Posterior Screw-Rod Fixation and Selective Axial Loosening for the Treatment of Atlantoaxial Instability or Dislocation Caused by Os Odontoideum: A Case Series for a Single Posterior Approach

2019 ◽  
Vol 132 ◽  
pp. e193-e201
Author(s):  
Jia Shao ◽  
Yan Zheng Gao ◽  
Kun Gao ◽  
Zheng Hong Yu
Keyword(s):  
Posterior Approach ◽  
Case Series ◽  
Atlantoaxial Instability ◽  
Os Odontoideum ◽  
Single Posterior Approach

Osteosynthesis of Common Acetabular Fractures Operated on Through a Single Posterior (Kocher-Langenbeck) Approach with or without Trochanteric Flip Osteotomy. A Case Series

2021 ◽  
Vol 23 (4) ◽  
pp. 271-277
Author(s):  
Qazi Waris Manzoor ◽  
Asif Sultan ◽  
Bashir Ahmed Mir
Keyword(s):  
Functional Outcome ◽  
Nerve Palsy ◽  
Posterior Approach ◽  
Case Series ◽  
Posterior Wall ◽  
Posterior Column ◽  
Acetabular Fractures ◽  
Single Posterior Approach ◽  
Necrosis Of Femoral Head ◽  
Trochanteric Flip Osteotomy

Background. The Kocher-Langenbeck approach is recommended in the majority of common posterior acetabular injuries. Trochanteric osteotomy can be used to extend the exposure of the Kocher-Langenbeck approach superiorly and anteriorly. We evaluated the functional outcome of common acetabular fractures operated on through the Kocher-Langenbeck approach with or without trochanteric flip osteotomy. Material and methods. This prospective study enrolled 42 patients with posterior wall, posterior column, transverse, posterior wall with posterior column, transverse with posterior wall and both column acetabular fractures. The Kocher-Langenbeck approach was used in 35 patients and trochanteric flip osteotomy was done in 7 patients. The radiological outcome was evaluated by Matta’s criteria and the functional outcome was evaluated using modified Merle d'Aubigné and Postel criteria. Results. D’Aubigne Postel scores at the final follow-up were excellent in 12 patients, good in 18, fair in 8 and poor in 4. Thirty-seven patients had congruent reduction (anatomical in 29, imperfect in 8) and 5 patients had non-congruent reduction on radiographs as per Matta’s criteria. Radiographic congruity (88.09%, 37 out of 42 cases) correlated fairly well with the functional outcome (excellent or good functional outcome in 71.4%, 30 out of 42 cases). The complications included traumatic nerve palsy (3 cases), iatrogenic nerve palsy (2 cases), deep venous thrombosis (2 cases), wound infection (3 cases), non-congruent reduction (5 cases), 8 cases of osteoarthritis of hip, 2 cases of avascular necrosis of femoral head and 3 cases of heterotrophic ossification. Conclusions. 1. Surgical treatment of common acetabular fractures with major posterior involvement can be attempted via a single posterior approach (Kocher-Langen­beck with or without trochanteric flip osteo­tomy) and leads to good-to-excellent results in a majority of the cases. 2. It is superior to conservative management, which has been found to be accompanied by a much higher rate of complications. 3. A thorough study of the pre-opera­tive radiographs, Judet’s views and 3D-reconstructed CT images helps in classifying the fracture and thereby assigning or not assigning it for the posterior approach.

Os Odontoideum with Posterior Atlantoaxial Instability

Spine ◽  
1991 ◽  
Vol 16 (7) ◽  
pp. 706-715 ◽  
Author(s):  
NOBUKI SHIRASAKI ◽  
KOZO OKADA ◽  
SHIRO OKA ◽  
NOBORU HOSONO ◽  
KAZUO YONENOBU ◽  
...  
Keyword(s):  
Atlantoaxial Instability ◽  
Os Odontoideum

Use of a titanium mesh cage for posterior atlantoaxial arthrodesis

2002 ◽  
Vol 96 (1) ◽  
pp. 127-130 ◽  
Author(s):  
Morio Matsumoto ◽  
Kazuhiro Chiba ◽  
Takashi Tsuji ◽  
Hirofumi Maruiwa ◽  
Yoshiaki Toyama ◽  
...  
Keyword(s):  
Donor Site ◽  
Atlantoaxial Instability ◽  
Os Odontoideum ◽  
Posterior Arch ◽  
Rigid Fixation ◽  
Titanium Mesh ◽  
Content Type ◽  
Atlantoaxial Fixation ◽  
Mesh Cage ◽  
Atlantoaxial Arthrodesis

✓ The authors placed titanium mesh cages to achieve posterior atlantoaxial fixation in five patients with atlantoaxial instability caused by rheumatoid arthritis or os odontoideum. A mesh cage packed with autologous cancellous bone was placed between the C-1 posterior arch and the C-2 lamina and was tightly connected with titanium wires. Combined with the use of transarticular screws, this procedure provided very rigid fixation. Solid fusion was achieved in all patients without major complications. The advantages of this method include more stable fixation, better control of the atlantoaxial fixation angle, and reduced donor-site morbidity compared with a conventional atlantoaxial arthrodesis in which an autologous iliac crest graft is used.

scholarly journals Reduction and fusion in high-grade L5-S1 spondylolisthesis by a single posterior approach. Results in 50 patients

