The voice of reason and history brought to bear against the present absurd and expensive method of transferring and encumbering immoveable property [electronic resource] /

Cover title.; "With some comments on the reformatory measures proposed in the opening speech of the Governor-in-Chief, and the bill recently introduced by The Hon. R.R. Torrens, Esq. into the House of Assembly"; Ferguson, J.A. Australia, 10625; Electronic reproduction. Canberra, A.C.T. : National Library of Australia, 2011.; Library's BIBLIO copy is possibly Mr. Torrens copy as indicated by the note. Part I. The Anglo-Saxon, the feudalist, and modern conveyancer -- Part. II. Review of the evils consequent on the error of attempting in modern conveyancing ... Part III. Code Napoleon on the notarial office and registration of rights on immoveables --Part IV. Merits of the systems of registry now practised in different nations and in South Australia ... -- Conclusion

Externe Ventrikeldrainage mittels Augmented Reality und Peer-to-Peer-Navigation

Das hier vorgestellte System verbindet das neue Konzept der Peer-to-Peer-Navigation mit dem Einsatz von Augmented Reality zur Unterstützung von bettseitig durchgeführten externen Ventrikeldrainagen. Das sehr kompakte und genaue Gesamtsystem beinhaltet einen Patiententracker mit integrierter Kamera, eine Augmented-Reality-Brille mit Kamera und eine Punktionsnadel bzw. einen Pointer mit zwei Trackern, mit dessen Hilfe die Anatomie des Patienten aufgenommen wird. Die exakte Position und Richtung der Punktionsnadel wird unter Zuhilfenahme der aufgenommenen Landmarken berechnet und über die Augmented-Reality-Brille für den Chirurgen sichtbar auf dem Patienten dargestellt. Die Methode zur Kalibrierung der statischen Transformationen zwischen Patiententracker und daran befestigter Kamera beziehungsweise zwischen den Trackern der Punktionsnadel sind für die Genauigkeit sehr wichtig und werden hier vorgestellt. Das Gesamtsystem konnte in vitro erfolgreich getestet werden und bestätigt den Nutzen eines Peer-to-Peer-Navigationssystems

Idiopathische ventrale Rückenmarksherniation

Idiopathic spinal cord herniation is a very rare defect of the thoracic ventral dura, most often between Th 2 and Th 8, with consecutive herniation of the spinal cord into this defect. After a long history, sometimes years, clinical signs and symptoms of a progressive, more or less severe myelopathy ensue, leading to a Brown-Sequard syndrome or parapareses as typical manifestations. Neither cause nor mechanism of the herniation are fully understood, yet. Amongst others, disc disease, like calcified microspurs, trauma, inflammation, connective tissue disorder and inherited duplication of the dura are considered. The most relevant differential diagnoses are arachnoid cysts and arachnoidal webs, that may push the spinal cord ventrally but leave the dura intact, as well as tumors, ischemic and traumatic spinal cord lesions. Despite excellent imaging possibilities sometimes it happens that the actual diagnosis of a spinal cord herniation with an underlying dural defect can only be made during microsurgery. Surgery, also for only mildly symptomatic patients, is challenging but the procedure of choice. The surgical goal is to release the spinal cord and then, depending on its size and location, either to close, augment, or widen the underlying dural defect. The risk for postoperative new deficits is 5-12%. The halt of the clinical progression is considered a treatment success, with ¾ of patients having the chance of postoperative improvement. Surgery should be performed with intraoperative neuromonitoring (SSEP, MEP, D-wave) in experienced centers. Patients in whom the indication for surgery has not yet been made should be closely monitored, because most likely the natural history of idiopathic ventral spinal cord herniation is progressive

Integrity of dural closure after autologous platelet rich fibrin augmentation: an in vitro study

Background: Watertight closure of the dura mater is fundamental in neurosurgery. Besides the classical suturing techniques, a variety of biomaterials have been proposed as sealants. Platelet rich fibrin (PRF) is an autologous biomaterial which can readily be obtained through low-speed centrifugation of patient’s own blood. It is rich in fibrin, growth factors, leucocytes and cytokines and has shown adhesive properties while promoting the physiological wound healing process. In this study, we investigated the effect of applying PRF in reinforcing the watertight dura mater closure. Methods: We created an in vitro testing device, where the watertight dura mater closure could be hydrostatically assessed. On 26 fresh harvested bovine dura maters, a standardised 20-mm incision was closed with a running suture, and the leak pressure was measured first without (primary leak pressure) and then with PRF augmentation (secondary leak pressure). The two groups of measurements have been statistically analysed with the Student’s paired t test. Results: The “running suture only group” had a leak pressure of 10.5 ± 1.2 cmH2O (mean ± SD) while the “PRF-augmented group” had a leak pressure of 47.2 ± 2.6 cm H2O. This difference was statistically significant (p  4-fold increased leak pressure after failure of the initial standard running suture technique

