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OBJECTIVE: has been rapid technological advancement in navigation-guided minimally invasive surgery over the past two decades, making these advancements an invaluable aid for surgeons by essentially providing real-time virtual reconstruction of patient anatomy. The objectives of these navigation- and robot-guided procedures are to reduce the likelihood of neural and vascular injury, minimize hospitalization time, decrease bleeding and postoperative pain, shorten healing time, and lower infection rates. METHODS: A unicentric, retrospective cohort study was conducted to evaluate the preoperative and postoperative clinical and radiographic outcomes of the first Latin American patients diagnosed with lumbar degenerative disease who underwent lumbar interbody fusion at the L4-L5 level via prone-position lateral lumbar interbody fusion-single position prone access. RESULTS: A total of 80 patients (40 assisted by fluoroscopy, 40 assisted by robotics) with 320 percutaneous pedicle screws were evaluated. The primary outcomes analyzed and compared were radiation exposure per screw (seconds), skin-to-skin operative time (minutes), and recovery time (days). Secondary outcomes included lumbar pain intensity (visual analog scale), reported functional disability (Oswestry Disability Index), and any potential complications. All secondary outcomes were collected at the postoperative time. CONCLUSION: Comparing minimally invasive spine interventions with free-hand instrumentation and robotic instrumentation, a statistically significant difference was identified in radiation exposure per screw and surgical time. The literature on Cirq Robotic is limited; however, minimally invasive spine surgery with robotic assistance appears advantageous in terms of radiation exposure and surgical time.
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ABSTRACT Thermography is an auxiliary diagnostic method widely used to assess soft tissues and thus diagnose neuropathic or inflammatory pain. The objective of this paper was to report a case in which thermography was used as an auxiliary method to diagnose neuropathic pain. The patient in question is a 43-year-old woman with complaints of pain and sensitivity in the upper and lower left dental arches, particularly when consuming alcoholic beverages. The case was assessed with thermography, followed by the Cold Stress Test. The symmetry of the thermographic images and the localized changes helped rule out neuropathic problems and diagnose the orofacial inflammatory pain. The thermography was used as an auxiliary instrument to diagnose orofacial pain, proving to be efficient. Also, the thermography helped rule out changes originating in peripheral, small-fiber, and inflammatory neuropathies, aiding the patient's differential diagnosis. The thermography also helped identify the thermo-anatomical points and, with the qualitative and quantitative analyses, noninvasively investigate the possible causes of the orofacial pain reported by the patient.
RESUMO A termografia é um método auxiliar diagnóstico muito utilizado para avaliação de tecidos moles e consequente diagnóstico de dores neuropáticas ou de origem inflamatória. O objetivo deste trabalho foi descrever a utilização da termografia como método auxiliar no diagnóstico das dores neuropáticas, por meio de um relato de caso. Trata-se de uma mulher, de 43 anos de idade, com queixas de dor e sensibilidade nas arcadas dentárias superior e inferior esquerda, principalmente durante a ingestão de bebidas alcoólicas. Para avalição do caso foram aplicadas as avaliações termográficas, seguida da realização do Cold Stress Test. A simetria das imagens termográficas, assim como alterações localizadas, permitiu descartar problemas neuropáticos e diagnosticar dor orofacial de origem inflamatória. A termografia foi utilizada como instrumento auxiliar diagnóstico nas dores orofaciais e mostrou-se ser eficiente para essa finalidade. Além disso, por meio da termografia foi possível descartar alterações neuropáticas de origem periférica, como as neuropatias de fibras finas e neuropatias inflamatórias, contribuindo para o diagnóstico diferencial da paciente. Com o auxílio da termografia, foi possível identificar os pontos termoanatômicos e investigar as possíveis causas das dores orofaciais relatadas pela paciente, de uma forma não invasiva por meio de análises qualitativas e quantitativas.