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Lumbar instrumentation

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https://www.readbyqxmd.com/read/27908615/unilaterally-posterior-lumbar-interbody-fusion-with-double-expandable-peek-cages-without-pedicle-screw-support-for-lumbar-disc-herniation
#1
Aydemir Kale, Ibrahim Ilker Oz, Ayhan Onk, Murat Kalaycı, Çağatay Büyükuysal
OBJECTIVES: Posterior lumbar interbody fusion (PLIF) is usually bilateral procedure, and it is combined with posterior by bilateral pedicle screw support or with fixation. The purpose of this retrospective study was to compare the surgical outcomes of simple discectomy and PLIF without pedicle screw support in patients with lumbar disc herniation (LDH). PATIENTS AND METHODS: 60 patients with single segment LDH were operated between February 2010 and June 2013. 40 patients were treated with simple discectomy (Group 1) and 20 patients were treated with PLIF using double expandable polyetheretherketone (PEEK) cages without instrumentation (Group 2) unilaterally...
November 17, 2016: Neurologia i Neurochirurgia Polska
https://www.readbyqxmd.com/read/27906938/technical-strategies-and-anatomic-considerations-for-an-extrapedicular-modified-inferior-endplate-access-to-thoracic-and-lumbar-vertebral-bodies
#2
Douglas P Beall, Blake Parsons, Scott Burner
BACKGROUND: Percutaneous access to the vertebral bodies is commonly done via the transpedicular approach for both diagnoses and treatment of spinal pathology. While this approach is effective in most cases, it is difficult in certain situations such as a patient with obstructing hardware from prior surgery. OBJECTIVES: To investigate and illustrate an alternative to the typical percutaneous access to the vertebral body via an extrapedicular approach and to determine the complications associated with this approach...
November 2016: Pain Physician
https://www.readbyqxmd.com/read/27898599/influence-of-sacral-slope-on-the-loading-of-pedicle-screws-in-postoperative-l5-s1-isthmic-spondylolisthesis-patient-a-finite-element-analysis
#3
Liang Chen, Yu Feng, Chun-Qing Che, Yong Gu, Ling-Jun Wang, Hui-Lin Yang
STUDY DESIGN: A finite element analysis. OBJECTIVE: To evaluate the influence of sacral slope (SS) on the loading of pedicle screws in postoperative isthmic spondylolisthesis (IS). SUMMARY OF BACKGROUND DATA: The spinopelvic anatomy was important for the biomechanics in spondylolisthesis. To our knowledge, no study concentrated on the postoperative biomechanics of the IS with the different SS. METHODS: Based on the computed tomography images, a finite model of L5/S1 IS was constructed...
December 1, 2016: Spine
https://www.readbyqxmd.com/read/27889355/cervical-sagittal-alignment-in-adult-hyperkyphosis-treated-by-posterior-instrumentation-and-in-situ-bending
#4
F Paternostre, Y P Charles, E A Sauleau, J-P Steib
BACKGROUND: In the normal adult spine, a link between thoracolumbar and cervical sagittal alignment exists, suggesting adaptive cervical positional changes allowing horizontal gaze. In patients with thoracic hyperkyphosis, cervical adaptation to sagittal global alignment might be different from healthy individuals. However, this relationship has not clearly been reported in hyperkyphotic deformity. PURPOSE: The purpose of this study was to identify cervical sagittal alignment types observed on radiographs in young adults with thoracic hyperkyphosis...
November 23, 2016: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/27879572/importance-of-distal-fusion-level-in-major-thoracolumbar-and-lumbar-adolescent-idiopathic-scoliosis-treated-by-rod-derotation-and-direct-vertebral-rotation-following-pedicle-screw-instrumentation
#5
Dong-Gune Chang, Jae Hyuk Yang, Se-Il Suk, Seung-Woo Suh, Young-Hoon Kim, Woojin Cho, Yeon-Seok Jeong, Jin-Hyok Kim, Kee-Yong Ha, Jung-Hee Lee
STUDY DESIGN: A retrospective comparative study. OBJECTIVE: To analyze the exact distal fusion level in the treatment of major thoracolumbar and lumbar (TL/L) adolescent idiopathic scoliosis (AIS) using rod derotation (RD) and direct vertebral rotation (DVR) following pedicle screw instrumentation (PSI). SUMMARY OF BACKGROUND DATA: Proper determination of distal fusion level is a very important factor in deformity correction and preservation of motion segments in the treatment of major TL/L AIS...
