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Piazza AM, McAnulty JF, Early P, Guevar J. Craniectomies for dogs with skull multilobular osteochondrosarcoma using the Misonix bone scalpel: cadaveric evaluation and retrospective case series. Top Companion Anim Med 2023; 53-54:100772. [PMID: 36990178 DOI: 10.1016/j.tcam.2023.100772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 09/11/2022] [Accepted: 03/22/2023] [Indexed: 03/30/2023]
Abstract
OBJECTIVES To evaluate the Misonix bone scalpel (MBS) for craniotomies in dogs and describe clinical findings and surgical experience in three dogs with large multilobular osteochondrosarcoma (MLO) of the skull. STUDY DESIGN Cadaver evaluation and retrospective case series. ANIMALS One canine cadaver; three client-owned dogs. METHODS Craniotomies of different sizes and at different locations were performed with MBS. Dural tear and bone discoloration were recorded. Clinical, imaging, and surgical findings of dogs diagnosed with MLO and where MBS was used for craniectomies were retrospectively included. RESULTS Cadaveric evaluation identified MBS as an efficient tool for rapid craniectomies (> 5minutes) albeit dural tears and some small foci of bone discoloration were observed. Craniectomies could be performed without complications in three dogs with MLO without dural tear or bone discoloration. .Excision was in complete in all cases. The short-term outcome was good, and the long-term outcome was fair to good. CONCLUSION Piezoelectric bone surgery with the Misonix bone scalpel is an alternative technology to perform craniectomies in dogs. It was not associated with complications in 3 dogs diagnosed and surgically treated for MLO. Dural tears and suspected bone necrosis can occur. Great care should be taken when using CT to establish disease free surgical osteotomy.
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Çanakçi FG, Er N, Duygu G, Tanan Karaca G. Does Saline Irrigation at Different Temperatures Affect Pain, Edema, and Trismus After Impacted Third Molar Surgery: A Clinical Trial. J Oral Maxillofac Surg 2023; 81:88-94. [PMID: 36116545 DOI: 10.1016/j.joms.2022.08.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 08/22/2022] [Accepted: 08/22/2022] [Indexed: 01/13/2023]
Abstract
PURPOSE Lower impacted third molar surgery is a very common oral-maxillofacial surgical procedure, which has complications such as facial swelling, pain, and trismus. This clinical trial aimed to compare the intensity of postoperative morbidity (pain, facial swelling, and trismus) following the third molar surgery performed using saline irrigation at different temperatures (4 °C, 10 °C, or 25 °C). MATERIALS AND METHODS This double-blind, single-center, split-mouth, randomized prospective clinical trial was conducted among 48 systemically and periodontally healthy patients who had bilaterally asymptomatic mandibular third molars. Patients were randomly allocated into 2 groups (n = 24) according to the temperature of the saline used. In each patient, one impacted third molar was determined as the test group (4 °C or 10 °C saline irrigation) and the other impacted third molar as the control group (25 °C saline irrigation). Trismus and swelling were evaluated on the 1st, 3rd, and 7th days postoperatively. Pain perception by visual analog scale (VAS) and the total number of analgesics taken during the 7 postoperative days were recorded. Data were analyzed using the Shapiro-Wilk test, the chi-square test, one-way analysis of variance, Duncan test, the Kruskal-Wallis test, the Dunn test, and the Friedman test (P < .05). RESULTS Forty-eight patients (28 females, 20 males) with a mean age of 24.6 ± 3.8 years were included in the study. The duration of operations was similar. VAS values of test groups [test group 1 (4 °C): 4.0, test group 1 (10 °C): 8.0] and the number of analgesics taken [test group 1 (4 °C): 0, test group 1 (10°) C): 3] were significantly lower (P < .001) than control groups (VAS, control group 1: 13.0, control group 2: 15.5, number of analgesic taken, control group 1: 5.5, control group 2: 4.0). Significant differences were found between the test groups in VAS values and the number of analgesics taken (P < .001). Also, the lowest trismus and facial swelling values were detected in the 4 °C test group at all time points (P < .001). CONCLUSION In the impacted third molar surgery, the use of cooled saline irrigation during bone removal may be a simple, inexpensive, and effective method for reducing early postoperative complaints.
