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Spine osteotomy

Juan Francisco Blanco, Marcelo Jiménez, Diego Rendón, David Pescador, Jorge Hugo Villafañe, Diego Garbossa, Pedro Berjano
PURPOSE: We present the case of a patient with a giant cell tumor of the thoracic wall that invaded the thoracic spine. MATERIAL AND METHODS: A giant cell tumor that affects the spine and the thoracic wall is very rare but can grow to a large size. We report a case of giant cell tumor of the left chest wall extending to the thoracic spine in a 28-year-old man. Positron emission tomography (PET) showed a tumor of 11 × 4 × 13 cm in size and the histopathology specimen of the first surgical procedure diagnosed a giant cell tumor...
March 19, 2018: Der Orthopäde
Kunal C Shah, Akshay Gadia, Premik Nagad, Shekhar Bhojraj, Abhay Nene
Buckling collapse is the term typically used to describe severe kyphosis more than 100 degrees, characteristically seen in thoracolumbar tuberculosis. Neurofibromatosis is rarely associated with severe cervical kyphosis. Dystrophic changes in vertebra make surgical correction and fusion challenging. Single stage cervical osteotomies (pedicle subtraction osteotomy, vertebral column resection etc) are commonly done in cervico-thoracic junction. However it is technically challenging and associated with high risk of vertebral artery injury, neural injury etc when performed in higher cervical spine...
March 14, 2018: World Neurosurgery
S Hemmer, H Almansour, W Pepke, M M Innmann, M Akbar
BACKGROUND: In the light of the increasingly aging population and the widespread understanding of the sagittal profile of symptomatic patients with adult spinal deformity (ASD), pervasive utilization of osteotomies on the vertebral column should be expected. These surgeries are accompanied with relatively high complication rates. However, there is no uniform definition or classification in terms of grading the severity or chronological incidence of complications after ASD surgery. OBJECTIVES: The aim of this work is to give an overview of the different classifications described in the literature hitherto and to propose a standardized, clinically utile classification of complications after ASD surgery...
March 15, 2018: Der Orthopäde
Micheal Raad, Amit Jain, Brian J Neuman, Hamid Hassanzadeh, Munish C Gupta, Douglas C Burton, Gregory M Mundis, Virginie Lafage, Eric O Klineberg, Richard A Hostin, Christopher P Ames, Shay Bess, Daniel M Sciubba, Khaled M Kebaish
STUDY DESIGN: Retrospective analysis of prospective registry OBJECTIVE.: To investigate associations of preoperative narcotic use with outcomes after adult spinal deformity (ASD) surgery. SUMMARY OF BACKGROUND DATA: We hypothesized that preoperative narcotic use would predict longer hospital stays, greater postoperative narcotic use, and greater disability 2 years after ASD surgery. METHODS: A multicenter database of surgical ASD patients was analyzed retrospectively for patients with self-reported data on preoperative narcotic use...
March 13, 2018: Spine
Weiwei Lin, Hongtao Xu, Guman Duan, Jinjin Xie, Yisheng Chen, Baohua Jiao, Haitao Lan
Purpose Tethered cord syndrome (TCS) is the clinical manifestation of an abnormal stretch on the spinal cord, caused by several pathological conditions. Tethered cord release is the gold standard treatment for TCS. However, direct untethering carries potential risks of spinal cord injury, post-operative retethering, and CSF-related complications. Spine-shortening osteotomy (SSO) has recently been performed as an alternative technique to avoid these risks. We aimed to systematically review the literature on indications and outcome of SSO in TCS patients...
March 12, 2018: Neurological Research
Dong-Ho Lee, Jae Hwan Cho, Choon Sung Lee, Chang Ju Hwang, Sung Hoon Choi, Chul Gie Hong
BACKGROUND CONTEXT: Conventional anterior decompression surgery for cervical myelopathy, including anterior corpectomy and fusion, is technically demanding and known to be associated with a higher incidence of surgery-related complications, including cerebrospinal fluid (CSF) leakage, neurologic deterioration, and graft failure compared with posterior surgery. PURPOSE: We introduce a novel anterior decompression technique (vertebral body sliding osteotomy; VBSO) for cervical myelopathy caused by ossification of posterior longitudinal ligament (OPLL) and evaluate the efficacy and safety of this procedure...
