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Cortical bone trajectory

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https://www.readbyqxmd.com/read/29670905/cortical-bone-trajectory-screws-in-posterior-lumbar-interbody-fusion-minimally-invasive-surgery-for-maximal-muscle-sparing-a-prospective-comparative-study-with-the-traditional-open-technique
#1
Nicola Marengo, Marco Ajello, Michele Federico Pecoraro, Giulia Pilloni, Giovanni Vercelli, Fabio Cofano, Francesco Zenga, Alessandro Ducati, Diego Garbossa
Introduction: A prospective comparative study between classical posterior interbody fusion with peduncular screws and the new technique with divergent cortical screws was conducted. Material and Methods: Only patients with monosegmental degenerative disease were recruited into this study. We analyzed a cohort of 40 patients treated from January 2015 to March 2016 divided into 2 groups (20 patients went to traditional open surgery and 20 patients under mini-invasive strategy)...
2018: BioMed Research International
https://www.readbyqxmd.com/read/29669577/is-a-patient-specific-drill-template-via-a-cortical-bone-trajectory-safe-in-cervical-anterior-transpedicular-insertion
#2
Peng Peng, Yafei Xu, Xintao Zhang, Meisong Zhu, Bingran Du, Wenrui Li, Wenhua Huang, Jun Song, Jianyi Li
BACKGROUND: This study aimed to develop patient-specific drill templates by computer numerical control or three-dimensional printing via two cortical bone trajectories (CBTs) and to evaluate their efficacies and accuracies in cervical anterior transpedicular insertion. METHODS: Preoperative CT images of 20 cadaveric cervical vertebrae (C3-C7) were obtained. After image processing, patient-specific drill templates were randomly assigned to be constructed via two CBTs (CBT0 and CBT0...
April 18, 2018: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/29663147/cortical-bone-trajectory-screws-for-circumferential-arthrodesis-in-lumbar-degenerative-spine-clinical-and-radiological-outcomes-of-101-cases
#3
Nicola Marengo, Pedro Berjano, Fabio Cofano, Marco Ajello, Francesco Zenga, Giulia Pilloni, Federica Penner, Salvatore Petrone, Lorenzo Vay, Alessandro Ducati, Diego Garbossa
PURPOSE: The use of cortical bone trajectory (CBT) pedicle screws for circumferential interbody fusion represents a viable alternative for single-level procedure with reduced invasiveness and less tissue destruction than the traditional technique. In addition, CBT screws have a potentially stronger pullout strength because of the greater amount of cortical bone intercepted. Only few series exist evaluating clinical and radiological outcomes of CBT screws. METHODS: This is a retrospective cohort study...
April 16, 2018: European Spine Journal
https://www.readbyqxmd.com/read/29604337/sexually-dimorphic-tibia-shape-is-linked-to-natural-osteoarthritis-in-str-ort-mice
#4
Behzad Javaheri, Hajar Razi, Miriam Piles, Roberto de Souza, Yu-Mei Chang, Iris Maric-Mur, Mark Hopkinson, Peter D Lee, Andrew A Pitsillides
OBJECTIVES: Human osteoarthritis (OA) is detected only at late stages. Male STR/Ort mice develop knee OA spontaneously with known longitudinal trajectory, offering scope to identify OA predisposing factors. We exploit the lack of overt OA in female STR/Ort and in both sexes of parental, control CBA mice to explore whether early divergence in tibial bone mass or shape are linked to emergent OA. METHOD: We undertook detailed micro-CT comparisons of trabecular and cortical bone, multiple structural/architectural parameters and finite element modelling (FEM) of the tibia from male and female STR/Ort and CBA mice at 8-10 (pre-OA), 18-20 (OA onset) and 40+ weeks (advanced OA) of age...
March 28, 2018: Osteoarthritis and Cartilage
https://www.readbyqxmd.com/read/29463278/clinical-and-radiological-effect-of-medialized-cortical-bone-trajectory-for-lumbar-pedicle-screw-fixation-in-patients-with-degenerative-lumbar-spondylolisthesis-study-protocol-for-a-randomized-controlled-trial-mpact
#5
Anja Tschugg, Pujan Kavakebi, Sebastian Hartmann, Sara Lener, Christoph Wipplinger, Wolfgang N Löscher, Sabrina Neururer, Matthias Wildauer, Claudius Thomé
BACKGROUND: Spinal fusion with pedicle screw fixation represents the gold standard for lumbar degenerative disc disease with instability. Although it is an established technique, it is nevertheless an invasive intervention with high complication rates. Therefore, minimally invasive approaches have been developed, the medialized bilateral screw pedicel fixation (mPACT) being one of them. The study objective is to evaluate prospectively the efficacy and safety of the mPACT technique compared with the traditional trajectory for degenerative lumbar spondylolisthesis...
