Clinical Evaluation of the NaviNetics Stereotactic System Using Intraoperative Portable Surgical Imaging System in DBS Surgery.

Background And Objectives: A typical workflow for deep brain stimulation (DBS) surgery consists of head frame placement, followed by stereotactic computed tomography (CT) or MRI before surgical implantation of the hardware. At some institutions, this workflow is prolonged when the imaging scanner is located far away from the operating room, thereby increasing workflow times by the addition of transport times. Recently, the intraoperative O-arm has been shown to provide accurate image fusion with preoperative CT or MR imaging, suggesting the possibility of obtaining an intraoperative localization scan and postoperative confirmation.

Robotic Applications in Cranial Neurosurgery: Current and Future.

Robotics applied to cranial surgery is a fast-moving and fascinating field, which is transforming the practice of neurosurgery. With exponential increases in computing power, improvements in connectivity, artificial intelligence, and enhanced precision of accessing target structures, robots are likely to be incorporated into more areas of neurosurgery in the future-making procedures safer and more efficient. Overall, improved efficiency can offset upfront costs and potentially prove cost-effective.

Electrode Placement Accuracy in Robot-Assisted Asleep Deep Brain Stimulation.

Deep brain stimulation (DBS) involves the implantation of electrodes into specific central brain structures for the treatment of Parkinson's disease. Image guidance and robot-assisted techniques have been developed to assist in the accuracy of electrode placement. Traditional DBS is performed with the patient awake and utilizes microelectrode recording for feedback, which yields lengthy operating room times.

Resistance to venous flow: A mathematical description and implications for compartment syndromes.

Background: The object of this work was to describe resistance to flow within a vein in a closed compartment.

Methods: A vein is mathematically modeled as a collapsible cylinder with fixed perimeter exposed to extraluminal hydrostatic pressure within a closed compartment of the body. The principle of minimization of energy is used to determine the cross-sectional area and resistance to flow through such a cylinder in various states of collapse.

The effect of variable waveform low-intensity pulsed ultrasound in a fourth metacarpal osteotomy gap model in horses.

The objective of this study was to evaluate the effects of variable waveform low-intensity ultrasound on the healing of a fracture gap of the fourth metacarpal bone in horses. A randomized, blinded, controlled trial was conducted in eight healthy adult horses. In each horse, a 1-cm osteotomy of the fourth metacarpal bone was created.

Are upright lateral cervical radiographs in the obtunded trauma patient useful? A retrospective study.

Background: The best method for radiographic "clearance" of the cervical spine in obtunded patients prior to removal of cervical immobilization devices remains debated. Dynamic radiographs or MRI are thought to demonstrate unstable injuries, but can be expensive and cumbersome to obtain. An upright lateral cervical radiograph (ULCR) was performed in selected patients to investigate whether this study could provide this same information, to enable removal of cervical immobilization devices in the multiple trauma patient.

The effects of extracorporeal shock-wave therapy on the ultrasonographic and histologic appearance of collagenase-induced equine forelimb suspensory ligament desmitis.

Extracorporeal shock-wave therapy (ESWT) may stimulate healing of desmitis in multiple species. The objective of this study was to evaluate the ultrasonographic and histologic appearance of collagenase-induced suspensory ligament (SUL) desmitis in untreated ligaments and ligaments treated with ESWT in horses. Four mature horses had SUL desmitis induced in both forelimbs.

The benefit of neurogenic mixed evoked potentials for intraoperative spinal cord monitoring during correction of severe scoliosis: a case study.

Study Design: A case report is presented.

Objective: To present a case in which surgical correction of a severe scoliotic curve caused unilateral loss of neurogenic mixed evoked potential data despite unchanged somatosensory data.

Summary Of Background Data: Surgical correction of large scoliotic curves presents a risk to the function of the spinal cord.

The rationale for and efficacy of surgical intervention for electrodiagnostic-negative cubital tunnel syndrome.

Because conservative management of McGowan grade 1 cubital tunnel syndrome (symptoms only) may be successful in a high percentage of patients, normal electrodiagnostic studies and the absence of intrinsic muscle weakness or decreased sensation or both may be viewed as contraindications to operative intervention. Because the results of surgery are known to be inferior once objective motor weakness and abnormal 2-point sensory discrimination (McGowan grades 2 and 3) develop, however, we advocate surgical intervention for patients with symptoms only, even when electrodiagnostic studies are normal. We enrolled 16 patients (18 elbows) with McGowan I cubital syndrome who underwent in situ ulnar nerve release and medial epicondylectomy.

Midfoot osteotomies.

Midfoot osteotomies are primarily used for reconstructive procedures for congenital or acquired deformities. Although used more in a younger population, they can used in most any patient population. With restoration of a more normal architecture, patients' symptoms resolve and prevention of long-term sequella can be avoided.

Analysis of vibrations induced during wheelchair propulsion.

Little is known about how dynamic acceleration affects wheelchair-rider comfort. The current study was to test both the operation of an instrumented wheelchair by a wheelchair user over a Simulated Road Course (SRC) and the operation of the same instrumented wheelchair during normal daily activities (a field test) by test subjects. Sixteen subjects participated in the protocol.

Evaluation of a manual wheelchair interface to computer games.

The sedentary lifestyle of many people with spinal cord injury (SCI) has lead to cardiovascular diseases being a major health concern. A suitable exercise program may help improve the SCI individual's cardiovascular fitness level. GAMEWheels is an interface between a custom wheelchair roller system and a computer that enables an individual to control computer video games by driving his or her wheelchair.

