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pedicle screw

Markus R Konieczny, Rüdiger Krauspe
STUDY DESIGN: This study was a retrospective radiographic analysis of consecutive patients. OBJECTIVES: To analyze exposure to radiation of the surgeon and-separately-of patients in minimally invasive surgery (MIS) of multilevel posterior stabilization by percutaneous pedicle screw insertion guided by navigation (PIN) versus percutaneous pedicle screw insertion guided by fluoroscopy (PIF). SUMMARY OF BACKGROUND DATA: Spine surgeons are exposed to a 12-fold higher dose of radiation than other nonspinal musculoskeletal surgeons and PIF in MIS leads to a 2-fold higher dose of radiation than in open surgery...
February 12, 2019: Clinical Spine Surgery
Jorge Ariel Rasmussen, Federico Landriel, Santiago Hem, Sebastián Kornfeld, Claudio Yampolsky
STUDY DESIGN: Systematic review and descriptive data meta-analysis. OBJECTIVE: The objective of this study was to appropriately establish the accuracy in the percutaneous transpedicular screws (PTS) placement using biplane radioscopy (Rx-2D). SUMMARY OF BACKGROUND DATA: The Rx-2D is a widely-used technique for PTS as it is practical, ubiquitous, and cost-effective. However, the reported "acceptable" accuracy attained by this method is widely variable ranging between 76% and 100%...
February 12, 2019: Clinical Spine Surgery
Kangwu Chen, Hao Chen, Kai Zhang, Peng Yang, Jiajia Sun, Jianqiang Mo, Feng Zhou, Huilin Yang, Haiqing Mao
STUDY DESIGN: This is a retrospective study. OBJECTIVE: The purpose of this study is to compare the clinical outcomes between O-arm navigation combined with microscope-assisted minimally invasive transforaminal lumbar interbody fusion (novel MIS-TLIF) and open-TLIF for the treatment of 1-level lumbar degenerative disease. SUMMARY OF BACKGROUND DATA: MIS-TLIF is becoming increasingly popular; however, the limited visualization may increase various surgical complications...
February 12, 2019: Clinical Spine Surgery
Jakub Godzik, Corey T Walker, Cory Hartman, Bernardo de Andrada, Clinton D Morgan, George Mastorakos, Steven Chang, Jay Turner, Randall W Porter, Laura Snyder, Juan Uribe
BACKGROUND: Minimally invasive surgery (MIS) and anterior (ALIF), transforaminal (TLIF), or lateral lumbar interbody fusion (LLIF) often require percutaneous pedicle screw fixation (PSF) to achieve circumferential fusion. Robotic guidance technology may augment workflow to improve screw placement and decrease operative time. OBJECTIVE: To report surgical experience with robotically assisted percutaneous screw placement following LLIF. METHODS: Data from fusions with robotically assisted PSF in prone or lateral decubitus positions was reviewed...
February 6, 2019: Operative Neurosurgery (Hagerstown, Md.)
Marc R Nuwer
No abstract text is available yet for this article.
January 31, 2019: Clinical Neurophysiology: Official Journal of the International Federation of Clinical Neurophysiology
Daipayan Guha, Raphael Jakubovic, Naif M Alotaibi, Jesse M Klostranec, Sidharth Saini, Ryan Deorajh, Shaurya Gupta, Michael G Fehlings, Todd G Mainprize, Albert Yee, Victor X D Yang
PURPOSE: Computer-assisted three-dimensional navigation often guides spinal instrumentation. Optical topographic imaging (OTI) offers comparable accuracy and significantly faster registration relative to current navigation systems in open posterior thoracolumbar exposures. Here, we validate the utility and accuracy of OTI in minimally-invasive (MIS) spinal approaches. METHODS: Mini-open midline posterior exposures were performed in four human cadavers. Square exposures of size 25, 30, 35, and 40mm were registered to preoperative CT imaging...
February 8, 2019: World Neurosurgery
Jean-Marc Mac-Thiong, Rodrigo Remondino, J Joncas, Stefan Parent, Hubert Labelle
PURPOSE: The objective of this study is to determine whether routine follow-up 5 years after adolescent idiopathic scoliosis (AIS) surgery is likely to affect postoperative care for patients treated with high-density pedicle screw constructs, when routine 2-year follow-up has been performed. METHODS: We reviewed 80 patients undergoing surgery for AIS using high-density pedicle screw constructs and followed routinely 2 and 5 years after surgery. Quality of life (QOL) was assessed using the SRS-30 outcome questionnaire...
