Comparison of fusion assessment techniques: computer-assisted versus manual measurements

2008 ◽  
Vol 8 (6) ◽  
pp. 544-547 ◽  
Author(s):  
Daniel R. Fassett ◽  
Ronald I. Apfelbaum ◽  
John A. Hipp
Keyword(s):  
Measurement Technique ◽  
Spinous Process ◽  
Angular Motion ◽  
Computer Assisted ◽  
Data Sets ◽  
Manual Measurement ◽  
Spinous Processes ◽  
Assessment Techniques ◽  
Limited Motion

Object Fusion assessment after cervical arthrodesis can be subjective. Measures such as bridging bone quantification or extent of (limited) motion on dynamic studies are common but difficult to interpret and fraught with biases. We compared manual measurement and computer-assisted techniques in assessing fusion after anterior cervical discectomy and fusion (ACDF). Methods One hundred patients who underwent ACDF (512 intervertebral levels) were randomly selected for this radiographic review (follow-up 3–36 months). Two assessment techniques were performed by different observers, with each blinded to the results of the other. The manual spinous process displacement measurement technique was used to calculate motion between the spinous processes under magnification on a digital imaging workstation. Computer-assisted measurements of intervertebral angular motion were made using Quantitative Motion Analysis (QMA) software. Fusion criteria were arbitrarily set at 1 mm of motion for the manual technique and 1.5° of angular motion for the QMA technique. Results The manual measurement technique revealed fusion in 61.7% (316 of 512) of the interspaces assessed, and QMA revealed fusion in 64.3% (329 of 512). These two assessment techniques agreed in 87.5% of cases, with a correlation coefficient of 0.68 between the two data sets. In cases in which the two techniques did not agree, QMA revealed fusion and the manual measurement revealed nonfusion in 64% of the disagreements; 98% of the disagreements occurred when motion was < 2 mm or 2°. Conclusions Although osseous fusion after arthrodesis remains difficult to assess, new computer-assisted techniques may remove the subjectivity generally associated with assessing fusion.

Data Management in an Epidemiological Study : Experiences from the Iowa 500 Field Follow-up and Family Study

1980 ◽  
Vol 19 (01) ◽  
pp. 37-41
Author(s):  
R. F. Woolson ◽  
M. T. Tsuang ◽  
L. R. Urban
Keyword(s):  
Data Management ◽  
Epidemiological Study ◽  
Family Study ◽  
Data Sets ◽  
Data Handling ◽  
Management Decisions ◽  
Numerous Data ◽  
Made In

We are now conducting a forty-year follow-up and family study of 200 schizophrenics, 325 manic-depressives and 160 surgical controls. This study began in 1973 and has continued to the present date. Numerous data handling and data management decisions were made in the course of collecting the data for the project. In this report some of the practical difficulties in the data handling and computer management of such large and bulky data sets are enumerated.

Stereotactic radiation treatment planning and follow-up studies involving fused multimodality imaging

2004 ◽  
Vol 101 (Supplement3) ◽  
pp. 326-333 ◽  
Author(s):  
Klaus D. Hamm ◽  
Gunnar Surber ◽  
Michael Schmücking ◽  
Reinhard E. Wurm ◽  
Rene Aschenbach ◽  
...  
Keyword(s):  
Image Fusion ◽  
Treatment Planning ◽  
Radiation Treatment ◽  
Data Sets ◽  
Slice Thickness ◽  
Radiation Treatment Planning ◽  
Content Type ◽  
Follow Up Studies ◽  
Fine Print

