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Pseudoarthrosis spine

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https://www.readbyqxmd.com/read/28822825/comparison-of-transforaminal-lumbar-interbody-fusion-outcomes-in-patients-receiving-rhbmp-2-versus-autograft
#1
Taleef R Khan, Kalin R Pearce, Steven J McAnany, Colleen M Peters, Munish C Gupta, Lukas P Zebala
BACKGROUND CONTEXT: Recombinant human bone morphogenetic protein 2 (rhBMP-2) plays a pivotal role in complex spine surgery. Despite its limited approval, the off-label use of rhBMP-2 is prevalent, particularly in transforaminal lumbar interbody fusions (TLIF) PURPOSE: To determine the effectiveness and safety of rhBMP-2 use in TLIF procedures versus autograft. STUDY DESIGN: Retrospective Cohort Study PATIENT SAMPLE: Patients older than 18 years undergoing spine surgery for lumbar degenerative spine disease at a single academic institution...
August 16, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28816877/fractures-in-spinal-ankylosing-disorders-a-narrative-review-of-disease-and-injury-types-treatment-techniques-and-outcomes
#2
Tarush Rustagi, Doniel Drazin, Cumhur Oner, Jonathan York, Gregory D Schroeder, Alexander R Vaccaro, Rod J Oskouian, Jens R Chapman
INTRODUCTION: Spinal ankylosing disorders encompass ankylosing spondylitis (AS), disseminated hyperostosis of the spine, and end-stage spondylosis. All these result in a stiffened and frequently deformed spinal column. This makes the spinal column highly susceptible to severe injuries that are commonly associated with unfavorable outcomes. Improved understanding of the underlying disease processes and clinical comorbidities may alter the poor injury related morbidity and mortality outcomes...
September 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28767625/patient-reported-outcomes-and-costs-associated-with-revision-surgery-for-degenerative-cervical-spine-diseases
#3
Elliott J Kim, Silky Chotai, Joseph B Wick, David P Stonko, Ahilan Sivaganesan, Clinton J Devin
STUDY DESIGN: Retrospective review of a prospective database. OBJECTIVE: Determine cost and outcomes of revision cervical spine surgery. SUMMARY OF BACKGROUND DATA: Revision rates for cervical spine surgery are steadily increasing. It is important to counsel patients on expected results following a revision procedure. However, outcomes and cost of these procedures are poorly defined in the literature. METHODS: Patients undergoing revision cervical spine surgery at a single institution were included between October 2010 and January 2016 in a prospective registry database...
August 1, 2017: Spine
https://www.readbyqxmd.com/read/28631069/-s2-ala-iliac-screws-for-extended-pelvic-fixation-in-longer-lumbar-instrumentations-description-of-a-freehand-technique
#4
REVIEW
F Lattig, S Weckbach
OBJECTIVE: To reduce the rate of implant failures at the lumbosacral junction in polysegmental lumbar fusions. INDICATIONS: Spinal fusion with deformity correction including L5/S1, revision surgery for pseudoarthrosis L5/S1, screw pull-out and pedicle fractures in S1, and S1/S2 fractures after polysegmental fusions. CONTRAINDICATIONS: Osteosynthesis of complex pelvic ring fractures, tumors of the ilium. Relative contraindication: infection, to avoid contamination of the iliosacral joint...
August 2017: Operative Orthopädie und Traumatologie
https://www.readbyqxmd.com/read/28593199/analysis-of-instrumentation-failures-after-three-column-osteotomies-of-the-spine
#5
Niranjan Kavadi, Richard A Tallarico, William F Lavelle
BACKGROUND: Correction of fixed spinal imbalance in a sagittal and/or coronal plane frequently needs a tricolumnar wedge resection when the deformity is rigid. Complications associated with deformity correction surgery are pseudoarthrosis and implant failure located along the construct. The purposes of this study were to assess comparative rates of pseudoarthrosis (implant failure) at weaker points along lumbosacral junction and level of osteotomy, estimate overall incidence of implant failure, and comparatively analyze failures at different points along the construct...
