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41. C-arm Positioning Is a Significant Source of Radiation in Spine Surgery. (PubMed)

localization is necessary in minimally invasive spine procedures to visualize anatomy, but increased radiation exposure is associated with health risks. Preoperative imaging for anatomical localization has not been previously analyzed as an appreciable source of radiation.From an institutional review board-approved database of more than 1100 procedures, the minimally invasive spine cases with recorded set-up radiation were extracted. The total radiation, set-up radiation, and procedure type data were (...) evaluated. Statistics were generated using a chi-squared analysis.Set-up and total radiation data were collected for 270 spine surgeries performed by four surgeons at two locations. There were 30 thoracic and 240 thoracolumbar/lumbar cases; 78 anterior and 192 posterior cases. Average total radiation (set-up and intraoperative) was 8.04 rad, and average setup radiation was 1.90 rad (28%, std 2.97 rad) across all cases. On average for the thoracolumbar/lumbar cases, set-up radiation accounted for almost

2017 Spine

42. C7 intra-laminar screws for complex cervicothoracic spine surgery—a case series (PubMed)

C7 intra-laminar screws for complex cervicothoracic spine surgery—a case series C7 has relatively unique anatomy compared to the remainder of the subaxial cervical spine (C3-C6) and upper thoracic spine. The C7 laminar has been previously reported in feasibility and biomechanical studies as an adequate fixation point in contrast to the lateral mass or pedicles, with few reports of its use in clinical practice. The purpose of this study was to review the safety and efficacy of using the C7 (...) laminar as a fixation point in constructs involving the cervical spine and cervicothoracic junction.Between February 2013 and July 2016, 10 patients (6 males, 4 females) had 19 C7 intra-laminar screws sited (bilateral in 9 patients, unilateral in 1 patient). Six patients had trauma as an underlying etiology, 2 of which had pseudoarthrosis from prior surgery. Three patients had cervical myelopathy from degenerative disease, 2 of which required anterior and posterior instrumentation for correction

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2017 Journal of Spine Surgery

43. A Custom-Designed MR Coil for Spine Radiotherapy Treatment Planning

Spine Coil During the participant's MR scan, the custom spine coil will be placed between the participant and the immobilization mold. image parameters will be optimized for spine anatomy for the pulse sequences which are standard for MR imaging. Diagnostic Test: FDA approved spine coil During the participant's MR scan, the FDA spine coil will be placed between the participant and the immobilization mold. image parameters will be optimized for spine anatomy for the pulse sequences which are standard (...) will classify this sample point as a "success". We will combine the 15 volunteers from the three cohorts (cervical-spine, thoracic-spine and lumbar-spine) and impose the following decision rule: If at least 12 out of the total 15 volunteers are success, then we declare the custom designed spine coil promising and worthy of further investigation. Eligibility Criteria Go to Information from the National Library of Medicine Choosing to participate in a study is an important personal decision. Talk with your

2017 Clinical Trials

44. Analysis of the techniques for thoracic- and lumbar-level localization during posterior spine surgery and the occurrence of wrong-level surgery: results from a national survey. (PubMed)

Analysis of the techniques for thoracic- and lumbar-level localization during posterior spine surgery and the occurrence of wrong-level surgery: results from a national survey. Despite the frequency with which surgeons perform posterior spinal surgery and the precautions against wrong-site surgery, operations on incorrect levels still occur. Wrong-level exposure is documented in 0.32% to 15% of cases. Additionally, there is little consensus as to what is the most accurate method for localizing (...) the correct spinal level.The purpose of this study is to investigate the most commonly used localization methods and their association with wrong-level surgery, to determine the prevalence of wrong-level localization, and to identify circumstances commonly associated with wrong-level surgery, and to offer recommendations that may reduce the incidence of these errors.This was an online survey study that was distributed to North American Spine Society (NASS) members (including both orthopedic surgeons

2013 The Spine Journal

45. Lateral extracavitary, costotransversectomy, and transthoracic thoracotomy approaches to the thoracic spine: review of techniques and complications. (PubMed)