Object. Innovative new software solutions may enable image fusion to produce the desired data superposition for precise target definition and follow-up studies in radiosurgery/stereotactic radiotherapy in patients with intracranial lesions. The aim is to integrate the anatomical and functional information completely into the radiation treatment planning and to achieve an exact comparison for follow-up examinations. Special conditions and advantages of BrainLAB's fully automatic image fusion system are evaluated and described for this purpose. Methods. In 458 patients, the radiation treatment planning and some follow-up studies were performed using an automatic image fusion technique involving the use of different imaging modalities. Each fusion was visually checked and corrected as necessary. The computerized tomography (CT) scans for radiation treatment planning (slice thickness 1.25 mm), as well as stereotactic angiography for arteriovenous malformations, were acquired using head fixation with stereotactic arc or, in the case of stereotactic radiotherapy, with a relocatable stereotactic mask. Different magnetic resonance (MR) imaging sequences (T1, T2, and fluid-attenuated inversion-recovery images) and positron emission tomography (PET) scans were obtained without head fixation. Fusion results and the effects on radiation treatment planning and follow-up studies were analyzed. The precision level of the results of the automatic fusion depended primarily on the image quality, especially the slice thickness and the field homogeneity when using MR images, as well as on patient movement during data acquisition. Fully automated image fusion of different MR, CT, and PET studies was performed for each patient. Only in a few cases was it necessary to correct the fusion manually after visual evaluation. These corrections were minor and did not materially affect treatment planning. High-quality fusion of thin slices of a region of interest with a complete head data set could be performed easily. The target volume for radiation treatment planning could be accurately delineated using multimodal information provided by CT, MR, angiography, and PET studies. The fusion of follow-up image data sets yielded results that could be successfully compared and quantitatively evaluated. Conclusions. Depending on the quality of the originally acquired image, automated image fusion can be a very valuable tool, allowing for fast (∼ 1–2 minute) and precise fusion of all relevant data sets. Fused multimodality imaging improves the target volume definition for radiation treatment planning. High-quality follow-up image data sets should be acquired for image fusion to provide exactly comparable slices and volumetric results that will contribute to quality contol.

Clinical Value of Computer-Assisted Taylor Three-dimensional External Fixation in the Treatment of Tibiofibular Fracture (Preprint)

2020 ◽  
Author(s):  
Hongfeng Sheng ◽  
Weixing Xu ◽  
Bin Xu ◽  
Hongpu Song ◽  
Di Lu ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Internal Fixation ◽  
External Fixation ◽  
External Fixator ◽  
Theoretical Basis ◽  
New Technology ◽  
Three Dimensional ◽  
Computer Assisted ◽  
Clinical Value

UNSTRUCTURED The retrospective study of Taylor's three-dimensional external fixator for the treatment of tibiofibular fractures provides a theoretical basis for the application of this technology. The paper collected 28 patients with tibiofibular fractures from the Department of Orthopaedics in our hospital from March 2015 to June 2018. After the treatment, the follow-up evaluation of Taylor's three-dimensional external fixator for the treatment of tibiofibular fractures and concurrency the incidence of the disease, as well as the efficacy and occurrence of the internal fixation of the treatment of tibial fractures in our hospital. The results showed that Taylor's three-dimensional external fixator was superior to orthopaedics in the treatment of tibiofibular fractures in terms of efficacy and complications. To this end, the thesis research can be concluded as follows: Taylor three-dimensional external fixation in the treatment of tibiofibular fractures is more effective, and the incidence of occurrence is low, is a new technology for the treatment of tibiofibular fractures, it is worthy of clinical promotion.

scholarly journals Combining 3D Structured Light Imaging and Spine X-ray Data Improves Visualization of the Spinous Lines in the Scoliotic Spine

2020 ◽  
Vol 11 (1) ◽  
pp. 301
Author(s):  
Sławomir Paśko ◽  
Wojciech Glinkowski
Keyword(s):  
Radiation Exposure ◽  
Surface Topography ◽  
Structured Light ◽  
Spinous Process ◽  
Three Dimensional ◽  
Diagnostic System ◽  
Measurement Tool ◽  
Adequate Treatment ◽  
X Ray ◽  
Spinous Processes

