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Lumbar instrumentation

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https://www.readbyqxmd.com/read/28547867/pull-out-strength-of-dual-outer-diameter-pedicle-screws-compared-to-uncemented-and-cemented-standard-pedicle-screws-a-biomechanical-in-vitro-study
#1
Andrea Lorenz, Carmen I Leichtle, Sandra Frantz, Marte Bumann, Ilias Tsiflikas, Thomas Shiozawa, Ulf G Leichtle
OBJECTIVE: To analyze the potential of the dual outer diameter screw and systematically evaluate the pull-out force of the dual outer diameter screw compared to the uncemented and cemented standard pedicle screws with special regard to the pedicle diameter and the vertebra level. METHODS: Sixty vertebrae of five human spines (T 6 -L 5 ) were sorted into three study groups for pairwise comparison of the uncemented dual outer diameter screw, the uncemented standard screw, and the cemented standard screw, and randomized with respect to bone mineral density (BMD) and vertebra level...
May 26, 2017: Orthopaedic Surgery
https://www.readbyqxmd.com/read/28546121/prognostic-factors-for-recovery-after-anterior-debridement-bone-grafting-and-posterior-instrumentation-for-lumbar-spinal-tuberculosis
#2
Yuan Yao, Huiyu Zhang, Huan Liu, Zhengfeng Zhang, Yu Tang, Yue Zhou
BACKGROUND: Anterior debridement/bone grafting/posterior instrumentation is a common selection for the treatment of lumbar spinal tuberculosis (LST). To date, no study has focused on the prognostic factors for recovery after this surgery. METHODS: 144 patients experienced anterior debridement/bone grafting/posterior instrumentation for LST were included. The recovery rate based on the Japanese Orthopedic Association (JOA) score was used to assess recovery. The Kaplan-Meier method and Cox regression analysis were used to identify the prognostic factors for recovery postoperatively...
May 22, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28546099/accuracy-of-pedicle-screw-placement-in-posterior-lumbosacral-instrumentation-by-computer-tomography-evaluation-a-multi-centric-retrospective-clinical-study
#3
Tianming Yu, Shuang Mi, Yuansong He, Zhenwu Zhang, Wenjie Dai, Jiqing Tian, Zhenghua Hong, Shunwu Fan, Fengdong Zhao
BACKGROUND: Pedicle screw misplacement rates are relatively high with fluoroscopically guided techniques. However, breach rates in the 5th lumbar and the 1st sacral spines in conventional operations have not been specifically concerned because of their broad cross sections. It's a retrospective study to evaluate the accuracy and safety of pedicle screw placement in posterior lumbosacral instrumentation under CT scan with reconstruction. MATERIALS AND METHODS: 401 patients were evaluated under CT scan with reconstruction in 3 hospitals by 2 professional observers after posterior lumbosacral instrumentation including 152 3rd lumbar spines (L3), 219 4th lumbar spines (L4), 270 5th lumbar spines (L5) and 95 1st sacral spines (S1) with screws placed...
May 22, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28540132/more-risks-and-complications-for-elective-spine-surgery-in-morbidly-obese-patients
#4
REVIEW
Nancy E Epstein
BACKGROUND: The vast majority of studies emphasize the greater morbidity/mortality for elective spine surgery in morbidly obese patients. METHODS: This review focuses on the increased morbidity/mortality of performing elective spinal operations in morbidly obese patients. There are two definitions of morbid obesity; a body mass index (BMI) of equal to or greater than 35 plus two major comorbid factors (e.g., hypertension, diabetes, etc.) or a BMI (morbidly obese III) of =≥40 kg/m(2)...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28523382/adult-spinal-deformity-effectiveness-of-interbody-lordotic-cages-to-restore-disc-angle-and-spino-pelvic-parameters-through-completely-mini-invasive-trans-psoas-and-hybrid-approach
#5
Giuseppe Barone, Laura Scaramuzzo, Antonino Zagra, Fabrizio Giudici, Andrea Perna, Luca Proietti
PURPOSE: The aim of the study is to assess and quantify the effectiveness of interbody lordotic cages applied by trans-psoas approach to improve radiographic parameters, showing the differences between completely mini-invasive and hybrid approach. METHODS: We collected data of 65 patients affected by degenerative lumbar deformity/diseases and underwent mini-invasive lateral interbody fusion followed by percutaneous (group A, completely mini-invasive) or open (group B, hybrid) posterior instrumentation...
