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1

Watson, JA, and JP Hollingdale. "Pre-operative planning for intramedullary nailing." Journal of Bone and Joint Surgery. British volume 74-B, no. 1 (January 1992): 158–59. http://dx.doi.org/10.1302/0301-620x.74b1.1732252.

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2

Sharma, S., M. Grover, S. N. Singh, T. Kataria, and R. S. Lakhawat. "Cochlear orientation: pre-operative evaluation and intra-operative significance." Journal of Laryngology & Otology 132, no. 06 (June 2018): 540–43. http://dx.doi.org/10.1017/s002221511800066x.

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AbstractObjectiveThe study primarily aimed to calculate the orientation of the cochlea pre-operatively, using high-resolution computed tomography of the temporal bone, and predict the ease of electrode insertion.MethodsPre-operatively, high-resolution computed tomography scans were conducted on children scheduled for cochlear implantation, and two angles, α and β, were calculated. The values of α and β were then correlated with intra-operative difficulty in insertion of the electrode array.ResultsNinety-six children were included in the study. Of the seven patients who had an α angle of less than 50 degrees, the surgeon experienced difficulties in electrode insertion. However, there were four patients with an α angle of more than 50 degrees for whom the surgeon also experienced difficulties in electrode insertion. In all these patients, the β angle was more than 20 degrees.ConclusionCalculation of cochlear orientation and its angle with the surgical axis (α and β) can aid the planning of surgery, particularly with regard to the cochleostomy site and preservation of residual hearing.
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Michalíková, Monika, Teodor Tóth, Viktória Rajťúková, and Jozef Živčák. "The Digital Pre-Operative Planning of Hip Surgical Interventions." Solid State Phenomena 199 (March 2013): 350–55. http://dx.doi.org/10.4028/www.scientific.net/ssp.199.350.

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Computer technology has many applications in different fields of industry, health care and medicine. This encompasses paper-based information processing as well as data processing machines (Hospital information system or Clinical information system) and image digitalization of a large variety of medical diagnostic equipment (e.g. computer images of X-ray, MR, CT). The aim of the computer technology in medicine is to achieve the best possible support of patient care, preoperative surgery planning and administration by electronic data processing. At the present time in many countries of the worlds preoperative planning of interventions for lumbar joint is realized with caliper, protractor, plastic templates and x-ray images. Orthopaedic surgeons use transparent template radiographs as part of pre-operative planning in order to gauge the suitability and correct size of an implant. The newly developed CoXaM software offers a simple solution of the problems by using the digital x-ray images and handmade transparent plastic templates. The CoXaM software was developed in Visual Studio 2005 in the Visual C++ programming language at the Department of Biomedical Engineering and Measurement at the Faculty of Mechanical Engineering, Technical University of Kosice. The software was designed for pre-operative planning and helps to determine on the X-ray image a length dimensions, a center of rotation, an angle values. It enables the digitalization of plastic templates from several producers, which will assess the suitability of the type of implant.
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Wade, R. H., J. Kevu, and J. Doyle. "Pre-operative planning in orthopaedics:a study of surgeons' opinions." Injury 29, no. 10 (December 1998): 785–86. http://dx.doi.org/10.1016/s0020-1383(98)00192-2.

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Basu, N., T. Ray, C. Arhi, R. Bernal, R. Guy, L. Apthorp, and E. F. Shah. "93 Axillary Staging – a Useful Pre-operative Planning Tool." European Journal of Cancer 48 (March 2012): S68. http://dx.doi.org/10.1016/s0959-8049(12)70161-2.

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Ho, Cindy, Haley Perlow, Alex Ritter, Yevgeniya Gokun, Jennifer Matsui, Joshua Wang, Mark Damante, et al. "RADT-12. PRE- AND POST-OPERATIVE RADIATION TREATMENT PLANNING FOR PATIENTS RECEIVING STEREOTACTIC RADIOSURGERY FOR BRAIN METASTASES: A VOLUMETRIC ANALYSIS." Neuro-Oncology 24, Supplement_7 (November 1, 2022): vii51. http://dx.doi.org/10.1093/neuonc/noac209.202.

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Abstract BACKGROUND Pre-operative stereotactic radiosurgery (SRS) has emerged as a recent treatment option to treat large or symptomatic brain metastases. Compared to post-operative SRS, pre-operative treatment may reduce rates of radiation necrosis (RN) and meningeal disease through treating a smaller treatment volume and by preventing post-operative tumor seeding. We hypothesize that pre-operative radiation volumes will be smaller than post-operative volumes, which in turn may lead to a decreased treatment morbidity. METHODS A retrospective analysis was conducted and patients who had surgical resection and post-operative SRS or fractionated stereotactic radiosurgery (FSRT) for a posterior fossa brain metastasis were eligible for inclusion. Both pre-operative and post-operative MRIs were required to allow for accurate radiation target delineation. A pre-operative tumor volume was added for each patient, and the post-operative clinical treatment volume (CTV) used for radiation treatment was included. Pre-operative tumor and post-operative cavity volumes were compared using Wilcoxon signed rank test. RESULTS 28 patients who received post-operative SRS or FSRT from 1/1/2016-12/31/2020 were included in this analysis. The mean pre-operative tumor volume was 14.9 ccs, and the mean post-operative CTV was 21.0 ccs (p < 0.01). 75% of patients had a smaller initial tumor size compared to the post-operative CTV used for radiation treatment planning. For patients with at least 4 follow up MRIs (n = 8), the size of the post-operative cavity progressively decreased with a mean initial cavity volume of 18.9 ccs and mean follow up volumes of 8.1, 7.1, 6.9, and 6.2 ccs. CONCLUSIONS In this study evaluating patients who received post-operative SRS, the pre-operative tumor volume was lower than the post-operative CTV for most patients. Previous studies including PROPS-BM have shown how pre-operative treatment may reduce the risk of RN because smaller radiation volumes are used. Pre-operative radiosurgery for patients with brain metastases requires prospective validation.
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Fatic, Nikola, Pasha Normahani, Dejan Mars, Nigel J. Standfield, and Usman Jaffer. "Validation of an assessment tool for pre-operative EVAR planning." Perfusion 33, no. 2 (September 4, 2017): 123–29. http://dx.doi.org/10.1177/0267659117728112.