February 11, 2019: European Spine Journal
Chao Wu, Jiayan Deng, Lun Tan, Xu Lin, Dechao Yuan
Objective: To investigate the accuracy of progressive three-dimensional navigation template system (abbreviated as progressive template) to assist atlas-axial pedicle screw placement. Methods: The clinical data of 33 patients with atlas-axial posterior internal fixation surgery between May 2015 and May 2017 were retrospectively analyzed. According to the different methods of auxiliary screw placement, the patients were divided into trial group (19 cases, screw placement assisted by progressive template) and control group (14 cases, screw placement assisted by single navigation template system, abbreviated as initial navigation template)...
February 1, 2019: Chinese Journal of Reparative and Reconstructive Surgery
Xiaoguang Han, Wei Tian, Yajun Liu, Bo Liu, Da He, Yuqing Sun, Xiao Han, Mingxing Fan, Jingwei Zhao, Yunfeng Xu, Qi Zhang
OBJECTIVEThe object of this study was to compare the safety and accuracy of pedicle screw placement using the TiRobot system versus conventional fluoroscopy in thoracolumbar spinal surgery.METHODSPatients with degenerative or traumatic thoracolumbar spinal disorders requiring spinal instrumentation were randomly assigned to either the TiRobot-assisted group (RG) or the freehand fluoroscopy-assisted group (FG) at a 1:1 ratio. The primary outcome measure was the accuracy of screw placement according to the Gertzbein-Robbins scale; grades A and B (pedicle breach < 2 mm) were considered clinically acceptable...
February 8, 2019: Journal of Neurosurgery. Spine
Frank Hartmann, Thomas Nusselt, Gerrit Maier, Pol Maria Rommens, Erol Gercek
BACKGROUND: Recent minimal-invasive posterior fusion devices are supposed to provide stability and obtain fusion in combination with interbody cages in the instrumented segment. The aim of the present study is to evaluate the primary stability of two minimal-invasive posterior prototypes compared to an established spinous process plate and standard pedicle screw instrumentation. METHODS: Seven fresh frozen human cadaver lumbar spines (L2-L5) were tested in a spinal testing device with a moment of 7...
February 1, 2019: Clinical Biomechanics
Joshua Bakhsheshian, Saman Sizdahkhani, Ifije Ohiorhenuan, Ian A Buchanan, Ben Strickland, Martin H Pham
Traumatic spondylolisthesis of C2-C3 is an unstable fracture. Posterior fixation techniques can be employed with intraoperative navigation, however this tool is not available to all spine surgeons. Furthermore, the evidence for posterior surgical stabilization of C2, while adhering to motion preservation principles is currently unknown. The authors describe a patient who had fractures of the pedicle and vertebral body of C2 and C3, which was successfully stabilized with freehand placement of C2 pedicle lag screws and subsequent C2-C5 fixation...
February 5, 2019: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Alexa J Karkenny, Joseph R Mendelis, David S Geller, Jaime A Gomez
An orthopaedic surgeon's knowledge of anatomical landmarks is crucial, but other modalities supplement this by providing guidance and feedback to a surgeon. Advances in imaging have enabled three-dimensional visualization of the surgical field and patient anatomy, whereas advances in computer technology have allowed for real-time tracking of instruments and implants. Together, these innovations have given rise to intraoperative navigation systems. The authors review these advances in intraoperative navigation across orthopaedic subspecialties, focusing on the most recent evidence on patient outcomes and complications, the associated learning curve, and the effects on operative time, radiation exposure, and cost...
February 1, 2019: Journal of the American Academy of Orthopaedic Surgeons
Daniel J Cognetti, Amer F Samdani, Joshua M Pahys, Mari L Groves, Steven W Hwang
Growing rod surgery for skeletally immature patients helps correct severe scoliosis while allowing continued spinal column growth. Previous reports have studied vertebral body changes following growing rod surgery, but there are currently no published reports on alterations in pedicle morphology. Given the potential need for definitive spinal fusion with pedicle screw instrumentation, an awareness of changes in pedicle morphology is critical. A morphometric analysis of pedicles was performed using 3D reconstructions of 3 CT scans (preoperative and at 3 and 6 years) obtained in a young girl with infantile idiopathic scoliosis (T7 apex) who underwent unilateral rib-to-spine growing rod (2nd-4th ribs to L1) implantation with lengthening every 6 months for 6 years...
February 1, 2019: Journal of Neurosurgery. Spine
Wei Fan, Li-Xin Guo
Previous studies have compared the effects of different interbody fusion approaches on biomechanical responses of the lumbar spine to static loadings. However, very few have dealt with the whole body vibration (WBV) condition that is typically present in vehicles. This study was designed to determine the biomechanical differences among anterior, posterior and transforaminal lumbar interbody fusion (ALIF, PLIF and TLIF) under vertical WBV. A previously developed and validated finite element (FE) model of the intact L1-sacrum human lumbar spine was modified to simulate ALIF, PLIF and TLIF with bilateral pedicle screw fixation at L4-L5...
