![]() On the General tab in the Database field, type the name of a schema that you want to use as default. Select a data source that you want to modify. In the Database Explorer Command 1 ( View | Tool Windows | Database Explorer), click the Data Source Properties icon ( ). You can open data source properties by using one of the following options: Set the default schema in connection settings When you select the default schema, you can omit the name of that schema or database in your statements.Ĭlick the list and select the schema that you need. You can select the default schema or database by using the list, which is in the upper-right part of the toolbar. In the Preview pane, you can view and change the generated SQL code. In the Modify dialog that opens, enter the name of your schema in the Name field. Right-click the data source, database, or schema node and select New | Schema. In the Database Explorer ( View | Tool Windows | Database Explorer), expand the data source tree until the nodes of databases or schemas. You can see a reference on node and object icons in the Data sources and their elements chapter of Database Explorer topic. Schemas can be seen in the Database Explorer. During introspection, DataGrip loads the metadata from the database and uses this data later. Also, by using this approach, you define which schemas you want to introspect. It can be useful if you have many databases and schemas. If you omitted the WHERE clause intentionally, you can execute current statements as you planned.DataGrip displays databases and schemas that you selected to be displayed in the Database Explorer. If you forgot to put the WHERE clause in DELETE and UPDATE statements, DataGrip displays a notification to remind you about that. Select to display warnings for potentially unsafe queries. Show warning before running potentially unsafe queries You can change them before running the statement.Ĭlear this checkbox and DataGrip will execute the statement immediately without showing you the parameter values. Select this checkbox and next time you execute the statement, DataGrip will show you the last used parameter values. When you run a statement with parameters, DataGrip saves parameter values in memory. For the Generic dialect, the separator is a semicolon. Into ANSI SQL statements: split scripts according to the SQL:2016 grammar.īy statement separator: extract and run statements by separators. ![]() Into valid ANSI SQL statements or by separator: DataGrip analyzes a script and splits it on valid statements or by separators. In the Generic dialect, all found errors are not highlighted. The Generic dialect differs from SQL:2016 in error highlighting. Set the query parsing for unsupported databases that use SQL:2016 or Generic dialects. Split a script for execution in Generic and ANSI SQL dialects In this case, when you get the result that you want to keep, you can pin the tab by right-clicking its header and selecting Pin Tab in the context menu. Information on the tab is updated to show the result. If the checkbox is cleared, the same tab is used to show query results. Using this approach, you can keep results of all the queries that you have run. Select the checkbox to create a new tab with query results each time you run the SELECT query. For the single tab, the tab is updated for each query. You can select to view query results on individual tabs, or on one and the same tab. For example, if there is at least one statement border within the selection, the selection is expanded to form a sequence of valid statements. Smart expand to script: expand a selection to form a sequence of valid statements. If the selection contains more than one statement, the statements are executed as separate statements. If the code is selected (highlighted), perform one of the following options:Įxactly as one statement: execute exactly what is selected as a single statement.Įxactly as separate statements: execute exactly what is selected. If the caret is outside a statement (for example, on a blank line or within a comment), perform one of the following actions:Įverything below caret: execute everything below the caret. For all other dialects, the same as the previous option.Įverything from caret: execute everything below the caret. For Transact-SQL (SQL Server and Sybase), the current batch of statements is executed. Largest statement or batch: execute the largest statement or a batch of statements from the script. For example, when the caret is inside a subquery, an outer statement is executed. Largest statement: execute the largest statement from the script. For example, when the caret is inside a subquery, the subquery is executed. Smallest statement: execute the smallest statement from the script. ![]() If the caret is inside a statement, perform the following actions:Īsk what to execute: display a popup where you can select what part of a statement or statements to execute.