May 18, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28522402/prophylactic-vertebral-cement-augmentation-at-the-uppermost-instrumented-vertebra-and-rostral-adjacent-vertebra-for-the-prevention-of-proximal-junctional-kyphosis-and-failure-following-long-segment-fusion-for-adult-spinal-deformity
#6
George M Ghobrial, Daniel G Eichberg, John Paul G Kolcun, Karthik Madhavan, Nathan H Lebwohl, Barth A Green, Joseph P Gjolaj
BACKGROUND CONTEXT: Proximal junctional kyphosis (PJK) and proximal junctional failure (PJF) are common problems after long segment (>5 levels) thoracolumbar instrumented fusions in the treatment of adult spinal deformity (ASD). No specific surgical strategy has definitively been shown to lower the risk of PJK as the result of a multifactorial etiology. PURPOSE: To assess the incidence of PJK and PJF in patients treated with prophylactic polymethylmethacrylate(PMMA) cement augmentation at the uppermost instrumented vertebrae(UIV) and rostral adjacent vertebrae(UIV+1)...
May 15, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28516166/onset-and-remodeling-of-coronal-imbalance-after-selective-posterior-thoracic-fusion-for-lenke-1c-and-2c-adolescent-idiopathic-scoliosis-a-pilot-study
#7
Masayuki Ishikawa, Kai Cao, Long Pang, Nobuyuki Fujita, Mitsuru Yagi, Naobumi Hosogane, Takashi Tsuji, Masafumi Machida, Shinichi Ishihara, Makoto Nishiyama, Yasuyuki Fukui, Masaya Nakamura, Morio Matsumoto, Kota Watanabe
BACKGROUND: Postoperative coronal imbalance is a significant problem after selective thoracic fusion for primary thoracic and compensatory lumbar curves in adolescent idiopathic scoliosis (AIS). However, longitudinal studies on postoperative behavior of coronal balance are lacking. This multicenter retrospective study was conducted to analyze factors related to onset and remodeling of postoperative coronal imbalance after posterior thoracic fusion for Lenke 1C and 2C AIS. METHODS: Twenty-one Lenke 1C or 2C AIS patients, who underwent posterior thoracic fusion ending at L3 or above, were included with a minimum 2-year follow-up...
2017: Scoliosis and Spinal Disorders
https://www.readbyqxmd.com/read/28512620/adjacent-bilateral-stress-pedicle-fractures-after-instrumented-lumbar-fusion-a-case-report
#8
Hak Sung Kim, Sang Woo Ha, Chang Il Ju, Seok Won Kim
Bilateral pedicle stress fractures are rare even in the elderly. Bilateral pedicle fractures are due to post-surgical complications at the level of fusion or stress related activities in most cases. The authors describe a unique case of adjacent L4 bilateral pedicle fractures, which developed 4 years after anterior lumbar interbody fusion with bone cement augmented screw fixation at the L5-S1 level. As far as the authors' knowledge, no similar case has been previously reported in the literature. The pathophysiological mechanism of this rare entity is discussed with review of relevant literature...
April 2017: Korean Journal of Neurotrauma
https://www.readbyqxmd.com/read/28511464/a-study-to-assess-the-functional-outcome-of-decompression-and-posterior-lumbar-interbody-fusion-of-low-grade-spondylolisthesis-of-lumbar-vertebra
#9
Deepak Hegde, Sameer Mehra, Santhosh Babu, Arjun Ballal
INTRODUCTION: Spondylolisthesis is defined as the forward displacement of one vertebra over the vertebra below. It is often accompanied by spinal canal stenosis and compression, which is the cause of all the symptoms. AIM: To assess and study the functional outcome after decompression and Posterior Lumbar Interbody Fusion (PLIF) of isthmic spondylolisthesis of lower lumbar vertebra and to study the complications occurring with this technique. MATERIALS AND METHODS: A prospective study was conducted in the Department of Orthopaedics in Justice KS Hegde Charitable Hospital, Mangalore, Karnataka, India from March 2015 to August 2016...
