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Rodrigo Oliva Perez - One of the best experts on this subject based on the ideXlab platform.

  • the estimate of the impact of Coccyx resection in surgical field exposure during abdominal perineal resection using preoperative high resolution magnetic resonance
    World Journal of Surgery, 2018
    Co-Authors: Guilherme Pagin São Julião, Cinthia D Ortega, Sergio Eduardo Alonso Araujo, Laura Melina Fernandez, F A B Coutinho, Bruna Borba Vailati, Angelita Habrgama, G. Brown, Gustavo Rossi, Rodrigo Oliva Perez
    Abstract:

    Objective To estimate the improvement in surgical exposure by removal of the Coccyx, during abdomino-perineal resection (APR), in rectal cancer patients. Methods Retrospective study of 29 consecutive patients with rectal cancer was carried out. Using MR T2 sagittal series, the solid angle was estimated using the angle determined by the anterior resection margin and the tip of Coccyx (no Coccyx resection) or the tip of last sacral vertebra (Coccyx resection). The solid angle provides an estimate of the tridimensional surface area provided by an original angle resulting in the best estimate of the surgeon's view/exposure to the critical dissecting point of choice (anterior rectal wall). The difference ("Gain") in surgical field exposure by removal of the Coccyx was compared by the solid angle variation between the two estimates (with and without the Coccyx). Results Routine removal of the Coccyx determines an average 42% (95% CI 27-57%) gain in surgical field exposure area facing the anterior rectal wall at the level of the prostate/vagina by the surgeon. Fifteen (51%) patients had >= 30% (median) estimated gain in surgical field exposure by coccygectomy. There was no association between BMI, age or gender and estimated gain in surgical field exposure area. Conclusions Routine removal of the Coccyx during APR may result in an average increase in 42% in surgical field exposure during APR's perineal dissection. Precise estimation of surgical field exposure gain by removal of the Coccyx may be predicted by MR sagittal series for each individual patient.

  • The Estimate of the Impact of Coccyx Resection in Surgical Field Exposure During Abdominal Perineal Resection Using Preoperative High-Resolution Magnetic Resonance.
    World Journal of Surgery, 2018
    Co-Authors: Guilherme Pagin São Julião, Cinthia D Ortega, Sergio Eduardo Alonso Araujo, Laura Melina Fernandez, F A B Coutinho, Bruna Borba Vailati, G. Brown, Gustavo Rossi, Angelita Habr-gama, Rodrigo Oliva Perez
    Abstract:

    To estimate the improvement in surgical exposure by removal of the Coccyx, during abdomino-perineal resection (APR), in rectal cancer patients. Retrospective study of 29 consecutive patients with rectal cancer was carried out. Using MR T2 sagittal series, the solid angle was estimated using the angle determined by the anterior resection margin and the tip of Coccyx (no Coccyx resection) or the tip of last sacral vertebra (Coccyx resection). The solid angle provides an estimate of the tridimensional surface area provided by an original angle resulting in the best estimate of the surgeon’s view/exposure to the critical dissecting point of choice (anterior rectal wall). The difference (“Gain”) in surgical field exposure by removal of the Coccyx was compared by the solid angle variation between the two estimates (with and without the Coccyx). Routine removal of the Coccyx determines an average 42% (95% CI 27–57%) gain in surgical field exposure area facing the anterior rectal wall at the level of the prostate/vagina by the surgeon. Fifteen (51%) patients had ≥30% (median) estimated gain in surgical field exposure by coccygectomy. There was no association between BMI, age or gender and estimated gain in surgical field exposure area. Routine removal of the Coccyx during APR may result in an average increase in 42% in surgical field exposure during APR’s perineal dissection. Precise estimation of surgical field exposure gain by removal of the Coccyx may be predicted by MR sagittal series for each individual patient.

Guilherme Pagin São Julião - One of the best experts on this subject based on the ideXlab platform.

  • the estimate of the impact of Coccyx resection in surgical field exposure during abdominal perineal resection using preoperative high resolution magnetic resonance
    World Journal of Surgery, 2018
    Co-Authors: Guilherme Pagin São Julião, Cinthia D Ortega, Sergio Eduardo Alonso Araujo, Laura Melina Fernandez, F A B Coutinho, Bruna Borba Vailati, Angelita Habrgama, G. Brown, Gustavo Rossi, Rodrigo Oliva Perez
    Abstract:

    Objective To estimate the improvement in surgical exposure by removal of the Coccyx, during abdomino-perineal resection (APR), in rectal cancer patients. Methods Retrospective study of 29 consecutive patients with rectal cancer was carried out. Using MR T2 sagittal series, the solid angle was estimated using the angle determined by the anterior resection margin and the tip of Coccyx (no Coccyx resection) or the tip of last sacral vertebra (Coccyx resection). The solid angle provides an estimate of the tridimensional surface area provided by an original angle resulting in the best estimate of the surgeon's view/exposure to the critical dissecting point of choice (anterior rectal wall). The difference ("Gain") in surgical field exposure by removal of the Coccyx was compared by the solid angle variation between the two estimates (with and without the Coccyx). Results Routine removal of the Coccyx determines an average 42% (95% CI 27-57%) gain in surgical field exposure area facing the anterior rectal wall at the level of the prostate/vagina by the surgeon. Fifteen (51%) patients had >= 30% (median) estimated gain in surgical field exposure by coccygectomy. There was no association between BMI, age or gender and estimated gain in surgical field exposure area. Conclusions Routine removal of the Coccyx during APR may result in an average increase in 42% in surgical field exposure during APR's perineal dissection. Precise estimation of surgical field exposure gain by removal of the Coccyx may be predicted by MR sagittal series for each individual patient.

  • The Estimate of the Impact of Coccyx Resection in Surgical Field Exposure During Abdominal Perineal Resection Using Preoperative High-Resolution Magnetic Resonance.
    World Journal of Surgery, 2018
    Co-Authors: Guilherme Pagin São Julião, Cinthia D Ortega, Sergio Eduardo Alonso Araujo, Laura Melina Fernandez, F A B Coutinho, Bruna Borba Vailati, G. Brown, Gustavo Rossi, Angelita Habr-gama, Rodrigo Oliva Perez
    Abstract:

    To estimate the improvement in surgical exposure by removal of the Coccyx, during abdomino-perineal resection (APR), in rectal cancer patients. Retrospective study of 29 consecutive patients with rectal cancer was carried out. Using MR T2 sagittal series, the solid angle was estimated using the angle determined by the anterior resection margin and the tip of Coccyx (no Coccyx resection) or the tip of last sacral vertebra (Coccyx resection). The solid angle provides an estimate of the tridimensional surface area provided by an original angle resulting in the best estimate of the surgeon’s view/exposure to the critical dissecting point of choice (anterior rectal wall). The difference (“Gain”) in surgical field exposure by removal of the Coccyx was compared by the solid angle variation between the two estimates (with and without the Coccyx). Routine removal of the Coccyx determines an average 42% (95% CI 27–57%) gain in surgical field exposure area facing the anterior rectal wall at the level of the prostate/vagina by the surgeon. Fifteen (51%) patients had ≥30% (median) estimated gain in surgical field exposure by coccygectomy. There was no association between BMI, age or gender and estimated gain in surgical field exposure area. Routine removal of the Coccyx during APR may result in an average increase in 42% in surgical field exposure during APR’s perineal dissection. Precise estimation of surgical field exposure gain by removal of the Coccyx may be predicted by MR sagittal series for each individual patient.

Jean-yves Maigne - One of the best experts on this subject based on the ideXlab platform.

  • Classification of fractures of the Coccyx from a series of 104 patients.
    European Spine Journal, 2019
    Co-Authors: Jean-yves Maigne, Levon Doursounian, Frédéric Jacquot
    Abstract:

    To describe a classification of fractures of the Coccyx, according to their mechanism. A series of 104 consecutive patients with a fracture of the Coccyx was studied. The mechanism, level, characteristics of the fracture line and complications were recorded. Three mechanisms are proposed to describe these fractures: flexion, compression and extension (types 1, 2 and 3, respectively). Flexion fractures (38 cases) involved the upper Coccyx in 35 cases, and in 3 cases with a perineal trauma, it was the lower Coccyx; compression fractures (24 cases) involved the middle Coccyx and occurred only when Co2 was square or cuneiform and Co3 was long and straight, hence a nutcracker mechanism; four patients were adolescents with a compression of the sacrum extremity and were labeled adolescent compression fracture of S5 (type 2b); extension fractures (38 cases) were obstetrical and involved the lower Coccyx; their key feature was a progressive separation of the fragments with time. Flexion fractures usually healed spontaneously, but an associated intermittent luxation was possible. Nutcracker and obstetrical fractures were instable in their majority. For the first time, a classification of fractures of the Coccyx is presented. Each type exhibits specific features. This should help the clinician in the management of these patients. These slides can be retrieved under Electronic Supplementary Material.

