Результаты поиска

Rationale, biomechanics, and surgical indications for Graf ligamentoplasty.

Graf ligamentoplasty stabilizes the unstable segment through coaptation of bilateral facet joints. Intervertebral disc height should be preserved to avoid postoperative neuroforaminal stenosis. Biomechanically and clinically, this procedure has the potential to treat "flexion instability" but cannot correct vertebral slippage or scoliotic deformity. Surgical indication or patient selection is the key to successful ligamentoplasty. The surgical indication is degenerative lumbar disorder with less than 25% of vertebral slip, minimal disc space narrowing, and coronal facet tropism. In the long-te

Minimally invasive lateral mass screws in the treatment of cervical facet dislocations: technical note.

OBJECTIVE: The technique of lateral mass screw and rod or plate fixation is a major advancement in the posterior instrumentation of the cervical spine. This technique provides rigid three-dimensional fixation, restores the dorsal tension band, and provides highly effective stabilization in patients with many types of traumatic injuries. METHODS: Patient 1 was a 32-year-old man who had been in a motor vehicle accident. He presented with right C5 radiculopathy. X-ray findings included 45% anterolisthesis of C4 on C5, bilateral facet disruption, and right unilateral C4-C5 facet fracture and disl

Lumbar motion segment pathology adjacent to thoracolumbar, lumbar, and lumbosacral fusions.

STUDY DESIGN: Fifty-eight patients came to two spinal surgeons with abnormalities adjacent to a previously fused thoracic or lumbosacral segment after they had been asymptomatic for more than 2 years. Radiographs, outcome analysis, analog pain evaluation, patient demographics, and medical indices were analyzed to evaluate risk factors for adjacent segment abnormality. OBJECTIVES: Risk factors for adjacent segment breakdown and pathophysiology of adjacent segment breakdown were analyzed in this longitudinal study. SUMMARY OF BACKGROUND DATA: Fifty-eight patients underwent a thoracolumbar, lum

Factors Influencing Surgical Decision-Making in the Posterior Laminectomy With Fixation for Degenerative Cervical Myelopathy (POLYFIX-DCM) Trial: Survey Study.

BACKGROUND: Degenerative cervical myelopathy (DCM) is estimated to affect 2% of the adult population. DCM occurs when degenerative processes … n-making, such as alignment, location of compression, number of levels operated, presence of mobile spondylolisthesis, and patient age. RESULTS: The majority of PIs (16/30, 53%) completed the survey. Overall, PIs favored a posterior approach (12/16, 75%) with instrumentation (75/112, average 66%) and would randomize (67/112, average 62%) most cases. Factors report …

Clinical Outcomes of Isobar TTL System with Isthmic Bone Grafting and Pedicle Screw-Vertebral Plate Hook with Direct Repair of Defect for Lumbar Spondylolysis: A Matched-Pair Case Control Study.

OBJECTIVE: Although direct isthmic repair, such as PSVPH, did not affect the mobility of the fixed segment and adjacent segment, it has a re … group were matched to 25 patients in PSVPH group for age, sex, body mass index (BMI), defect side, spondylolisthesis meyerding, and follow-up duration. The intervertebral space height (IH) of stabilized segment at postoperative 1 week and final follow-up in the TTL group was higher than those in the PSVPH group, respectively (P = 0.030; P = 0.013). The ROM of stab …

Back pain in adolescent athletes: a narrative review.

BACKGROUND: Back pain in young athletes is common. Adolescents are at an increased risk for back pain related to several factors including r … ement was reached. RESULTS: Adolescent athletes have a higher risk of developing spondylolysis and spondylolisthesis than their non-athletic counterparts. Participation in athletic activity alone, increased body mass index, varsity status, and nationally/internationally competitive status are identified are demographic risk factors. Weightlifters, gymnasts, footba …

Endoscopic transforaminal lumbar interbody fusion without general anesthesia: operative and clinical outcomes in 100 consecutive patients with a minimum 1-year follow-up.

OBJECTIVEOpen spinal fusion surgery is often associated with significant blood loss, postoperative pain, and prolonged recovery times. Seeki … n criteria for the procedure consisted of diagnosis of degenerative disc disease with grade I or II spondylolisthesis and evidence of spinal stenosis or nerve impingement with intractable symptomatology.RESULTSOf the first 100 patients, 56 were female and 44 were male. Single-level fusion was performed in 84 patients and two-level fusion in 16 patients. The most co …

Paraspinal textiloma after posterior lumbar surgery: a wolf in sheep's clothing.

OBJECTIVE: Paraspinal textiloma (ParaTex) is a well-known complication after posterior lumbar surgery. However, there are few articles on th … omy for a lumbar spinal stenosis, and a Gill's procedure was performed in one patient with a lumbar spondylolisthesis. The time from the causative operation to presentation ranged from 2 months to 6 years. All patients presented with nonspecific lower back pain and/or surgical site infection without fever or neurological symptoms. Laboratory parameters showed incre …

Preliminary results of a randomized, equivalence trial of fluoroscopic caudal epidural injections in managing chronic low back pain: Part 4--Spinal stenosis.

