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Deformity surgery

Gustav Burström, Christian Buerger, Jurgen Hoppenbrouwers, Rami Nachabe, Cristian Lorenz, Drazenko Babic, Robert Homan, John M Racadio, Michael Grass, Oscar Persson, Erik Edström, Adrian Elmi Terander
OBJECTIVEThe goal of this study was to develop and validate a system for automatic segmentation of the spine, pedicle identification, and screw path suggestion for use with an intraoperative 3D surgical navigation system.METHODSCone-beam CT (CBCT) images of the spines of 21 cadavers were obtained. An automated model-based approach was used for segmentation. Using machine learning methodology, the algorithm was trained and validated on the image data sets. For measuring accuracy, surface area errors of the automatic segmentation were compared to the manually outlined reference surface on CBCT...
March 22, 2019: Journal of Neurosurgery. Spine
Khoi D Than, Paul Park, Stacie Tran, Gregory M Mundis, Kai-Ming Fu, Juan S Uribe, David O Okonkwo, Pierce D Nunley, Richard G Fessler, Robert K Eastlack, Adam Kanter, Neel Anand, Frank LaMarca, Peter G Passias, Praveen V Mummaneni
BACKGROUND: Spinal deformity surgery is often invasive and lengthy. Staging surgery over separate operative days may reduce complications. Staging is often used in minimally invasive treatment of adult spinal deformity (ASD). OBJECTIVE: To investigate the impact of staging on complication rates between hybrid (HYB; minimally invasive interbody with open posterior screw and rod fixation) and circumferential minimally invasive surgery (cMIS; minimally invasive interbody and screw/rod placement) procedures in ASD patients...
March 18, 2019: World Neurosurgery
Mirza Biscevic, Aida Sehic, Sejla Biscevic, Ismet Gavrankapetanovic, Barbara Smrke, Damir Vukomanovic, Ferid Krupic
OBJECTIVE: The aim of this study was to evaluate the differences in transcranial electric motor-evoked potentials - TceMEP on upper limbs and the incidences of postoperative brachial plexopathy between patients with kyphotic and scoliotic trunk shapes. METHODS: In the period of January 2011-January 2017, 61 consecutive patients (mean age: 18.4 years ± 4.4 years (range: 10-32)) with pediatric spinal deformity underwent surgery in our Department. Eight of them had a kyphotic trunk deformity (Scheuermann kyphosis, neurofibromatosis, posterior thoracic hemivertebra), and the rest of the 53 patients had a scoliotic trunk deformity (mostly adolescent idiopathic scoliosis - AIS, lateral hemivertebra)...
March 18, 2019: Acta Orthopaedica et Traumatologica Turcica
Annie M Q Wang, Min Kim, Emily S Ho, Kristen M Davidge
BACKGROUND: Camptodactyly is a pediatric hand condition, the treatment of which remains controversial. The authors' aim was to improve patient care through clarifying the definition of camptodactyly and indications for surgical and/or conservative management, summarizing outcomes, and defining risks. METHODS: A systematic review was conducted of articles in all languages on outcomes following surgical and/or conservative management of idiopathic camptodactyly in children using MEDLINE (Medical Literature Analysis and Retrieval System Online), PubMed, EMBASE (Excerpta Medica database), AMED (Allied and Complementary Medicine), and CINAHL (Cumulative Index of Nursing and Allied Health Literature) (until January 2017)...
March 22, 2019: Hand: Official Journal of the American Association for Hand Surgery
Chang-Hyeon Lee, Seoung-Won Cho, Ju-Won Kim, Hyo-Jung Ahn, Young-Hee Kim, Byoung-Eun Yang
Orthognathic surgery (OGS) is a relatively common procedure for solving functional and aesthetic problems in facial and jaw areas in patients with dentofacial deformities. The positioning of the mandibular condylar segment during OGS has an impact on the surgical outcome. This study aimed to investigate the changes in the condyle-fossa relationship three dimensionally after OGS using the centric relation (CR) bite and the ramal reference line (RRL).Thirty-two patients with skeletal malocclusion underwent OGS...
March 2019: Medicine (Baltimore)
Darren F Lui, Hai Ming Yu, Joseph Butler, Karan Malhotra, Susanne Selvadurai, Adam Benton, Obiekezie Agu, Sean Molloy
STUDY DESIGN: Retrospective review of prospectively collected data OBJECTIVE.: Determine the safety of MOLIF versus PSO SUMMARY OF BACKGROUND DATA.: Complex Adult Spinal Deformity (CASD) represents a challenging cohort of patients. The Scoli-RISK-1 study has shown a 22.18% perioperative risk of neurological injury. Restoration of sagittal parameters is associated with good outcome in ASD. Pedicle subtraction osteotomies (PSO) is an important technique for sagittal balance in ASD but is associated with significant morbidity...
