Spine
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Comparative Study
Transpedicular screw placement evaluated by axial computed tomography of the cervical pedicle.
We evaluated the trajectory of transpedicular screws in the cervical spine using axial computed tomography (CT). ⋯ Axial CT measurements should facilitate transpedicular screw fixation in the cervical spine. We believe that the screw insertion angle should be close to 50 degrees, which is the mean pedicle transverse angle from C3-C6. The entry point of the pedicle screw should be located as laterally as possible in the posterior surface of the lateral mass.
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Comparative Study
Occupational gonadal and embryo/fetal doses from fluoroscopically assisted surgical treatments of spinal disorders.
Simulation of lumbar spine fluoroscopy used during surgical treatments of spinal disorders on a humanoid phantom and monitoring of the scattered radiation levels. ⋯ Radiogenic genetic and embryo/fetal risks resulting from occupational exposure due to fluoroscopically assisted surgical treatments of spinal disorders are well within tolerance levels provided that rigorous confinement to all pertinent occupational dose constraints is established.
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This is a retrospective review on the application of the authors' technique of atlantoaxial lateral mass plate and screw fixation on a rare subset of patients having mobile and reducible atlantoaxial subluxation in the presence of occipitalized atlas. ⋯ Although lateral mass plate and screw fixation in the presence of occipitalized atlas is technically a relatively difficult and anatomically a precise surgical procedure, the firm and segmental stabilization that it provides offers an optimum situation for bony fusion.
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This is a case report. ⋯ Epidural emphysema secondary to traumatic pneumomediastinum is benign and self-limiting. However, the life-threatening causes should be considered and ruled out.
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Comparative Study
Complications associated with lumbar laminectomy: a comparison of spinal versus general anesthesia.
A case-controlled, comparative study of 400 patients undergoing lumbar surgery, treated with either spinal or general anesthesia. An independent observer analyzed outcomes. ⋯ For patients undergoing decompressive lumbar surgery, spinal anesthesia is at least comparable to general anesthetic with respect to complications. Specific advantages to spinal anesthesia include decreased nausea and antiemetic requirements, reduced analgesic requirements, and reduced overall complication rate.