Radiation exposure of a mobile 3D C-arm with large flat-panel detector for intraoperative imaging and navigation - an experimental study using an anthropomorphic Alderson phantom

Background!#!Intraoperative 3-dimensional (3D) navigation is increasingly being used for pedicle screw placement. For this purpose, dedicated mobile 3D C-arms are capable of providing intraoperative fluoroscopy-based 3D image data sets. Modern 3D C-arms have a large field of view, which suggests a higher radiation exposure. In this experimental study we therefore investigate the radiation exposure of a new mobile 3D C-arm with large flat-panel detector to a previously reported device with regular flat-panel detector on an Alderson phantom.!##!Methods!#!We measured the radiation exposure of the Vision RFD 3D (large 30 × 30 cm detector) while creating 3D image sets as well as standard fluoroscopic images of the cervical and lumbar spine using an Alderson phantom. The dosemeter readings were then compared with the radiation exposure of the previous model Vision FD Vario 3D (smaller 20 × 20 cm detector), which had been examined identically in advance and published elsewhere.!##!Results!#!The larger 3D C-arm induced lower radiation exposures at all dosemeter sites in cervical 3D scans as well as at the sites of eye lenses and thyroid gland in lumbar 3D scans. At ​​male and especially female gonads in lumbar 3D scans, however, the larger 3D C-arm showed higher radiation exposures compared with the smaller 3D C-arm. In lumbar fluoroscopic images, the dosemeters near/in the radiation field measured a higher radiation exposure using the larger 3D C-arm.!##!Conclusions!#!The larger 3D C-arm offers the possibility to reduce radiation exposures for specific applications despite its larger flat-panel detector with a larger field of view. However, due to the considerably higher radiation exposure of the larger 3D C-arm during lumbar 3D scans, the smaller 3D C-arm is to be recommended for short-distance instrumentations (mono- and bilevel) from a radiation protection point of view. The larger 3D C-arm with its enlarged 3D image set might be used for long instrumentations of the lumbar spine. From a radiation protection perspective, the use of the respective 3D C-arm should be based on the presented data and the respective application

Correction to: Integrity of dural closure after autologous platelet rich fibrin augmentation: an in vitro study

The article “Integrity of dural closure after autologous platelet rich fibrin augmentation: an in vitro study”, written by Vasilikos, I., Beck, J., Ghanaati, S., Grauvogel, J., Nisyrios, T., Grapatsas, K., and Hubbe, U., was originally published Online First without Open Access. After publication in volume 162, issue 4, page 737–743 the author decided to opt for Open Choice and to make the article an Open Access publication. Therefore, the copyright of the article has been changed to © The Author(s) 2020 and the article is forthwith distributed under the terms of the Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0. Open access funding enabled and organized by Projekt DEAL

Accidental Durotomy in Minimally Invasive Transforaminal Lumbar Interbody Fusion: Frequency, Risk Factors, and Management

Purpose. To assess the frequency, risk factors, and management of accidental durotomy in minimally invasive transforaminal lumbar interbody fusion (MIS TLIF). Methods. This single-center study retrospectively investigates 372 patients who underwent MIS TLIF and were mobilized within 24 hours after surgery. The frequency of accidental durotomies, intraoperative closure technique, body mass index, and history of previous surgery was recorded. Results. We identified 32 accidental durotomies in 514 MIS TLIF levels (6.2%). Analysis showed a statistically significant relation of accidental durotomies to overweight patients (body mass index ≥25 kg/m2; P=0.0493). Patient age older than 65 years tended to be a positive predictor for accidental durotomies (P=0.0657). Mobilizing patients on the first postoperative day, we observed no durotomy-associated complications. Conclusions. The frequency of accidental durotomies in MIS TLIF is low, with overweight being a risk factor for accidental durotomies. The minimally invasive approach seems to minimize durotomy-associated complications (CSF leakage, pseudomeningocele) because of the limited dead space in the soft tissue. Patients with accidental durotomy can usually be mobilized within 24 hours after MIS TLIF without increased risk. The minimally invasive TLIF technique might thus be beneficial in the prevention of postoperative immobilization-associated complications such as venous thromboembolism. This trial is registered with DRKS00006135