scholarly journals The use of an Intraoperative Computed Tomograph with a Navigation Station for Operations on the Spine

2020 ◽  
Vol 1 (51) ◽  
pp. 24-39
Author(s):  
Khanat Mukhametzhanov ◽  
◽  
Dulat Mukhametzhanov ◽  
Buratay Karibayev ◽  
Sholpan Bulekbayeva ◽  
...  
Keyword(s):  
Image Intensifier ◽  
Modern Method ◽  
Anatomical Landmarks ◽  
Surgical Interventions ◽  
Intraoperative Computed Tomography ◽  
Minimally Invasive Surgical ◽  
Current Operation ◽  
Computed Tomograph ◽  
Operation Results ◽  
Computed Tomography Scanner

The aim of the study: to analyze the results of using an intraoperative computed tomography scanner with a navigation station during spinal operations. Methods. The authors conducted a retrospective and prospective analysis of the results of 350 operations using the image intensifier tube, 390 operations with O arm and 11 operations with O arm and the Stealth-Station navigation station (Medtronic, USA). To the 350 patients operated on using the image intensifier, 1822 screws were implanted, on average 5.2 screws per operation. 117 (6.5%) screws were implanted incorrectly, of which a permissible or clinically insignificant malposition of the screw was noted in 90 (4.9%) patients. Incorrectly installed screws remaining in 27 (1.5%) patients required revision surgery. To 390 patients operated with O arm, 2477 screws were implanted, on average 6.3 screws during one operation. Incorrectly 33 (1.3%) screws were implanted, of which 25 screws were acceptable malposition. Invalid malposition of 8 (0.3%) screws was eliminated during the current operation. Results. Comparative studies of the total number of incorrectly implanted screws during operations using the image intensifier tube and O arm showed that they were more often observed when using the image intensifier tube (p <0.001) and there was no unacceptable malposition of the screws when performing the operation under O arm, since it was diagnosed in time during current operation and eliminated. A total of 66 screws were implanted in 11 patients operated using O arm and the Stealth-Station navigation station, an average of 6 screws during one operation. Inaccurate implantation of screws was not observed in any patient. Conclusions. O-arm with the Stealth-Station navigation station is the most modern method of controlling the correctness of spinal operations when anatomical landmarks are partially invisible - with open operations or invisible at all - with minimally invasive surgical interventions in real time.

scholarly journals Intraoperative Computed Tomography Scanner-Guided Craniovertebral Junction Surgery in a Patient with an Occipitalized C1

2021 ◽  
Author(s):  
Mohammad Ashraf ◽  
Usman Ahmad Kamboh ◽  
Naveed Ashraf
Keyword(s):  
Craniovertebral Junction ◽  
Facet Joints ◽  
Intraoperative Ct ◽  
Intraoperative Computed Tomography ◽  
Transoral Odontoidectomy ◽  
Posterior Subluxation ◽  
Lateral Mass Screws ◽  
Complex Surgery ◽  
Computed Tomography Scanner

AbstractCraniovertebral junction surgery is associated with unique difficulties. Type 2 odontoid fractures (Anderson and D Alonzo) have a great potential for nonunion and malunion. These fracture patients may require a circumferential decompression and fixation. The addition of intraoperative CT with neuronavigation greatly aids in craniovertebral junction surgery. We operated on a 59-year-old-male with a type 2 fracture with posterior subluxation of C1 anterior arch and a cranially displaced odontoid peg. First, a transoral odontoidectomy was performed followed by a craniocervical fixation. Occipital plates and C3–C4 lateral mass screws were used as C1 was discovered to be occipitalized intraoperatively and atlantoaxial facet joints could not be reduced as discovered by intraoperative CT resconstruction. Intraoperative CT scan was crucial to this circumferential decompression and fixation, allowed us to resect the odontoid peg safely and completely and to confirm adequate screw trajectory making this complex surgery easier for us and safer for the patient. The patient was discharged 4 months after admission with stable neurology. Intraoperative CT was fundamental to correct decision making.

scholarly journals Analysis of the subcapital two-part humerus fracture by fluoroscopy: objective criteria for classification and decision making