February 20, 2018: Trials
https://www.readbyqxmd.com/read/29462734/divergent-bilateral-plif-with-cortical-screw-fixation-description-of-new-trajectory-for-interbody-technique-from-midline-exposure
#6
Michael A Bohl, Randy J Hlubek, U Kumar Kakarla, Steve W Chang
BACKGROUND: A major drawback to the use of cortical bone trajectory pedicle screws (CBTPS) with traditional posterior lumbar interbody fusion (PLIF) and transforaminal lumbar interbody fusion (TLIF) grafts is that traditional graft insertion trajectories require a wider posterior exposure. This wider exposure, beyond the limits otherwise required for CBTPS placement, negates a primary benefit of CBTPS fixation. OBJECTIVE: To define an alternative surgical technique for interbody graft placement that, when used in conjunction with CBTPS fixation, permits both minimal soft tissue dissection and optimal graft placement...
February 17, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29433165/considerations-in-meta-analysis-regarding-complications-of-cortical-bone-trajectory-versus-traditional-pedicle-screw-fixation
#7
Kevin Phan, Ralph J Mobbs
No abstract text is available yet for this article.
February 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29394462/sex-ethnic-and-age-specific-centile-curves-for-pqct-and-hr-pqct-derived-measures-of-bone-structure-and-strength-in-adolescents-and-young-adults
#8
Leigh Gabel, Lindsay A Nettlefold, Heather M Macdonald, Heather A McKay
There are presently no adolescent centile curves for bone parameters at the tibial midshaft using peripheral quantitative computed tomography (pQCT) or at the distal radius and tibia using high-resolution pQCT (HR-pQCT). Thus, we aimed to develop sex-, ethnic-, site- and age-specific centile curves for pQCT and HR-pQCT-derived bone outcomes for youth and young adults aged 10-21 years. We acquired pQCT scans (XCT3000) at the tibial midshaft (50% site) and HR-pQCT scans (XtremeCT, Scanco Medical) at the distal radius (7% site) and tibia (8% site) in a convenience sample of participants in the mixed-longitudinal University of British Columbia Healthy Bones III Study...
February 2, 2018: Journal of Bone and Mineral Research: the Official Journal of the American Society for Bone and Mineral Research
https://www.readbyqxmd.com/read/29354747/systematic-review-of-cortical-bone-trajectory-versus-pedicle-screw-techniques-for-lumbosacral-spine-fusion
#9
REVIEW
Kevin Phan, Vignesh Ramachandran, Tommy M Tran, Kevin P Shah, Matthew Fadhil, Alan Lackey, Nicholas Chang, Ai-Min Wu, Ralph J Mobbs
Fusion of the lumbosacral spine is a common surgical procedure to address a range of spinal pathologies. Fixation in lumbar fusion has traditionally been performed using pedicle screw (PS) augmentation. However, an alternative method of screw insertion via cortical bone trajectory (CBT) has been advocated as a less invasive approach which improves initial fixation and reduces neurovascular injury. There is a paucity of robust clinical evidence to support these claims, particularly in comparison to traditional pedicle screws...
December 2017: Journal of Spine Surgery (Hong Kong)
https://www.readbyqxmd.com/read/29319607/longitudinal-resting-state-functional-magnetic-resonance-imaging-in-a-mouse-model-of-metastatic-bone-cancer-reveals-distinct-functional-reorganizations-along-a-developing-chronic-pain-state
#10
David Buehlmann, Joanes Grandjean, Jael Xandry, Markus Rudin
Functional neuroimaging has emerged as attractive option for characterizing pain states complementing behavioral readouts or clinical assessment. In particular, resting-state functional magnetic resonance imaging (rs-fMRI) enables monitoring of functional adaptations across the brain, for example, in response to chronic nociceptive input. We have used rs-fMRI in a mouse model of chronic pain from breast cancer-derived tibial bone metastases to identify pain-induced alterations in functional connectivity. Combined assessment of behavioral readouts allowed for defining a trajectory as model function for extracting pain-specific functional connectivity changes from the fMRI data reflective of a chronic pain state...
