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Sacral AND Fracture

Matthew T Houdek, Peter S Rose, Mario Hevesi, Joseph H Schwab, Anthony M Griffin, John H Healey, Ivy A Petersen, Thomas F DeLaney, Peter W Chung, Michael J Yaszemski, Jay S Wunder, Francis J Hornicek, Patrick J Boland, Franklin H Sim, Peter C Ferguson
BACKGROUND: We reviewed the disease control and complications of the treatment of sacrococcygeal chordoma from four tertiary cancer centers with emphasis on the effects of radiotherapy in surgically treated patients. METHODS: A total of 193 patients with primary sacrococcygeal chordoma from 1990 to 2015 were reviewed. There were 124 males, with a mean age of 59 ± 15 years and a mean follow-up of 7 ± 4 years. Eighty-nine patients received radiotherapy with a mean total dose of 61...
February 7, 2019: Journal of Surgical Oncology
Brett D Crist, Ferris M Pfeiffer, Michael S Khazzam, Rebecca A Kueny, Gregory J Della Rocca, William L Carson
Background: Pelvic ring-comminuted transforaminal sacral fracture injuries are rotationally and vertically unstable and have a high rate of failure. Objective: Our study purpose was to use three-dimensional (3D) optical tracking to detect onset location of bone-implant interface failure and measure the distances and angles between screws and line of applied force for correlation to strength of pelvic fracture fixation techniques. Methods: 3D relative motion across sacral-rami fractures and screws relative to bone was measured with an optical tracking system...
January 2019: Journal of Orthopaedic Translation
R Seidel, E Barbakow
The authors describe in a clinical case series (n = 7) of older (age 78-95 years) high-risk patients the successful surgical treatment of proximal femoral fractures in a peripheral regional anesthesia technique. After positioning on the non-fractured side, a double injection technique (dual guidance concept: sonography plus nerve stimulation) was chosen. The injections were performed parasacrally (blockade of the sacral plexus under the piriformis muscle) and lumbar-paravertebrally (psoas compartment block and transmuscular quadratus lumborum block)...
February 5, 2019: Der Anaesthesist
Kyongsong Kim, Toyohiko Isu, Daijiro Morimoto, Rinko Kokubo, Naotaka Iwamoto, Akio Morita
In rare cases, pedicle fracture is associated with spine surgery, spondylolysis, or stress fracture. We report a patient without trauma whose bilateral lumbar pedicle fracture was detected incidentally. A 67-year-old woman reported leg numbness and pain. Lumbar MRI showed spinal canal stenosis at the L4/L5 level. Drug treatment was only partially effective. A lumbar computed tomography (CT) scan performed 3 months later revealed bilateral pedicle fracture at L4. A second lumbar MRI showed fresh bilateral L4 pedicle fracture that was not observed on the first scan...
January 2019: NMC Case Report Journal
Kristen E Jones, Matthew A Hunt, Christopher T Martin, David W Polly
BACKGROUND AND IMPORTANCE: Pedicle subtraction osteotomy (PSO) is a 3-column osteotomy used to correct rigid, large magnitude sagittal spinal deformity. PSO is an inherently destabilizing procedure intraoperatively, with high risk of neurological deficits from vertebral body subluxation or translation during osteotomy closure. Traditionally, PSO closure has been performed utilizing compression or cantilevering forces across adjacent level instrumentation. Such forces can loosen the instrumentation or cause abrupt subluxation or translation due to the magnitude of force required for PSO closure, resulting in neurological injury...
January 23, 2019: Operative Neurosurgery (Hagerstown, Md.)
Henrik Eckardt, Franziska Saxer
No abstract text is available yet for this article.
February 2019: Journal of Orthopaedic Trauma
Jakub Godzik, Randall J Hlubek, Anna G U S Newcomb, Jennifer N Lehrman, Bernardo de Andrada Pereira, S Harrison Farber, Lawrence G Lenke, Brian P Kelly, Jay D Turner
BACKGROUND CONTEXT: Rod fracture at the lumbosacral (LS) junction remains challenging in long segment fusions and likely stems from increased lumbosacral strain. Reduction of LS instrumentation strain may help reduce fracture rates. PURPOSE: The goal of this investigation was to assess the effect of supplemental posterior 4-rod (4R) construction on LS stability and rod strain compared to standard 2-rod (2R) construction in a long segment fusion model. STUDY DESIGN/SETTING: Cadaveric biomechanical study...
