scholarly journals Clinical effect of individualized 3D printing guide assisted placement of upper cervical pedicle screw

2021 ◽  
Author(s):  
Guoqi Niu ◽  
Chao Li ◽  
Jianzhong Bai ◽  
Gong Zhou ◽  
Lutan Liu ◽  
...  
Keyword(s):  
3D Printing ◽  
Blood Loss ◽  
Pedicle Screw ◽  
Operation Time ◽  
Intraoperative Blood Loss ◽  
Cervical Pedicle Screw ◽  
Upper Cervical ◽  
Group A ◽  
Cervical Pedicle ◽  
Group B

Abstract Objective To investigate the clinical effect of individualized 3D printing guide assisted upper cervical pedicle screw placement. Methods Eighteen patients with upper cervical spine injury requiring surgical treatment were included in our hospital from May 2010 to May 2019. These patients were divided into guide plate assisted screw implantation group (Group A, N = 10) and traditional operation group (Group B, N = 8). All patients were followed up for more than 6 months. Screw implant accuracy, cervical spine JOA score, ASIA score, VAS score, operation time, intraoperative blood loss were compared between the two groups. Result A total of 72 atlantoaxial pedicle screws were implanted, 40 in group A and 32 in group B. The accuracy rate of nail implantation was 97.50% in group A and 81.25% in group B (P < 0.05). The operation time in group A (189.7 ± 16.1 mins) and group B (242.1 ± 23.2 mins), P < 0.05. The intraoperative blood loss in group A (216.0 ± 49.7 ml) and group B (385.0 ± 23.5 ml), P < 0.05. The intraoperative fluoroscopic times was 8.7 ± 1.1 in group A and 30.0 ± 3.3 in group B (P < 0.05). Besides, the JOA, Asia and VAS scores of the two groups at one week after operation and the last follow-up were significantly different from those before operation. One week after operation, the JOA, Asia and VAS scores of group A were significantly better than those of group B, but there was no significant difference between the two groups at the last follow-up. Conclusions individualized 3D printing guide assisted placement of upper cervical pedicle screw can significantly improve the accuracy of screw implantation and postoperative function of patients, reduce the times of X-ray fluoroscopy, operation time, and intraoperative blood loss, which is a safe and effective approach and worthy of clinical promotion.

scholarly journals Application of 3D Printing in the Surgical Planning of Trimalleolar Fracture and Doctor-Patient Communication

2016 ◽  
Vol 2016 ◽  
pp. 1-5 ◽  
Author(s):  
Long Yang ◽  
Xian-Wen Shang ◽  
Jian-Nan Fan ◽  
Zhi-Xu He ◽  
Jian-Ji Wang ◽  
...  
Keyword(s):  
3D Printing ◽  
Operation Time ◽  
Patient Communication ◽  
Intraoperative Blood Loss ◽  
Trimalleolar Fractures ◽  
Physician Patient Communication ◽  
Group A ◽  
3D Printed ◽  
Group B ◽  
Physician Patient

To evaluate the effect of 3D printing in treating trimalleolar fractures and its roles in physician-patient communication, thirty patients with trimalleolar fractures were randomly divided into the 3D printing assisted-design operation group (Group A) and the no-3D printing assisted-design group (Group B). In Group A, 3D printing was used by the surgeons to produce a prototype of the actual fracture to guide the surgical treatment. All patients underwent open reduction and internal fixation. A questionnaire was designed for doctors and patients to verify the verisimilitude and effectiveness of the 3D-printed prototype. Meanwhile, the operation time and the intraoperative blood loss were compared between the two groups. The fracture prototypes were accurately printed, and the average overall score of the verisimilitude and effectiveness of the 3D-printed prototypes was relatively high. Both the operation time and the intraoperative blood loss in Group A were less than those in Group B (P<0.05). Patient satisfaction using the 3D-printed prototype and the communication score were9.3±0.6points. A 3D-printed prototype can faithfully reflect the anatomy of the fracture site; it can effectively help the doctors plan the operation and represent an effective tool for physician-patient communication.

scholarly journals Clinical efficacy of extended modified posteromedial approach versus posterolateral approach for surgical treatment of posterior pilon fracture: a retrospective analysis

2020 ◽  
Author(s):  
Qin-Ming Zhang ◽  
Hai-Bin Wang ◽  
Xiao-Yan Li ◽  
Feng-Long Chu ◽  
Liang Han ◽  
...  
Keyword(s):  
Blood Loss ◽  
Scale Score ◽  
Steel Plate ◽  
Plate Fixation ◽  
Operation Time ◽  
Posterolateral Approach ◽  
Intraoperative Blood Loss ◽  
Pilon Fracture ◽  
Group A ◽  
Group B