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Affiliation(s)
- F Gülfeşan Çanakçi
- Assistant Professor, Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Trakya University, Edirne, Turkey.
| | - Nilay Er
- Assistant Professor, Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Trakya University, Edirne, Turkey
| | - Gonca Duygu
- Associated Professor, Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Tekirdağ Namik Kemal University, Tekirdağ, Turkey
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Changes of Functional, Morphological, and Inflammatory Reactions in Spontaneous Peripheral Nerve Reinnervation after Thermal Injury. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2022; 2022:9927602. [PMID: 35154578 PMCID: PMC8826209 DOI: 10.1155/2022/9927602] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 07/25/2021] [Accepted: 01/04/2022] [Indexed: 12/27/2022]
Abstract
In recent decades, the use of energy-based devices has substantially increased the incidence of iatrogenic thermal injury to nerves (cauterization, etc.). While recovery of the nerve after thermal injury is important, the changes in neural structure, function, and peripheral inflammatory reactions postinjury remain unclear. This study is aimed at demonstrating the changes mentioned above during the acute, subacute, and chronic stages of nerve reinnervation after thermal injury. Spontaneous reinnervation was evaluated, including the neural structures, nerve conduction abilities, and muscle regeneration. These effects vary depending on the severity of thermal injury (slight, moderate, and severe). Peripheral inflammatory reactions, as impediments to reinnervation, were found in significant numbers 3 days after thermal injury, exhibiting high expression of IL-1β and TNF-α, but low expression of IL-10. Our findings reveal the pathogenesis of peripheral nerve reinnervation after thermal injury, which will assist in selecting appropriate treatments in further research.
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Dongaonkar KR, Aoki K, Zwueste D, Bates M. Effect of irrigation technique on the vertebral canal temperature during thoracolumbar hemilaminectomy in dogs: An ex vivo study. Vet Surg 2021; 50:1276-1282. [PMID: 33959971 DOI: 10.1111/vsu.13654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 04/15/2021] [Accepted: 04/26/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To determine the influence of continuous and intermittent bolus irrigation on vertebral canal temperature during thoracolumbar hemilaminectomy. STUDY DESIGN Ex vivo study. SAMPLE POPULATION Ten canine cadavers. METHODS Six consecutive thoracolumbar hemilaminectomies starting at T12-13 with alternating left- or right-side selection, and alternating continuous or intermittent bolus irrigation were performed in each dog resulting in 30 hemilaminectomies per irrigation technique. Drilling was performed for 15 s followed by a 10-s pause and resumed until completion of hemilaminectomy. Continuous irrigation consisted of saline delivered at 15 ml/min during drilling. Bolus irrigation consisted of manual delivery of 10 ml saline during the pause. Temperatures were recorded with two sensors placed within the vertebral canal adjacent to target hemilaminectomy site and compared between techniques with a linear mixed model. RESULTS Intermittent bolus irrigation was associated with lower peak vertebral canal temperatures (mean 15.7°C; range 9.4-23.3°C) than continuous irrigation (mean 16.7°C; range 9.6-27.6°C, p = .003) (mean difference of 1.1°C, p = .006). Similarly, mean vertebral canal temperatures remained lower when hemilaminectomies were performed under intermittent rather than continuous irrigation (mean difference of 0.48°C, p = .006, linear mixed model). CONCLUSION Lower vertebral canal temperatures were maintained during hemilaminectomy with intermittent bolus rather than continuous irrigation. CLINICAL SIGNIFICANCE Both intermittent bolus and continuous irrigation are suitable to prevent elevations in canine vertebral canal temperature during hemilaminectomy.
