Articles: surgery.
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Case Reports
Image-guided surgery in resection of benign cervicothoracic spinal tumors: a report of two cases.
Osseous spinal tumors are an uncommon cause of persistent axial pain and muscle spasm, but even benign lesions may grow to cause deformity or neurological signs. Traditional treatment approaches to resection can be debilitating even when the tumor is benign. ⋯ Image guidance can accurately localize and guide excision of benign vertebral lesions while minimizing soft tissue trauma and collateral damage, allowing patients a rapid and complete return to high-demand function.
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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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The lifetime prevalence of spinal pain has been reported as 54% to 80%, with as many as 60% of patients continuing to have chronic pain five years or longer after the initial episode. Spinal pain is associated with significant economic, societal, and health impact. Available evidence documents a wide degree of variance in the definition and the practice of interventional pain management. ⋯ These guidelines included the evaluation of evidence for diagnostic and therapeutic procedures in managing chronic spinal pain and recommendations for managing spinal pain. However, these guidelines do not constitute inflexible treatment recommendations. These guidelines do not represent "a standard of care".
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While both fluoroscopic and CT-guidance during cervical nerve root blocks have been well documented in the literature, the use of CT fluoroscopy (CTF) has not. CTF is well suited to provide imaging guidance during these procedures due to its combination of excellent anatomic detail, relatively low radiation dose and the ability to perform an initial dynamic contrast injection, and is a viable alternative to fluoroscopic guidance. Details of the technique along with the initial experience at one institution are presented.