November 22, 2016: Spine
https://www.readbyqxmd.com/read/27879571/radiographic-predictors-for-mechanical-failure-following-adult-spinal-deformity-surgery-a-retrospective-cohort-study-in-138-patients
#6
Dennis Winge Hallager, Sven Karstensen, Naeem Bukhari, Martin Gehrchen, Benny Dahl
STUDY DESIGN: Retrospective cohort study at a single institution. OBJECTIVE: We aimed at estimating the rate of revision procedures and identify radiographic predictors of mechanical failure following adult spinal deformity surgery. SUMMARY OF BACKGROUND DATA: Mechanical failure rates following adult spinal deformity surgery range 12% to 37% in literature. While the importance of spinal and spino-pelvic alignment is well documented for surgical outcome and ideal alignment has been proposed as sagittal vertical axis (SVA) < 5 cm, pelvic tilt < 20° and lumbar lordosis (LL) = pelvic incidence ± 9°, the role of radiographic sagittal spine parameters and alignment targets as predictors for mechanical failure remains uncertain...
November 22, 2016: Spine
https://www.readbyqxmd.com/read/27879512/uhmwpe-sublaminar-wires-in-posterior-spinal-instrumentation-stability-and-biocompatibility-assessment-in-an-ovine-pilot-study
#7
Rob Bogie, Laura Voss, Jacobus J Arts, Arno Lataster, Paul C Willems, Boudewijn Brans, Lodewijk W van Rhijn, Tim J M Welting
STUDY DESIGN: An animal study. OBJECTIVE: To explore ultra-high molecular weight polyethylene (UHMWPE) sublaminar wires in spinal surgery and to assess stability and biocompatibility of the UHMWPE instrumentation in an ovine model. SUMMARY OF BACKGROUND DATA: Sublaminar wiring is a well-established technique in segmental scoliosis surgery. However, during introduction and/or removal of the metal sublaminar wires, neurological problems can occur...
December 2016: Clinical Spine Surgery
https://www.readbyqxmd.com/read/27879509/surgical-site-infections-following-the-transoral-approach-a-review-of-172-consecutive-cases
#8
QingShui Yin, Hong Xia, ZengHui Wu, XiangYang Ma, FuZhi Ai, Kai Zhang, JianHua Wang, Tao Zhang, ZhaoHui Bai, ZhiYun Wang
STUDY DESIGN: A retrospective review. OBJECTIVE: The aim of this study was to discuss the characteristics, treatment, and incidence of surgical site infection (SSI) following transoral approach surgery. SUMMARY OF BACKGROUND DATA: One of the primary risks associated with transoral approach surgery is postoperative SSI. Few reports exist detailing the specific circumstances, treatment options, and incidence of SSIs following transoral approach surgery in a large series of consecutive cases...
December 2016: Clinical Spine Surgery
https://www.readbyqxmd.com/read/27879505/the-effect-of-transpedicular-screw-design-on-its-performance-in-vertebral-bone-under-tensile-loads-a-parametric-study
#9
Ron N Alkaly, Dan L Bader
STUDY DESIGN: A biomechanical study using bovine thoracolumbar spines. OBJECTIVE: To study investigated whether thread design parameters aimed at altering the state of stress at the screw-bone interface increase the screw's holding power. SUMMARY AND BACKGROUND DATA: Internal spinal fixators utilizing transpedicular screw fixation are used to achieve early stabilization of the injured spine in a range of clinical conditions. Despite advances in the design of internal spinal fixation systems, implant loosening, and catastrophic failures at the screw-bone interface remains a serious complication in adult spine surgery...
December 2016: Clinical Spine Surgery
https://www.readbyqxmd.com/read/27872896/comparison-of-clinical-and-radiologic-outcome-of-adolescent-idiopathic-scoliosis-treated-with-hybrid-hook-screw-instrumentation-versus-universal-clamp-system
#10
Ebrahim Ghayem Hassankhani, Farzad Omidi-Kashani, Shahram Moradkhani, Golnaz Ghayem Hassankhani, Mohammad Taghi Shakeri
Background. In surgical treatment of adolescent idiopathic scoliosis (AIS), hybrid universal clamp system has been used by some authors. We aimed to compare the clinical and radiologic outcome of hybrid universal clamp with hybrid thoracic hook lumbar screw. Methods. A prospective study was performed on 56 consecutive patients with AIS, who had alternatively undergone a posterior spinal fusion and instrumentation with hybrid thoracic hook lumbar screw system (28 patients: group A) and hybrid universal clamp system (28 patients: group B) between June 2006 and January 2014 at Imam Reza University Hospital and had been followed up for more than two years...