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Affiliation(s)
- Kaustubh R Dongaonkar
- Department of Small Animal Clinical Sciences, Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Koji Aoki
- Department of Small Animal Clinical Sciences, Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Danielle Zwueste
- VCA Vancouver Animal Emergency and Referral Centre, Vancouver, British Columbia, Canada
| | - Miriam Bates
- Department of Small Animal Clinical Sciences, Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
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Kitahama Y, Shizuka H, Kimura R, Suzuki T, Ohara Y, Miyake H, Sakai K. Fluid Lubrication and Cooling Effects in Diamond Grinding of Human Iliac Bone. ACTA ACUST UNITED AC 2021; 57:medicina57010071. [PMID: 33466923 PMCID: PMC7830225 DOI: 10.3390/medicina57010071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Revised: 01/03/2021] [Accepted: 01/07/2021] [Indexed: 11/16/2022]
Abstract
Background and Objectives: Although there have been research on bone cutting, there have been few research on bone grinding. This study reports the measurement results of the experimental system that simulated partial laminectomy in microscopic spine surgery. The purpose of this study was to examine the fluid lubrication and cooling in bone grinding, histological characteristics of workpieces, and differences in grinding between manual and milling machines. Materials and Methods: Thiel-fixed human iliac bones were used as workpieces. A neurosurgical microdrill was used as a drill system. The workpieces were fixed to a 4-component piezo-electric dynamometer and fixtures, which was used to measure the triaxial power during bone grinding. Grinding tasks were performed by manual activity and a small milling machine with or without water. Results: In bone grinding with 4-mm diameter diamond burs and water, reduction in the number of sudden increases in grinding resistance and cooling effect of over 100 °C were confirmed. Conclusion: Manual grinding may enable the control of the grinding speed and cutting depth while giving top priority to uniform torque on the work piece applied by tools. Observing the drill tip using a triaxial dynamometer in the quantification of surgery may provide useful data for the development of safety mechanisms to prevent a sudden deviation of the drill tip.
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Affiliation(s)
- Yoshihiro Kitahama
- Spine Center, Omaezaki Municipal Hospital, Shizuoka 437-1696, Japan;
- Medical Photonics Research Center, Hamamatsu University School of Medicine, Hamamatsu 431-3192, Japan;
- Correspondence:
| | - Hiroo Shizuka
- Department of Mechanical Engineering, Faculty of Engineering, Shizuoka University, Hamamatsu 422-8529, Japan; (H.S.); (R.K.); (K.S.)
| | - Ritsu Kimura
- Department of Mechanical Engineering, Faculty of Engineering, Shizuoka University, Hamamatsu 422-8529, Japan; (H.S.); (R.K.); (K.S.)
| | - Tomo Suzuki
- Spine Center, Omaezaki Municipal Hospital, Shizuoka 437-1696, Japan;
| | - Yukoh Ohara
- Department of Neurosurgery, Juntendo University School of Medicine, Tokyo 113-8421, Japan;
| | - Hideaki Miyake
- Medical Photonics Research Center, Hamamatsu University School of Medicine, Hamamatsu 431-3192, Japan;
| | - Katsuhiko Sakai
- Department of Mechanical Engineering, Faculty of Engineering, Shizuoka University, Hamamatsu 422-8529, Japan; (H.S.); (R.K.); (K.S.)
