Pelvic incidence change on the operating table

2021 ◽  
Author(s):  
Junichi Ohya ◽  
Naohiro Kawamura ◽  
Eiji Takasawa ◽  
Yuki Onishi ◽  
Nozomu Ohtomo ◽  
...  
Keyword(s):  
Pelvic Incidence ◽  
Operating Table

The impact of increasing interbody fusion levels at the fractional curve on lordosis, curve correction, and complications in adult patients with scoliosis

2020 ◽  
pp. 1-10
Author(s):  
Dominic Amara ◽  
Praveen V. Mummaneni ◽  
Shane Burch ◽  
Vedat Deviren ◽  
Christopher P. Ames ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Revision Surgery ◽  
Lumbar Lordosis ◽  
Interbody Fusion ◽  
Pelvic Incidence ◽  
Secondary Analysis ◽  
Lumbar Interbody Fusion ◽  
Curve Correction ◽  
Surgery Rates

OBJECTIVERadiculopathy from the fractional curve, usually from L3 to S1, can create severe disability. However, treatment methods of the curve vary. The authors evaluated the effect of adding more levels of interbody fusion during treatment of the fractional curve.METHODSA single-institution retrospective review of adult patients treated for scoliosis between 2006 and 2016 was performed. Inclusion criteria were as follows: fractional curves from L3 to S1 > 10°, ipsilateral radicular symptoms concordant on the fractional curve concavity side, patients who underwent at least 1 interbody fusion at the level of the fractional curve, and a minimum 1-year follow-up. Primary outcomes included changes in fractional curve correction, lumbar lordosis change, pelvic incidence − lumbar lordosis mismatch change, scoliosis major curve correction, and rates of revision surgery and postoperative complications. Secondary analysis compared the same outcomes among patients undergoing posterior, anterior, and lateral approaches for their interbody fusion.RESULTSA total of 78 patients were included. There were no significant differences in age, sex, BMI, prior surgery, fractional curve degree, pelvic tilt, pelvic incidence, pelvic incidence − lumbar lordosis mismatch, sagittal vertical axis, coronal balance, scoliotic curve magnitude, proportion of patients undergoing an osteotomy, or average number of levels fused among the groups. The mean follow-up was 35.8 months (range 12–150 months). Patients undergoing more levels of interbody fusion had more fractional curve correction (7.4° vs 12.3° vs 12.1° for 1, 2, and 3 levels; p = 0.009); greater increase in lumbar lordosis (−1.8° vs 6.2° vs 13.7°, p = 0.003); and more scoliosis major curve correction (13.0° vs 13.7° vs 24.4°, p = 0.01). There were no statistically significant differences among the groups with regard to postoperative complications (overall rate 47.4%, p = 0.85) or need for revision surgery (overall rate 30.7%, p = 0.25). In the secondary analysis, patients undergoing anterior lumbar interbody fusion (ALIF) had a greater increase in lumbar lordosis (9.1° vs −0.87° for ALIF vs transforaminal lumbar interbody fusion [TLIF], p = 0.028), but also higher revision surgery rates unrelated to adjacent-segment pathology (25% vs 4.3%, p = 0.046). Higher ALIF revision surgery rates were driven by rod fracture in the majority (55%) of cases.CONCLUSIONSMore levels of interbody fusion resulted in increased lordosis, scoliosis curve correction, and fractional curve correction. However, additional levels of interbody fusion up to 3 levels did not result in more postoperative complications or morbidity. ALIF resulted in a greater lumbar lordosis increase than TLIF, but ALIF had higher revision surgery rates.

Operating table failure and suggested safety precautions

2009 ◽  
Vol 23 (4) ◽  
pp. 641-642
Author(s):  
Hiroyuki Kinoshita ◽  
Mamoru Kawakami ◽  
Toshiyuki Minonishi ◽  
Yoshio Hatano
Keyword(s):  
Operating Table

scholarly journals The Level of Conus Medullaris in 629 Healthy Japanese Individuals

2021 ◽  
Vol 10 (14) ◽  
pp. 3182
Author(s):  
Hiroaki Nakashima ◽  
Keigo Ito ◽  
Yoshito Katayama ◽  
Mikito Tsushima ◽  
Kei Ando ◽  
...  
Keyword(s):  
Regression Analysis ◽  
Magnetic Resonance ◽  
Pelvic Tilt ◽  
Pelvic Incidence ◽  
Multivariate Regression Analysis ◽  
Conus Medullaris ◽  
Magnetic Resonance Images ◽  
Factors Affecting ◽  
Adult Volunteers ◽  
Significant Factors