2016: Advances in Medicine
https://www.readbyqxmd.com/read/27867080/biomechanical-advantages-of-robot-assisted-pedicle-screw-fixation-in-posterior-lumbar-interbody-fusion-compared-to-free-hand-technique-in-a-prospective-randomized-controlled-trial-perspective-for-patient-specific-finite-element-analysis
#11
Ho-Joong Kim, Kyoung-Tak Kang, Sung-Cheol Park, Bong-Soon Chang, Choon-Ki Lee, Jin S Yeom, Lawrence G Lenke
BACKGROUND CONTEXT: There have been conflicting results regarding the surgical outcome of lumbar fusion surgery using two different techniques between robot-assisted pedicle screw fixation and conventional free-hand technique. In addition, there have been no studies about biomechanical issues between the both techniques. PURPOSE: To investigate biomechanical properties in terms of stress at adjacent segments using robot-assisted pedicle screw insertion technique (robot-assisted minimally invasive posterior lumbar interbody fusion, Rom-PLIF) and free-hand technique (conventional, free-hand, open approach, posterior lumbar interbody fusion, Cop-PLIF) for instrumented lumbar fusion surgery...
November 17, 2016: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/27858395/low-back-pain-and-internet-infopollution
#12
Yavuz Samanci, Suat Erol Çelik
AIM: Increasing number of patients engages in health information seeking via the Internet. We aimed to determine the quality of information on Internet for treatment of three common neurosurgical conditions associated with lower back pain using the DISCERN® instrument. MATERIAL AND METHODS: The search phrases "lumbar disc herniation treatment", "lumbar spinal stenosis treatment" and "lumbar spondylolisthesis treatment" were searched in the Google® search engine using simple searching method...
October 14, 2016: Turkish Neurosurgery
https://www.readbyqxmd.com/read/27856380/t9-versus-t10-as-the-upper-instrumented-vertebra-for-correction-of-adult-deformity-rationale-and-recommendations
#13
Hwee Weng Dennis Hey, Kimberly-Anne Tan, Christabel Shao-En Neo, Eugene Tze-Chun Lau, Denise Ai-Wen Choong, Leok-Lim Lau, Gabriel Ka-Po Liu, Hee-Kit Wong
BACKGROUND CONTEXT: Adult spinal deformity correction sometimes involves long posterior pedicle screw constructs extending from the lumbosacral spine to the thoracic vertebra. As fusion obliterates motion and places supraphysiological stress on adjacent spinal segments, it is crucial to ascertain the ideal upper instrumented vertebra (UIV) to minimize risk of proximal junctional failure (PJF). The T10 vertebra is often chosen to allow bridging of the thoracolumbar junction into the immobile thoracic vertebrae on the basis that it is the lowest immobile thoracic vertebra strut by the rib cage...
November 14, 2016: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/27851660/the-utility-of-intraoperative-neuromonitoring-for-lumbar-pedicle-screw-placement-is-questionable-a-review-of-9957-cases
#14
Remi M Ajiboye, Stephen D Zoller, Anthony D'Oro, Zachary D Burke, William Sheppard, Christopher Wang, Zorica Buser, Jeffrey C Wang, Sina Pourtaheri
STUDY DESIGN: Retrospective database study OBJECTIVE.: The goal of this study was to 1). Evaluate the trends in the use of electromyography (EMG) for instrumented posterolateral lumbar fusions (PLFs) in the United States and 2). Assess the risk of neurological injury following PLFs with and without EMG. SUMMARY OF BACKGROUND DATA: Neurologic injuries from iatrogenic pedicle wall breaches during screw placement are known complications of PLFs. The routine use of intraoperative neuromonitoring (ION) such as EMG during PLF to improve the accuracy and safety of pedicle screw implantation remains controversial...
November 15, 2016: Spine
https://www.readbyqxmd.com/read/27843683/spinal-neuromodulation-as-a-novel-surgical-option-for-failed-back-surgery-syndrome-following-rhbmp-exuberant-bony-growth-in-instrumented-lumbar-fusion-a-case-report-and-literature-review
#15
Ramsis F Ghaly, Alexei Lissounov, Tatiana Tverdohleb, David Kohanchi, Kenneth D Candido, Nebojsa Nick Knezevic
BACKGROUND: Bone morphogenic protein (BMP) for instrumented lumbar fusion was approved in 2002, and since then has led to an increasing incidence of BMP-related neuropathic pain. These patients are usually resistant to conventional medical therapy and frequently undergo multiple surgical revisions without any pain relief. CASE DESCRIPTION: A 58-year-old male was referred to the author's outpatient clinic after four lumbar surgeries did not provide satisfactory pain relief...