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Introduction: Current methods of teaching endovascular aortic aneurysm repair (EVAR) planning involve non-criteria-based observations that lack validity. The primary aim of this study was to validate an EVAR Planning Objective Structured Assessment of Skill (EpOSAS) tool for the assessment of pre-operative EVAR planning skills. Methods: Content analysis was performed in order to inform the formulation of EpOSAS domains. Thirty-five participants planned two cases of infra-renal abdominal aortic aneurysm for EVAR, using the OsiriX 7 platform. EVAR planning measurements, with accompanying screenshots, were uploaded onto an electronic data collection sheet. Performance was assessed by three blinded assessors using the EpOSAS tool. Construct and concurrent validity were evaluated. Results: Inter-observer reliability for the three assessors for total EpOSAS scores was high (Cronbach’s α 0.89). There were statistically significant differences in total EpOSAS scores between the different experience groups, demonstrating construct validity (Novice (5.3, IQR 5-5.3), Intermediate (15.3, IQR 14.8-16.8) and Experts (17.5, IQR 17-17.7), p<0.001). A statistically significant correlation was found between total EpOSAS scores and percentage error in measurements, demonstrating concurrent validity (Spearman’s rank correlation coefficient: R=-0.250, p<0.001). Receiver-operator characteristics analysis established a cut-off point of 16 out of 18 for determining competence. Conclusion: We have developed and validated a tool that can be used for the assessment of pre-operative EVAR planning skills.
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De Paolis, Lucio Tommaso, Marco Pulimeno, and Giovanni Aloisio. "Advanced Visualization and Interaction Systems for Surgical Pre-operative Planning." Journal of Computing and Information Technology 18, no. 4 (2010): 385. http://dx.doi.org/10.2498/cit.1001878.

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9

Facco, G., A. Mari, L. Greco, A. Forcellese, N. Specchia, and M. Valenti. "New frontiers in pre-operative planning of complex spinal deformities." Physica Medica 92 (December 2021): S134—S135. http://dx.doi.org/10.1016/s1120-1797(22)00286-1.

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10

Lakstein, Dror, Zachary Tan, Nugzar Oren, Tatu Johannes Mäkinen, Allan E. Gross, and Oleg Safir. "Pre-Operative Planning of Total Hip Arthroplasty on Dysplastic Acetabuli." HIP International 27, no. 1 (October 24, 2016): 55–59. http://dx.doi.org/10.5301/hipint.5000419.

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Background When performing total hip arthroplasty (THA) on a dysplastic hip, proper positioning of the acetabular component may not allow for more than 70% coverage. Structural support in the form of an autograft or a high porosity metal augment may be necessary. The purpose of the study was to investigate the value of pre-operative templating and deformity classification in predicting cup coverage and the need for structural support. Methods 65 cases of THA for DDH were retrospectively analysed. 2 observers independently classified each dysplastic hip according to Hartofilakidis and determined the extent of cup coverage via templating software on pre-operative digital AP pelvic radiographs. Results Weighted kappa interobserver agreement was 0.68 for cup coverage and 0.76 for Hartofilakidis type. Structural support was necessary in 10 hips. No structural support was necessary in Hartofilakidis type 1, dysplasia cases. However, 27-30% of cases with type 2 or type 3 dysplasia required structural support. All cases with templated cup coverage of 65% or less required structural support. Templated coverage within 65-75% and over 75% resulted in 20% and 10% of patients receiving structural augmentation, respectively. Conclusions Pre-Operative planning for THA in the setting of hip dysplasia is crucial and can provide valuable insight to the need for column augmentation. However, the 3-D severity of the deformity may be underestimated in the 2-D radiographs.
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Castanho, Rafael Resende, Glaucia Bordignon, and Hélio Cezar Gomes dos Reis. "Pre-operative tomographic evaluation of calcaneum fractures in surgical planning." Scientific Journal of the Foot & Ankle 12, no. 4 (December 30, 2018): 332–37. http://dx.doi.org/10.30795/scijfootankle.2018.v12.859.

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Objective: To perform the correlation between the preoperative tomographic evaluation of patients with calcaneal fracture diagnosis and the access routes of choice, as well as the synthesis materials used.Methods: We reviewed 19 medical records of patients between 23 and 56 years old who underwent calcaneal fracture surgery from 01/01/2014 to 12/31/2015. We evaluated the mechanism of trauma, side, Essex-Lopresti classification, Böhler and Gissane angle in the pre- and postoperative period, Sanders tomographic classification and type of osteosynthesis performed. Angular measurements served as a reference for radiological analysis of the quality of the reduction. Results: 90% of the cases were of joint depression, the other 10% considered extra-articular. The preoperative Böhler angle varied between 5 and 40°, and between 10 and 38° in the postoperative period, and 55% of the fractures had an angular reconstruction considered good (between 20° and 40°). Gissane’s angle, on the other hand, varied between 110 and 170° in the preoperative period, and 102 and 132° in the postoperative period. In the tomographic analysis, Sanders IV classification was predominant (65%), followed by type IIIBC fractures (20%), and fractures type I, IIA and IIIAB (5% each). Osteosynthesis with plate and screw was the most used method (89.47%). Conclusion: Correct use of existing diagnostic imaging resources through radiographic and tomographic results provides the possibility of better preoperative planning in the intra-articular fractures of the calcaneus. However, in this study, there was no difference in the access route and synthesis according to the tomographic classification. Level of Evidence III; Diagnostic Studies; Study of Non-Consecutive Patients.
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Clijmans, T., J. Abeloos, F. Gelaude, M. Mommaerts, P. Suetens, and J. Vander Sloten. "O142 Computer-aided pre-operative planning of mandibular reconstruction surgery." Oral Oncology Supplement 2, no. 1 (May 2007): 107. http://dx.doi.org/10.1016/s1744-7895(07)70206-7.

