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Sven Hoppe, Christoph E Albers, Tarek Elfiky, Moritz C Deml, Helena Milavec, Sebastian F Bigdon, Lorin M Benneker
The aim of this study was to assess the performance of a new vacuum plasma sprayed (VPS) titanium-coated carbon/polyetheretherketone (PEEK) cage under first use clinical conditions. Forty-two patients who underwent a one or two segment transforaminal lumbar interbody fusion (TLIF) procedure with a new Ca/PEEK composite cage between 2012 and 2016 were retrospectively identified by an electronic patient chart review. Fusion rates (using X-ray), patient's satisfaction, and complications were followed up for two years...
March 14, 2018: Journal of Functional Biomaterials
John P Kleimeyer, Ivan Cheng, Todd F Alamin, Serena S Hu, Thomas Cha, Vijay Yanamadala, Kirkham B Wood
STUDY DESIGN: This is a retrospective cohort study. OBJECTIVE: To evaluate the long-term outcomes of selective one- to two-level anterior lumbar interbody fusions (ALIFs) in the lower lumbar spine versus continued nonsurgical management. SUMMARY OF BACKGROUND DATA: Low back pain associated with lumbar intervertebral disc degeneration is common with substantial economic impact, yet treatment remains controversial. Surgical fusion has previously provided mixed results with limited durable improvement of pain and function...
March 9, 2018: Spine
A Tateen, J Bogert, H Koller, A Hempfing
BACKGROUND: Surgical correction of ASD can be challenging. The indication for surgery is individual and after specification of the therapeutic goals, detailed planning of the surgery is essential to achieve a good postoperative result. COMPLICATIONS AND INDICATION: The reasons for the comparatively high complication rate are well investigated and are often located at the lumbosacral junction. In addition to negative general factors like osteoporosis, especially undercorrection of the sagittal profile and insufficient lumbo-pelvic stabilization are causative...
March 5, 2018: Der Orthopäde
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
Kamal Woods, Ahtziri Fonseca, Larry E Miller
Introduction Oblique lumbar interbody fusion (OLIF) is a newer procedure that avoids the psoas and lumbosacral plexus due to its oblique trajectory into the retroperitoneal space. While early experience with OLIF is reassuring, the longer-term clinical efficacy has not been well established. The purpose of this study was to describe two-year clinical outcomes with OLIF performed by a single surgeon during the learning curve without the aid of the neuromonitoring. Materials and methods Chart review was performed for the consecutive patients who underwent OLIF by a single surgeon...
December 22, 2017: Curēus
Yongli Wang, Xiangyang Wang
PURPOSE: To report a minimum 12 months follow-up results of our improved bone graft method For upper cervica surgery with posterior approach. METHODS: 52 consecutive patients which included odontoid nonunion in 33 patients, atlantoaxial instability in 11 patients and occipito-cervical deformity in 8 patients who underwent posterior C1-C2 transarticular screw /screw-rod internal fixation ( 41 cases )and occipitocervical fusion ( 11 cases ) with the improved bone graft technique...
February 21, 2018: World Neurosurgery
Anshit Goyal, Panagiotis Kerezoudis, Mohammed Ali Alvi, Sandy Goncalves, Mohamad Bydon
A variety of surgical approaches have been described to treat low grade lumbar degenerative spondylolisthesis (DS). Minimally invasive spinal fusion techniques were first introduced to minimize morbidities associated with invasive surgical treatments. Minimally invasive lateral transpsoas interbody fusion, also known as lateral lumbar interbody fusion (LLIF), is a relatively new method of lumbar arthrodesis that avoids various approach related complications compared to its posterior and anterior counterparts...
February 16, 2018: Clinical Neurology and Neurosurgery
Eric H Ledet, Glenn P Sanders, Darryl J DiRisio, Joseph C Glennon
BACKGROUND: Context: Achieving a successful spinal fusion requires the proper biologic and biomechanical environment. Optimizing load-sharing in the interbody space can enhance bone formation. For anterior cervical discectomy and fusion (ACDF), loading and motion are largely dictated by the stiffness of the plate which can facilitate a balance between stability and load-sharing. The advantages of load-sharing may be substantial for patients with comorbidities and in multi-level procedures where pseudarthrosis rates are significant...
