- Evaluation of the accuracy of mobile cone-beam computed tomography after spinal instrumentation surgery
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Ki Seong Eom, Eun Sung Park, Dae Won Kim, Jong Tae Park, Kwon-Ha Yoon
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J Trauma Inj. 2022;35(1):12-18. Published online December 29, 2021
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DOI: https://doi.org/10.20408/jti.2021.0010
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- Purpose
Pedicle screw fixation provides 3-column stabilization, multidimensional control, and a higher rate of interbody fusion. Although computed tomography (CT) is recommended for the postoperative assessment of pedicle screw fixation, its use is limited due to the radiation exposure dose. The purpose of this preliminary retrospective study was to assess the clinical usefulness of low-dose mobile cone-beam CT (CBCT) for the postoperative evaluation of pedicle screw fixation. Methods: The author retrospectively reviewed postoperative mobile CBCT images of 15 patients who underwent posterior pedicle screw fixation for spinal disease from November 2019 to April 2020. Pedicle screw placement was assessed for breaches of the bony structures. The breaches were graded based on the Heary classification. Results: The patients included 11 men and four women, and their mean age was 66±12 years. Of the 122 pedicle screws, 34 (27.9%) were inserted in the thoracic segment (from T7 to T12), 82 (67.2%) in the lumbar segment (from L1 to L5), and six (4.9%) in the first sacral segment. Although there were metal-related artifacts, the image of the screw position (according to Heary classification) after surgery could be assessed using mobile CBCT at all levels (T7–S1). Conclusions: Mobile CBCT was accurate in determining the location and integrity of the pedicle screw and identifying the surrounding bony structures. In the postoperative setting, mobile CBCT can be used as a primary modality for assessing the accuracy of pedicle screw fixation and detecting postoperative complications.
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Summary
- Traumatic Posterior Fossa Subdural Hematoma in a Neonate: A Case Report
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Ki Seong Eom
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J Trauma Inj. 2020;33(4):256-259. Published online November 10, 2020
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DOI: https://doi.org/10.20408/jti.2020.009
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Although traumatic posterior fossa subdural hematoma (TPFSH) in neonates immediately after birth is extremely rare, it can pose a serious clinical problem in the neonatal period. Here, the author presents the case of a 3-day-old male infant who underwent emergency surgical treatment of TPFSH with a favorable outcome. Debate continues about surgical versus conservative treatment of TPFSH in neonates. The clinical symptoms, extent of hemorrhage, early diagnosis, and prompt and appropriate surgery are the most important factors in the treatment of TPFSH in neonates. Therefore, neurosurgeons should establish treatment strategies based on the newborn’s clinical condition, the size and location of the TPFSH, and the potential of the hematoma to cause long-term complications. -
Summary
- Comparison of the Surgical Approaches for Frontal Traumatic Intracerebral Hemorrhage
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Eun Sung Park, Seong Keun Moon, Ki Seong Eom
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J Trauma Inj. 2019;32(2):71-79. Published online June 30, 2019
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DOI: https://doi.org/10.20408/jti.2019.002
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Purpose
Recent developments in minimally invasive techniques have the potential to reduce surgical morbidity, promote patient recovery, accelerate surgical procedures, and thus improve cost-effectiveness in case management. In this study, we compared the treatment efficacy and results of supraorbital keyhole approach (SOKA) with those of conventional unilateral frontal craniotomy (CUFC) for traumatic intracerebral hemorrhage (TICH) in the frontal lobe.
Methods
We analyzed the data of 38 patients who underwent CUFC (n=30) and SOKA (n=8) and retrospectively reviewed their medical records and radiological findings. Furthermore, we tried to identify the best surgical method for such lesions by including patients who underwent burr hole aspiration and drainage (BHAD) (n=9) under local anesthesia due to various circumstances.
Results
The difference in the initial Glasgow coma scale score, operative time, and length of hospitalization between the CUFC and SOKA were statistically significant. All radiological features between the two groups including associated skull fracture, amount of pre- and postoperative hematoma, percentage of complete hematoma removal, pre- and postoperative midline shifting of the hematoma, and development of postoperative delayed hematoma were not statistically significant. Our experience of 46 patients with TICH in the frontal lobe with any of the three different surgical methods including BHAD enabled us to obtain valuable findings.
Conclusions
Although it is difficult to insist that one particular approach is more useful than the other, we are confident that SOKA will have more advantages over CUFC in carefully selected patients with frontal TICH depending on the surgical experience of a neurosurgeon.
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Citations
Citations to this article as recorded by  - A Study to Evaluate Prognostic Factors and Define a Critical Volume for Early Surgery in Patients with Bifrontal Brain Contusions
Manoranjitha Kumari M, T.P. Jeyaselva Senthilkumar, Yamunadevi Ravi
Indian Journal of Neurosurgery.2024; 13(01): 044. CrossRef - Applications of supraorbital keyhole craniotomy in pediatric cranial trauma: illustrative series of two cases and systematic literature review
Joshua J. Loya, Chenyi Yang, Zach Pennington, Nolan J. Brown, Ali I. Rae, Jesse L. Winer
Child's Nervous System.2023; 39(12): 3531. CrossRef - Supraorbital eyebrow approach: A single-center experience
Blessing Ndlovu, Mohammed Ouwais Abdul Sattar, Mlamuli Mzamo Mkhaliphi, Keletso Leola, Morena Nthuse Mpanza, John Richard Ouma, Christos Profyris
Surgical Neurology International.2022; 13: 566. CrossRef - Re: Comparison of the Surgical Approaches for frontal Traumatic Intracerebral Hemorrhage
Luis Rafael Moscote-Salazar, Ezequiel Garcia-Ballestas, Pradeep Chouksey, Amit Agrawal
Journal of Trauma and Injury.2020; 33(1): 59. CrossRef
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