51
|
Jarvis S, Salottolo K, Madayag R, Pekarek J, Nwafo N, Wessel A, Duane T, Roberts Z, Lieser M, Corrigan C, Bar-Or D. Delayed hospital admission for traumatic hip fractures during the COVID-19 pandemic. J Orthop Surg Res 2021; 16:237. [PMID: 33794939 PMCID: PMC8012515 DOI: 10.1186/s13018-021-02382-w] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Accepted: 03/23/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Concerns of contracting the highly contagious disease COVID-19 have led to a reluctance in seeking medical attention, which may contribute to delayed hospital arrival among traumatic patients. The study objective was to describe differences in time from injury to arrival for patients with traumatic hip fractures admitted during the pandemic to pre-pandemic patients. MATERIALS AND METHODS This retrospective cohort study at six level I trauma centers included patients with traumatic hip fractures. Patients with a non-fall mechanism and those who were transferred in were excluded. Patients admitted 16 March 2019-30 June 2019 were in the "pre-pandemic" group, patients were admitted 16 March 2020-30 June 2020 were in the "pandemic" group. The primary outcome was time from injury to arrival. Secondary outcomes were time from arrival to surgical intervention, hospital length of stay (HLOS), and mortality. RESULTS There were 703 patients, 352 (50.1%) pre-pandemic and 351 (49.9%) during the pandemic. Overall, 66.5% were female and the median age was 82 years old. Patients were similar in age, race, gender, and injury severity score. The median time from injury to hospital arrival was statistically shorter for pre-pandemic patients when compared to pandemic patients, 79.5 (56, 194.5) min vs. 91 (59, 420), p = 0.04. The time from arrival to surgical intervention (p = 0.64) was statistically similar between groups. For both groups, the median HLOS was 5 days, p = 0.45. In-hospital mortality was significantly higher during the pandemic, 1.1% vs 3.4%, p = 0.04. CONCLUSIONS While time from injury to hospital arrival was statistically longer during the pandemic, the difference may not be clinically important. Time from arrival to surgical intervention remained similar, despite changes made to prevent COVID-19 transmission.
Collapse
Affiliation(s)
- Stephanie Jarvis
- ION Research, 501 East Hampden Avenue, Englewood, Colorado 80113 USA
| | - Kristin Salottolo
- ION Research, 501 East Hampden Avenue, Englewood, Colorado 80113 USA
| | | | - Jennifer Pekarek
- ION Research, 501 East Hampden Avenue, Englewood, Colorado 80113 USA
- St. Anthony Hospital, Lakewood, CO USA
| | | | | | | | | | - Mark Lieser
- Research Medical Center, Kansas City, MO USA
| | | | - David Bar-Or
- ION Research, 501 East Hampden Avenue, Englewood, Colorado 80113 USA
| |
Collapse
|
52
|
Hyland SJ, Brockhaus KK, Vincent WR, Spence NZ, Lucki MM, Howkins MJ, Cleary RK. Perioperative Pain Management and Opioid Stewardship: A Practical Guide. Healthcare (Basel) 2021; 9:333. [PMID: 33809571 PMCID: PMC8001960 DOI: 10.3390/healthcare9030333] [Citation(s) in RCA: 58] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 03/02/2021] [Accepted: 03/10/2021] [Indexed: 12/20/2022] Open
Abstract
Surgical procedures are key drivers of pain development and opioid utilization globally. Various organizations have generated guidance on postoperative pain management, enhanced recovery strategies, multimodal analgesic and anesthetic techniques, and postoperative opioid prescribing. Still, comprehensive integration of these recommendations into standard practice at the institutional level remains elusive, and persistent postoperative pain and opioid use pose significant societal burdens. The multitude of guidance publications, many different healthcare providers involved in executing them, evolution of surgical technique, and complexities of perioperative care transitions all represent challenges to process improvement. This review seeks to summarize and integrate key recommendations into a "roadmap" for institutional adoption of perioperative analgesic and opioid optimization strategies. We present a brief review of applicable statistics and definitions as impetus for prioritizing both analgesia and opioid exposure in surgical quality improvement. We then review recommended modalities at each phase of perioperative care. We showcase the value of interprofessional collaboration in implementing and sustaining perioperative performance measures related to pain management and analgesic exposure, including those from the patient perspective. Surgery centers across the globe should adopt an integrated, collaborative approach to the twin goals of optimal pain management and opioid stewardship across the care continuum.