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13

Rioual, Kristell, Edurne Unanua, Soizic Laguitton, Mireille Garreau, Dominique Boulmier, Pascal Haigron, Christophe Leclercq, and Jean-Louis Coatrieux. "MSCT labelling for pre-operative planning in cardiac resynchronization therapy." Computerized Medical Imaging and Graphics 29, no. 6 (September 2005): 431–39. http://dx.doi.org/10.1016/j.compmedimag.2005.04.005.

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14

Sadri, Amir, Adrian D. Murphy, and Joy Odili. "iPad local flap pre-operative planning: A good training tool." Journal of Plastic, Reconstructive & Aesthetic Surgery 65, no. 12 (December 2012): 1746. http://dx.doi.org/10.1016/j.bjps.2012.04.018.

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15

Newman, K. J. H. "The role of X-ray templates in pre-operative planning." Injury 25 (January 1994): SB22. http://dx.doi.org/10.1016/0020-1383(94)90225-9.

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Korgaonkar-Cherala, Chaitali, Bijal Parikh, Harmehar K. Kohli, Megan Gorman, James Bernasko, Diana Garretto, David Garry, Cassandra Heiselman, and Kimberly Herrera. "Pre-operative planning for placenta accreta spectrum and delivery outcomes." American Journal of Obstetrics and Gynecology 228, no. 1 (January 2023): S287—S288. http://dx.doi.org/10.1016/j.ajog.2022.11.510.

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17

Fiorucci, P., F. Gaetani, R. Minciardi, and E. Trasforini. "Natural risk assessment and decision planning for disaster mitigation." Advances in Geosciences 2 (May 13, 2005): 161–65. http://dx.doi.org/10.5194/adgeo-2-161-2005.

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Abstract. In this paper, decisional models are introduced aiming at defining a general framework for natural disaster mitigation. More specifically, an integrated approach based on system modelling and optimal resource assignment is presented in order to support the decision makers in pre-operational and real-time management of forest fire emergencies. Some strategies for pre-operative and real time risk management will be described and formalized as optimal resource assignment problems. To this end, some models capable to describe the resources dynamics will be introduced, both in pre-operative phase and in real-time phase.
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18

Schizas, C. G., B. Parker, and P. F. Leyvraz. "A Study of Pre-Operative Planning in CLS total Hip Arthroplasty." HIP International 6, no. 2 (April 1996): 75–81. http://dx.doi.org/10.1177/112070009600600205.

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This study involved 200 cementless primary total hip arthroplasties of which 100 had formal pre-operative planning as recommended by the manufacturer using standardised radiographs, templates and tracing paper. The remaining 100 had no formal pre-operative planning. The operations were performed by two different groups of surgeons using different surgical exposures. The variables measured included radiological magnification, component sizing, intra-operative lengthening, positioning of the centre of the femoral head and femoral component fit and fill. Clinical data was obtained from a questionnaire. The results indicate an improved position of the centre of rotation and better leg length equalisation in the planned group. There was no significant difference in the number of intra-operative fractures among the two groups. No correlation was found between femoral fit and upper femoral morphology nor between fit and the surgeon's seniority. There was no significant difference in the incidence of thigh pain in the two groups at an average follow-up of 28 months. The more striking finding was the poorer femoral fit and fill encountered in the unplanned group.
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Ou-Yang, David, Evalina L. Burger, and Christopher J. Kleck. "Pre-Operative Planning in Complex Deformities and Use of Patient-Specific UNiD Instrumentation." Global Spine Journal 12, no. 2_suppl (April 2022): 40S—44S. http://dx.doi.org/10.1177/21925682211055096.

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Study Design Review of current literature and authors experience. Objective Pre-operative planning is an integral part of complex spine surgery. With the advent of computer-assisted planning, multiple surgical plans can be evaluated utilizing alignment parameters, and the best plan for individual patients selected. However, the ability to evaluate and measure surgical correction goals intraoperatively are still limited. The use of patient-specific UNiD rods, created based on pre-operative plans, provided an initial tool for implementation of pre-operative plans in the operative setting. Methods A literature review for the use of patient-specific UNiD rods in thoracolumbar spine complex surgery was performed. The articles were selected and reviewed for the initial experience/outcomes of these techniques. Further, the initial experience of the authors at The University of Colorado is described. Results The use of UNiD patient-specific rods, in combination with pre-operative planning has been shown to provide a higher rate of patients with spinopelvic alignment parameters within currently accepted ranges. This includes improvement of sagittal vertical axis (SVA) < 50 mm and pelvic incidence (PI)–lumbar lordosis (LL) = ± 10°. Multiple authors have shown improvement in pelvic tilt to age adjusted values but note continued difficulties in obtaining correction goals. Conclusions The use of pre-operative planning software and UNiD patient-specific rods has been shown to improve surgeon’s ability to achieve spinopelvic alignment parameters, specifically SVA and PI-LL, along with other possible benefits. Further research is needed regarding long-term value of the technology.
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Buckley, Simon. "(i) Informed consent and pre-operative planning for total hip arthroplasty." Orthopaedics and Trauma 27, no. 5 (October 2013): 269–71. http://dx.doi.org/10.1016/j.mporth.2013.08.010.

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Saffarini, Mo, Jacobus H. Müller, Giuseppe La Barbera, Gerjon Hannink, Kyung Jin Cho, Cécile Toanen, and David Dejour. "Inadequacy of computed tomography for pre-operative planning of patellofemoral arthroplasty." Knee Surgery, Sports Traumatology, Arthroscopy 26, no. 5 (March 7, 2017): 1485–92. http://dx.doi.org/10.1007/s00167-017-4474-1.