Scoliosis is a three-dimensional trunk and spinal deformity. Patient evaluation is essential for the decision-making process and determines the selection of specific and adequate treatment. The diagnosis requires a radiological evaluation that exposes patients to radiation. This exposure reaches hazardous levels when numerous, repetitive radiographic studies are required for diagnostics, monitoring, and treatment. Technological improvements in radiographic devices have significantly reduced radiation exposure, but the risk for patients remains. Optical three-dimensional surface topography (3D ST) measurement systems that use surface topography (ST) to screen, diagnose, and monitor scoliosis are safer alternatives to radiography. The study aimed to show that the combination of plain X-ray and 3D ST scans allows for an approximate presentation of the vertebral column spinous processes line in space to determine the shape of the spine’s deformity in scoliosis patients. Twelve patients diagnosed with scoliosis, aged 13.1 ± 4.5 years (range: 9 to 20 years) (mean: Cobb angle 17.8°, SD: ±9.5°) were enrolled in the study. Patients were diagnosed using full-spine X-ray and whole torso 3D ST. The novel three-dimensional assessment of the spinous process lines by merging 3D ST and X-ray data in patients with scoliosis was implemented. The method’s expected uncertainty is less than 5 mm, which is better than the norm for a standard measurement tool. The presented accuracy level is considered adequate; the proposed solution is accurate enough to monitor the changes in the shape of scoliosis’s spinous processes line. The proposed method allows for a relatively precise calculation of the spinous process lines based on a three-dimensional point cloud obtained with a four-directional, three-dimensional structured light diagnostic system and a single X-ray image. The method may help reduce patients’ total radiation exposure and avoid one X-ray in the sagittal projection if biplanar radiograms are required for reconstructing the three-dimensional line of the spinous processes line.

scholarly journals Who Gets Lost, and What Difference Does It Make? Mixed Modes, Nonresponse Follow-up Surveys and the Estimation of Turnout

2019 ◽  
Vol 7 (4) ◽  
pp. 520-544 ◽  
Author(s):  
Andreas C Goldberg ◽  
Pascal Sciarini
Keyword(s):  
Voter Turnout ◽  
Measurement Errors ◽  
Response Rate ◽  
Mail Survey ◽  
Computer Assisted ◽  
Political Factors ◽  
Demographic Groups ◽  
Telephone Interviews ◽  
Politically Active

Abstract This article assesses whether—and to what extent—turnout bias in postelection surveys is reduced by adding a short nonresponse follow-up (NRFU) survey to a mixed-mode survey. Specifically, we examine how the NRFU survey influences response propensities across demographic groups and political factors and whether this affects data quality. We use a rich dataset on validated voter turnout data, collected across two different ballots. In addition to the main survey that comprises computer-assisted telephone interviews (CATI) and web respondents, both studies include a short follow-up mail survey for nonrespondents. The results demonstrate that collecting extra information from additional respondents on so-called “central” questions is worth the effort. In both studies, the NRFU survey substantially increases representativeness with respect to sociodemographic and participation variables. In particular, voters and politically active citizens are more accurately represented in the NRFU survey. This tends to result in better estimates of turnout determinants in the final (combined) sample than is seen from CATI/web respondents only. Moreover, the increase in response rate and the decrease in nonresponse bias comes at almost no price in terms of measurement errors. Vote overreporting is only slightly higher in the mail follow-up survey than in the main CATI/web survey.

Posterior Lumbar Interbody Fusion Using an En-Bloc Resected Lamina as an Interbody Spacer in Combination with Spinal Instruments

1998 ◽  
Vol 02 (04) ◽  
pp. 325-332
Author(s):  
Shigeru Hirabayashi ◽  
Kiyoshi Kumano ◽  
Takeshi Uchida
Keyword(s):  
Interbody Fusion ◽  
Spinous Process ◽  
Degenerative Spondylolisthesis ◽  
Spinal Instrumentation ◽  
Posterior Lumbar Interbody Fusion ◽  
Bony Union ◽  
Lumbar Interbody Fusion ◽  
En Bloc ◽  
Time Of Operation

We developed a new method of posterior lumbar interbody fusion (PLIF) using an en-bloc resected lamina with or without a hydroxyapatite block as an interbody spacer instead of auto-iliac bone, in combination with rigid-type spinal instrumentation. The purpose of this study was to evaluate the effectiveness of our method. There were 23 patients (13 males, 10 females, age at the time of operation: 21–71 years, mean 50.5 years; follow-up: 1–4 years, mean 2 years and 3 months). In 10 patients with spondylolitic spondylolisthesis and 3 patients with spondylolysis, the floating lamina was resected enbloc by mid-line splitting. In 7 patients with degenerative spondylolisthesis and 3 patients with unstable spine, a cleavage was made at the isthmus and then the complex of lamina and inferior spinous process was resected en-bloc. Seventeen patients with olisthesis underwent reduction. PLIF was performed at the L4/L5 level in 10 patients and the L5/S1 level in 13 patients. Sixteen patients with preoperative low back pain recovered, except for one patient with instability at the adjacent vertebra. All of the seven patients with preoperative gait disturbance recovered. The ratio of olisthesis changed from preoperative 30% to postoperative 18% on average. Good bony union was obtained in both the patients with and those without a hydroxyapatite spacer. Posterior lumbar interbody fusion using an en-bloc resected lamina as an interbody spacer in combination with rigid-type spinal instrumentation was useful.