March 6, 2019: Spine
Christopher P Ames, Justin S Smith, Ferran Pellisé, Michael P Kelly, Jeffrey L Gum, Ahmet Alanay, Emre Acaroğlu, Francisco Javier Sánchez Pérez-Grueso, Frank S Kleinstück, Ibrahim Obeid, Alba Vila-Casademunt, Douglas C Burton, Virginie Lafage, Frank J Schwab, Christopher I Shaffrey, Shay Bess, Miquel Serra-Burriel
STUDY DESIGN: Retrospective analysis of prospectively-collected, multicenter adult spinal deformity (ASD) databases. OBJECTIVE: To predict the likelihood of reaching minimum clinically important differences in patient-reported outcomes after ASD surgery. SUMMARY OF BACKGROUND DATA: Adult spinal deformity (ASD) surgeries are costly procedures that do not always provide the desired benefit. In some series only 50% of patients achieve minimum clinically important differences (MCID) in patient-reported outcomes (PROs)...
March 13, 2019: Spine
Maram E A Abdalla Elsayed, Marco Mura, Hassan Al Dhibi, Silvana Schellini, Rizwan Malik, Igor Kozak, Patrik Schatz
PURPOSE: To provide a focused review of sickle cell retinopathy in the light of recent advances in the pathogenesis, multimodal retinal imaging, management of the condition, and migration trends, which may lead to increased prevalence of the condition in the Western world. METHODS: Non-systematic focused literature review. RESULTS: Sickle retinopathy results from aggregation of abnormal hemoglobin in the red blood cells in the retinal microcirculation, leading to reduced deformability of the red blood cells, stagnant blood flow in the retinal precapillary arterioles, thrombosis, and ischemia...
March 20, 2019: Graefe's Archive for Clinical and Experimental Ophthalmology
Caio Pundek Garcia, Ana Zulmira Diniz Badin
INTRODUCTION: With aging, progressive changes occur in the eyelid region. The novel technique for repositioning of the fat pads described herein addresses Hester classification type II, lower eyelid aging with minimal decrease in the eyelid/cheek juncture. MATERIALS AND METHODS: In this retrospective study of patients undergoing surgery at our clinic between 2000 and 2018, 92 were classified as Hester II and a transconjunctival surgical procedure was performed with repositioning of the fat pads and intranasal fixation assisted by the Casagrande needle...
March 20, 2019: Aesthetic Plastic Surgery
Sara Soliman, Mohammad Dehis, Mamdouh Ahmed, Engy El Kateeb
BACKGROUND: There is a scarcity in the published literature which evaluates the postoperative inflammatory response and patients' immunity following orthognathic surgery. AIM: The present prospective study aimed to evaluate the changes in two immunological callipers to measure the traumatic effect of orthognathic surgery. METHODS: In the present prospective cohort study, we included women (age range 16-30 years) with severe dentofacial deformities who were scheduled for bimaxillary osteotomy...
February 28, 2019: Open Access Macedonian Journal of Medical Sciences
Handayani, Faldi Yaputra, Berkat Hia, Victor Telaumbanua, I Putu Eka Widyadharma
BACKGROUND: Access to modern medicine is still limited in some rural areas in Indonesia. This is mostly due to lack of people's knowledge and concern for their health, especially in orthopaedic cases. Osteomyelitis is generally described as infection and inflammation of the bone, which results in local bone destruction, necrosis, and apposition of new bone. Chronic post-traumatic osteomyelitis (CPTO) is a complex condition and one of the most challenging problems in orthopaedic surgery that cause considerable morbidity...
February 28, 2019: Open Access Macedonian Journal of Medical Sciences
Thomas Rückschloß, Oliver Ristow, Michael Müller, Reinald Kühle, Sebastian Zingler, Michael Engel, Jürgen Hoffmann, Christian Freudlsperger
INTRODUCTION: Because of the many limitations of conventional surgery planning for the treatment of orthognathic deformities, as well as advancements in computer-assisted planning, there is an urgent need for technical devices that transfer the surgical plan into the operating theatre. In this regard, additive-manufactured, patient-specific implants (PSI) and additive-manufactured interocclusal splints represent promising approaches. The aim of this retrospective study was to compare the accuracy of these two devices, with regard to preoperative virtual treatment planning for maxillary Le-Fort I advancement surgery using IPS CaseDesigner® , and based on a new analysis method without the use of landmarks...
March 2, 2019: Journal of Cranio-maxillo-facial Surgery
Xinjian Pei, Jiuhui Han
BACKGROUND: The aim of this study was to assess the feasibility and efficacy of proximal radioulnar derotational osteotomy followed by internal fixation for the treatment of congenital radioulnar synostosis (CRUS). METHODS: Between May 2008 and August 2016, 31 patients (36 forearms) with CRUS who underwent derotational osteotomy at the proximal radioulnar synostosis site were evaluated. There were 20 boys and 11 girls. The mean age at the time of surgery was 4.87 ± 3...