January 23, 2019: Spine Journal: Official Journal of the North American Spine Society
Ye Peng, Wei Zhang, Gongzi Zhang, Xiang Wang, Shuwei Zhang, Xin Ma, Peifu Tang, Lihai Zhang
BACKGROUND: Sacral fracture and sacral nerve injury remain problems in orthopedics, especially in a sacral fracture combined with an anterior sacral nerve injury. Treating a sacral nerve injury with open reduction neurolysis or more conservative treatment cannot meet the clinical needs. Open reduction sacral nerve neurolysis will increase the number of severe, life-threatening injuries, regardless of whether the anterior or posterior approach is used. In recent years, computer- and robot-assisted orthopedic surgery has emerged as part of many clinical treatments...
January 25, 2019: Journal of Orthopaedic Surgery and Research
Li He, Chengla Yi, David J Hak, Zhiyong Hou
PURPOSE: To delineate the changes in functional outcomes of surgically treated U-shaped sacral fractures. METHODS: Forty-one patients with U-shaped sacral fractures were followed for a mean of 4.1 years after surgery. Impairment of lower extremities was assessed via a modified Gibbons score. Urinary function was assessed with a structured interview and residual urine volume. Sexual and bowel functions, as well as patient-reported health, were evaluated using a structured interview, and pain was evaluated with the visual analog scale...
January 24, 2019: European Spine Journal
F Liuzza, L Capasso, M Florio, F Mocini, G Masci, G Cazzato, G Ciolli, N Silluzio, G Maccauro
Pelvic fractures are quite uncommon, they represent only 2-8% of all fractures. Osteosynthesis with percutaneous trans-Iliosacral screw is recognized as one of the standard procedures for the treatment of unstable posterior pelvic ring lesions. Because of the high number of complications associated with the conservative treatment of these kind of lesions such as pain, limb heterometry, difficulty in walking and sexual disability, percutaneous fixation with trans-iliosacral screw has found wide use and has become very popular among orthopedic surgeons...
November 2018: Journal of Biological Regulators and Homeostatic Agents
Masakuni Sakaguchi, Toshiya Maebayashi, Takuya Aizawa, Naoya Ishibashi
AIM: To evaluate the incidence and risk factors of sacral insufficiency fractures (SIFs), particularly dose-volume histogram (DVH) parameters, in patients with cervical cancer after whole pelvic radiation therapy (WPRT). PATIENTS AND METHODS: The medical records of 61 patients with cervical cancer who underwent WPRT were retrospectively reviewed. The cumulative incidence of SIF, as well as the risk factors that could affect its incidence were assessed. RESULTS: Of the 61 patients, 11 (18%) were diagnosed with SIF, as revealed by computed tomography...
January 2019: Anticancer Research
Hayato Kinoshita, Naohisa Miyakoshi, Takashi Kobayashi, Toshiki Abe, Kazuma Kikuchi, Yoichi Shimada
BACKGROUND: Patients with sacral insufficiency fractures can have a range of symptoms, and because these fractures are difficult to detect using plain radiographs, it can be tough to make a definitive diagnosis of fracture early after injury. The aim of this study was to compare the diagnosis and treatment of patients with known sacral insufficiency fractures to those with suspected insufficiency fractures to clarify the features of sacral insufficiency fractures. METHODS: We compared patients with sacral insufficiency fractures (S group) to those with suspected insufficiency fractures (N group) using demographic data, symptoms, time to definitive diagnosis, radiological methods, and treatments...
December 21, 2018: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
Yoshihiro Katsuura, Dirk Kiner
Butterfly vertebrae are rare developmental anomalies representing failure of formation of the vertebral body. There have only been 8 previous reports of a butterfly vertebra occurring at S1. This is the first described case of a butterfly vertebra presenting with a sacral fracture and pelvic ring injury.
