Study design
Prospective multi-center study.
Objective
The study aimed to evaluate the accuracy of pedicle screw placement using a skin marker-based optical surgical navigation system for minimal invasive thoraco-lumbar-sacral pedicle screw placement.
Methods
The study was performed in a hybrid Operating Room with a video camera-based navigation system integrated in the imaging hardware. The patient was tracked with non-invasive skin markers while the instrument tracking was via an on-shaft optical marker pattern. The screw placement accuracy assessment was performed by three independent reviewers, using the Gertzbein grading. The screw placement time as well as the staff and patient radiation doses was also measured.
Results
In total, 211 screws in 39 patients were analyzed for screw placement accuracy. Of these 32.7% were in the thoracic region, 59.7% were in the lumbar region, and 7.6% were in the sacral region. An overall accuracy of 98.1% was achieved. No screws were deemed severely misplaced (Gertzbein grading 3). The average time for screw placement was 6 min and 25 secs (± 3 min 33 secs). The average operator radiation dose per subject was 40.3 µSv. The mean patient effective dose (ED) was 11.94 mSv.
Conclusion
Skin marker-based ON can be used to achieve very accurate thoracolumbarsacral pedicle screw placements.
Objectives: The value of biofeedback before elective coronary computed tomography angiography (CCTA) to reduce patients’ heart rates (HR) was investigated in the current work.
Methods: 60 patients who received CCTA to exclude coronary artery disease were included in our study and separated into two groups: with biofeedback (W-BF) and without biofeedback (WO-BF). The W-BF group used a biofeedback device for 15 min before CCTA. HR was determined in each patient at five measurement time points (MTP): during the pre-examination interview (MTP1), positioning on the CT patient table (MTP2), immediately before CCTA (MTP3), CCTA image acquisition (MTP4), and after completing CCTA (MTP5). If necessary, beta-blockers were administered in both groups after MTP3 until a HR of less than 65 bpm was achieved. Two board-certified radiologists subsequently assessed the image quality and analyzed the findings.
Results: Overall, the need for beta-blockers was significantly lower in patients in W-BF group than in WO-BF group (p=0.032). In patients with a HR of 81-90, beta-blockers were not required in 4 of 6 cases in the W-BF group, whereas in the WO-BF group all patients needed beta-blockers (p=0.03). We found a significant decrease in HR between MTP1 and MTP2 in W-BF as compared to WO-BF. There was no significant difference between the W-BF and WO-BF groups regarding image quality (p=0.179).
Conclusion: By using biofeedback prior to elective CCTA beta-blocker use can be significantly decreased due to effective reduction of HR, especially in patients with a HR above 80 bpm, without compromising CT image quality and analysis.
Objectives: The value of biofeedback before elective coronary computed tomography angiography (CCTA) to reduce patients’ heart rates (HR) was investigated in the current work.
Methods: 60 patients who received CCTA to exclude coronary artery disease were included in our study and separated into two groups: with biofeedback (W-BF) and without biofeedback (WO-BF). The W-BF group used a biofeedback device for 15 min before CCTA. HR was determined in each patient at five measurement time points (MTP): during the pre-examination interview (MTP1), positioning on the CT patient table (MTP2), immediately before CCTA (MTP3), CCTA image acquisition (MTP4), and after completing CCTA (MTP5). If necessary, beta-blockers were administered in both groups after MTP3 until a HR of less than 65 bpm was achieved. Two board-certified radiologists subsequently assessed the image quality and analyzed the findings.
Results: Overall, the need for beta-blockers was significantly lower in patients in W-BF group than in WO-BF group (p=0.032). In patients with a HR of 81-90, beta-blockers were not required in 4 of 6 cases in the W-BF group, whereas in the WO-BF group all patients needed beta-blockers (p=0.03). We found a significant decrease in HR between MTP1 and MTP2 in W-BF as compared to WO-BF. There was no significant difference between the W-BF and WO-BF groups regarding image quality (p=0.179).
Conclusion: By using biofeedback prior to elective CCTA beta-blocker use can be significantly decreased due to effective reduction of HR, especially in patients with a HR above 80 bpm, without compromising CT image quality and analysis.
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