Liver Pain Liver pain is a common clinical occurrence, but it is often poorly diagnosed and treated. The liver can serve as a source of pain in and of itself through the sympathetic nervous system and via referred pain secondary to peritoneal irritation through the intercostal and subcostal nerves. Pain that emanates from the liver …
Foix Alajouanine Syndrome Foix Alajouanine syndrome is an uncommon cause of lower thoracic and lumbosacral pain. It is caused by an arteriovenous malformation of the lower thoracic and lumbosacral spinal cord, with the grey matter of the spinal cord more severely compromised when compared with the white matter. Also known as subacute necrotizing myelopathy, angiodysgenetic …
Ankylosing Spondylitis Ankylosing spondylitis is an inflammatory disease of the spine, sacroiliac joints, and occasionally extra-articular structures, including the eye. It also is known as Marie Strumpell disease. The cause of ankylosing spondylitis is unknown, but autoimmune-mediated mechanisms and environmental factors such as alterations in gut microbiota have been implicated. Approximately 90% of patients with …
What is the standard workflow for spinal CT navigation? • Patient setup • Exposure • Reference frame placement • Intraoperative image acquisition (CT spin) • Calibration of instruments • Navigated screw placement (point-drill-tap-screw) • Decompression, cage placement (if necessary) • Rod measurement and placement • Additional CT spins may be required when anatomy is altered, for multilevel implant constructs, or to confirm implant placement
How is the workflow for CT navigation different from other imaging modalities such as fluoroscopy? CT navigation in spinal surgery is a high-demand technologic advancement for the delivery of instrumentation. It relies heavily on input from multiple disciplines (radiology, anesthesia and nursing staff, surgical technologists, navigation technologists) to successfully implement image guidance in the operative …
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What are the current indications for use of spinal navigation? Spinal navigation was initially used to guide placement of pedicle screws in the thoracic and lumbar regions. Subsequently, use of spinal navigation has expanded to all types of spinal surgery including cervical instrumentation, iliac and S2 alar-iliac screw placement, transoral procedures, spinal deformity surgery, revision …
How is pedicle screw instrumentation accuracy measured? Accuracy rates of pedicle screw placement are commonly reported based on whether pedicle screws are located entirely within the pedicle. The amount of pedicle breach is commonly measured in millimeters and graded from A to E according to the Gertzbein-Robbins classification: Grade A (0 mm breach), B (<2 mm), C …
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