The Modified Maquet Procedure (MMP) in Dogs: Technical Development and Initial Clinical Experience

2016 ◽  
Vol 52 (4) ◽  
pp. 242-250 ◽  
Author(s):  
Malcolm Graham Ness
Keyword(s):  
Cruciate Ligament ◽  
Major Complication ◽  
Tibial Tuberosity ◽  
Radiographic Examination ◽  
Computer Assisted ◽  
Clinical Report ◽  
Modified Technique ◽  
Cranial Cruciate Ligament ◽  
Titanium Foam

ABSTRACT The literature about tibial tuberosity advancement surgery in dogs and humans informed the development of a version of the operation using a wedge-shaped implant of titanium foam. Computer-assisted drawing and stereolithography was used to create instruments and implants that were evaluated by cadaver surgery. A trial, involving 26 client-owned dogs with lameness due to cranial cruciate ligament failure, was started. Follow-up was done by clinical and radiographic examination after 4 wk and clinical examination again 6–11 mo after surgery. The titanium foam implant maintained tibial tuberosity advancement easily and effectively. The same major complication occurred in 2 of the first 6 cases before, a slightly modified technique was used to treat 20 dogs without complication. At mid-term follow-up (6–11 mo), 20/26 dogs (77%) had returned to full function, two dogs (7.7%) had acceptable function, two dogs (7.7%) could not be evaluated due to recent contra lateral modified Maquet procedure surgery, and two (7.7%) dogs had died for reasons unrelated to the study. This is the first clinical report of the use of titanium foam in veterinary orthopaedics. Modified Maquet procedure appears to be an effective treatment for lameness due to failure of the cranial cruciate ligament in dogs.

scholarly journals Enhanced Care Assistant Training to Address the Workforce Crisis in Home Care: Changes Related to Job Satisfaction and Career Commitment

2007 ◽  
Vol 8 (2) ◽  
pp. 71-81 ◽  
Author(s):  
Constance L. Coogle ◽  
Iris A. Parham ◽  
Rita Jablonski ◽  
Jason A. Rachel
Keyword(s):  
Job Satisfaction ◽  
Home Care ◽  
Career Commitment ◽  
Management Training ◽  
Data Sets ◽  
Term Care ◽  
Training Models ◽  
Intrinsic Job Satisfaction

Changes in job satisfaction and career commitment were observed as a consequence of a geriatric case management training program focusing on skills development among personal care attendants in home care. A comparison of pretraining and posttraining scores uncovered a statistically significant increase in Intrinsic Job Satisfaction scores for participants 18–39 years of age, whereas levels declined among the group of middle aged participants and no change was observed among participants age 52 and older. On the other hand, a statistically significant decline in Extrinsic Job Satisfaction was documented over all participants, but this was found to be primarily due to declines among participants 40–51 years of age. When contacted 6–12 months after the training series had concluded, participants indicated that the training substantially increased the likelihood that they would stay in their current jobs and improved their job satisfaction to some extent. A comparison of pretraining and posttraining scores among participants providing follow-up data revealed a statistically significant improvement in levels of Career Resilience. These results are discussed as they relate to similar training models and national data sets, and recommendations are offered for targeting future educational programs designed to address the long-term care workforce shortage.

scholarly journals Effect of preservation of the C-6 spinous process and its paraspinal muscular attachment on the prevention of postoperative axial neck pain in C3–6 laminoplasty

2015 ◽  
Vol 22 (3) ◽  
pp. 221-229 ◽  
Author(s):  
Eiji Mori ◽  
Takayoshi Ueta ◽  
Takeshi Maeda ◽  
Itaru Yugué ◽  
Osamu Kawano ◽  
...  
Keyword(s):  
Neck Pain ◽  
Spinous Process ◽  
Posterior Longitudinal Ligament ◽  
Paraspinal Muscle ◽  
Vas Scores ◽  
The Mean ◽  
Axial Neck Pain ◽  
Process Length ◽  
Preservation Technique

