63 year old female with Adult Idiopathic Scoliosis, Spondylolisthesis, and facet screws at L4-L5. Dr. Pashman treated the patient with a posterior spinal fusion from T10 to Pelvis. KIM/SRP Classification 2
Case Review #B: Spondylolisthesis Surgery Robert Pashman
A 16-year-old female presented with lower back and left leg pain following a motor vehicle accident. Imaging showed spondylolisthesis at L5 from fractures of the pars interarticularis. She underwent microscopic bilateral L5 laminotomy, foraminotomy, and repair of the L5 pars fractures with bone grafting and instrumentation. Post-operatively, her symptoms resolved and she was able to return to normal activities.
Case Review #3: 35 year old male from Norway presented with Pseudoarthrosis a...Robert Pashman
35 year old male for Norway presented with pseudarthrosis, Flatback, and a screw in the spinal canal status post L4-S1 posterior fusion. Dr. Pashman performed revision surgery on the patient, The patient healed completely, returned to work, and his normal activities.
Case Review #2: Patient required revision following failed minimaly invasive ...Robert Pashman
31 year old female presented status post minimally invasive Dynesys surgery. The hardware had failed. Dr. Pashman performed revision surgery, and treated the patient with posterior spinal fusion.
Case Review #2: Isthmic Spondylolisthesis Grade IVRobert Pashman
Case review: A 58 year old female with Isthmic Spondylolisthesis status post surgery. She continued to experience back pain and leg pain, and was treated with spinal surgery.
Case Review #27: 59 Year Old Female with Progressive Adult ScoliosisRobert Pashman
59 year old female presented with Progressive Adult Idiopathic Scoliosis, Spondylolisthesis, Flatback Deformity, and Stenosis. The patient was treated with a spinal fusion,
Case Review #2: 41 year old female presented with Adult Scoliosis and Spodylo...Robert Pashman
A 41 year old female with a 50° thoracolumbar curve and Spondylolisthesis. Dr. Pashman treated the patient with an Posterior Spinal Fusion from T10-Pelvis. Her curve was a KIM/SRP Classification 2.
Case Review #B: Spondylolisthesis Surgery Robert Pashman
A 16-year-old female presented with lower back and left leg pain following a motor vehicle accident. Imaging showed spondylolisthesis at L5 from fractures of the pars interarticularis. She underwent microscopic bilateral L5 laminotomy, foraminotomy, and repair of the L5 pars fractures with bone grafting and instrumentation. Post-operatively, her symptoms resolved and she was able to return to normal activities.
Case Review #3: 35 year old male from Norway presented with Pseudoarthrosis a...Robert Pashman
35 year old male for Norway presented with pseudarthrosis, Flatback, and a screw in the spinal canal status post L4-S1 posterior fusion. Dr. Pashman performed revision surgery on the patient, The patient healed completely, returned to work, and his normal activities.
Case Review #2: Patient required revision following failed minimaly invasive ...Robert Pashman
31 year old female presented status post minimally invasive Dynesys surgery. The hardware had failed. Dr. Pashman performed revision surgery, and treated the patient with posterior spinal fusion.
Case Review #2: Isthmic Spondylolisthesis Grade IVRobert Pashman
Case review: A 58 year old female with Isthmic Spondylolisthesis status post surgery. She continued to experience back pain and leg pain, and was treated with spinal surgery.
Case Review #27: 59 Year Old Female with Progressive Adult ScoliosisRobert Pashman
59 year old female presented with Progressive Adult Idiopathic Scoliosis, Spondylolisthesis, Flatback Deformity, and Stenosis. The patient was treated with a spinal fusion,
Case Review #2: 41 year old female presented with Adult Scoliosis and Spodylo...Robert Pashman
A 41 year old female with a 50° thoracolumbar curve and Spondylolisthesis. Dr. Pashman treated the patient with an Posterior Spinal Fusion from T10-Pelvis. Her curve was a KIM/SRP Classification 2.
Case Review #31: 60 Year Old Female with Adult Idiopathic ScoliosisRobert Pashman
60 year old female presented with Adult Idiopathic Scoliosis and Grade 2 Isthmic Spondylolisthesis. She was treated with an anterior and posterior spinal fusion.
Case Review #37: 64 year old female with ScoliosisRobert Pashman
The patient presented after two scoliosis surgeries and in situ fusions. The patient's spinal curvature progressed to 80 degrees and she required revision surgery.
