literature, it can be concluded that an early correction of spine deformities in Rett syndrome patients may prevent a life-threatening collapsing spine syndrome.