Maxillary Posterior Surgery, the Sinus, and Managing Palatal Access

2017 ◽  
pp. 151-162 ◽  
Author(s):  
Garrett Guess ◽  
Samuel Kratchman
Keyword(s):  
Posterior Surgery

scholarly journals Application of Intraoperative CT-Guided Navigation in Simultaneous Minimally Invasive Anterior and Posterior Surgery for Infectious Spondylitis

2017 ◽  
Vol 2017 ◽  
pp. 1-7 ◽  
Author(s):  
Meng-Huang Wu ◽  
Navneet Kumar Dubey ◽  
Ching-Yu Lee ◽  
Yen-Yao Li ◽  
Chin-Chang Cheng ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Pedicle Screws ◽  
Ct Guided ◽  
Posterior Surgery ◽  
Intraoperative Computed Tomography ◽  
Reactive Protein ◽  
Angle Correction ◽  
Average Operative Time ◽  
Placement Accuracy ◽  
Infectious Spondylitis

This study was aimed at evaluating the safety and efficacy of using intraoperative computed tomography- (iCT-) guided navigation in simultaneous minimally invasive anterior and posterior surgery for infectious spondylitis. Nine patients with infectious spondylitis were enrolled in this study. The average operative time was 327.6 min (range, 210–490) and intraoperative blood loss was 407 cc (range, 50–1,200). The average duration of hospital stay was 48.9 days (range, 11–76). Out of a total of 54 pedicle screws employed, 53 screws (98.1%) were placed accurately. A reduced visual analog scale on back pain (from 8.2 to 2.2) and Oswestry disability index (from 67.1% to 25.6%) were found at the 2-year follow-up. All patients had achieved resolution of spinal infection with reduced average erythrocyte sedimentation rate (from 83.9 to 14.1 mm/hr) and average C-reactive protein (from 54.4 to 4.8 mg/dL). Average kyphotic angle correction was 10.5° (range, 8.4°–12.6°) postoperatively and 8.5° (range, 6.9°–10.1°) after 2 years. In conclusion, the current iCT-guided navigation approach has been demonstrated to be an alternative method during simultaneous minimally invasive anterior and posterior surgery for infectious spondylitis. It can provide a good intraoperative orientation and visualization of anatomic structures and also a high pedicle screw placement accuracy in patient’s lateral decubitus position.

Nerve sheath tumors involving the sacrum

2003 ◽  
Vol 15 (2) ◽  
pp. 1-6 ◽  
Author(s):  
Paul Klimo ◽  
Ganesh Rao ◽  
Richard H. Schmidt ◽  
Meic H. Schmidt
Keyword(s):  
Type I ◽  
Nerve Sheath Tumor ◽  
Delayed Presentation ◽  
Type Ii ◽  
Complete Excision ◽  
Posterior Surgery ◽  
Sacral Nerve ◽  
Type Iii ◽  
Nerve Sheath Tumors ◽  
Nerve Sheath

Nerve sheath tumors that involve the sacrum are rare. Delayed presentation is common because of their slow-growing nature, the permissive surrounding anatomical environment, and nonspecific symptoms. Consequently, these tumors are usually of considerable size at the time of diagnosis. The authors discuss a case of a sacral nerve sheath tumor. They also propose a classification scheme for these tumors based on their location with respect to the sacrum into three types (Types I–III). Type I tumors are confined to the sacrum; Type II originate within the sacrum but then locally metastasize through the anterior and posterior sacral walls into the presacral and subcutaneous spaces, respectively; and Type III are located primarily in the presacral/retroperitoneal area. The overwhelming majority of sacral nerve sheath tumors are schwannomas. Neurofibromas and malignant nerve sheath tumors are exceedingly rare. Regardless of their histological features, the goal of treatment is complete excision. Adjuvant radiotherapy may be used in patients in whom resection was subtotal. Approaches to the sacrum can generally be classified as anterior or posterior. Type I tumors may be resected via a posterior approach alone, Type III may require an anterior approach, and Type II tumors usually require combined anterior–posterior surgery.

