scholarly journals Percutaneous Dorsal Instrumentation of Vertebral Burst Fractures: Value of Additional Percutaneous Intravertebral Reposition—Cadaver Study

2015 ◽  
Vol 2015 ◽  
pp. 1-10 ◽  
Author(s):  
Antonio Krüger ◽  
Maya Schmuck ◽  
David C. Noriega ◽  
Steffen Ruchholtz ◽  
Gamal Baroud ◽  
...  
Keyword(s):  
Spinal Canal ◽  
Posterior Instrumentation ◽  
Surgical Techniques ◽  
Cadaver Study ◽  
Cement Augmentation ◽  
Dorsal Instrumentation ◽  
Burst Fractures ◽  
Anatomical Restoration

Purpose. The treatment of vertebral burst fractures is still controversial. The aim of the study is to evaluate the purpose of additional percutaneous intravertebral reduction when combined with dorsal instrumentation.Methods. In this biomechanical cadaver study twenty-eight spine segments (T11-L3) were used (male donors, mean age 64.9 ± 6.5 years). Burst fractures of L1 were generated using a standardised protocol. After fracture all spines were allocated to four similar groups and randomised according to surgical techniques (posterior instrumentation; posterior instrumentation + intravertebral reduction device + cement augmentation; posterior instrumentation + intravertebral reduction device without cement; and intravertebral reduction device + cement augmentation). After treatment, 100000 cycles (100–600 N, 3 Hz) were applied using a servohydraulic loading frame.Results. Overall anatomical restoration was better in all groups where the intravertebral reduction device was used (p<0.05). In particular, it was possible to restore central endplates (p>0.05). All techniques decreased narrowing of the spinal canal. After loading, clearance could be maintained in all groups fitted with the intravertebral reduction device. Narrowing increased in the group treated with dorsal instrumentation.Conclusions. For height and anatomical restoration, the combination of an intravertebral reduction device with dorsal instrumentation showed significantly better results than sole dorsal instrumentation.

Controversies in Managing of Thoracic-Lumbar Upper Burst Fractures

2018 ◽  
Vol 1 (2) ◽  
Author(s):  
Sahat Edison Sitorus
Keyword(s):  
Decision Making ◽  
Spinal Cord ◽  
Posterior Instrumentation ◽  
Burst Fracture ◽  
Surgical Decompression ◽  
Neurologic Deficit ◽  
Retroperitoneal Approach ◽  
Burst Fractures ◽  
Lateral Fixation

Upper burst fracture of Th12-L1 has unique anatomy because it contains lower spinal cord, medullary cone, and diaphragm which separates between the thoracic and lumbar spine.The presence or absence of neurologic deficit is the single most important factor in the decision making. The presence of profound but incomplete neural deficit in association with canal compromise represents an urgent indication of surgical decompression. Antero-lateral direct decompression with trans-thoracic trans-pleural–retroperitoneal approach given the proximity the cord and conus is the most effective method, with inter-vertebral instrumentation with or without lateral fixation or posterior instrumentation.

Experimental Third Ventriculostomy Performed Using Endovascular Surgical Techniques and Their Adaptation to Percutaneous Intradural Neuronavigation: Proof of Concept Cadaver Study

Neurosurgery ◽  
2003 ◽  
Vol 53 (2) ◽  
pp. 387-392 ◽  
Author(s):  
Michael B. Horowitz ◽  
Kamal Ramzipoor ◽  
Ajit Nair ◽  
Susan Miller ◽  
George Rappard ◽  
...  
Keyword(s):  
Third Ventricle ◽  
Surgical Techniques ◽  
Cadaver Study ◽  
Brain Parenchyma ◽  
Third Ventriculostomy ◽  
General Anesthetic ◽  
The Third ◽  
Noncommunicating Hydrocephalus ◽  
Pass Through ◽  
The Brain

Abstract OBJECTIVE Endoscopic third ventriculostomy has developed into a therapeutic alternative to shunting for the management of carefully selected patients with primarily noncommunicating hydrocephalus. This procedure, however, requires a general anesthetic and necessitates violation of the brain parenchyma and manipulation near vital neural structures to access the floor of the third ventricle. Using two cadavers and off-the-shelf angiographic catheters, we sought to determine whether it was possible to navigate a catheter, angioplasty balloon, and stent percutaneously through the subarachnoid space from the thecal sac into the third ventricle so as to perform a third ventriculostomy from below. METHODS Using biplane angiography and off-the-shelf angiographic catheters along with angioplasty balloons and stents, we were able to pass a stent coaxially from the thecal sac to and across the floor of the third ventricle so as to achieve a third ventriculostomy from below. RESULTS Coaxial catheter techniques allowed for the percutaneous insertion of a stent across the floor of the third ventricle. Ventriculostomy was confirmed by injecting contrast medium into the lateral ventricle and seeing it pass through the stent and into the chiasmatic cistern. CONCLUSION We describe the performance of third ventriculostomies in two cadavers by use of the new concept of percutaneous intradural neuronavigation. This procedure may obviate the need for general anesthetic and minimize the potential for brain and vascular injury, especially if ultimately combined with magnetic resonance fluoroscopy.

