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Lumbar instrumentation

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https://www.readbyqxmd.com/read/28431396/skeletal-muscle-measures-and-physical-function-in-older-adults-with-cancer-sarcopenia-or-myopenia
#1
Grant R Williams, Allison M Deal, Hyman B Muss, Marc S Weinberg, Hanna K Sanoff, Kirsten A Nyrop, Mackenzi Pergolotti, Shlomit Strulov Shachar
BACKGROUND: Skeletal muscle loss, commonly known as sarcopenia, is highly prevalent in older adults and linked with adverse outcomes in cancer, yet the definition and role of sarcopenia remains uncertain. The aim of this study was to examine the association of Computerized Tomography (CT) assessed skeletal muscle measures with physical function in older adults with cancer. RESULTS: CTs for 185 patients were available. Median age 73 (IQR 68-76) and 56.5% female. After controlling for sex and BMI, we found no evidence that SMI was associated with physical function impairments...
April 5, 2017: Oncotarget
https://www.readbyqxmd.com/read/28416437/the-ct-based-fractal-analysis-of-trabecular-bone-structure-may-help-in-detecting-decreased-quality-of-bone-prior-to-urgent-spinal-procedures
#2
Marcin Czyz, Arion Kapinas, James Holton, Renata Pyzik, Bronek M Boszczyk, Nasir A Quraishi
BACKGROUND CONTEXT: To date no reliable method is available to determine the parameters of bone density based on the routine spinal CT in the emergency setup. We propose the use of fractal analysis to detect patients with poor quality of bone prior to urgent or semi-urgent spinal procedures. PURPOSE: To validate the hypothesis that the CT-based fractal analysis of the trabecular bone structure may help in detecting patients with poor quality of bone prior to urgent spinal procedures...
April 14, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28410566/biomechanical-effect-of-interspinous-process-distraction-height-after-lumbar-fixation-surgery-an-in-vitro-model
#3
Lin Fu, Jianxiong Ma, Bin Lu, Haobo Jia, Jie Zhao, Mingjie Kuang, Rui Feng, Liyan Xu, Haohao Bai, Lei Sun, Ying Wang, Xinlong Ma
Pedicle screw fixation may induce abnormal activity at adjacent segment and accelerate the degeneration of lumbar vertebrae. Dynamic stabilizers could provide an intermediate solution between conservative treatment and fusion surgery. Lumbar vertebral segment cephalad to instrumented fixation was the most common localization of adjacent segment degeneration. The aim of this study is to explore the use of interspinous process devices in the lumbar vertebral segment cephalad to fixation segment in changing the mechanical distribution and limiting abnormal activity of the spine...
April 1, 2017: Proceedings of the Institution of Mechanical Engineers. Part H, Journal of Engineering in Medicine
https://www.readbyqxmd.com/read/28400658/complication-rate-during-multilevel-lumbar-fusion-in-patients-above-60-years
#4
Bijjawara Mahesh, Bidre Upendra, S Vijay, Gc Arun Kumar, Srinivas Reddy
BACKGROUND: Spine surgery in elderly with comorbidities is reported to have higher complication rates and increased cost. However, the surgical outcome is good irrespective of the complications. Hence, it is essential to identify the factors affecting the complication rates in such patients and the measures to reduce them. This retrospective observational study determines the perioperative complications, their incidence and the measures to reduce complications in the elderly with comorbidities, operated by instrumented multilevel lumbar fusion...
March 2017: Indian Journal of Orthopaedics
https://www.readbyqxmd.com/read/28400657/transforaminal-lumbar-interbody-fusion-versus-instrumented-posterolateral-fusion-in-grade-i-ii-spondylolisthesis
#5
Shanmugasundaram Pooswamy, Niranjanan Raghavn Muralidharagopalan, Sivasubramaniam Subbaiah
BACKGROUND: Spondylolisthesis refers to slippage of one vertebra over the other, which may be caused by a variety of reasons such as degenerative, trauma, and isthmic. Surgical management forms the mainstay of treatment to prevent further slip and worsening. However, there is no consensus regarding the best surgical option to treat these patients. This study compares TLIF and instrumented PLF in patients with Grade I and II spondylolisthesis and analysis the outcome with respect to functional outcome, pain, fusion rate, adequacy of medial facetectomy for decompression, and complications...