Case Review #5: 43 year old woman with Adult Idiopathic ScoliosisRobert Pashman
A 43 year old woman, presented with Adult Idiopathic Scoliosis, 50° lumbar curve. Dr. Pashman treated her with Posterior Spinal Fusion from T9 - L5. Curve was a KIM/SRP Classification 2.
Case Review #42: 39 year old female with Adult Congenital ScoliosisRobert Pashman
A 39 year old female with Congenital Scoliosis presented to Dr. Pashman. The patient had a fusion at age six, and her spinal curve continued to progress. Dr. Pashman treated the patient with a posterior spinal fusion from T3-Pelvis. KIM/SRP Classification 3.
Case Review #36: 34 year old female with Adult Idiopathic Scoliosis and a bro...Robert Pashman
This patient is a 34-year-old female with idiopathic scoliosis who previously had spinal fusion with Luque instrumentation at age 13. The Luque rod had broken and was protruding from her skin. She now has a residual thoracic curve of over 86 degrees without a solid fusion. The surgery involved removing the failed hardware, performing multiple osteotomies, installing new segmental spinal instrumentation from T2 to the sacrum with pelvic fixation, and posterior spinal fusion. Post-operatively, the patient was perfectly balanced in the sagittal and coronal planes.
Case Review #6: 45 year old woman with flatback syndrome after several surger...Robert Pashman
A 45-year old female with a flat back due to multiple spine surgeries for scoliosis underwent surgery to correct her sagittal imbalance. The surgical strategy included a T10 to sacrum fusion with pedicle subtraction osteotomy at L3 to induce lordosis. Post-operatively, sagittal balance was restored but a slight coronal imbalance remained due to prior fusion in a shifted position. Good functional outcomes are expected with less than 4cm of coronal imbalance.
Case Review #28: Patient with Lumbar Scoliosis status post surgery with Harr...Robert Pashman
A 37 year old female presented status post posterior spinal fusion for Adolescent Idiopathic Scoliosis. She had Harrington Rods and the lumbar curve continued to progress, requiring surgical intervention.
Case Review #50: 29 year old woman presents with dislodged instrumentation fo...Robert Pashman
A 29-year old woman presented with dislodged hardware from three previous surgeries for adolescent idiopathic scoliosis. She had retained loose instrumentation from her past operations that posed a medical risk. The surgical strategy was to remove the retained hardware through osteotomies, perform spinal fusions from T4 to L3, and place new segmental instrumentation from L2 to L3.
Case Review #3: 65 year old woman with 55 degree Thoracolumbar ScoliosisRobert Pashman
A 65 year old female with a 55° thoracolumbar curve, spondylolisthesis, and flatback syndrome. Treated with an Anterior/Posterior Spinal Fusion. KIM/SRP Classification 3.
Case Review #2: 66 year old female with severe Flatback SyndromeRobert Pashman
A 66 year old female presented with severe Flat back Syndrome, Kyphosis, and critical stenosis. Dr. Pashman treated the patient with a posterior spinal fusion T2 to the pelvis. The patient was able to stand up straight following surgery.
Case Review #4: 31 year old woman with Adult Idiopathic ScoliosisRobert Pashman
A 31 year old woman, with Adult Idiopathic Scoliosis, 75° stiff lumbar curve, rotated 90°. Dr. Pashman treated the patient with and Anterior Spinal Fusion followed by a Posterior Spinal Fusion. KIM/SRP Classification 2.
Case Review #6: 53 year old woman with Adult ScoliosisRobert Pashman
A 53 year old woman, with an 85° thoracic curve, and a 75° lumbar curve. Dr. Pashman treated her with an Anterior fusion followed by a Posterior Spinal Fusion from T1 to the Pelvis. Curve was a KIM/SRP Classification 3.
Case Review #25: 39 year old female with Progressive Adult ScoliosisRobert Pashman
39 year old female presented with Progressive Adult Idiopathic Scoliosis. Dr. Pashman treated the patient with a posterior spinal fusion from T3-L4. KIM/SRP Classification 1
Case Review #7: 51 year old female with severe flatback after multiple surge...Robert Pashman
A 51 year old female status post multiple spine surgeries presented to Dr. Pashman with severe Flatback Syndrome and psueoarthrosis. Dr. Pashman treated the patient with a Posterior Spinal Fusion T4-Pelvis.
Case Review #5: 67 year old woman with flatback syndrome following 5 spinal s...Robert Pashman
A 67 year old female presented to Dr. Pashman with severe Flat back Syndrome after 5 previous spine surgeries for Adult Idiopathic Scoliosis. Dr. Pashman treated her with a Posterior Spinal Fusion from T8 to S1.