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![]() Others are subtle yet significant tweaks to certain builds or playstyles. Some of these weapons are not your stereotypical RPG powerhouses. Thus, we deem it necessary to add more of the best weapons in Pillars of Eternity 2 so that you get to be more flexible with your builds. Pillars of Eternity 2 weapons are special in that they're more generous to players compared to what most other CRPGs have on offer. As it stands, there's plenty of options in the game for every build. Updated October 28, 2021, by Sid Natividad: Pillars of Eternity 2: Deadfire is such a complex and in-depth RPG that a handful of weapon selections simply won't do. RELATED: RPGs That Are Rough Around The Edges - But More Than Worth The Effort These weapons let you poke those holes deeper, faster, or bigger - take your pick. What can a measly mortal such as you do against such overwhelming omnipotence? The game gets generous with its weapons, some of which can be used to poke holes, in Eothas' toenails. This gives both weapons the recovery time reduction from dual wielding and frees the need to swap weapons, but you lose the ability to use a shield and the accuracy bonus you would have normally gained if you were wielding each weapon by itself.Oh, and that same god also seeks to undo the world and remake it into his image, so now you're forced to confront him. Dual wielding a ranged weapon with a melee weapon will have the character only shoot by default against targets outside of melee range, but use the melee weapon exclusively against targets in melee. Dual wielding pistols and blunderbusses reduces their loading time, just as with melee weapons, though firing a brace and switching to another set is still often faster. The biggest change to firearms in Deadfire is that Pistols and Blunderbusses are now 1-handed weapons. Self: +2 Penetration with War Bow weapons, +50% Recovery Time with War Bow weaponsįirearms are very slow to reload, taking longer to reload than any other weapons and aren't very accurate, but they make up for it by dealing high damage and their unique advantage in dealing with Wizards standard magical defense with their Veil Piercing effect.Rangers specializing with either any gun or the Arbalest itself should favor Penetration over Critical Damage. You typically want Armor reduction from some supporting source if you decide to specialize for Penetration as a damage enhancer. Lastly, Penetration provides consistent results if you build towards it, and most melee types can benefit with decently enough Accuracy. After that, comes Modals that apply a direct Damage Bonus, but those work best for melee-range specialists not for characters multiclassed as a spell caster. One major difference as compared to Pillars of Eternity is the introduction of Penetration as a counter to armor value in combat. As before, there are no class or race restrictions on weapons use. Picking the right tool for the job is a large part of defeating enemies you come across in your journeys. ![]() Of course, each weapon (and shield, since they're coded as off-hand weapons) also has its own, unique tactical niche: Daggers deal low damage, but attack fast, pikes are slow, but have increased reach. You only won't have access to that weapon's modal ability. Note that there is no penalty for using a weapon your character is not proficient in. These are granted by weapon proficiencies chosen at level-up or character creation. ![]() As usual, weapons are your primary method of aggressively negotiating with other denizens of the Archipelago (the other being your sharp wit), but added modal abilities to each weapon type allow you to further refine your playstyle. Weapons in Pillars of Eternity II: Deadfire build on the mechanics introduced in Pillars of Eternity, introducing a number of wrinkles to the formula. This article is about weapons in Pillars of Eternity II: Deadfire. For weapons in Pillars of Eternity and expansions, see Weapons. 11/5/2023 0 Comments Sean lock funeral![]() Here, in his element, he took his elaborate prop work as seriously as the numbers game, and revealed himself a secret grandmaster of ‘Carrot In A Box’. When the programme fused with daytime TV favourite Countdown from 2012, Lock’s humour was given free rein in his individual segment to the point where all eyes were on him for the first 20 minutes of any show. At the same time, his stand-up was becoming increasingly acclaimed – he won the 2000 British Comedy Award for Best Live Comic and would later be included in Channel 4’s 100 Greatest Stand-Ups.