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pedicle screw

Koji Ishikawa, Tomoaki Toyone, Toshiyuki Shirahata, Yoshifumi Kudo, Akira Matsuoka, Hiroshi Maruyama, Chikara Hayakawa, Soji Tani, Masaya Sekimizu, Koki Tsuchiya, Takeshi Eguro, Yusuke Oshita, Tomoyuki Ozawa, Yusuke Nakao, Shigeo Sano, Takashi Nagai, Koji Kanzaki, Katsunori Inagaki
STUDY DESIGN: Prospective feasibility study on consecutive patients. OBJECTIVE: The aim of this study was to investigate the ability of regional BMD around the pedicle screw to predict the screw fixation. SUMMARY OF BACKGROUND DATA: Pedicle screw fixation is the gold standard technique for spinal fusion. Despite the advantage of biomechanical stability, screw loosening is a common complication. In previous studies, pullout strength and screw insertional torque were correlated, and most importantly, affected by bone mineral density (BMD)...
August 10, 2018: Clinical Spine Surgery
Lee A Tan, Ronald A Lehman
We demonstrate the setup and workflow of performing robotic spine surgery using the Mazor XTM system (MAZOR Robotics Inc, Orlando, Florida) in this video. An illustrative case was presented, including detailed steps for S2AI screw and lumbar pedicle screw placement using robotic assistance. A step-by-step narration is provided along with discussion of surgical nuances. Robotic spine surgery can be a safe and efficient method for screw placement, which can potentially reduce the risk of screw malposition. Spine surgeons should be familiar with this technology and keep this technique in their armamentarium...
August 7, 2018: Operative Neurosurgery (Hagerstown, Md.)
Chankue Park, Eugene Lee, Yujin Yeo, Yusuhn Kang, Joon Woo Lee, Joong Mo Ahn, Heung Sik Kang
BACKGROUND AND PURPOSE: Slice-encoding metal artifact corrections (SEMAC)-view-angle tilting (VAT) sequences have recently been used in clinical protocols to reduce metal artifacts in MR scans of patients with spinal instrumentation. The objective of this study was to compare the SEMAC-VAT sequence with the conventional MR sequence with a low bandwidth turbo-spin echo (TSE) in terms of image quality, visibility of periprosthetic structures, and diagnostic confidence for detection of postoperative complications in patients who underwent pedicle screw fixation at 1...
August 9, 2018: Magnetic Resonance Imaging
Zheng Li, Chong Chen, Youxi Lin, Xingye Li, Haining Tan, Matthew Tv Chan, William Kk Wu, Songtao Zhan, Qun Cao, Jianxiong Shen
Posterior spinal reconstruction with rods and pedicle screws has been widely used to corrects coliosis and other forms of degenerative spinal deformities. However, insertion of pedicle screwsis often clinically challenging, particularlyin patients with severe deformity. Bioelectrical impedance analysis is a technique that exploits the electrical properties of biological organs and tissues to indicate their compositions. Bioelectrical impedance measurement is non-invasive, simple, with adequate repeatability, and at a relatively low cost...
2018: American Journal of Translational Research
Hui-Min Li, Ren-Jie Zhang, Hai Gao, Chong-Yu Jia, Tao Xing, Jian-Xiang Zhang, Fu-Long Dong, Cai-Liang Shen
OBJECTIVE: Selecting optimal strategies for improving fixation in the osteoporotic lumbar spine remains an important issue in clinical research. Cortical bone trajectory (CBT) screws have been proven to enhance screw pullout strength. However, the biomechanical efficacy of these screws remains understudied. The aim of this study was to evaluate the biomechanical efficacy of CBT screws in the osteoporotic lumbar spine. METHODS: A total of 31 vertebrae from 14 cadaveric lumbar spines were obtained...
August 6, 2018: World Neurosurgery
Ryan Adams, Sarah Herrera-Nicol, Arthur L Jenkins
Background ā€ƒAdvancements in radiological imaging and diagnostic criteria enable doctors to more accurately identify lumbosacral transitional vertebrae (LSTV) and their association with back and L5 distribution leg pain. It is considered the most common congenital anomaly of the lumbosacral spine with an incidence between 4 and 35%, 3 although many practitioners describe 10 to 12% overall incidence. LSTVs include sacralization of the L5 vertebral body and lumbarization of the S1 segment while demonstrating varying morphology, ranging from broadened transverse processes to complete fusion...