February 13, 2018: Spine Journal: Official Journal of the North American Spine Society
Nathan E How, John T Street, Marcel F Dvorak, Charles G Fisher, Brian K Kwon, Scott Paquette, Justin S Smith, Christopher I Shaffrey, Tamir Ailon
We conducted a systematic review with meta-analysis and qualitative synthesis. This study aims to characterize pseudarthrosis after long-segment fusion in spinal deformity by identifying incidence rates by etiology, risk factors for its development, and common features. Pseudarthrosis can be a painful and debilitating complication of spinal fusion that may require reoperation. It is poorly characterized in the setting of spinal deformity. The MEDLINE, EMBASE, and Cochrane databases were searched for clinical research including spinal deformity patients treated with long-segment fusions reporting pseudarthrosis as a complication...
February 6, 2018: Neurosurgical Review
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
A Carlier, A Vasilevich, M Marechal, J de Boer, L Geris
To date poor treatment options are available for patients with congenital pseudarthrosis of the tibia (CPT), a pediatric orphan disease. In this study we have performed an in silico clinical trial on 200 virtual subjects, generated from a previously established model of murine bone regeneration, to tackle the challenges associated with the small, pediatric patient population. Each virtual subject was simulated to receive no treatment and bone morphogenetic protein (BMP) treatment. We have shown that the degree of severity of CPT is significantly reduced with BMP treatment, although the effect is highly subject-specific...
February 6, 2018: Scientific Reports
N Gutteck, H Martin, T Hanke, J B Matthies, A Heilmann, H Kielstein, G Gradl, K S Delank, D Wohlrab
BACKGROUND: A number of studies report on limitations of the screw arthrodesis in severe malalignment of the hindfoot, neuropathic deformity, poor bone quality and osteoporosis. METHODS: Fourteen anatomically correct polyurethane foam models of the right leg (Sawbones Europe, Malmö, Sweden) and eighteen fresh-frozen human lower leg specimens (9 pairs) were used for the comparative biomechanical testing. RESULTS: The statistical analysis of the stiffness of the fixation developed a significant difference in favor of the plate in all test directions...
February 20, 2017: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
Krzysztof B Siemionow, Pawel Glowka, Robert J Blok, Mark C Gillespy, Mukund I Gundanna, William D Smith, Zeshan Hyder, Bruce M McCormack
Context: Posterior cervical cages have recently become available as an alternative to lateral mass fixation in patients undergoing cervical spine surgery. Aims: The purpose of this study was to quantify the perioperative complications associated with cervical decompression and fusion in patients treated with a posterior cervical fusion (PCF) and bilateral cages. Settings and Design: A retrospective, multicenter review of prospectively collected data was performed at 11 US centers...
October 2017: Journal of Craniovertebral Junction and Spine
Mona I Winge, Magne Røkkum
The purpose of this prospective randomised study was to compare the clinical and radiological outcomes of injectable CaP bone cement with corticocancellous bone graft used to fill voids after corrective opening wedge osteotomies in the distal radius. 17 women/3 men, median age 56 (51.3; 61.0), underwent an open-wedge osteotomy of a dorsal malunion in the distal radius randomised to filling the defect either with bone graft (10) or CaP bone cement (10). Dorsal titanium locking plates were used and the wrist was plastered for 8 weeks...
November 22, 2017: Injury
Mihail-Lazar Mioc, Radu Prejbeanu, Bogdan Deleanu, Bogdan Anglitoiu, Horia Haragus, Marius Niculescu
Distal tibia fractures are reported to have a high complication rate pre-operatively as well as post-operatively, which can include open fractures, soft tissue damage, infection, malalignment, pseudarthrosis and ankle arthrosis. The operative treatment for the extra-articular distal tibia fractures is a controversial topic in the orthopaedic literature. Some of these fractures are proximal enough to be treated with an intramedullary nail while others are too distal for that. The aim of our study was to compare the results we have had with intramedullary nail (IMN) and minimally invasive plate osteosynthesis (MIPO) in distal metaphyseal (extra-articular) tibia fractures...
