The Experts below are selected from a list of 3024 Experts worldwide ranked by ideXlab platform
Masakazu Takayasu - One of the best experts on this subject based on the ideXlab platform.
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Reliability of an Intraoperative Radiographic Anteroposterior View of the Spinal Midline for Detection of Pedicle Screws Breaching the Medial Pedicle Wall in the Thoracic, Lumbar, and Sacral Spine.
World neurosurgery, 2019Co-Authors: Ryuya Maejima, Mikinobu Takeuchi, Norimitsu Wakao, Mitsuhiro Kamiya, Masahiro Aoyama, Masahiro Joko, Koji Osuka, Masakazu TakayasuAbstract:Objective The purpose of this study was to determine the sensitivity and specificity of using the spinal midline (M line) on a radiographic anteroposterior (AP) view for detecting pedicle screws (PSs) breaching the medial pedicle wall. Methods We retrospectively reviewed 145 patients who underwent fusion surgery using PSs between January 2006 and May 2017. We defined the M line as a line that connected the upper and lower spinous processes through the fixed vertebrae. The M line was positive if the tip of the PS crossed the M line. The reference standard was a computed tomography scan. The reliability of the M line was examined. Results The subjects included 145 patients (70 men and 75 women; mean age, 63.4 years). A total of 599 PSs were examined. Most cases were because of spondylolisthesis (66.9%). Most screws were inserted at a lower lumber level (77.6%). Analysis of the diagnostic accuracy of the M line yielded a sensitivity of 74.1% and a specificity of 95.3%. In addition, the positive predictive value of the M line was 42.6%, and the negative predictive value of the M line was 98.7%. Conclusions Assessment of the M line via an intraoperative radiographic AP view is a simple, readily available, complementary method for detecting PSs that have breached the medial pedicle wall in the thoracic, lumbar, and Sacral Spine. In particular, the M line has a strong negative predictive value, which is much more meaningful.
Marcel Gutberlet - One of the best experts on this subject based on the ideXlab platform.
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computer tomography assessment of pedicle screw placement in lumbar and Sacral Spine comparison between free hand and o arm based navigation techniques
European Spine Journal, 2011Co-Authors: Joshua Silbermann, Yasser Allam, H Koeppert, Franziska Riese, T Reichert, Marcel GutberletAbstract:Transpedicular screw fixation has been accepted worldwide since Harrington et al. first placed pedicle screws through the isthmus. In vivo and in vitro studies indicated that pedicle screw insertion accuracy could be significantly improved with image-assisted systems compared with conventional approaches. The O-arm is a new generation intraoperative imaging system designed without compromise to address the needs of a modern OR like no other system currently available. The aim of our study was to check the accuracy of O-arm based and S7-navigated pedicle screw implants in comparison to free-hand technique described by Roy-Camille at the lumbar and Sacral Spine using CT scans. The material of this study was divided into two groups, free-hand group (group I) (30 patients; 152 screws) and O-arm group (37 patients; 187 screws). The patients were operated upon from January to September 2009. Screw implantation was performed during PLIF or TLIF mainly for spondylolisthesis, osteochondritis and post-laminectomy syndrome. The accuracy rate in our work was 94.1% in the free-hand group compared to 99% in the O-arm navigated group. Thus it was concluded that free-hand technique will only be safe and accurate when it is in the hands of an experienced surgeon and the accuracy of screw placement with O-arm can reach 100%.
Ron Tribell - One of the best experts on this subject based on the ideXlab platform.
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Thoracic, Lumbar, and Sacral Spine Anatomy for Endoscopic Surgery
Neurosurgery, 2002Co-Authors: T. Glenn Pait, Alexandre J.r. Elias, Ron TribellAbstract:Abstract WE DISCUSS THE anatomy of the thoracic, lumbar, and Sacral levels of the spinal cord. Given the nature of endoscopic surgery, it is recommended that the surgeon have thorough knowledge not only of the bony architecture but also of important visceral and other soft tissue structures. It is essential to understand the normal anatomy to recognize the abnormal and anatomic variations. We present the so-called normal anatomic configurations and illustrate how these structures vary at the different levels of the spinal column.
Maximilian J Hartel - One of the best experts on this subject based on the ideXlab platform.
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Assessment of bone quality at the lumbar and Sacral Spine using CT scans: a retrospective feasibility study in 50 comparing CT and DXA data.