July 2018: Journal of Neurological Surgery Reports
Qiu-Ju Li, Tong Yu, Lian-Hua Liu, Jian-Wu Zhao
RATIONALE: This study describes the technique of combined Orbic 3D navigation (O3DN) and 3D rapid prototyping (3DRP) to assist surgical correction of congenital scoliosis. PATIENT CONCERNS: A 12-year-old boy with congenital scoliosis. His father brought him to our hospital upon noticing the boy's asymmetry of the trunk. DIAGNOSES: Congenital scoliosis. INTERVENTIONS: O3DN and 3DRP were used to assist correction surgery in this patient...
August 2018: Medicine (Baltimore)
Jeremiah Easley, Christian M Puttlitz, Ross Palmer, Nicole Ramo, Celeste Abjornson, Frank P Cammisa, Kirk McGilvray
BACKGROUND CONTEXT: Screw loosening is a prevalent failure mode in orthopaedic hardware, particularly in osteoporotic bone or revision procedures where the screw-bone engagement is limited. PURPOSE: The objective of this study was to evaluate the efficacy of a novel screw retention technology (SRT) in an ovine lumbar fusion model. STUDY DESIGN/SETTING: This was a biomechanical, radiographic, and histology study utilizing an ovine lumbar spine model...
July 31, 2018: Spine Journal: Official Journal of the North American Spine Society
James L West, Madison Arnel, Atilio E Palma, John Frino, Alexander K Powers, Daniel E Couture
OBJECTIVE Spine surgery is less common in children than adults. These surgeries, like all others, are subject to complications such as bleeding, infection, and CSF leak. The rate of incidental durotomy in the pediatric population, and its associated complications, has scarcely been reported in the literature. METHODS This is a retrospective chart review of all pediatric patients operated on at Wake Forest Baptist Health from 2012 to 2017 who underwent spine surgeries. The authors excluded any procedures with intended durotomy, such as tethered cord release or spinal cord tumor resection...
August 3, 2018: Journal of Neurosurgery. Pediatrics
Xinghai Yang, Shaohui He, Jian Yang, Dongyu Peng, Jian Jiao, Weibo Liu, Chen Ye, Tielong Liu, Haifeng Wei, Jianru Xiao
PURPOSE: Osteotomy through anterior exposure is challenging with severe complications for upper cervical kyphosis (CK), especially for cases with previous anterior fusion. A novel technique regarding one-stage osteotomy via posterolateral-only approach is introduced for the treatment of CK secondary to C2-C4 laminectomy for neurofibroma removal and subsequent anterior fusion. METHODS: A 42-year-old patient was presented to our department with progressive numbness and weakness of upper and lower limbs...
July 28, 2018: World Neurosurgery
Qasim Zaidi, Olumide Danisa, Wayne Cheng
STUDY DESIGN: Systematic Review OBJECTIVE.: To evaluate the clinical utility of assessing bone quality using computed tomography (CT) attenuation in Hounsfield units (HU). SUMMARY OF BACKGROUND DATA: Assessing bone quality prior to spine instrumentation is an essential step of preoperative planning. Dual energy x-ray absorptiometry (DEXA) has been the gold standard for assessing bone mineral density (BMD), however DEXA can result in spuriously elevated BMD measurements in patients with degenerative disease, compression fractures and/or vascular calcifications...
July 30, 2018: Spine
Zhi Wang, Ghassan Boubez, Daniel Shedid, Sung Jo Yuh, Amer Sebaaly
Nonunion at the lumbosacral junction is a classic complication of long construct and deformity corrections. Iliac fixations have been extensively studied in the literature and have demonstrated superior biomechanical proprieties and lower complication rates. S2 alar iliac screws address the drawbacks of classical iliac screws but demonstrate similar biomechanical advantage. The main aim of this paper was to describe the S1 alar iliac (S1AI) screw fixation technique while evaluating our early results. S1AI screw fixation technique has the advantage of being able to achieve pelvic fixation without dissection to the S2 pedicle entry and is therefore a viable option for salvage of a failed S1 promontory screw...
August 2018: Asian Spine Journal
Vibhu Krishnan Viswanathan, Surabhi Subramanian, Sushma Viswanathan
STUDY DESIGN: Radiological cohort study. PURPOSE: The options of posteriorly stabilizing C7 vertebra include using lateral mass, pedicle or lamina, as bony anchors. The current study is a computed tomography (CT)-based morphometric analysis of C7 vertebra of 100 Indian patients and discusses the feasibility of these different techniques. OVERVIEW OF LITERATURE: C7 is a peculiar vertebra with unique anatomy, which poses challenges for each of these fixation modalities...