Posterior Surgery of Neurologically Compromised Osteoporotic Kyphosis - Posterolateral Decompression and Stabilization using Titanium Mesh -

2008 ◽  
Vol 43 (6) ◽  
pp. 791
Author(s):  
Jung-Hee Lee ◽  
Ki-Tack Kim ◽  
Kyung-Soo Suk ◽  
Sang-Hun Lee ◽  
Dae-Woo Hwang ◽  
...  
Keyword(s):  
Titanium Mesh ◽  
Posterior Surgery

scholarly journals Efficacy Analysis of One-stage Posterior-only Surgical Treatment for Thoracic Spinal Tuberculosis in the T4-6 Segments with Minimum 5-year Follow-up

2021 ◽  
Author(s):  
Yi Zhan ◽  
Xin Kang ◽  
Wenjie Gao ◽  
Xinliang Zhang ◽  
Lingbo Kong ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Cobb Angle ◽  
Clinical Efficacy ◽  
Spinal Tuberculosis ◽  
Surgical Trauma ◽  
Posterior Surgery ◽  
One Stage ◽  
Thoracic Spinal ◽  
Thoracic Spinal Tuberculosis

Abstract In recent years, with the in-depth research on spinal tuberculosis, posterior surgery alone has been praised highly by more and more surgeons due to the better correction of kyphosis, better maintenance of spinal physiological curvature, smaller surgical trauma and fewer surgical complications. However, there is currently lack of relevant reports about the efficacy of posterior surgery alone in the treatment of tuberculosis in the T4-6 segments. This study aimed to evaluate the clinical study efficacy and feasibility of one-stage posterior-only surgical treatment for thoracic spinal tuberculosis in the T4-6 segments. 67 patients with tuberculosis in T4-6 segments who underwent one-stage posterior-only surgery were included in this study. The clinical efficacy was evaluated using statistical analysis based on the data about erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), Oswestry Dability Index (ODI) score, Visual Analogue Scale (VAS) score and Cobb angle before surgery, after surgery and at the last follow-up. All patients completed fusion during the follow-up period of 6–9 months. ESR and CRP were returned to normal for all patients at 6 months follow-up. In the meanwhile, among the 27 patients combined with neurological impairment, neurological functions of 22 cases (81.48%) recovered completely at the last follow-up (P < 0.05). Cobb angle of the kyphosis was improved from preoperative 34.8 ± 10.9° to postoperative 9.6 ± 2.8°, maintaining at 11.3 ± 3.2° at the last follow-up, The ODI and VAS scores were improved by 77.10% and 81.70%, respectively. This 5-year follow-up study shows that better clinical efficacy can be achieved for tuberculosis in T4-6 segments using one-stage posterior-only approach by costotransverse debridement in combination with bone graft and internal fixation. The posterior surgical method cannot only effectively accomplish debridement, obtain satisfactory clinical results, but also well correct kyphotic deformity and maintain it.

scholarly journals Anterior cervical discectomy and fusion performed using structural allograft or polyetheretherketone: pseudarthrosis and revision surgery rates with minimum 2-year follow-up

2020 ◽  
Vol 32 (4) ◽  
pp. 562-569
Author(s):  
Minghao Wang ◽  
Dean Chou ◽  
Chih-Chang Chang ◽  
Ankit Hirpara ◽  
Yilin Liu ◽  
...  
Keyword(s):  
Revision Surgery ◽  
Plate Fixation ◽  
Anterior Cervical Discectomy ◽  
Anterior Plate ◽  
Cervical Discectomy ◽  
Posterior Surgery ◽  
Structural Allograft ◽  
Significant Difference ◽  
Surgery Rates