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Gregorič, Minja, and Andrej Bergauer. "Pre-operative planning of pedicled perforator flaps with contrast-enhanced ultrasound." Journal of Plastic, Reconstructive & Aesthetic Surgery 67, no. 11 (November 2014): 1609. http://dx.doi.org/10.1016/j.bjps.2014.09.020.

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Acuña, Alexander J., Linsen T. Samuel, Bilal Mahmood, and Atul F. Kamath. "Systematic review of pre-operative planning modalities for correction of acetabular dysplasia." Journal of Hip Preservation Surgery 6, no. 4 (November 28, 2019): 316–25. http://dx.doi.org/10.1093/jhps/hnz057.

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Abstract Acetabular dysplasia, related to developmental dysplasia of the hip, causes the abnormal distribution of hip joint forces. Surgical correction of acetabular dysplasia involves repositioning the acetabulum to achieve improved coverage of the femoral head. However, ideal placement of the acetabular fragment is challenging, and has led to an increased interest in pre-operative planning modalities. In this study, we used the PubMed and EBSCO host databases to systematically review all the modalities for pre-operative planning of acetabular dysplasia proposed in the current literature. We included all case-series, English, full-text manuscripts pertaining to pre-operative planning for congenital acetabular dysplasia. Exclusion criteria included: total hip arthroplasty (THA) planning, patient population mean age &gt;35, and double/single case studies. A total of 12 manuscripts met our criteria for a total of 186 hips. Pre-operative planning modalities described were: Amira (Thermo Fischer Scientific; Waltham, MA, USA) 12.9%, OrthoMap (Stryker Orthopaedics; Mahwah, NJ, USA) 36.5%, Amira + Biomechanical Guidance System 5.9%, Mills et al. method 16.1%, Klaue et al. method 16.1%, Armand et al. method 6.5%, Tsumura et al. method 3.8% and Morrita et al. method 2.2%. As a whole, there was a notable lack of prospective studies demonstrating these modalities’ efficacy, with small sample sizes and lack of commercial availability diminishing their applicability. Future studies are needed to comprehensively compare computer-assisted planning with traditional radiographic assessment of ideal osteotomy orientation.
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McAfee, Paul C., Bryan W. Cunningham, Ken Mullinex, Lukas Eisermann, and Daina M. Brooks. "Computer Simulated Enhancement and Planning, Robotics and Navigation With Patient Specific Implants and 3-D Printed Cages." Global Spine Journal 12, no. 2_suppl (April 2022): 7S—18S. http://dx.doi.org/10.1177/21925682211003554.

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Study Design: This is a retrospective cohort study. Objectives: Pre and postop Measurement Testing. This is a retrospective study of 33 consecutive interbody spacers in 21 patients who underwent pre, intra, and postoperative measurement of the middle column to determine if this would lead to more precise restoration of middle column height and spacer fit. Scaled transparencies of the pre-operative simulation of angular correction and spacer geometry could be overlayed on the post-operative imaging studies. Methods: Multiple Observers Measurement Testing. 33 consecutive vertebral levels requiring interbody spacers for multilevel deformities had middle column height pre and post operatively measured by 3 blinded observers. The preoperative and postoperative measurements were compared using a linear regression analysis and Pearson product-moment correlation. Results: Pre and postop Measurement Testing: Thirty-three interbody devices in 21 patients had pre-operative planning, simulation of cage dimensions to determine the proper cage fit which would provide for the desired correction of foraminal height and sagittal balance parameters. The simulated preoperative plan overlayed the final post-operative radiograph and was a near-perfect match in 20 of 21 patients (95.2%). Multiple Observers Measurement Testing: A Pearson product-moment correlation was run between each individual’s pre-op and post-op middle column measurements. There was a strong, positive correlation between pre-operative and post-operative measurements, which was statistically significant ( r = 0.903, n = 33, P < 0.001). Conclusions: This consecutive series of 33 cases demonstrated the utility of measuring the preoperative middle column length in predicting the optimal height of the spacers, intervertebral disks, and posterior vertebral body height simultaneously restoring sagittal and coronal plane alignment.
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Karatsis, E., I. Chalkidis, T. Charamis, and G. Athanasiadis. "A general geometrical modeling procedure for biomechanical simulations, supporting pre-operative planning and post-operative examination." Journal of Biomechanics 39 (January 2006): S425. http://dx.doi.org/10.1016/s0021-9290(06)84730-5.

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Van Hoe, Stefaan, Eman Shaheen, Karla de Faria Vasconcelos, Joseph Schoenaers, Constantinus Politis, and Reinhilde Jacobs. "Contribution of three-dimensional images in the planning of cementoblastoma resection." BJR|case reports 7, no. 3 (May 2021): 20200156. http://dx.doi.org/10.1259/bjrcr.20200156.

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Cementoblastomas are rare benign tumours that represent less than 1% of all odontogenic tumours. Complete resection is mandatory to avoid recurrence. This case report describes the contribution of three-dimensional imaging and three-dimensional printing in the pre-operative surgical planning of a large cementoblastoma that not only caused substantial compression on the inferior alveolar and mental nerves, but also caused thinning and partial erosion of the lingual and vestibular cortical bone, thus increasing the risk of pre-operative mandibular fracture.
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Cheng, Michael C. F., and Joerg Steier. "Pre-operative screening for sleep disordered breathing: obstructive sleep apnoea and beyond." Breathe 18, no. 3 (September 2022): 220072. http://dx.doi.org/10.1183/20734735.0072-2022.

