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Cortical bone trajectory

Paul Justin Tortolani, D Alexander Stroh
No abstract text is available yet for this article.
November 2016: Journal of the American Academy of Orthopaedic Surgeons
Kingsley R Chin, Fabio J R Pencle, André V Coombs, Mohamed Elsharkawy, Corrine F Packer, Elijah A Hothem, Jason A Seale
STUDY DESIGN: Level III. OBJECTIVE: To report on the outcomes of midline cortical bone trajectory (CBT) pedicle screw surgical technique for posterior lumbar fixation in the outpatient surgery center (OSC) compared with traditional pedicle screws in the hospital. SUMMARY OF BACKGROUND DATA: Traditional pedicle screws have been the gold standard for posterior lumbar fusion. Advances in spine surgery, including less invasive procedures have propelled the design of instruments and implants to achieve greater posterior spinal fixation, with decreased tissue destruction and higher safety margins...
September 16, 2016: Clinical Spine Surgery
Christian Michelitsch, Thi Dan Linh Nguyen-Kim, Thorsten Jentzsch, Hans-Peter Simmen, Clément M L Werner
INTRODUCTION: Typical stabilisation of pelvic open book injuries consists of plate fixation of the symphysis. No previous literature has been published about the evaluation of screw placement and their trajectory with four oblique 4.5 mm screws using a four-hole plate in symphysis diastasis. The aim of this study was to define insertion points and angles of trajectory for crossed screw placement regardless of any plate design based on an analysis of three-dimensional computed tomography data sets...
September 14, 2016: Archives of Orthopaedic and Trauma Surgery
Yi-Ren Chen, Sayantan Deb, Lan Pham, Harminder Singh
OBJECTIVE: Our study aims to evaluate the clinical outcomes of cortical screws in regards to postoperative pain. BACKGROUND: Pedicle screw fixation is the current mainstay technique for posterior spinal fusion. Over the past decade, a new technique called cortical screw fixation has been developed, which allows for medialized screw placement through stronger cortical bone. There have been several studies that showed either biomechanical equivalence or superiority of cortical screws...
2016: Curēus
Sun-Ren Sheng, Jiao-Xiang Chen, Wei Chen, En-Xing Xue, Xiang-Yang Wang, Qing-An Zhu
To quantify the reference data concerning the morphometrics of the middle-upper thorax to guide the placement of cortical bone trajectory (CBT) screws.Eighty patients were studied on computed tomography (CT) scans. The reference anatomical parameters were measured. Next, 20 cadaveric specimens were implanted with CBT screws based on CT measurements. These specimens were then judged directly from the cadaveric vertebrae and X-ray.The maximum length of the trajectory, the maximum diameter, and the cephaled angle exhibited a slight increase trend while the transverse and sagittal angles of the pedicle tended to decrease from T3 to T8...
August 2016: Medicine (Baltimore)
Alan M Rathbun, Michelle Shardell, Denise Orwig, J Richard Hebel, Gregory E Hicks, Thomas J Beck, Jay Magaziner, Marc C Hochberg
Prior studies have shown that women have declines in bone structure and strength after hip fracture, but it is unclear whether men sustain similar changes. Therefore, the objective was to examine sex differences in proximal femur geometry following hip fracture. Hip structural analysis was used to derive metrics of bone structure and strength: aerial bone mineral density, cross-sectional bone area (CSA), cortical outer diameter, section modulus (SM), and buckling ratio (BR) from dual-energy x-ray absorptiometry scans performed at baseline (within 22days of hospital admission), two, six, or twelve months after hip fracture in men and women (n=282) enrolled in the Baltimore Hip Studies 7th cohort...
November 2016: Bone
Hironobu Sakaura, Toshitada Miwa, Tomoya Yamashita, Yusuke Kuroda, Tetsuo Ohwada
STUDY DESIGN: Clinical case series. PURPOSE: In the posterior lumbar interbody fusion (PLIF) procedure in our institute, the cephalad screw trajectory follows a mediolateral and caudocephalad directed path according to the original cortical bone trajectory (CBT) method. However, the starting point of the caudal screw is at the medial border of the pedicle on an articular surface of the superior articular process, and the trajectory takes a mediolateral path parallel to the cephalad endplate...