Abstract Background: Posterior pilon fracture is a type of ankle fracture associated with poorer treatment results compared to the conventional ankle fracture. This is partly related to the lack of consensus on the classification, approach selection, and internal fixation method for this type of fracture. This study aimed to investigate the clinical efficacy of posterolateral approach versus extended modified posteromedial approach for surgical treatment of posterior pilon fracture. Methods: Data of 67 patients with posterior pilon fracture who received fixation with a buttress plate between January 2015 and December 2018 were retrospectively reviewed. Patients received steel plate fixation through either the posterolateral approach (n = 35, group A) or the extended modified posteromedial approach (n = 32, group B). Operation time, intraoperative blood loss, excellent and good rate of reduction, fracture healing time, American Orthopaedic Foot & Ankle Society (AOFAS) Ankle-Hindfoot Scale score, and Visual Analogue Scale score were compared between groups A and B. Results: All patients were followed up for an average period of 15.4 months. No nonunion, failure of internal fixation, or anklebone stiffness occurred in either group during the follow-up period. However, the operation time was significantly shorter, intraoperative blood loss was significantly lower, AOFAS Ankle-Hindfoot Scale score was significantly higher, and Visual Analogue Scale score was significantly lower in group B than in group A (P < 0.05). Conclusion: Compared to the posterolateral approach, the extended modified posteromedial approach can provide a better surgical field for the treatment of posterior pilon fracture, which allows reduction and fixation of this type of fractures under direct vision and evaluation of reduction effects, and reduces operation time and intraoperative blood loss. Combining this approach with supporting steel plate fixation enables early functional rehabilitation of the ankle with more satisfactory clinical results.

scholarly journals Efficacy evaluation of three-dimensional printing assisted osteotomy guide plate in accurate osteotomy of adolescent cubitus varus deformity

2019 ◽  
Vol 14 (1) ◽  
Author(s):  
Yuan-Wei Zhang ◽  
Xin Xiao ◽  
Wen-Cheng Gao ◽  
Yan Xiao ◽  
Su-Li Zhang ◽  
...  
Keyword(s):  
3D Printing ◽  
Blood Loss ◽  
Three Dimensional ◽  
Operation Time ◽  
Varus Deformity ◽  
Conventional Group ◽  
Intraoperative Blood Loss ◽  
Cubitus Varus ◽  
Guide Plate ◽  
Significant Difference

Abstract Background This present study is aimed to retrospectively assess the efficacy of three-dimensional (3D) printing assisted osteotomy guide plate in accurate osteotomy of adolescent cubitus varus deformity. Material and methods Twenty-five patients (15 males and 10 females) with the cubitus varus deformity from June 2014 to December 2017 were included in this study and were enrolled into the conventional group (n = 11) and 3D printing group (n = 14) according to the different surgical approaches. The operation time, intraoperative blood loss, osteotomy degrees, osteotomy end union time, and postoperative complications between the two groups were observed and recorded. Results Compared with the conventional group, the 3D printing group has the advantages of shorter operation time, less intraoperative blood loss, higher rate of excellent correction, and higher rate of the parents’ excellent satisfaction with appearance after deformity correction (P < 0.001, P < 0.001, P = 0.019, P = 0.023). Nevertheless, no significant difference was presented in postoperative carrying angle of the deformed side and total complication rate between the two groups (P = 0.626, P = 0.371). Conclusions The operation assisted by 3D printing osteotomy guide plate to correct the adolescent cubitus varus deformity is feasible and effective, which might be an optional approach to promote the accurate osteotomy and optimize the efficacy.

scholarly journals Surgery for thoracolumbar junction (T12-L1) tuberculosis a multicentre, retrospective study

2019 ◽  
Author(s):  
Yanping Zeng ◽  
Peng Cheng ◽  
Jiulin Tan ◽  
Zhilin Li ◽  
Yuan Chen ◽  
...  
Keyword(s):  
Blood Loss ◽  
Posterior Approach ◽  
Spinal Tuberculosis ◽  
Surgical Techniques ◽  
Operation Time ◽  
Thoracolumbar Junction ◽  
Group A ◽  
The Mean ◽  
Group B ◽  
Approach Group

