Salvage posterior atlantoaxial fixation techniques: A retrospective study

Neurocirugía ◽  
2021 ◽  
Author(s):  
Mehmet Seçer ◽  
Oğuz Durmuş Karakoyun ◽  
Murat Ulutaş ◽  
Aykut Gökbel ◽  
Kadir Çınar ◽  
...  
1999 ◽  
Vol 91 (2) ◽  
pp. 186-192 ◽  
Author(s):  
Siviero Agazzi ◽  
Alain Reverdin ◽  
Daniel May

Object. The authors conducted a retrospective study to provide an independent evaluation of posterior lumbar interbody fusion (PLIF) in which impacted carbon cages were used. Interbody cages have been developed to replace tricortical interbody grafts in anterior and PLIF procedures. Superior fusion rates and clinical outcomes have been claimed by the developers. Methods. In a retrospective study, the authors evaluated 71 consecutive patients in whom surgery was performed between 1995 and 1997. The median follow-up period was 28 months. Clinical outcome was assessed using the Prolo scale. Fusion results were interpreted by an independent radiologist. The fusion rate was 90%. Overall, 67% of the patients were satisfied with their outcome and would undergo the same operation again. Based on the results of the Prolo scale, however, in only 39% of the patients were excellent or good results achieved. Forty-six percent of the work-eligible patients resumed their working activity. Clinical outcome and return-to-work status were significantly associated with socioeconomic factors such as preoperative employment (p = 0.03), compensation issues (p = 0.001), and length of preoperative sick leave (p = 0.01). Radiographically demonstrated fusion was not statistically related to clinical outcome (p = 0.2). Conclusions. This is one of the largest independent series in which PLIF with cages has been evaluated. The results show that the procedure is safe and effective with a 90% fusion rate and a 66% overall satisfaction rate, which compare favorably with those of traditional fixation techniques but fail to match the higher results claimed by the innovators of the cage techniques. The authors' experience confirms the reports of others that many patients continue to experience incapacitating back pain despite successful fusion and neurological recovery.


1993 ◽  
Vol 10 (1) ◽  
pp. 15-19
Author(s):  
David J. Gingrass

The sliding genioplasty for cosmetic augmentation of microgenia is a common procedure performed by maxillofacial and cosmetic surgeons. There are multiple designs for this osteotomy, and multiple fixation techniques proposed, among which include wires, screws, bone plates, and pins. Likewise, there are many advantages and disadvantages to each of the designs and the fixation techniques that will be utilized according to the surgical indications and the surgeon's preference. A techique used at the Medical College of Wisconsin in Milwaukee involves fixation of the osteotomy segments with Kirschner pins placed at multiple divergent angles. This technique allows for placement of the free segments in virtually any location, and provides for a type of rigid stabilization, particularly in large anterior and vertical movements. One criticism that has been suggested with the use of Kirschner pins is the possibility of migration. This retrospective study evaluates 13 patients who underwent augmentation genioplasty, rigidly fixated with Kirschner pins. Twenty-eight total Kirschner pins were placed, with one being removed. The mean postoperative follow-up was 32 months, and the average number of pins placed was 2.15 per patient. It would appear then, from this study, that migration of Kirschner pins when used with the sliding genioplasty, is not a significant postoperative concern.


2008 ◽  
Vol 9 (6) ◽  
pp. 522-527 ◽  
Author(s):  
Michael B. Donnellan ◽  
Ioannis G. Sergides ◽  
William R. Sears

The authors present a novel technique of atlantoaxial fixation using multiaxial C-1 posterior arch screws. The technique involves the insertion of bilateral multiaxial C-1 posterior arch screws, which are connected by crosslinked rods to bilateral multiaxial C-2 pars screws. The clinical results are presented in 3 patients in whom anomalies of the vertebral arteries, C-1 lateral masses, and/or posterior arch of C-1 presented difficulty using existing fixation techniques with transarticular screws, C-1 lateral mass screws, or posterior wiring. The C-1 posterior arch screws achieved solid fixation and their insertion appeared to be technically less demanding than that of transarticular or C-1 lateral mass screws. This technique may reduce the risk of complications compared with existing techniques, especially in patients with anatomical variants of the vertebral artery, C-1 lateral masses, or C-1 posterior arch. This technique may prove to be an attractive fixation option in patients with normal anatomy.


