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pedicle screw

Shigeto Ebata, Tetsuro Ohba, Hiroki Oba, Hirotaka Haro
BACKGROUND: Surgery for adult spinal deformity requires optimal patient-specific spino-pelvic-lower extremity alignment. Distal fixation in thoracolumbar spinal deformity surgery is crucial when arthrodesis to the sacrum is indicated. Although we had performed sacro-pelvic fixation with bilateral S1 and bilateral single iliac screws previously, iliac screw loosening and/or S1 screw loosening occurred frequently. So, the authors attempted to fuse spino-pelvic lesions with the dual iliac screws and S1 pedicle screws...
October 19, 2018: Journal of Orthopaedic Surgery and Research
Zhao Meng, Chen Wang, Li-Jun Tian, Xue-Jun Zhang, Dong Guo, Yan Zou
BACKGROUND: Little data are available regarding the effects of pedicle screws on the intervertebral disc stress for different spinal segments. The aim of this study was to analyze the intervertebral disc stress in response to the placement of pedicle screws. METHODS: T3-4, T11-12, T15-L1, L3-4, and L4-5 intervertebral disc segments from six porcine spine specimens were harvested. A compressive load of 200 N was applied both before and after the pedicle screw was implanted on the left side of each target segment; the resulting pressure was measured during vertical, 5° anterior flexion, 5° posterior extension, and 5° lateral bending...
October 16, 2018: Journal of Orthopaedic Surgery and Research
Justin Arockiaraj, Magdalenal Robert, Winsley Rose, Rohit Amritanand, Kenny Samuel David, Venkatesh Krishnan
Study Design: Retrospective case series. Purpose: The aim of the study is to report the clinical characteristics, early diagnosis, management, and outcome of children with multidrug-resistant (MDR) tubercular spondylodiscitis and to assess the early detection of rifampicin resistance using the Xpert MTB/ RIF assay. Overview of Literature: MDR tuberculosis is on the rise, especially in developing countries. The incidence rate of MDR has been reported as 8...
October 18, 2018: Asian Spine Journal
Liujun Zhao, Jianqing Chen, Jiayong Liu, Lina Elsamaloty, Xiaochen Liu, Jie Li, Hossein Elgafy, Jihui Zhang, Leining Wang
BACKGROUND: Anterior cervical trans-pedicle screw fixation was introduced to overcome some of the disadvantages associated with anterior cervical corpectomy and fusion. In vitro biomechanical studies on the trans-pedicle screw fixation have shown excellent pull-out strength and favorable stability. Comprehensive biomechanical performance studies on the trans-pedicle screw fixation, however, are lacking. METHODS: The control computed tomography images (C2-T2) were obtained from a 22-year-old male volunteer...
October 11, 2018: Clinical Biomechanics
Dejan Knez, Janez Mohar, Robert J Cirman, Boštjan Likar, Franjo Pernuš, Tomaž Vrtovec
STUDY DESIGN: A comparison among preoperative pedicle screw placement plans, obtained from computed tomography (CT) images manually by two spine surgeons and automatically by a computer-assisted method. OBJECTIVE: To analyze and compare the manual and computer-assisted approach to pedicle screw placement planning in terms of the inter- and intraobserver variability. SUMMARY OF BACKGROUND DATA: Several methods for computer-assisted pedicle screw placement planning have been proposed; however, a systematic variability analysis against manual planning has not been performed yet...
November 1, 2018: Spine
Mahmood Ali Arbash, Ashik Mohsin Parambathkandi, Abdul Moeen Baco, Abduljabbar Alhammoud
Study Design: Retrospective review. Purpose: To detect the effect of cannulated (poly-axial head) and solid (mono-axial head) screws on the local kyphotic angle, vertebral body height, and superior and inferior angles between the screw and the rod in the surgical management of thoracolumbar fractures. Overview of Literature: Biomechanics studies showed that the ultimate load, yield strength, and cycles to failure were significantly lower with cannulated (poly-axial head) pedicle comparing to solid core (mono-axial head)...
October 16, 2018: Asian Spine Journal
Yogi Prabowo, Irsan Abubakar
INTRODUCTION: Giant Cell tumors (GCT) are benign tumors with potential for aggressive behavior and capacity to metastasize. Although considered to be benign tumors of bone, GCT has a relatively high recurrence rate. Tumor often extends to the articular subchondral bone or even abuts the cartilage. The joint and/or its capsule are rarely invaded. Surgical resection is the universal standard of care for the treatment of bone GCT. The key ensuring an adequate surgical treatment with complete removal of tumor is by obtaining adequate exposure of the lesion...