January 22, 2018: International Orthopaedics
Jesse Li, Remi M Ajiboye, Michael H Orden, Akshay Sharma, Austin Drysch, Sina Pourtaheri
STUDY DESIGN: Systematic review and meta-analysis. OBJECTIVE: The purpose of this study was to evaluate the effect of postoperative ketorolac administration (ie, dosage and duration of use) on pseudarthrosis following thoracolumbar posterolateral spinal fusions. SUMMARY OF BACKGROUND DATA: Ketorolac is a nonsteroidal anti-inflammatory drug often administered for pain control after spine surgery. The main concern with ketorolac is the risk of pseudarthrosis following fusion...
January 18, 2018: Clinical Spine Surgery
An Yan, Hai-Bo Mei, Kun Liu, Jiang-Yan Wu, Jin Tang, Guang-Hui Zhu, Wei-Hua Ye
OBJECTIVE: Treatment of congenital pseudarthrosis of the tibia (CPT) remains a challenge. The autogenic iliac bone graft is important consistent of treatment for CPT. The purpose of this study was to investigate the role of wrapping autogenic iliac bone graft in improvement of the curing opportunities of CPT. METHODS: We combined Ilizarov fixator with intramedullary rodding of the tibia and wrapping autogenic iliac bone graft for treatment 51 cases of CPT between 2007 and 2010...
December 2017: Medicine (Baltimore)
M R Fernández-Marín, M Hidalgo-Pérez, G Arias-Rodríguez, A García-Mendoza, E Prada-Chamorro, G Domecq-Fernández de Bobadilla
OBJECTIVE: This is a retrospective study of 98 diaphyseal forearm fractures in adults, treated by a percutaneous technique with intramedullar Kirchner wires. MATERIALS AND METHOD: We reviewed 64 patients with 98 forearm fractures with a radiographic follow-up, assessing the presence of pseudarthrosis or delayed bone union and evaluating functional outcomes with the Anderson and the Disability of the Arm, Shoulder and Hand scale. RESULTS: Clinical and radiological bone union was achieved in an average of 12 weeks...
January 3, 2018: Revista Española de Cirugía Ortopédica y Traumatología
Metin Işık, Hacı Mustafa Özdemir, Abdurrahman Sakaoğulları, Bertan Cengiz, Nevres Hürriyet Aydoğan
Background/aim: This study was performed to show the efficacy of in situ local autograft with a comparison of in situ local autograft, local autograft with allograft, and local autograft with posterior iliac crest autograft.Materials and methods: In this prospective randomized study, a total of 65 adolescent idiopathic scoliosis (AIS) patients were separated into 3 groups: Group 1 using local autograft and allograft, Group 2 using local autograft only, and Group 3 using local autograft and posterior iliac crest autograft...
December 19, 2017: Turkish Journal of Medical Sciences
Juan Delgado-Fernández, Paloma Pulido, María Ángeles García-Pallero, Guillermo Blasco, Natalia Frade-Porto, Rafael G Sola
OBJECTIVE Spondylolisthesis is a prevalent spine disease that recent studies estimate could be detected in 9% of the population. High-grade spondylolisthesis (HGS), however, is much less frequent, which makes it difficult to develop a general recommendation for its treatment. Posterior transdiscal fixation was proposed in 1994 for HGS, and the use of spine navigation could make this technique more accessible and reduce the morbidity associated with the procedure. The purpose of this study was to present a case series involving adult patients with HGS and correct spinal alignment who were treated with transdiscal pedicle screw placement guided with neuronavigation and compare the results to those achieved previously without image guidance...
January 2018: Neurosurgical Focus
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