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Pseudoarthrosis spine

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https://www.readbyqxmd.com/read/29933804/preventing-pseudoarthrosis-and-proximal-junctional-kyphosis-how-to-deal-with-the-osteoporotic-spine
#1
REVIEW
Isaac O Karikari, Lionel N Metz
The increase in the aging population has led to an overall increase in the number of elderly patients undergoing spinal fusion surgery. This patient population, however, exhibits significant treatment challenges because of poor bone quality. By virtue of exhibiting decreased pullout strength and insertional torque, osteoporotic patients are at a substantial risk of developing vertebral fractures, instrumentation failure, pseudoarthrosis, and proximal junctional failures. It is, therefore, imperative for the treating surgeon to optimize bone health before recommending a spinal fusion surgery...
July 2018: Neurosurgery Clinics of North America
https://www.readbyqxmd.com/read/29933803/the-nuances-of-pedicle-subtraction-osteotomies
#2
REVIEW
Sachin Gupta, Munish C Gupta
In adult spinal deformity, the pedicle subtraction osteotomy is a useful technique to provide correction, especially in rigid, previously fused spines. However, it is not without its complications. In an effort to prevent pseudoarthrosis, a new technique using 4 rods has been pioneered to decrease stress on the 2 long rods while allowing for maintenance of correction with 2 smaller rods. One should also use careful neuromonitoring, especially during closure, to be able to make adjustments in time to prevent the development of neurologic deficits...
July 2018: Neurosurgery Clinics of North America
https://www.readbyqxmd.com/read/29643538/-anterior-cervical-discectomy-and-fusion-to-treat-cervical-spondylosis-with-sympathetic-symptoms
#3
H Liu, L Yue, S L Chen, B Hu, C D Li, X D Yi, H Li, H L Lu, Y Wang, Z R Yu, H L Sun, S J Wang, Y Zhao, L T Qi, R Wang
OBJECTIVE: To investigate the clinical effectiveness of polytheretherketone (PEEK) cages assisted anterior cervical discetomy and fusion (ACDF) to treat cervical spondylosis with sympathetic symptoms. METHODS: Retrospective analysis was undertaken for 39 patients who were diagnosed as cervical spondylosis with sympathetic symptoms and underwent ACDF with PEEK cages. Radiographs obtained before surgery, after surgery, and at the final follow-up were assessed for quality of fusion...
April 18, 2018: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
https://www.readbyqxmd.com/read/29510280/surgical-management-of-lumbosacral-giant-invasive-spinal-schwannoma-a-case-report-and-literature-review
#4
Danika Paulo, Alexa Semonche, Rachana Tyagi
BACKGROUND: Giant invasive spinal schwannomas (GISS) comprise a rare, specific subtype of schwannomas that extend over two spinal levels, erode vertebral bodies and invade extraspinal tissues. Optimal surgical management of resulting spinal instability has yet to be determined, and overall there is limited published literature on GISS. We report an innovative method used to treat a rare case of lumbosacral GISS using a triangular frame reconstruction to reconnect the spinal column to the pelvis after tumor debulking...
March 3, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29371585/biomechanical-stability-of-a-cross-rod-connection-with-a-pedicle-screw-system
#5
Tetsutaro Mizuno, Toshihiko Sakakibara, Takamasa Yoshikawa, Tadashi Inaba, Takaya Kato, Yuichi Kasai
BACKGROUND Surgery with pedicle screw instrumentation does not provide sufficient torsional stability. This leads to pseudoarthrosis, loosening of the pedicle screws, and, ultimately, implant failure. MATERIAL AND METHODS Functional spinal units from 18 deer were evaluated using a 6-axis material testing machine. As specimen models, we prepared an intact model, a damaged model, a cross-rod model, and a cross-link model. We measured the range of motion (ROM) during bending and rotation tests. RESULTS The range of motions of cross-rod model were almost equal to those of cross-link model during the bending test...
January 26, 2018: Medical Science Monitor Basic Research
https://www.readbyqxmd.com/read/29354732/c7-intra-laminar-screws-for-complex-cervicothoracic-spine-surgery-a-case-series
#6
Peter John Wilson, Michael Derrick Selby
Background: C7 has relatively unique anatomy compared to the remainder of the subaxial cervical spine (C3-C6) and upper thoracic spine. The C7 laminar has been previously reported in feasibility and biomechanical studies as an adequate fixation point in contrast to the lateral mass or pedicles, with few reports of its use in clinical practice. The purpose of this study was to review the safety and efficacy of using the C7 laminar as a fixation point in constructs involving the cervical spine and cervicothoracic junction...
December 2017: Journal of Spine Surgery (Hong Kong)
https://www.readbyqxmd.com/read/29223523/effect-of-smoking-status-on-successful-arthrodesis-clinical-outcome-and-complications-after-anterior-lumbar-interbody-fusion-alif
#7
MULTICENTER STUDY
Kevin Phan, Matthew Fadhil, Nicholas Chang, Gloria Giang, Cristian Gragnaniello, Ralph J Mobbs
BACKGROUND: Anterior lumbar interbody fusion (ALIF) is a surgical technique indicated for the treatment of several lumbar pathologies. Smoking has been suggested as a possible cause of reduced fusion rates after ALIF, although the literature regarding the impact of smoking status on lumbar spine surgery is not well established. This study aims to assess the impact of perioperative smoking status on the rates of perioperative complications, fusion, and adverse clinical outcomes in patients undergoing ALIF surgery...