February 26, 2018: Spine Journal: Official Journal of the North American Spine Society
Shaofu Wang, Jing Li, Guohua Lü, Bing Wang, Xiaobin Wang
PURPOSE: Hemivertebra of the cervical spine is a rare but complex spinal malformation. To our knowledge, only one publication describes excision of an upper-middle cervical (between C2 and C4) hemivertebra. We present our experience with two cases of C3 hemivertebra resection and torticollis correction via a combined anterior-posterior-anterior surgical approach and short segment fixation. METHODS: Two 12-year-old patients with torticollis due to congenital C3 hemivertebra underwent surgery consisting of combined anterior vertebral body osteotomy, posterior element resection with segment instrumentation and deformity correction, and iliac bone graft reconstruction and fixation via an anterior approach...
February 28, 2018: European Spine Journal
Shoji Seki, Yasuhito Yahara, Hiroto Makino, Yoshiharu Kawaguchi, Tomoatsu Kimura
BACKGROUND: Ponte osteotomy is a useful method in posterior spinal release. However, it is unclear whether Ponte osteotomy itself contributes to vertebral derotation in surgery for adolescent idiopathic scoliosis (AIS) patients compared to inferior facetectomy alone. This study aimed to assess the effect of Ponte osteotomy on the magnitude of periapical vertebral body rotation compared to inferior facetectomy alone. This study was a prospective collected data. METHODS: The study included 63 patients with AIS (Thoracic curve type, 35; thoracolumbar/lumbar curve type, 27), who underwent surgery between August 2011 and January 2015...
February 22, 2018: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
Silviu Sabou, Hossein Mehdian, Dritan Pasku, Luca Boriani, Nasir A Quraishi
PURPOSE: Ankylosing spondylitis (AS) can result in severe cervico-thoracic kyphotic deformity (CTKD). Few studies have addressed the relationship between cervico-thoracic osteotomies in AS and health-related quality of life scores. The aim of this study is to evaluate the impact of cervico-thoracic osteotomy (CTO) on improving quality of life for patients with fixed CTKD. METHODS: A database of all patients who underwent a CTO for CTKD in patients with AS was created...
February 22, 2018: European Spine Journal
Sravisht Iyer, Eric O Klineberg, Lukas P Zebala, Michael P Kelly, Robert A Hart, Munish C Gupta, D Kojo Hamilton, Gregory M Mundis, Daniel Sciubba, Christopher P Ames, Justin S Smith, Virginie Lafage, Douglas Burton, Han Jo Kim
Study Design: Retrospective cohort study. Objectives: Describe the rate of dural tears (DTs) in adult spinal deformity (ASD) surgery. Describe the risk factors for DT and the impact of this complication on clinical outcomes. Methods: Patients with ASD undergoing surgery between 2008 and 2014 were separated into DT and non-DT cohorts; demographics, operative details, radiographic, and clinical outcomes were compared. Statistical analysis included t tests or χ2 tests as appropriate and a multivariate analysis...
February 2018: Global Spine Journal
Hengyan Zhang, Qiyi Li
RATIONALE: Surgical site infection (SSI) following spine surgeries involving internal fixation often require removing the instrument; however, this can cause spinal instability. Previous reports have demonstrated the usefulness of vacuum sealing drainage (VSD) therapy, but the cases require wound opening, aseptic condition to replace the VSD device, and a secondary operation to close the wound. Thus, to improve the VSD treatment and develop a maneuverable procedure, make sense in spine surgery...
February 2018: Medicine (Baltimore)
Ali K Ozturk, Patricia Zadnik Sullivan, Vincent Arlet
The importance of sagittal spinal balance and lumbopelvic parameters is now well understood. The popularization of various osteotomies, including Smith-Peterson, Ponte, and pedicle subtraction osteotomies (PSOs), as well as vertebral column resections, have greatly enhanced the spine surgeon's ability to recognize and effectively treat sagittal imbalance. Yet rare circumstances remain, most notably in distal kyphotic deformities and patients with extremely elevated pelvic incidences, where these techniques remain inadequate...
February 9, 2018: Journal of Neurosurgery. Spine
Frederick Galla, Dirk Wähnert, Ulf Liljenqvist
INTRODUCTION: A balanced ratio of the main parameters of lumbar lordosis (LL) and pelvic incidence (PI) has high clinical relevance. A postoperative mismatch of LL and PI has been described in the literature to be associated with an inferior clinical outcome and higher postoperative revision rates. The aim of this retrospective, radiological study is to evaluate the magnitude of relordosing in mono-/bisegmental TLIF spondylodesis affecting the spino-pelvic alignment and the main contributing factors...