įrom there it was a natural leap to 8 Out Of 10 Cats in 2005, where his regular role as team captain married the familiar glasses-waggling aesthetic of the traditional panel show with the unpredictability of 21st century comedy. The show’s merging of grey estate life with outlandish scenarios (Lock’s downbeat character Vince found himself destroying graveyards with stolen ploughs or accidentally revealing his secret history of swan murder) showcased Sean’s ability to remodel deadpan everyman humour for the Mighty Boosh era. Becoming a regular panellist on various radio comedy shows, Lock made the leap to TV when his own 1998 radio series 15 Minutes Of Misery – in which he’d eavesdrop on the comic antics of his neighbours in a south London tower block – was developed into the Radio 4 sitcom 15 Storeys High and then on to the BBC in 2002. ![]() ![]() One of his first was as a regular player in Rob Newman and David Baddiel’s Newman And Baddiel In Pieces series in 1993 as their support acts on the pair’s peak-era shows, he became one of the first comedians to perform at Wembley Arena while still a virtual unknown. He emerged from comedy’s boiler room over the course of the ‘90s, having previously worked various odd jobs from labouring to (he’d claim, at least) goat-herding in France – while making his name as a stand-up he contributed material to shows by Harry Hill, Bill Bailey and Lee Evans among others, and would make sporadic cameo appearances on TV and radio. The deep respect Sean commanded in the comedy field was the result of decades of background groundwork beneath the mainstream radar. His work straddled the observational and the fantastical with a rare seamlessness, his everyman persona belying the madcap comedy mind at work behind the specs. The inventive lengths that Sean would go to in order to turn a couple of minutes of casual quiz show air-filler into extended, unfettered odysseys of comedy gold spoke to the brilliance of this much-loved comedian, who died today age 58 following a long battle with cancer. Or a wicker basket containing what he’d modestly describe as “total comedy”. Few set-up lines have unleashed such wild comedic digressions as “Sean, have you got a mascot?” The fundamental genius of 8 Out Of 10 Cats Does Countdown was encapsulated in the next – utterly unpredictable – few minutes, as Sean Lock reached beneath the desk and let his imagination run riot. 11/5/2023 0 Comments Manifold garden screenshots![]() ![]() I know a review isn't there to serve the developer. Here is a collection of gifs showing gameplay mechanics in the game (spoiler warning): These mechanics are not in secret or hidden areas either (which the game does include), but are mechanics that you'd experience in a regular playthrough. None of this is mentioned here in the review. You can plant seed in order to grow trees, redirect streams of water, freeze water to form new paths, manipulate large tetrominoes to create bridges, and solve puzzles with portals. While the early area focuses on cube manipulation, the rest of the game goes on to explore many more mechanics. The review states “Flicking between walls, ceilings and floors to manipulate multiple elements in order to get a single box where you want it isn't just common – it's pretty much all you do.” Note that this youtuber gets to where the reviewer’s screenshots are in about 30 minutes of gameplay: The full video is about 6 hours and 30 minutes long, and that's close to the average play length. Here is a blind playthrough of the game I found on YouTube. From the screenshots and the text, it seems like the reviewer only did one of these. In this first level, there are 3 puzzles. After that, the player emerges outside and is first introduced to the world wrapping mechanic, then they come to the first main level. I am very disappointed with this review, not because of the score, but because it seems like this review is based only on the first 30 minutes of the game (around 10% of the entire game).Īt the start of the game, there is an indoor tutorial area that introduces the basic mechanics: gravity changing, manipulating cubes, and opening doors. ![]() The gameplay doesn't match the ambition of Manifold Garden's visuals, and with some of the trickier to execute puzzles we found ourselves just wanting to get them over with so we could get back to the cool stuff. Your goal seems indeterminate – you're effectively opening doors to move forward, yes, but it can be somewhat jarring to move from these outrageous, surrealist landscapes into a smaller room with a bit of glorified Sokoban to play. That's not to say it's bad, or that said puzzles aren't fun to figure out, it just struck us as being a little detached from the presentation. Less impressively, we found that the consistently remarkable spectacle of Manifold Garden is a little at odds with its relatively benign and straightforward puzzle-solving. Given you can't traditionally jump, this is actually the easiest way to cross gaps in the environment, which can lead to a thoroughly exhilarating fall as you wrap around from top to bottom, gradually making your way forwards. Traversal is both helped and hindered by the fact that the game's world is looped and mirrored – in outdoor spaces, it's easy to accidentally