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Lumbar instrumentation

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https://www.readbyqxmd.com/read/28225365/magnitude-location-and-factors-related-to-regional-and-global-sagittal-alignment-change-in-long-adult-deformity-constructs-report-of-183-patients-with-2-year-follow-up
#1
Alexander A Theologis, Michael Safaee, Justin K Scheer, Virginie Lafage, Rick Hostin, Robert A Hart, Eric O Klineberg, Themistocles S Protopsaltis, Vedat Deviren, Douglas C Burton, Daniel M Sciubba, Khaled Kebaish, Shay Bess, Christopher I Shaffrey, Frank Schwab, Justin S Smith, Christopher P Ames
STUDY DESIGN: This is a retrospective review of a prospective multicenter adult spinal deformity (ASD) database. OBJECTIVE: To quantify the location and magnitude of sagittal alignment changes within instrumented and noninstrumented spinal segments and to investigate the factors associated with these changes after surgery for ASD. SUMMARY OF BACKGROUND DATA: Spinal realignment is one of the major goals in ASD surgery and changes in the alignment are common following surgical correction...
February 20, 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28223688/sequence-variant-at-8q24-21-associates-with-sciatica-caused-by-lumbar-disc-herniation
#2
Gyda Bjornsdottir, Stefania Benonisdottir, Gardar Sveinbjornsson, Unnur Styrkarsdottir, Gudmar Thorleifsson, G Bragi Walters, Aron Bjornsson, Ingvar H Olafsson, Elfar Ulfarsson, Arnor Vikingsson, Ragnheidur Hansdottir, Karl O Karlsson, Thorunn Rafnar, Ingileif Jonsdottir, Michael L Frigge, Augustine Kong, Asmundur Oddsson, Gisli Masson, Olafur T Magnusson, Tomas Gudbjartsson, Hreinn Stefansson, Patrick Sulem, Daniel Gudbjartsson, Unnur Thorsteinsdottir, Thorgeir E Thorgeirsson, Kari Stefansson
Lumbar disc herniation (LDH) is common and often debilitating. Microdiscectomy of herniated lumbar discs (LDHsurg) is performed on the most severe cases to resolve the resulting sciatica. Here we perform a genome-wide association study on 4,748 LDHsurg cases and 282,590 population controls and discover 37 highly correlated markers associating with LDHsurg at 8q24.21 (between CCDC26 and GSDMC), represented by rs6651255[C] (OR=0.81; P=5.6 × 10(-12)) with a stronger effect among younger patients than older. As rs6651255[C] also associates with height, we performed a Mendelian randomization analysis using height polygenic risk scores as instruments to estimate the effect of height on LDHsurg risk, and found that the marker's association with LDHsurg is much greater than predicted by its effect on height...
February 22, 2017: Nature Communications
https://www.readbyqxmd.com/read/28222402/impact-of-anchor-type-on-porcine-lumbar-biomechanics-finite-element-modelling-and-in-vitro-validation
#3
Martin Brummund, Vladimir Brailovski, Yvan Petit, Yann Facchinello, Jean-Marc Mac-Thiong
BACKGROUND: Rigid posterior implants used for spinal stabilization can be anchored to the vertebrae using pedicle screws or screws combined with transverse process hooks. In the present study, a finite element model of a porcine lumbar spine instrumented with screws and hooks is presented and validated. METHODS: The porcine lumbar spine model was validated using in-vitro measurements on six porcine specimens. Validation metrics included intervertebral rotations (L1 to L6) and nucleus pressure in the topmost cranial instrumented disc...
February 14, 2017: Clinical Biomechanics
https://www.readbyqxmd.com/read/28221177/semirigid-waved-rod-system-for-the-treatment-of-the-degenerative-lumbar-diseases
#4
Lei Wang, Dasheng Lin, Weitao Zou, Hui Liu, Kejian Lian
BACKGROUND: The semirigid pedicle screw instrumentation has gained wide popularity in recent decennium in lumbar fusion surgery. However, few data were documented to compare the clinical efficacy between semirigid and traditional rigid pedicle screw systems. MATERIALS AND METHODS: A total of 96 patients with degenerative lumbar diseases were selected to perform operations between 2008 and 2013. The patients were prospectively randomized into 2 groups: 50 patients were managed by semirigid waved rod systems and 46 patients were intervened by traditional rigid straight stiff rod systems...