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Sleep disordered breathing describes an important group of conditions that causes abnormal nocturnal gas exchange, with important implications in the peri-operative management plan. An understanding of the pathophysiology behind obstructive sleep apnoea and other disorders that may lead to hypoventilation can help to prevent complications. Patients with these disorders may be minimally symptomatic and it requires careful screening in the pre-operative assessment process for a diagnosis to be made. Decisions regarding initiation of therapy, such as positive airway pressure, and delay of the operation need to be carefully weighed up against the urgency of the surgical intervention. Planning of the peri-operative care, including the use of positive airway pressure therapy and appropriate post-operative monitoring, can help to avoid respiratory and cardiovascular morbidities and improve clinical outcomes.Educational aimsTo review different types of sleep disordered breathing and available screening methods in pre-operative assessment.To understand the pathophysiology behind sleep disordered breathing and how it can lead to complications in the peri-operative setting.To review the planning and treatment strategies that should be considered as part of peri-operative management.
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Manning, Paul M., Michael R. Shroads, Julie Bykowski, and Mahmood F. Mafee. "Role of Radiologic Imaging in Otosclerosis." Current Otorhinolaryngology Reports 10, no. 1 (January 4, 2022): 1–7. http://dx.doi.org/10.1007/s40136-021-00377-z.

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Abstract Purpose of Review To review the role of imaging in otosclerosis with an emphasis on pre- and post-operative imaging evaluation. Recent Findings Pre-operative CT imaging can help define the extent of bone involvement in otosclerosis and may help avoid surgical complications due to variant anatomy or unsuspected alternative causes of conductive hearing loss. In patients with recurrent hearing loss after surgery, CT imaging can clarify prosthesis position and re-assess anatomy. Summary CT imaging complements otologic exam and audiometry findings in patients with suspected otosclerosis, for pre-operative planning, and post-operative assessment for patients with recurrent symptoms.
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Hogan, Niamh M., and Myles R. Joyce. "Surgical Management of Locally Recurrent Rectal Cancer." International Journal of Surgical Oncology 2012 (2012): 1–6. http://dx.doi.org/10.1155/2012/464380.

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Developments in chemotherapeutic strategies and surgical technique have led to improved loco regional control of rectal cancer and a decrease in recurrence rates over time. However, locally recurrent rectal cancer continues to present considerable technical challenges and results in significant morbidity and mortality. Surgery remains the only therapy with curative potential. Despite a hostile intra-operative environment, with meticulous pre-operative planning and judicious patient selection, safe surgery is feasible. The potential benefit of new techniques such as intra-operative radiotherapy and high intensity focussed ultrasonography has yet to be thoroughly investigated. The future lies in identification of predictors of recurrence, development of schematic clinical algorithms to allow standardised surgical technique and further research into genotyping platforms to allow individualisation of therapy. This review highlights important aspects of pre-operative planning, intra-operative tips and future strategies, focussing on a multimodal multidisciplinary approach.
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Weston, Erica, Christina Raker, David Huang, and Cara Amanda Mathews. "The association between mindfulness and post-operative pain in gynecologic oncology patients undergoing minimally invasive hysterectomy." Journal of Clinical Oncology 35, no. 15_suppl (May 20, 2017): 10079. http://dx.doi.org/10.1200/jco.2017.35.15_suppl.10079.

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10079 Background: Studies demonstrate an inverse relationship between mindfulness and chronic pain. However, the relationship between mindfulness and acute post-operative pain has not yet been thoroughly investigated. The objective of this study is to determine if there is an association between pre-operative level of mindfulness and post-operative pain outcomes in women undergoing minimally invasive hysterectomy. Methods: For this prospective cohort study, women planning to undergo laparoscopic or robotic hysterectomy were prospectively recruited at the gynecologic oncology outpatient clinic at our institution. Baseline mindfulness was assessed at the pre-operative clinic visit using the Five Facet Mindfulness Questionnaire (FFMQ). Post-operative pain, using the Visual Numeric Rating Scale (VNRS-11), and opiate pain medication usage were evaluated via chart review and post-operative surveys completed at 1 to 2 week and 4 to 6 week post-operative clinic visits. Results: One hundred twenty four women completed the 6 week post-operative follow-up period, of which 80% were undergoing surgery for malignancy. Baseline mindfulness was inversely correlated with post-operative pain as measured by both the average and highest reported VNRS-11 values during the inpatient stay (r = -0.21, p = 0.019; r = -0.21, p = 0.016). At the 1 to 2 week post-operative visit, self-reported pain score was also inversely correlated with pre-operative mindfulness score (r = -0.24, p = 0.009). This relationship was not observed at the 4 to 6 week post-operative visit (r = -0.08, p = 0.403). Higher pre-operative mindfulness was also associated with lower opiate usage (r = -0.16, p = 0.077), though this relationship was not statistically significant. Conclusions: Higher pre-operative mindfulness is associated with more favorable post-operative pain outcomes, including lower reported numeric pain scores, in gynecologic oncology patients undergoing minimally invasive hysterectomy. This relationship provides an opportunity to target the modifiable personality characteristic of mindfulness, to improve post-operative pain in women planning gynecologic surgery.
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Power, A., J. Lantz, S. Carrington, N. Baez Hernandez, M. Bano, R. Butts, and R. R. Davies. "Pre-Operative Planning to Mitigate Risk in Complex Single Ventricular Assist Devices." Journal of Heart and Lung Transplantation 41, no. 4 (April 2022): S522—S523. http://dx.doi.org/10.1016/j.healun.2022.01.1325.

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32

Krekel, P. R., P. W. de Bruin, E. R. Valstar, F. H. Post, P. M. Rozing, and C. P. Botha. "Evaluation of bone impingement prediction in pre-operative planning for shoulder arthroplasty." Proceedings of the Institution of Mechanical Engineers, Part H: Journal of Engineering in Medicine 223, no. 7 (March 3, 2009): 813–22. http://dx.doi.org/10.1243/09544119jeim531.

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33

ONOE, Keiji, Futoshi YOKOTA, Koichiro UEKI, Yoshiyuki KAGIYAMA, and Yasumi ITO. "Development of pre-operative planning assistance framework for sagittal split ramus osteotomy." Proceedings of Yamanashi District Conference 2016 (2016): 606. http://dx.doi.org/10.1299/jsmeyamanashi.2016.606.

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LEE, Wonbin, Futoshi YOKOTA, Koichiro UEKI, Yoshiyuki KAGIYAMA, and Yasumi ITO. "Development of pre-operative planning assistance framework for sagittal split ramus osteotomy." Proceedings of Yamanashi District Conference 2017 (2017): 651. http://dx.doi.org/10.1299/jsmeyamanashi.2017.651.