2021 ◽  
Author(s):  
Nicolas Bless ◽  
Nicola Keller ◽  
Amir Steinitz ◽  
Thibaut Klein ◽  
Daniel Rikli
Keyword(s):  
Decision Making ◽  
Proximal Humerus ◽  
Image Intensifier ◽  
Anatomical Landmarks ◽  
Proximal Point ◽  
Level Of Evidence ◽  
Lesser Tuberosity ◽  
Varus Angulation ◽  
Exact Degree ◽  
Humerus Fractures

Abstract Background Surgical decision making in the treatment of proximal humerus fractures (PHFx) is primarily based on fracture classification using standard radiographs. Due to the lack of objective criteria, this classification process is associated with high interobserver variation. In this study, we investigate the fluoroscopic analysis of humerus fractures through the surgical neck using a semi-quantitative determination of distinct angulation patterns of the proximal humerus as they appear in the image intensifier. Methods Using a saw bone model, defined subcapital 2-part fracture configurations were generated and assessed radiographically. Anatomical landmarks—including the greater and lesser tuberosity as well as anatomical neck—were identified using an image converter, and the exact degree of fracture displacement with 10° up to 70° (in 10° increments) of posterior, varus or combined posterior-varus angulation was compared to nondisplaced controls. From the resultant series of radiographs, the appearance of these angulations in anteroposterior (AP) and scapular Y-views were also visualized and defined. Results An angulation of 50° or more of any given 2-part fracture through the surgical neck is present when the greater tuberosity becomes the most proximal point in AP view (varus and combined posterior-varus angulation) or a bimodal form is found for the superior contour of the head with the lesser tuberosity being the most proximal point in the Y-view (posterior angulation). Conclusion The radiological appearance of various PHFx constellations can be well visualized using the saw bone shoulder model. The presence of angulation in accordance with the Neer classification for group III fractures can be adequately determined by analyzing the relative position of the greater or lesser tuberosity to the humeral head calotte. This can assist the surgeon’s decision on whether to operate or opt for a conservative approach. Level of evidence Basic Science, Anatomy Study, Imaging.

scholarly journals Pathophysiological aspects as the object of the treatment tactics in acute pancreatitis (review)

2021 ◽  
Vol 8 (2) ◽  
pp. 87-94
Author(s):  
Igor Kryvoruchko ◽  
Anastasiya Drozdova ◽  
Nataliya Goncharova
Keyword(s):  
Acute Pancreatitis ◽  
Minimally Invasive ◽  
Postoperative Period ◽  
Surgical Trauma ◽  
Fast Track Surgery ◽  
Surgical Interventions ◽  
Minimally Invasive Surgical ◽  
Treatment Measures ◽  
Mechanisms Of Development ◽  
Adequate Management

The review presents a modern view on the features of the course and treatment of acute pancreatitis, based on a cascade of pathophysiological mechanisms of this disease. A number of concepts of development and course of acute pancreatitis on the basis of randomized prospective and retrospective researches devoted to this problem are considered. Attention is paid to the mechanisms of development of organ failure in acute pancreatitis. In accordance with the above, the main positions of treatment measures for acute pancreatitis, which are based on the principles of tactics "step-up approach" were highlighted. Among them, attention is focused on the features of the conservative treatment program, minimally invasive surgical interventions, as well as the management of the postoperative period of patients. Minimally invasive surgical interventions perform the main tasks of surgical treatment in acute pancreatitis, but significantly reduce surgical trauma compared to "open" methods. Adequate management of the postoperative period of patients is carried out through the implementation of protocols "fast-track surgery".