  • Classification of fractures of the Coccyx from a series of 104 patients
    European Spine Journal, 2019
    Co-Authors: Jean-yves Maigne, Levon Doursounian, Frédéric Jacquot
    Abstract:

    Purpose To describe a classification of fractures of the Coccyx, according to their mechanism. Methods A series of 104 consecutive patients with a fracture of the Coccyx was studied. The mechanism, level, characteristics of the fracture line and complications were recorded. Results Three mechanisms are proposed to describe these fractures: flexion, compression and extension (types 1, 2 and 3, respectively). Flexion fractures (38 cases) involved the upper Coccyx in 35 cases, and in 3 cases with a perineal trauma, it was the lower Coccyx; compression fractures (24 cases) involved the middle Coccyx and occurred only when Co2 was square or cuneiform and Co3 was long and straight, hence a nutcracker mechanism; four patients were adolescents with a compression of the sacrum extremity and were labeled adolescent compression fracture of S5 (type 2b); extension fractures (38 cases) were obstetrical and involved the lower Coccyx; their key feature was a progressive separation of the fragments with time. Flexion fractures usually healed spontaneously, but an associated intermittent luxation was possible. Nutcracker and obstetrical fractures were instable in their majority. Conclusions For the first time, a classification of fractures of the Coccyx is presented. Each type exhibits specific features. This should help the clinician in the management of these patients. Graphic abstract These slides can be retrieved under Electronic Supplementary Material.

  • Magnetic resonance imaging morphology and morphometry of the Coccyx in coccydynia.
    Spine, 2013
    Co-Authors: Jason T. K. Woon, Jean-yves Maigne, Vivekanandan Perumal, Mark D Stringer
    Abstract:

    STUDY DESIGN Retrospective case-control study. OBJECTIVE To determine if differences exists between the bony anatomy of the Coccyx in patients with coccydynia and that in subjects with no known coccygeal pathology. SUMMARY OF BACKGROUND DATA Numerous bony characteristics of the Coccyx have been described in patients with coccydynia but their significance is uncertain. This study aimed to evaluate these in patients with coccydynia and compare them with normal coccyges. METHODS Magnetic resonance scans of the Coccyx from 107 adults (mean age, 43 ± 12 yr; 84 females) with clinically diagnosed coccydynia were retrospectively analyzed and compared with 112 computed tomographic scans from sex-matched adults with normal coccyges. The following were assessed: coccygeal segmentation; sacrococcygeal and intercoccygeal joint fusion, angles, and curvature; bony spicule formation; and subluxation. RESULTS Compared with normal, females with coccydynia had a more ventrally curved Coccyx (curvature index, 85 ± 7 vs. 90 ± 5; P< 0.01), a lower prevalence of sacrococcygeal joint fusion (27% vs. 58%, P< 0.01), and a higher frequency of bony spicule formation (44% vs. 19%, P< 0.01). Males with coccydynia showed a trend toward a more ventrally curved Coccyx (curvature index: 86 ± 6 vs. 89 ± 5, P< 0.08), and a lower prevalence of sacrococcygeal (27% vs. 60%, P< 0.02) and intercoccygeal (0% vs. 22%, P< 0.02) joint fusion. Combining statistically significant coccygeal parameters in a logistic regression model yielded sensitivity, specificity, and positive predictive values of 72%, 71%, and 73%, respectively in females and 52%, 92%, and 73%, respectively in males. CONCLUSION This is the most detailed comparison of coccygeal morphology and morphometry in adults with and without coccydynia investigated using cross-sectional imaging. Anatomical differences in joint fusion and coccygeal curvature may either predispose to the development of coccydynia or arise as a result of this condition.

  • CT morphology and morphometry of the normal adult Coccyx.
    European Spine Journal, 2012
    Co-Authors: Jason T. K. Woon, Jean-yves Maigne, Vivekanandan Perumal, Mark D Stringer
    Abstract:

    Purpose Lack of data on the in vivo morphology and morphometry of the normal adult Coccyx hampers understanding of radiological abnormalities in idiopathic coccydynia. The aim of this study was to investigate normal adult sacrococcygeal morphometry.

  • Magnetic resonance imaging findings in the painful adult Coccyx
    European Spine Journal, 2012
    Co-Authors: Jean-yves Maigne, Isabelle Pigeau, Bernard Roger
    Abstract:

    Objective Imaging of the painful Coccyx currently relies on standard and dynamic radiography. There are no literature data on MRI of the Coccyx. This examination could provide information on the cause of pain.

K Dincer - One of the best experts on this subject based on the ideXlab platform.