The conus medullaris typically terminates at the L1 level; however, variations in its level and the factors associated with the conus medullaris level are unclear. We investigated the level of conus medullaris on magnetic resonance imaging in healthy volunteers. In total, 629 healthy adult volunteers (≥50 individuals of each sex and in each decade of age from 20 to 70) were enrolled. The level of the conus medullaris was assessed based on the T2-weighted sagittal magnetic resonance images, and factors affecting its level were investigated employing multivariate regression analysis including the participants’ background and radiographical parameters. L1 was the most common conus medullaris level. Participant height was significantly shorter in the caudally placed conus medullaris (p = 0.013). With respect to the radiographical parameters, pelvic incidence (p = 0.003), and pelvic tilt (p = 0.03) were significantly smaller in participants with a caudally placed conus medullaris. Multiple regression analysis showed that the pelvic incidence (p < 0.0001) and height (p < 0.0001) were significant factors affecting the conus medullaris level. These results indicated that the length of the spinal cord varies little among individuals and that skeletal differences affect the level of the conus medullaris.

scholarly journals The Pelvic Incidence Stratified Sagittal Spinopelvic Alignment in Asymptomatic Chinese Population With Different Age Groups

2021 ◽  
pp. 219256822198964
Author(s):  
Siyu Zhou ◽  
Zhuoran Sun ◽  
Wei Li ◽  
Da Zou ◽  
Weishi Li
Keyword(s):  
Chinese Population ◽  
Pelvic Incidence ◽  
Sagittal Alignment ◽  
Age Groups ◽  
Vertical Axis ◽  
Elderly Subjects ◽  
Sagittal Vertical Axis ◽  
Cross Sectional ◽  
Sagittal Parameters ◽  
Very High

Study Design: Cross-sectional study. Objective: To provide the age- and pelvic incidence-related variations of sagittal alignment in asymptomatic Chinese population. Methods: This study recruited asymptomatic adult subjects. All subjects undertook the standing whole spinal radiograph and the sagittal parameters were measured: sagittal vertical axis (SVA), T1 pelvic angle (TPA), lumbar lordosis (LL), thoracic kyphosis (TK), pelvic incidence (PI) and pelvic tilt (PT). All subjects were divided into young, middle aged and elderly groups, then each age group was further divided into 5 subgroups (very low, low, average, high and very high) based on PI values. The relations between PI, age and other parameters were evaluated. The differences in sagittal parameters of each PI subgroup were compared. Results: 546 subjects were included with an average age of 38.6 years (18 to 81). The number of subjects over 70 years and with very low PI was relatively small. The average of PI, TPA, PT and LL were 45.9° ± 8.4°, 6.4° ± 6.2°, 11.9° ± 6.6° and 49.2° ± 10.1°, respectively. SVA, TPA, TK and PT increased with age ( P < 0.05), while SVA, TPA, PT, PI-LL also increased with PI ( P < 0.05). LL, PT, TPA, PI-LL and LL-TK were different among the 5 PI subgroups ( P < 0.05). However, the values of LL in elderly subjects with high and very high PI were similar. Conclusion: The age- and PI-related variations in sagittal alignment of Chinese population were provided. The sagittal parameters were significantly influenced by age and PI. The individual pelvic morphology should be carefully considered during the assessment and restoration of sagittal balance.

scholarly journals Characteristics of the spinopelvic parameters of patients with sacroiliac joint pain

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Juichi Tonosu ◽  
Hiroyuki Oka ◽  
Kenichi Watanabe ◽  
Hiroaki Abe ◽  
Akiro Higashikawa ◽  
...  
Keyword(s):  
Sacroiliac Joint ◽  
Joint Pain ◽  
Pelvic Incidence ◽  
Demographic Characteristics ◽  
Sacral Slope ◽  
Low Back ◽  
Spinopelvic Parameters ◽  
Sacroiliac Joint Pain ◽  
Physical Findings ◽  
Univariate Analyses

AbstractTo evaluate the characteristics of the spinopelvic parameters on radiography in patients with sacroiliac joint pain (SIJP). Two hundred fifty patients were included and divided into the SIJP group (those diagnosed with SIJP based on physical findings and response to analgesic periarticular injections; n = 53) and the non-SIJP group (those with low back pain [LBP] because of other reasons; n = 197). We compared their demographic characteristics and spinopelvic parameters using radiography. All differences found in the patients’ demographic characteristics and spinopelvic parameters were analyzed. More female participants experienced SIJP than male participants (P = 0.0179). Univariate analyses revealed significant differences in pelvic incidence (PI) (P = 0.0122), sacral slope (SS) (P = 0.0034), and lumbar lordosis (LL) (P = 0.0078) between the groups. The detection powers for PI, SS, and LL were 0.71, 0.84, and 0.66, respectively. Logistic regression analyses, after adjustment for age and sex, revealed significant differences in PI (P = 0.0308) and SS (P = 0.0153) between the groups, with odds ratios of 1.03 and 1.05, respectively. More female participants experienced SIJP than male participants. Higher PI and SS values were related to SIJP among LBP patients.

scholarly journals Operating Room Fomites as Potential Sources for Microbial Transmission in Burns Theatres

