Preferred Angle

The tops of the screws have a tulip. The tulip is typically polyaxial such that the rotation allows capture of the rod. In the picture below, the tulip is silver and blue part that does not have treads. If you look at the screw, the silver collar that rotates has a notch. This notch allows

Journal Club: Characteristics of Sagittal Spinopelvic Alignment Changes After Symptom Relief After Simple Lumbar Decompression

Title and Citation Characteristics of Sagittal Spinopelvic Alignment Changes After Symptom Relief After Simple Lumbar Decompression Neurosurgery 2022 Background and importance Sagittal spinal pelvic alignment used to determine/diagnose adult spinal deformities Misdiagnosis can lead to inappropriate surgery Trial design Retrospective cohort Analyzed patients who underwent lumbar decompression via laminectomy or laminectomy with discectomy without instrumentation

Empirical targets for acute hemodynamic management of individuals with spinal cord injury

Author: Squair, Jordan PhD et al Title: Empirical targets for acute hemodynamic management of individuals with spinal cord injury Background: Ideal clinically significant BP goals and/or spinal cord perfusion pressure goals are not well defined Guidelines suggest MAP 85-90mmHg x7 days after injury Trial Design: prospective observational n=92 Intrathecal lumbar catheter placed L2-3 or L3-4

Pedicle Angulation

Today’s post is a short post on pedicle angulation. In general the pedicles have a “textbook” angle in how to align the screw to obtain the proper trajectory through the pedicle without violating the walls and possibly injuring nearby structures. The angles are a general heuristic. However studying preoperative imaging can aid in refining plan

Cell Saver

Blood loss is a factor to consider in many surgeries and is especially important for longer surgeries in which blood loss is expected. This can be for reasons such as prior anticoagulant use, antiplatelets, or hemodialysis. Reversal agents are typically given, however there is still bleeding. Sometimes elevated blood pressure goals are needed and this

Prep

Prep Solutions I have no financial stake in companies that produce below products. The products below are for surgical prep. What that means is they are made to clean the skin to prevent bacterial invasion. So, a good prep will remove bacteria currently on the skin and will prevent bacterial invasion during the surgical procedure.

Fixed angle screws vs variable angle screws

What the heck? What’s the difference, can’t I angle both screws? The below discussion is with regards to the anterior cervical instrumentation. Fixed angle screws and variable screws are used to hold an anterior cervical plate in place. These screws have a limitation on the amount of angulation that is “allowed” because placing them at

Parallax

The term kind of sounds like a superhero or villain. Their super power is to alter perspective. Almost sounds like mind control, or the power of illusion. Maybe Parallax can be a magician like Doctor Strange. Edit: upon further review there already is a comic book villain in the DC universe called Parallax. Anyway, parallax

Fluoroscopy vs CT Considerations When Placing Screws

Placement of screws during spine surgery is a common practice. The manner in which the screws are placed can range from “free hand” where a surgeon cannulates the desired path by feel and then subsequently places the screw to using intraoperative navigation. Today’s post is about the differences in images obtained from fluoroscopy and CT.