scholarly journals The Role of Minimally Invasive Techniques in Scoliosis Correction Surgery

2018 ◽  
Vol 2018 ◽  
pp. 1-6
Author(s):  
Michael B. Cloney ◽  
Jack A. Goergen ◽  
Angela M. Bohnen ◽  
Zachary A. Smith ◽  
Tyler Koski ◽  
...  

Objective. Recently, minimally invasive surgery (MIS) has been included among the treatment modalities for scoliosis. However, literature comparing MIS to open surgery for scoliosis correction is limited. The objective of this study was to compare outcomes for scoliosis correction patients undergoing MIS versus open approach. Methods. We retrospectively collected data on demographics, procedure characteristics, and outcomes for 207 consecutive scoliosis correction surgeries at our institution between 2009 and 2015. Results. MIS patients had lower number of levels fused (p<0.0001), shorter surgeries (p=0.0023), and shorter overall lengths of stay (p<0.0001), were less likely to be admitted to the ICU (p<0.0001), and had shorter ICU stays (p=0.0015). On multivariable regression, number of levels fused predicted selection for MIS procedure (p=0.004), and multiple other variables showed trends toward significance. Age predicted ICU admission and VTE. BMI predicted any VTE, and DVT specifically. Comorbid disease burden predicted readmission, need for transfusion, and ICU admission. Number of levels fused predicted prolonged surgery, need for transfusion, and ICU admission. Conclusions. Patients undergoing MIS correction had shorter surgeries, shorter lengths of stay, and shorter and fewer ICU stays, but there was a significant selection effect. Accounting for other variables, MIS did not independently predict any of the outcomes.

2021 ◽  
Vol 20 (4) ◽  
pp. E292-E292
Author(s):  
Travis Hamilton ◽  
Mohamed Macki ◽  
Thomas M Zervos ◽  
Victor Chang

Abstract As the popularity of minimally invasive surgery (MIS) continues to grow, novel techniques are needed to meet the demands of multisegment fixation for advanced spinal diseases. In one such example, iliac bolts are often required to anchor large fusion constructs, but MIS technical notes are missing from the literature.  A 67-yr-old female presented with a symptomatic coronal deformity: preoperative pelvic incidence = 47°, pelvic tilt = 19°, and lumbar lordosis = 29°, sagittal vertical axis = +5.4 cm with 30° of scoliosis. The operative plan included T10-ilium fusion with transforaminal interbody grafts at L2-3, L3-4, L4-5, and L5-S1. The intraoperative video is of minimally invasive placement of iliac bolts using the O-Arm Surgical Imaging System (Medtronic®). The patient consented to the procedure.  A mini-open exposure that remains above the fascial planes allows for multilevel instrumentation with appropriate decompression at the interbody segments. After the placement of the pedicle screws under image-guidance, the direction is turned to the minimally invasive iliac bolts. Following the trajectory described in the standard open approach,1 the posterior superior iliac spine (PSIS) is identified with the navigation probe, which will guide the Bovie cautery through the fascia. This opening assists in the trajectory of the navigated-awl tap toward the anterior superior iliac spine (ASIS). Next, 8.5 mm x 90 mm iliac screws were placed in the cannulated bone under navigation. After intraoperative image confirmation of screw placement, the contoured rods are threaded under the fascia. The setscrews lock the rod in position. MIS approaches obviate cross-linking the rods, rendering pelvic fixation more facile.  This technique allows for minimal dissection of the posterior pelvic soft tissue while maintaining adequate fixation.


2014 ◽  
Vol 61 (1) ◽  
pp. 75-80
Author(s):  
Tomislav Pejcic ◽  
Zoran Dzamic ◽  
Miodrag Acimovic ◽  
Boris Kajmakovic ◽  
Jovan Hadzi-Djokic

Background: Benign prostatic hyperplasia (BPH) and chronic prostatitis (CP) are disorders with high prevalence and have a great impact on overall morbidity in men. The patients that do not respond to medical therapy for lower urinary tract symptoms (LUTS) related to BPH are candidates for surgery. However, the number of men with BPH/LUTS seeking for non- surgical, or for less invasive treatment is growing. Aim: To present the basic information about minimally invasive treatment modalities for BPH and CP: intraprostatic injections, urethral lift procedures, modifications of transurethral microwave thermotherapy (TUMT), prostatic artery embolization etc. Conclusion: The majority of these techniques is still in experimental phase and not widely accepted. However, it is very likely that new, safe and minimally invasive techniques will appear in the near future.