August 29, 2018: International Journal of Surgery Case Reports
Jose Ramirez-Villaescusa, Jesús López-Torres Hidalgo, Antonio Martin-Benlloch, David Ruiz-Picazo, Francisco Gomar-Sancho
OBJECT: Adjacent segment disease (ASD) has been described as a frequent complication after a lumbar spinal fusion procedure, though its incidence and the factors related to its appearance are not well established. The radiographic signs that identify ASD in unfused segments may be a consequence of biomechanical changes induced by the fusion procedure. This study sought to analyse the incidence of radiographic changes (radiographic ASD) in all adjacent unfused segments, the clinical changes that require a second procedure (clinical ASD), and the risk factors of their appearance evaluated at different follow-up times...
October 13, 2018: British Journal of Neurosurgery
Hiroshi Miyamoto, Terumasa Ikeda, Masao Akagi
PURPOSE: To elucidate the usefulness of the pedicle marker (PM) for more accurate insertion of cervical pedicle screws (CPSs). METHODS: Artificial bone study. Fifty pedicles of five artificial bone specimens were examined. PMs were inserted in five different positions (confirmed by computed tomography (CT)); (1) insertion angle correct, insertion point too medial, (2) both insertion angle and insertion point correct, (3) insertion angle correct, insertion point too lateral, (4) insertion point correct, insertion angle too big, and (5) insertion point correct, insertion angle too small...
October 10, 2018: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
Hiroshi Uei, Yasuaki Tokuhashi, Masafumi Maseda, Masahiro Nakahashi, Hirokatsu Sawada, Koji Matsumoto, Hiroyuki Miyakata
BACKGROUND: Proximal junctional kyphosis (PJK) following adult spinal deformity (ASD) surgery in elderly patients is markedly influenced by osteoporosis causing additional vertebral fracture and loosening of pedicle screws (PS). This study aimed to investigate the association between mean bone density represented in Hounsfield units (HU) on spinal computed tomography (CT) and revision surgery for PJK or postoperative additional vertebral fracture following ASD surgery in elderly patients...
October 12, 2018: Journal of Orthopaedic Surgery and Research
Wei Hu, Shun-Li Kan, Hui-Bin Xu, Ze-Gang Cao, Xue-Li Zhang, Ru-Sen Zhu
The aim of this study is to evaluate the safety and effectiveness in the treatment of thoracic aggressive vertebral hemangiomas (AVHs) with neurologic deficit by multiple surgical treatments.The clinical and radiographic data of 5 patients suffering from thoracic AVHs with neurologic deficit and treated by multiple surgical treatments, including percutaneous curved vertebroplasty (PCVP) combined with pedicle screw fixation and decompressive laminectomy, were reviewed and analyzed retrospectively.Five patients (3 women and 2 man, with a mean age of 57...
October 2018: Medicine (Baltimore)
Feng Tian, Lai-Yong Tu, Wen-Fei Gu, En-Feng Zhang, Zhen-Bin Wang, Ge Chu, Haer Ka, Jiang Zhao
BACKGROUND: To assess the safety and efficacy of percutaneous short-segment pedicle instrumentation compared with conventionally open short-segment pedicle instrumentation and provide recommendations for using these procedures to treat thoracolumbar fractures. METHODS: The Medline database, Cochrane database of Systematic Reviews, Cochrane Clinical Trial Register, and Embase were searched for articles published. The randomized controlled trials (RCTs) and non-RCTs that compared percutaneous short-segment pedicle instrumentation to open short-segment pedicle instrumentation and provided data on safety and clinical effects were included...
October 2018: Medicine (Baltimore)
Yong Huang, Ganjun Feng, Limin Liu, Xi Yang, Yueming Song, Chunguang Zhou, Lei Wang, Zhongjie Zhou
The treatment of congenital hemivertebrae in the upper thoracic region is challenging. The objective of this study was to investigate the outcomes of posterior hemivertebral resection for the upper thoracic region. Twenty-one patients diagnosed with upper thoracic congenital scoliosis were included. All of them received hemivertebral resection surgery via the posterior-only approach with at least 2 years of follow-up. The radiographic parameters and Scoliosis Research Society-22 score were analyzed. All the intraoperative and postoperative complications were recorded retrospectively...
October 10, 2018: Journal of Pediatric Orthopedics. Part B
Chia-Wei Chang, Tsung-Ting Tsai, Chi-Chien Niu, Tsai-Sheng Fu, Po-Liang Lai, Lih-Huei Chen, Wen-Jer Chen
BACKGROUND: Traditionally, non-operative management with long-term antibiotics and bed rest has been recommended as the first-line treatment for most post-operative discitis patients. However, a recent trend in treatment under a limited range of indications has been to perform surgical debridement followed by the long-term administration of antibiotics. This descriptive study investigated whether transforaminal lumbar interbdoy debridement and fusion (TLIDF) combined with intravenous antibiotics is appropriate to manage post-discectomy discitis...
