With the advent of newer diagnostic imaging tools, the reported prevalence of acute pulmonary embolism (PE) following total hip (THA) and total knee (TKA) arthroplasty appears to be increasing. However, the true prevalence and clinical relevance of these events are unclear. Our study was designed to evaluate the results of routine multi-detector computed tomography (MDCT) in this patient population in the early postoperative period. We prospectively performed MDCT scans on 48 consecutive THA/TKA patients on the first postoperative day in 2009. Patients underwent routine postoperative care and data were collected regarding the development of symptoms such as tachycardia, fever, chest pain, or shortness of breath. Scans were kept blinded and read at the end of study recruitment for the diagnosis of acute PE.Purpose
Method
Using post-operative CT analysis the clinical accuracy of computer-assisted fluoroscopy for the placement of thoracic (n=69) and lumbosacral (n=271) pedicle screws was assessed. All screws were placed using the Fluoro-Nav™ system (Medtronic Sofamor Danek, Memphis, TN, USA). Screw position was completely intrapedicular in 86.5%. There were no clinically significant screw misplacements. Pedicle breaches with a potential for neurological injury (>
2 mm; medial) was 0.6%. The overall pedicle screw misplacement rate in this study is less than or comparable to reported misplacement rates using other techniques. The use of computer-assisted fluoroscopy may improve the safety of pedicle screw placement. The purpose of this prospective study is to evaluate the clinical accuracy of computer-assisted fluoroscopy for the placement of thoracic (T) and lumbosacral (LS) pedicle screws. The overall thoracic and lumbar pedicle screw misplacement rate in this study is less than or comparable to reported misplacement rates using other techniques. The use of computer-assisted fluoroscopy may improve the safety of pedicle screw placement. Postoperative computed tomographs (CT) of three hundred and forty pedicle screws were independently reviewed. All screws were placed using the Fluoro-Nav™ system (Medtronic Sofamor Danek, Memphis, TN, USA). The relative position of the screw to the pedicle was assessed and graded as follows – Overall screw position was graded FluoroNav™ appears to be a safe and practical adjunct for the placement of thoracic and lumbosacral pedicle screws.