2021 ◽  
Vol 9 (12) ◽  
pp. 147
Author(s):  
Hetal Desai ◽  
Cameron A. Stewart ◽  
Yoav Finer

In recent years, due to a better understanding of the caries pathology and advances in dental materials, the utilization of non-invasive and minimally invasive techniques that delay/obviate the need for traditional restorations has started gaining momentum. This literature review focuses on some of these approaches, including fluoride varnish, silver diamine fluoride, resin sealants, resin infiltration, chemomechanical caries removal and atraumatic restorative treatment, in the context of their chemistries, indications for use, clinical efficacy, factors determining efficacy and limitations. Additionally, we discuss strategies currently being explored to enhance the antimicrobial properties of these treatment modalities to expand the scope of their application.


2020 ◽  
Vol 5 (3) ◽  
pp. 1-9
Author(s):  
Tiffany Peng Hwa ◽  
Michael Cheng ◽  
Babak Sadoughi

Branchial anomalies can present in the parapharyngeal space, creating unique challenges in management. Historically, this approach warranted an open approach, including transcervical, transparotid with total parotidectomy and retromandibular dissection, or transmandibular dissection with mandibulotomy. However, the advent of minimally invasive transoral techniques and laser resection have allowed for successful resection of masses in this anatomical region without an external approach. We illustrate these advancements with the case of a 30-year-old man with globus sensation and throat discomfort, found to have a mass of the right posterolateral oropharynx causing severe airway obstruction. Imaging showed a parapharyngeal mass with extension to the carotid sheath and retropharyngeal space, which was successfully resected with potassium-titanyl-phosphate (KTP) laser using a minimally invasive transoral approach with no major complications. Transoral excision offers decreased morbidity and a cosmetically favorable outcome compared to transcervical excision. KTP laser may be safely used for transoral excision of a benign parapharyngeal mass.


2016 ◽  
Vol 1 (13) ◽  
pp. 169-176
Author(s):  
Lisa M. Evangelista ◽  
James L. Coyle

Esophageal cancer is the sixth leading cause of death from cancer worldwide. Esophageal resection is the mainstay treatment for cancers of the esophagus. While curative, surgical resection may result in swallowing difficulties that require intervention from speech-language pathologists (SLPs). Minimally invasive surgical procedures for esophageal resection have aimed to reduce morbidity and mortality associated with more invasive techniques. Both intra-operative and post-operative complications, regardless of the surgical approach, can result in dysphagia. This article will review the epidemiological impact of esophageal cancers, operative complications resulting in dysphagia, and clinical assessment and management of dysphagia pertinent to esophageal resection.


2014 ◽  
Vol 4 (1_suppl) ◽  
pp. s-0034-1376724-s-0034-1376724
Author(s):  
K. Vladimirovich Tyulikov ◽  
K. Korostelev ◽  
V. Manukovsky ◽  
V. Litvinenko ◽  
V. Badalov

2020 ◽  
Author(s):  
Moustafa Ali ◽  
Nyall London ◽  
Daniel Prevedello ◽  
Tekin Baglam ◽  
Ray Cho ◽  
...  

2020 ◽  
Vol 12 (45) ◽  
pp. 34-39
Author(s):  
Flavia Sukekava ◽  
Julia Helena Luiz ◽  
Paloma Palma ◽  
Jaques Luiz

Gummy smile is a characteristic in which the patient exposes more than 2 mm of keratinized gingiva in forced smile. With a multifactorial cause, its correct planning depends directly on the correct diagnosis. Usually, the procedures that involve manipulation and the enlargement of the aesthetical crown lengthening are surgical. The objective of this case series was to show the advantages of surgical crown augmentation surgery in aesthetic areas with minimally invasive techniques. Three cases of gummy smile were presented, with different treatment plans and techniques for execution. In the 3 cases, bone removal was performed with piezoelectric ultrasound, which made the postoperative more comfortable for patients. These cases illustrate the use of technology to reduce morbidity in patients who need to undergo bone removal to treat gingival smile.


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