February 17, 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28216210/prevention-of-proximal-junctional-kyphosis-are-polyaxial-pedicle-screws-superior-to-monoaxial-pedicle-screws-at-the-upper-instrumented-vertebrae
#5
Hui Wang, Wenyuan Ding, Lei Ma, Lijun Zhang, Dalong Yang
INTRODUCTION: Evidence regarding whether the polyaxial pedicle screws at the upper instrumented vertebrae (UIV) are superior to monoaxial pedicle screws in prevention of proximal junctional kyphosis (PJK) is less clear. The aim of this study was therefore to explore the influence of different type of pedicle screws at UIV on the incidence of PJK. METHODS: 242 patients surgically treated with instrumented segmental posterior spinal fusion at a minimum 4 motion segments were reviewed retrospectively...
February 12, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28207660/predictors-of-distal-adding-on-in-thoracic-major-curves-with-ar-lumbar-modifiers
#6
Joshua S Murphy, Vidyadhar V Upasani, Burt Yaszay, Tracey P Bastrom, Carrie E Bartley, Amer Samdani, Lawrence G Lenke, Peter O Newton
STUDY DESIGN: Retrospective review of prospectively collected data. OBJECTIVE: To determine whether the last substantially touched vertebra (LSTV) is a valid lowest instrumented vertebra (LIV) for both Lenke 1 and 2 curve patterns with AR lumbar modifiers, and to identify preoperative risk factors of distal adding-on. SUMMARY OF BACKGROUND DATA: Previous studies have recommended selecting the LSTV as the LIV for Lenke 1AR curves (main thoracic curve with A lumbar modifier and L4 tilt to the right (thoracic overhang/King type IV curve)...
February 15, 2017: Spine
https://www.readbyqxmd.com/read/28207621/mri-based-decision-making-of-implant-removal-in-deep-wound-infection-after-instrumented-lumbar-fusion
#7
Masahiro Kanayama, Tomoyuki Hashimoto, Keiichi Shigenobu, Fumihiro Oha, Akira Iwata, Masaru Tanaka
STUDY DESIGN: A retrospective study. OBJECTIVE: The aim of the study was to review the treatment of deep wound infection after posterior instrumented lumbar fusion, and thereby to optimize the decision-making process of implant removal or retention on the basis of magnetic resonance imaging (MRI) assessment. SUMMARY OF BACKGROUND DATA: Biofilm formed on the surface of the spinal implant prevents infiltration of antibiotics and makes the infection treatment more complicated...
March 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28207620/maintenance-of-segmental-lordosis-and-disk-height-in-stand-alone-and-instrumented-extreme-lateral-interbody-fusion-xlif
#8
Gregory M Malham, Ngaire J Ellis, Rhiannon M Parker, Carl M Blecher, Rohan White, Ben Goss, Kevin A Seex
STUDY DESIGN: A prospective single-surgeon nonrandomized clinical study. OBJECTIVE: To evaluate the radiographic and clinical outcomes, by fixation type, in extreme lateral interbody fusion (XLIF) patients and provide an algorithm for determining patients suitable for stand-alone XLIF. SUMMARY OF BACKGROUND DATA: XLIF may be supplemented with pedicle screw fixation, however, since stabilizing structures remain intact, it is suggested that stand-alone XLIF can be used for certain indications...
March 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28204925/circumferential-fusion-for-degenerative-lumbar-spondylolisthesis-complicated-by-distal-junctional-grade-4-spondylolisthesis-in-the-sub-acute-post-operative-setting
#9
Alexander A Theologis, Deeptee Jain, Christopher P Ames, Murat Pekmezci
INTRODUCTION: Surgical management for lumbar stenosis is generally safe and provides significant improvements in pain, disability, and function. Successful lumbar decompression hinges on removing an appropriate amount of lamina and other compressive pathology in the lateral recess. Too little bony decompression can result in persistent pain and disability, while over resection of the pars and/or facets may jeopardize spinal stability. CASE REPORT: In this unique report, we present for the first time an acute iatrogenic grade 4 L5-S1 spondylolisthesis distal to a L3-5 laminectomy and circumferential instrumented fusion due to bilateral iatrogenic L5 pars fractures and its management and clinical outcomes after revision operation...
February 15, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28199880/is-pelvic-fixation-the-only-option-to-provide-additional-stability-to-the-sacral-anchorage-in-long-lumbar-instrumentation-a-comparative-biomechanical-study-of-new-techniques
#10
David Volkheimer, Heiko Reichel, Hans-Joachim Wilke, Friederike Lattig
BACKGROUND: Supplementary iliac screws have the highest potential to protect S1-pedicle-screws from loosening in long fusion constructs. However, this technique bridges the iliosacral joint with potential disadvantages for the patient. This study aimed to evaluate if two different established fixation techniques can be used in addition to pedicle screws as alternative to iliac screws, and if these two techniques can provide similar stability when S1-pedicle-screws are loosened. METHODS: Flexibility testing with pure moments of 7...