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Kang MS, Hwang JH, Choi DJ, Chung HJ, Lee JH, Kim HN, Park HJ. Clinical outcome of biportal endoscopic revisional lumbar discectomy for recurrent lumbar disc herniation. J Orthop Surg Res 2020; 15:557. [PMID: 33228753 PMCID: PMC7685633 DOI: 10.1186/s13018-020-02087-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 11/10/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Although literature provides evidence regarding the superiority of surgery over conservative treatment in patients with lumbar disc herniation, recurrent lumbar disc herniation (RLDH) was the indication for reoperation in 62% of the cases. The major problem with revisional lumbar discectomy (RLD) is that the epidural scar tissue is not clearly isolated from the boundaries of the dura matter and nerve roots; therefore, unintended durotomy and nerve root injury may occur. The biportal endoscopic (BE) technique is a newly emerging minimally invasive spine surgical modality. However, clinical evidence regarding BE-RLD remains limited. We aimed to compare the clinical outcomes after performing open microscopic (OM)-RLD and BE-RLD to evaluate the feasibility of BE-RLD. METHODS This retrospective study included 36 patients who were diagnosed with RLDH and underwent OM-RLD and BE-RLD. RLDH is defined as the presence of herniated disc material at the level previously operated upon in patients who have experienced a pain-free phase for more than 6 months. BE-RLD was performed as follows: two independent surgical ports were made inside the medial pedicular line of the target segment and on the intact upper and lower laminas. Peeling off the soft tissue from the vertebral lamina helps to easily identify the traversing nerve root and the recurrent disc material without dealing with the fibrotic scar tissue. Clinical outcomes were obtained using a visual analog scale (VAS) and the modified Macnab criteria before and at 2 days, 2 and 6 weeks, and 3, 6, and 12 months after surgery. RESULTS The data of 20 and 16 patients who underwent OM-RLD and BE-RLD, respectively, were evaluated. The demographic and perioperative data were comparable between the groups. During the year following the surgery, in the BE-RLD group, the VAS scores at each point were significantly improved over the baseline and remained improved up to 2 weeks after surgery (p < 0.05); however, no statistical difference between the two groups was observed after 6 weeks of surgery (p > 0.05). According to the modified Macnab criteria on the follow-up, the excellent or good satisfaction rates reported at 2 weeks, 6 weeks, 6 months, and 12 months after surgery were 81.25%, 81.25%, 75%, and 81.25%, respectively, in the BE-RLD group, and 50%, 75%, 75%, and 80%, respectively, in the OM-RLD group. CONCLUSION BE-RLD yielded similar outcomes to OM-RLD, including pain improvement, functional improvement, and patient satisfaction, at 1 year after surgery. However, faster pain relief, earlier functional recovery, and better patient satisfaction were observed when applying BE-LRD. TRIAL REGISTRATION Retrospectively registered.
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Affiliation(s)
- Min-Seok Kang
- Department of Orthopedic Surgery, Bumin Hospital, Seoul, Republic of Korea
| | - Jin-Ho Hwang
- Department of Orthopedic Surgery, Himnaera Hospital, Busan, Republic of Korea
| | - Dae-Jung Choi
- Department of Orthopedic Surgery, Himnaera Hospital, Busan, Republic of Korea
| | - Hoon-Jae Chung
- Department of Orthopedic Surgery, Bumin Hospital, Seoul, Republic of Korea
| | - Jong-Hwa Lee
- Department of Orthopedic Surgery, Spine Center, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, 1, Singil-ro, Yeongdeungpo-gu, Seoul, Republic of Korea
| | - Hyong-Nyun Kim
- Department of Orthopedic Surgery, Spine Center, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, 1, Singil-ro, Yeongdeungpo-gu, Seoul, Republic of Korea
| | - Hyun-Jin Park
- Department of Orthopedic Surgery, Spine Center, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, 1, Singil-ro, Yeongdeungpo-gu, Seoul, Republic of Korea.
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Ishiguro H, Takenaka S, Kashii M, Ukon Y, Nagamoto Y, Furuya M, Makino T, Sakai Y, Kaito T. Direct Involvement of Concomitant Foraminotomy for Radiculomyelopathy in Postoperative Upper Limb Palsy in Cervical Laminoplasty. World Neurosurg 2020; 146:e14-e21. [PMID: 32992066 DOI: 10.1016/j.wneu.2020.09.105] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 09/18/2020] [Accepted: 09/19/2020] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Although concomitant foraminotomy has been reported to increase the risk of postoperative upper limb palsy (ULP) in cervical laminoplasty, the specific effects of concomitant foraminotomy on ULP remain uncertain. This study aimed to clarify the effect of concomitant foraminotomy on ULP in cervical laminoplasty. METHODS We identified 19 patients who developed ULP after laminoplasty with concomitant foraminotomy for radiculomyelopathy with nerve root impingement (laminoplasty with concomitant foraminotomy group [F-group]) from 4080 patients who underwent primary cervical laminoplasty at 27 affiliated institutions between 2012 and 2018. An age- and sex-matched control group comprised patients who developed ULP after laminoplasty without concomitant foraminotomy (n = 76, 4:1 ratio with F-group). Collected data included the time of onset and distribution of ULP (side and level). The site of foraminotomy was recorded in the F-group. RESULTS The F-group showed a significantly higher incidence of ULP than the candidates for the control group (15.1% vs. 3.1%, P < 0.001). The site of foraminotomy was consistent with the distribution of ULP in 79% (15 of 19 patients) of the F-group. The F-group showed a significantly higher proportion of preoperative upper-limb muscle weakness (74% vs. 37%, P = 0.005) and early-onset ULP occurring by postoperative day 1 (63% vs. 33%, P = 0.02) compared with the control group. CONCLUSIONS Our results indicate that the foraminotomy procedure in the stenotic foramen is directly involved in ULP. Combined with a previous report suggesting that early-onset ULP is associated with thermal nerve damage, our results indicate that thermal nerve damage partly explains the increased incidence of ULP in the F-group.