Abstract Purpose A multicentre, retrospective study was conducted to evaluate the safety and efficacy of different surgical techniques for thoracolumbar junction (T12-L1) tuberculosis. Methods The medical records of thoracolumbar junction tuberculosis patients (n = 257) from January 2005 to January 2015 were collected and reviewed. A total of 45 patients were operated on by an anterior approach (Group A), 52 by a combined anterior and posterior approach (Group B) and 160 by a posterior approach (Group C). Anti-tuberculosis therapy was performed both before and after surgery. Clinical outcomes, laboratory indexes and radiological results of the three groups were compared. Results All three surgical approaches achieved bone fusion, pain relief and neurological recovery. The mean loss of correction in group A at last follow-up was higher than in groups B and C (P < 0.05), and the difference between groups B and C was not significant (P > 0.05). The mean operation time and blood loss in group B were greater than in groups A and C. Conclusions For patients with thoracolumbar junction (T12-L1) tuberculosis, the posterior-only approach is superior to the anterior-only approach in the correction of kyphosis and maintenance of spinal stability. The posterior-only approach is recommended because it achieves the same efficacy as the anterior-only or combined approach but with shorter operation times, less trauma and less blood loss. Keywords Spinal tuberculosis; Thoracolumbar junction; Three approaches.

scholarly journals Effect of Intraoperative Blood Loss on Perioperative Complications and Neurological Outcome in Adult Patients Undergoing Elective Brain Tumor Surgery

2019 ◽  
Vol 10 (04) ◽  
pp. 631-640 ◽  
Author(s):  
Vanitha Rajagopalan ◽  
Rajendra Singh Chouhan ◽  
Mihir Prakash Pandia ◽  
Ritesh Lamsal ◽  
Girija Prasad Rath
Keyword(s):  
Brain Tumor ◽  
Blood Loss ◽  
Blood Volume ◽  
Perioperative Complications ◽  
Tumor Surgery ◽  
Intraoperative Blood Loss ◽  
Brain Tumor Surgery ◽  
Group A ◽  
Group B ◽  
Group D

Abstract Background Major blood loss during neurosurgery can lead to several complications, including life-threatening hemodynamic instabilities. Studies addressing these complications in patients undergoing intracranial tumor surgery are limited. Materials and Methods During the study period, 456 patients who underwent elective craniotomy for brain tumor excision were categorized into four groups on the basis of estimated intraoperative blood volume loss: Group A (<20%), Group B (20–50%), Group C (>50–100%), and Group D (more than estimated blood volume). The occurrence of various perioperative complications was correlated with these groups to identify if there was any association with the amount of intraoperative blood loss. Results The average blood volume loss was 11% ± 5.3% in Group A, 29.8% ± 7.9% in Group B, 68.3% ± 13.5% in Group C, and 129.1% ± 23.9% in Group D. Variables identified as risk factors for intraoperative bleeding were female gender (p < 0.001), hypertension (p = 0.008), tumor size >5 cm (p < 0.001), high-grade glioma (p = 0.004), meningioma (p < 0.001), mass effect (p = 0.002), midline shift (p = 0.014), highly vascular tumors documented on preoperative imaging (p < 0.001), extended craniotomy approach (p = 0.002), intraoperative colloids use >1,000 mL (p < 0.001), intraoperative brain bulge (p = 0.03), intraoperative appearance as highly vascular tumor (p < 0.001), and duration of surgery >300 minutes (p < 0.001). Conclusions Knowledge of these predictors may help anesthesiologists anticipate major blood loss during brain tumor surgery and be prepared to mitigate these complications to improve patient outcome.

scholarly journals Comparison of laparoscopic continuous inverting mattress suture + suction curettage and laparoscopic hysterotomy for exogenous cesarean scar pregnancy(CSP-Ⅱ)

2021 ◽  
Author(s):  
Yan Zhang ◽  
Qing-Bing Zhang
Keyword(s):  
Recovery Time ◽  
Operation Time ◽  
Muscle Layer ◽  
Intraoperative Blood Loss ◽  
Mattress Suture ◽  
Suction Curettage ◽  
Group A ◽  
Menstruation Recovery ◽  
Β Hcg ◽  
Group B