Lateral extracavitary, costotransversectomy, and transthoracic thoracotomy approaches to the thoracic spine: review of techniques and complications. Systematic review.The authors review complications, as reported in the literature, associated with ventral and posterolateral approaches to the thoracic spine.The lateral extracavitary, costotransversectomy, and transthoracic thoracotomy techniques allow surgeons to access the ventral thoracic spine for a wide range of spinal disorders including (...) tumor, degeneration, trauma, and infection. Although the transthoracic thoracotomy has been used traditionally to reach the ventral thoracic spine when access to the vertebral body is required, modifications to the various dorsal approaches have enabled surgeons to achieve goals of decompression, reconstruction, and stabilization through a single approach.A systematic Medline search from 1991 to 2011 was performed to identify series reporting clinical data related to these surgical approaches

2013 Journal of spinal disorders & techniques

46. Comparative Study of Nonintubated Uniport Thoracoscopic Surgery Using Thoracic Paravertebral Nerve Block Versus Intercostal Nerve Block for Peripheral Solitary Pulmonary Nodule Patients

diseases Exclusion Criteria: refusal or inability to comply with the informed consent the nodule of the nature of the non small cell lung caner is excluded hypovolemia, blood disorders or abnormal clotting mechanism the abnormal cardiopulmonary function(the American Society of Anesthesiologists greater than 3) lower airway infection,more than airway secretion abnormal anatomy of the spine,the history of thoracic back surgery impaired lung function(forced expiratory volume in second 1 less than (...) Comparative Study of Nonintubated Uniport Thoracoscopic Surgery Using Thoracic Paravertebral Nerve Block Versus Intercostal Nerve Block for Peripheral Solitary Pulmonary Nodule Patients Comparative Study of Nonintubated Uniport Thoracoscopic Surgery Using Thoracic Paravertebral Nerve Block Versus Intercostal Nerve Block for Peripheral Solitary Pulmonary Nodule Patients - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration

2017 Clinical Trials

47. A cadaveric study of the serratus anterior muscle and the long thoracic nerve. (PubMed)

A cadaveric study of the serratus anterior muscle and the long thoracic nerve. The anatomy and function of the serratus anterior muscle and the long thoracic nerve have not been fully elucidated. The purposes of this investigation were (1) to clarify which nerve roots of the cervical spine supply each part of the muscle and contribute to the long thoracic nerve and (2) to investigate the anatomy of the 3 parts of the muscle to understand the function of each part. We collected specimens from 70 (...) dissections of 35 cadavers (11 men and 24 women). The serratus anterior muscle consisted of the upper, middle, and lower parts. The upper part was supplied mainly by the C5 nerve root, and the C4, C6, or C7 nerve roots also had multiple branches in 64 of 70 dissections. The long thoracic nerve, consisting of the C6 and C7 nerve roots, innervated the middle and lower parts. The upper part traversed in a posterior direction compared with the middle or lower part. The upper part of the muscle, which

2017 Journal of Shoulder and Elbow Surgery

48. Management of Pediatric Cervical Spine and Spinal Cord Injuries

neurological prognosis. Treatment Level III: Thoracic elevation or an occipital recess is recommended in children < 8 years of age to prevent flexion of the head and neck when restrained supine on an otherwise flat backboard for better neutral alignment and immobilization of the cervical spine. Closed reduction and halo immobilization are recommended for injuries of the C2 synchondrosis in children < 7 years of age. Reduction with manipulation or halter traction is recommended for patients with acute AARF (...) differ from those that occur in adults. The diagnostic studies and images necessary to exclude a cervical spine injury in a child may be different than in the adult as well. The interpretation of pediatric radiographic studies must be made with knowledge of age-related development of the osseous and ligamentous anatomy. Methods of reduction, stabilization, and subsequent treatment, surgical and non-surgical, must be customized to each child, taking into account the child's degree of physical

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2013 Congress of Neurological Surgeons

