scholarly journals Lumbar hemivertebra resection in congenital scoliosis utilizing cone-beam navigation: less radiation, more accuracy—proof of concept

2021 ◽  
Author(s):  
Christian Fisahn ◽  
Chris Lindemann ◽  
Brittni Burgess ◽  
Patrick Strube ◽  
Timo Zippelius
Keyword(s):  
Cobb Angle ◽  
Radiation Exposure ◽  
Congenital Scoliosis ◽  
Cone Beam ◽  
Pediatric Case ◽  
Case Presentation ◽  
Hemivertebra Resection ◽  
Preoperative Ct ◽  
Whole Spine ◽  
Spine Mri

Abstract Purpose To present the first known pediatric utilization of cone-beam navigation system (CBNS) for hemivertebra resection and spondylodesis Case presentation A 14-year-old female with congenital scoliosis, diagnosed at 8 years of age, presenting with progressive symptoms, a Cobb angle (L3-5) of 38° at time of surgery, treated historically with conservative measures. Presence of spinal intramedullary disease was excluded prior to operation via whole spine MRI. Results Patient successfully underwent surgical correction utilizing the CBNS (O-arm™, Medtronic®). Post-operative Cobb angle (L3-5) was restored to 8°. Following four different pediatric patient’s radiation exposures (two receiving correction via the O-arm platform and two via the traditional method employing fluoroscopy), we show a reduction in radiation exposure using the CBNS system. Conclusion We present the first known pediatric case of the utilization of the CBNS system for hemivertebra correction. We demonstrate that utilizing the CBNS platform can not only increase surgical accuracy but also decrease pediatric patient’s radiation exposure as a preoperative CT scan is not needed. Future studies should continue to explore additional benefits of implementing the system into surgical practice.

scholarly journals Posterior hemivertebra resection and monosegmental fusion in the treatment of congenital scoliosis

2014 ◽  
Vol 96 (1) ◽  
pp. 41-44 ◽  
Author(s):  
X Zhu ◽  
X Wei ◽  
J Chen ◽  
C Li ◽  
M Li ◽  
...  
Keyword(s):  
Cobb Angle ◽  
Sagittal Plane ◽  
Congenital Scoliosis ◽  
Coronal Plane ◽  
X Ray ◽  
Hemivertebra Resection ◽  
The Mean ◽  
Whole Spine

INTRODUCTION Posterior hemivertebra resection combined with multisegmental or bisegmental fusion has been applied successfully for congenital scoliosis. However, there are several immature bones and their growth can be influenced by long segmental fusion in congenital patients. Posterior hemivertebra resection and monosegmental fusion was therefore suggested for treatment of congenital scoliosis caused by hemivertebra. METHODS Between June 2001 and June 2010, 60 congenital scoliosis patients (aged 2–18 years) who underwent posterior hemivertebra resection and monosegmental fusion were enrolled in our study. A standing anteroposterior x-ray of the whole spine was obtained preoperatively, postoperatively and at the last follow-up appointment to analyse the Cobb angle in the coronal and sagittal planes as well as the trunk shift. RESULTS The mean preoperative coronal plane Cobb angle was 41.6°. This was corrected to 5.1° postoperatively and 5.3° at the last follow-up visit (correction 87.3%). The compensatory cranial curve was improved from 18.1° preoperatively to 7.1° postoperatively and 6.5° at the last follow-up visit while the compensatory caudal curve was improved from 21.5° to 6.1° after surgery and 5.6° at the last follow-up visit. The mean sagittal plane Cobb angle was 23.3° before surgery, 7.3° after surgery and 6.8° at the last follow-up visit (correction 70.1%). The trunk shift of 18.5mm was improved to 15.2mm. CONCLUSIONS Posterior hemivertebra resection and monosegmental fusion seems to be an effective approach for treatment of congenital scoliosis caused by hemivertebra, allowing for excellent correction in both the frontal and sagittal planes.

scholarly journals Application of 3D tooth model for monitoring of implant space and inter-root distance without radiographs: a proof of concept study