March 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28506822/the-effect-of-prophylactic-vertebroplasty-on-the-incidence-of-proximal-junctional-kyphosis-and-proximal-junctional-failure-following-posterior-spinal-fusion-in-adult-spinal-deformity-a-5-year-follow-up-study
#10
Tina Raman, Emily Miller, Christopher T Martin, Khaled Kebaish
BACKGROUND CONTEXT: The incidence of proximal junctional kyphosis (PJK) ranges from 5-46% following adult spinal deformity (ASD) surgery. Approximately 66-76% of PJK occurs within 3 months of surgery. A subset of these patients, reportedly 26-47%, develop proximal junctional failure (PJF) within 6 months postoperatively. To date, there are no studies evaluating the impact of prophylactic vertebroplasty on PJK/PJF incidence at long term follow-up. PURPOSE: The purpose of this study is to evaluate the long term radiographic and clinical outcomes, and incidence of PJK and PJF, after prophylactic vertebroplasty for long segment thoracolumbar posterior spinal fusion...
May 12, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28502881/multilevel-schwab-grade-ii-osteotomies-for-sagittal-plane-correction-in-the-management-of-adult-spinal-deformity
#11
George M Ghobrial, Nathan H Lebwohl, Barth A Green, Joseph P Gjolaj
BACKGROUND CONTEXT: Prior reports have compared posterior column osteotomies to pedicle subtraction osteotomies in terms of utility for correcting fixed sagittal imbalance in adolescent patients with deformity. No prior reports have described the use of multilevel Smith-Petersen Osteotomies (SPOs) alone for surgical correction in the adult spinal deformity (ASD) population. PURPOSE: To determine the utility of multilevel Smith-Petersen Osteotomies (SPOs) in the management of global sagittal imbalance in adult spinal deformity (ASD) patients...
May 11, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28502688/evaluating-outcomes-of-stand-alone-anterior-lumbar-interbody-fusion-a-systematic-review
#12
Gloria Giang, Ralph Mobbs, Steven Phan, Tommy Manh Tran, Kevin Phan
BACKGROUND: Stand-alone anterior lumbar interbody fusion (ALIF) is an effective surgical approach for selected spinal pathologies. It avoids the morbidity and complications associated with instrumented ALIF such as plate fixation and the traditionally used posterior approach. Despite improved disc space visualisation and clearance, the associated posterior instability and increased risk of non-fusion present major challenges to this approach. The integral cage design aims to address these challenges by providing the necessary stabilisation through intracorporeal screws...
May 11, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28496357/incidence-and-risk-factors-of-persistent-low-back-pain-following-posterior-decompression-and-instrumented-fusion-for-lumbar-disk-herniation
#13
Hui Wang, Tao Wang, Qian Wang, Wenyuan Ding
INTRODUCTION: The aim of this study was to explore the incidence and risk factors of persistent low back pain (PLBP) following posterior decompression and instrumented fusion for lumbar disk herniation and to provide references in decision-making and surgical planning for both spinal surgeons and surgically treated patients. PATIENTS AND METHODS: By retrieving the medical records from January 2013 to December 2016, 221 patients were retrospectively reviewed. Patients were classified as having PLBP if numeric rating scale (NRS) scores were >50 at all postoperative follow-up time points (3 months, 6 months, and 12 months)...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28479812/unilateral-vision-loss-without-ophthalmoplegia-as-a-rare-complication-of-spinal-surgery
#14
Elif Akpınar, Mehmet Sabri Gürbüz, Gülfidan Bitirgen, Mehmet Özerk Okutan
Postoperative visual loss is an extremely rare complication of nonocular surgery. The most common causes are ischemic optic neuropathy, central retinal artery occlusion, and cerebral ischemia. Acute visual loss after spinal surgery is even rarer. The most important risk factors are long-lasting operations, massive bleedings, fluid overload, hypotension, hypothermia, coagulation disorders, direct trauma, embolism, long-term external ocular pressure, and anemia. Here, we present a case of a 54-year-old male who developed acute visual loss in his left eye after a lumbar instrumentation surgery and was diagnosed with retinal artery occlusion...
April 2017: Journal of Neurosciences in Rural Practice
https://www.readbyqxmd.com/read/28473610/sex-differences-in-sympathetic-vasoconstrictor-responsiveness-and-sympatholysis
#15
Timothy P Just, Darren S DeLorey
The purpose of the present study was to investigate the hypothesis that sympathetic vasoconstrictor responsiveness would be blunted and NO-mediated inhibition of sympathetic vasoconstriction enhanced in females compared to males. Male (M; n=8) and Female (F; n=10) Sprague-Dawley rats were anesthetized and surgically instrumented for measurement of arterial blood pressure and femoral artery blood flow and stimulation of the lumbar sympathetic chain. The percentage change of femoral vascular conductance (%FVC) in response to sympathetic chain stimulation delivered at 2 and 5 Hz was determined at rest and during muscle contraction before (control) and after NOS blockade...
