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11.
R. Morger 《Langenbeck's archives of surgery / Deutsche Gesellschaft fur Chirurgie》1965,313(1):690-693
Ohne ZusammenfassungMit 3 Abbildungen 相似文献
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目的验证乳腺钼钯X线检查前给予对乙酰氨基酚、布洛酚和(或)4%利多卡因凝胶能否减轻检查不适或提高普查中有恐惧感妇女的满意度。方法本前瞻性研究为 相似文献
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John?T.?Machin John?HardmanEmail authorView authors OrcID profile William?Harrison Timothy?W.?R.?Briggs Mike?Hutton 《European spine journal》2018,27(11):2693-2699
Purpose
The aim of this study is to evaluate the true incidence of all clinical negligence claims against spinal surgery performed by orthopaedic spinal surgeons and neurosurgeons in the National Health Service (NHS) in England, including both open and closed claims.Methods
This study was a retrospective review of 978 clinical negligence claims held by NHS Resolution against spinal surgery cases identified from claims against ‘Neurosurgery’ and ‘Orthopaedic Surgery’. This category included all emergency, trauma and elective work and all open and closed cases without exclusion between April 2012 and April 2017.Results
Clinical negligence claims in spinal surgery were estimated to cost £535.5 million over this five-year period. There is a trend of both increasing volume and estimated costs of claims. The most common causes for claims were ‘judgement/timing’ (512 claims, 52.35%), ‘interpretation of results/clinical picture’ (255 claims, 26.07%), ‘unsatisfactory outcome to surgery’ (192 claims, 19.63%), ‘fail to warn/informed consent’ (80 claims, 8.13%) and ‘never events’ including ‘wrong site surgery’ or ‘retained instrument post-operation’ (26 claims, 2.66%). A sub-analysis of 3 years including 574 claims revealed the most prevalent pathologies were iatrogenic nerve damage (132 claims, 23.00%), cauda equina syndrome (CES) (131 claims, 22.82%), inadequate decompression (91 claims, 15.85%), iatrogenic cord damage (72 claims, 12.54%), and infection (51 claims, 8.89%).Conclusions
The volume and costs of clinical negligence claims is threatening the future of spinal surgery. If spinal surgery is to continue to serve the patients who need it, most thorough investigation, implementation and sharing of lessons learned from litigation claims must be systematically carried out.Graphical abstract
These slides can be retrieved under Electronic Supplementary Material.
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Nicola?Marengo Pedro?Berjano Fabio?Cofano Marco?Ajello Francesco?Zenga Giulia?Pilloni Federica?PennerEmail authorView authors OrcID profile Salvatore?Petrone Lorenzo?Vay Alessandro?Ducati Diego?Garbossa 《European spine journal》2018,27(2):213-221
Purpose
The use of cortical bone trajectory (CBT) pedicle screws for circumferential interbody fusion represents a viable alternative for single-level procedure with reduced invasiveness and less tissue destruction than the traditional technique. In addition, CBT screws have a potentially stronger pullout strength because of the greater amount of cortical bone intercepted. Only few series exist evaluating clinical and radiological outcomes of CBT screws.Methods
This is a retrospective cohort study. All patients that underwent circumferential lumbar interbody fusion with CBT screws in our institution from 2014 to 2017 were reviewed. Patient demographics, clinical outcome with visual analogue scale (VAS) and Oswestry Disability Index (ODI), radiological data such as fusion, lordosis and muscle trauma, operative blood loss, hospital stay and use of fluoroscopy were evaluated.Results
A total of 101 patients undergoing CBT-arthrodesis for degenerative lumbo-sacral disease were reviewed. Mean procedural time was 187 min. The mean operative blood loss and X-ray dose per procedure was 383 ml and 1.60 mg cm2, respectively. The mean hospital stay was 3.47 days. The mean follow-up was 18.23 months. Mean lordosis increment at the treated level was 4.2°. When the follow-up was longer than 12 months (53% of patients), fusion was obtained in 94% of cases. Mean ODI and VAS index improved with statistical significance.Conclusions
This is to our knowledge that the largest available study regarding CBT for circumferential arthrodesis. Results underlined the safety of this technique and the promising clinical and radiological outcomes that will need a longer follow-up.Graphical abstract
These slides can be retrieved under Electronic Supplementary material.
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Daemen J Wenaweser P Tsuchida K Abrecht L Vaina S Morger C Kukreja N Jüni P Sianos G Hellige G van Domburg RT Hess OM Boersma E Meier B Windecker S Serruys PW 《Lancet》2007,369(9562):667-678