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Lumbar instrumentation

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https://www.readbyqxmd.com/read/29149848/the-patterns-of-loss-of-correction-after-posterior-wedge-osteotomy-in-ankylosing-spondylitis-related-thoracolumbar-kyphosis-a-minimum-of-five-year-follow-up
#1
Mu Qiao, Bang-Ping Qian, Sai-Hu Mao, Yong Qiu, Bin Wang
BACKGROUND: Short-term studies have demonstrated good surgical outcomes after pedicle subtraction osteotomy (PSO) in ankylosing spondylitis (AS) patients, but there is a paucity of literature focused on middle-term results, especially regarding patterns of loss of correction. The objective of this study is to assess the durability of surgical outcomes and the patterns of loss of correction in thoracolumbar kyphosis secondary to AS following lumbar PSO with over 5-year follow-up. METHODS: We performed a retrospective review of 155 consecutive AS patients undergoing lumbar PSO from January 2001 to December 2011...
November 17, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/29148922/feasibility-and-safety-of-using-thoracic-and-lumbar-cortical-bone-trajectory-pedicle-screws-in-spinal-constructs-in-children-technical-note
#2
Jonathan N Sellin, Jeffrey S Raskin, Kristen A Staggers, Alison Brayton, Valentina Briceño, Amee J Moreno, Andrew Jea
Thoracic and lumbar cortical bone trajectory pedicle screws have been described in adult spine surgery. They have likewise been described in pediatric CT-based morphometric studies; however, clinical experience in the pediatric age group is limited. The authors here describe the use of cortical bone trajectory pedicle screws in posterior instrumented spinal fusions from the upper thoracic to the lumbar spine in 12 children. This dedicated study represents the initial use of cortical screws in pediatric spine surgery...
November 17, 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/29145877/trajectory-of-instantaneous-axis-of-rotation-in-fixed-lumbar-spine-with-instrumentation
#3
Masataka Inoue, Tetsutaro Mizuno, Toshihiko Sakakibara, Takaya Kato, Takamasa Yoshikawa, Tadashi Inaba, Yuichi Kasai
BACKGROUND: Several studies showed instantaneous axis of rotation (IAR) in the intact spine. However, there has been no report on the trajectory of the IAR of a damaged spine or that of a fixed spine with instrumentation. It is the aim of this study to investigate the trajectory of the IAR of the lumbar spine using the vertebra of deer. METHODS: Functional spinal units (L5-6) from five deer were evaluated with six-axis material testing machine. As specimen models, we prepared a normal model, a damaged model, and a pedicle screw (PS) model...
November 16, 2017: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/29145437/assessment-of-the-suitability-of-biodegradable-rods-for-use-in-posterior-lumbar-fusion-an-in-vitro-biomechanical-evaluation-and-finite-element-analysis
#4
Fon-Yih Tsuang, Yueh-Ying Hsieh, Yi-Jie Kuo, Chia-Hsien Chen, Feng-Huei Lin, Chen-Sheng Chen, Chang-Jung Chiang
Interbody fusion with posterior instrumentation is a common method for treating lumbar degenerative disc diseases. However, the high rigidity of the fusion construct may produce abnormal stresses at the adjacent segment and lead to adjacent segment degeneration (ASD). As such, biodegradable implants are becoming more popular for use in orthopaedic surgery. These implants offer sufficient stability for fusion but at a reduced stiffness. Tailored to degrade over a specific timeframe, biodegradable implants could potentially mitigate the drawbacks of conventional stiff constructs and reduce the loading on adjacent segments...
2017: PloS One
https://www.readbyqxmd.com/read/29133325/minimally-invasive-surgery-versus-open-surgery-in-the-treatment-of-lumbar-spondylolisthesis-study-protocol-of-a-multicentre-randomised-controlled-trial-misos-trial
#5
Mark P Arts, Jasper Fc Wolfs, Jos Ma Kuijlen, Godard Cw de Ruiter
INTRODUCTION: Patients with symptomatic spondylolisthesis are frequently treated with nerve root decompression, in addition to pedicle screw fixation and interbody fusion. Minimally invasive approaches are gaining attention in recent years, although there is no clear evidence supporting the proclamation of minimally invasive spine surgery (MISS) being better than open surgery. We present the design of the MISOS (Minimal Invasive Surgery versus Open Surgery) trial on the effectiveness of MISS versus open surgery in patients with degenerative or spondylolytic spondylolisthesis...
