RESUMO
OBJECTIVES: To study the accuracy and safety of pedicle screw insertion by three-dimensional frameless stereo-tactic-guided technique. MATERIAL AND METHOD: Twelve patients underwent spinal surgery using three- dimensional frameless stereo-tactic-guided technique at King Chulalongkorn Memorial Hospital (KCMH) during June - December 2004. In all patients, post-operative CT scan of the operated spinal segments were obtained and evaluated for the position of each screw placed. Medical records were reviewed and all patients were interviewed by telephone to assess clinical outcomes and complications RESULTS: 5I pedicle screws were inserted in 12 patients. Postoperative CT scan of the instrumented spine revealed that 50 screws were considered grade I screw while one screw was considered grade II. No patient suffered direct vascular or neurological injury. CONCLUSION: Three-dimensional frameless stereotactic-guided technique provides additional safety to spinal instrumentation
Assuntos
Adulto , Idoso , Parafusos Ósseos , Feminino , Hospitais Universitários , Humanos , Masculino , Pessoa de Meia-Idade , Cuidados Pós-Operatórios , Estudos Prospectivos , Medição de Risco , Estudos de Amostragem , Sensibilidade e Especificidade , Índice de Gravidade de Doença , Doenças da Coluna Vertebral/diagnóstico , Fusão Vertebral/instrumentação , Técnicas Estereotáxicas , Cirurgia Assistida por Computador/métodos , Tailândia , Tomografia Computadorizada por Raios X/métodos , Resultado do TratamentoRESUMO
In the present paper the authors examine two cases of Currarino syndrome and review the existing literature on the disease. Both cases presented with chronic constipation. The first concerns a two year old male born with anorectal stenosis and diagnosed with Currarino syndrome when scimitar sacrum and anterior meningocele were finally detected. The second concerns a 25 year old female who suffered from chronic constipation but was not diagnosed until thorough examination revealed ectopic anus with Hirschsprung disease, scimitar sacrum and anterior meningocele. Because these patients were not diagnosed with Currarino syndrome when first seen, the authors reviewed its prevalence, embryogenesis, clinical manifestations, diagnosis and treatment. The authors' research supports the significance of prompt diagnosis in effective treatment and reduction of morbidity.