Spinal motion and intradiscal pressure measurements before and after lumbar spine instrumentation with titanium or PEEK rods

2014 ◽  
Vol 21 (4) ◽  
pp. 651-655 ◽  
Author(s):  
Kingsley Abode-Iyamah ◽  
Sam Byeong Kim ◽  
Nicole Grosland ◽  
Rajinder Kumar ◽  
Muhittin Belirgen ◽  
...  
Keyword(s):  
Lumbar Spine ◽  
Intradiscal Pressure ◽  
Pressure Measurements ◽  
Spinal Motion ◽  
Peek Rods ◽  
Spine Instrumentation ◽  
Before And After

Is it possible to estimate the compressive force in the lumbar spine from intradiscal pressure measurements? A finite element evaluation

2013 ◽  
Vol 35 (9) ◽  
pp. 1385-1390 ◽  
Author(s):  
Marcel Dreischarf ◽  
Antonius Rohlmann ◽  
Rui Zhu ◽  
Hendrik Schmidt ◽  
Thomas Zander
Keyword(s):  
Finite Element ◽  
Lumbar Spine ◽  
Compressive Force ◽  
Intradiscal Pressure ◽  
Pressure Measurements

Experimentally Validated Computational Simulation of Lumbar Spine Intervertebral Disc Puncture

2011 ◽  
Author(s):  
Kristen E. Lipscomb ◽  
Nesrin Sarigul-Klijn
Keyword(s):  
Back Pain ◽  
Lumbar Spine ◽  
Intervertebral Disc ◽  
Nucleus Pulposus ◽  
Chronic Back Pain ◽  
Medical Condition ◽  
Computational Simulation ◽  
Element Model ◽  
Before And After ◽  
Spine Model

Back pain is a debilitating medical condition, often with an unclear source. Over time, back pain can affect the work and lifestyle of an individual by reducing job productivity and time spent on enjoyable activities. Discography of the intervertebral disc (IVD) is often used to diagnose pathology of the disc and determine if it may be a source for chronic back pain. It has recently been suggested that discography may lead to IVD degeneration, and has been a cause of controversy among spine care physicians. Using the results from a cadaveric experimental model, a finite element model was first validated. Then, a study was conducted to better understand the changes caused by discography on human spine mechanics. An anatomically accurate L3-L5 lumbar spine model was developed using computed tomography scans. Discography was simulated in the model as an area in the disc affected by needle puncture. The material properties in the nucleus pulposus were adjusted to match experimental data both before and after puncture. The results show that puncture of the IVD leads to increased deformation as well as increased stresses in the disc. Pressure in the nucleus pulposus found to decrease after puncture, and was calculated in the course of this study. Puncturing the IVD changes disc mechanics and may lead to progressive spine issues in the future such as disc degeneration. While discography has been the gold standard to determine if the disc was a source of back pain in patients for many years, the potential long-term degenerative effects of the procedure are only now coming into light, and must be closely examined.

scholarly journals Radiographic Accuracy of Percutaneous Pedicle Screw Placement in Fluoroscopic- Versus CT Navigation-Guided Lumbar Spine Instrumentation

Neurosurgery ◽  
2019 ◽  
Vol 66 (Supplement_1) ◽  
Author(s):  
Guang-Ting Cong ◽  
Avani Vaishnav ◽  
Joseph Barbera ◽  
Hiroshi Kumagai ◽  
James Dowdell ◽  
...  
Keyword(s):  
Lumbar Spine ◽  
Minimally Invasive ◽  
Pedicle Screw ◽  
Spinal Instrumentation ◽  
Screw Placement ◽  
Pedicle Screw Placement ◽  
Intraoperative Computed Tomography ◽  
Percutaneous Pedicle Screw ◽  
Spine Instrumentation ◽  
Surgical Methods

Abstract INTRODUCTION Posterior spinal instrumentation for fusion using intraoperative computed tomography (CT) navigation is gaining traction as an alternative to the conventional two-dimensional fluoroscopic-guided approach to percutaneous pedicle screw placement. However, few studies to date have directly compared outcomes of these 2 minimally invasive instrumentation methods. METHODS A consecutive cohort of patients undergoing primary percutaneous posterior lumbar spine instrumentation for spine fusion was retrospectively reviewed. Revision surgeries or cases converted to open were excluded. Accuracy of screw placement was assessed using a postoperative CT scan with blinding to the surgical methods used. The Gertzbein-Robbins classification was used to grade cortical breach: Grade 0 (<0 mm cortical breach), Grade I (<2 mm), Grade II (2-4 mm), Grade III (4-6 mm), and Grade IV (>6 mm). RESULTS CT navigation was found to significantly improve accuracy of screw placement (P < .022). There was significantly more facet violation of the unfused level in the fluoroscopy group vs the CT group (9% vs 0.5%; P < .0001). There was also a higher proportion of poor screw placement in the fluoroscopy group (10.1% vs 3.6%). No statistical difference was found in the rate of tip breach, inferomedial breach, or lateral breach. Regression analysis showed that fluoroscopy had twice the odds of incurring poor screw placement as compared to CT navigation. CONCLUSION This radiographic study comparing screw placement in minimally invasive fluoroscopy- vs CT navigation-guided lumbar spine instrumentation provides evidence that CT navigation significantly improves accuracy of screw placement, especially in optimizing the screw trajectory so as to avoid facet violation. Long-term follow-up studies should be performed to ascertain whether this difference can contribute to an improvement in clinical outcomes.