August 2016: Asian Spine Journal
Jun Xuan, Di Zhang, Hai-Ming Jin, Jiao-Xiang Chen, Dao-Liang Xu, Hong-Ming Xu, Yao-Sen Wu, Xiang-Yang Wang
PURPOSE: To evaluate the feasibility of cortical bone trajectory (CBT) screws fixation via pedicle or pedicle rib unit in the cadaveric thoracic spine (T9-T12). METHODS: Computed tomography (CT) images of 100 patients are analyzed by multiplanar reconstruction. Ten cadaveric thoracic spines are used to insert 4.5 × 35.0 mm CBT screws at all levels from T9 to T12. RESULTS: Maximal screw length obtained by CT has a tendency to gradually increase from T9 (29...
August 23, 2016: European Spine Journal
Jun Chen, Michael Carl, Yajun Ma, Hongda Shao, Xing Lu, Bimin Chen, Eric Y Chang, Zhihong Wu, Jiang Du
We report the three-dimensional ultrashort-TE (3D UTE) and adiabatic inversion recovery UTE (IR-UTE) sequences employing a radial trajectory with conical view ordering for bi-component T2 * analysis of bound water (T2 *(BW) ) and pore water (T2 *(PW) ) in cortical bone. An interleaved dual-echo 3D UTE acquisition scheme was developed for fast bi-component analysis of bound and pore water in cortical bone. A 3D IR-UTE acquisition scheme employing multiple spokes per IR was developed for bound water imaging. Two-dimensional UTE (2D UTE) and IR-UTE sequences were employed for comparison...
October 2016: NMR in Biomedicine
J Pazour, M Křivohlávek, R Lukáš
UNLABELLED: PURPOSE OF THE STUDY The aim of the study was to analyse the options for sustentacular screw placement in osteosynthesis of intra-articular fractures of the heel bone and to assess the effect of various screw positions on failure to maintain the reduction in the postoperative period. In addition, problems related to screw-end protrusion over the medial cortical bone or to screw penetration into the talocalcaneal joint were assessed. MATERIAL AND METHODS The group comprised 23 patients with a total of 25 intra-articular fractures of the heel bone treated by surgery...
2016: Acta Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaca
Taku Sugawara, Naoki Higashiyama, Shuichi Kaneyama, Masatoshi Sumi
STUDY DESIGN: Prospective clinical trial of the screw insertion method for posterior C1-C2 fixation utilizing the patient-specific screw guide template technique. OBJECTIVE: To evaluate the efficacy of this method for insertion of C1 lateral mass screws (LMS), C2 pedicle screws (PS), and C2 laminar screws (LS). SUMMARY OF BACKGROUND DATA: Posterior C1LMS and C2PS fixation, also known as the Goel-Harms method, can achieve immediate rigid fixation and high fusion rate, but the screw insertion carries the risk of injury to neuronal and vascular structures...
July 22, 2016: Spine
Kailiang Xu, Jean-Gabriel Minonzio, Dean Ta, Bo Hu, Weiqi Wang, Pascal Laugier
The 2-D Fourier transform analysis of multichannel signals is a straightforward method to extract the dispersion curves of guided modes. Basically, the time signals recorded at several positions along the waveguide are converted to the wavenumber-frequency space, so that the dispersion curves (i.e., the frequency-dependent wavenumbers) of the guided modes can be extracted by detecting peaks of energy trajectories. In order to improve the dispersion curve extraction of low-amplitude modes propagating in a cortical bone, a multiemitter and multireceiver transducer array has been developed together with an effective singular vector decomposition (SVD)-based signal processing method...
October 2016: IEEE Transactions on Ultrasonics, Ferroelectrics, and Frequency Control
Vishal J Patel, Sohum K Desai, Ken Maynard, Randall Zain Allison, Thomas Frank, Daniel Branch, Aaron Mohanty
INTRODUCTION: Idiopathic scoliosis is the lateral curvature of the spinal column greater than 10° with no established etiology. In skeletally immature pediatric patients, risk of progression is associated with the severity of curvature. It has been estimated that this risk is nearly 90% for patients with curvatures exceeding 50°, and this is typically the severity at which surgical management is indicated. Current surgical techniques rely heavily on posterior instrumentation with pedicle screw systems...
August 2016: Neurosurgery
Jeffrey P Mullin, Breanna Perlmutter, Eric Schmidt, Edward Benzel, Michael P Steinmetz
OBJECTIVE In 2009, Santoni and colleagues described a novel technique of posterior instrumentation; the cortical bone trajectory (CBT) was described as a caudocephalad and medial-to-lateral trajectory. Reported indications for CBT fixation include patients with osteoporosis, single-level degenerative disease, or adjacent-segment disease (ASD). In cases of revision surgery, it is technically possible and beneficial to place a traditional pedicle screw and a CBT screw at the same spinal level and side. It remains unclear as to the feasibility of placing both a traditional and a CBT screw at all levels of the lumbar spine and with varying trajectories of the preexisting traditional pedicle screws...
