Articles: surgery.
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Acta Neurochir. Suppl. · Jan 2005
Clinical TrialSurgical radio-frequency epiduroscopy technique (R-ResAblator) and FBSS treatment: preliminary evaluations.
Failed back surgery syndrome represents a heterogeneous situation that suggests a fibrosis or neuroinflammatory genesis. The social cost related to this issue are enormous. Several surgical techniques have been applied to FBSS patients with controversial effectiveness. In 1998 we evaluated the efficiency and limits of epiduroscopy treatment; it proved to be effective in 75% of cases, but in 45% of cases it needed to be repeated after 12 months. Therefore we subjected 14 patients, who had previously experienced a short temporary benefit by using a traditional epiduroscopic approach, to a new epiduroscopy fibrolysis using a radio-frequency device named "R-Resablator Epiduroscopy". Clinical evaluation was performed before myeloscopy and after 1-3-6 months. After myeloscopy, 93% of patients reported a general improvement. Among the latter, pain was reduced by 90% in 8 patients, by 60-70% in 5, and by less than 30% in 1. ⋯ It can be concluded that RF-Epiduroscopy offers greater therapeutic benefit than traditional epiduroscopy or other surgical techniques. Furthermore, RF-Epiduroscopy is more easily performed and repeated.
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Image guidance provides additional anatomic information to the surgeon, which may allow more accurate insertion of spinal implants. Imprecise placement of anterior thoracic screws places the spinal cord and paraspinal structures at risk for injury. Image guidance may afford a safety benefit to patients when anterior thoracic screws are required in the setting of spinal stabilization after trauma. ⋯ Spinal image-guidance systems may allow spine surgeons to place anterior thoracic screws more precisely, particularly in the axial plane. The improved accuracy of spinal implant insertion could ultimately provide a benefit to patient safety, especially in the setting of malaligned vertebral bodies after trauma.
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J Burn Care Rehabil · Jan 2005
Biography Historical ArticleBurns down under: lessons lost, lessons learned.
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Clinical Trial
Intraoperative Iso-C C-arm navigation in cervical spinal surgery: review of the first 52 cases.
Fifty-two study participants underwent cervical spine surgery using intraoperative Iso-C imaging with or without spinal navigation. ⋯ Iso-C intraoperative fluoroscopy is an accurate and rapid way to perform CT-quality image-guided navigation in cervical spinal surgery. In most cases, it obviates the need for postoperative imaging.
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Clinical Trial
Computer-assisted fluoroscopic navigation of pedicle screw insertion: an in vivo feasibility study.
Accurate placement of pedicle screws is difficult. ⋯ Using computer-assisted 2D fluoroscopic image navigation, it is possible to achieve reliable and accurate pedicle screw insertion during low thoracic and lumbar spinal surgery.