Radiation exposure and avoidance in minimally invasive spine surgery

© Springer Nature Switzerland AG 2019. The advent of minimally invasive spine surgery (MIS or MISS) heralds an important milestone in the surgical management of spinal disorders. MIS provides the modern spine surgeon the ability to treat spine pathology in a precise, less morbid manner when compared to open procedures. The benefits of MIS over open procedures include, but are not limited to, decreased blood loss, decreased infection rates, and decreased hospital length of stay. These benefits of MIS coexist with the burden of an increased reliance on radiographic imaging in the operating theater. Radiography in MIS can produce significant amounts of radiation, placing both the surgeon and patient at risk. Efforts to limit radiation exposure in MIS stem from a basic understanding of the physical nature of ionizing radiation and its effects on living tissue. Although the quantity of radiation produced in various MIS procedures varies in the literature, a surgeon’s hands and thyroid gland may represent structures consistently at risk. Techniques to limit radiation exposure include preoperative considerations, such as prudently planning when imaging is necessary during a case, and intraoperative adjustments such as appropriately positioning the radiation source in relation to the patient and surgeon. Knowledge of these techniques allows spine surgeons to effectively perform MIS while simultaneously reducing radiation exposure

A Biomechanical Model of the Shoulder Including Acromioclavicular Joint Ligaments: Preliminary Results

In this study an upper limb biomechanical model which includes strain-adjustable ligaments of the acromioclavicular joint was developed. The model including 7° of freedom is able to evaluate the movements of the shoulder, elbow and wrist. The ligaments strain can be adjusted in order to simulate different types of Rockwood acromioclavicular dislocation. Movements recorded from three healthy subjects are used as preliminary assessment of the proposed model