BACKGROUND: Spinal stenosis is one of the 3 most common diagnoses of low back and leg symptoms which also include disc herniation and degenerative spondylolisthesis. Spinal stenosis is a narrowing of the spinal canal with encroachment on the neural structures by surrounding the bone and soft tissue. In the United States, one of the most commonly performed interventions for managing chronic low back pain are epidural injections, including their use for spinal stenosis. However, there have not been any randomized trials and evidence is limited with regards to the effectiveness of epidural inject…

Juvenile degenerative disc disease: a report of 76 cases identified by magnetic resonance imaging.

BACKGROUND: Persistent low back pain in the young remains a significant diagnostic and treatment challenge for clinicians. Traditionally, ch … ck pain for greater that 6 months were identified. Patients with scoliosis, Scheuermann's kyphosis, spondylolisthesis, fracture, tumor, and metabolic bone disease were excluded. Standard demographic information, relevant medical history and physical examination findings were collected. Patients were evaluated with an MRI of their spines to detect any potential unde …

Harvesting local cylinder autograft from adjacent vertebral body for anterior lumbar interbody fusion: surgical technique, operative feasibility and preliminary clinical results.

Autogenous iliac crest has long served as the gold standard for anterior lumbar arthrodesis although added morbidity results from the bone g … indications for surgery were failed conservative treatment of a lumbar degenerative disc disease or spondylolisthesis. The purpose of this study, therefore, was to report on the surgical technique, operative feasibility, safety, benefits, and drawbacks of this technique with our primary clinical experience. An independent researcher reviewed all data that had been …

Open vertebral cement augmentation combined with lumbar decompression for the operative management of thoracolumbar stenosis secondary to osteoporotic burst fractures.

Osteoporotic burst fractures with neurologic symptoms are typically treated with neural decompression and multilevel instrumented fusion. Th … ectomy of the stenotic level(s) was followed by vertebral cement augmentation (9 VP; 16 KP). When a spondylolisthesis at the decompressed level was present, instrumentation was applied across the listhetic level (n = 9). Clinical outcome (1 = poor to 4 = excellent) was assessed on last clinical follow-up (mean, 44.8 wks). In addition, a modified MacNab's grading cr …

Oral Presentations

Аннотация не предоставлена источником. Откройте карточку для перехода к публикации.

Совпадение в полном тексте источника
… Little evidence focuses on the treatment of degenerative spondylolisthesis. The objective of this study was to compare post-operative patient rated outcomes (PROs) of posterolateral fusion (PLF) versus IF surgery in patients with lumbar degenerative spondylolisthesis. … Conclusions: Our study found equivalence in PROs between PLF and IF in propensity matched patients with degenerative spondylolisthesis at 12 months. …

Assessing the Intraoperative Accuracy of Pedicle Screw Placement by Using a Bone-Mounted Miniature Robot System through Secondary Registration.

INTRODUCTION: Pedicle screws are commonly employed to restore spinal stability and correct deformities. The Renaissance robotic system was developed to improve the accuracy of pedicle screw placement. PURPOSE: In this study, we developed an intraoperative classification system for evaluating the accuracy of pedicle screw placements through secondary registration. Furthermore, we evaluated the benefits of using the Renaissance robotic system in pedicle screw placement and postoperative evaluations. Finally, we examined the factors affecting the accuracy of pedicle screw implantation. RESULTS:

Posterior lumbar fusion by peek rods in degenerative spine: preliminary report on 30 cases.

PURPOSE: Pre-curved peek rods to support posterior lumbar fusion have been available in the market since 4 years. Potential advantages using this new technology are increased load sharing on the anterior column promoting interbody fusion, reduced stress on bone-screw interface decreasing the rate of screw mobilization and, in the long term, reduced incidence of adjacent level disc degeneration. METHODS: The authors retrospectively reviewed 30 cases in which posterior fusion was supported by peek rods, analyzing early complications, rate of fusion and clinical outcome. RESULTS: At an average

Lumbosacral dislocation: a review of the literature and current aspects of management.

Lumbosacral fracture dislocation is a very rare lesion and was first described by Watson-Jones in 1940. Two anatomical classifications are described in the literature, all other reports are case presentations. This fracture type is characterised by an antero- or retrolisthesis or a lateral translation of the 5th lumbar vertebra in relation to the sacrum. Biomechanics are discussed controversially. Most patients suffer from a high energy trauma with concomitant severe injuries. There is a high rate of additional neurological deficits. Fractures of the transverse process are thought to be sentin

A biomechanical comparison of different types of lumbopelvic fixation.

STUDY DESIGN: Comparative biomechanical testing in calf spines. OBJECTIVE: To biomechanically evaluate 4 techniques of lumbosacral fixation. SUMMARY OF BACKGROUND DATA: Pelvic fixation is a problematic area, and currently, the preferred method of pelvic fixation is controversial. Clinically, iliac screws have demonstrated decreased rod breakage rates, and better correction of pelvic obliquity than unthreaded rods (Galveston technique), but several modern methods of iliac fixation have not been compared. METHODS: A total of 32 male calf spines were tested under axial rotation, flexion/extens