European spine journal : official publication of the European Spine Society the European Spinal Deformity Society and the European Section of the Cerv, 2020Co-Authors: Josephine Berger-groch, Darius M. Thiesen, Dimitris Ntalos, F. Hennes, Maximilian J HartelAbstract:Computed tomography (CT) is a standard diagnostic tool for preoperative screening for many indications in spinal and pelvic surgery. The gold standard for diagnosing osteoporosis is standard dual-energy X-ray absorptiometry (DXA). The aim of the present study was to compare the accuracy of Hounsfield unit (HU) measurements not only at the lower lumbar, but also at the Sacral Spine using standard CT scans. Main inclusion criterion for this retrospective analysis in 50 patients was the availability of both a CT scan of the lumbar and Sacral Spines and a DXA scan. HUs were measured in intact vertebral bodies L4, L5 and S1. Results of the HU in CT scan were compared to the T-score and bone mineral density in DXA. A group with normal bone density (T-score higher − 1, n = 26) was compared with a group with impaired bone density (T-score lower − 1, n = 24). A multivariant binary logistic regression analysis showed significant results for HU measurement in L4 (p = 0.009), L5 (p = 0.005) and S1 (p = 0.046) with respect to differentiation between normal and impaired bone quality. Cutoffs between normal and impaired bone density values for trabecular region of interest attenuation for L4, L5 and S1 are presented. In L4 100% sensitivity to detect normal bone was reached when HU was higher than 161, HU higher than 157 in L5 and HU higher than 207 in S1. HU measurements in CT scans have proven to be a feasible tool to additionally assess bone quality at the lumbar and Sacral Spine with good sensitivity, when compared with the gold standard DXA. III. These slides can be retrieved under Electronic Supplementary Material.
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Assessment of bone quality at the lumbar and Sacral Spine using CT scans: a retrospective feasibility study in 50 comparing CT and DXA data
European Spine Journal, 2020Co-Authors: Josephine Berger-groch, Darius M. Thiesen, Dimitris Ntalos, F. Hennes, Maximilian J HartelAbstract:Purpose Computed tomography (CT) is a standard diagnostic tool for preoperative screening for many indications in spinal and pelvic surgery. The gold standard for diagnosing osteoporosis is standard dual-energy X-ray absorptiometry (DXA). The aim of the present study was to compare the accuracy of Hounsfield unit (HU) measurements not only at the lower lumbar, but also at the Sacral Spine using standard CT scans. Patients and methods Main inclusion criterion for this retrospective analysis in 50 patients was the availability of both a CT scan of the lumbar and Sacral Spines and a DXA scan. HUs were measured in intact vertebral bodies L4, L5 and S1. Results of the HU in CT scan were compared to the T -score and bone mineral density in DXA. A group with normal bone density ( T -score higher − 1, n = 26) was compared with a group with impaired bone density ( T -score lower − 1, n = 24). Results A multivariant binary logistic regression analysis showed significant results for HU measurement in L4 ( p = 0.009), L5 ( p = 0.005) and S1 ( p = 0.046) with respect to differentiation between normal and impaired bone quality. Cutoffs between normal and impaired bone density values for trabecular region of interest attenuation for L4, L5 and S1 are presented. In L4 100% sensitivity to detect normal bone was reached when HU was higher than 161, HU higher than 157 in L5 and HU higher than 207 in S1. Conclusions HU measurements in CT scans have proven to be a feasible tool to additionally assess bone quality at the lumbar and Sacral Spine with good sensitivity, when compared with the gold standard DXA. Level of evidence III. Graphic abstract These slides can be retrieved under Electronic Supplementary Material.
Paul Park - One of the best experts on this subject based on the ideXlab platform.
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Tarlov cysts: a controversial lesion of the Sacral Spine
Neurosurgical focus, 2011Co-Authors: Corrado Lucantoni, Khoi D. Than, Anthony C. Wang, Juan M. Valdivia-valdivia, Cormac O. Maher, Frank La Marca, Paul ParkAbstract:The primary aim of our study was to provide a comprehensive review of the clinical, imaging, and histopathological features of Tarlov cysts (TCs) and to report operative and nonoperative management strategies in patients with Sacral TCs. A literature review was performed to identify articles that reported surgical and nonsurgical management of TCs over the last 10 years. Tarlov cysts are often incidental lesions found in the Spine and do not require surgical intervention in the great majority of cases. When TCs are symptomatic, the typical clinical presentation includes back pain, coccyx pain, low radicular pain, bowel/bladder dysfunction, leg weakness, and sexual dysfunction. Tarlov cysts may be revealed by MR and CT imaging of the lumboSacral Spine and must be meticulously differentiated from other overlapping spinal pathological entities. They are typically benign, asymptomatic lesions that can simply be monitored. To date, no consensus exists about the best surgical strategy to use when indicated. The...