Case Review #22: 21 year old with Progressive Adolescent Idiopathic ScoliosisRobert Pashman
A 21 year old female presented to Dr. Pashman with Progressive Adolescent Idiopathic Scoliosis. The patient had been followed for scoliosis, and was compliant wearing her brace. Her spinal curvature progressed despite physical therapy and bracing. Dr. Pashman treated her with a Posterior Spinal Fusion T3-L1.
Case Review#20: 64 year old female with Adult Scoliosis and Flatback SyndromeRobert Pashman
This case review summarizes the surgical treatment of a 64-year-old female patient with degenerative lumbar scoliosis, spondylolisthesis, and flatback syndrome. She presented with a 28 degree lumbar curvature, flatback deformity, and spondylolisthesis. Her condition caused severe pain and disability. The surgical strategy involved segmental spinal instrumentation from L1 to the sacrum, posterior spinal fusion from L1 to S1, osteotomies from L1 to S1 to correct the deformity, and decompression of spinal stenosis. Post-operatively, her X-rays showed excellent alignment and core exercises provided pain relief, allowing for improved function.
Case Review #9: Adult Idiopathic Scoliosis with a Double CurvatureRobert Pashman
A 54 year old female presented with Adult Idiopathic Scoliosis. In addition to lower back pain, she noticed that her height was decreasing. Her spine was significantly rotated and she required a spinal fusion.
Case Review #24: 67 year old female with Degenerative ScoliosisRobert Pashman
67 year old female presented with DeNovo Scoliosis, with significant rotation due to Adolescent Idiopathic Scoliosis. Dr. Pashman treated the patient with a posterior spinal fusion from T10-Pelvis. KIM/SRP Classification 2.
Case Review #43: 43 year old female with Adult Idiopathic Scoliosi requiring...Robert Pashman
1. A 43-year old female with adult idiopathic scoliosis underwent anterior spinal surgery with instrumentation from T12 to L3 to correct curves of 60° thoracic and 57° lumbar, reducing them to 41°.
2. A 48-year old female with Kim/SRP type III scoliosis underwent revision surgery with anterior lumbar interbody fusion from L4-S1 and posterior spinal fusion from T3 to S1 to correct increasing proximal thoracic curvature and subadjacent degeneration.
3. Post-operatively, the patient was well-balanced in sagittal and coronal planes with thoracic and lumbar curves reduced to 26° and 27° respectively.
This document discusses how libraries can use Web 2.0 tools. It begins with defining Web 2.0 as communication, collaboration and multimedia tools that allow users to interact and connect with information. Examples of tools covered include blogs, wikis, social bookmarking, Flickr, podcasts, and review sites. The document also discusses things to consider when implementing these tools like staff skills, ongoing maintenance, costs, and ensuring technology enhances rather than replaces services. It concludes with posing discussion questions to workshop participants.
Performance, concept & narrative music videosJshepherd1460
1) Performance-based music videos focus on footage of the artist performing and often include live stage performances or depictions of the artist in everyday situations.
2) Narrative-based music videos tell a story, either related to the song's lyrics or suggested by them, using a beginning, middle, and end structure or references to a story. They sometimes promote a related film through clips.
3) Concept-based music videos center around a single unusual or surreal idea to entertain viewers and keep their attention on the screen through the video's symbolic or thematic content.
Case Review #31: 60 Year Old Female with Adult Idiopathic ScoliosisRobert Pashman
60 year old female presented with Adult Idiopathic Scoliosis and Grade 2 Isthmic Spondylolisthesis. She was treated with an anterior and posterior spinal fusion.
Case Review #37: 64 year old female with ScoliosisRobert Pashman
The patient presented after two scoliosis surgeries and in situ fusions. The patient's spinal curvature progressed to 80 degrees and she required revision surgery.
Case Review #5: 43 year old woman with Adult Idiopathic ScoliosisRobert Pashman
A 43 year old woman, presented with Adult Idiopathic Scoliosis, 50° lumbar curve. Dr. Pashman treated her with Posterior Spinal Fusion from T9 - L5. Curve was a KIM/SRP Classification 2.
Case Review #42: 39 year old female with Adult Congenital ScoliosisRobert Pashman
A 39 year old female with Congenital Scoliosis presented to Dr. Pashman. The patient had a fusion at age six, and her spinal curve continued to progress. Dr. Pashman treated the patient with a posterior spinal fusion from T3-Pelvis. KIM/SRP Classification 3.