fall into what seems like a never-ending void, only to find yourself landing on the very platform from which you tripped. Captured on Nintendo Switch (Handheld/Undocked) There's also a refreshing lack of hand-holding it's up to the player to figure out exactly how the game's elements work together, and how to solve the conundrums that arise from its building blocks. Thankfully, while difficult, Manifold Garden is rarely frustrating – its rules are extremely clear and it never breaks them in an effort to trick the player. Figuring out how to manipulate gravity in order to "freeze" boxes in mid-air so you can stack further boxes atop them is a headscratcher, and sometimes finding your way through the labyrinthine structures to get where you need to be is a challenge in itself. Every puzzle is essentially a block puzzle, though the goals aren't always the same. 11/5/2023 0 Comments Izotope iris 2![]() I uninstalled it in my last 'cull pass' (where I. Nine soundscapes (pt.2 of 5) for iZotopes Iris, derived from originally recorded choir samples and field recordings. Im not sure exactly how youre using it, but it hasnt been updated in like 8 years. Load one of the hundreds of patches and easily experiment with the most relevant parameters via dedicated macro controls, or develop expressive, dynamic, and evolving musical sounds with the new modulation system. In any case, Iris 2 is the only Instrument iZotope makes that serves a purpose that isnt easily replaced by another (BreakTweaker is easily replaced by the Samplers and Pattern/Drum Editors in lots of DAWs). If Iris has been downloaded directly from iZotope or another re-seller, the serial number will be e-mailed along with the link to download the product. ![]() Description iZotope Iris 2 Sample Based Synthesizer- Educational VersionĪvailable for download, Iris 2 from iZotope is a sample-based synthesizer that combines the power of a sampler with the flexibility of a modular synthesizer, along with spectral filtering. iZotope Iris Help Documentation 2 Authorization Each purchased copy of Iris contains a unique serial number printed on the installer DVD sleeve. ![]() Click Server on the upper-right corner of the settings menu.On your Plex Media Server, open up the main menu and click Settings.Connect your TV tuner to Plex Media Server.Unbox your OTA antenna and connect it to your digital TV tuner.Here are the basic steps for adding Plex DVR & Live TV to your Plex media center. Now that you know what you need, let’s dive into the setup steps. A Plex Pass subscription – Available at.An updated Plex media server – Make sure you’re running the latest version of Plex.A supported DVR tuner and OTA antenna – A list of supported devices can be found here.What you’ll need to setup Plex Live TV & DVR Plex channels give you a way to watch live web TV through Plex. If you don't want to invest in a Plex Pass, scroll down to learn about Plex channels. While Plex Pass does have some good features, it is pricey. There's also a one-time “Lifetime” membership fee of $119.99. Plex Pass subscriptions can be purchased for $4.99/month or $39.99/year. To use it, you need a Plex Pass subscription. Plex Live TV & DVR is one of the newer Plex features. Tips for watching live internet TV via third-party Plex channels.How to watch live over-the-air TV on Plex using an antenna.If you’re interested in finding out how to watch live TV on Plex, read on to learn: Plex recently announced support for live streaming TV through OTA antennas and compatible digital tuners. ![]() It allows you to stream your own music, movies, and TV shows, so it's great for cord-cutters. Plex's third-party channels add even more options.Īnd now, Plex is even more powerful. ![]() Plex is one of the most powerful home theater servers available. We may receive an affiliate commission from product sales generated through these affiliate links. Flixed.io's contributors and editorial team will often recommend products we believe to be useful for our readers. 11/4/2023 0 Comments D3dx9 30 dll flatout 2![]() setup_dxvk.sh install to install d9vk directly into the proton wineprefix, FlatOut 2 launches to a black screen. The GOG version runs wonderfully with D9VK. (Failed to create effect: data/shader/pro_static2x.sha) UPDATE: this only seems to happen with the steam version of Flatout 2. i can hear audio tho.įlatout 2: starts, but nothing is displayed until i either switch to another open application, or drop down the yakuake terminal console and it then errors out with an error about being unable to create a shader. game also stopped responding at the menu.įlatout: Launches, dxvk hud is displayed, but only a black screen. have to kill via terminal command.īlur still starts to a white screen and requires killing via terminal.