February 2019: Trauma Case Reports
N A Faruk, M Z Mohd-Amin, D N Awang-Ojep, Y Y Teo, C C Wong
Giant cell tumour (GCT) is a benign tumour but can be locally aggressive and with the potential to metastasise especially to the lungs. Successful treatments have been reported for long bone lesions; however, optimal surgical and medical treatment for spinal and sacral lesions are not well established. In treating spinal GCTs, the aim is to achieve complete tumour excision, restore spinal stability and decompress the neural tissues. The ideal surgical procedure is an en bloc spondylectomy or vertebrectomy, where all tumour cells are removed as recurrence is closely related to the extent of initial surgical excision...
November 2018: Malaysian Orthopaedic Journal
Yi Liu, Wu Zhou, Tian Xia, Jing Liu, Bo-Bin Mi, Liang-Cong Hu, Zeng-Wu Shao, Guo-Hui Liu
This study is aimed to explore the clinical application of the guiding template designed by three-dimensional printing data for the insertion of sacroiliac screws. A retrospective study of 7 cases (from July 2016 to December 2016), in which the guiding template printed by the threedimensional printing technique was used for the insertion of sacroiliac screws of patients with posterior ring injuries of pelvis, was performed. Totally, 4 males and 3 females were included in template group, aged from 38 to 65 years old (mean 50...
December 2018: Current medical science
Dietmar Krappinger, Verena Kaser, Christian Kammerlander, Carl Neuerburg, Anke Merkel, Richard A Lindtner
INTRODUCTION: The classification and management of osteoporotic pelvic ring injuries (OPRI) remain challenging. The fragility fractures of the pelvis (FFP) classification system proposed by Rommens and Hofmann constitutes the first comprehensive classification system of OPRI and may contribute to a more thorough assessment and grading of these injuries. The reliability of the FFP classification system, however, has not been evaluated yet. The purpose of this study therefore was to determine the inter- and intraobserver reliability of the FFP classification system and to critically analyse its strengths and weaknesses...
November 15, 2018: Injury
Jasper Reenalda, Erik Maartens, Jaap H Buurke, Allison H Gruber
BACKGROUND: Tibial stress fractures are common running related injury and their etiology may include biomechanical factors like impact forces, shock attenuation, lower limb kinematics and how these factors are influenced by intense or prolonged running. Inertial-magnetic measurement units (IMUs) have recently emerged as an alternative to motion capture but their use to date was mostly limited to segmental and joint motion. RESEARCH QUESTION: The present study sought to examine the effects of a prolonged run on shock attenuation, peak tibial and sacral acceleration (PTA, PSA), and lower limb kinematics using IMUs...
November 19, 2018: Gait & Posture
A J Rensing, K M Szymanski, S Dunn, S King, M P Cain, B M Whittam
INTRODUCTION: Historically, there have been few treatment options for children with severe refractory bladder and bowel dysfunction (BBD). Sacral neuromodulation (SNM) continues to show promising results in this challenging pediatric population with recalcitrant lower urinary tract symptoms. At the authors institution, they have begun offering explantation to those with persistent improvement after >6 months of having device turned off. The authors hypothesized that (1) SNM explantation for cure increases with extended follow-up and (2) those explanted for cure would have improved symptoms and quality of life when compared to those explanted for complication...
October 19, 2018: Journal of Pediatric Urology
Terufumi Kawamoto, Kei Ito, Tomohisa Furuya, Keisuke Sasai, Katsuyuki Karasawa
Stereotactic body radiation therapy (SBRT) allows the targeting of high doses of radiation with steep dose gradients. Vertebral fracture is increasingly recognized as an adverse event after SBRT; however, no sacral fractures have been observed after SBRT. We report an extremely rare case of sacral insufficiency fracture after SBRT.
November 2018: Clinical Case Reports
P J Nicholson, C A Hilditch, W Brinjikji, A C O Tsang, R Smith
Sacral insufficiency fractures result in significant morbidity, and percutaneous sacroplasty has emerged as a promising technique for their treatment. We present a technical note regarding our method of treating these fractures using a "single-needle" lateral technique with a combination of conebeam CT and biplane fluoroscopy. We treated 10 patients, in whom the median Visual Analog Scale pain score decreased from 7.0 to 0 ( P < .001). We concluded that single-needle sacroplasty is feasible and safe using this technique...
November 15, 2018: AJNR. American Journal of Neuroradiology
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