OBJECTIVEBoth structural allograft and PEEK have been used for anterior cervical discectomy and fusion (ACDF). There are reports that PEEK has a higher pseudarthrosis rate than structural allograft. The authors compared pseudarthrosis, revision, subsidence, and loss of lordosis rates in patients with PEEK and structural allograft.METHODSThe authors performed a retrospective review of patients who were treated with ACDF at their hospital between 2005 and 2017. Inclusion criteria were adult patients with either PEEK or structural allograft, anterior plate fixation, and a minimum 2-year follow-up. Exclusion criteria were hybrid PEEK and allograft cases, additional posterior surgery, adjacent corpectomies, infection, tumor, stand-alone or integrated screw and cage devices, bone morphogenetic protein use, or lack of a minimum 2-year follow-up. Demographic variables, number of treated levels, interbody type (PEEK cage vs structural allograft), graft packing material, pseudarthrosis rates, revision surgery rates, subsidence, and cervical lordosis changes were collected. These data were analyzed by Pearson’s chi-square test (or Fisher’s exact test, according to the sample size and expected value) and Student t-test.RESULTSA total of 168 patients (264 levels total, mean follow-up time 39.5 ± 24.0 months) were analyzed. Sixty-one patients had PEEK, and 107 patients had structural allograft. Pseudarthrosis rates for 1-level fusions were 5.4% (PEEK) and 3.4% (allograft) (p > 0.05); 2-level fusions were 7.1% (PEEK) and 8.1% (allograft) (p > 0.05); and ≥ 3-level fusions were 10% (PEEK) and 11.1% (allograft) (p > 0.05). There was no statistical difference in the subsidence magnitude between PEEK and allograft in 1-, 2-, and ≥ 3-level ACDF (p > 0.05). Postoperative lordosis loss was not different between cohorts for 1- and 2-level surgeries.CONCLUSIONSIn 1- and 2-level ACDF with plating involving the same number of fusion levels, there was no statistically significant difference in the pseudarthrosis rate, revision surgery rate, subsidence, and lordosis loss between PEEK cages and structural allograft.

scholarly journals Biomechanical evaluation of the ProDisc-C stability following graded posterior cervical injury

2018 ◽  
Vol 29 (5) ◽  
pp. 515-524
Author(s):  
Michael D. Staudt ◽  
Doron Rabin ◽  
Ali A. Baaj ◽  
Neil R. Crawford ◽  
Neil Duggal
Keyword(s):  
Axial Rotation ◽  
Control Group ◽  
Lateral Bending ◽  
Cervical Injury ◽  
Cervical Arthroplasty ◽  
Posterior Surgery ◽  
Flexion Extension ◽  
Posterior Element ◽  
And Control ◽  
Flexion And Extension

OBJECTIVEThere are limited data regarding the implications of revision posterior surgery in the setting of previous cervical arthroplasty (CA). The purpose of this study was to analyze segmental biomechanics in human cadaveric specimens with and without CA, in the context of graded posterior resection.METHODSFourteen human cadaveric cervical spines (C3–T1 or C2–7) were divided into arthroplasty (ProDisc-C, n = 7) and control (intact disc, n = 7) groups. Both groups underwent sequential posterior element resections: unilateral foraminotomy, laminoplasty, and finally laminectomy. Specimens were studied sequentially in two different loading apparatuses during the induction of flexion-extension, lateral bending, and axial rotation.RESULTSRange of motion (ROM) after artificial disc insertion was reduced relative to that in the control group during axial rotation and lateral bending (13% and 28%, respectively; p < 0.05) but was similar during flexion and extension. With sequential resections, ROM increased by a similar magnitude following foraminotomy and laminoplasty in both groups. Laminectomy had a much greater effect: mean (aggregate) ROM during flexion-extension, lateral bending, and axial rotation was increased by a magnitude of 52% following laminectomy in the setting of CA, compared to an 8% increase without arthroplasty. In particular, laminectomy in the setting of CA introduced significant instability in flexion-extension, characterized by a 90% increase in ROM from laminoplasty to laminectomy, compared to a 16% increase in ROM from laminoplasty to laminectomy without arthroplasty (p < 0.05).CONCLUSIONSForaminotomy and laminoplasty did not result in significant instability in the setting of CA, compared to controls. Laminectomy alone, however, resulted in a significant change in biomechanics, allowing for significantly increased flexion and extension. Laminectomy alone should be used with caution in the setting of previous CA.

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