Articles: surgery.
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Objectives. Recent publications on dual program spinal cord stimulation (SCS) system demonstrate more flexible electrode programming, which helps to steer paresthesias towards all of the affected areas including the low back area. Materials and Methods. The following data were retrospectively sought from 20 nonrandomized failed back surgery patients at two centers treated by a dual quadripolar surgically implanted SCS lead: pain and paresthesia, VAS ratings, medication use, sleep patterns, daily activities, hardware problems, and willingness to repeat the procedure. The data were analyzed by the Wilcoxon signed rank test (p value < 0.05). ⋯ The number of patients taking benzodiazepines decreased. Sixty percent reported increased participation in social activities. Conclusions. This dual program surgical SCS technique is simple, respects patients' autonomy, and provides adequate analgesia with an increase in quality of life.
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Randomized Controlled Trial
Computer-assisted guidewire insertion for hip fracture fixation.
: This study was designed to test in a laboratory setting a novel computer-assisted fluoroscopic technique and a conventional fluoroscopic technique for open reduction and internal fixation (ORIF) of hip fractures. Our hypothesis is that a novel computer-assisted fluoroscopic technique will achieve acceptable guidewire placement in one pass, with decreased fluoroscopic time and with accuracy and precision better than conventional technique. ⋯ The computer-assisted technique was significantly more accurate and precise than conventional technique. It also required fewer drill tracks through the femur and exposed the patient and the surgical team to significantly less ionizing radiation.
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Retrospective clinical and intraoperative navigational data review. ⋯ Image-guided thoracoscopic spinal surgery can provide 3-dimensional orientation to a 2-dimensional imaging procedure that ultimately improves accuracy, efficiency, and safety. Future developments in combining guidance technology with standard surgical procedures will likely continue.
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Case Reports
Image-guided transsacral approach to presacral lesions of nerve root origin: technical note.
The utility of image guidance in fashioning a posterior transsacral operative corridor for approaching small presacral neural lesions has not previously been reported. ⋯ An image-guided transsacral approach is a viable option for accessing small to moderately sized lesions of nerve root origin located within the presacral space.