49. Subaxial Cervical Spine Injury Classification Systems

ligaments and the influence of facet anatomy in determining stability. However, despite its apparent simplicity, it has not been widely put into practice and has never been validated. FIGURE 2. Five different patterns of osseous and ligamentous injuries of the cervical spine proposed by Holdsworth. Sagittal reformatted computed tomography depicts Flexion, Flexion/Rotation, Compression and Shear injuries to the cervical spine. Reformatted T2W magnetic resonance imaging shows a typical example (...) ( 8 ): 817 – 831 . 2. Harris JH Jr , Edeiken-Monroe B , Kopaniky DR A practical classification of acute cervical spine injuries . Orthop Clin North Am . 1986 ; 17 ( 1 ): 15 – 30 . 3. Holdsworth F Fractures, dislocations, and fracture-dislocations of the spine . J Bone Joint Surg Am . 1970 ; 52 ( 8 ): 1534 – 1551 . 4. Mirza SK , Mirza AJ , Chapman JR , Anderson PA Classifications of thoracic and lumbar fractures: rationale and supporting data . J Am Acad Orthop Surg . 2002 ; 10 ( 5 ): 364 – 377 . 5

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2013 Congress of Neurological Surgeons

50. Brachial Plexus Anatomy

) Gray's Anatomy 20th ed (in at or ) IV. Anatomy: Plexus Divisions Upper Plexus abductors External rotators flexors Sensation to and radial arm Lower Plexus and Hand motor function Sensation to ulnar arm, , and hand First Thoracic (T1) Sympathetic face fibers Perceived enophthalmos Anhidrosis V. Anatomy: Cords Posterior Cord Supplies Medial Cord Supplies 1/2 Supplies all of Lateral Cord Supplies 1/2 Supplies Musculocutaneous VI. Anatomy: Plexus course Passes between middle and anterior scalene muscles (...) Brachial Plexus Anatomy Brachial Plexus Anatomy Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Brachial Plexus Anatomy Brachial

2018 FP Notebook

51. Shoulder Anatomy

Anatomy , Shoulder II. Anatomy Bone and Ligament Also available as a . See Also available as a . See Lewis (1918) Gray's Anatomy 20th ed (in at or ) Lewis (1918) Gray's Anatomy 20th ed (in at or ) Lewis (1918) Gray's Anatomy 20th ed (in at or ) Muscles Lewis (1918) Gray's Anatomy 20th ed (in at or ) Lewis (1918) Gray's Anatomy 20th ed (in at or ) Lewis (1918) Gray's Anatomy 20th ed (in at or ) III. Anatomy: Bones r spine Third thoracic e r inferior angle Eighth thoracic e (7th rib) Clavicle IV (...) Shoulder Anatomy Shoulder Anatomy Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Shoulder Anatomy Shoulder Anatomy Aka: Shoulder

2018 FP Notebook

52. Lumbar Spine Anatomy

Lumbar Spine Anatomy Lumbar Spine Anatomy Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Lumbar Spine Anatomy Lumbar Spine Anatomy (...) Aka: Lumbar Spine Anatomy , L-Spine Anatomy , Lumbar Spine , Lumbosacral Spine II. Anatomy: Nerve Course Disc disease affects nerve exiting one level below Nerve passes over the affected disc Example L4-5 disc tion affects L5 nerve Contrast with III. Anatomy: Components Spinal cord terminates at L1-L2 in the adult Lumbosacral nerve roots comprise cauda equina IV. Images: Bone Lewis (1918) Gray's Anatomy 20th ed (in at or ) Lewis (1918) Gray's Anatomy 20th ed (in at or ) Lewis (1918) Gray's Anatomy