2015 ◽  
Vol 28 (1) ◽  
pp. E49-E55 ◽  
Author(s):  
Shigeki Oshima ◽  
Hideki Sudo ◽  
Manabu Ito ◽  
Kuniyoshi Abumi

Spine ◽  
2002 ◽  
Vol 27 (22) ◽  
pp. 2435-2440 ◽  
Author(s):  
Robert P. Melcher ◽  
Christian M. Puttlitz ◽  
Frank S. Kleinstueck ◽  
Jeffrey C. Lotz ◽  
Juergen Harms ◽  
...  

Spine ◽  
1992 ◽  
Vol 17 (5) ◽  
pp. 480-490 ◽  
Author(s):  
Dieter Grob ◽  
Joseph J. Crisco ◽  
Manohar M. Panjabi ◽  
Ping Wang ◽  
Jiri Dvorak

2018 ◽  
Vol 23 (2) ◽  
pp. 152-156
Author(s):  
Lucas Alves Aurich ◽  
Jerônimo Buzetti Milano ◽  
Erasmo Barros Da Silva Júnior ◽  
Ricardo Ramina

Atlantoaxial instability often requires surgical treatment. Several techniques are available to perform antlantoaxial stabilization, and all of these have their different advantages and disadvantages. In 2004, Wright described the C2translaminar screw fixation, which offers rigid fixation but without the technical demands of C2 pars placement and eliminates the risk of vertebral artery injury. The aim of this study is to review the C2 translaminar screw fixation technique, emphasizing operative details, risks and benefits comparing with the others atlantoaxial fixation techniques. 


Author(s):  
R. Sanjay ◽  
V. Aakash ◽  
Menakuru Sreya Reddy ◽  
G. Ram Kumar

Introduction: The distal end radius fracture is a common fracture type and represents about one sixth of all skeletal fractures. They commonly occur in young males and older females. In young adults it is more common to see a fracture of the Intra-articular component in distal radius, probably due to high-energy trauma such as road traffic accidents. The patient may come with symptoms of  pain and swelling around the wrist, sometimes with deformity around the wrist or tenderness at an area with no obvious deformity. Objectives: To analyse the various treatment methods and their outcomes. Materials and Methods: It is a retrospective study conducted on the distal end of radius fractures by the orthopedic department of Saveetha Medical College and Hospital in the years 2018, 2019 and 2020. All the patients were examined both clinically and radiologically. Anteroposterior (AP) and lateral views of the wrist joint on both sides were obtained at the time of injury presentation. Fractures were classified according to the AO classification and anatomical features like the presence of dorsal tilt, radial shortening and loss of radial inclination are also assessed using the Sarmiento’s modification of Lindstrom Criteria. Results: Anatomical results evaluated according to Sarmiento’s modification of Lindstrom criteria showed excellent results were more frequent with open reduction and internal fixation techniques but the most frequently used treatment modality is closed reduction and cast immobilisation. Conclusion: There is no customised treatment for all distal end of radius fractures hence the treatment depends on various factors like the fracture type, characters, patient’s demands and the surgeon’s preference.


Author(s):  
C. H. Haigler ◽  
A. W. Roberts

Tracheary elements, the water-conducting cells in plants, are characterized by their reinforced walls that became thickened in localized patterns during differentiation (Fig. 1). The synthesis of this localized wall involves abundant secretion of Golgi vesicles that export preformed matrix polysaccharides and putative proteins involved in cellulose synthesis. Since the cells are not growing, some kind of endocytotic process must also occur. Many researchers have commented on where exocytosis occurs in relation to the thickenings (for example, see), but they based their interpretations on chemical fixation techniques that are not likely to provide reliable information about rapid processes such as vesicle fusion. We have used rapid freezing to more accurately assess patterns of vesicle fusion in tracheary elements. We have also determined the localization of calcium, which is known to regulate vesicle fusion in plant and animal cells.Mesophyll cells were obtained from immature first leaves of Zinnia elegans var. Envy (Park Seed Co., Greenwood, S.C.) and cultured as described previously with the following exceptions: (a) concentration of benzylaminopurine in the culture medium was reduced to 0.2 mg/l and myoinositol was eliminated; and (b) 1.75ml cultures were incubated in 22 x 90mm shell vials with 112rpm rotary shaking. Cells that were actively involved in differentiation were harvested and frozen in solidifying Freon as described previously. Fractures occurred preferentially at the cell/planchet interface, which allowed us to find some excellently-preserved cells in the replicas. Other differentiating cells were incubated for 20-30 min in 10(μM CTC (Sigma), an antibiotic that fluoresces in the presence of membrane-sequestered calcium. They were observed in an Olympus BH-2 microscope equipped for epi-fluorescence (violet filter package and additional Zeiss KP560 barrier filter to block chlorophyll autofluorescence).


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