Road loads acting on manual wheelchairs.

A barrier to performing more in-depth analyzes during the wheelchair design process is a lack of dynamic reaction force and moment data, and the instrumentation to collect this data. Instrumentation was developed to collect the dynamic force and moment data. New data collections methodologies and analysis techniques were implemented to facilitate computer-aided-engineering for wheelchair designs.

Use of radiography, computed tomography and magnetic resonance imaging for evaluation of navicular syndrome in the horse.

Radiographic evaluation of navicular syndrome is problematic because of its inconsistent correlation with clinical signs. Scintigraphy often yields false positive and false negative results and diagnostic ultrasound is of limited value. Therefore, we assessed the use of computed tomography and magnetic resonance imaging in a horse with clinical and radiographic signs of navicular syndrome.

User assessment of manual wheelchair ride comfort and ergonomics.

Objective: To examine wheelchair-user perceived ride comfort during propulsion and to compare the ride comfort of ultralight and lightweight manual wheelchairs. An ultralight wheelchair is defined as having a high degree of adjustability, whereas a lightweight wheelchair has minimal adjustability.

Design And Participants: Repeated measures design of a sample of 30 community-dwelling manual wheelchair users evaluating 7 different manual wheelchairs over an activities of daily living course.

A unified method for calculating the center of pressure during wheelchair propulsion.

The measurement of the center of pressure (COP) has been and continues to be a successful tool for gait analysis. The definition of a similar COP for wheelchair propulsion. however, is not straightforward.

Performance of selected lightweight wheelchairs on ANSI/RESNA tests. American National Standards Institute-Rehabilitation Engineering and Assistive Technology Society of North America.

Objective: This study provides data for clinicians and wheelchair users to compare the durability, stability, and cost effectiveness of three different lightweight wheelchair models: the Everest & Jennings EZ Lite, the Invacare Rolls 2000, and the Quickie Designs Breezy. A second objective was to compare the results from this study to those published for ultralight and institutional depot wheelchairs.

Design: Randomized standards testing of three wheelchair models from each manufacturer (nine wheelchairs total).

Uncertainty analysis for wheelchair propulsion dynamics.

Wheelchair propulsion kinetic measurements require the use of custom pushrim force/moment measuring instruments which are not currently commercially available. With the ability to measure pushrim forces and moments has come the development of several dynamic metrics derived for analyzing key aspects of wheelchair propulsion. This paper presents several of the equations used to calculate or derive the primary variables used in the study of wheelchair propulsion biomechanics.

Methods for determining three-dimensional wheelchair pushrim forces and moments: a technical note.

This technical note illustrates that some of the differences that have been reported regarding wheelchair propulsion may be due to the methods used to calculate key variables. Wheelchair ambulation is a very important form of locomotion that lacks a standard pushrim force and moment analysis system. We have developed tools for analyzing upper limb biomechanics during manual wheelchair propulsion.

Determination of wheelchair dynamic load data for use with finite element analysis.

A methodology is introduced for the experimental determination of the dynamic loads which act on a wheelchair. A box frame wheelchair and a cantilever frame wheelchair were tested on an ANSI/RESNA curb-drop tester [1]. The accelerations of an ANSI/RESNA test dummy [1] were recorded with an array of 12 accelerometers mounted as four three-axis groups.

Projection of the point of force application onto a palmar plane of the hand during wheelchair propulsion.

The objective of this study was to develop and test a method for projecting the pushrim point of force application (PFA) onto a palmar plane model of the hand. Repetitive wheelchair use often leads to hand and wrist pain or injury. The manner by which the hands grasp the pushrim and how the forces and moments applied to the pushrim are directed may contribute to the high incidence of pain and injury.

Life-cycle analysis of depot versus rehabilitation manual wheelchairs.

The proper selection of a wheelchair requires making several critical decisions, not the least of which is what type of wheelchair is appropriate. The International Organization for Standards (ISO) continues to develop and refine wheelchair standards. Standards allow the objective comparison of products from various sources, permitting consumers or clinicians to assess wheelchairs with which they are not familiar by comparing test results.

Power wheelchair range testing and energy consumption during fatigue testing.

The range of a power wheelchair depends on many factors including: battery type, battery state, wheelchair/rider weight, terrain, the efficiency of the drive train, and driving behavior. The purpose of this study was to evaluate the feasibility of three methods of estimating power wheelchair range. Another significant purpose was to compare the current draw on pavement to current draw on an International Standards Organization (ISO) Double Drum tester at one m/sec.

Evaluation of methods for determining rearward static stability of manual wheelchairs.

Wheelchair standards have been under development for several years. A set of tests has been approved by the American National Standards Institute (ANSI) and by the International Standards Organization (ISO) but continue to be refined. Static stability is one of the indicators used to evaluate manual wheelchairs and is measured by placing a loaded wheelchair on a platform that is tilted until the wheelchair's front wheels lift off of the platform.

Effect of two muscle sling techniques on early morbidity after femoral head and neck excision in dogs.

Femoral head and neck excision was performed on the left coxofemoral joint of 18 dogs. The osteotomy site was padded with a partial-thickness biceps femoris muscle sling in one group of six dogs, and with a deep gluteal muscle flap in another group of six dogs. In a third group of six dogs, a partial-thickness biceps flap was created and sutured back in its original location.