November 12, 2017: BMJ Open
https://www.readbyqxmd.com/read/29130140/transforaminal-intrathecal-delivery-of-nusinersen-using-cone-beam-computed-tomography-for-children-with-spinal-muscular-atrophy-and-extensive-surgical-instrumentation-early-results-of-technical-success-and-safety
#6
John J Weaver, Niranjana Natarajan, Dennis W W Shaw, Susan D Apkon, Kevin S H Koo, Giri M Shivaram, Eric J Monroe
BACKGROUND: Nusinersen, the only treatment approved by the United States Food and Drug Administration for spinal muscular atrophy (SMA), is delivered intrathecally. Many children with SMA have extensive spinal instrumentation and deformities, often precluding the use of standard approaches for gaining intrathecal access. Furthermore the anatomical distortion that often occurs with rotoscoliosis can complicate the use of fluoroscopic guidance. Compared to fluoroscopy, CT affords superior guidance for complex needle placements...
November 13, 2017: Pediatric Radiology
https://www.readbyqxmd.com/read/29125429/graft-subsidence-as-a-predictor-of-revision-surgery-following-stand-alone-lateral-lumbar-interbody-fusion
#7
Zachary J Tempel, Michael M McDowell, David M Panczykowski, Gurpreet S Gandhoke, D Kojo Hamilton, David O Okonkwo, Adam S Kanter
OBJECTIVE Lateral lumbar interbody fusion (LLIF) is a less invasive surgical option commonly used for a variety of spinal conditions, including in high-risk patient populations. LLIF is often performed as a stand-alone procedure, and may be complicated by graft subsidence, the clinical ramifications of which remain unclear. The aim of this study was to characterize further the sequelae of graft subsidence following stand-alone LLIF. METHODS A retrospective review of prospectively collected data was conducted on consecutive patients who underwent stand-alone LLIF between July 2008 and June 2015; 297 patients (623 levels) met inclusion criteria...
November 10, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/29119045/lumbar-stenosis-surgery-spine-surgeons-not-insurance-companies-should-decide-when-enough-is-better-than-too-much
#8
EDITORIAL
Nancy E Epstein
Background: Lumbar surgery for spinal stenosis is the most common spine operation being performed in older patients. Nevertheless, every time we want to schedule surgery, we confront the insurance industry. More often than not they demand patients first undergo epidural steroid injections (ESI); clearly they are not aware of ESI's lack of long-term efficacy. Who put these insurance companies in charge anyway? We did. How? Through performing too many unnecessary or overly extensive spinal operations (e...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/29119044/nursing-review-of-diagnosis-and-treatment-of-lumbar-degenerative-spondylolisthesis
#9
Nancy E Epstein, Renee D Hollingsworth
Background: In the lumbar spine, degenerative spondylolisthesis or degenerative (not traumatic) slippage of one vertebral body over another is divided into 4 grades - grade I (25%), grade II (50%), grade III (75%), and grade IV (100%). Dynamic X-rays, magnetic resonance (MR), and computed tomography (CT) scans document the slip secondary to arthritic changes of the facet joint plus stenosis, ossification of the yellow ligament, disc herniations, and synovial cysts. MR best demonstrates soft tissue pathology whereas CT better delineates ossific/calcified disease...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/29118083/the-effect-of-magnification-loupes-on-dental-hygienists-posture-while-exploring
#10
Emily A Ludwig, Gayle B McCombs, Susan L Tolle, Daniel M Russell
Purpose: The purpose of this study was to determine the effects of dental magnification loupes on posture during instrumentation.Methods: A convenience sample of 27 right-handed dental hygienists, with no prior history of injuries or disabilities of the head, neck, or trunk region, enrolled in the study. Baseline posture calibration was taken and tri-axial accelerometers were placed on four locations of the head and trunk (occipital region of head; cervical vertebrae C5; thoracic vertebrae T5; lumbar vertebrae L1) to measure acceleration and the orientation of the body to gravity...