2016: Surgical Neurology International
https://www.readbyqxmd.com/read/27843680/non-neurological-major-complications-of-extreme-lateral-and-related-lumbar-interbody-fusion-techniques
#16
Nancy E Epstein
BACKGROUND: Complications exclusive of new neurological deficits/injuries that follow extreme lateral interbody fusion (XLIF) and related lateral lumbar interbody techniques should be better recognized to determine the safety of these procedures. Unfortunately, a review of the XLIF literature did not accurately reflect the frequency of these "other complications" as few US surgeons publish such adverse events that may lead to medicolegal suits. METHODS: Major complications occurring with XLIF included sympathectomy, major vascular injuries, bowel perforations, sterile seromas, and instrumentation failures...
2016: Surgical Neurology International
https://www.readbyqxmd.com/read/27843678/commentary-on-the-role-of-surgery-for-treatment-of-low-back-pain-insights-from-the-randomized-controlled-sport-trials
#17
Nancy E Epstein
BACKGROUND: The SPORT trial database offered much useful information regarding the efficacy of surgical treatment for lumbar disc herniations, lumbar spinal stenosis, and degenerative spondylolisthesis. Data were obtained from 13 sites and included 2500 patients. METHODS: The randomized trial for lumbar disc herniations was contaminated by the immense crossover of patients from surgical (50%) to non-surgical (30%) groups. Weinstein et al. concluded that they could not claim superiority of one treatment modality over the other...
2016: Surgical Neurology International
https://www.readbyqxmd.com/read/27843677/commentary-on-laminectomy-plus-fusion-versus-laminectomy-alone-for-lumbar-spondylolisthesis-by-ghogawala-z-dziura-j-butler-we-dai-f-terrin-n-magge-sn-et-al-nejm-2016-374-15-1424-34
#18
Nancy E Epstein
BACKGROUND: How does an article involving only 66 patients randomized into two spinal surgical groups get into the New England Journal of Medicine? Nevertheless, this one did. The article by Ghogawala et al. entitled Laminectomy plus fusion versus laminectomy alone for lumbar spondylolisthesis, compared the efficacy/outcomes of pedicle/screw/rod instrumented posterolateral lumbar fusions vs. decompressions alone for treating lumbar stenosis with grade I degenerative spondylolisthesis (DS)...
2016: Surgical Neurology International
https://www.readbyqxmd.com/read/27835831/spatial-distribution-of-surface-emg-on-trapezius-and-lumbar-muscles-of-violin-and-cello-players-in-single-note-playing
#19
Babak Afsharipour, Francesco Petracca, Mauro Gasparini, Roberto Merletti
Musicians activate their muscles in different patterns, depending on their posture, the instrument being played, and their experience level. Bipolar surface electrodes have been used in the past to monitor such activity, but this method is highly sensitive to the location of the electrode pair. In this work, the spatial distribution of surface EMG (sEMG) of the right trapezius and right and left erector spinae muscles were studied in 16 violin players and 11 cello players. Musicians played their instrument one string at a time in sitting position with/without backrest support...
December 2016: Journal of Electromyography and Kinesiology
https://www.readbyqxmd.com/read/27831994/pseudarthrosis-repair-using-autologous-cultured-osteoblasts-in-complex-type-1-neurofibromatosis-spinal-deformity-a-case-report-and-review-of-the-literature
#20
Young-Hoon Kim, Genriech N Reoyan, Kee-Yong Ha, Chul-Kyu Kim
STUDY DESIGN: A case report and literature review. OBJECTIVE: To report a late dislocation of the vertebra caused by progressive dural ectasia combined with type-1 neurofibromatosis (NF-1) and the clinical results of pseudarthrosis repairs using autologous cultured osteoblasts. SUMMARY OF BACKGROUND DATA: NF-1 is a well-known genetic disorder that is commonly characterized by spinal deformities including kyphoscoliosis. Late dislocation of the vertebra resulting from progressive dural ectasia after surgical correction of NF-1 scoliosis is a very rare occurrence, and pseudarthrosis frequently develops after surgical intervention for this complex spinal deformity...
November 15, 2016: Spine
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