īad Rats: starts and displays DXVK HUD, but displays a white screen same as BlurĪrcanum: starts but i cannot confirm if it is using d9vk as it is started via a launcher and the DXVK_HUD variable doesn't seem to get passed to the exe. played for about 10mins with no issuesīattle for Middle Earth II: starts up, DXVK HUD displays, but only a black screen. Other Support Options ( ): Use the Web to ask a question, to contact Microsoft Customer Support Services, or to provide feedback.1TB Intel 760p PCIE NVME 2280 NGFF SSD contained in an Asrock PCIE x16 ULTRA QUAD M.2 card(boot drive)ĦTB raid 0 array(12x Intel 545s 512GB SSDs) controlled by an Areca 1231-ML PCIE x8 SATA II RAID HBA w/ 2GB DDR 2 RAM(800 MHz IO processor)ĮVGA NVIDIA 2060 6GB GPU with driver 430.09 ![]() Searchable Knowledge Base ( ): Search technical support information and self-help tools for Microsoft products. Solution Centers ( ): View product-specific frequently asked questions (FAQ) and support highlights. Microsoft Community( ): Interact with peers and with Microsoft Most Valuable Professionals (MVPs). This Web site provides the following services: If you need more help, visit the Microsoft Customer Support Services Web site to find other solutions. Note If you have installed more than one game on the computer, repeat steps 5 and 6 for the other games. Note In this path, Drive represents the drive letter of the drive on which the game is installed, and Game Title represents the game that you want to repair. Note Use the Apr2005_d3dx9_25_圆4.cab file for the 圆4-based version of the Microsoft Windows operating system. Note If you have installed more than one game on the computer, repeat steps 7and 8 for the other games.Ĭlick Start, point to Programs, point to Accessories, and then click Windows Explorer. Right-click the game folder that corresponds to the game that is installed on the computer, and then click Paste. Note In this path, Driverepresents the drive letter on which the game is installed, and Game Title represents the game that you want to repair. Locate the following folder for your game:ĭrive:\Program Files\Microsoft Games\ Game Title Note Use the Apr2005_d3dx9_25_圆4.cab file for the 圆4-based version of the Windows operating system. Note In this path, CDDriverepresents the drive letter of the CD drive.ĭouble-click Apr2005_d3dx9_25_x86.cab, right-click d3dx9_25.dll, and then click Copy. Locate and then click the following folder: Insert the disc 1 CD/DVD for your game into the CD/DVD drive of the computer. ![]() To do this, follow the appropriate steps for your version of Windows: Windows 7 or Windows Vista ![]() To resolve this issue, copy the D3dx9_25.dll file or the D3dx9_27.dll file from the disc 1 CD/DVD of the game CD/DVD pack to the corresponding game folder. (Tell me why this testing is important.)įor more information, click the following article number to view the article in the Microsoft Knowledge Base:Ĩ22798 You cannot install some updates or programs The software you are installing has not passed Windows Logo testing to verify its compatibility with this version of Windows. 11/4/2023 0 Comments Hibiscus mexican drink![]() Don Julio or Patron are recommended for this cocktail, but feel free to use your favorite tequila. The sweet and floral hibiscus syrup complements the tart grapefruit and lime juices, creating a perfectly balanced drink. After all, agua fresca literally means cool water. Made with tequila, grapefruit juice, lime juice, and hibiscus simple syrup, this cocktail is a twist on the classic Paloma. (Or not! Skip the straining if you prefer a pulpier drink.) You can serve it right away or keep it in your fridge for a few hours-but either way, you’ll definitely want to pour it over ice. Once the mixture is blended and smooth, use a fine mesh sieve to strain it into a pitcher. ![]() The most important thing is that they are made fresh and served over ice." And that brings us to the final-and perhaps most important-step. “You can use less water or more water, less sugar or more sugar. “Don’t sweat it too much, just have fun with it,” says Goût. Kamata turhipiti: It is black atole made with cocoa shell, corn hair and coconut. (If you want to add sugar after you’ve strained the mixture, it might make sense to use the bartender method of sweetening with simple syrup-that is, sugar dissolved in water-so that you don’t get a grainy drink.) With Purepecha origin, its literal meaning is atole which is a drink prepared from corn or wheat and it is very popular in Michoacn with countless presentations, the main ones are: Tri kamate: It is wheat atole seasoned with epazote and chili. If you add the sugar before blending, it will incorporate more evenly, but feel free to add gradually, tasting and blending in a little more as you go. If you're using 2 cups of mangoes and 2 cups of water, for instance, start with 2 ½ tablespoons of sugar, and adjust by adding a little more, if needed. One great thing about making aguas frescas at home is that you can control the sugar based on your own preference and the ripeness or tartness of your