March 2017: Indian Journal of Orthopaedics
https://www.readbyqxmd.com/read/28399557/radiological-results-and-clinical-patient-outcome-after-implantation-of-a-hydraulic-expandable-vertebral-body-replacement-following-traumatic-vertebral-fractures-in-the-thoracic-and-lumbar-spine-a-3-year-follow-up
#6
Michael Kreinest, Dorothee Schmahl, Paul A Grützner, Stefan Matschke
STUDY DESIGN: A prospective monocentric study. OBJECTIVE: The aim of the current study was the analysis of patient outcome and radiological results 3 years after implantation of a hydraulic expandable vertebral body replacement (VBR) system. SUMMARY OF BACKGROUND DATA: Around 70% to 90% of all traumatic spinal fractures are located in the thoracic and lumbar spine. Dorso-ventral stabilization is a frequently used procedure in traumatic vertebral body fracture treatment...
April 15, 2017: Spine
https://www.readbyqxmd.com/read/28387967/intraoperative-biomechanics-of-lumbar-pedicle-screw-loosening-following-successful-arthrodesis
#7
Hope B Pearson, Christopher J Dobbs, Eric Grantham, Glen L Niebur, James L Chappuis, Joel D Boerckel
Pedicle screw loosening has been implicated in recurrent back pain after lumbar spinal fusion, but the degree of loosening has not been systematically quantified in patients. Instrumentation removal is an option for patients with successful arthrodesis, but remains controversial. Here, we quantified pedicle screw loosening by measuring screw insertion and/or removal torque at high statistical power (β = 0.98) in N = 108 patients who experienced pain recurrence despite successful fusion after posterior instrumented lumbar fusion with anterior lumbar interbody fusion (L2-S1)...
April 7, 2017: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
https://www.readbyqxmd.com/read/28385519/complications-and-readmission-after-lumbar-spine-surgery-in-elderly-patients-an-analysis-of-2-320-patients
#8
Ahmed Saleh, Caroline Thirukumaran, Addisu Mesfin, Robert W Molinari
BACKGROUND CONTEXT: There is a paucity of literature describing risk factors for adverse outcomes after geriatric lumbar spinal surgery. As the geriatric population increases, so does the number of lumbar spinal surgeries in this cohort. PURPOSE: The purpose of the study is to determine how safe is lumbar surgery in elderly patients? Does patient selection, type of surgery, length of surgery, and other elderly patient comorbidities affect complication and readmission rates after surgery? STUDY DESIGN/SETTING: Retrospective Cohort Study PATIENT SAMPLE: American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) Database...
April 3, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28382391/maverick-total-disc-arthroplasty-performs-well-at-10%C3%A2-years-follow-up-a-prospective-study-with-hrql-and-balance-analysis
#9
N Plais, X Thevenot, A Cogniet, J Rigal, J C Le Huec
PURPOSE: The treatment of low back pain associated to Disc Degenerative Disease (DDD) is still controversial. Segmental Fusion is the gold standard, but many studies have reported that motion-preserving devices bring substantial clinical benefits to patients. Concerns on the associated complications and on the long-term clinical effectiveness of such instrumentations are still present and have led recently to a decrease of the number of Lumbar Total Disk Replacements (TDR). The objective of this prospective study is to present the clinical and radiographic outcomes of the Maverick Lumbar disk prostheses (Medtronic, TE, Memphis, USA) at long-term follow-up...
April 5, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28377862/arthrodesis-rate-and-patient-reported-outcomes-after-anterior-lumbar-interbody-fusion-utilizing-a-plasma-sprayed-titanium-coated-peek-interbody-implant-a-retrospective-observational-analysis
#10
Joseph A Sclafani, Sophea R Bergen, Miranda Staples, Kevin Liang, Ramin Raiszadeh
BACKGROUND: Anterior lumbar interbody fusion (ALIF) is utilized in symptomatic spinal disc destabilization due to degenerative lumbar disc disease, isthmic and degenerative spondylolisthesis, internal disc disruption, or pseudarthrosis after non-operative treatments fail. The addition of a plasma-sprayed titanium coating (PTC) to polyether ether ketone spacers (PEEK) may reduce the rate of implant subsidence or non-union secondary to poor osseous-integration of non-coated PEEK or metal interbody systems...
