Clinical and radiological results of treating lumbar spondylosis with cortical bone trajectory screws

Abstract Background: The cortical bone trajectory (CBT) technique is a popular minimally invasive spine surgery. Few studies have reported long-term outcomes. Here, we evaluated the complication profile and long-term follow-up of patients with lumbar degenerative disease treated with the CBT technique. Methods: This retrospective analysis included the first 40 consecutive patients that underwent the CBT technique. The indication for surgery was critical stenosis of the intervertebral foramen, which required removal of the entire intervertebral joint, on at least one side, during decompression. Results: The CBT technique was performed on one spine level, in 29 cases, and on two levels, in 11 cases. The last follow-up showed minimal clinically important differences in the numerical rating scale (NRS) of leg pain, the NRS of back pain, and the Oswestry Disability Index (ODI), in 97%, 95%, and 95% of patients, respectively. Thirty-nine patients completed long-term radiological follow-ups. Computed tomography demonstrated solid bone unions on 47 (92%) operated levels, collapsed unions on 2 (4%) levels, non-union on 1 (2%) level, and 1 (2%) lost to follow-up. Seven patients experienced complications (4 hardware-related). Three patients required four revision surgeries.Conclusions: The CBT technique effectively achieved spinal fusion; over 90% of patients achieved clinical improvement at a mean follow-up of 4.4 years (minimum 3 years in all cases).

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Medium-term clinical and radiological results of surgically treated stage 3A Kienböck’s disease

Hand Surgery and Rehabilitation ◽

10.1016/j.hansur.2021.07.002 ◽

2021 ◽

Author(s):

Kazim Onur Unal ◽

Olgun Bingol ◽

Alperen Korucu ◽

Enver Kilic ◽

Guzelali Ozdemir ◽

...

Keyword(s):

Medium Term ◽

Kienböck’S Disease ◽

Kienböck's Disease ◽

Radiological Results ◽

Clinical And Radiological Results ◽

Kienbock’S Disease

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Depth of vertebral screw insertion using a cortical bone trajectory technique in lumbar spinal fusion: radiological significance of a long cortical bone trajectory

Journal of Neurosurgery Spine ◽

10.3171/2021.2.spine202229 ◽

2021 ◽

pp. 1-6

Author(s):

Keitaro Matsukawa ◽

Yoshihide Yanai ◽

Kanehiro Fujiyoshi ◽

Takashi Kato ◽

Yoshiyuki Yato

Keyword(s):

Cortical Bone ◽

Vertebral Body ◽

Screw Loosening ◽

Lumbar Spinal Fusion ◽

Insertion Depth ◽

Cortical Bone Trajectory ◽

Screw Insertion ◽

Bone Fusion ◽

Screw Length ◽

Lumbar Spinal

OBJECTIVE Contrary to original cortical bone trajectory (CBT), “long CBT” directed more anteriorly in the vertebral body has recently been recommended because of improved screw fixation and load sharing within the vertebra. However, to the authors’ knowledge there has been no report on the clinical significance of the screw length and screw insertion depth used with the long CBT technique. The aim of the present study was to investigate the influence of the screw insertion depth in the vertebra on lumbar spinal fusion using the CBT technique. METHODS A total of 101 consecutive patients with L4 degenerative spondylolisthesis who underwent single-level posterior lumbar interbody fusion at L4–5 using the CBT technique were included (mean follow-up 32.9 months). Screw loosening and bone fusion were radiologically assessed to clarify the factors contributing to these outcomes. Investigated factors were as follows: 1) age, 2) sex, 3) body mass index, 4) bone mineral density, 5) intervertebral mobility, 6) screw diameter, 7) screw length, 8) depth of the screw in the vertebral body (%depth), 9) facetectomy, 10) crosslink connector, and 11) cage material. RESULTS The incidence of screw loosening was 3.1% and bone fusion was achieved in 91.7% of patients. There was no significant factor affecting screw loosening. The %depth in the group with bone fusion [fusion (+)] was significantly higher than that in the group without bone fusion [fusion (−)] (50.3% ± 8.2% vs 37.0% ± 9.5%, respectively; p = 0.001), and multivariate logistic regression analysis revealed that %depth was a significant independent predictor of bone fusion. Receiver operating characteristic curve analysis identified %depth > 39.2% as a predictor of bone fusion (sensitivity 90.9%, specificity 75.0%). CONCLUSIONS This study is, to the authors’ knowledge, the first to investigate the significance of the screw insertion depth using the CBT technique. The cutoff value of the screw insertion depth in the vertebral body for achieving bone fusion was 39.2%.

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128 Application of Cortical Bone Trajectory Instrumentation for Juvenile and Adolescent Idiopathic Scoliosis

Neurosurgery ◽

10.1227/01.neu.0000489698.26409.70 ◽

2016 ◽

Vol 63 ◽

pp. 152-153 ◽

Cited By ~ 1

Author(s):

Vishal J. Patel ◽

Sohum K. Desai ◽

Ken Maynard ◽

Randall Zain Allison ◽

Thomas Frank ◽

...

Keyword(s):

Adolescent Idiopathic Scoliosis ◽

Idiopathic Scoliosis ◽

Cortical Bone ◽

Cortical Bone Trajectory

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Clinical and Radiological Results over the Medium Term of Isolated Acetabular Revision

The Scientific World JOURNAL ◽

10.1155/2014/148592 ◽

2014 ◽

Vol 2014 ◽

pp. 1-7 ◽

Cited By ~ 4

Author(s):

Nicola Piolanti ◽

Lorenzo Andreani ◽

Paolo Domenico Parchi ◽

Enrico Bonicoli ◽

Francesco Niccolai ◽

...

Keyword(s):

Groin Pain ◽

Large Diameter ◽

Acetabular Revision ◽

Acetabular Cup ◽

Medium Term ◽

Retrospective Design ◽

Radiological Results ◽

Functional Scores ◽

Clinical And Radiological Results

Acetabular cup loosening is associated with pain, reduced function, and instability of the implant. If such event happens while the femoral implant is in a satisfactory position and is well fixed to the bone, isolated acetabular revision surgery is indicated. The aim of this single-center retrospective study was to evaluate the clinical and radiological results over the medium term (12-month follow-up mean 36, max 60) of isolated acetabular revisions surgery using a porous hemispheric revision shell matched with a cemented all-poly cup and large diameter femoral head (>32). 33 patients were enrolled. We collect any relevant data from the clinical board. Routine clinical and radiographic examinations were performed preoperatively; the postoperative follow-up was made at 1, 3, and 6 months and yearly thereafter. At the last available follow-up, we report satisfactory improvement of functional scores in all the patients; 2 patients (6.1%) showed thigh pain and only 4 hips (12.11%) presented mild groin pain; all the femoral components are well fixed and there were no potential or pending rerevisions. With bias due to the follow-up and to the retrospective design of the study, we report clinical, functional, and radiological satisfactory results.

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