  • Coccyx fractures in patients with spinal cord injury
    European Journal of Physical and Rehabilitation Medicine, 2010
    Co-Authors: Levent Tekin, Levent Özçakar, B Yilmaz, R Alaca, K Dincer
    Abstract:

    AIM The aim of this study was to report whether Coccyx fractures are present in spinal cord injury (SCI) patients, who suffered from painful symptoms in the low back, gluteal, hip and thigh regions; and to determine the pain characteristics of coccydynia in these patients. METHODS Twenty males and six females with traumatic SCI (mean age: 31.57+/-12.23 years) who described painful symptoms in the low back, hip, gluteal or thigh regions were included in the study. Pain assessment was done by using visual analogue scale (VAS) and the short form of McGill pain questionnaire. Radiological assessment comprised two-sided lumbar vertebrae, hip and Coccyx X-ray graphics. RESULTS Mean duration of SCI was 19.54+/-30.08 months. Nine patients (34.62%) had Coccyx fractures. Sensory Pain Index and total McGill scores were found to be significantly higher in patients with Coccyx fractures. Correlation analyses revealed significant correlations between VAS, SPI, affective pain index, present pain intensity and McGill total scores (all P<0.05). Duration of SCI was correlated with SPI (P=0.03) and total McGill scores (P=0.05). CONCLUSION Coccyx fractures have been detected in patients with SCI and the presence of such fractures seems to affect the pain scenario unfavorably. Involved patients will be treated promptly and their rehabilitation process will be enhanced when these fractures are recognized early.

G. Brown - One of the best experts on this subject based on the ideXlab platform.

  • the estimate of the impact of Coccyx resection in surgical field exposure during abdominal perineal resection using preoperative high resolution magnetic resonance
    World Journal of Surgery, 2018
    Co-Authors: Guilherme Pagin São Julião, Cinthia D Ortega, Sergio Eduardo Alonso Araujo, Laura Melina Fernandez, F A B Coutinho, Bruna Borba Vailati, Angelita Habrgama, G. Brown, Gustavo Rossi, Rodrigo Oliva Perez
    Abstract:

    Objective To estimate the improvement in surgical exposure by removal of the Coccyx, during abdomino-perineal resection (APR), in rectal cancer patients. Methods Retrospective study of 29 consecutive patients with rectal cancer was carried out. Using MR T2 sagittal series, the solid angle was estimated using the angle determined by the anterior resection margin and the tip of Coccyx (no Coccyx resection) or the tip of last sacral vertebra (Coccyx resection). The solid angle provides an estimate of the tridimensional surface area provided by an original angle resulting in the best estimate of the surgeon's view/exposure to the critical dissecting point of choice (anterior rectal wall). The difference ("Gain") in surgical field exposure by removal of the Coccyx was compared by the solid angle variation between the two estimates (with and without the Coccyx). Results Routine removal of the Coccyx determines an average 42% (95% CI 27-57%) gain in surgical field exposure area facing the anterior rectal wall at the level of the prostate/vagina by the surgeon. Fifteen (51%) patients had >= 30% (median) estimated gain in surgical field exposure by coccygectomy. There was no association between BMI, age or gender and estimated gain in surgical field exposure area. Conclusions Routine removal of the Coccyx during APR may result in an average increase in 42% in surgical field exposure during APR's perineal dissection. Precise estimation of surgical field exposure gain by removal of the Coccyx may be predicted by MR sagittal series for each individual patient.

  • The Estimate of the Impact of Coccyx Resection in Surgical Field Exposure During Abdominal Perineal Resection Using Preoperative High-Resolution Magnetic Resonance.
    World Journal of Surgery, 2018
    Co-Authors: Guilherme Pagin São Julião, Cinthia D Ortega, Sergio Eduardo Alonso Araujo, Laura Melina Fernandez, F A B Coutinho, Bruna Borba Vailati, G. Brown, Gustavo Rossi, Angelita Habr-gama, Rodrigo Oliva Perez
    Abstract:

    To estimate the improvement in surgical exposure by removal of the Coccyx, during abdomino-perineal resection (APR), in rectal cancer patients. Retrospective study of 29 consecutive patients with rectal cancer was carried out. Using MR T2 sagittal series, the solid angle was estimated using the angle determined by the anterior resection margin and the tip of Coccyx (no Coccyx resection) or the tip of last sacral vertebra (Coccyx resection). The solid angle provides an estimate of the tridimensional surface area provided by an original angle resulting in the best estimate of the surgeon’s view/exposure to the critical dissecting point of choice (anterior rectal wall). The difference (“Gain”) in surgical field exposure by removal of the Coccyx was compared by the solid angle variation between the two estimates (with and without the Coccyx). Routine removal of the Coccyx determines an average 42% (95% CI 27–57%) gain in surgical field exposure area facing the anterior rectal wall at the level of the prostate/vagina by the surgeon. Fifteen (51%) patients had ≥30% (median) estimated gain in surgical field exposure by coccygectomy. There was no association between BMI, age or gender and estimated gain in surgical field exposure area. Routine removal of the Coccyx during APR may result in an average increase in 42% in surgical field exposure during APR’s perineal dissection. Precise estimation of surgical field exposure gain by removal of the Coccyx may be predicted by MR sagittal series for each individual patient.