2017: Scoliosis and Spinal Disorders
https://www.readbyqxmd.com/read/28409128/the-use-of-bone-morphogenetic-proteins-bmp-and-pseudarthrosis-a-literature-review
#6
REVIEW
Oberdan Ribeiro Gonçalves de Oliveira, Saul Pinheiro Rebouças Martins, Wyvison Gomes de Lima, Marília Maia Gomes
Bone morphogenetic proteins (BMP) are multi-functional growth factors to promote bone healing with the proposal of less morbidity compared to the usual methods of bone graft harvest. Pseudoarthrosis occur when the fusion attempt fails, a solid fusion is not achieved, or there is motion across the segment leading to it, and it can be clinically symptomatic as pain, deformity, neurocompression, or hardware failure. BMPs are used at spinal fusion as a tool for the treatment of degenerative, traumatic, neoplastic and infectious conditions of the spine...
March 2017: Revista Brasileira de Ortopedia
https://www.readbyqxmd.com/read/28296812/pedicled-vascularized-clavicular-graft-for-anterior-cervical-arthrodesis-cadaveric-feasibility-study-technique-description-and-case-report
#7
Michael A Bohl, Michael A Mooney, Joshua S Catapano, Kaith K Almefty, Mark C Preul, Steve W Chang, U Kumar Kakarla, Edward M Reece, Jay D Turner, Randall W Porter
STUDY DESIGN: Cadaveric feasibility study. OBJECTIVES: To assess the anatomic and technical feasibility of rotating a clavicular segment on a sternocleidomastoid muscle (SCM) pedicle into the ventral cervical spine using a cadaveric model and to provide the first clinical case description of performing this procedure. SUMMARY OF BACKGROUND DATA: Reconstruction of the anterior cervical spine in patients with a high risk of pseudoarthrosis may require the use of a vascularized bone graft (VBG)...
March 14, 2017: Spine
https://www.readbyqxmd.com/read/28253944/-management-of-odontoid-fractures-with-compression-screw-and-anterior-transarticular-screw-fixation-in-elderly-patients
#8
J Kočiš, M Kelbl, R Veselý, T Kočiš
PURPOSE OF THE STUDY In the management of dens axis fractures in patients older than 65 years of age the posterior approach is preferred due to osteoporosis and the risk of a failure of anterior osteosynthesis. The posterior approach, however, is associated with a higher incidence of complications. A combination of anterior transarticular fixation of C1/2 (ATS) with compression osteosynthesis of dens axis significantly increases the stability of osteosynthesis. MATERIAL AND METHODS In the period from 2009 to 2015 our hospital admitted 13 patients older than 65 years of age with a diagnosed type III dens axis fracture based on AO classification...
2017: Acta Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaca
https://www.readbyqxmd.com/read/28204927/bicortical-facet-screws-as-a-new-option-for-posterior-c2-fixation-anatomical-study-and-clinical-experience
#9
Angelo Rusconi, E Freitas-Olim, P Coloma, R Messerer, C Barrey
PURPOSE: C2 fixation is a demanding procedure, particularly in patients with variants of C1-C2 anatomy. The inferior articular process (IAP) of the axis can be an alternative for screw placement. We report the results of a CT study of C2 IAP anatomy and we present the clinical experience of 28 patients operated with this technique. METHODS: Anatomical study: 50 CT angiographies of the vertebral arteries (VA) were used for this study and, therefore, 100 IAPs were considered...
February 15, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28202380/impact-of-surgical-site-infection-and-surgical-debridement-on-lumbar-arthrodesis-a-single-institution-analysis-of-incidence-and-risk-factors
#10
Timothy Y Wang, Adam G Back, Eliza Hompe, Kevin Wall, Oren N Gottfried
This study identifies the rate of pseudarthrosis following surgical debridement for deep lumbar spine surgical site infection and identify associated risk factors. Patients who underwent index lumbar fusion surgery from 2013 to 2014 were included if they met the following criteria: 1) age >18years, 2) had debridement of deep lumbar SSI, and had 3) lumbar spine AP, lateral and flexion/extension X-rays and computed tomography (CT) at 12months or greater postoperatively. Criteria for fusion included 1) solid posterolateral, facet, or disk space bridging bone, 2) no translational or angular motion on flexion/extension X-rays, and 3) intact posterior hardware without evidence of screw lucency or breakage...
