Articles: cations.
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The aim of this article to outline proposals for the use of high stakes technical performance assessments, defined as assessments of technical skill that take place outside of the operating theatre, across the continuum of surgical training. ⋯ High-stakes performance assessments can play an important role as part of a programmatic approach to surgical training and certification. They can and should be designed with an appropriate level of professional authenticity to ensure adequate and appropriate representation of the assessment construct.
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To investigate the incidence and risk factors of proximal junctional kyphosis (PJK), proximal junctional failure (PJF), and rod fractures in patients undergoing long-segment (≥4 levels) fusion surgery with anterior column realignment (ACR) for adult spinal deformity. ⋯ The incidence and risk factors of PJK, PJF, and rod fractures were similar to those observed in previous studies on long-segment fusion surgery without ACR. The number of ACR levels was not a significant risk factor for PJK, PJF, or rod fractures. When performing deformity correction using ACR, surgeons should carefully consider the direction of the UIV screw and ensure that overcorrection is avoided.
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Minerva anestesiologica · Sep 2024
Understanding the anatomy of pelvic fascia: implications for regional anesthesia.
The fascia, a continuous structure around the whole body across various anatomical locations, remains underexplored in regional anesthesia. The pelvic fascia is a particularly controversial and complicated anatomical structure. It holds significant relevance not only for surgeons but also in the realms of regional anesthesia and pain management. ⋯ A thorough understanding of pelvic fascia anatomy is crucial for understanding the potential pathways and barriers for spread of local anesthetics, enhancing analgesia, and minimizing side effects. Currently, a systematic discussion of pelvic fascia from the perspective of regional anesthesia and pain therapy is notably absent. This narrative review aims to consolidate knowledge on the anatomy of pelvic fascia pertinent to regional anesthesia and pain management, detailing relevant pelvic nerves, and associated peripheral nerve blocking techniques.