The Effect of Cement Augmentation and Extension of Posterior Instrumentation on Stabilization and Adjacent Level Effects in the Elderly Spine

Spine ◽  
2008 ◽  
Vol 33 (25) ◽  
pp. 2728-2740 ◽  
Author(s):  
Juay-Seng Tan ◽  
Sandeep Singh ◽  
Qing-An Zhu ◽  
Marcel F. Dvorak ◽  
Charles G. Fisher ◽  
...  
Keyword(s):  
Posterior Instrumentation ◽  
The Elderly ◽  
Cement Augmentation ◽  
Adjacent Level ◽  
Adjacent Level Effects

Cement augmentation versus extended dorsal instrumentation in the treatment of osteoporotic vertebral fractures

2016 ◽  
Vol 98-B (8) ◽  
pp. 1099-1105 ◽  
Author(s):  
L. Weiser ◽  
M. Dreimann ◽  
G. Huber ◽  
K. Sellenschloh ◽  
K. Püschel ◽  
...  
Keyword(s):  
Vertebral Fractures ◽  
Cement Augmentation ◽  
Dorsal Instrumentation ◽  
Osteoporotic Vertebral Fractures

Decompression with Lateral Pediculectomy and Circumferential Reconstruction for Unstable Thoracolumbar Burst Fractures: Surgical Techniques and Results in 18 Patients

2018 ◽  
Vol 120 ◽  
pp. e53-e62
Author(s):  
Woo-Keun Kwon ◽  
Woong-Bae Park ◽  
Gun-Young Lee ◽  
Joo Han Kim ◽  
Youn-Kwan Park ◽  
...  
Keyword(s):  
Surgical Techniques ◽  
Thoracolumbar Burst Fractures ◽  
Burst Fractures

scholarly journals A Systematic Review of Treatment Strategies for the Prevention of Junctional Complications After Long-Segment Fusions in the Osteoporotic Spine

2020 ◽  
pp. 219256822093990 ◽  
Author(s):  
Murray Echt ◽  
William Ranson ◽  
Jeremy Steinberger ◽  
Reza Yassari ◽  
Samuel K. Cho
Keyword(s):  
Systematic Review ◽  
Thoracolumbar Spine ◽  
Surgical Techniques ◽  
Treatment Strategies ◽  
Compression Fracture ◽  
Deformity Correction ◽  
Preventive Treatment ◽  
Cement Augmentation ◽  
Mineral Density ◽  
Junctional Kyphosis

Study Design: Systematic review Objectives: Proximal junctional kyphosis (PJK) and proximal junctional failure (PJF) are well-known complications after long-segment fusions in the thoracolumbar spine of osteoporotic patients. Recent advances in anti-resorptive and anabolic medications, instrumentation, surgical technique, and cement augmentation have all aided in the avoidance of junctional kyphosis. In this article, current literature on the prevention of PJK and PJF in the osteoporotic spine is reviewed. Methods: A systematic literature review was conducted using the PubMed/MEDLINE and Embase databases in order to search for the current preventive treatment methods for PJK and PJF published in the literature (1985 to present). Inclusion criteria included (1) published in English, (2) at least 1-year mean and median follow-up, (3) preoperative diagnosis of osteoporosis, (4) at least 3 levels instrumented, and (5) studies of medical treatment or surgical techniques for prevention of junctional kyphosis. Results: The review of the literature yielded 7 studies with low levels of evidence ranging from level II to IV. Treatment strategies reviewed addressed prophylaxis against ligamentous failure, adjacent vertebral compression fracture, and/or bone-implant interface failure. This includes studies on the effect of osteoporosis medication, cement augmentation, multi-rod constructs, and posterior-tension band supplementation. The role of perioperative teriparatide therapy maintains the highest level of evidence. Conclusions: Perioperative teriparatide therapy represents the strongest evidence for preventive treatment, and further clinical trials are warranted. Use of cement augmentation, sublaminar tethers, and multi-rod constructs have low or insufficient evidence for recommendations. Future guidelines for adult spinal deformity correction may consider bone mineral density–adjusted alignment goals.

scholarly journals CT evaluation of the spinal canal after thoracolumbar burst fractures.

1990 ◽  
Vol 38 (4) ◽  
pp. 1650-1653
Author(s):  
Takashi Toyoumi ◽  
Sekio Tominaga ◽  
Kazutomo Date ◽  
Keiji Ohuchi ◽  
Minoru Katayama ◽  
...  
Keyword(s):  
Spinal Canal ◽  
Thoracolumbar Burst Fractures ◽  
Burst Fractures ◽  
Ct Evaluation

The Effect of Radioscapholunate Fusion On Wrist Movement and the Subsequent Effects of Distal Scaphoidectomy and Triquetrectomy

2010 ◽  
Vol 35 (9) ◽  
pp. 740-745 ◽  
Author(s):  
M.J. Berkhout ◽  
M.N. Shaw ◽  
L.J. Berglund ◽  
K.N. An ◽  
R.A. Berger ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Surgical Techniques ◽  
Cadaver Study ◽  
Salvage Procedure ◽  
Ulnar Deviation ◽  
Radiocarpal Joint ◽  
Flexion Extension ◽  
Radioscapholunate Fusion ◽  
Tracking Device ◽  
Radioscapholunate Arthrodesis

Radioscapholunate arthrodesis is a salvage procedure indicated for osteoarthritis of the radiocarpal joint involving the lunate facet of the radius. This cadaver study examines changes in wrist motion resulting from radioscapholunate arthrodesis, and the effects of surgical techniques to improve the range of motion. Simulated radioscapholunate arthrodesis, distal scaphoidectomy and triquetrectomy were carried out sequentially on six cadaver forearms and measurements (maximum flexion/extension and radial/ulnar deviation) were taken in the intact situation and after each surgical step using a magnetic tracking device. Radioscapholunate arthrodesis diminishes the amplitudes of movements of the wrist in all directions, but range of motion in the radioscapholunate fused wrist improves after scaphoidectomy and improves further after triquetrectomy (88% of original flexion/extension and 98% of original radial/ulnar deviation). Radioscapholunate arthrodesis causes a significant change in kinematics between the hamate and the triquetrum in flexion/extension.

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