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Affiliation(s)
- Hiroyuki Ishiguro
- Department of Orthopaedic Surgery, National Hospital Organization Osaka National Hospital, Osaka, Osaka, Japan
| | - Shota Takenaka
- Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Masafumi Kashii
- Department of Orthopaedic Surgery, Toyonaka Municipal Hospital, Toyonaka, Osaka, Japan
| | - Yuichiro Ukon
- Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Yukitaka Nagamoto
- Department of Orthopaedic Surgery, Osaka Rosai Hospital, Sakai, Osaka, Japan
| | - Masayuki Furuya
- Department of Orthopaedic Surgery, Osaka Rosai Hospital, Sakai, Osaka, Japan
| | - Takahiro Makino
- Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Yusuke Sakai
- Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Takashi Kaito
- Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Suita, Osaka, Japan.
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Mediouni M, Kucklick T, Poncet S, Madiouni R, Abouaomar A, Madry H, Cucchiarini M, Chopko B, Vaughan N, Arora M, Gökkuş K, Lozoya Lara M, Paiva Cedeño L, Volosnikov A, Hesmati M, Ho K. An overview of thermal necrosis: present and future. Curr Med Res Opin 2019; 35:1555-1562. [PMID: 30943796 DOI: 10.1080/03007995.2019.1603671] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Introduction: Many orthopaedic procedures require drilling of bone, especially fracture repair cases. Bone drilling results in heat generation due to the friction between the bone and the drill bit. A high-level of heat generation kills bone cells. Bone cell death results in resorption of bone around bone screws.Methods: We searched in the literature for data on parameters that influence drilling bone and could lead to thermal necrosis. The points of view of many orthopaedists and neurosurgeons based upon on previous practices and clinical experience are presented.Results: Several potential complications that lead to thermal necrosis are discussed and highlighted.Discussion: Even in the face of growing evidence as to the negative effects of heat induction during drilling, simple and effective methods for monitoring and cooling in real-time are not in widespread usage today. For that purpose, we propose some suggestions for the future of bone drilling, taking note of recent advances in autonomous robotics, intelligent systems and computer simulation techniques.Conclusions: These advances in prevention of thermal necrosis during bone drilling surgery are expected to reduce the risk of patient injury and costs for the health service.