May 4, 2017: Journal of Applied Physiology
https://www.readbyqxmd.com/read/28470542/a-comparative-analysis-of-a-disposable-and-a-reusable-pedicle-screw-instrument-kit-for-lumbar-arthrodesis-integrating-hta-and-mcda
#16
Claudia Ottardi, Alessio Damonti, Emanuele Porazzi, Emanuela Foglia, Lucrezia Ferrario, Tomaso Villa, Enrico Aimar, Marco Brayda-Bruno, Fabio Galbusera
OBJECTIVE: Lumbar arthrodesis is a common surgical technique that consists of the fixation of one or more motion segments with pedicle screws and rods. However, spinal surgery using these techniques is expensive and has a significant impact on the budgets of hospitals and Healthcare Systems. While reusable and disposable instruments for laparoscopic interventions have been studied in literature, no specific information exists regarding instrument kits for lumbar arthrodesis. The aim of the present study was to perform a complete health technology assessment comparing a disposable instrument kit for lumbar arthrodesis (innovative device) with the standard reusable instrument...
December 2017: Health Economics Review
https://www.readbyqxmd.com/read/28463918/outcomes-of-posterolateral-fusion-with-and-without-instrumentation-and-of-interbody-fusion-for-isthmic-spondylolisthesis-a-prospective-study
#17
Peter Endler, Per Ekman, Hans Möller, Paul Gerdhem
BACKGROUND: Various methods for the treatment of isthmic spondylolisthesis are available. The aim of this study was to compare outcomes after posterolateral fusion without instrumentation, posterolateral fusion with instrumentation, and interbody fusion. METHODS: The Swedish Spine Register was used to identify 765 patients who had been operated on for isthmic spondylolisthesis and had at least preoperative and 2-year outcome data; 586 of them had longer follow-up (a mean of 6...
May 3, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28463696/spinal-fusion-without-instrumentation-experimental-animal-study
#18
Sandra Reitmaier, Julian Schuelke, Hendrik Schmidt, David Volkheimer, Anita Ignatius, Hans-Joachim Wilke
BACKGROUND: The number and cost of instrumented spinal fusion surgeries have increased rapidly, primarily for the treatment of lumbar segmental instabilities. However, what if the organism itself is able to restore segmental stability over time? This large-animal study using sheep aimed to investigate whether the reparative response after destabilization via facetectomy and nucleotomy without instrumentation can effectively fuse the spinal segment comparable to instrumented standard fusion surgery...
April 25, 2017: Clinical Biomechanics
https://www.readbyqxmd.com/read/28460344/an-evaluation-of-internet-use-by-neurosurgery-patients-prior-to-lumbar-disc-surgery-and-of-information-available-on-internet
#19
Ibrahim Burak Atci, Hakan Yilmaz, Umit Kocaman, Mustafa Yavuz Samanci
OBJECTIVE: The aim of this study was to evaluate the Internet use of a group of lumbar disc surgery candidates in order to determine the rate of Internet search by the patients on their disorders and more importantly the reliability of the accessed websites. PATIENTS AND METHODS: Fifty patients who were scheduled for lumbar disc surgery were divided into 2 groups, namely patients who accepted the surgery at the first offer and those who wanted to think over. Educational level information was obtained and patients were asked whether they had searched their disorder and offered surgery on the Internet...
July 2017: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/28458818/lumbar-vertebral-body-and-pars-fractures-following-laminectomy
#20
Akshay Yadhati, Swamy Kurra, Richard A Tallarico, William F Lavelle
A 56-year-old alcoholic male incurred L5 vertebral body and bilateral L4 pars fractures with progressive L4 on L5 anterolisthesis following low-energy falls while intoxicated. Recently, he had a L3-S1 laminectomy for lumbar spinal stenosis with claudication. Preoperative imaging and radiographs were negative for pars defects and instability, so an isolated decompressive surgery was performed. Following low-energy falls, his outpatient work-up revealed fractures through the bilateral L4 pedicles and posterior third of L5 vertebral body, with recurrence of axial back pain and bilateral lower extremity radiculopathy...
February 2017: Journal of Surgical Case Reports
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