68 research outputs found

    New technique and case report: Robot-assisted intralaminar screw fixation of spondylolysis in an adolescent

    No full text
    Introduction: Management of spondylolysis in adolescents is generally successful with conservative management. Uncommonly, surgical fixation is necessary for refractory cases. Direct repair with intralaminar screws is one commonly utilized technique. Recently, less invasive spinal procedures are becoming viable with the enabling of technologies, including robotics. Case description: A 14-year-old baseball player and surfer presented with low back pain, diagnosed by MRI as bony edema and stress fractures of the posterior spinal elements. After 18 months, the pain was unresponsive to rest, physical therapy, and bracing. There was no radicular pain or neurologic symptoms. Computed tomography (CT) revealed bilateral, chronic nonhealing pars defects at L5. He underwent outpatient, robot-assisted percutaneous intralaminar fixation with hydroxyapatite-coated screws through a 2 cm skin incision. Outcome: On postoperative day 1, the patient reported relief of his preoperative pain and he was ambulating without difficulty. At 2 weeks follow-up, the patient was completely pain free and surfing. At 2 months follow-up, low-dose CT demonstrated partial incorporation of the hydroxyapatite-coated screws, and the patient returned to sports. At 6 months follow-up, the patient had no pain and was swinging his baseball bat with full force. Low-dose CT revealed complete healing of the defects with full incorporation of the hydroxyapatite-coated screws. Conclusions: A novel minimally invasive robotic percutaneous approach for direct spondylolysis repair using hydroxyapatite-coated screws is a potential surgical treatment option for non-healing pars defects in adolescent patients

    Risk-Based Decision Support for Dredging the Lower Mississippi River

    No full text
    The paper reviews progress of a U.S. Army Corps of Engineers project to develop a prototype risk-based decision support system (DSS) for operational scheduling of dredging on the Lower Mississippi River. The DSS incorporates uncertainty in dredging costs, navigation control depths, and navigation costs avoided in an integrated manner to explore the risks and costs associated with potential operational dredging decisions. The DSS is intended to provided economic and risk-based operational guidance and justification in the scheduling, operation, and movement of maintenance dredges. Several lessons are inferred for risk analysis modeling of maintenance dredging activities, and risk analysis in general

    CAUSES OF INTOEING GAIT IN CHILDREN WITH CEREBRAL PALSY

    No full text
    corecore