The Functional State Of The Mucous Membrane Of The Nasal Cavity And Paranasal Sinuses After Radical And Minimally Invasive Surgical Interventions

2021 ◽  
Vol 03 (01) ◽  
pp. 31-40
Author(s):  
Mukhammadbobur Makhsitaliev ◽  
◽  
Jamolbek Djuraev ◽  
Shokhimardon Khodjanov ◽  
Abdurasul Botirov ◽  
...  
Keyword(s):  
Paranasal Sinuses ◽  
Adult Population ◽  
Annual Increase ◽  
Surgical Interventions ◽  
Minimally Invasive Surgical ◽  
Priority Task ◽  
Nose And Paranasal Sinuses ◽  
A Priority ◽  
Ethmoid Labyrinth ◽  
Sphenoid Sinuses

Improving the effectiveness of treatment of chronic rhinosinusitis (CRS) is a priority task of modern otorhinolaryngology, not only domestic, but also foreign. This interest in the problem is due to the widespread prevalence of this pathology. In different countries, the criteria for accounting for the incidence, algorithms for the diagnosis and treatment of rhinosinusitis differ significantly, and for CRS these differences are more pronounced than for acute. A retrospective analysis of the structure and prevalence of ENT diseases according to inpatient observations for 5 years showed that chronic diseases of the nose and paranasal sinuses (SNP) occupied a priority place among hospitalized patients (45.8 ± 0.9% and 55.5 ± 1,0%). In the structure of the main diseases of SNP, the largest share in the adult population is occupied by inflammation of the maxillary sinus (HPP), in which there is an annual increase in the incidence of 1-1.5%, the second most frequent is inflammation of the ethmoid labyrinth cells, then the frontal and sphenoid sinuses.

An anatomical study of the superficial palmar communicating branch between the median and ulnar nerves

2015 ◽  
Vol 41 (2) ◽  
pp. 191-197 ◽  
Author(s):  
S. Sulaiman ◽  
R. Soames ◽  
C. Lamb
Keyword(s):  
Anatomical Study ◽  
Metacarpophalangeal Joint ◽  
Anatomical Landmarks ◽  
Risk Area ◽  
Surgical Interventions ◽  
Total Distance ◽  
Flexor Retinaculum ◽  
Communicating Branch ◽  
Branching Patterns ◽  
Operative Complications

The palmar communicating branch between the median and ulnar nerves was investigated in 98 hands with the aim of outlining its most common branching patterns and describing its relationship to well-defined anatomical landmarks, including the bistyloid line, wrist crease and flexor retinaculum. Five branching patterns were identified and classified based on their proximal and distal attachments. The palmar communicating branch was found to lie between 26%–79% of the total distance between the metacarpophalangeal joint of the long finger and the wrist crease, and 35%–75% of the total distance between the metacarpophalangeal joint of the long finger and the middle of the bistyloid line. With the aid of the morphometric indices obtained from this study, a risk area where the palmar communicating branch is most likely to be found is outlined. Knowledge of the branching patterns and location of the palmar communicating branch can help clinicians to better assess variations in the patterns of sensation, preserve the nerve during surgical interventions to the palm and better assess post-operative complications involving the branch.

scholarly journals Do We Need Radiological Guidance for Intra-Articular Hip Injections?

2014 ◽  
Vol 8 (1) ◽  
pp. 114-117 ◽  
Author(s):  
Jagwant Singh ◽  
Wasim S Khan ◽  
Simrat Marwah ◽  
Gareth Wells ◽  
Dina K Tannous ◽  
...  
Keyword(s):  
Success Rate ◽  
Hip Joint ◽  
Image Intensifier ◽  
Primary Outcome Measure ◽  
Secondary Outcome ◽  
Anatomical Landmarks ◽  
Radiological Method ◽  
Needle Position ◽  
Successful Group ◽  
Reducing Costs

There is still a debate as to whether radiological guidance is needed for intra-articular hip injections. The aim of this study was to evaluate correct needle positioning for the hip joint performed with a non-radiological method and confirmed on arthrogram under image intensifier. Patients listed for diagnostic and therapeutic hip joint injections were included in our study. Eighty seven patients (100 hips) underwent injections with the non-radiological method using anatomical landmarks. Fluoroscopy and arthrogram were then used to confirm the needle position. The primary outcome measure was the success rate of correct positioning of the needle in hip joint by the non-radiological method, as confirmed on arthrogram under image intensifier. The secondary outcome measures were relationship between the grade of the surgeon and patient BMI to success rate of hip injections by the non-radiological method. Overall success rate with the non-radiological method was 67%. Consultants were 77.1% successful and registrars 57.7% (P = 0.039). The average body mass index (BMI) in the successful group was 28.45 (SD = 5.21) and 32.03 (SD = 4.84) in the unsuccessful group (p=0.001). Success was further improved to 88% when performed by a consultant in low BMI (< 30) patients. This prospective study shows that hip injections can be performed with reasonable success without radiological guidance. Experienced surgeons may be able to perform this procedure in outpatient clinics in normal BMI patients; thereby reducing costs and the need for bed space.