May 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28126356/efficacy-comparison-of-accell-evo3-and-grafton-demineralized-bone-matrix-putties-against-autologous-bone-in-a-rat-posterolateral-spine-fusion-model
#11
Antonio T Brecevich, Paul D Kiely, B Victor Yoon, Joseph T Nguyen, Frank P Cammisa, Celeste Abjornson
BACKGROUND CONTEXT: Spinal fusion procedures are intended to stabilize the spinal column for a multitude of disorders including abnormal curvature, traumatic instability, degenerative instability, and damage from infections or tumors. As an aid in the bone healing response, bone graft materials are used to bridge joints for arthrodesis and promote unions in pseudoarthrosis. Currently, the gold standard for stabilizing fusion masses in spinal procedures involves using the osteogenic, osteoinductive, and osteoconductive properties of autologous iliac crest corticocancellous bone...
January 23, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/27858238/instrumentation-failure-following-pedicle-subtraction-osteotomy-the-role-of-rod-material-diameter-and-multi-rod-constructs
#12
Andrea Luca, Claudia Ottardi, Maurizio Sasso, Liliana Prosdocimo, Luigi La Barbera, Marco Brayda-Bruno, Fabio Galbusera, Tomaso Villa
PURPOSE: Pedicle subtraction osteotomy (PSO) has a complication rate noticeably higher than other corrective surgical techniques used for the treatment of spinal sagittal imbalance. In particular, rod breakage and pseudoarthrosis remain burning issues of this technique. Goal of this study was to investigate the biomechanical performance of several hardware constructs. METHODS: The study was performed using two validated finite element models of the lumbosacral spine (L1-S1) incorporating a PSO on L3 and L4, respectively...
November 17, 2016: European Spine Journal
https://www.readbyqxmd.com/read/27792409/stand-alone-anterior-lumbar-interbody-fusion-indications-techniques-surgical-outcomes-and-complications
#13
REVIEW
Mena Kerolus, Mazda K Turel, Lee Tan, Harel Deutsch
Anterior lumbar interbody fusion (ALIF) is a well-established technique to achieve lumbar spine fusion with various indications including degenerative disk disease, spondylolisthesis, recurrent disk herniation, adjacent level disease, pseudoarthrosis, as well as being used as part of the overall strategy to restore sagittal balance. ALIF can be an extremely useful tool in any spine surgeon's armamentarium. However, like any surgical procedure, proper patient selection is key to success. A solid understanding of the biomechanics, careful surgical planning, along with clear knowledge of the advantages and disadvantages of stand-alone ALIF will ensure optimal clinical outcome...
December 2016: Expert Review of Medical Devices
https://www.readbyqxmd.com/read/27683705/minimally-invasive-surgery-in-adult-degenerative-scoliosis-a-systematic-review-and-meta-analysis-of-decompression-anterior-lateral-and-posterior-lumbar-approaches
#14
Kevin Phan, Ya Ruth Huo, Jarred A Hogan, Joshua Xu, Alexander Dunn, Samuel K Cho, Ralph J Mobbs, Patrick McKenna, Trichy Rajagopal, Farhaan Altaf
BACKGROUND: Minimally invasive approaches for the treatment of adult degenerative scoliosis have been increasingly implemented. However, little data exists regarding the safety and complication profiles of minimally invasive lumbar interbody fusion (LIF) for adult degenerative scoliosis. This study aimed to greater understand different minimally invasive surgical approaches for adult degenerative scoliosis with respect to clinical outcomes, changes in radiographic measurements, and complication profiles via meta-analytical techniques...
June 2016: Journal of Spine Surgery (Hong Kong)
https://www.readbyqxmd.com/read/27520991/surgical-treatment-for-an-uncommon-headache-a-gap-of-4800-years
#15
Albert Isidro, Joan Manel Burdeus, Sergi Loscos, Javier Bara, Josep Bosch, Anna Gallart
BACKGROUND: Surgical management of headache due to anomalies in the cervical spine is uncommon, as most cases improve with drugs and/or physical therapy. CASE: We report two instances of a very uncommon congenital upper cervical spine anomaly due to the presence of a pseudoarthrosis between a unilateral paracondylar process in the base of the skull and an epitransverse process arising from the transverse apophysis (PCP/ETA). The first one corresponds to a male on whom an endoscopic guided puncture was performed, and the second to an adult male from the Neolithic period who showed two cranial trepanations together with the presence of morphine metabolites in both bones and dental calculus...