Case Review #36: 34 year old female with Adult Idiopathic Scoliosis and a bro...Robert Pashman
This patient is a 34-year-old female with idiopathic scoliosis who previously had spinal fusion with Luque instrumentation at age 13. The Luque rod had broken and was protruding from her skin. She now has a residual thoracic curve of over 86 degrees without a solid fusion. The surgery involved removing the failed hardware, performing multiple osteotomies, installing new segmental spinal instrumentation from T2 to the sacrum with pelvic fixation, and posterior spinal fusion. Post-operatively, the patient was perfectly balanced in the sagittal and coronal planes.
Case Review #6: 45 year old woman with flatback syndrome after several surger...Robert Pashman
A 45-year old female with a flat back due to multiple spine surgeries for scoliosis underwent surgery to correct her sagittal imbalance. The surgical strategy included a T10 to sacrum fusion with pedicle subtraction osteotomy at L3 to induce lordosis. Post-operatively, sagittal balance was restored but a slight coronal imbalance remained due to prior fusion in a shifted position. Good functional outcomes are expected with less than 4cm of coronal imbalance.
Case Review #28: Patient with Lumbar Scoliosis status post surgery with Harr...Robert Pashman
A 37 year old female presented status post posterior spinal fusion for Adolescent Idiopathic Scoliosis. She had Harrington Rods and the lumbar curve continued to progress, requiring surgical intervention.
Case Review #50: 29 year old woman presents with dislodged instrumentation fo...Robert Pashman
A 29-year old woman presented with dislodged hardware from three previous surgeries for adolescent idiopathic scoliosis. She had retained loose instrumentation from her past operations that posed a medical risk. The surgical strategy was to remove the retained hardware through osteotomies, perform spinal fusions from T4 to L3, and place new segmental instrumentation from L2 to L3.
Case Review #3: 65 year old woman with 55 degree Thoracolumbar ScoliosisRobert Pashman
A 65 year old female with a 55° thoracolumbar curve, spondylolisthesis, and flatback syndrome. Treated with an Anterior/Posterior Spinal Fusion. KIM/SRP Classification 3.
Case Review #2: 66 year old female with severe Flatback SyndromeRobert Pashman
A 66 year old female presented with severe Flat back Syndrome, Kyphosis, and critical stenosis. Dr. Pashman treated the patient with a posterior spinal fusion T2 to the pelvis. The patient was able to stand up straight following surgery.
Case Review #4: 31 year old woman with Adult Idiopathic ScoliosisRobert Pashman
A 31 year old woman, with Adult Idiopathic Scoliosis, 75° stiff lumbar curve, rotated 90°. Dr. Pashman treated the patient with and Anterior Spinal Fusion followed by a Posterior Spinal Fusion. KIM/SRP Classification 2.
Case Review #6: 53 year old woman with Adult ScoliosisRobert Pashman
A 53 year old woman, with an 85° thoracic curve, and a 75° lumbar curve. Dr. Pashman treated her with an Anterior fusion followed by a Posterior Spinal Fusion from T1 to the Pelvis. Curve was a KIM/SRP Classification 3.
Case Review #25: 39 year old female with Progressive Adult ScoliosisRobert Pashman
39 year old female presented with Progressive Adult Idiopathic Scoliosis. Dr. Pashman treated the patient with a posterior spinal fusion from T3-L4. KIM/SRP Classification 1
Case Review #7: 51 year old female with severe flatback after multiple surge...Robert Pashman
A 51 year old female status post multiple spine surgeries presented to Dr. Pashman with severe Flatback Syndrome and psueoarthrosis. Dr. Pashman treated the patient with a Posterior Spinal Fusion T4-Pelvis.
Case Review #5: 67 year old woman with flatback syndrome following 5 spinal s...Robert Pashman
A 67 year old female presented to Dr. Pashman with severe Flat back Syndrome after 5 previous spine surgeries for Adult Idiopathic Scoliosis. Dr. Pashman treated her with a Posterior Spinal Fusion from T8 to S1.
Case Review #22: 21 year old with Progressive Adolescent Idiopathic ScoliosisRobert Pashman
A 21 year old female presented to Dr. Pashman with Progressive Adolescent Idiopathic Scoliosis. The patient had been followed for scoliosis, and was compliant wearing her brace. Her spinal curvature progressed despite physical therapy and bracing. Dr. Pashman treated her with a Posterior Spinal Fusion T3-L1.