2015 FP Notebook

53. Cervical Spine Anatomy

Anatomy Aka: Cervical Spine Anatomy , C-Spine Anatomy , Cervical Vertebrae , Cervical Spine II. Anatomy: Seven Cervical Vertebrae Level C1: Atlas Level C2: Axis with Dens and Odontoid process Level C7: prominens Spinous process long and prominent C8 cervical nerve root exits below C7 III. Anatomy: General Cervical spinal nerves C1-C7 exit about their corresponding e In transitioning to , C8 exits below the C7 , and above T1 In contrast, all thoracic and lumbar spinal nerves exit below (...) Cervical Spine Anatomy Cervical Spine Anatomy Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Cervical Spine Anatomy Cervical Spine

2015 FP Notebook

54. Suspected Spine Trauma

contrast Usually Not Appropriate O MRI cervical spine without and with IV contrast Usually Not Appropriate O Variant 9: Age greater than or equal to 16 years. Blunt trauma meeting criteria for thoracic and lumbar imaging. Initial imaging. Procedure Appropriateness Category Relative Radiation Level CT thoracic and lumbar spine without IV contrast Usually Appropriate ??? Radiography thoracic and lumbar spine May Be Appropriate ??? CT myelography thoracic and lumbar spine Usually Not Appropriate ???? CT (...) thoracic and lumbar spine with IV contrast Usually Not Appropriate ??? CT thoracic and lumbar spine without and with IV contrast Usually Not Appropriate ???? MRI thoracic and lumbar spine without and with IV contrast Usually Not Appropriate O MRI thoracic and lumbar spine without IV contrast Usually Not Appropriate O Variant 10: Age greater than or equal to 16 years. Acute thoracic or lumbar spine injury detected on radiographs or noncontrast CT. Neurologic abnormalities. Next imaging study. Procedure

2012 American College of Radiology

55. ACR-ASNR-SCBT-MR Practice Guideline for the Performance of Magnetic Resonance Imaging (MRI) of the Adult Spine

, and epidural abscess. b. Spinal cord infection including abscess. 4. Vascular disorders a. Spinal vascular malformations and/or the cause of occult subarachnoid hemorrhage. b. Spinal cord infarction. 5. Degenerative conditions a. Degenerative disk disease and its sequelae in the lumbar, thoracic, and cervical spine. b. Neurodegenerative disorders such as subacute combined degeneration, spinal muscular atrophy, amyotrophic lateral sclerosis. 6. Trauma Nature and extent of injury to spinal cord, vertebral (...) to cover the areas of concern. Use of intravenous contrast agents may increase conspicuity of the anatomy and pathology relative to surrounding vascular structures and may help to define avascular areas. PRACTICE GUIDELINE MRI of the Adult Spine / 5 K. Demyelinating Diseases MR imaging, without and with intravenous contrast, is the examination of choice for the imaging diagnosis and follow up of demyelinating processes affecting the spinal cord. Only MRI can identify the extent of disease

2012 American Society of Neuroradiology

56. Arthroscopic discectomy and interbody fusion of the thoracic spine: A report of ipsilateral 2-portal approach (PubMed)

is necessary; postoperative morbidity can be significant. The retropleural procedures are in their infancy, but the published results are promising. The purpose of this study is to introduce the posterolateral arthroscopic thoracic decompression and fusion procedure, which is extrapleural, less disruptive to normal anatomy, and cost-effective.Fifteen consecutive patients who underwent arthroscopic decompression and interbody fusion of the thoracic spine were prospectively studied according (...) Arthroscopic discectomy and interbody fusion of the thoracic spine: A report of ipsilateral 2-portal approach The standard approach to the thoracic disc is through thoracotomy. The video-assisted thoracoscopic approach has been used as an alternative to the open approach for nearly 20 years, and more recently, extracavitary, posterolateral approaches have been introduced. Both the transthoracic procedures involve deflating the lung for access to the spine, and postoperative thoracic drainage

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2012 International journal of spine surgery