April 2018: Pain
https://www.readbyqxmd.com/read/29287813/pedicle-screw-with-increased-cortical-purchase-can-be-inserted-with-same-accuracy-as-the-screw-in-straightforward-trajectory-using-3d-modeling-landmarks
#11
Michal Szczodry, Giovanni F Solitro, Farid Amirouche, Priyesh Patel
STUDY DESIGN: Comparison, in terms of insertion accuracy and biomechanical performance, between an increased cortical purchase and straightforward pedicle screw trajectory. OBJECTIVE: This study aims to compare a trajectory with increased cortical purchase to the more common straightforward trajectory in terms of strength and insertion accuracy using real-time navigation. SUMMARY OF BACKGROUND DATA: In previous studies, it was suggested that pedicle screw pullout strength is strongly correlated with bone mineral density, and using a more cortical tract allows a greater portion of the denser bone, the cortex, to be in contact with the screw...
January 2018: Spine Deformity
https://www.readbyqxmd.com/read/29260301/regional-hounsfield-unit-measurement-of-screw-trajectory-for-predicting-pedicle-screw-fixation-using-cortical-bone-trajectory-a-retrospective-cohort-study
#12
Keitaro Matsukawa, Yuichiro Abe, Yoshihide Yanai, Yoshiyuki Yato
BACKGROUND: The sufficiency of screw anchoring is a critical factor for achieving successful spinal fusion; however, no reliable method for predicting pedicle screw fixation has been established. Recently, Hounsfield units (HU) obtained from computed tomography (CT) was developed as a new reliable tool to determine the bone quality. The purpose of the present study was to demonstrate the utility of regional HU measurement of the screw trajectory to predict the primary and long-term fixation strength of pedicle screws...
February 2018: Acta Neurochirurgica
https://www.readbyqxmd.com/read/29208475/cortical-bone-trajectory-screws-fixation-in-lumbar-adjacent-segment-disease-a-technique-note-with-case-series
#13
Chao-Hsuan Chen, Hsieng-Ming Huang, Der-Cherng Chen, Chih-Ying Wu, Han-Chun Lee, Der-Yang Cho
Lumbar adjacent segment disease after lumbar fusion surgery often requires surgical intervention. However, subsequent surgical treatment often needs to expose and remove all of the previous instruments. This additional surgery leads to significant post-operative pain, muscular fibrosis, poor wound healing and infection, etc. From October 2015 to March 2016, we collected six cases underwent cortical bone trajectory screws fixation with minimal invasive inter-body cage fusion for lumbar adjacent segment disease...
February 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29155112/posterior-lumbar-interbody-fusion-with-3d-navigation-guided-cortical-bone-trajectory-screws-for-l4-5-degenerative-spondylolisthesis-1-year-clinical-and-radiographic-outcomes
#14
Ibrahim Hussain, Michael S Virk, Thomas W Link, Apostolos J Tsiouris, Eric Elowitz
OBJECTIVE: We describe our technique and evaluate clinical and radiographic outcomes for patients undergoing L4/5 posterior lumbar interbody fusion with 3D-navigation guided cortical bone trajectory screws (PLIF-CBT) for grade 1 or 2 degenerative spondylolisthesis with a minimum follow-up time of 12 months. METHODS: A single-institution series of 18 patients was evaluated with data prospectively collected and retrospectively analyzed. Pain and disability scores were collected preoperatively and at a minimum of 12 months postoperatively, including back and bilateral leg pain visual analog scores (VAS) and Oswestry Disability Index (ODI) scores...
