Articles: surgery.
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Comput. Aided Surg. · May 2008
Comparative StudyNavigated pedicle screw placement: experimental comparison between CT- and 3D fluoroscopy-based techniques.
Even with CT-based navigation, the misplacement rate for pedicle screws is reported to be as high as 10%. Using fluoroscopy-based 3D navigation, misplacement rates of 1.7 to 6% occur. The purpose of this study was to compare the accuracy of CT-based and Iso-C-based navigation in an experimental context. ⋯ The overall image-to-reality accuracy for CT- and Iso-C-based navigation was assessed in the described experimental setup. An apparent tendency towards higher accuracy with Iso-C-based navigation was evaluated; however, the differences were not significant.
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J. Oral Maxillofac. Surg. · May 2008
Facial trauma coverage among level-1 trauma centers of the United States.
A large portion of patients admitted to trauma centers present with isolated or concomitant facial injuries. Multiple surgical specialties including oral and maxillofacial, plastic, and otolaryngology/head and neck surgeons are trained and involved in the management of oral and maxillofacial trauma. The purpose of this study is to evaluate the current distribution of different specialties that cover facial trauma among the leading trauma centers in the United States. ⋯ Treatment of facial trauma is an essential and demanding aspect of all the surgical specialties that provide this service. All major trauma centers require the support of facial trauma specialists for management of these injuries. When considering the ratio of surgeons per specialty and the percentage of facial trauma coverage provided by each specialty, oral and maxillofacial surgeons and plastic surgeons provide the greatest proportion of facial trauma coverage among the level-1 trauma centers that participated in the survey.
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The primary goal of drilling procedures for the treatment of osteonecrotic lesions is revascularisation of the defect area. In the literature good results are reported for this technique in 70% of cases. Precise drilling of the necrosed area as part of a minimally invasive technique does, however, require unequivocal intraoperative identification of the region visually, either by arthroscopy or by fluoroscopy. ⋯ In future, we hope it will prove possible to transfer the image data back into the navigation system after they have been merged. At present this is only possible with CT and MRI images. A comparative clinical trial is needed to find to what extent the success rate is improved over that achieved with conventional techniques.