OBJECT Axial neck pain after C3–6 laminoplasty has been reported to be significantly lesser than that after C3–7 laminoplasty because of the preservation of the C-7 spinous process and the attachment of nuchal muscles such as the trapezius and rhomboideus minor, which are connected to the scapula. The C-6 spinous process is the second longest spinous process after that of C-7, and it serves as an attachment point for these muscles. The effect of preserving the C-6 spinous process and its muscular attachment, in addition to preservation of the C-7 spinous process, on the prevention of axial neck pain is not well understood. The purpose of the current study was to clarify whether preservation of the paraspinal muscles of the C-6 spinous process reduces postoperative axial neck pain compared to that after using nonpreservation techniques. METHODS The authors studied 60 patients who underwent C3–6 double-door laminoplasty for the treatment of cervical spondylotic myelopathy or cervical ossification of the posterior longitudinal ligament; the minimum follow-up period was 1 year. Twenty-five patients underwent a C-6 paraspinal muscle preservation technique, and 35 underwent a C-6 nonpreservation technique. A visual analog scale (VAS) and VAS grading (Grades I–IV) were used to assess axial neck pain 1–3 months after surgery and at the final follow-up examination. Axial neck pain was classified as being 1 of 5 types, and its location was divided into 5 areas. The potential correlation between the C-6/C-7 spinous process length ratio and axial neck pain was examined. RESULTS The mean VAS scores (± SD) for axial neck pain were comparable between the C6-preservation group and the C6-nonpreservation group in both the early and late postoperative stages (4.1 ± 3.1 vs 4.0 ± 3.2 and 3.8 ± 2.9 vs 3.6 ± 3.0, respectively). The distribution of VAS grades was comparable in the 2 groups in both postoperative stages. Stiffness was the most prevalent complaint in both groups (64.0% and 54.5%, respectively), and the suprascapular region was the most common site in both groups (60.0% and 57.1%, respectively). The types and locations of axial neck pain were also similar between the groups. The C-6/C-7 spinous process length ratios were similar in the groups, and they did not correlate with axial neck pain. The reductions of range of motion and changes in sagittal alignment after surgery were also similar. CONCLUSIONS The C-6 paraspinal muscle preservation technique was not superior to the C6-nonpreservation technique for preventing postoperative axial neck pain.

scholarly journals Posterior Arch Augmentation (Spinoplasty) before and after Single and Double Interspinous Spacer Introduction at the Same Level: Preventing and Treating the Failure?

2014 ◽  
Vol 20 (5) ◽  
pp. 626-631 ◽  
Author(s):  
Luigi Manfré
Keyword(s):  
Spinal Canal ◽  
Prophylactic Treatment ◽  
Bone Remodelling ◽  
Posterior Arch ◽  
Ct Guided ◽  
Interspinous Spacer ◽  
Canal Stenosis ◽  
Spinous Processes ◽  
Before And After

Lumbar spinal canal stenosis (LSCS) is one of the most common degenerative diseases in elderly patients. Failure of he treatment can occur, generally related to bone remodelling/fracture of spinous processes. PMMA augmentation of the posterior arch (spinoplasty, SP) has recently been proposed in case of neoplastic involvement. This study evaluated the efficacy of SP as a prophylactic treatment before introducing an interspinous spacer (IS). Moreover, we consider the possibility to treat patients who previously underwent IS implants with subsequent failure of the device, by introducing a second spacer at the same level, performing accessory SP. From January 2009 to September 2011, 174 patients with LSCS underwent CT-guided percutaneous IS implant in our department. From January 2011, all patients with osteoporosis underwent prophylactic SP before introducing the spacer. Moreover, in patients with re-stenosis related to bone remodelling and/or fracture, after strengthening the spinous processes with PMMA introduction, a second similar device was introduced to re-open the stenotic spinal canal. In patients with prophylactic treatment before spacer introduction, no restenosis occurred at three to 12 month follow-up. Patients who underwent second spacer implant at the same level after posterior arch augmentation again obtained a resolution of symptoms, and no further bone remodelling had occurred at follow-up controls. In conclusion, prophylactic SP prevents single spacer failure for bone remodelling/fracture, and allows failure repair by introducing a second spacer at the same level.

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