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35

Kolkman-Deurloo, I. K. K., A. G. Visser, C. G. J. H. Niël, P. J. C. M. Nowak, and P. C. Levendag. "19 Treatment planning of interstitial brain implants using pre-operative CT-images." Radiotherapy and Oncology 31 (April 1994): S26. http://dx.doi.org/10.1016/0167-8140(94)91117-7.

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36

Jacobs, R., A. Adriansens, I. Naert, M. Quirynen, R. Hermans, and D. Van Steenberghe. "Predictability of reformatted computed tomography for pre-operative planning of endosseous implants." Dentomaxillofacial Radiology 28, no. 1 (January 1999): 37–41. http://dx.doi.org/10.1038/sj.dmfr.4600403.

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37

Warren, Andrew, Vishal Prasad, and Mark Thomas. "Pre-operative planning when using the Wiltse approach to the lumbar spine." Annals of The Royal College of Surgeons of England 92, no. 1 (January 2010): 74–75. http://dx.doi.org/10.1308/rcsann.2010.92.1.74.

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38

Aslam, Nadim, and Steven Lo. "Pre-operative planning and the role of templating in total knee arthroplasty." Journal of Evaluation in Clinical Practice 11, no. 1 (February 2005): 93–94. http://dx.doi.org/10.1111/j.1365-2753.2004.00509.x.

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39

Kraay, Matthew J. "Pre-operative planning for revision total knee replacement: Ensuring a successful result." Seminars in Arthroplasty 24, no. 3 (September 2013): 135–41. http://dx.doi.org/10.1053/j.sart.2013.08.006.

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40

Essig, H., P. Schumann, D. Lindhorst, M. Rücker, and N. C. Gellrich. "Patient specific mandible reconstruction—virtual pre-operative planning for ideal oral rehabilitation." International Journal of Oral and Maxillofacial Surgery 42, no. 10 (October 2013): 1255. http://dx.doi.org/10.1016/j.ijom.2013.07.287.

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41

Ross, Megan Elizabeth, Lindsay J. Wheeler, Dina M. Flink, and Carolyn Lefkowits. "Pre-operative opioid use in gynecologic oncology: a common comorbidity relevant to the peri-operative period." International Journal of Gynecologic Cancer 29, no. 9 (August 30, 2019): 1411–16. http://dx.doi.org/10.1136/ijgc-2019-000508.

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ObjectivesPre-operative opioid use is common and should be considered a comorbidity among surgical candidates. Our objective was to describe the rate of pre-operative opioid use and patterns of post-operative outpatient opioid prescribing in a cohort of gynecologic oncology patients.MethodsA retrospective cohort study was conducted with 448 gynecologic oncology surgical patients undergoing surgery for a suspected or known cancer diagnosis from January 2016 to December 2016. Pre-operative opioid users (n=97) were identified. Patient and surgical characteristics were abstracted, as was post-operative opioid prescription (type of opioid, oral morphine equivalents amount) and length of stay. For pre-operative opioid users, the type of opioid prescribed post-operatively was compared with the type of pre-operative opioid. Pre-operative opioid users were compared with non-users, stratified by surgery type. Descriptive statistics were analyzed using χ2 statistic, and medians were compared using a Mann-Whitney U statistic.ResultsPre-operative opioid prescriptions were noted in 21% of patients, and 24% of these had two or more opioid prescriptions before surgery. The majority of pre-operative opioid users (51%) were maintained on the same agent post-operatively at the time of discharge, but 36% were switched to a different opioid and 7% were prescribed an additional opioid. Overall and in laparotomies, pre-operative opioid users received higher volume post-operative prescriptions than non-users. There was no difference in post-operative prescription volume for minimally invasive surgeries or in length of stay between pre-operative users and non-users.ConclusionsPre-operative opioid use is common in gynecologic oncology patients and should be considered during pre-operative planning. Pre-operative opioid use was associated with a higher volume and wider range of post-operative prescription. Over 40% of opioid users were discharged with either an additional opioid or a new opioid, highlighting a potential missed opportunity to optimize opioid safety. Further research is needed to characterize the relationship between pre-operative opioid use and peri-operative outcomes and to develop strategies to manage pain effectively in this population without compromising opioid safety.
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Moralidou, Maria, Anna Di Laura, Johann Henckel, Harry Hothi, and Alister J. Hart. "Three-dimensional pre-operative planning of primary hip arthroplasty: a systematic literature review." EFORT Open Reviews 5, no. 12 (December 2020): 845–55. http://dx.doi.org/10.1302/2058-5241.5.200046.

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Three-dimensional (3D) pre-operative planning in total hip arthroplasty (THA) is being recognized as a useful tool in planning elective surgery, and as crucial to define the optimal component size, position and orientation. The aim of this study was to systematically review the existing literature for the use of 3D pre-operative planning in primary THA. A systematic literature search was performed using keywords, through PubMed, Scopus and Google Scholar, to retrieve all publications documenting the use of 3D planning in primary THA. We focussed on (1) the accuracy of implant sizing, restoration of hip biomechanics and component orientation; (2) the benefits and barriers of this tool; and (3) current gaps in literature and clinical practice. Clinical studies have highlighted the accuracy of 3D pre-operative planning in predicting the optimal component size and orientation in primary THAs. Component size planning accuracy ranged between 34–100% and 41–100% for the stem and cup respectively. The absolute, average difference between planned and achieved values of leg length, offset, centre of rotation, stem version, cup version, inclination and abduction were 1 mm, 1 mm, 2 mm, 4°, 7°, 0.5° and 4° respectively. Benefits include 3D representation of the human anatomy for precise sizing and surgical execution. Barriers include increased radiation dose, learning curve and cost. Long-term evidence investigating this technology is limited. Emphasis should be placed on understanding the health economics of an optimized implant inventory as well as long-term clinical outcomes. Cite this article: EFORT Open Rev 2020;5:845-855. DOI: 10.1302/2058-5241.5.200046
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Seaward, JR, PA Wilson, and CA Stone. "Computer-aided surgical planning in the treatment of soft-tissue sarcoma." Annals of The Royal College of Surgeons of England 92, no. 8 (November 2010): 639–42. http://dx.doi.org/10.1308/003588410x12699663904556.