Case Review#20: 64 year old female with Adult Scoliosis and Flatback SyndromeRobert Pashman
This case review summarizes the surgical treatment of a 64-year-old female patient with degenerative lumbar scoliosis, spondylolisthesis, and flatback syndrome. She presented with a 28 degree lumbar curvature, flatback deformity, and spondylolisthesis. Her condition caused severe pain and disability. The surgical strategy involved segmental spinal instrumentation from L1 to the sacrum, posterior spinal fusion from L1 to S1, osteotomies from L1 to S1 to correct the deformity, and decompression of spinal stenosis. Post-operatively, her X-rays showed excellent alignment and core exercises provided pain relief, allowing for improved function.
Case Review #9: Adult Idiopathic Scoliosis with a Double CurvatureRobert Pashman
A 54 year old female presented with Adult Idiopathic Scoliosis. In addition to lower back pain, she noticed that her height was decreasing. Her spine was significantly rotated and she required a spinal fusion.
Case Review #24: 67 year old female with Degenerative ScoliosisRobert Pashman
67 year old female presented with DeNovo Scoliosis, with significant rotation due to Adolescent Idiopathic Scoliosis. Dr. Pashman treated the patient with a posterior spinal fusion from T10-Pelvis. KIM/SRP Classification 2.
Case Review #43: 43 year old female with Adult Idiopathic Scoliosi requiring...Robert Pashman
1. A 43-year old female with adult idiopathic scoliosis underwent anterior spinal surgery with instrumentation from T12 to L3 to correct curves of 60° thoracic and 57° lumbar, reducing them to 41°.
2. A 48-year old female with Kim/SRP type III scoliosis underwent revision surgery with anterior lumbar interbody fusion from L4-S1 and posterior spinal fusion from T3 to S1 to correct increasing proximal thoracic curvature and subadjacent degeneration.
3. Post-operatively, the patient was well-balanced in sagittal and coronal planes with thoracic and lumbar curves reduced to 26° and 27° respectively.
This document discusses how libraries can use Web 2.0 tools. It begins with defining Web 2.0 as communication, collaboration and multimedia tools that allow users to interact and connect with information. Examples of tools covered include blogs, wikis, social bookmarking, Flickr, podcasts, and review sites. The document also discusses things to consider when implementing these tools like staff skills, ongoing maintenance, costs, and ensuring technology enhances rather than replaces services. It concludes with posing discussion questions to workshop participants.
Performance, concept & narrative music videosJshepherd1460
1) Performance-based music videos focus on footage of the artist performing and often include live stage performances or depictions of the artist in everyday situations.
2) Narrative-based music videos tell a story, either related to the song's lyrics or suggested by them, using a beginning, middle, and end structure or references to a story. They sometimes promote a related film through clips.
3) Concept-based music videos center around a single unusual or surreal idea to entertain viewers and keep their attention on the screen through the video's symbolic or thematic content.
The history of horror began with 18th century Gothic literature influencing early monster films of the late 19th century. German Expressionism of the 1920s popularized the use of distorted sets and shadows. Universal films of the 1930s, like Dracula, brought horror to sound cinema. Psychological horror films of the 1940s-1960s with low budgets became highly profitable. Subgenres that followed included occult, creature, slasher, and torture porn films of the 2000s that utilized graphic violence and found footage styles. Current zombie films reflect fears of pandemics but the subgenre may be declining with parodies like Shaun of the Dead.
The document summarizes the contents page created for a vintage music magazine. It describes the design process and how the initial plan did not work when implemented. The contents page was then redesigned following conventions seen in other magazines, including using three columns to neatly display information. Some conventions were challenged, such as only featuring photographs of single artists and all being female, to make the magazine more modern. Evaluation sections describe design elements like the masthead carrying over from the cover and advertising social media, concerts, and subscription options to engage the target audience.
El documento presenta una historia sobre una ciudad gobernada por el Licenciado Sergio, quien alegaba poseer una biblioteca secreta y era el único con acceso al conocimiento. Un grupo de jóvenes y un anciano llamado Don Félix no estaban de acuerdo con el gobierno y querían saber qué había detrás de los muros que rodeaban la ciudad. A pesar de no obtener el apoyo de sus familias, decidieron explorar por su cuenta, perforaron el muro y Don Félix reconoció lo que había más allá antes de que desaparec
North Queensland Audio Visual (NQAV) is a managed technology company that provides audio visual, lighting, and control systems solutions. They take a holistic client consultation approach to determine needs, budgets, and timelines. As one of the largest suppliers in Australia with over 200 partners, NQAV has experience providing solutions to a wide range of client sectors including education, government, sports, corporate, and more. They pride themselves on on-time, on-budget project delivery and support.