Collapse
Affiliation(s)
- Sara J. Hyland
- Department of Pharmacy, Grant Medical Center (OhioHealth), Columbus, OH 43215, USA
| | - Kara K. Brockhaus
- Department of Pharmacy, St. Joseph Mercy Hospital Ann Arbor, Ypsilanti, MI 48197, USA;
| | | | - Nicole Z. Spence
- Department of Anesthesiology, Boston University School of Medicine, Boston Medical Center, Boston, MA 02118, USA;
| | - Michelle M. Lucki
- Department of Orthopedics, Grant Medical Center (OhioHealth), Columbus, OH 43215, USA;
| | - Michael J. Howkins
- Department of Addiction Medicine, Grant Medical Center (OhioHealth), Columbus, OH 43215, USA;
| | - Robert K. Cleary
- Department of Surgery, St. Joseph Mercy Hospital Ann Arbor, Ypsilanti, MI 48197, USA;
| |
Collapse
|
53
|
Abstract
AIMS The purpose of this study was to compare the clinical, radiological, and patient-reported outcome measures (PROMs) in the first 100 consecutive patients undergoing total hip arthroplasty (THA) via a direct superior approach (DSA) with a matched group of patients undergoing THA by the same surgeon, using a posterolateral approach (PLA). METHODS This was a retrospective single surgeon study comparing the first 100 consecutive DSA THA patients with a matched group of patients using a standard PLA. Case notes were examined for patient demographics, length of hospital stay, operating time, intra- and postoperative complications, pain score, satisfaction score, and Oxford Hip Score (OHS). Leg length discrepancy and component positioning were measured from postoperative plain radiographs. RESULTS The DSA patients had a shorter length of hospital stay (mean 2.09 days (SD 1.20) DSA vs 2.74 days (SD 1.17) PLA; p < 0.001) and shorter time to discharge from the inpatient physiotherapy teams (mean 1.44 days (SD 1.17) DSA vs 1.93 days (SD 0.96) PLA; p < 0.001). There were no differences in operating time (p = 0.505), pain levels up to postoperative day 1 (p = 0.106 to p =0.242), OHS (p = 0.594 to p = 0.815), satisfaction levels (p = 0.066 to p = 0.299), stem alignment (p = 0.240), acetabular component inclination (p < 0.001) and anteversion (p < 0.001), or leg length discrepancy (p = 0.134). CONCLUSION While the DSA appears safe and was not associated with a significant difference in PROMs, radiological findings, or intraoperative or postoperative complications, a randomized controlled trial with functional outcomes in the postoperative phase is needed to evaluate this surgical approach formally. Cite this article: Bone Joint J 2021;103-B(3):500-506.
Collapse
Affiliation(s)
- Hollie J Leonard
- Department of Orthopaedics, Golden Jubilee National Hospital, Glasgow, UK
| | - Nicholas E Ohly
- Department of Orthopaedics, Golden Jubilee National Hospital, Glasgow, UK
| |
Collapse
|
54
|
Perticarini L, Rossi SMP, Medetti M, Benazzo F. Clinical and radiological outcomes of acetabular revision surgery with trabecular titanium cups in Paprosky type II and III bone defects. J Orthop Traumatol 2021; 22:9. [PMID: 33675431 PMCID: PMC7937008 DOI: 10.1186/s10195-021-00571-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Accepted: 02/21/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This prospective study aims to evaluate the mid-term clinical outcomes and radiographic stability of two different types of cementless trabecular titanium acetabular components in total hip revision surgery. METHODS Between December 2008 and February 2017, 104 cup revisions were performed using trabecular titanium revision cups. Mean age of patients was 70 (range 29-90; SD 11) years. The majority of revisions were performed for aseptic loosening (86 cases, 82.69%), but in all the other diagnoses (18 cases), a significant bone loss (Paprosky type II or III) was registered preoperatively. Bone defects were classified according to Paprosky acetabular classification. We observed 53 type II defects and 42 type III defects. Cups were chosen according to the type of defect. RESULTS Average follow-up was 91 (range 24-146) months. Mean Harris Hip Score (HHS) improved from 43.7 (range 25-70; SD 9) preoperatively to 84.4 (range 46-99; SD 7.56) at last follow-up. One (1.05%) cup showed radiographic radiolucent lines inferior to 2 mm and was clinically asymptomatic. One (1.05%) cup was loose and showed periacetabular allograft reabsorption. Kaplan-Meier survivorship was assessed to be 88.54% (95% CI 80.18-93.52%) at 71 months, with failure of the cup for any reason as the endpoint. CONCLUSION Trabecular titanium revision cups showed good clinical and radiographic results at mid-term follow-up in Paprosky type II and III bone defects. LEVEL OF EVIDENCE Level IV prospective case series.
