Latest Articles
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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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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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To develop a universally accepted complexity and experience grading system to guide the safe implementation of robotic and laparoscopic minimally invasive pancreatoduodenectomy (MIPD). ⋯ This ISGPS complexity and experience grading system for robotic and laparoscopic MIPD may enable surgeons to optimally select patients after duly considering specific risk factors known to influence the complexity of the procedure. This grading system will likely allow for a thoughtful and stepwise implementation of MIPD and facilitate a fair comparison of outcomes between centers and countries.
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Although the value of patient-reported outcomes (PROs) regarding assessing patient and quality-of-care outcomes is increasingly recognized within spine surgery, the benefits and challenges associated with the collection and clinical use of PROs remain to be established. The aim of this review was to discuss the published evidence on the wealth of clinically relevant data provided by PRO measures within spine surgery. ⋯ Physician-reported outcomes are often unable to provide a comprehensive evaluation of clinical and quality-of-care outcomes within spine surgery. Incorporation of PROs in patient evaluation is an integral part of efforts aimed at achieving excellence in health care delivery, as PROs help gain insight into individual patients' experiences and integrate an appraisal of patients' perspectives into clinical practice.