Library Instruction: Using Technology to TeachBridget S
This document discusses methods for library instruction including lectures, demonstrations, and collaboration. It provides examples of different types of instruction like reference consultations and topical workshops. The document also explores using technology for instruction, providing examples of tools like Delicious, Google Docs, podcasts, and YouTube. It discusses assessing the effectiveness of instruction through evaluations, surveys, and analytics. The document emphasizes that technology should enhance instruction and not replace it.
Music videos began in the late 1920s/early 1930s with short films pairing songs with visuals to promote music recordings. They developed through the 1950s/60s with early examples from artists like Bessie Smith and Tony Bennett. The 1964 film A Hard Day's Night helped establish the genre with its musical segments influencing countless subsequent pop videos. The 1970s saw the rise of lower-cost video production and more conceptual videos from acts like Queen. MTV's 1981 launch was a key moment, greatly increasing the commercial importance of music videos. Artists in the 1980s like Michael Jackson and Madonna helped establish music videos as a major marketing force and art form through increasingly sophisticated concepts, effects and narratives. Today, music videos are
This document reflects on the author's learning through reflective practice. It discusses how the author's culture and environment have shaped who she is and how she approaches her work. The author's whakapapa, roots in the land and water, and connection to her people help define her identity and perspective. Reflective practice allows her to consider how her environment influences her purpose, processes, and sustainability. Drawing from her culture strengthens her resilience and guides her actions and interactions respectfully. Understanding where she comes from through reflective practice helps her recognize where she is going.
El documento presenta el plan de trabajo para el período de diciembre en la asignatura de Matemática para 5to año en el Colegio Las Cumbres. Se detallan las fechas de controles de carpetas, evaluaciones y recuperatorios entre el 5 y el 20 de diciembre. También se especifican las condiciones para la aprobación de cada contenido nodal, que requieren la entrega de actividades, obtener 6 o más en la evaluación escrita y asistir al 75% de las clases.
Case Review #22: 50 year old female presented with Scoliosis and spondylolis...Robert Pashman
50 year old female presented with Adult Idiopathic Scoliosis and Spondylolisthesis. She suffered from low back pain and leg pain. Dr. Pashman performed a spinal fusion on the patient.
Case Presentation #54: 60 year old female failed minimally invasive scoliosis...Robert Pashman
A 60 year old woman presented after a failed minimally invasive XLIF surgery for Adult Idiopathic Scoliosis. The patient had multiple complications, and required extensive revision surgery.
This 1939 cartoon by American cartoonist Herb Block depicts Poland as a vulnerable little girl confronted by a wolf (representing Nazi Germany) and a bear (representing Soviet Russia). The wolf has a Hitler hairstyle and the words "Nazi Germany" on its pillow, while the bear resembles Stalin and has "Soviet Russia" on its pillow. They have gotten into bed together, symbolizing the alliance formed between Nazi Germany and Soviet Russia to conquer and divide Poland following the Nazi-Soviet Pact. The cartoon was meant to express American disgust with the pact.
The document promotes the educational game "Odd One Out" where students identify the item that is different from the others. It suggests using the game for starters, breaks, and plenaries. Teachers are also encouraged to have students create their own "Odd One Out" questions based on the current topic. The game is presented as a fun activity that allows for multiple correct answers.
Esquema de contenidos nodales dic 2016.fisica 4 añocolegiolascumbres
El documento presenta el esquema de contenidos de Física para el 4to año de secundaria en el Colegio Las Cumbres. Incluye los subtemas a cubrir en Cinemática, Hidrostática, Estática y Dinámica durante los tres trimestres, como movimiento rectilíneo uniforme, principio de Arquímedes, sistemas de fuerzas y conservación de la energía.
Case Review #1: 27 year old female presents with foot drop after 3rd lumbar s...Robert Pashman
A 27 year old female presented status post three microdiscectomies. The patient had a sudden onset of foot drop. Dr. Pashman performed a posterior spinal fusion on the patient.
Case Review #33: 49 year old Dancer presented with Idiopathic ScoliosisRobert Pashman
A 49 year old male with Adult Scoliosis presented with low back pain and leg pain. The patient is a professional dancer. He failed conservative therapy and was seeking a surgical opinion.
Case Review: 42 year old woman with Grade 3 Isthmic SpondylolisthesisRobert Pashman
A 42 year old very athletic woman presented with Grade 3 Isthmic Spondylolisthesis. She had a long history of back pain. Dr. Pashman performed an anterior and posterior spinal fusion.