Collapse
Affiliation(s)
- Loris Perticarini
- Sezione Di Chirurgia Protesica Ad Indirizzo Robotico - Unità Di Traumatologia Dello Sport, U.O. Ortopedia e Traumatologia Fondazione Poliambulanza, Via Bissolati 57, 25124, Brescia, Italy
| | - Stefano Marco Paolo Rossi
- Sezione Di Chirurgia Protesica Ad Indirizzo Robotico - Unità Di Traumatologia Dello Sport, U.O. Ortopedia e Traumatologia Fondazione Poliambulanza, Via Bissolati 57, 25124, Brescia, Italy.
| | - Marta Medetti
- Clinica Ortopedica e Traumatologica, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Francesco Benazzo
- Sezione Di Chirurgia Protesica Ad Indirizzo Robotico - Unità Di Traumatologia Dello Sport, U.O. Ortopedia e Traumatologia Fondazione Poliambulanza, Via Bissolati 57, 25124, Brescia, Italy.,Università Degli Studi Di Pavia, Pavia, Italy
| |
Collapse
|
55
|
Liang W, Han B, Hai JJ, Hai Y, Chen L, Kang N, Yin P. 3D-printed drill guide template, a promising tool to improve pedicle screw placement accuracy in spinal deformity surgery: A systematic review and meta-analysis. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2021; 30:1173-1183. [PMID: 33558972 DOI: 10.1007/s00586-021-06739-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 12/22/2020] [Accepted: 01/17/2021] [Indexed: 12/24/2022]
Abstract
PURPOSE This study aimed to compare the pedicle screw placement accuracy and surgical outcomes between 3D-printed (3DP) drill guide template technique and freehand technique in spinal deformity surgery. METHODS A comprehensive systematic literature search of databases (PubMed, Embase, Cochrane Library, and Web of Science) was conducted. The meta-analysis compared the pedicle screw placement accuracy and other important surgical outcomes between the two techniques. RESULTS A total of seven studies were included in the meta-analysis, comprising 87 patients with 1384 pedicle screws placed by 3DP drill guide templates and 88 patients with 1392 pedicle screws placed by freehand technique. The meta-analysis results revealed that the 3DP template technique was significantly more accurate than the freehand technique to place pedicle screws and had a higher rate of excellently placed screws (OR 2.22, P < 0.001) and qualifiedly placed screws (OR 3.66, P < 0.001), and a lower rate of poorly placed screws (OR 0.23, P < 0.001). The mean placement time per screw (WMD-1.99, P < 0.05), total screw placement time (WMD-27.86, P < 0.001), and blood loss (WMD-104.58, P < 0.05) were significantly reduced in the 3DP template group compared with the freehand group. Moreover, there was no significant statistical difference between the two techniques in terms of the operation time and correction rate of main bend curve. CONCLUSIONS This study demonstrated that the 3DP drill guide template was a promising tool for assisting the pedicle screw placement in spinal deformity surgery and deserved further promotion.
Collapse
Affiliation(s)
- Weishi Liang
- Department of Orthopedic Surgery, Beijing Chaoyang Hospital, Capital Medical University, GongTiNanLu 8#, Chaoyang District, Beijing, 100020, China
| | - Bo Han
- Department of Orthopedic Surgery, Beijing Chaoyang Hospital, Capital Medical University, GongTiNanLu 8#, Chaoyang District, Beijing, 100020, China
| | - Junrui Jonathan Hai
- Junior High School, The High School Affiliated to Renmin University of China, Beijing, 100080, China
| | - Yong Hai
- Department of Orthopedic Surgery, Beijing Chaoyang Hospital, Capital Medical University, GongTiNanLu 8#, Chaoyang District, Beijing, 100020, China.