August 2017: Journal of Dental Hygiene: JDH
https://www.readbyqxmd.com/read/29114274/outcomes-of-minimally-invasive-surgery-compared-to-open-posterior-lumbar-instrumentation-and-fusion
#11
Low Yong Lee, Zamzuri Idris, Tan Boon Beng, Teo Yian Young, Wong Chung Chek, Jafri Malin Abdullah, Wong Sii Hieng
Introduction: Degenerative spine disease is increasingly common. There are many spinal fusion techniques used to treat degenerative spine disease. This study aims to compare the functional outcome of open versus minimally invasive surgery (MIS) technique in posterior lumbar instrumentation and fusion in degenerative spine disease and to evaluate the perioperative outcome and complications between MIS and open surgery. Materials and Methods: This is an observational cross-sectional study conducted on all degenerative spine disease patients who underwent both methods of posterior lumbar instrumentation and fusion from 2010 to 2014 by the Orthopedic and Neurosurgery Department, Sarawak General Hospital...
October 2017: Asian Journal of Neurosurgery
https://www.readbyqxmd.com/read/29105726/complications-of-2-level-dynamic-stabilization
#12
Mert Ciplak, Tuncer Suzer, Salim Senturk, Onur Yaman, Mehdi Sasani, Tunc Oktenoglu, Atilla Yilmaz, Deniz Ufuk Erbulut, Ali Fahir Özer
AIM: A retrospective chart and a radiographic review. Evaluation of postoperative complications, clinical improvements and radiological parameters in patients who underwent surgery using a dynamic system for 2-level lumbar stabilization. We aimed to investigate the postoperative complications, such as screw loosening, screw breakage and ASD, in patients who underwent surgery with 2-level dynamic stabilization systems. MATERIALS AND METHODS: Dynamic lumbar systems enable the stabilization of unstable degenerative spines, while preventing fusion-related complications, such as adjacent segment disease(ASD) and pseudarthrosis...
September 25, 2017: Turkish Neurosurgery
https://www.readbyqxmd.com/read/29103156/treatment-for-recurrent-lumbar-disc-herniation
#13
REVIEW
Randall J Hlubek, Gregory M Mundis
PURPOSE OF REVIEW: Recurrent lumbar disc herniation (RLDH) is the most common indication for reoperation after a lumbar discectomy. The purpose of this manuscript is to review the incidence, risk factors, and treatment for RLDH. RECENT FINDINGS: Patients who require revision surgery for RLDH improved significantly compared to baseline; however, the magnitude of improvement is less than in primary discectomy patients. Treatment with either repeat discectomy or instrumented fusion has comparable clinical outcomes...
December 2017: Current Reviews in Musculoskeletal Medicine
https://www.readbyqxmd.com/read/29095296/the-treatment-strategies-for-spine-fractures-in-patients-with-ankylosing-spondylitis-a-case-report
#14
RuSen Zhu, WenYe Song, Wei Hu, ZeHua Jiang, JianJun Yuan, ZiJian Cui, Jun Wan, Yan Liu, ShiQing Feng, XueLi Zhang
PURPOSE: The aim of the study was to explore surgical strategies for effectively treating spine fractures in patients with ankylosing spondylitis (AS) and investigate the postoperative outcomes. METHODS: We retrospectively analyzed 9 patients with AS that was complicated by spine fractures, who underwent surgery at our spine and spinal cord clinic between 2005 and 2012. The surgical methods included posterior instrumentation and bone grafting, with or without decompression...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29093791/postoperative-spinal-subdural-lesions-following-lumbar-spine-surgery-prevalence-and-risk-factors
#15
Yukitaka Nagamoto, Shota Takenaka, Hiroyuki Aono
Study Design: Retrospective case-control study. Purpose: To clarify the prevalence and risk factors for spinal subdural lesions (SSDLs) following lumbar spine surgery. Overview of Literature: Because SSDLs, including arachnoid cyst and subdural hematoma, that develop following spinal surgery are seldom symptomatic and require reoperation, there are few reports on these pathologies. No study has addressed the prevalence and risk factors for SSDLs following lumbar spine surgery...