fruit. After straining and tasting, if you want to make it lighter, you can always stir in a bit more water, or even add sparkling water if you want something bubbly. “Remember, if you’re using fruit like watermelon, which already carries a lot of water, you won’t need to add as much water to the mixture,” Gerson says. In some cases, Gerson says, you can use two or three times (by volume) more water than the amount of fruit you’re using (so, 4 to 6 cups for 2 cups of fruit), but sometimes you don't need that much. One study showed that hibiscus extract reduced body weight, body fat, and body. Aguas frescas are traditionally much lighter and thinner than, say, a smoothie, but if you want a thicker drink, just use less water. Several studies show the potential of hibiscus tea to promote weight loss and prevent obesity. To make two margaritas, add ice, cooled hibiscus tea concentrate, lime juice, tequila and 1 Tbsp agave nectar (optional // amount as original recipe is written // adjust if altering batch size) to a cocktail shaker and shake vigorously to combine. This guide shows them in chronological story order. Mass Effect Andromeda's Elaaden Vault is a very effective way to raise the planet's viability, so you should pay the dungeon a visit as soon as you can if you hope to make the surface habitable. Solving all puzzles unlocks the Cryptographer trophy or achievement. The console just inside the door will shut down the purification field. There are 20 Remnant Glyph Puzzle Solutions & Locations in Mass Effect Andromeda.Shoot the remnant bots as you have to, but you can also ignore them - your goal is to get out, not clear the bad guys. Just retrace your steps across the room and back toward the gravity well, hopping across pillars as you go. Escape the purification field and exit the vault.Hit one of the safe zone force fields to recharge as you deal with the remnant bots. Use the pillars to continue into the room toward your HUD marker.Take out the remnant bots you meet there. Just across the pillars to the platform on the right side of the room. Leave the first console you come to alone (the active beam should be pointed off to your right).Just come back here to where you started to meet back up with us. Mass Effect Andromedas Elaan Vault is a very effective way to raise the planets viability, so you should pay the dungeon a visit as soon as you can if you hope to make the surface habitable. We’re going to focus on the critical path, but feel free to explore the left side of the room. There are two directions you can go when you enter this room - to the left for a couple containers and some things to scan for research points, or to the right to the console that controls this vault.There are several ways to do this, but the easiest is to use the in-game map. The goal is to rotate the glyphs so that they match the symbols on the walls. The puzzle is not too difficult, but it can be time-consuming. There is a glyph puzzle in the Elaaden Vault in Mass Effect: Andromeda. The next room is a problem because it’s cold - you’re going to have to solve the puzzles while keeping yourself warm (meaning you have to periodically use the force field bubbles to recharge your life support). Mass Effect Andromeda Glyph Puzzle Elaaden Vault.Then, head to the back of the room on top of the balcony to get the door open. You first must locate hidden glyphs, which are always in close. The Remnant puzzles are similar to Sudoku. , Mass Effect: Andromeda for the Playstation 4. At the bottom, walk straight forward to turn on the power. Solve all 20 puzzles in a single playthrough to get the Cryptographer. Head inside, and take the gravity well down. The vault will poke out of the ice when you get close. Just install this mod and all those mysterious alien glyphs will be replaced by perfectly readable Arabic numerals. Now thanks to NexusMods user Smorris2012, it can look even more like the age-old pen and paper game. Those Remnant decryption puzzles you need to solve at monoliths to gain access to the vaults? Here’s something you might not have realized. Take a peek and see what grabs your attention! 35. To help you out I’ve organized my definitive list of Mass Effect: Andromeda mods worth checking out. Using the glyphs available, you’ll need to complete a symbol-related puzzle in which you’ll need to use all four symbols once in each line. ![]() If you’re looking for a new adventure in the Mass Effect universe and haven’t gotten around to playing Andromeda, you have a golden opportunity to supercharge your experience with some of these mods. ![]() Even if this spin-off pales in the face of the original CommanderShepard trilogy, it’s still an incredibly fun game. If youre watching this guide, then that means you pro. Regrettably the game’s shock value was derived from the sheer amount of bugs, questionable game design choices, and an overall disappointing launch.