| | - Long Chen
- Department of Orthopedic Surgery, Beijing Chaoyang Hospital, Capital Medical University, GongTiNanLu 8#, Chaoyang District, Beijing, 100020, China
| | - Nan Kang
- Department of Orthopedic Surgery, Beijing Chaoyang Hospital, Capital Medical University, GongTiNanLu 8#, Chaoyang District, Beijing, 100020, China
| | - Peng Yin
- Department of Orthopedic Surgery, Beijing Chaoyang Hospital, Capital Medical University, GongTiNanLu 8#, Chaoyang District, Beijing, 100020, China
| |
Collapse
|
56
|
Soler E, Farah SN, Bustos VP, Medina SEM, Gómez JF, Lema EM, Moreno CÁ. Experience of clinical screening for COVID-19 among patients undergoing elective orthopedic surgeries: an alternative proposal. J Orthop Surg Res 2021; 16:103. [PMID: 33531037 PMCID: PMC7851635 DOI: 10.1186/s13018-021-02217-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Accepted: 01/07/2021] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic is the largest global event in recent times, with millions of infected people and hundreds of thousands of deaths worldwide. Colombia has also been affected by the pandemic, including by the cancellation of medically necessary surgical procedures that were categorized as nonessential. The objective of this study was to show the results of the program implemented in two institutions in Bogotá, Colombia, in April 2020 to support the performance of elective essential and nonessential low- and medium-complexity orthopedic surgeries during the mitigation phase of the COVID-19 pandemic, which involved a presurgical clinical protocol without serological or molecular testing. METHODS This was a multicenter, observational, retrospective, descriptive study of a cohort of patients who underwent elective orthopedic surgery at two institutions in the city of Bogota, Colombia, in April 2020. We implemented a preoperative clinical protocol that did not involve serological or molecular tests; the protocol consisted of a physical examination, a survey of symptoms and contact with confirmed or suspected cases, and presurgical isolation. We recorded the types of surgeries, the patients' scores on the medically necessary, time-sensitive (MeNTs) scale, the presence of signs, symptoms, and mortality associated with COVID-19 developed after the operation. RESULTS A total of 179 patients underwent orthopedic surgery. The average age was 47 years (Shapiro-Wilk, P = 0.021), and the range was between 18 and 81 years. There was a female predominance (61.5%). With regard to the types of surgeries, 86 (48%) were knee operations, 42 (23.5%) were hand surgeries, 34 (19%) were shoulder surgeries, and 17 (9.5%) were foot and ankle surgeries. The average MeNTs score was 44.6 points. During the 2 weeks after surgery, four patients were suspected of having COVID-19 because they developed at least two symptoms associated with the disease. The incidence of COVID-19 in the postoperative period was 2.3%. Two (1.1%) of these four patients visited an emergency department where RT-PCR tests were performed, and they tested negative for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). No patients died or were hospitalized for symptoms of COVID-19. CONCLUSION Through the implementation of a presurgical clinical protocol consisting of a physical examination; a clinical survey inquiring about signs, symptoms, and epidemiological contact with suspected or confirmed cases; and presurgical isolation but not involving the performance of molecular or serological diagnostic tests, positive results were obtained with regard to the performance of low- and medium-complexity elective orthopedic surgeries in an early stage of the COVID-19 pandemic. LEVEL OF EVIDENCE IV.
Collapse
Affiliation(s)
- Edwarth Soler
- Department of Orthopedics, Keralty Group, Clínica Universitaria Colombia, Bogotá, Colombia.
| | - Sammy Nicolás Farah
- Department of Orthopedics, Keralty Group, Fundación Universitaria Sanitas, Bogotá, Colombia
| | - Valeria P Bustos
- Faculty of Medicine, Pontificia Universidad Javeriana, Bogotá, Colombia
| | | | - Jairo Fernando Gómez
- Department of Orthopedics, Keralty Group, Clínica Universitaria Colombia, Bogotá, Colombia
| | | | | |
Collapse
|
57
|
Jitprapaikulsarn S, Chantarapanich N, Gromprasit A, Mahaisavariya C, Patamamongkonchai C. Single lag screw and reverse distal femur locking compression plate for concurrent cervicotrochanteric and shaft fractures of the femur: biomechanical study validated with a clinical series. EUROPEAN JOURNAL OF ORTHOPAEDIC SURGERY AND TRAUMATOLOGY 2021; 31:1179-1192. [PMID: 33417049 DOI: 10.1007/s00590-020-02868-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 12/29/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND The optimal surgical management of concurrent cervicotrochanteric and shaft fractures of the femur has not been consensual. The authors investigated the reliability of combined single lag screw and reverse distal femur locking compression plate (LCP-DF) by finite element (FE) study and retrospectively described the present technique for these dual fractures. METHOD Intact femurs were derived from CT data, and the implant models were created by using CAD software. The fractured femur and implant models were virtually aligned based on the surgical techniques before converting to the FE model. In the FE model, applied boundary conditions included body weight, muscle forces, and constraint of the joints. Regarding clinical series, three patients with these dual fractures of the femur and 2 with cervicotrochanteric fractures with subtrochanteric extension were operated on by the proposed technique. The collected data include operative time, postoperative complications, union times, and clinical outcomes. RESULTS Equivalent von Mises stress exhibited on dynamic hip screws with an anti-rotational screw was higher than the other techniques, close to the yield stress of the material. Multiple screw fixation produced better stability for transcervical fractures whereas the proposed technique of combined single lag screw and reverse LCP-DF provided better stability for intertrochanteric fractures. No significant difference in cortical bone stress was found between multiple screw construct and the proposed technique. The proposed technique presented a lower risk of secondary fractures, as the strain energy density (SED) in cancellous bone was lower than multiple screw construct. Regarding clinical series, all fractures were united with a mean union time of-16.1 weeks (range 12-20). There were no any postoperative complications. Regarding the Harris score, 1 was determined to be excellent value, and 4 to be good. CONCLUSION By the FE results, a combination of a single lag screw and reverse LCP-DF is an effective technique for fixation of cervicotrochanteric fractures. Empowered by the clinical results, this proposed technique could be an alternative for concurrent cervicotrochanteric and shaft fractures of the femur especially when either single-system or dual-system devices seem not to be suitable.