Abstract Background:Type II CSP is usually treated by surgery, such as transabdominal, transvaginal, hysteroscopic and laparoscopic resection, It takes a long time for contraception,For patients with urgent fertility requirements, the above methods lack advantages,We are trying to find a safe and effective treatment to shorten the time of contraception.Methods: A total of 41 cases of CSP-Ⅱ were selected from January 1, 2019 to June 30, 2020 in the first people's Hospital of Kunshan City, Jiangsu Province,The patients were divided into two groups, group A(20 cases) was laparoscopic continuous inverting mattress suture + suction curettage,Group B(21 cases) was laparoscopic hysterotomy.Group A was compared with group B:serum β-hCG levels on the first day after operation;Inpatient time;time for serum β-hCG levels to return to normal;HGB on the first day after operation;menstruation recovery time;The differences in the intraoperative blood loss;operation time;The decrease rate of serum β - hCG level on the first day after operation.Results: Group A was compared with group B,serum β-hCG levels on the first day after operation,Inpatient time were not statistically significant (p > 0.05);time for serum β-hCG levels to return to normal,HGB on the first day after operation,menstruation recovery time were statistically significant (p < 0.05),Group A was significantly higher than group B;The differences in the intraoperative blood loss,operation time were significant difference between the two groups (P < 0.05),Group A was significantly lower than group B;The level of serum β - hCG on the first day after operation decreased by 50% in both groups.In group B, the pathology of the excised scar muscle layer showed that there was a little villus tissue in the muscle layer, and a large number of trophoblast cells were seen between the fibrous smooth muscle tissues.Conclusions: In group A,the method is more simple, less bleeding, shorter operation time and less trauma;it also can remove the diverticulum and increase the thickness of the lower uterine segment;the contraception time was shortened,but the decrease of serum β - hCG was slow and the recovery time of menstruation was long.

scholarly journals Comparing the Effectiveness of 3D Printing Technology in the Treatment of Clavicular Fracture between Surgeons with Different Experiences

2021 ◽  
Author(s):  
Jiang long Guo ◽  
Hong yi Li ◽  
Kui Zhao ◽  
Meng Zhang ◽  
Jing zhi Ye ◽  
...  
Keyword(s):  
3D Printing ◽  
Standard Dose ◽  
Operation Time ◽  
3D Models ◽  
P Value ◽  
Printing Technology ◽  
3D Printing Technology ◽  
Value Range ◽  
Group A ◽  
Group B

Abstract Purpose To comparethe effectiveness of the three-dimensional (3D) printing technology in the treatment of clavicularfracturebetween experienced and inexperienced orthopedic surgeons. Methods A total of 80 patients with clavicle fracture (from February 2017 to May 2021)were enrolled in our study. Patients were divided randomly into four groups: group A: Patients underwent low-dose CT scan and 3D models were printed before surgeries performed by inexperienced surgeons; group B: Standard-dose CT were taken and 3D models were printed before surgeries performed by experienced surgeons; group C and D: Standard-dose CT were taken in both groups, and the operations were performed differently by inexperienced (group C) and experienced (group D) surgeons. Operation time, blood loss, length of incision and number of intraoperative fluoroscopy were recorded. Results No statistically significant differences were found in age, gender, fracture site and fracture type (P value: 0.23–0.88).Group A showed shorter incision length and less intraoperative fluoroscopy times than group C and D (P value < 0.05). There were no significant differences in blood loss volume, incision length and number of intraoperative time between group A and group B (P value range: 0.11–0.28). The operation time of group A was no longer than that of group C and D (P value range: 0.11 and 0.24). Conclusion The surgical effectiveness of inexperienced surgeons who applied 3D printing technology before clavicular fracture operation were better than those of both inexperienced and experienced surgeons did not use preoperative 3D printing technology.

scholarly journals Comparison of Conventional Fenestration Discectomy Versus Percutaneous Transforaminal Endoscopic Discectomy for Treating Lumbar Disc Herniation

2020 ◽  
Author(s):  
Quanyi Li ◽  
yongchun zhou
Keyword(s):  
Blood Loss ◽  
Hospital Stay ◽  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Lumbar Disc ◽  
Intraoperative Blood Loss ◽  
Endoscopic Discectomy ◽  
Percutaneous Transforaminal Endoscopic Discectomy ◽  
Group A ◽  
Group B

Abstract Purpose: To compare the efficacy of conventional interlaminar fenestration discectomy (IFD) versus percutaneous transforaminal endoscopic discectomy (PTED) for treating lumbar disc herniation (LDH). Methods: The clinical data of 1,100 patients who had been diagnosed with LDH from January 2012 to December 2017 were retrospectively analysed. IFD was performed on the 605 patients in Group A, while PTED was performed on the 505 patients in Group B. The Oswestry Disability Index (ODI), Visual Analogue Scale (VAS) for pain, and modified Macnab criteria were adopted to evaluate the outcomes. Moreover, the surgery durations, intraoperative blood loss, postoperative off-bed activities, and postoperative lengths of hospital stay for the two groups were observed. Results: The follow-up period ranged from 24 months to 60 months, with an average duration of 43 months. As the excellent and good outcome rate was 93.5% in Group A and 92.6% in Group B, there were no significant differences in efficacy between the two groups (P > 0.05). However, Group B had significantly less intraoperative blood loss and shorter bed rest durations and postoperative lengths of hospital stay than did Group A (P < 0.05). There were two cases of postoperative recurrence in Group A and three in Group B. Conclusions: Although conventional IFD and PTED had similar levels of efficacy in treating LDH, transforaminal endoscopic discectomy exhibited several advantages, such as less trauma, less bleeding, and a shorter length of hospital stay, and it can be considered an ideal surgical option for treating LDH.Save and Continue