October 8, 2018: World Neurosurgery
Qing-Bo Lv, Xiang Gao, Xiang-Xiang Pan, Hai-Ming Jin, Xiao-Ting Lou, Shu-Min Li, Ying-Zhao Yan, Cong-Cong Wu, Yan Lin, Wen-Fei Ni, Xiang-Yang Wang, Ai-Min Wu
Purpose: The purpose of this study was to investigate finite element biomechanical properties of the novel transpedicular transdiscal (TPTD) screw fixation with interbody arthrodesis technique in lumbar spine. Methods: An L4-L5 finite element model was established and validated. Then, two fixation models, TPTD screw system and bilateral pedicle screw system (BPSS), were established on the validated L4-L5 finite element model. The inferior surface of the L5 vertebra was set immobilised, and moment of 7...
October 2018: Journal of Orthopaedic Translation
Werner Schmoelz, Alexander Keiler, Marko Konschake, Richard A Lindtner, Alessandro Gasbarrini
BACKGROUND: Pedicle screws can be augmented with polymethylmethacrylate (PMMA) cement through cannulated and fenestrated pedicle screws to improve screw anchorage. To overcome the drawbacks of PMMA, a modified augmentation technique applying a self-curing elastomeric material into a balloon-created cavity prior to screw insertion was developed and evaluated. The aim of the study was to compare the effect of the established and novel augmentation technique on pedicle screw anchorage in a biomechanical in vitro experiment...
October 11, 2018: Journal of Orthopaedic Surgery and Research
Zhongyang Xu, Yanping Zheng
OBJECTIVE: To investigate the safety and efficacy of percutaneous endoscopic debridement and irrigation for thoracic infections and to make an appropriate choice according to the patient's condition. METHODS.: Thirty patients with thoracic infections who received surgical treatment from August 2014 to December2016 were retrospectively analyzed. There were 16 males and 14 females, aged from 41 to 90 years, with an average of 64.4 years. A total of 9 cases were treated with percutaneous endoscopic debridement and irrigation (minimal group), and 21 cases were treated with open debridement in combination with pedicle screw fixation (conventional group)...
June 2018: Revista da Associação Médica Brasileira
John H Chi, Kurt M Eichholz, Paul A Anderson, Paul M Arnold, Andrew T Dailey, Sanjay S Dhall, James S Harrop, Daniel J Hoh, Sheeraz Qureshi, Craig H Rabb, P B Raksin, Michael G Kaiser, John E O'Toole
BACKGROUND: Treatment of thoracolumbar burst fractures has traditionally involved spinal instrumentation with fusion performed with standard open surgical techniques. Novel surgical strategies, including instrumentation without fusion and percutaneous instrumentation alone, have been considered less invasive and more efficient treatments. OBJECTIVE: To review the current literature and determine the role of fusion in instrumented fixation, as well as the role of percutaneous instrumentation, in the treatment of patients with thoracolumbar burst fractures...
October 8, 2018: Neurosurgery
Wei Fan, Li-Xin Guo
This study aimed to examine breakage risk of the bilateral pedicle screw (BPS) fixation system under static and vibration loadings after three different types of lumbar interbody fusion surgery. A previously validated intact L1-sacrum finite element model was modified to simulate anterior, posterior and transforaminal lumbar interbody fusion (ALIF, PLIF and TLIF) with BPS fixation system (consisting of pedicle screws and rigid connecting rods) at L4-L5. As a risk parameter for breakage, the von Mises stresses in the pedicle screws and the rods for the ALIF, PLIF and TLIF models under static loading (flexion, extension, lateral bending and axial torsion moments) and vibration loading (sinusoidal vertical load) were calculated and compared...
October 7, 2018: International Journal for Numerical Methods in Biomedical Engineering
G Sudhir, Nitin Maruti Adsul, Shankar Acharya, Rupinder S Chahal
Background: Compartment syndromes have been reported in nearly every anatomical area of the extremities. Similarly, in the lumbar spine, there is a risk of a compartment syndrome following either direct or indirect injury to the paraspinal muscles. In this study, we present a case of lumbar paraspinal compartment syndrome after percutaneous pedicle screw fixation for a spine fracture. Case Description: A 27-year-old obese female sustained a fall and an L1 fracture...
2018: Surgical Neurology International
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