BACKGROUND Pedicle screw instrumentation is a critical technique in spinal surgery,offering effective stabilization for various spinal conditions.However,the impact of intraoperative imaging quality—specifically the ...BACKGROUND Pedicle screw instrumentation is a critical technique in spinal surgery,offering effective stabilization for various spinal conditions.However,the impact of intraoperative imaging quality—specifically the use of both anteroposterior(AP)and lateral views—on surgical outcomes remains insufficiently studied.Evaluating whether the adequacy of these imaging modalities affects the risk of unplanned returns to theatre(URTT)within 90 days due to screw malplacement is essential for refining surgical practices and improving patient care.AIM To evaluate how intraoperative imaging adequacy influences unplanned returnto-theatre rates,focusing on AP and lateral fluoroscopic views.METHODS This retrospective cohort study analyzed 1335 patients who underwent thoracolumbar and sacral pedicle screw instrumentation between January 2013 and December 2022.Data on intraoperative imaging adequacy,screw placement,and URTT events were collected and statistically analyzed using IBM SPSS v23.Imaging adequacy was assessed based on the presence of both AP and lateral views,and outcomes were compared between imaging groups.RESULTS A total of 9016 pedicle screws were inserted,with 82 screws identified as malplaced in 52 patients.Of these,46 patients required URTT due to screw malplacement,with 37 returning within 90 days(URTT90).Patients with both AP and lateral imaging saved intraoperatively had significantly lower URTT90 rates compared to those with only lateral imaging saved,demonstrating the critical role of imaging adequacy in improving surgical outcomes.CONCLUSION This study underscores that comprehensive intraoperative imaging with both AP and lateral views reduces unplanned returns,improves outcomes,enhances precision,and offers a cost-effective approach for better spinal surgery results.展开更多
Background: Insertion of an external ventricular drain (EVD) is an important neurosurgical technique. There is a minor risk of misplacement, and complications including infections or hemorrhages have been reported. Tr...Background: Insertion of an external ventricular drain (EVD) is an important neurosurgical technique. There is a minor risk of misplacement, and complications including infections or hemorrhages have been reported. Transient neurological complications are, however, very rare, especially when EVD is placed under endoscope assistance. We report a case of unilateral transient oculomotor palsy after an EVD procedure. Case presentation: An 11-year-old boy with past medical history of moyamoya disease suffered from intraventricular hemorrhage and acute hydrocephalus. Insertion of EVD and hematoma removal was performed with endoscope assistance. After the surgery, transient oculomotor palsy occurred by the direct compression of the brain stem by the drainage tube. Conclusion: Transient unilateral oculomotor palsy due to the direct compression of the midbrain by an EVD tube is a very rare, but possible complication, even under endoscopic assistance. Attention through the procedure is required until skin closure to avoid tube dislocation.展开更多
文摘BACKGROUND Pedicle screw instrumentation is a critical technique in spinal surgery,offering effective stabilization for various spinal conditions.However,the impact of intraoperative imaging quality—specifically the use of both anteroposterior(AP)and lateral views—on surgical outcomes remains insufficiently studied.Evaluating whether the adequacy of these imaging modalities affects the risk of unplanned returns to theatre(URTT)within 90 days due to screw malplacement is essential for refining surgical practices and improving patient care.AIM To evaluate how intraoperative imaging adequacy influences unplanned returnto-theatre rates,focusing on AP and lateral fluoroscopic views.METHODS This retrospective cohort study analyzed 1335 patients who underwent thoracolumbar and sacral pedicle screw instrumentation between January 2013 and December 2022.Data on intraoperative imaging adequacy,screw placement,and URTT events were collected and statistically analyzed using IBM SPSS v23.Imaging adequacy was assessed based on the presence of both AP and lateral views,and outcomes were compared between imaging groups.RESULTS A total of 9016 pedicle screws were inserted,with 82 screws identified as malplaced in 52 patients.Of these,46 patients required URTT due to screw malplacement,with 37 returning within 90 days(URTT90).Patients with both AP and lateral imaging saved intraoperatively had significantly lower URTT90 rates compared to those with only lateral imaging saved,demonstrating the critical role of imaging adequacy in improving surgical outcomes.CONCLUSION This study underscores that comprehensive intraoperative imaging with both AP and lateral views reduces unplanned returns,improves outcomes,enhances precision,and offers a cost-effective approach for better spinal surgery results.
文摘Background: Insertion of an external ventricular drain (EVD) is an important neurosurgical technique. There is a minor risk of misplacement, and complications including infections or hemorrhages have been reported. Transient neurological complications are, however, very rare, especially when EVD is placed under endoscope assistance. We report a case of unilateral transient oculomotor palsy after an EVD procedure. Case presentation: An 11-year-old boy with past medical history of moyamoya disease suffered from intraventricular hemorrhage and acute hydrocephalus. Insertion of EVD and hematoma removal was performed with endoscope assistance. After the surgery, transient oculomotor palsy occurred by the direct compression of the brain stem by the drainage tube. Conclusion: Transient unilateral oculomotor palsy due to the direct compression of the midbrain by an EVD tube is a very rare, but possible complication, even under endoscopic assistance. Attention through the procedure is required until skin closure to avoid tube dislocation.