February 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29096033/cervical-spine-deformity-part-3-posterior-techniques-clinical-outcome-and-complications
#8
Lee A Tan, K Daniel Riew, Vincent C Traynelis
The goals of cervical deformity surgery include deformity correction, restoration of horizontal gaze, decompression of neural elements, spinal stabilization with a biomechanically sound construct, and meticulous arthrodesis technique to prevent pseudoarthrosis and minimizing surgical complications. Many different surgical options exist, but selecting the correct approach that ensures the optimal clinical outcome can be challenging and often controversial. In this last part of the cervical deformity review series, various posterior deformity correction techniques are discussed in detail, along with an overview of surgical outcome and postoperative complications...
December 1, 2017: Neurosurgery
https://www.readbyqxmd.com/read/29021682/spontaneous-regression-of-retro-odontoid-post-traumatic-cicatrix-following-occipitocervical-fixation
#9
Priyank Sinha, Ming-Te Lee, Sasan Panbehchi, Ankur Saxena, Debasish Pal
This case report describes a patient who presented with myelopathy secondary to a large retro-odontoid post traumatic cicatrix. The objective of this study was to discuss the clinical presentation, pathogenesis, imaging, and surgical management of pseudoarthrosis tissue mass associated with odontoid nonunion. Atlantoaxial subluxation (AAS) has been widely reported in patients with rheumatoid arthritis. AAS leads to repeated cycles of partial tear and repair of ligaments around the altantoaxial complex, resulting in the formation of periodontoid mass (pseudotumor)...
July 2017: Journal of Craniovertebral Junction and Spine
https://www.readbyqxmd.com/read/28937465/treatment-of-cervicogenic-headache-concurrent-with-cervical-stenosis-by-anterior-cervical-decompression-and-fusion
#10
Hong Liu, Avraam Ploumis, Shijun Wang, Chunde Li, Hong Li
STUDY DESIGN: Retrospective study. OBJECTIVE: To report the efficacy of anterior cervical decompression and fusion surgery as treatment method for cervicogenic headache (CeH). SUMMARY OF BACKGROUND DATA: The exact diagnostic criteria and optimal treatment of CeH is still under investigation. METHODS: A total of 34 consecutive patients (mean age 55.8 y) with CeH (in addition to cervical stenosis symptomatology) resistant to nonoperative treatment were treated by anterior cervical decompression and fusion from 1 up to 3 levels and were followed for at least 1 year...
October 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28937458/transpedicular-corpectomy-and-cage-placement-in-the-treatment-of-traumatic-lumbar-burst-fractures
#11
Martin H Pham, Alexander Tuchman, Thomas C Chen, Frank L Acosta, Patrick C Hsieh, John C Liu
STUDY DESIGN: Retrospective review. OBJECTIVE: To review the feasibility of a posterior-only approach for instrumented reconstruction in lumbar burst fractures. BACKGROUND: Burst fractures of the lumbar spine have been treated through a variety of techniques, including anterior, posterior, or combined approaches. Here we review series of patients undergoing posterior-only transpedicular corpectomy with instrumented fusion for traumatic lumbar burst fracture...
October 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28894679/management-of-thoracic-disc-herniations-via-posterior-unilateral-modified-transfacet-pedicle-sparing-decompression-with-segmental-instrumentation-and-interbody-fusion
#12
Daniel A Carr, Andrey A Volkov, David L Rhoiney, Pradeep Setty, Ryan J Barrett, Roderick Claybrooks, Peter L Bono, Doris Tong, Teck M Soo
STUDY DESIGN: Retrospective consecutive case series. OBJECTIVE: The objective of this case series was to demonstrate the safety of a modified transfacet pedicle-sparing decompression and instrumented fusion in patients with thoracic disc herniations (TDHs). METHODS: Consecutive patients undergoing operative management of TDH from July 2007 to December 2011 using a posterior unilateral modified transfacet pedicle-sparing approach were identified...
September 2017: Global Spine Journal
https://www.readbyqxmd.com/read/28822825/comparison-of-transforaminal-lumbar-interbody-fusion-outcomes-in-patients-receiving-rhbmp-2-versus-autograft
#13
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 (TLIFs). 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...
March 2018: 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
#14
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
#15
Elliott J Kim, Silky Chotai, Joseph B Wick, David P Stonko, Ahilan Sivaganesan, Clinton J Devin
STUDY DESIGN: A retrospective review of a prospective database. OBJECTIVE: The aim of this study was to 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...
April 1, 2018: Spine
https://www.readbyqxmd.com/read/28631069/-s2-ala-iliac-screws-for-extended-pelvic-fixation-in-longer-lumbar-instrumentations-description-of-a-freehand-technique
#16
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
#17
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
#18
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
#19
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. OBJECTIVE: 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)...
November 1, 2017: Spine
https://www.readbyqxmd.com/read/28253944/-management-of-odontoid-fractures-with-compression-screw-and-anterior-transarticular-screw-fixation-in-elderly-patients
#20
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
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