2021 ◽  
Vol 2 (1) ◽  
pp. 1-8
Author(s):  
Mariam Rela ◽  
Sophia Opel ◽  
Sarah Williams ◽  
Declan P. Collins ◽  
Kevin Martin ◽  
...  
Keyword(s):  
Bacterial Contamination ◽  
Point Of Care ◽  
Enterobacter Cloacae ◽  
Operating Table ◽  
Healthcare Associated Infections ◽  
Burn Patients ◽  
Degree Of Contamination ◽  
First Case ◽  
Bacterial Transmission ◽  
Healthcare Associated

Background: Burn patients are susceptible to healthcare-associated infections. Contaminated surfaces play a role in microbial transmission. This study aimed to quantify the degree of contamination of burns theatre fomites during routine clinical use. Methods: The Patslide Patient Transfer Board (PAT slide) and operating table were investigated using two methods—bacterial swabs to culture viable organisms and adenosine triphosphate (ATP) swabs to measure biological material. Both items were sampled four times a day: before the first case, immediately after a case, immediately before the next case after cleaning and after the terminal clean. Results: Among 82 bacterial samples, four organisms were isolated, including Staphylococcus aureus, Enterobacter cloacae (E. cloacae) x2 and Pseudomonas aeruginosa (P. aeruginosa), all from the PAT slide. The E. cloacae persisted after cleaning. In 9/82 swabs, the ATP count was >10 relative light units (RLU). In all cases where an organism was identified, the ATP count was >10 RLU. Hence the sensitivity and specificity of ATP > 10 RLU in detecting an organism were 100% and 94% respectively. Conclusions: Within burns theatres, there are instances of bacterial contamination on surfaces that persist despite cleaning. ATP luminometers as a point-of-care device may have a role in determining the cleanliness of surfaces, potentially minimizing onwards-bacterial transmission.

Predictive Value of Pelvic Incidence in Progression of Spondylolisthesis

Spine ◽  
2003 ◽  
Vol 28 (20) ◽  
pp. 2381-2385 ◽  
Author(s):  
Robert P. Huang ◽  
Henry H. Bohlman ◽  
George H. Thompson ◽  
Connie Poe-Kochert
Keyword(s):  
Predictive Value ◽  
Pelvic Incidence

scholarly journals Postless Hip Arthroscopy: A Safer Alternative for Treatment of Femoracetabular Impingement Syndrome

2021 ◽  
Vol 1 (3) ◽  
pp. 263502542110067
Author(s):  
Michael B. Held ◽  
Liana J. Tedesco ◽  
Mario H. Lobao ◽  
T. Sean Lynch
Keyword(s):  
Hip Joint ◽  
Hip Arthroscopy ◽  
Pudendal Nerve ◽  
Patient Positioning ◽  
Central Compartment ◽  
Operating Table ◽  
Complication Rates ◽  
Iatrogenic Complications ◽  
Diagnostic Arthroscopy ◽  
Hip Distraction

Background: Hip arthroscopy for femoroacetabular impingement (FAI) syndrome continues to gain popularity and indications for its use are expanding. Though low complication rates have previously been reported, there are iatrogenic complications specific to the use of the perineal post, such as pudendal nerve injuries, and possible pressure skin necrosis that warrant concern in the healthy young patient. The risk of these complications are increased during simultaneous bilateral hip arthroscopy. Indications: We describe a new technique, which will prevent such problems by using a postless pink pad technique in order to achieve adequate hip distraction. Technique Description: Arthroscopic investigation begins with proper, safe patient positioning in order to gain access to the hip joint with sufficient joint distraction. In the postless technique, a dense foam pad is utilized in lieu of a perineal post. The static friction between the pad, bed, and the patient counters the manual gross traction necessary to distract the hip joint while preventing the patient from sliding down or off of the operating table. The postless technique avoids pressure to the perineum and also allows for greater range of motion during dynamic intraoperative examination and femoroplasty. After hip distraction, standard portal placement allows for access to the central compartment in order to assess intraarticular pathology. Once identified on diagnostic arthroscopy, appropriate techniques are utilized to correct acetabular-sided pincer lesions, labral tears, and femoral-sided cam deformities. Results: When discussing this technique with patients, it is important to highlight that it diminishes the possibility of iatrogenic pressure injury to the pudendal nerve and skin of the perineum. The risk of these injuries typically occurs when the pudenal nerve is compressed against the post during traction and abduction. As such, postless technique prevents any compression and pressure to these regions. Discussion/Conclusion: Hip arthroscopy is a minimally invasive, low morbidity technique for treating a variety of chondral, ligamentous, and bony conditions of the hip. However, studies suggest that pudenal nerve injury is seen in up to 4.3% of patients following hip arthroscopy. Given avoidance of iatrogenic post complications, we describe a postless technique for achieving hip distraction during hip arthroscopy.

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