Eur J Trauma Emerg S
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Eur J Trauma Emerg S · Apr 2011
3D-based navigation in posterior stabilisations of the cervical and thoracic spine: problems and benefits. Results of 451 screws.
Navigated procedures in spinal surgery have been established due to an increasing demand for precision. Especially, 3D C-arms connected to navigation systems are being used more often and can be utilised intraoperatively for the planning and controlling of screw positions. This prospective study analyses our experiences with 3D-based navigation in posterior stabilisations in the cervical and thoracic spine. ⋯ Intraoperative 3D imaging navigation for posterior spinal stabilisations is technically feasible and reliable in clinical use. The image quality depends on the individual bone density. With undisturbed visibility of the vertebral body, the reliability of 3D-based navigation is comparable to that of CT-based procedures. Additionally, it has the advantage of skipping the preoperative acquisition of data as well as the matching process, with reduced radiation doses.
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Eur J Trauma Emerg S · Apr 2011
Doppler ultrasound for the assessment of conservatively treated blunt splenic injuries: a prospective study.
The type and need for follow-up of non-operatively managed blunt splenic injuries remain controversial. The use of Doppler ultrasound to identify post-traumatic splenic pseudoaneurysms, considered to be the main cause of "delayed" splenic rupture, has not been well described. ⋯ Doppler ultrasound can be an effective and a safe noninvasive modality for evaluation and follow-up of patients with blunt splenic injury. The utility and cost-effectiveness of routine surveillance requires further study.
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Eur J Trauma Emerg S · Apr 2011
O-arm(®)-based spinal navigation and intraoperative 3D-imaging: first experiences.
Since the first use of instrument-tracking techniques in the early 1990s, image-guided technologies became a leading topic in all branches of spine surgery. Today, navigation is a widely available tool in spine surgery and has become a part of clinical routine in many centers for a large variety of indications. Spinal navigation may not only contribute to more precision during surgery, but it may also reduce radiation exposure and fluoroscopy time, with advantages not only for the patient but also for the operating room personnel. ⋯ In combination with the Stealth(®) station system, navigation may start immediately after automated registration with already referenced instruments. After instrumentation, an additional scan may confirm intraoperatively the correct positioning of the instrumentation. The first experiences with the system are described in this paper.
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To determine the injury patterns, complications, and mortality after alcohol consumption in trauma patients. ⋯ In a mixed population of trauma patients, an AP screen is associated with an increased incidence of admission hypotension and depressed GCS score. In this case-matched study, alcohol exposure appeared to increase mortality after injury.
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Eur J Trauma Emerg S · Apr 2011
Isolated blunt chest injury leads to transient activation of circulating neutrophils.
The acute respiratory distress syndrome (ARDS) is a severe and frequently seen complication in multi-trauma patients. ARDS is caused by an excessive innate immune response with a clear role for neutrophils. As ARDS is more frequently seen in trauma patients with chest injury, we investigated the influence of chest injury on the systemic neutrophil response and the development of ARDS. ⋯ Blunt chest trauma caused a systemic inflammatory reaction with transient activation of neutrophils and mobilization of young neutrophils into the circulation. Isolated chest injury, however, was not abundant enough to cause ARDS, so a second hit appears crucial.