February 7, 2018: European Spine Journal
Kuenzang Wangdi, Bungo Otsuki, Shunsuke Fujibayashi, Shimei Tanida, Kazutaka Masamoto, Shuichi Matsuda
PURPOSE: To report on suggested technique with four screws in a single vertebra (two pedicle screws and two direct vertebral body screws) for enhanced fixation with just one level cranially to a pedicle subtraction osteotomy (PSO). METHODS: A 60-year-old woman underwent L4/5 fusion surgery for degenerative spondylolisthesis. Two years later, she was unable to stand upright even for a short time because of lumbar kyphosis caused by subsidence of the fusion cage and of Baastrup syndrome in the upper lumbar spine [sagittal vertical axis (SVA) of 114 mm, pelvic incidence of 75°, and lumbar lordosis (LL) of 41°]...
February 7, 2018: European Spine Journal
Guillaume Racloz, Dennis Dominguez, Antonio Faundez, Romain Dayer
Adult scoliosis is a common condition. Symptoms could be very debilitating. Surgical management requires a clear assessment of the functional impact of scoliosis, the failure of conservative treatments and precise analysis of radiological investigations (full spine views, dynamic X-rays and MRI). Surgical techniques (anterior and posterior approaches, minimal invasive techniques, osteotomies, all spine instrumentation) must be tailored to each patient. The main goals of surgery are treatment of symptoms, correction of deformity in coronal and sagittal plane and achievement of a solid fusion...
February 7, 2018: Revue Médicale Suisse
C Birkenmaier
There are numerous factors that can lead to construct failure and pseudarthrosis after corrective pedicle subtraction osteotomy (PSO) in the lumbar spine. Frequently, several factors are of relevance in these problematic cases. This article attempts to explain the surgical, biomechanical and biological aspects that should be understood in order to minimize the risk of pseudarthrosis and construct failure. It addresses technical varieties of the PSO procedure as well as the surgical technique, the choice of rod material and the design of multirod constructs...
February 6, 2018: Der Orthopäde
W Thompson, A Cogniet, M Challali, R Saddiki, J Rigal, Jean Charles Le Huec
OBJECTIVE: To evaluate postoperative changes within the cervical alignment following surgical lumbar correction by pedicle subtraction osteotomy (PSO) in patients affected with sagittal global malalignment disease. METHODS: This was a monocentric, radiographic, and prospective study. 79 patients, who underwent sagittal correction by PSO, performed an EOS imaging pre- and postoperatively between January 2008 and December 2013 at the University Hospital of Bordeaux...
February 2, 2018: European Spine Journal
F Lattig, E Stettin, S Weckbach
OBJECTIVE: Correction of a segmental or global lumbar hypolordosis to improve a sagittal imbalance. INDICATIONS: Lumbar segments fixed in kyphosis; degenerative or posttraumatic hypolordotic deformity of the lumbar spine with sagittal imbalance. CONTRAINDICATIONS: Bechterew disease; extended adhesions in the retroperitoneum. SURGICAL TECHNIQUE: Segmental correction of a kyphotic fixed segment using a unilateral transforaminal approach to release the annulus and anterior longitudinal ligament...
February 2, 2018: Operative Orthopädie und Traumatologie
Jennifer Lb Martay, Antony Jr Palmer, Neil K Bangerter, Stuart Clare, A Paul Monk, Cameron P Brown, Andrew J Price
BACKGROUND: High tibial osteotomy (HTO) re-aligns the weight-bearing axis (WBA) of the lower limb. The surgery reduces medial load (reducing pain and slowing progression of cartilage damage) while avoiding overloading the lateral compartment. The optimal correction has not been established. This study investigated how different WBA re-alignments affected load distribution in the knee, to consider the optimal post-surgery re-alignment. METHODS: We collected motion analysis and seven Tesla MRI data from three healthy subjects, and combined this data to create sets of subject-specific finite element models (total=45 models)...
January 21, 2018: Knee
Anouar Bourghli, Derek Cawley, Felipe Novoa, Manuela Rey, Abdulmajeed Alzakri, Daniel Larrieu, Jean-Marc Vital, Olivier Gille, Louis Boissiere, Ibrahim Obeid
PURPOSE: Pedicle Subtraction Osteotomy (PSO) is an effective surgical technique for the correction of fixed sagittal malalignment of the spine. It is a demanding technique that requires a long learning curve. The aim of this study is to analyze a surgeon's learning curve for lumbar PSO in relation to the preoperative, perioperative, and postoperative management, with assessment of the global outcome. MATERIALS AND METHODS: 102 patients operated over an 8-year period were included, distributed in 3 groups over the time, and retrospectively analyzed...
January 30, 2018: European Spine Journal
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