57. Safety of fluoroscopy guided percutaneous access to the thoracic spine. (PubMed)

Safety of fluoroscopy guided percutaneous access to the thoracic spine. Fluoroscopy-guided percutaneous access to thoracic vertebrae is technically demanding due to the complex radiological anatomy and close proximity of the spinal cord, major vessels and pleural cavity. There is a trend towards computed tomography (CT) guidance due to a perceived reduction in the risk of spinal canal intrusion by instrumentation causing neurological injury. Due to limited access to CT guidance, there is a need (...) -related complications including neurological, vascular and visceral injury using physiological parameters.No patient in our series was identified to have sustained a neurological deficit or deterioration of preoperative neurological status.Percutaneous access to the thoracic spine using fluoroscopic guidance is safe. The crucial step of the protocol is not to advance the tool beyond the medial pedicle wall on the anterior-posterior projection until the tip of the instrument has reached the posterior

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2012 European Spine Journal

58. Computer tomography assessment of pedicle screw placement in thoracic spine: comparison between free hand and a generic 3D-based navigation techniques. (PubMed)

Computer tomography assessment of pedicle screw placement in thoracic spine: comparison between free hand and a generic 3D-based navigation techniques. Although pedicle screw fixation is a well-established technique for the lumbar spine, screw placement in the thoracic spine is more challenging because of the smaller pedicle size and more complex 3D anatomy. The intraoperative use of image guidance devices may allow surgeons a safer, more accurate method for placing thoracic pedicle screws (...) while limiting radiation exposure. This generic 3D imaging technique is a new generation intraoperative CT imaging system designed without compromise to address the needs of a modern OR.The aim of our study was to check the accuracy of this generic 3D navigated pedicle screw implants in comparison to free hand technique described by Roy-Camille at the thoracic spine using CT scans.The material of this study was divided into two groups: free hand group (group I) (18 patients; 108 screws) and 3D group

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2012 European Spine Journal

59. ACR-ASNR-ASSR-SPR Practice Guideline for the Performance of Computed Tomography (CT) of the Spine

multi-detector row CT. AJNR 2003;24:13-17. 9. Nunez DB, Jr. Helical CT for the Evaluation of Cervical Vertebral Injuries. Semin Musculoskelet Radiol 1998;2:19-26. 10. Obenauer S, Alamo L, Herold T, Funke M, Kopka L, Grabbe E. Imaging skeletal anatomy of injured cervical spine specimens: comparison of single-slice vs multi-slice helical CT. Eur Radiol 2002;12:2107- 2111. 11. Rivas LA, Fishman JE, Munera F, Bajayo DE. Multislice CT in thoracic trauma. Radiol Clin North Am 2003;41:599-616. 12. Stabler (...) . If there is a clinical concern for spinal injury, MRI should be considered in pediatric patients. CT may be used when radiographs of a spinal segment (cervical, thoracic, lumbar, and/or sacral spine) are abnormal, equivocal, or nondiagnostic following a traumatic event. CT can be used for evaluating vertebral compression/insufficiency fractures in both acute and chronic clinical situations [1-15]. 2. Degenerative conditions and osteoarthritis evaluation. CT is often used to study the spine for conditions

2011 American Society of Neuroradiology

60. MIND Demons for MR-to-CT Deformable Image Registration In Image-Guided Spine Surgery (PubMed)

MIND Demons for MR-to-CT Deformable Image Registration In Image-Guided Spine Surgery Localization of target anatomy and critical structures defined in preoperative MR images can be achieved by means of multi-modality deformable registration to intraoperative CT. We propose a symmetric diffeomorphic deformable registration algorithm incorporating a modality independent neighborhood descriptor (MIND) and a robust Huber metric for MR-to-CT registration.The method, called MIND Demons, solves (...) convergence. Registration performance and sensitivity to registration parameters were analyzed in simulation, in phantom experiments, and clinical studies emulating application in image-guided spine surgery, and results were compared to conventional mutual information (MI) free-form deformation (FFD), local MI (LMI) FFD, and normalized MI (NMI) Demons.The method yielded sub-voxel invertibility (0.006 mm) and nonsingular spatial Jacobians with capability to preserve local orientation and topology

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2016 Proceedings of SPIE--the International Society for Optical Engineering

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