Case Review 4: A 58 year old female presented with Scheurmann's KyphosisRobert Pashman
A 58-year-old female with severe rigid thoracolumbar kyphosis due to Scheuermann's disease and degeneration underwent a posterior spinal fusion from T2 to the pelvis. She had a 70 degree curvature that was rigid. The surgery involved segmental spinal instrumentation, multiple osteotomies to correct the curvature, decompression of neural elements, and an 18-level posterior fusion. Post-operatively, the patient's curvature was fully corrected and she gained 2 inches in height.
Case Review #35: 43 year old female with Adult Scoliosis and a Transitional V...Robert Pashman
1. This case review summarizes the treatment of a 43-year-old female patient with adult scoliosis and a lumbar sacral transitional vertebra.
2. She had a 40 degree lumbar curve and a fused L5-S1 region on the right side.
3. Her treatment plan involved an anterior interbody fusion at L4-5 and L5-S1 followed by posterior segmental spinal instrumentation, spinal osteotomies, and posterior spinal fusion to correct her deformities and relieve her pain.
Case Review #18: 79 year old female with Degenerative scoliosisRobert Pashman
1) A 79-year-old female with adult degenerative scoliosis, herniated discs, and spondylolisthesis underwent spinal fusion surgery.
2) The surgery involved segmental spinal instrumentation from L1 to the pelvis, a pedicle subtraction osteotomy at L3 to create lordosis, and posterior spinal fusion from L1 to the pelvis.
3) Post-operatively, the patient's sagittal balance was normalized, with 5 degrees of lordosis achieved compared to 20 degrees of kyphosis pre-operatively, improving her ability to walk with less pain.
Case Review #19: 40 year old Male with Adult Idiopathic Scoliosis with Flatba...Robert Pashman
A 40 year old male presented after scoliosis surgery at age 14. He presented with Flatback Syndrome and increasing low back pain and required revision surgery.
Case Review #46: 56 year old female with Adult Idiopathic Scoliosis and Burst...Robert Pashman
56 year old female with Idiopathic Scoliosis, status post burst fracture, presented with junctional kyphosis. Dr. Pashman treated the patient with a posterior spinal fusion from T2-pelvis. Spinal curvature was a KIM/SRP Classification 3.
Case Review #34: 44 Year Old Woman with Adult Idiopathic ScoliosisRobert Pashman
A 44 year old woman presented with Adult Idiopathic Scoliosis. She wore a brace as a child, and the curvature progressed to the point she required surgery.
Case Review #11: Adult Idiopathic ScoliosisRobert Pashman
A 60 year old male presented with a 50+ degree curvature. He was status post lumbar fusion from L4-S1, and continued to have significant low back pain.
Case Review #1: 39 year old female with Congenital Scoliosis Robert Pashman
A 39-year-old female with progressive congenital scoliosis underwent spinal fusion from T3 to the pelvis. She had a previous fusion at age 6 but her curvature had worsened. The surgery included multiple osteotomies and instrumentation to correct her frontal and sagittal plane deformities. Post-operatively, her curvature was reduced from 31 to 18 degrees and she had improved balance and pain relief.
Case Review #26: 73 year old female with KyphoscoliosisRobert Pashman
73 year old female presented with Kyphoscoliosis. Dr, Pashman, treated the patient with a posterior spinal fusion from T2-Pelvis. KIM/SRP Classification 3.
Case Review #44: 64 male presented with Denovo Scoliosis and InfectionRobert Pashman
A 64 year old male presented with collapsing denova scoliosis, after several failed back surgeries. The patient was found to have an infection and required salvage surgery.
Case Review #39: 55 year old male with Progressive ScoliosisRobert Pashman
A 55 year old male presented with Progressive Adult Idiopathic Scoliosis. While he was preparing for surgery, he lifted a heavy item, and had neck pain and pain going down his arm. The patient was found to have myeloradiculopathy and spinal cord effacement and required an Anterior Cervical Fusion prior to scoliosis surgery. The following year he had a posterior spinal fusion for Scoliosis.
Case Review #29: 57 year old female with Adult Thorcolumber ScoliosisRobert Pashman
57 year old female with Adult Idiopathic Scoliosis. She presented with a 62 degree thoracolumbar curve. Dr. Pashman treated the patient with a posterior spinal fusion from T10-Pelvis. Dr. Pashman took great care with incision closure to preserve the patient's tattoo. KIM/SRP Classification 2.