scholarly journals TONSILLECTOMY IN PAEDIATRIC POPULATION

2016 ◽  
Vol 23 (04) ◽  
pp. 499-503
Author(s):  
Raheel Ahmad ◽  
Farhan Salam ◽  
Abdul Saeed Khan ◽  
Faisal Bashir ◽  
Atif Rafique
Keyword(s):  
Standard Deviation ◽  
Blood Loss ◽  
Operative Time ◽  
Controlled Trial ◽  
Operation Time ◽  
Group A ◽  
Group B ◽  
Cold Steel Dissection ◽  
Cold Dissection ◽  
Dissection Method

Objectives: To compare mean operative time and Intra operative blood lossbetween bipolar electro dissection and cold dissection tonsillectomy in paediatric population.Study Design: Randomized controlled trial. Place and Duration: Department of ENT and Headand Neck Surgery, Continental Medical College, Hospital Lahore, from 1 January 2015 to 30September 2015. Materials and Methods: This study included 164 patients of age group 4 to12 years of either gender undergoing tonsillectomy. The patients were divided into two equalgroups designated as A and B each having 82 patients using simple random sampling. Patientsin group A were operated for tonsillectomy by bipolar electrocautry while group B underwenttonsillectomy by cold steel dissection method. All patients in both groups were assessed foroperating time and intra-operative blood loss. Results: Out of 82 cases of Bipolar DissectionGroup 49(60%) patients were male and 33(40%) patients were female. Whereas in 82 casesof Cold Dissection Group 51(62%) patients were male and 31(38%) patients were female.Mean age of patients was 7.2(SD ± 1.97) years. Mean operation time was 15 minutes withstandard deviation ± 1.21 in group A as compared to group B where mean operation time was20 minutes with standard deviation ± 1.87. Mean blood loss was 7 ml with standard deviation± 2.53 in patients of group A as compared to Patients in group B who mean blood loss of 30ml with standard deviation ± 3.46. Group A had statistically significant lower operative time andblood loss than group B. Conclusion: Tonsillectomy with bipolar electro dissection method ismuch better than cold steel dissection method. It has an advantage of less blood loss duringsurgery. It significantly reduces intra operative time.

scholarly journals Managing Sacral Giant Cell Tumor with Surgery and Various Adjuvant Therapies

2020 ◽  
Author(s):  
Yushen Zhang ◽  
Jun Fu ◽  
Yingsen Xue ◽  
Zheng Guo ◽  
Zhen Wang ◽  
...  
Keyword(s):  
Blood Loss ◽  
Giant Cell Tumor ◽  
Giant Cell ◽  
Recurrence Rate ◽  
Operation Time ◽  
Arterial Embolization ◽  
Cell Tumor ◽  
Adjuvant Therapies ◽  
Group A ◽  
Group B

Abstract Background and purpose: There is no consensus regarding the appropriate treatment of sacral giant cell tumor (SGCT). This study is to compare oncological and neurological outcomes of SGCT managed by surgery and various adjunctive therapies.Methods: A total of 31 patients with SGCT were retrospectively studied. They were divided into two Groups. A: 13 patients underwent surgery plus SAE and radiotherapy; Group B: 18 patients underwent surgery plus one arterial embolization and denosumab. The postoperative functional outcomes, recurrence, mortality, and complications were compared.Results: The mean operation time (231±49min) and blood loss (3167±856mL) of group B were significantly less than those of group A (283±41min, 5054±689mL) (p<0.05). The average follow-up was 68.5 months. The neurologic function scores showed no significant difference. The recurrence rate of group B (11.2%) was much lower than that of group A (30.7%, p=0.17). The cumulative survival rate of group B was higher than that of group A (p=0.133).Conclusions: In comparison to other adjuvant therapies, one arterial embolization plus denosumab can reduce the intra-operative blood loss, shorten the operation time, and decrease the recurrence rate in patients with SGCT.

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