2016 ◽  
Vol 102 (2) ◽  
pp. 233-237 ◽  
Author(s):  
S. Moreau ◽  
G. Lonjon ◽  
P. Guigui ◽  
T. Lenoir ◽  
C. Garreau de Loubresse ◽  
...  
Keyword(s):  
Posterior Approach ◽  
High Grade ◽  
Single Posterior Approach

Minimally invasive tubular surgery for transforaminal lumbar interbody fusion

2013 ◽  
Vol 35 (v2supplement) ◽  
pp. Video19 ◽  
Author(s):  
Jon Kimball ◽  
Andrew Yew ◽  
Ruth Getachew ◽  
Daniel C. Lu
Keyword(s):  
Minimally Invasive ◽  
Posterior Approach ◽  
Interbody Fusion ◽  
Transforaminal Lumbar Interbody Fusion ◽  
Lumbar Interbody Fusion ◽  
Postoperative Patient ◽  
Common Procedure ◽  
Circumferential Fusion ◽  
Single Posterior Approach ◽  
Invasive Techniques

Transforaminal lumbar interbody fusion (TLIF) was originally developed as a method for circumferential fusion via a single posterior approach and is now an extremely common procedure for the treatment of lumbar instability. More recently, minimally invasive techniques have been applied to this procedure with the goal of decreasing tissue disruption, blood loss and postoperative patient discomfort. Here we describe a minimally invasive tubular TLIF on a 60-year-old male with radiculopathy from an unstable L4–5 spondylolisthesis.The video can be found here: http://youtu.be/0BbxQiUmtRc.

scholarly journals Posterior malleolar fractures. New classification and treatment algorithm

2020 ◽  
Vol 14 (3) ◽  
pp. 254-259
Author(s):  
Diego Yearson ◽  
Ignacio Melendez ◽  
Federico Anain ◽  
Santiago Siniscalchi ◽  
Juan Drago
Keyword(s):  
Posterior Approach ◽  
Treatment Algorithm ◽  
Case Series ◽  
Fracture Pattern ◽  
Joint Surface ◽  
Medial Malleolus ◽  
New Classification ◽  
Level Of Evidence ◽  
Malleolar Fractures ◽  
Posterior Malleolus

Objective: This study proposes a new classification of posterolateral malleolar fractures and a treatment algorithm. Methods: We divided the posterolateral malleolus, which we considered as the posterior malleolus, from the posteromedial one, which we considered as being part of the medial malleolus fracture. The experience with 77 patients treated from February 2017 to February 2020 was assessed. All of them were assessed by frontal and profile radiographies and computed tomography (CT). Among the parameters to classify these fractures, we believe the most determining ones are fracture size, followed by presence of fracture displacement. Results: Fractures were divided into those whose posterior fragment was 25% smaller than the tibial joint surface and those that compromised more than 25% of this joint. The first group underwent syndesmotic opening and was subclassified into 1A (stable fractures), which do not require surgical treatment, and 1B (unstable), which require syndesmotic stabilization. The second group, which comprised the larger fractures, was subclassified into 2 A (non-displaced fractures, or with a displacement below 2 mm), which underwent percutaneous osteosynthesis, 2B (displaced fractures), and 2C (comminuted fractures), which underwent open reduction and internal fixation using a posterior approach. Conclusion: The classifications published so far are anatomic or descriptive, but none of them proposes a therapeutic algorithm for each type of fracture. We believe it will be helpful for its interpretation and decision-making on the need to perform a posterior approach, prioritizing the anatomical reduction of the joint fragment and resolution of syndesmotic instability linked to each fracture pattern using the most simple and effective method. Level of Evidence IV; Therapeutic Studies; Case Series.

scholarly journals Posterior transdural resection of giant calcified thoracic disc herniation in a case series of 12 patients

2020 ◽  
Author(s):  
Chiara Negwer ◽  
Vicki M. Butenschoen ◽  
Sandro M. Krieg ◽  
Bernhard Meyer
Keyword(s):  
Spinal Cord ◽  
Posterior Approach ◽  
Clinical Status ◽  
Case Series ◽  
Postoperative Outcome ◽  
Complete Recovery ◽  
Neurosurgical Department ◽  
Duration Of Surgery ◽  
Optimal Approach ◽  
Thoracic Disc

Abstract Calcified thoracic disc herniations present a rare and challenging entity. Due to the close proximity to the spinal cord and relative narrowing of the spinal canal, the optimal approach remains a matter of debate. While the transthoracic approach is usually preferred, we adapted a new technique described in 2012: the transdural posterior approach. Our aim was to evaluate its benefits in patients with giant thoracic disc protrusions. We retrospectively reviewed all patients treated in our neurosurgical department from July 2012 to March 2020. Demographics, pre- and postoperative clinical status, and operative technique and complications were extracted and analyzed. In total, 12 patients underwent a posterior transdural resection of giant calcified thoracic hard discs between 2012 and 2020. All patients underwent a posterior decompression (laminectomy, hemilaminectomy, or laminoplasty). The median duration of surgery was 152 min. Transient postoperative neurological deterioration occurred in 4 patients, with complete recovery until time of discharge. No patient underwent a surgical revision. The transdural resection of giant calcified thoracic hard discs through a posterior approach provides an excellent decompression with sufficient visualization of the spinal cord and a satisfying postoperative outcome.

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