Case Review #45: 35 year old male with Junctional KyphosisRobert Pashman
35 year old male status post T4-L1 fusion for Adult Idiopathic Scoliosis, presented with junctional kyphosis. The patient was treated with a posterior spinal fusion from T2-L4. KIM/SRP Classification 1.
Case Review 15: Adult Scoliosis treated with Spinal Fusion and OteotomiesRobert Pashman
A 50 year old female presented with progressive Adult Idiopathic Scoliosis. The patient had severe low back pain and leg pain. She was treated with a posterior spinal fusion with spinal osteotomies.
Case Review #52: 54 Year Old Female with Adult Idiopathic Scoliosis and leg painRobert Pashman
A 54 year old female with progressive Idiopathic Scoliosis presented with low back pain and leg pain. Due to her daily function declining, the patient chose to have spinal surgery.
Case Review #12: Adult Scoliosis Revision Surgery due to FlatbackRobert Pashman
A 59 year old male presented status post scoliosis surgery using Cotrel-Duboussett instrumentation. The patient had Flatback Syndrome, low back pain, leg pain, and required revision surgery.
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Case Review #11: Progressive Adolescent Idiopathic ScoliosisRobert Pashman
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Case Review #17: 63 year old female with Denovo Scoliosis
1. Case Review:
63 year old Female with Adult
Idiopathic Scoliosis and
Spondylolisthesis
53°
Robert S Pashman, MD
Scoliosis and Spinal Deformity
www.eSpine.com
2. Patient History
63-year-old female
Presented with failure to thrive. She cannot ambulate
due to severe low back pain and radiculopathy.
Status post attempted posterior instrumented fusion of
L4 to S1 using facet screws
Spondylolisthesis slippage.
Chronic pain related to collapsing scoliosis proximally.
3. Pre-op X-rays
Status post attempted
posterior instrumented
fusion of L4 to S1
using facet screws
53°
4. Indications for Surgery
1. Adult idiopathic scoliosis.
2. De novo scoliosis.
3. Status post posterior instrumented fusion for
degenerative spondylolisthesis at 4-5.
4. L4 to S1 status post instrumented fusion for low back
pain and spondylolisthesis.
5. Status post laminectomy, L4 to S1, for spinal stenosis.
6. Now with collapsing frontal and sagittal plane deformity
and unremitting pain.
7. Multiple co morbidities.
5. Surgical Strategy
1. Segmental spinal instrumentation, T10 to the sacral pelvis, using CD
Legacy 5.5 stainless steel screw-rod construct.
2. Re-exploration and repeat laminectomy, L3 to S1, using microscope
and high power illumination.
3. Interlaminar decompression, L1 to L3 bilaterally, using the
microscope and high intensity illumination for lateral recess stenosis
and clearance of pseudarthrosis at L3-4 and L4-5.
4. Four level Smith-Petersen osteotomies for mobilization of the spine.
5. Repair of pseudarthrosis at L3-4 and L4-5.
6. Posterior spinal fusion with combination of locally harvested
autogenous and rh-BMP graft, T10 to the sacral pelvis.
7. Intraoperative somatosensory and motor evoked potentials.
8. Intraoperative fluoroscopy.
9. Removal of retained hardware facet screws.
6. Findings during surgery
The fusion mass of L5-S1 was solid but, at L4-5, there was a clear
pseudarthrosis. The facet screws were intact, but not holding onto
anything, as if maybe there was a pars fracture at L4-5 that went on to
non-healing or went on to stress fracture. The adjacent segment at L3-4
was chronically degenerative and, as the patient tried to stand up and
extend, the adjacent segment no doubt caused critical spinal stenosis
with collapse and pseudarthrosis with critical compression of the exiting
L3, L4 and L5 nerve roots bilaterally.
The patient was stuck in partial flat back lumbar kyphosis from the
previous spondylolisthesis attempted fusion, and this was necessary to
be made up by multiple level Smith-Petersen osteotomies and takedown
of the fusion mass so that hyperextension could be induced with
correction of the coronal plane. The patient's bone was generally of
moderate quality. There was significant dense scar over the
laminectomy, a site that needed to be decompressed. This took a
significant amount of time and effort to dig out the scar from around the
edges of the previous laminectomy and to extricate the L5 and L4 nerve
roots caught in the pseudarthrosis and underneath the fusion mass.
There were no other abnormalities. There was no puss or sign of
infection or fluid.
7. Post-Op Films
The patient is completely
relieved of her lower extremity
symptoms and her back pain.
Her x-rays look perfect with
excellent sagittal and coronal
plane balance.