February 8, 2017: Clinical Biomechanics
https://www.readbyqxmd.com/read/28193137/risk-factors-for-adjacent-segment-degeneration-after-iliac-screw-fixation-in-lumbar-degenerative-kyphoscoliosis
#11
Sang-Il Kim, Kee-Yong Ha, Dong-Whan Suh, In-Soo Oh
PURPOSE: To analyze pre- and postoperative spinopelvic parameters and sagittal profiles in lumbar degenerative kyphoscoliosis (LDK) patients who underwent surgery using iliac screw (IS) and the incidence and risk factor of radiological adjacent segment degeneration (ASD). METHODS: A total of 32 patients, who had undergone surgical correction and lumbar/thoracolumbar fusion with pedicle screws and IS instrumentation for LDK with a minimum 2-year follow-up, were included...
January 2017: Journal of Orthopaedic Surgery
https://www.readbyqxmd.com/read/28187070/proximal-junctional-kyphosis-after-posterior-spinal-instrumentation-and-fusion-in-young-children-with-congenital-scoliosis-a-preliminary-report-on-its-incidence-and-risk-factors
#12
Xi Chen, Zhong-Hui Chen, Yong Qiu, Ze-Zhang Zhu, Song Li, Liang Xu, Xu Sun
STUDY DESIGN: A retrospective study. OBJECTIVE: To determine the incidence and risk factors of proximal junctional kyphosis (PJK) in young children who underwent posterior instrumented spinal fusion. SUMMARY OF BACKGROUND DATA: PJK is a well-recognized postoperative complication in adults and adolescents. However, there is a paucity of valid data with regard to PJK in young children with congenital scoliosis who were treated with posterior correction surgery...
February 9, 2017: Spine
https://www.readbyqxmd.com/read/28185981/analysis-of-the-s2-alar-iliac-screw-as-compared-with-the-traditional-iliac-screw-does-it-increase-stability-with-sacroiliac-fixation-of-the-spine
#13
Daniel G Hoernschemeyer, Troy D Pashuck, Ferris M Pfeiffer
BACKGROUND CONTEXT: Arthrodesis of the lumbosacral junction continues to be a challenge in pediatric and adult spinal deformity surgery. PURPOSE: To evaluate the biomechanical rigidity of two types of lumbosacral fixation. Our hypothesis was that the use of S2 alar-iliac (S2AI) fixation will result in statistically similar biomechanical fixation as compared with use of an iliac screw with a 95% confidence interval. STUDY SETTING: Controlled biomechanical laboratory METHODS: Ten human cadaveric lumbosacral specimens were separated into two test groups: (1) S2AI (n=5) and (2) iliac screw (n=5)...
February 6, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28169957/comparison-of-surgical-outcome-of-adolescent-idiopathic-scoliosis-and-young-adult-idiopathic-scoliosis-a-match-pair-analysis-of-160-patients
#14
Feng Zhu, Hongda Bao, Peng Yan, Shunan Liu, Zezhang Zhu, Zhen Liu, Mike Bao, Yong Qiu
STUDY DESIGN: Retrospective study OBJECTIVE.: To investigate if the surgical outcome of young adults was equivalent to adolescents for surgical correction of thoracic adolescent idiopathic scoliosis (AIS). SUMMARY OF BACKGROUND DATA: Despite numerous reports on the satisfactory surgical correction, some AIS patients or families still have the assumption that delay of surgery into young adulthood may be more beneficial. Hence, the strict paired analysis of clinical outcome between AIS and adult idiopathic scoliosis (AdIS) is required, which lacks report in the current literatures...
February 6, 2017: Spine
https://www.readbyqxmd.com/read/28168338/radiation-exposure-to-the-patients-in-thoracic-and-lumbar-spine-fusion-using-a-new-intraoperative-cone-beam-computed-tomography-imaging-technique-a-preliminary-study
#15
Ludovic Kaminski, V Cordemans, O Cartiaux, M Van Cauter
PURPOSE: The goals of this paper are to assess the ionizing radiation exposure to the patients during thoracic and lumbar spinal fusion using a new intraoperative 3D imaging system and to evaluate the factors that could explain the variability in the observed doses. METHOD: We retrospectively reviewed 97 patients who underwent posterior instrumented thoracic and/or lumbar spinal fusion from December 2013 to November 2014. Primary data were the total dose area product (total DAP, Gy cm(2)) and total skin dose (total SD, mGy)...