March 20, 2019: Journal of Orthopaedic Surgery and Research
Nakul S Talathi, John M Flynn, Joshua M Pahys, Amer F Samdani, Burt Yaszay, Baron S Lonner, Firoz Miyanji, Suken A Shah, Patrick J Cahill
BACKGROUND: At academic medical centers, residents and fellows play an integral role as surgical first assistants in spinal deformity surgery. However, limited data exist on whether the experience level of the surgical assistant affects outcomes. METHODS: We conducted a multicenter, multisurgeon study comparing perioperative and postoperative outcomes after adolescent idiopathic scoliosis (AIS) surgery for the same 11 surgeons who performed cases that were assisted by residents compared with cases that were assisted by fellows...
March 20, 2019: Journal of Bone and Joint Surgery. American Volume
Fatih Aktoz, Ozgur Ozyuncu, Atakan Tanacan, Erdem Fadiloglu, Canan Unal, Tutku Soyer, Tolga Celik, Mehmet Sinan Beksac
OBJECTIVE: To evaluate and compare the outcomes of pregnancies with prenatally detected gastroschisis and omphalocele. MATERIALS AND METHODS: We retrospectively evaluated prenatally detected gastroschisis and omphalocele cases. Cases were compared in terms of maternal demographic and clinical characteristics as well as pregnancy and neonatal outcomes. RESULTS: This study consisted of 17 gastroschisis and 30 omphalocele cases. Only one case with gastroschisis was terminated due to additional severe limb deformities...
March 20, 2019: Fetal and Pediatric Pathology
Patrick G Rice, Bhaskar K Somani, Rowland W Rees
INTRODUCTION: Plaque incision and grafting (PIG) is indicated for men with complex or severe penile curvature and, despite a multitude of incision types and grafting materials having been used, no individual technique has proven superiority. AIM: To assess outcomes following PIG and to understand the operative technique. METHODS: A systematic review was performed to find all relevant studies reporting on use of the PIG technique to correct curvature resulting from Peyronie's disease...
March 16, 2019: Sexual Medicine
Umran Aydemir Sezer, Vildan Sanko, Mehmet Gulmez, Basak Aru, Elif Sayman, Ali Aktekin, Fugen Vardar Aker, Gulderen Yanıkkaya Demirel, Serdar Sezer
Hernia surgeries are at the top of the general surgery operations. However, visceral adhesion, which is one of the worst complications of these operations, is still a major problem. One of the most preferred methods to prevent adhesion is the use of biomaterials. Polypropylene (PP) mesh is frequently preferred product in clinical applications owing to its mechanically robust structure against deformation within the body. However, PP meshes do not have anti-adhesive properties. Oxidized regenerated cellulose (ORC), on the other hand, is one of the most preferred products in preventing the adhesion in clinical use...
June 2019: Materials Science & Engineering. C, Materials for Biological Applications
Norberto Confalonieri, Alessio Biazzo
INTRODUCTION: Total knee replacement (TKR) is one of the most frequent orthopaedic procedures performed every year. At the same time 20% of patients who underwent TKR are not satisfied with the outcome. The reasons are unknown; we think that a mechanical alignment beyond 3° of varus-valgus can represent the most important cause of failure of TKR and consequently patient dissatisfaction. MATERIALS AND METHODS: Neutral mechanical alignment is the main goal in every TKR: this can be achieved through different tools, such as extramedullary and intramedullary guides, patient-specific instrumentation (PSI) and computer-assisted surgery (CAS)...
January 22, 2019: Acta Bio-medica: Atenei Parmensis
Lin He, Xueyuan Yu, Xiangyu Liu, Wendy Chen, Maoguo Shu
BACKGROUND: In the last decade, many surgeons have reported their perspectives on microform cleft lip repair, including techniques for incision placement and size, philtral reconstruction, and nasal base reconstruction. This interest demonstrates continued controversy in the repair of microform cleft lip. METHODS: This is a retrospective cohort of patients from 2010 to 2016. The authors included patients with microform cleft lip repaired by our described technique who had both preoperative photographs, as well as photographs taken at >1-year follow-up...
March 14, 2019: Journal of Craniofacial Surgery
Nipun Sodhi, Anton Khlopas, Joseph O Ehiorobo, Caitlin Condrey, Kevin Marchand, Robert C Marchand, Matthew S Hepinstall, Michael A Mont
INTRODUCTION: Tibial or femoral extra-articular deformities complicate the goal achieving optimal mechanical axis alignment for successful total knee arthroplasty (TKA) outcomes. In the presence of these extra-articular deformities, standard operative techniques and instruments may not be reliable. Robotic-arm assisted technology was developed to help achieve a well-aligned and balanced knee in a variety of clinical scenarios. Although prior case series have reported on the use of robotic-arm assisted devices for cases with severe angular deformity, there is a lack of data concerning the use of the robotic device for patients with other potentially complex surgical factors...
March 18, 2019: Surgical Technology International
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