February 4, 2019: Computer Methods in Biomechanics and Biomedical Engineering
Ralf Wagner, Albert E Telfeian
Pedicle screw instrumentation is a widely used technique for fixating the spine in fusion surgery. One of the complications associated with pedicle screw placement is when a screw breaches the pedicle medially and causes the patient radicular pain or numbness or weakness. Revising a breached pedicle screw in a patient who has undergone a multilevel fusion surgery often requires that the patient undergo a very invasive revision surgical procedure. Here the authors present a technical note on decompressing an S1 nerve compressed by a breached pedicle screw by performing an endoscopic surgical approach through a 1-cm incision and drilling down the threads of the pedicle screw, directly decompressing the nerve without removing the screw...
December 2018: Journal of Spine Surgery (Hong Kong)
Manuel García-Fantini, Ricardo De Casas
Background: Three-dimensional (3D) navigation techniques can theoretically provide higher accuracy rates and increased safety for pedicle screw (PS) placement than traditional fluoroscopy (FL) guided methods. In this study, we compare the pedicular accuracy of 3D isocentric fluoroscopic navigation (3DFL) versus FL guidance in PS L4-L5-S1 fixation and evaluate the differential cortical purchase and safety of fixation of the S1 PS. Methods: This is a single-centre retrospective study of 810 PSs placed in open L4-L5-S1 fixation between 2012 and 2017 in 39 patients using standard FL and in 96 patients under 3DFL...
December 2018: Journal of Spine Surgery (Hong Kong)
Mitchell Fung, Ellen Frydenberg, Leslie Barnsley, Joga Chaganti, Timothy Steel
Background: Atlantoaxial (C1-C2) osteoarthritis (AAOA) causes severe suboccipital pain exacerbated by lateral rotation. The pain is usually progressive and resistant to conservative therapy. Posterior fusion surgery is performed to stabilise the C1-C2 segment. This is the first Australian study reporting the outcome of posterior atlantoaxial fixation including hybrid fixations performed for AAOA. Methods: All patients who underwent posterior atlantoaxial fixation surgery for AAOA from 2005 to 2015 at our institutions were enrolled (N=23)...
December 2018: Journal of Spine Surgery (Hong Kong)
Chason Ziino, Jaclyn A Konopka, Remi M Ajiboye, Justin B Ledesma, Jayme C B Koltsov, Ivan Cheng
Background: To compare perioperative and radiographic outcomes following lateral lumbar interbody fusions in two cohorts of patients who either underwent single position or dual position surgery. Methods: Patients over the age of 18 with degenerative lumbar pathology who underwent a lumbar interbody fusion via lateral access from 2012-2015 from a single surgeon met inclusion criteria. Patients who underwent combined procedures, had a history of retroperitoneal surgery, or had inadequate preoperative imaging were excluded...
December 2018: Journal of Spine Surgery (Hong Kong)
Zhonghao Han, Keyi Yu, Lei Hu, Weishi Li, Huilin Yang, Minfeng Gan, Na Guo, Biao Yang, Hongsheng Liu, Yuhan Wang
BACKGROUND: Minimally invasive procedures are rapidly growing in popularity thanks to advancements in medical robots, visual navigation and space registration techniques. This paper presents a precise and efficient targeting method for robot-assisted percutaneous needle placement under C-arm fluoroscopy. METHOD: A special end-effector was constructed to perform fluoroscopy calibration and robot to image-space registration simultaneously and automatically. In addition, formulations were given to compute the movement of robot targeting and evaluate targeting accuracy using only one X-ray image...
February 2, 2019: Computer Assisted Surgery (Abingdon, England)
Murat Korkmaz, Turgut Akgul, Kerim Sariyilmaz, Okan Ozkunt, Fatih Dikici, Onder Yazicioglu
INTRODUCTION: Proximal junctional kyphosis - PJK has been defined by a 10 or greater increase in kyphosis at the proximal junction as measured by the Cobb angle from the caudal endplate of the uppermost instrumented vertebrae (UIV) to the cephalad endplate of the vertebrae 1 segments cranial to the UIV. In this biomechanical study, it is aimed to evaluate effects of interspinosus ligament complex distruption and facet joint degeneration on PJK development. MATERIALS AND METHODS: Posterior instrumentation applied between T2 - T7 vertebrae using pedicle screws to randomly selected 21 sheeps, divided into 3 groups...
January 30, 2019: Acta Orthopaedica et Traumatologica Turcica
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