CALCULATION OF CARDIAC OUTPUT FROM BLOOD PRESSURE MEASUREMENTS BEFORE AND AFTER MEALS

1936 ◽  
Vol 116 (3) ◽  
pp. 551-562 ◽  
Author(s):  
H. C. Bazett ◽  
J. C. Scott ◽  
M. E. Maxfield ◽  
M. D. Blithe
Keyword(s):  
Blood Pressure ◽  
Cardiac Output ◽  
Pressure Measurements ◽  
Before And After

scholarly journals Trajectories of Bone Remodeling Markers and Bone Mineral Density during Treatment with Strontium Ranelate in Postmenopausal Women Previously Treated with Bisphosphonates

2014 ◽  
Vol 7 ◽  
pp. CMED.S15086 ◽  
Author(s):  
Helisane Lima ◽  
Juliana Maia ◽  
Francisco Bandeira
Keyword(s):  
Bone Mineral Density ◽  
Lumbar Spine ◽  
Postmenopausal Women ◽  
Bone Mineral ◽  
Strontium Ranelate ◽  
Mineral Density ◽  
Bone Remodeling Markers ◽  
Before And After ◽  
Previously Treated

Objective To evaluate the responses of C-terminal telopeptide (CTX) and serum osteocalcin after the first 4 months of treatment with strontium ranelate (SR) and demonstrate their association with long-term bone density changes. Subjects and Methods A sample of 13 postmenopausal women with osteoporosis was analyzed (mean age 65 ± 7.7 years), who were treated with SR for an average of 2.56 ± 0.86 years. All patients had undergone previous treatment with bisphosphonates for an average period of 4.88 ± 2.27 years. Serum CTX and osteocalcin levels were determined before and after four months of treatment with SR. Bone mineral density in the lumbar spine and femoral neck were obtained before and after treatment with SR. Results We observed an average increase of 53.7% in the CTX levels, and 30.7% in the osteocalcin levels. The increase in bone markers was associated with a mean 4.8% increase in lumbar spine bone mineral density (BMD) from 0.820 to 0.860 g/cm2 ( T-score from –2.67 to –1.92; P= 0.001), after 2.5 years of treatment with SR. Conclusion These data suggest an anabolic effect of SR on postmenopausal women who were previously treated with long-term bisphosphonates.

Assessment of the effectiveness of physiotherapy after surgical treatment of the cervical or lumbar spine

2020 ◽  
Vol XXIII (4) ◽  
pp. 19-30
Author(s):  
Adrian KUŻDŻAŁ ◽  
Justyna LISZKA
Keyword(s):  
Surgical Treatment ◽  
Lumbar Spine ◽  
Spine Surgery ◽  
Rehabilitation Program ◽  
Lumbar Pain ◽  
Lumbar Spine Surgery ◽  
Cervical Pain ◽  
Cervical Spine Surgery ◽  
Before And After ◽  
Degree Of Disability

Objective. The aim of the study was to assess the effectiveness of physiotherapy, including assessment of the functional level of patients after surgical treatment of the spine. Material and methods. The study involved 46 people after cervical or lumbar spine surgery. The research was carried out using the author's questionnaire, the Oswestry questionnaire was used to assess the level of disability in people with lumbar pain. The NDI questionnaire was used to assess the degree of disability in people with cervical pain. The study was conducted before and after the ZUS-rehabilitation program, i.e. 3 weeks after it was started. Results. The intensity of lumbar pain before the stay remained strong, while after rehabilitation the pain remained moderate. The intensity of cervical pain before rehabilitation remained strong, while after rehabilitation the pain was mild. Before rehabilitation of patients after lumbar spine surgery the degree of disability was moderate and severe, while after rehabilitation it was mild and to a lesser extent moderate. In patients after cervical spine surgery, the level of disability before the stay was moderate and severe, but after physiotherapy - mild. Conclusions. The implemented physiotherapy program of patients after spine surgery is effective in reducing pain and improving the functioning of patients in daily activities. However, it is still necessary to verify and improve the methods of post operative physiotherapy of the spine so as to increase efficiency and therapy effectiveness in all evaluated domains.

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