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INTRODUCTION Soft-tissue sarcoma resections are often highly complex procedures that demand meticulous pre-operative planning in order to maximise the potential for complete excision with clear margins, while preserving vital neurovascular structures and muscle groups. SUBJECTS AND METHODS We present a computer-aided model for surgical planning using Microsoft Powerpoint as a tool for cross referencing magnetic resonance images and normal anatomical diagrams. RESULTS Using this system the operator follows a sequence of pre-planned steps, minimising intra-operative decision making and unexpected adverse events. Four case studies are discussed. CONCLUSIONS The visual plan optimises the potential to meet surgical and oncological goals, and serves as an excellent nct to the operation note for documentation of the procedure.
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Pennati, Giancarlo, Chiara Corsini, Daria Cosentino, Tain-Yen Hsia, Vincenzo S. Luisi, Gabriele Dubini, and Francesco Migliavacca. "Boundary conditions of patient-specific fluid dynamics modelling of cavopulmonary connections: possible adaptation of pulmonary resistances results in a critical issue for a virtual surgical planning." Interface Focus 1, no. 3 (March 9, 2011): 297–307. http://dx.doi.org/10.1098/rsfs.2010.0021.

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Cavopulmonary connections are surgical procedures used to treat a variety of complex congenital cardiac defects. Virtual pre-operative planning based on in silico patient-specific modelling might become a powerful tool in the surgical decision-making process. For this purpose, three-dimensional models can be easily developed from medical imaging data to investigate individual haemodynamics. However, the definition of patient-specific boundary conditions is still a crucial issue. The present study describes an approach to evaluate the vascular impedance of the right and left lungs on the basis of pre-operative clinical data and numerical simulations. Computational fluid dynamics techniques are applied to a patient with a bidirectional cavopulmonary anastomosis, who later underwent a total cavopulmonary connection (TCPC). Multi-scale models describing the surgical region and the lungs are adopted, while the flow rates measured in the venae cavae are used at the model inlets. Pre-operative and post-operative conditions are investigated; namely, TCPC haemodynamics, which are predicted using patient-specific pre-operative boundary conditions, indicates that the pre-operative balanced lung resistances are not compatible with the TCPC measured flows, suggesting that the pulmonary vascular impedances changed individually after the surgery. These modifications might be the consequence of adaptation to the altered pulmonary blood flows.
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Jung, Sung Min, Dae Young Cheung, Jin Il Kim, Jae J. Kim, Sang Woo Lee, and Hyun Chae Jung. "Staging of gastric cancer: Comparison of post-operative pathologic staging to pre-operative CT and endoscopic ultrasonographic staging." Journal of Clinical Oncology 34, no. 4_suppl (February 1, 2016): 11. http://dx.doi.org/10.1200/jco.2016.34.4_suppl.11.

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11 Background: Stomach CT and endoscopic ultrasonography are used for evaluating pre-operative staging of gastric cancer. The aim of this study was to compare the pre-operative CT and endoscopic ultrasonographic staging to post-operative pathologic staging. Methods: We reviewed medical records of 567 patients with gastric cancer from 2012 to 2015, and compared their pre-operative CT staging to post-operative pathologic staging. Among the 567 patients, 149 patients underwent pre-operative endoscopic ultrasonographic staging, so we compared their pre-operative endoscopic ultrasonographic staging to post-operative pathologic staging. We also investigated lymph node metastasis in 146 patients with gastric cancer invading submucosa, planning to undergo endoscopic submucosal dissection. Results: The numbers of patients diagnosed as T1, T2, T3, T41, and T4b by pre-operative CT staging were 327, 97, 93, 46, and 4, respectively. However, the numbers of patients diagnosed as T1, T2, T3, T41, and T4b by post-operative pathologic staging were 208, 153, 53, 83, 62, and 8, resulting the pre-operative CT staging to be under-estimated. Similarly, pre-operative endoscopic ultrasonographic staging was also under-estimated, as although 48, 67, 32, and 2 patients were diagnosed as T1a, T1b, T2, and T3, respectively, by the pre-operative endoscopic ultrasonographic staging, post-operative pathologic staging revealed 72, 55, 13, 7, and 2 patients. In patients with gastric cancer invading submucosa (sm), there were 56 patients with sm1 invasion, 32 patients with sm2 invasion, and 91 patients with sm3 invasion. Lymph node metastasis was observed in 7 patients with sm1 invasion, 3 patients with sm2 invasion, and 22 patients with sm3 invasion. Poorly cohesive gastric cancer was the most common pathologic diagnosis in patients with metastatic lymph node. Conclusions: Physicians should keep in mind that pre-operative stomach CT and endoscopic ultrasonographic staging can be under-estimated compared to post-operative pathologic staging. Also, patients with poorly cohesive adenocarcinoma had more lymph node metastasis than patients with differentiated adenocarcinoma.
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46

Burd, Christian, Irumee Pai, and Steve EJ Connor. "Active middle ear implantation: imaging in the pre-operative planning and post-operative assessment of the Vibrant SoundbridgeTM." British Journal of Radiology 93, no. 1109 (May 1, 2020): 20190741. http://dx.doi.org/10.1259/bjr.20190741.