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Kyungmin Lee ◽  
Gyu-Hyoung Lee
Keyword(s):  
Computed Tomography ◽  
Radiation Exposure ◽  
Cone Beam Computed Tomography ◽  
Alveolar Bone ◽  
Tooth Movement ◽  
Treatment Evaluation ◽  
Cone Beam ◽  
Proof Of Concept ◽  
Cbct Image ◽  
Root Position

Abstract Background Radiographs are integral in evaluating implant space and inter-root distance. The purpose of this report is to introduce a method for evaluating the 3D root position with minimal radiation using a 3D tooth model composed of an intraoral-scanned crown and a cone-beam computed tomography (CBCT)-scanned root. Materials and methods Intraoral scan and CBCT scan of the patient were obtained before treatment. In the CBCT image, tooth segmentation was performed by isolating individual teeth from the maxillary and mandibular alveolar bone using software program. The 3D tooth model was fabricated by combining segmented individual teeth with the intraoral scan. Results A post-treatment intraoral scan was integrated into the tooth model, and the resulting position of the root could be predicted without additional radiographs. It is possible to monitor the root position after a pretreatment CBCT scan using a 3D tooth model without additional radiographs. Conclusion The application of the 3D tooth model benefits the patient by reducing repeated radiation exposure while providing the clinician with a precise treatment evaluation to monitor tooth movement.

scholarly journals Posterior thoracolumbar hemivertebra resection and short-segment fusion in congenital scoliosis: surgical outcomes and complications with more than 5-year follow-up

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Beixi Bao ◽  
Qingjun Su ◽  
Yong Hai ◽  
Peng Yin ◽  
Yaoshen Zhang ◽  
...  
Keyword(s):  
Pedicle Screw ◽  
Surgical Outcomes ◽  
Screw Fixation ◽  
Congenital Scoliosis ◽  
Pedicle Screw Fixation ◽  
Rigid Fixation ◽  
Short Segment ◽  
Hemivertebra Resection ◽  
Main Curve

Abstract Background Treatment of congenital hemivertebra is challenging and data on long-term follow-up (≥ 5 years) are lacking. This study evaluated the surgical outcomes of posterior thoracolumbar hemivertebra resection and short-segment fusion with pedicle screw fixation for treatment of congenital scoliosis with over 5-year follow-up. Methods This study evaluated 27 consecutive patients with congenital scoliosis who underwent posterior thoracolumbar hemivertebra resection and short-segment fusion from January 2007 to January 2015. Segmental scoliosis, total main scoliosis, compensatory cranial curve, compensatory caudal curve, trunk shift, shoulder balance, segmental kyphosis, and sagittal balance were measured on radiographs. Radiographic outcomes and all intraoperative and postoperative complications were recorded. Results The segmental main curve was 40.35° preoperatively, 11.94° postoperatively, and 13.24° at final follow-up, with an average correction of 65.9%. The total main curve was 43.39° preoperatively, 14.13° postoperatively, and 16.06° at final follow-up, with an average correction of 60.2%. The caudal and cranial compensatory curves were corrected from 15.78° and 13.21° to 3.57° and 6.83° postoperatively and 4.38° and 7.65° at final follow-up, with an average correction of 69.2% and 30.3%, respectively. The segmental kyphosis was corrected from 34.30° to 15.88° postoperatively and 15.12° at final follow-up, with an average correction of 61.9%. A significant correction (p < 0.001) in segmental scoliosis, total main curve, caudal compensatory curves and segmental kyphosis was observed from preoperative to the final follow-up. The correction in the compensatory cranial curve was significant between preoperative and postoperative and 2-year follow-up (p < 0.001), but a statistically significant difference was not observed between the preoperative and final follow-up (p > 0.001). There were two implant migrations, two postoperative curve progressions, five cases of proximal junctional kyphosis, and four cases of adding-on phenomena. Conclusion Posterior thoracolumbar hemivertebra resection after short-segment fusion with pedicle screw fixation in congenital scoliosis is a safe and effective method for treatment and can achieve rigid fixation and deformity correction.