July 8, 2016: Journal of Neurosurgery. Spine
Keitaro Matsukawa, Yoshiyuki Yato, Richard A Hynes, Hideaki Imabayashi, Naobumi Hosogane, Takashi Asazuma, Matsui Toshiyasu, Yasushi Kobayashi, Koichi Nemoto
STUDY DESIGN: A morphometric measurement of new thoracic pedicle screw trajectory using computed tomography (CT) and a biomechanical study on cadaveric thoracic vertebrae using insertional torque. OBJECTIVE: To introduce a new thoracic pedicle screw trajectory which maximizes engagement with denser bone. SUMMARY OF BACKGROUND DATA: Cortical bone trajectory (CBT) which maximizes the thread contact with cortical bone provides enhanced screw purchase...
June 20, 2016: Clinical Spine Surgery
Rohan-Jean Bianco, Pierre-Jean Arnoux, Eric Wagnac, Jean-Marc Mac-Thiong, Carl-Éric Aubin
STUDY DESIGN: Detailed biomechanical analysis of the anchorage performance provided by different pedicle screw design and placement strategies under pullout loading. OBJECTIVE: To biomechanically characterize the specific effects of surgeon-specific pedicle screw design parameters on anchorage performance using a finite element model (FEM). SUMMARY OF BACKGROUND DATA: Pedicle screw fixation is commonly used in the treatment of spinal pathologies...
June 20, 2016: Clinical Spine Surgery
Hironobu Sakaura, Toshitada Miwa, Tomoya Yamashita, Yusuke Kuroda, Tetsuo Ohwada
OBJECTIVE Several biomechanical studies have demonstrated the favorable mechanical properties of the cortical bone trajectory (CBT) screw. However, no reports have examined surgical outcomes of posterior lumbar interbody fusion (PLIF) with CBT screw fixation for degenerative spondylolisthesis (DS) compared with those after PLIF using traditional pedicle screw (PS) fixation. The purposes of this study were thus to elucidate surgical outcomes after PLIF with CBT screw fixation for DS and to compare these results with those after PLIF using traditional PS fixation...
May 27, 2016: Journal of Neurosurgery. Spine
Charles A Sansur, Nicholas M Caffes, David M Ibrahimi, Nathan L Pratt, Evan M Lewis, Ashley A Murgatroyd, Bryan W Cunningham
OBJECTIVE Optimal strategies for fixation in the osteoporotic lumbar spine remain a clinical issue. Classic transpedicular fixation in the osteoporotic spine is frequently plagued with construct instability, often due to inadequate cortical screw-bone purchase. A cortical bone trajectory maximizes bony purchase and has been reported to provide increased screw pullout strength. The aim of the current investigation was to evaluate the biomechanical efficacy of cortical spinal fixation as a surgical alternative to transpedicular fixation in the osteoporotic lumbar spine under physiological loading...
May 13, 2016: Journal of Neurosurgery. Spine
Ya-Jun Ma, Eric Y Chang, Graeme M Bydder, Jiang Du
Ultrashort-TE (UTE) sequences can obtain signal directly from short-T2 , collagen-rich tissues. It is generally accepted that bound and free water can be detected with UTE techniques, but the ability to detect protons directly on the collagen molecule remains controversial. In this study, we investigated the potential of UTE sequences on a 3-T clinical scanner to detect collagen protons via freeze-drying and D2 O-H2 O exchange studies. Experiments were performed on bovine cortical bone and human Achilles tendon specimens, which were either subject to freeze-drying for over 66 h or D2 O-H2 O exchange for 6 days...
July 2016: NMR in Biomedicine
Kimberly Ashayeri, Rani Nasser, Jonathan Nakhla, Reza Yassari
INTRODUCTION: This technical note presents, to the authors' knowledge, the first reported case of a hybrid pedicle-cortical screw system for instrumented fusion in a patient with congenital vertebral column deformity. CASE: Cortical screws were navigated using stereotactic guidance to extend a prior non-segmented fusion mass, facilitating instrumentation in a circumstance with completely distorted anatomy. This technique provided a safe trajectory with excellent cortical purchase in an anatomically deformed spine...
May 2, 2016: European Spine Journal
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