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Active middle ear implants augment sound waves and directly stimulate the middle ear structures. The most frequently utilised active middle ear implant is the Vibrant Soundbridge TM (VSB). CT plays a vital role in appropriate patient selection and surgical planning of active middle ear implant surgery. The VSB TM offers a number of options for implant placement. The ideal location is influenced by the patient’s middle ear and mastoid anatomy as well as the type and severity of the hearing loss. CT provides important information on the surgical access to the middle ear and helps determine the most appropriate implant site by assessing the adjacent middle ear anatomy and the continuity of the ossicular chain. Post-operative active middle ear implant imaging may be indicated in the setting of poor auditory outcomes and when revision surgery is being considered so as to assess for suboptimal implant placement or migration. This pictorial review will describe the VSB TM middle ear device and explain the role of imaging in both the pre-operative and post-operative settings.
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47

Mardini, Mamoun, Catherine Price, Patrick Tighe, and Todd Manini. "EXPLAINABLE MACHINE-LEARNING FOR PREDICTING PREOPERATIVE FRAILTY PHENOTYPE USING ELECTRONIC HEALTH RECORDS." Innovation in Aging 6, Supplement_1 (November 1, 2022): 564. http://dx.doi.org/10.1093/geroni/igac059.2127.

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Abstract Pre-operative frailty among patients is strongly associated with poor post-operative outcomes. Operationalizing frailty in clinical practice is challenging due to the lack of resources and pragmatic complexities. Feasible tools are needed to cover the scarcity in this area. Harnessing electronic health records (EHR) to screen pre-operative frailty and its related post-operative outcomes would be important for decision making and planning care management. This study aimed to validate an EHR-based machine learning model for pre-operative frailty ascertainment. Measures of the frailty phenotype (slowness, weight loss, exhaustion, low physical activity, and grip strength) were collected on approximately 14,000 patients (aged 65-100 years) by nurses housed in the UF Health pre-surgical center. Patients with at least 3 out of 5 syndromic components were considered frail. We utilized an explainable machine learning algorithm, eXtreme Gradient Boosting (XGBoost), to build our models to predict pre-operative frailty phenotype. We extracted the important predictors that contributed to predicting the outcome and evaluated their relationship with the outcome. The machine learning model achieved an area under the curve (AUC) of 0.71 in recognizing pre-operative frailty across all surgical specialties. The top five predictors for frailty phenotype were hemoglobin level, sex, education level, history of COPD, and diabetes. Using explainable machine learning approaches on EHR data provides a moderate mapping of the frailty phenotype in pre-operative settings. Funding: UF Claude D. Pepper Older Americans Independence Center P30AG028740 and R01 AG055337.
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Palaniswamy, Mohankumar, Anis Suhaila Shuib, and Shajan Koshy. "Load bearing analysis on Lumbosacral Disc in Pre-operative and Post-operative Thoracic Scoliosis Patient." Asian Journal Of Medical Technology 1, no. 1 (July 30, 2021): 18–29. http://dx.doi.org/10.32896/ajmedtech.v1n1.18-29.

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Scoliosis is a musculoskeletal disorder seen all around the world. It affects both the alignment of the vertebra and intervertebral disc. Scoliosis can be treated conservatively with a cast and brace or surgically with spinal instrumentation. During planning for surgical instrumentation, several factors need to be considered. Among those, biomechanical changes in the non-scoliotic vertebrae and discs are important. This is vital in determining the future degenerative changes of the spine. For this reason, this study was conducted with a finite element model of the lumbosacral joint using CT scan files to find the total deformation and equivalent static strain of the lumbosacral disc between pre and post-operative thoracic scoliosis patient. From the results, it is evident that there is a biomechanical change in the lumbosacral disc and structural change in the vertebral alignment followed immediately after corrective surgery. The correction in the alignment of the scoliotic spine brings changes to the biomechanical functionality and load-bearing capacity of the lumbosacral intervertebral disc before and after surgery.
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El Shafie, Rami, Eric Tonndorf-Martini, Daniela Schmitt, Dorothea Weber, Aylin Celik, Thorsten Dresel, Denise Bernhardt, et al. "Pre-Operative Versus Post-Operative Radiosurgery of Brain Metastases—Volumetric and Dosimetric Impact of Treatment Sequence and Margin Concept." Cancers 11, no. 3 (March 1, 2019): 294. http://dx.doi.org/10.3390/cancers11030294.

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Background: Pre-operative radiosurgery (SRS) preceding the resection of brain metastases promises to circumvent limitations of post-operative cavity SRS. It minimizes uncertainties regarding delineation and safety margins and could reduce dose exposure of the healthy brain (HB). Methods: We performed a systematic treatment plan comparison on 24 patients who received post-operative radiosurgery of the resection cavity at our institution. Comparative treatment plans were calculated for hypofractionated stereotactic radiotherapy (7 × 5 Gray (Gy)) in a hypothetical pre-operative (pre-op) and two post-operative scenarios, either with (extended field, post-op-E) or without the surgical tract (involved field, post-op-I). Detailed volumetric comparison of the resulting target volumes was performed, as well as dosimetric comparison focusing on targets and the HB. Results: The resection cavity was significantly smaller and different in morphology from the pre-operative lesion, yielding a low Dice Similarity Coefficient (DSC) of 53% (p = 0.019). Post-op-I and post-op-E targets showed high similarity (DSC = 93%), and including the surgical tract moderately enlarged resulting median target size (18.58 ccm vs. 22.89 ccm, p < 0.001). Dosimetric analysis favored the pre-operative treatment setting since it significantly decreased relevant dose exposure of the HB (Median volume receiving 28 Gy: 6.79 vs. 10.79 for pre-op vs. post-op-E, p < 0.001). Dosimetrically, pre-operative SRS is a promising alternative to post-operative cavity irradiation that could furthermore offer practical benefits regarding delineation and treatment planning. Comparative trials are required to evaluate potential clinical advantages of this approach.
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Fishman, Z., Jerry Liu, Joshua Pope, J. A. Fialkov, and C. M. Whyne. "Validating 3D face morphing towards improving pre-operative planning in facial reconstruction surgery." Computer Methods in Biomechanics and Biomedical Engineering: Imaging & Visualization 9, no. 5 (January 22, 2021): 480–87. http://dx.doi.org/10.1080/21681163.2020.1865839.

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