February 2018: World Neurosurgery
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
#15
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/29125430/cortical-bone-trajectory-screw-fixation-versus-traditional-pedicle-screw-fixation-for-2-level-posterior-lumbar-interbody-fusion-comparison-of-surgical-outcomes-for-2-level-degenerative-lumbar-spondylolisthesis
#16
Hironobu Sakaura, Toshitada Miwa, Tomoya Yamashita, Yusuke Kuroda, Tetsuo Ohwada
OBJECTIVE The cortical bone trajectory (CBT) screw technique is a new nontraditional pedicle screw (PS) insertion method. However, the biomechanical behavior of multilevel CBT screw/rod fixation remains unclear, and surgical outcomes in patients after 2-level posterior lumbar interbody fusion (PLIF) using CBT screw fixation have not been reported. Thus, the purposes of this study were to examine the clinical and radiological outcomes after 2-level PLIF using CBT screw fixation for 2-level degenerative lumbar spondylolisthesis (DS) and to compare these outcomes with those after 2-level PLIF using traditional PS fixation...
January 2018: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/29093793/review-of-cortical-bone-trajectory-evidence-of-a-new-technique
#17
REVIEW
Juan Delgado-Fernandez, Maria Ángeles García-Pallero, Guillermo Blasco, Paloma Pulido-Rivas, Rafael G Sola
This article summarizes recent evidence on the cortical bone trajectory (CBT) obtained from published anatomical, biomechanical, and clinical studies. CBT was proposed by Santoni in 2009 as a new trajectory that can improve the fixation of pedicle screws in response to screw loosening in osteoporotic patients. Recently, research interest has been growing with increasing numbers of published series and frequent reports of new applications. We performed an online database search using the terms "cortical bone trajectory," "pedicle screw," "CBT spine," "CBT fixation," "MISS CBT," and "traditional trajectory...
October 2017: Asian Spine Journal
https://www.readbyqxmd.com/read/29074318/pedicle-screws-with-modular-head-vs-preassembled-head-used-in-cortical-bone-trajectory-can-pars-and-pedicle-fractures-be-prevented-in-osteoporotic-bone
#18
Wayne K Cheng, Yusuf T Akpolat, Serkan İnceoğlu, Olumide A Danisa
Pars and pedicle fractures as a result of CBT (cortical bone trajectory) during pedicle screw placement have been reported. The primary aim of the study is to compare the fracture rate between screws with modular heads to screws with standard pre-assembled tulip heads. The secondary aim of the study is to determine the potential variables that can be identified prior to instrumentation in order to predict risk of fractures. Twenty-four fresh frozen lumbar vertebrae were obtained from five different cadavers...
January 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29061616/transforaminal-lumbar-interbody-fusion-with-cortical-bone-trajectory-screws-versus-traditional-pedicle-screws-fixation-a-study-protocol-of-randomised-controlled-trial
#19
Zhenhua Feng, Xiaobin Li, Qian Tang, Chenggui Wang, Wenhao Zheng, Hui Zhang, Ai-Min Wu, Naifeng Tian, Yaosen Wu, Wenfei Ni
INTRODUCTION: Transforaminal lumbar interbody fusion (TLIF) has been widely used in the treatment of lumbar degenerative disc disorders and shows favourable clinical results. Recently, cortical bone trajectory (CBT) has become a new trajectory for screw insertion in the lumbar spine. Several biomechanical studies have demonstrated that the CBT technique achieves screw purchase and strength greater than the traditional method. Currently, the available data on the clinical effectiveness of the two performed surgeries, TLIF with CBT screws (CBT-TLIF) and TLIF with traditional pedicle screws (PS-TLIF), are insufficient...
October 22, 2017: BMJ Open
https://www.readbyqxmd.com/read/28966154/comparative-study-of-cortical-bone-trajectory-pedicle-screw-cortical-screw-versus-conventional-pedicle-screw-in-single-level-posterior-lumbar-interbody-fusion-a-2-year-post-hoc-analysis-from-prospectively-randomized-data
#20
RANDOMIZED CONTROLLED TRIAL
Gun Woo Lee, Myun-Whan Ahn
OBJECTIVE: The aim of this study was to report 2-year follow-up outcomes of posterior lumbar interbody fusion (PLIF) with cortical bone trajectory-pedicle screw (CS), in terms of fusion rates, clinical outcomes, surgical outcomes, and complications, and to compare these outcomes with outcomes for PLIF with conventional pedicle screw (PS). METHODS: We enrolled 79 patients and randomly assigned them to 2 groups (group A with PS, 39 patients; group B with CS, 40 patients), and finally 37 and 35 in group A and B were analyzed in the study...
January 2018: World Neurosurgery
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