October 2017: Asian Spine Journal
https://www.readbyqxmd.com/read/29093780/does-the-addition-of-a-dynamic-pedicle-screw-to-a-fusion-segment-prevent-adjacent-segment-pathology-in-the-lumbar-spine
#16
Hayati Aygun, Osman Yaray, Muren Mutlu
Study Design: Retrospective clinical cohort study. Purpose: To investigate whether the combined use of dynamic pedicle screws and polyaxial pedicle screws was effective on adjacent segment pathology (ASP). Overview of Literature: Various screw and rod models have been recently developed for preventing adjacent segment disease, and hybrid systems have been described along with posterior instrumentation in the fusion segment. In the literature, although the success of dynamic systems has been demonstrated in non-fusion posterior instrumentation, it remains unclear whether the addition of a screw-based dynamic system to a fusion segment would successfully prevent ASP in the long term...
October 2017: Asian Spine Journal
https://www.readbyqxmd.com/read/29090359/oblique-retroperitoneal-approach-for-lumbar-interbody-fusion-from-l1-to-s1-in-adult-spinal-deformity
#17
Ki-Tack Kim, Dae-Jean Jo, Sang-Hyun Lee, Eun-Min Seo
In recent years, with advancements in surgical techniques and instrumentation, the lateral lumbar interbody fusion is being used increasingly as an alternative procedure to anterior approach. In this study, we illustrated a oblique retroperitoneal approach for lumbar interbody fusion with one incision site and tilting of the operation table in adult spinal deformity and evaluate the radiographical findings and clinical outcomes of patients treated using this technique. This study included 32 patients scheduled to undergo anterior and posterior long-level fusions for lumbar degenerative kyphosis or degenerative lumbar scoliosis...
October 31, 2017: Neurosurgical Review
https://www.readbyqxmd.com/read/29089514/design-and-computational-modeling-of-a-modular-compliant-robotic-assembly-for-human-lumbar-unit-and-spinal-cord-assistance
#18
Gunjan Agarwal, Matthew A Robertson, Harshal Sonar, Jamie Paik
Wearable soft robotic systems are enabling safer human-robot interaction and are proving to be instrumental for biomedical rehabilitation. In this manuscript, we propose a novel, modular, wearable robotic device for human (lumbar) spine assistance that is developed using vacuum driven, soft pneumatic actuators (V-SPA). The actuators can handle large, repetitive loads efficiently under compression. Computational models to capture the complex non-linear mechanical behavior of individual actuator modules and the integrated assistive device are developed using the finite element method (FEM)...
October 31, 2017: Scientific Reports
https://www.readbyqxmd.com/read/29077603/correlation-of-functional-outcomes-and-sagittal-alignment-after-long-instrumented-fusion-for-degenerative-thoracolumbar-spinal-disease
#19
Kuang-Ting Yeh, Ru-Ping Lee, Ing-Ho Chen, Tzai-Chiu Yu, Kuan-Lin Liu, Cheng-Huan Peng, Jen-Hung Wang, Wen-Tien Wu
STUDY DESIGN: A retrospective function and radiography study of the patients who have received long instrumented thoracolumbar fusion. OBJECTIVE: To investigate the correlation between the sagittal spinopelvic alignment and the functional outcomes after long instrumented fusion for degenerative thoracolumbar spinal disease. SUMMARY OF BACKGROUND DATA: Restoring better sagittal alignment is known as a key factor to spine fusion surgeries. The relationship between function and radiographic results in the elderly group is barely known...
October 26, 2017: Spine
https://www.readbyqxmd.com/read/29076042/interbody-fusion-techniques-in-the-surgical-management-of-degenerative-lumbar-spondylolisthesis
#20
REVIEW
Peter B Derman, Todd J Albert
PURPOSE OF REVIEW: The various lumbar interbody fusion (IBF) techniques and the evidence for their use in the treatment of degenerative lumbar spondylolisthesis (DLS) are described in this review. RECENT FINDINGS: The existing evidence is mixed regarding the indications for and utility of IBF in DLS, but its use in the setting of pre-operative instability is most strongly supported. Anterior (ALIF), lateral (LLIF), posterior (PLIF), transforaminal (TLIF), and axial (AxiaLIF) lumbar IBF approaches have been described...
December 2017: Current Reviews in Musculoskeletal Medicine
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