February 6, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28161752/reversibility-of-nerve-root-sedimentation-sign-in-lumbar-spinal-stenosis-patients-after-decompression-surgery
#16
Christian Barz, Markus Melloh, Lukas P Staub, Sarah J Lord, Harry R Merk, Thomas Barz
PURPOSE: The nerve root sedimentation sign (SedSign) is a magnetic resonance imaging (MRI) sign for the diagnosis of lumbar spinal stenosis (LSS). It is included in the assessment of LSS to help determine whether decompression surgery is indicated. Assessment of the reversibility of the SedSign after surgery may also have clinical implications for the decision about whether or not a secondary operation or revision is needed. This study investigated if lumbar decompression leads to a reversal of the SedSign in patients with LSS and a positive SedSign pre-operatively; and if a reversal is associated with more favourable clinical outcomes...
February 4, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28159488/lateral-lumbar-retroperitoneal-transpsoas-approach-in-the-setting-of-spondylodiscitis-a-technical-note
#17
George M Ghobrial, Fadi Al-Saiegh, Daniel Franco, Daniel Benito, Joshua Heller
Thoracolumbar spondylodiscitis is a morbid disease entity, impacting a sick patient population with multiple comorbidities. Wherever possible, surgical measures in this population should limit the extent of soft tissue disruption and overall morbidity that is often associated with anteroposterior thoracolumbar decompression and fusion. The authors describe the rationale, technique, and use of the lateral lumbar transpsoas retroperitoneal approach in tandem with posterior decompression and instrumented fusion in the treatment of circumferential thoracolumbar spondylodiscitis with or without epidural abscesses...
January 31, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28157811/one-stage-surgical-management-for-lumbar-brucella-spondylitis-by-posterior-debridement-autogenous-bone-graft-and-instrumentation-a-case-series-of-24-patients
#18
Yangbin Chen, Jun-Song Yang, Tao Li, Peng Liu, Tuan-Jiang Liu, Li-Min He, Li-Xiong Qian, Ding-Jun Hao
STUDY DESIGN: Clinical case series. OBJECTIVE: To explore the efficacy and safety of one-stage debridement, autogenous bone graft and instrumentation for lumbar brucella spondylitis (LBS) via a posterior approach. SUMMARY OF BACKGROUND DATA: Reports on LBS are sporadic, and the therapeutic effect and safety of surgical interventions have not been assessed in clinical studies. METHODS: Between January 2012 and January 2014, 24 consecutive patients with symptomatic LBS who underwent a one-stage operation that combined debridement, autogenous bone graft and instrumentation via a posterior approach were enrolled...
February 2, 2017: Spine
https://www.readbyqxmd.com/read/28156208/image-guided-intrathecal-baclofen-pump-catheter-implantation-a-technical-note-and-case-series
#19
Shenandoah Robinson, Faith C Robertson, Hormuzdiyar H Dasenbrock, Cormac P O'Brien, Charles Berde, Horacio Padua
OBJECTIVE Medically refractory spasticity and dystonia are often alleviated with intrathecal baclofen (ITB) administration through an indwelling catheter inserted in the lumbar spine. In patients with cerebral palsy, however, there is a high incidence of concomitant neuromuscular scoliosis. ITB placement may be technically challenging in those who have severe spinal deformity or who have undergone prior instrumented thoracolumbar fusion. Although prior reports have described drilling through the lumbar fusion mass with a high-speed bur, as well as IT catheter implantation at the foramen magnum or cervical spine, these approaches have notable limitations...
February 3, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28156207/is-lumbar-facet-fusion-biomechanically-equivalent-to-lumbar-posterolateral-onlay-fusion
#20
Jeffrey M Toth, Kevin T Foley, Mei Wang, Howard B Seim, A Simon Turner
OBJECTIVE This study was designed with the following research objectives: 1) to determine the efficacy of facet fusion with recombinant human bone morphogenetic protein-2 (rhBMP-2) on an absorbable collagen sponge (ACS) in an ovine lumbar facet fusion model; 2) to radiographically and histologically compare the efficacy of lumbar facet fusion with rhBMP-2/ACS to facet fusion with an iliac crest bone graft (ICBG); and 3) to biomechanically compare lumbar facet fusion with rhBMP-2/ACS to lumbar posterolateral fusion (PLF) with ICBG...
February 3, 2017: Journal of Neurosurgery. Spine
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