2017: International Journal of Spine Surgery
https://www.readbyqxmd.com/read/28374330/timing-of-pmma-cement-application-for-pedicle-screw-augmentation-affects-screw-anchorage
#11
Werner Schmoelz, Christian Heinz Heinrichs, Sven Schmidt, Angel R Piñera, Felix Tome-Bermejo, Javier M Duart, Marlies Bauer, Luis Álvarez Galovich
INTRODUCTION: Cement augmentation is an established method to increase the pedicle screw (PS) anchorage in osteoporotic vertebral bodies. The ideal timing for augmentation when a reposition maneuver is necessary is controversial. While augmentation of the PS before reposition maneuver may increase the force applied it on the vertebrae, it bears the risk to impair PS anchorage, whereas augmenting the PS after the maneuver may restore this anchorage and prevent early screw loosening. The purpose of the present study was to evaluate the effect of cement application timing on PS anchorage in the osteoporotic vertebral body...
April 3, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28373082/five-major-controversial-issues-about-fusion-level-selection-in-corrective-surgery-for-adolescent-idiopathic-scoliosis-a-narrative-review
#12
REVIEW
Choon Sung Lee, Chang Ju Hwang, Dong-Ho Lee, Jae Hwan Cho
BACKGROUND CONTEXT: Shoulder imbalance, coronal decompensation, and adding-on phenomenon following corrective surgery in adolescent idiopathic scoliosis patients are known to be related to the fusion level selected. Although many studies have assessed the appropriate selection of the proximal and distal fusion level, no definite conclusions have been drawn thus far. PURPOSE: We aimed to assess the problems with fusion level selection for corrective surgery in patients with adolescent idiopathic scoliosis, and to enhance understanding about these problems...
March 31, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28373080/is-a-gradual-reduction-of-stiffness-on-top-of-posterior-instrumentation-possible-with-a-suitable-proximal-implant-a-biomechanical-study
#13
Tobias Lange, Werner Schmoelz, Georg Gosheger, Martin Eichinger, Christian H Heinrichs, Albert Schulze Bövingloh, Tobias L Schulte
BACKGROUND CONTEXT: Proximal junctional kyphosis (PJK) is a challenging complication after rigid posterior instrumentation (RI) of the spine. Several risk factors have been described in literature so far, including the rigidity of the cranial aspect of the implant. PURPOSE: The aim of this biomechanical study was to compare different proximal implants designed to gradually reduce the stiffness between the instrumented and non-instrumented spine. STUDY DESIGN/SETTING: This is a biomechanical study...
March 31, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28371922/effectiveness-of-percutaneous-lumbar-extraforaminotomy-in-patients-with-lumbar-foraminal-spinal-stenosis-a-prospective-single-armed-observational-pilot-study
#14
Sang Chul Lee, Won-Joong Kim, Chang-Soon Lee, Jee Youn Moon
Objective. : In lumbar foraminal spinal stenosis (LFSS), numerous ligaments may play an important role in causing radiculopathy by narrowing the exit of the nerve root. In order to achieve effective decompression of lumbar foraminal ligaments, a specially designed instrument for percutaneous lumbar extraforaminotomy (PLEF) was invented. The purpose of this study was to evaluate the effectiveness of PLEF in patients with intractable radiculopathy from LFSS. Design. : A prospective, single-armed, observational pilot study...
March 22, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28365496/optimum-pelvic-incidence-minus-lumbar-lordosis-value-after-operation-for-patients-with-adult-degenerative-scoliosis
#15
Xiang-Yao Sun, Xi-Nuo Zhang, Yong Hai
BACKGROUND CONTEXT: Schwab classification for adult degenerative scoliosis (ADS) concluded that health-related quality of life (HRQOL) was closely related to curve type and three sagittal modifiers. It was suggested that pelvic incidence minus lumbar lordosis value (PI-LL) should be corrected within -10°~+10°. However, recent studies also indicated that ideal clinical outcomes could also be achieved in patients without ideal PI-LL mentioned above. PURPOSE: This study evaluated the relation between the clinical outcomes and the pelvic incidence minus lumbar lordosis value (PI-LL) of Chinese patients with ADS who received long posterior internal fixation and fusion...
March 29, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28343332/posterior-elements-disruption-with-hybrid-constructs-in-ais-patients-is-there-an-impact-on-proximal-junctional-kyphosis
#16
S Ghailane, Sebastien Pesenti, E Peltier, E Choufani, B Blondel, J L Jouve
PURPOSE: Proximal junctional kyphosis (PJK) is a frequent proximal adjacent segment disease following spinal fusion in adolescent idiopathic scoliosis (AIS) and its rate has been estimated to 28% in the literature. The etiology is multifactorial, and risk factors associated with PJK are controversial. The aim of this study was to demonstrate that the disruption of muscular and bony tissue above the upper instrumented vertebra (UIV) during surgery does not increase the rate of PJK in patients undergoing posterior fusion for adolescent idiopathic scoliosis...