īut after the dust settled and some much-needed patches were released, we ended up with a pretty competent game that scratches that very Mass Effect itch most fans have. If there is one thing Im not fond of in my video games, such as Mass Effect: Andromeda, its puzzles. Mass Effect: Andromeda came out some years ago to shock long-time fans of the franchise. 11/4/2023 0 Comments Hughston clinic columbus ga![]() The surgeon accesses the spine using small instruments that fit inside the tubular retractor. The tubular retractor holds the muscles open creating a tunnel to the problem area in the spine. ![]() To do the surgery, the surgeon will make small incisions to reduce blood loss and limit tissue damage, and will use specialized tools and tubular retractors to separate the muscles while performing the operation. This problem has considerably improved with the use of the tubular retractor. For example, a major drawback of open surgery was the retraction of the muscle, which often caused damage to the soft tissue, resulting in additional pain and healing time. There are a number of devices and approaches that help the surgeon perform spine surgery. Those who perform this specialized surgery are spinal surgeons with additional training in minimally invasive surgery. Researchers developed less invasive surgical techniques to treat spinal problems with less injury to the muscles and other structures in the spine. In contrast, the surgeon who practice minimally invasive spinal techniques use tiny incisions and special instruments to perform the surgery ( Fig). Then, the surgeon can place bone graft material, cages, rods, or screws as needed. Once the muscles are moved, the surgeon can access the spine and remove any diseased or damaged bone or tissue. With traditional open spinal surgery, the surgeon makes a long incision and then retracts, or moves the muscles to the side. Since then, minimally invasive procedures have advanced significantly, becoming the mainstay across orthopedics. In 1939, orthopedic surgeons first performed knee arthroscopy. These procedures, both diagnostic (an exam or test to determine a condition, disease, or illness) and therapeutic (a treatment), have been around for a long time. Surgeons perform minimally invasive procedures through tiny incisions instead of a large opening. Although the approach to back surgery was invasive and required a long recovery, it was the only option for many people seeking relief from chronic back pain caused by ruptured discs, trauma, tumors, deformities, degenerative disc disease, and infection. With damage to the soft tissue, it often took patients months to heal and to return to normal activity. The traditional surgery was often “invasive,” meaning that the procedure required a sizeable incision, and cutting into muscles to reach the problem area. For those who do require surgery, he uses the least invasive operative solution possible to help the patient heal quickly and achieve the very best outcome.In the very early days of spine surgery, the surgeon had little more than his or her training, experience, and a scalpel to perform complex and delicate musculoskeletal cases. Many of his patients do not require surgery, and are often successfully treated using nonsurgical options. Westerlund appreciates that every patient is unique and that every neck and back problem requires a special, thoughtful solution. As a fellowship-trained reconstructive spine surgeon, Dr. ![]() Westerlund specializes in orthopaedic spinal surgery with an emphasis on minimally invasive techniques. He will continue to research spinal disease and injuries at the Hughston Foundation and to present his findings at national and international meetings.ĭr. Westerlund has published extensively in scientific journals and he has published numerous textbook chapters. He is a Fellow of the American College of Surgeons and a member of the Georgia Orthopedic Society and Southern Orthopedic Association. Westerlund is a member of the American Academy of Orthopaedic Surgeons, the American Board of Orthopaedic Surgery and the North American Spine Society. Westerlund completed a fellowship at the Thomas Jefferson University Medical Center and Rothman Institute Division of Spine Surgery in Philadelphia, PA.ĭr. To receive his speciality in spine surgery, Dr. He also completed his residency in orthopaedic surgery at the University of Virginia Health Sciences Center in Charlottesville, VA. After medical school, he went to the University of Virginia Health Sciences Center where he completed a general surgery internship and a post-doctoral research fellowship in Applied Orthopaedic Biomechanics. Erik Westerlund, MD, FACS, graduated from The University of Virginia with a Bachelor of Arts degree in Biological Sciences in Charlottesville, VA, and he earned his medical degree from Georgetown University School of Medicine in Washington, DC. |
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