Collapse
Affiliation(s)
| | - Nattapon Chantarapanich
- Department of Mechanical Engineering, Faculty of Engineering at Sriracha, Kasetsart University, Sriracha, Chonburi, Thailand.
| | - Arthit Gromprasit
- Department of Orthopedics, Buddhachinaraj Hospital, Phitsanulok, Thailand
| | - Chantas Mahaisavariya
- Golden Jubilee Medical Center, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | | |
Collapse
|
58
|
Mariani CL, Zlotnick JA, Harrysson O, Marcellin-Little DJ, Malinak K, Gavitt A, Guevar J. Accuracy of three-dimensionally printed animal-specific drill guides for implant placement in canine thoracic vertebrae: A cadaveric study. Vet Surg 2020; 50:294-302. [PMID: 33373470 DOI: 10.1111/vsu.13557] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 10/07/2020] [Accepted: 11/26/2020] [Indexed: 12/30/2022]
Abstract
OBJECTIVE To assess the accuracy of three-dimensionally (3-D) printed drill guides in constraining the trajectory of drill tracts for implants in canine thoracic vertebrae. STUDY DESIGN Experimental ex vivo study. SAMPLE POPULATION Five canine thoracic vertebral column specimens. METHODS Guides to constrain drill trajectories were designed on the basis of computed tomographic (CT) imaging of six thoracic vertebrae (T8-T13) and were 3-D printed. The guides were used to create drill tracts in these vertebrae by both an experienced and a novice surgeon, and CT imaging was repeated. The entry point and angulation of actual and planned drill tracts were compared for both surgeons. Unintended cortical violations were also assessed by using a modified Zdichavsky classification. RESULTS Fifty-eight drill tracts were created in 30 vertebrae. Mean entry point deviation was 1.4 mm (range, 0.4-3.4), and mean angular deviation was 5.1° (range, 1.5°-10.8°). There were no differences between surgeons in entry point deviation (P = .07) or angular deviation (P = .22). There were no unintended cortical bone violations, and all drill tracts were classified as modified Zdichavsky grade I. CONCLUSION The 3-D printed guides used in the current study yielded drill tracts with small linear and angular errors from intended paths and 100% accuracy for placement within vertebral pedicles and bodies. This technique was conveniently used by both an experienced and a novice surgeon. CLINICAL SIGNIFICANCE This technique might be immediately applicable to clinical cases requiring thoracic vertebral stabilization and may allow safe and accurate implant placement for surgeons with varying experience levels.
Collapse
Affiliation(s)
- Christopher L Mariani
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina.,Comparative Neuroimmunology & Neuro-oncology Laboratory, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina.,Veterinary Hospital, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina
| | - Joshua A Zlotnick
- Comparative Neuroimmunology & Neuro-oncology Laboratory, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina
| | - Ola Harrysson
- Edward P. Fitts Department of Industrial and Systems Engineering, North Carolina State University, Raleigh, North Carolina.,Center for Additive Manufacturing and Logistics, North Carolina State University, Raleigh, North Carolina
| | - Denis J Marcellin-Little
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina.,Veterinary Hospital, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina
| | - Kristen Malinak
- Comparative Neuroimmunology & Neuro-oncology Laboratory, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina
| | - Ashley Gavitt
- Comparative Neuroimmunology & Neuro-oncology Laboratory, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina
| | - Julien Guevar
- Veterinary Hospital, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina
| |
Collapse
|
59
|
3D-printed navigation template in cervical spine fusion: a systematic review and meta-analysis. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2020; 30:389-401. [DOI: 10.1007/s00586-020-06601-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2020] [Revised: 06/28/2020] [Accepted: 09/05/2020] [Indexed: 12/19/2022]
|