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Cortical bone trajectory

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 designs 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. SUMMARY OF BACKGROUND DATA: Pedicle screw fixation is commonly used in the treatment of spinal pathologies...
April 2017: Clinical Spine Surgery
Shota Takenaka, Yoshihiro Mukai, Kosuke Tateishi, Noboru Hosono, Takeshi Fuji, Takashi Kaito
STUDY DESIGN: This study is a retrospective cohort study using prospectively collected data. OBJECTIVE: To compare the effectiveness of posterior lumbar interbody fusion (PLIF) using the cortical bone trajectory (CBT) and conventional pedicle screw (PS) techniques. SUMMARY OF BACKGROUND DATA: There are few published studies to date comparing PLIF using CBT technique with PLIF using the conventional PS technique. METHODS: We studied 119 consecutive patients who underwent single-level PLIF between 2010 and 2014 with a minimum 12-month follow-up...
March 6, 2017: Clinical Spine Surgery
Vishal J Patel, Sohum K Desai, Ken Maynard, Randall Zain Allison, Thomas Frank, Daniel Branch, Aaron Mohanty
No abstract text is available yet for this article.
August 1, 2016: Neurosurgery
Jun Xuan, Jian Chen, Hui He, Hai-Ming Jin, Di Zhang, Yao-Sen Wu, Nai-Feng Tian, Xiang-Yang Wang
Thoracic cortical bone trajectory (CBT) screw fixation can maximize the thread contact with cortical bone, and it is 53.8% higher than that of the traditional pedicle screws. Moreover, it can also enable less tissue dissection and retraction for reduced muscle disruption.Eighty pediatric patients are divided into 4 age groups and their thoracic vertebrae are analyzed on computed tomography (CT) images. The maximal screw length, maximal screw diameter, screw diameter, and the cephalad angle are measured. The statistical analysis is performed using the Student's t-test and Pearson's correlation analysis...
February 2017: Medicine (Baltimore)
Bernhard Rieger, Hongzhen Jiang, Daniel Ruess, Clemens Reinshagen, Marek Molcanyi, Jozef Zivcak, Huaiyu Tong, Gabriele Schackert
PURPOSE: First description of MIS-VLIF, a minimally invasive lumbar stabilization, to evaluate its safety and feasibility in patients suffering from weak bony conditions (lumbar spondylodiscitis and/or osteoporosis). METHODS: After informed consent, 12 patients suffering from lumbar spondylodiscitis underwent single level MIS-VLIF. Eight of them had a manifest osteoporosis, either. Pre- and postoperative clinical status was documented using numeric rating scale (NRS) for leg and back pain...
December 27, 2016: European Spine Journal
Mateusz Bielecki, Przemysław Kunert, Marek Prokopienko, Arkadiusz Nowak, Tomasz Czernicki, Andrzej Marchel
INTRODUCTION: Midline lumbar fusion (MIDLF) using cortical bone trajectory is an alternative method of transpedicular spinal fusion for degenerative disease. The new entry points' location and screwdriving direction allow the approach-related morbidity to be reduced. AIM: To present our preliminary experience with the MIDLF technique on the first 5 patients with lumbar degenerative disease and with follow-up of at least 6 months. MATERIAL AND METHODS: Retrospective analysis was performed on the first 5 patients with foraminal (4) or central (1) stenosis operated on between December 2014 and February 2015...
2016: Wideochirurgia i Inne Techniki Mało Inwazyjne, Videosurgery and Other Miniinvasive Techniques
Koshi Ninomiya, Koichi Iwatsuki, Yu-Ichiro Ohnishi, Toshika Ohkawa, Toshiki Yoshimine
STUDY DESIGN: Retrospective study. PURPOSE: Cortical bone trajectory (CBT), a more medial-to-lateral and shorter path than the traditional one for spinal fusion, is thought to be effective for severely degenerated vertebrae because screws are primarily stabilized at the posterior elements. We evaluated the efficacy of this approach through in vivo insertional torque measurement. OVERVIEW OF LITERATURE: There has been only one prior in vivo study on CBT insertional torque...
October 2016: Asian Spine Journal
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...
December 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...
July 26, 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...
March 15, 2017: 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
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