scholarly journals History of surgical treatment of obesity and metabolic disorders

2018 ◽  
Vol 9 (4) ◽  
pp. 87-104
Author(s):  
Dmitrij I. Vasilevsky ◽  
Yuri I. Sedletsky ◽  
Kristina A. Anisimova ◽  
Leysan I. Davletbaeva
Keyword(s):  
Bariatric Surgery ◽  
Surgical Treatment ◽  
Cultural Values ◽  
Medical Science ◽  
Surgical Techniques ◽  
Main Idea ◽  
Surgical Interventions ◽  
Minimally Invasive Surgical ◽  
Negative Side Effects ◽  
Stomach Volume

Surgery of obesity (bariatric surgery) as a separate area of medical science dates back its history from the middle of the previous century. The foundation for its development was based on the ideas of physiology of digestion, the causes and mechanisms of its disturbances that had been formed at that time. An important role was played by achievements in related areas of medicine: anesthesiology, transfusiology. Before that effective antibacterial drugs have already been created. Rich experience in various fields was brought for medicine by the Second World War. The return of society to pre-war cultural values became the impetus for bariatric surgery genesis. For two first decades, the main method of surgical treatment of overweight was shunting operations in the small intestine, aimed at reducing absorption of nutrients (malabsorption techniques). However, a significant number of negative side effects gradually forced to abandon this group of procedures and were the basis for the search for other options in surgical interventions. Since the late 60-es of the 20th century for two decades, methods have been actively developed that limited the flow of nutrients (restrictive approach). The main idea in the development of this group of operations was to reduce the volume of the stomach. At the same time, attempts were made to combine both malabsorptive and restrictive mechanisms in one technique. By the beginning of the 90-es, practically all the available variants of surgical interventions have been proposed and introduced into clinical practice. At the same time, minimally invasive surgical technologies began to be actively introduced into this area of medicine. By the beginning of the 21st century almost all surgical techniques have been adapted to endovideo- (laparoscopic-) surgery. Over the past decade, intraluminal (endoscopic) methods for reducing stomach volume and reducing nutrient absorption have been developed.

scholarly journals FEMOROPOPLITEALNI OBVOD Z UPORABO ENDOSKOPSKE METODE

2015 ◽  
Vol 84 (10) ◽  
Author(s):  
Ingrid Požar ◽  
Matjaž Špan
Keyword(s):  
Peripheral Arterial Disease ◽  
Arterial Disease ◽  
Femoropopliteal Bypass ◽  
Surgical Interventions ◽  
Endoscopic Vein Harvesting ◽  
Minimally Invasive Surgical ◽  
Vascular Bypass ◽  
Endoscopic Method ◽  
Peripheral Arterial ◽  
Vein Harvesting

Femoropopliteal bypass is a surgical procedure used in the advanced stages of peripheral arterial disease on lower limb arteries. The most common cause of arterial peripheral disease is the atherosclerotic plaque, which significantly narrows the vascular lumen. This kind of lesion is treated with vascular interventions. Those are divided into endovascular percutaneous interventions and into classic surgical interventions. In addition there is emerging a new endoscopic method in vascular bypass operations as an alternative to the already existing classic surgical intervention. Endoscopic vein harvesting is a minimally invasive surgical technique that enables vein dissection and its usage for vascular bypass with the help of videoscopic equipment. The case report presents a 68-years old male with diagnosed peripheral arterial disease. He was a suitable candidate for surgical treatment, therefore a femoropopliteal bypass was done in his right lower extremity. The distinctive note of this operation was the usage of anewer technique, that is, endoscopic vein harvesting of the greater saphenous vein.

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