March 25, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/28342975/biomechanical-testing-of-a-peek-based-dynamic-instrumentation-device-in-a-lumbar-spine-model
#17
Christian Herren, Agnes Beckmann, Sabine Meyer, Miguel Pishnamaz, Marion Mundt, Rolf Sobottke, Andreas Prescher, Marcus Stoffel, Bernd Markert, Philipp Kobbe, Hans-Christoph Pape, Peer Eysel, Jan Siewe
BACKGROUND: The purpose of this study was to investigate the range-of-motion after posterior polyetheretherketone-based rod stabilisation combined with a dynamic silicone hinge in order to compare it with titanium rigid stabilisation. METHODS: Five human cadaveric lumbar spines with four vertebra each (L2 to L5) were tested in a temperature adjustable spine-testing set-up in four trials: (1) native measurement; (2) kinematics after rigid monosegmental titanium rod instrumentation with anterior intervertebral bracing of the segment L4/5; (3) kinematics after hybrid posterior polyetheretherketone rod instrumentation combined with a silicone hinge within the adjacent level (L3/4) and (4) kinematics after additional decompression with laminectomy of L4 and bilateral resection of the inferior articular processes (L3)...
March 18, 2017: Clinical Biomechanics
https://www.readbyqxmd.com/read/28342920/which-is-the-more-appropriate-proximal-fusion-level-for-adult-lumbar-degenerative-flat-back
#18
Jeong-Hoon Choi, Jee-Soo Jang, Hyeun-Sung Kim, Il-Tae Jang
OBJECTIVE: To determine the optimal proximal fusion level after long instrumented fusion to the sacrum for lumbar degenerative flat back. METHODS: Data from 70 patients with lumbar degenerative flat back were reviewed retrospectively. Three groups were designated according to the upper instrumented vertebrae (UIV) : Group 1 (UIV = T10 or above), Group 2 (UIV = T11 to T12), and Group 3 (UIV = L1 or below). Preoperative and postoperative pelvic parameters, degree of correction, and prevalence of proximal junctional kyphosis (PJK) and its risk factors were evaluated...
March 22, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28342094/comparison-of-the-use-of-rhbmp-7-versus-iliac-crest-autograft-in-single-level-lumbar-fusion-a-meta-analysis-of-randomized-controlled-trials
#19
Fubiao Ye, Zhiyuan Zeng, Jianru Wang, Hui Liu, Hua Wang, Zhaomin Zheng
The aim of this study was to evaluate the safety and clinical effectiveness of rhBMP-7 (or osteogenic protein-1) versus that of autogenous iliac crest bone graft (ICBG) in single-level posterolateral fusion (PLF) of the lumbar spine. A systematic search of all articles published through July 1, 2016 was conducted in databases such as PubMed, EMBASE, Scopus, and the Cochrane Collaboration Library. Randomized controlled trials (RCTs) that compared rhBMP-7 with ICBG for the treatment of single-level degenerative spondylolisthesis, provided the fusion rate, clinical success rate, safety and adverse events report, operation time, and hospital stay durations as the outcome were assessed...
March 24, 2017: Journal of Bone and Mineral Metabolism
https://www.readbyqxmd.com/read/28330963/decrease-in-a%C3%AE-42-predicts-dopa-resistant-gait-progression-in-early-parkinson-disease
#20
Lynn Rochester, Brook Galna, Sue Lord, Alison J Yarnall, Rosie Morris, Gordon Duncan, Tien K Khoo, Brit Mollenhauer, David J Burn
OBJECTIVE: This prospective observational study investigates the role of CSF biomarkers in predicting progression of dopa-resistant gait impairments in Parkinson disease (PD) in the first 36 months from diagnosis. METHODS: Quantitative gait analysis was carried out longitudinally using an instrumented walkway (GAITRite) in 108 people with PD and 130 age-matched controls. A subgroup of 44 people with PD underwent lumbar puncture from which a battery of CSF biomarkers was measured: β-amyloid 1-42 and 1-40 (Aβ42 and Aβ40), total and phosphorylated tau protein (t-tau/p-tau181), and α-synuclein (αSyn)...
March 22, 2017: Neurology
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