Multilevel non-contiguous spinal injuries: incidence and patterns based on whole spine MRI

2015 ◽  
Vol 25 (4) ◽  
pp. 1163-1169 ◽  
Author(s):  
Rishi Mugesh Kanna ◽  
Chandrasekar V. Gaike ◽  
Anupama Mahesh ◽  
Ajoy Prasad Shetty ◽  
S. Rajasekaran
Keyword(s):  
Spinal Injuries ◽  
Whole Spine ◽  
Spine Mri

scholarly journals Misdiagnosis and Mismanagement of an Infectious Impacted Canine: A Case Presentation

2021 ◽  
Vol 16 (3) ◽  
Author(s):  
Alireza Navabazam ◽  
Somayyeh Ebrahimi ◽  
Hadi Noori
Keyword(s):  
Nasal Congestion ◽  
Maxillofacial Surgery ◽  
Acute Bronchitis ◽  
Response To Treatment ◽  
Cone Beam ◽  
Oral And Maxillofacial Surgery ◽  
Case Presentation ◽  
Tooth Impaction ◽  
Impacted Canine ◽  
The Face

: Tooth impaction is defined as a partial or complete eruption of a tooth regarding the eruption time. Hereby, we present an infectious canine in a 38-year-old man that primarily presented with chest pain and dyspnea. After two days, he demonstrated a painful swelling and erythema of the face, severe perspiration, nasal congestion, and pleural effusion. The patient was diagnosed with acute bronchitis, mucormycosis, and nasal septum abscess, leading to unnecessary antibiotic therapy and lack of treatment response. After oral and maxillofacial surgery consultation, cone-beam computed tomography (CBCT) revealed an impacted and infectious canine that was surgically extracted. Due to lack of desired response to treatment, he underwent CBCT after oral and maxillofacial surgery consultation. An impacted and infectious canine was detected, which was surgically extracted. Three days later, his symptoms significantly improved, and he was discharged with a stable general condition.

Radiation Exposure During Transarterial Chemoembolization: Angio-CT Versus Cone-Beam CT

2019 ◽  
Vol 42 (11) ◽  
pp. 1609-1618 ◽  
Author(s):  
Lauranne Piron ◽  
Julien Le Roy ◽  
Christophe Cassinotto ◽  
Julien Delicque ◽  
Ali Belgour ◽  
...  
Keyword(s):  
Radiation Exposure ◽  
Transarterial Chemoembolization ◽  
Cone Beam Ct ◽  
Cone Beam ◽  
Angio Ct

Spine Metastasis of Thymic Carcinoma in a Pediatric Patient: A Case Report and Comprehensive Literature Review

2020 ◽  
Vol 55 (5) ◽  
pp. 289-294
Author(s):  
Kadir Oktay ◽  
Ebru Guzel ◽  
Okay Baykara ◽  
Mevlana Akbaba ◽  
Ibrahim Sari ◽  
...  
Keyword(s):  
Pediatric Patients ◽  
Thymic Carcinoma ◽  
Tumor Resection ◽  
Treatment Protocol ◽  
Spinal Column ◽  
Spinal Instability ◽  
Pediatric Case ◽  
Case Presentation ◽  
Intrathoracic Tumor ◽  
History Of

<b><i>Introduction:</i></b> Thymic carcinoma metastases of the spinal column are very rare, especially in pediatric patients. To our knowledge, this is the first such pediatric case in the literature. <b><i>Case Presentation:</i></b> We report the case of a 14-year-old male patient with T12 and L1 metastases of thymic carcinoma. He had history of thymectomy and intrathoracic tumor resection 7 months previously. The patient’s neurological condition deteriorated; therefore, tumor resection and decompression of the spinal canal were performed. He underwent instrumentation and fusion procedures to prevent spinal instability. <b><i>Conclusion:</i></b> The main purpose of the treatment is gross total resection of the thymic carcinoma. However, adjuvant methods such as radiotherapy and chemotherapy should be added to the treatment protocol in patients who have higher stage diseases or those in whom total tumor resection cannot be achieved.

scholarly journals Patient Knowledge Regarding Radiation Exposure from Orthopaedic Foot and Ankle Imaging

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0015
Author(s):  
Daniel Bohl ◽  
Blaine Manning ◽  
George Holmes ◽  
Simon Lee ◽  
Johnny Lin ◽  
...  
Keyword(s):  
Ionizing Radiation ◽  
Ct Scan ◽  
Radiation Exposure ◽  
Cone Beam Ct ◽  
Plain Film ◽  
Ct Scans ◽  
Cone Beam ◽  
X Rays ◽  
Foot And Ankle ◽  
X Ray