August 2018: Asian Spine Journal
Akira Matsumura, Takashi Namikawa, Minori Kato, Shoichiro Oyama, Yusuke Hori, Akito Yabu, Noriaki Hidaka, Hiroaki Nakamura
STUDY DESIGN: Retrospective comparative study. PURPOSE: To compare the incidence of proximal junctional kyphosis (PJK) between transverse process hooks (TPHs) and pedicle screws (PSs) at the upper instrumented vertebrae (UIV) following adult spinal deformity (ASD) surgery. OVERVIEW OF LITERATURE: The choice of UIV implant type may be important for avoiding PJK; however, few comparative clinical studies have evaluated the incidence of PJK according to the type of UIV implant used in ASD surgery...
August 2018: Asian Spine Journal
Vicky Varghese, Venkatesh Krishnan, Gurunathan Saravana Kumar
STUDY DESIGN: A biomechanical study of pedicle-screw pullout strength. PURPOSE: To develop a decision tree based on pullout strength for evaluating pedicle-screw instrumentation. OVERVIEW OF LITERATURE: Clinically, a surgeon's understanding of the holding power of a pedicle screw is based on perioperative intuition (which is like insertion torque) while inserting the screw. This is a subjective feeling that depends on the skill and experience of the surgeon...
August 2018: Asian Spine Journal
M Shahnaz Hasan, Jin-Keat Tan, Chris Yin Wei Chan, Mun Keong Kwan, Fathil Syafiq Abdul Karim, Khean-Jin Goh
BACKGROUND: Drugs used in anesthesia can affect somatosensory evoked potential (SSEP) monitoring, which is used routinely for intraoperative monitoring of spinal cord integrity during spinal surgery. OBJECTIVE: The objective of this study was to determine whether combined total intravenous anesthesia (TIVA) technique with propofol/remifentanil is associated with less SSEP suppression when compared to combined volatile agent desflurane/remifentanil anesthesia during corrective scoliosis surgery at a comparable depth of anesthesia...
May 2018: Journal of Orthopaedic Surgery
Maximilian Lenz, Carolin Meyer, Christoph Kolja Boese, Jan Siewe, Peer Eysel, Max Joseph Scheyerer
Previous studies have shown coherence between obesity and higher rates of complications following spinal surgery. However, there is a lack of information about the influence of obesity and the mass of outer abdominal fat (OAF) on adjacent segment instability after spinal fusion surgery. Radiographs of 194 patients with spinal fusion surgery were assessed retrospectively. Radiographs were performed after surgery during two years' follow-up and signs of adjacent segment instability were documented. Patients were classified regarding their BMI and extent of OAF was assessed using CT at the umbilical level...
June 14, 2018: Orthopedic Reviews
Wen-Bin Liu, Wen-Tao Zhao, Peng Shen, Fu-Jiang Zhang
Purpose: We conducted a meta-analysis of controlled clinical trials to evaluate the efficacy of bisphosphonates in lumbar fusion. Introduction: Bisphosphonates reduce bone resorption and remodeling by osteoclast activity inhibition, inactivation, and apoptosis. However, it remains controversial whether bisphosphonate therapy affects spinal fusion. Methods: We searched MEDLINE, Cochrane CENTRAL, ScienceDirect, EMBASE, and Google Scholar to identify studies reporting the effects of bisphosphonates on osteoporotic patients after lumbar fusion...
2018: Drug Design, Development and Therapy
Taku Sugawara, Shuichi Kaneyama, Naoki Higashiyama, Shinya Tamura, Takuro Endo, Masato Takabatake, Masatoshi Sumi
STUDY DESIGN: A prospective clinical study of a multistep screw insertion method using a patient-specific screw guide template system (SGTS) for the cervical and thoracic spine. OBJECTIVE: To evaluate the efficacy of SGTS for inserting screws into the cervical and thoracic spine. SUMMARY OF BACKGROUND DATA: Posterior screw fixation is a standard procedure for spinal instrumentation; however, screw insertion carries the risk of injury to neuronal and vascular structures...
July 24, 2018: Spine
Xingwei Pu, Chunshan Luo, Tinsheng Lu, Shudan Yao, Qiling Chen
OBJECTIVES: To investigate the primary clinical value of atlantoaxial pedicle screw placement assisted by a modified 3D-printed navigation template. METHODS: We retrospectively analyzed the cases of 17 patients treated from June 2015 to September 2016 with atlantoaxial pedicle screw placement assisted by a modified 3D-printed navigation template. All procedures were performed prior to surgery, including thin-slice CT scanning, medical image sampling and computerized 3D modeling of the atlantoaxial joint, optimal pedicle screw trajectory determination, and anatomical trait acquisition for the atlantoaxial pedicle, spinous process of the axis, vertebral lamina and posterior lateral mass, and design of a reverse template...
July 19, 2018: Clinics
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