August 12, 2016: Cephalalgia: An International Journal of Headache
https://www.readbyqxmd.com/read/27433416/evaluation-of-a-hybrid-dynamic-stabilization-and-fusion-system-in-the-lumbar-spine-a-10-year-experience
#16
Ahmed Kashkoush, Nitin Agarwal, Erin Paschel, Ezequiel Goldschmidt, Peter C Gerszten
INTRODUCTION: The development of adjacent-segment disease is a recognized consequence of lumbar fusion surgery. Posterior dynamic stabilization, or motion preservation, techniques have been developed which theoretically decrease stress on adjacent segments following fusion. This study presents the experience of using a hybrid dynamic stabilization and fusion construct for degenerative lumbar spine pathology in place of rigid arthrodesis. METHODS: A clinical cohort investigation was conducted of 66 consecutive patients (31 female, 35 male; mean age: 53 years, range: 25 - 76 years) who underwent posterior lumbar instrumentation with the Dynesys Transition Optima (DTO) implant (Zimmer-Biomet Spine, Warsaw, IN) hybrid dynamic stabilization and fusion system over a 10-year period...
2016: Curēus
https://www.readbyqxmd.com/read/27411527/role-of-minimally-invasive-surgery-for-adult-spinal-deformity-in-preventing-complications
#17
REVIEW
Chun-Po Yen, Yusef I Mosley, Juan S Uribe
With the aging population, there is a rising prevalence of degenerative spinal deformity and need of surgical care for these patients. Surgical treatment for adult spinal deformity (ASD) is often fraught with a high rate of complications. Minimally invasive surgery (MIS) has for the past decade been adopted by spine surgeons to treat ASD in the hopes of reducing access-related morbidity and perioperative complications. The benefits of MIS approach in general and recent development of MIS techniques to avoid long-term complications such as pseudoarthrosis or proximal junctional kyphosis are reviewed...
September 2016: Current Reviews in Musculoskeletal Medicine
https://www.readbyqxmd.com/read/27399444/165%C3%A2-what-is-the-effect-of-open-vs-percutaneous-screws-on-complications-among-patients-undergoing-lateral-interbody-fusion-for-adult-spinal-deformity
#18
Khoi Duc Than, Stacie Nguyen, Paul Park, Dean Chou, Frank La Marca, Juan S Uribe, Todd Douglas Vogel, Pierce D Nunley, Robert Eastlack, Neel Anand, Adam S Kanter, Praveen V Mummaneni, Gregory M Mundis
INTRODUCTION: This study aims to compare differences in incidence and type of complications (COMP) between circumferential minimally invasive surgery (cMIS, ie MIS transforaminal lumbar interbody fusion [TLIF] and/or lumbar lateral interbody fusion [LLIF] with MIS screws) and hybrid approaches (HYB, ie MIS LLIF ± with open screws). METHODS: A retrospective review of a multicenter MIS deformity database was performed. Inclusion criteria for this database: age >18 years, and at least one of the following: coronal Cobb angle (CCA) >20, SVA >5 cm, PI-LL >10, and PT > 20...
August 2016: Neurosurgery
https://www.readbyqxmd.com/read/27396376/rhbmp-2-protects-against-reoperation-for-pseudoarthrosis-and-or-instrumentation-failure-a-matched-case-control-study-of-448-patients
#19
Mohamed Macki, Sbaa Syeda, Panagiotis Kerezoudis, Ali Bydon, Timothy F Witham, Daniel M Sciubba, Jean-Paul Wolinsky, Mohamad Bydon, Ziya Gokaslan
The objective of this independent study is to determine the impact of recombinant human bone morphogenetic protein 2 (rhBMP-2) on reoperation for pseudarthrosis and/or instrumentation failure. A nested case-control study of first-time posterolateral, instrumented fusion of the lumbar spine for degenerative spinal disease was undertaken. Cases of reoperation for pseudoarthrosis and/or instrumentation failure were assigned to controls, who did not experience the primary outcome measure at the time of reoperation...
October 2016: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/27364425/introduction-to-lumbosacral-and-sacropelvic-fixation-strategies
#20
Patrick C Hsieh, Praveen V Mummaneni
We are pleased to present this Neurosurgical Focus video supplement on lumbosacral and sacropelvic fixation strategies. Despite advancement in surgical techniques and technologies in spine, achieving consistent solid fusion across the lumbosacral junction remains a major challenge. The anatomy of the lumbosacral junction allows for a higher range of motion compared to other areas of the thoracolumbar spine. The L5-S1 interspace is exposed to significant shear forces. As a result, complications such as pseudoarthrosis, screw pull-out, implant fracture, or sacral fractures can occur...
July 2016: Neurosurgical Focus
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