Intrapelvic Anterior Plate Fixation for Crescent Fracture-Dislocation of Sacroiliac Joint

OBJECTIVEBoth structural allograft and PEEK have been used for anterior cervical discectomy and fusion (ACDF). There are reports that PEEK has a higher pseudarthrosis rate than structural allograft. The authors compared pseudarthrosis, revision, subsidence, and loss of lordosis rates in patients with PEEK and structural allograft.METHODSThe authors performed a retrospective review of patients who were treated with ACDF at their hospital between 2005 and 2017. Inclusion criteria were adult patients with either PEEK or structural allograft, anterior plate fixation, and a minimum 2-year follow-up. Exclusion criteria were hybrid PEEK and allograft cases, additional posterior surgery, adjacent corpectomies, infection, tumor, stand-alone or integrated screw and cage devices, bone morphogenetic protein use, or lack of a minimum 2-year follow-up. Demographic variables, number of treated levels, interbody type (PEEK cage vs structural allograft), graft packing material, pseudarthrosis rates, revision surgery rates, subsidence, and cervical lordosis changes were collected. These data were analyzed by Pearson’s chi-square test (or Fisher’s exact test, according to the sample size and expected value) and Student t-test.RESULTSA total of 168 patients (264 levels total, mean follow-up time 39.5 ± 24.0 months) were analyzed. Sixty-one patients had PEEK, and 107 patients had structural allograft. Pseudarthrosis rates for 1-level fusions were 5.4% (PEEK) and 3.4% (allograft) (p > 0.05); 2-level fusions were 7.1% (PEEK) and 8.1% (allograft) (p > 0.05); and ≥ 3-level fusions were 10% (PEEK) and 11.1% (allograft) (p > 0.05). There was no statistical difference in the subsidence magnitude between PEEK and allograft in 1-, 2-, and ≥ 3-level ACDF (p > 0.05). Postoperative lordosis loss was not different between cohorts for 1- and 2-level surgeries.CONCLUSIONSIn 1- and 2-level ACDF with plating involving the same number of fusion levels, there was no statistically significant difference in the pseudarthrosis rate, revision surgery rate, subsidence, and lordosis loss between PEEK cages and structural allograft.

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Comparative Study of Anterior Cervical Discectomy and Fusion by Cages versus Tricortical Bone Graft with Anterior Plate Fixation for Degenerative Cervical Disc Disease

International Journal of Clinical Studies and Medical Case Reports ◽

10.46998/ijcmcr.2020.06.000133 ◽

2020 ◽

Vol 6 (2) ◽

Author(s):

Anowarul Islam

Keyword(s):

Comparative Study ◽

Bone Graft ◽

Plate Fixation ◽

Anterior Cervical Discectomy ◽

Cervical Disc ◽

Cervical Disc Disease ◽

Anterior Plate ◽

Disc Disease ◽

Cervical Discectomy ◽

Degenerative Cervical Disc Disease

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The correlation between the teardrop angle and anterior lunate facet displacement in plating distal radial fractures

Journal of Hand Surgery (European Volume) ◽

10.1177/1753193418822470 ◽

2019 ◽

Vol 44 (5) ◽

pp. 462-467 ◽

Cited By ~ 1

Author(s):

Teun Teunis ◽

Sjoerd Meijer ◽

Jesse Jupiter ◽

Daniel Rikli ◽

Keyword(s):

Computed Tomography ◽

Surface Area ◽

Plate Fixation ◽

Three Dimensional ◽

Anterior Plate ◽

Distal Radial Fractures ◽

Computed Tomography Scans ◽

Before And After ◽

Anterior Plating ◽

Three Dimensional Models

This study aimed to determine the association of teardrop angle and anteroposterior distance with anterior lunate facet displacement and articular congruity before and after anterior plating of distal radial fractures. We included 36 patients with complete intra-articular distal radial fractures with separate anterior lunate facet fragments. On radiographs we determined the teardrop angle and anteroposterior distance. On digital three-dimensional models we measured proximal-distal, anteroposterior and ulnoradial anterior lunate facet displacement, and we outlined the gap surface area. Preoperatively, teardrop angle was highly associated with the extent of anterior lunate facet displacement. Increased anteroposterior distance was mainly associated with articular incongruity after anterior plate fixation. This information may reduce the need of preoperative computed tomography scans in fractures with a normal tear drop angle. This is particularly useful in low-resource settings.

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Biomechanics of a lumbar interspinous anchor with anterior lumbar interbody fusion

Journal of Neurosurgery Spine ◽

10.3171/2009.10.spine09305 ◽

2010 ◽

Vol 12 (4) ◽

pp. 372-380 ◽

Cited By ~ 37

Author(s):

Dean G. Karahalios ◽

Taro Kaibara ◽

Randall W. Porter ◽

Udaya K. Kakarla ◽

Phillip M. Reyes ◽

...

Keyword(s):

Interbody Fusion ◽

Plate Fixation ◽

Pedicle Screws ◽

Axial Rotation ◽

Anterior Lumbar Interbody Fusion ◽

Lumbar Interbody Fusion ◽

Lateral Bending ