Latest Articles
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Systematic review. ⋯ "DH," especially as measured by DHC, may be an important intraoperative consideration when selecting implant size during CDR. Maintaining DHC <2 mm may optimize PROMs and ROM. Improving technique and implant sizing may aid in translating ex vivo advantages in implant mobility to in vivo improvements in ROM and PROMs.
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Thoracolumbar minimally invasive spine surgery (MIS) has become widely adopted over the past two decades. MIS cervical fixation has lagged behind, largely because of complex and variable cervical spinal anatomy. Traditional open spine fixation techniques are associated with high fusion rates but are plagued by significant approach-related morbidity. ⋯ With the incorporation of new enabling navigation technologies, this technique is feasible, reproducible, and safe. In addition, these procedures have provided unique solutions for approaching cervical pathology in line with currently accepted MIS principles of the thoracolumbar spine. This review article discusses current minimally invasive posterior fusion strategies with a description of the technique and case demonstrations.
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Dizziness and vertigo are common presenting symptoms in acute care settings. This article describes the most common causes of acute dizziness and vertigo with practical, evidence-based guidance on evaluation of these patients. ⋯ If episodic, determine whether symptoms are triggered or spontaneous. Classify the patient as having post-exposure acute vestibular syndrome (AVS), spontaneous AVS, triggered episodic vestibular syndrome (EVS), or spontaneous EVS.
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Robotic-assisted spine surgery has significantly advanced surgical precision and safety. This is particularly pertinent in minimally invasive spine surgeries that rely on imaging and technologies for visualization and the ability to accomplish surgical goals through smaller surgical corridors. The ability to preoperatively plan and then place pedicle screws across a wide range of applications has reduced the difficulty of even complex surgeries that once may have been considered prohibitive for minimally invasive approaches. While challenges and limitations remain, ongoing research and development aim to address these to continually expand the benefits of robotic-assisted spine surgery.
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Status epilepticus is a time-sensitive neuro-emergency, linked to poor functional outcomes and higher mortality rates. Prompt diagnosis and treatment are crucial to reduce its morbidity and mortality. ⋯ A standardized treatment protocol should include prompt and adequately dosed first benzodiazepines as line therapy. Treatment approaches for second-line and third-line management continue to evolve as new anti-seizure medications become available.