Category: Other Introduction/Purpose: Foot and ankle surgeons routinely prescribe diagnostic imaging that exposes patients to potentially harmful ionizing radiation. The purpose of this study is to characterize patients’ knowledge regarding radiation exposure associated with common forms of foot and ankle imaging. Methods: A survey was administered to all new patients prior to their first foot and ankle clinic appointments. Patients were asked to compare the amount of harmful radiation associated with chest x-rays to that associated with various types of foot and ankle imaging. Results were tabulated and compared to actual values of radiation exposure from the published literature. Results: A total of 890 patients were invited to participate, of whom 791 (88.9%) completed the survey. The majority of patients believed that a foot x-ray, an ankle x-ray, a “low dose” CT scan of the foot and ankle (alluding to cone-beam CT), and a traditional CT scan of the foot and ankle all contain similar amounts of harmful ionizing radiation to a chest x-ray (Table 1). This is in contrast to the published literature, which suggests that foot x-rays, ankle x-rays, cone beam CT scans of the foot and ankle, and traditional CT scans of the foot and ankle expose patients to 0.006, 0.006, 0.127, and 0.833 chest x-rays worth of radiation. Conclusion: The results of the present study suggest that patients greatly over-estimate the amount of harmful ionizing radiation associated with plain film and cone-beam CT scans of the foot and ankle. Interestingly, their estimates of radiation associated with traditional CT scans of the foot and ankle were relatively accurate. Results suggest that patients may benefit from increased counseling by surgeons regarding the relatively low risk of radiation exposure associated with plain film and cone-beam CT imaging of the foot and ankle.

scholarly journals EVALUATION OF THE VEPTR SYSTEM IN THE MANAGEMENT OF SPINAL DEFORMITIES BETWEEN 2008 AND 2014 AT THE ROOSEVELT INSTITUTE

2018 ◽  
Vol 17 (4) ◽  
pp. 266-269
Author(s):  
Carlos Segundo Montero ◽  
David Meneses ◽  
Fernando Alvarado ◽  
Wilmer Godoy ◽  
Maria Margarita Acosta ◽  
...  
Keyword(s):  
Cobb Angle ◽  
Early Onset ◽  
Case Series ◽  
Deformity Correction ◽  
Congenital Scoliosis ◽  
Neuromuscular Scoliosis ◽  
Three Dimensions ◽  
Thoracic Wall ◽  
Level Of Evidence ◽  
Radiographic Images

ABSTRACT Objective: Traditional surgical treatments, such as on-site fusion and hemiepiphysiodesis, have not addressed chest deformity in its three dimensions, and are usually insufficient and unpredictable for the management of congenital and neuromuscular scoliosis. The application of the Vertical Expandable Prosthetic Titanium Rib (VEPTR) is a technique developed to treat early-onset progressive scoliosis that elongates the spine and thoracic wall, allowing adequate lung development. Methods: A case series retrospective study was conducted. We included 23 patients, including fifteen females and eight males diagnosed with congenital and neuromuscular scoliosis, who were treated with VEPTR type implants between January 2008 and May 2014. We obtained data about the implant and pre and postoperative radiographic images to assess the magnitude of the curve, and we measured the Cobb angle and length after lengthening, as well as evaluating the complications found. Results: There was an improvement in the postoperative Cobb angle. In patients with congenital scoliosis, deformity correction was 8.6% (p=0.014), and in neuromuscular scoliosis, we observed deformity correction of 19.5% (p=0.009). Likewise, we found gains in thoracic height through the device, which results in an average 10% lengthening of the spine in congenital scoliosis. In this study, we identified complications such as material migrations, rib synostosis, pressure zones, rib fracture, hemothorax, and deep wound infection. Conclusion: The natural history of progressive spinal deformity was improved in most of the minors, through the use of VEPTR. This allows us to continue managing patients in the future, in order to make a deeper assessment of its performance in treatment of early onset scoliosis. Level of Evidence III; Therapeutic studies - Investigating the results of a treatment.

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