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Affiliation(s)
| | | | - Sébastien Poncet
- Mechanical Engineering Department, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Riadh Madiouni
- University of Paris-Est Créteil, Vitry sur Seine, France
| | | | - Henning Madry
- Saarland University Medical Center, Homburg, Germany
| | | | | | - Neil Vaughan
- Department of Computer Science, University of Chester, Chester, UK
| | - Manit Arora
- Department of Orthopaedics and Sports Medicine, Fortis Hospital, Chandigarh, India
| | - Kemal Gökkuş
- Department of orthopaedics, Memorial Antalya, Antalya, Turkey
| | | | - Lorenlay Paiva Cedeño
- Departement of orthopaedics, Francisco de Miranda Experimental University, Falcón, Venezuela
| | - Alexander Volosnikov
- Restorative Traumatology and Orthopaedics of Ministry of Healthcare Kurgan, Federal State Budgetary Institution Russian Ilizarov Scientific Center, Kurgan, Russia Region
| | - Mohamed Hesmati
- Departement of orthopaedics, Tehran University Medical of Sciences, Tehran, Iran
| | - Kevin Ho
- University of Western Australia, Perth, Australia
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Abstract
STUDY DESIGN This was a controlled, interventional animal study. OBJECTIVE This study aimed to investigate the thermal injury of nerve root by cauterization near the nerve root and to identify the prevention or rescue procedure of nerve root injury. SUMMARY OF BACKGROUND DATA In spine surgery, bipolar cauterization of epidural venous plexus near the nerve root is an essential procedure to control bleeding. Although a potential risk of neurological thermal damage exists, the underlying mechanism and prevention have not been elucidated. METHODS Temperature measurement and histological evaluation after bipolar cauterization near the posterior branch of the nerve root were performed using a rabbit model. Subsequently, the effect of saline irrigation or changing the direction of bipolar forceps to reduce thermal elevation during bipolar cauterization was evaluated. Finally, the effectiveness of locally injected corticosteroid after bipolar cauterization was evaluated. RESULTS After bipolar cauterization, temperature of the surrounding site reached 60.9 °C, and 47.8% of the nerves were histologically injured. Using saline irrigation, thermal elevation was significantly suppressed up to 42.7 °C (P < 0.01), and no nerve was histologically injured. When bipolar cauterization was performed in the perpendicular direction, temperature of the surrounding site reached only 40.4 °C (P < 0.01). Locally injected corticosteroid reduced the incidence of nerve injury to 25.0%. However, a significant increase in nerve damage remained compared with the sham group (P < 0.01). CONCLUSION Bipolar cauterization near the nerve roots can increase the temperature of nerve roots and cause thermal nerve root injury, despite no accidental direct nerve root injury. Using saline irrigation, or setting bipolar forceps perpendicular to nerve roots, thermal elevation could be suppressed and nerve injury could be prevented. Therefore, it is recommended that surgeons set bipolar forceps perpendicular to nerve roots or use saline irrigation for the prevention of nerve root injury. LEVEL OF EVIDENCE N/A.
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Mediouni M, R Schlatterer D, Madry H, Cucchiarini M, Rai B. A review of translational medicine. The future paradigm: how can we connect the orthopedic dots better? Curr Med Res Opin 2018; 34:1217-1229. [PMID: 28952378 DOI: 10.1080/03007995.2017.1385450] [Citation(s) in RCA: 86] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2017] [Accepted: 09/21/2017] [Indexed: 12/26/2022]
Abstract
INTRODUCTION Patients with complex medical and surgical problems often travel great distances to prestigious university medical centers in search of solutions and in some cases for nothing more than a diagnosis of their condition. Translational medicine (TM) is an emerging method and process of facilitating medical advances efficiently from the scientist to the clinician. Most established clinicians and those in training know very little about this new discipline. The purpose of this article is to illustrate TM in varied scientific, medical and surgical fields. MATERIALS AND METHODS Anecdotal events in medicine and orthopaedics based upon a practicing orthopaedic surgeon's training and clinical experience are presented. RESULTS TM is rapidly assuming a greater presence in the medical community. The National Institute of Health (NIH) recognizes this discipline and has funded TM projects. Numerous institutions in Europe and the USA offer advanced degrees in TM. Finally there is a European Society for Translational Medicine (EUTMS), an International Society for Translational Medicine, and an Academy of Translational Medical Professionals (ATMP). DISCUSSION The examples of TM presented in this article support the argument for the formation of more TM networks on the local and regional levels. The need for increased participation of researchers and clinicians requires further study to identify the economic and social impact of TM. CONCLUSIONS The examples of TM presented in this article support the argument for the formation of more TM networks on the local and regional levels. Financial constraints for TM can be overcome by pooling government, academic, private, and industry resources in an organized fashion with oversight by a lead TM researcher.
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Affiliation(s)
| | | | - Henning Madry
- c Saarland University Medical Center , Homburg , Germany
| | | | - Balwant Rai
- d JBR Health Education and Research Organization , Copenhagen , Denmark
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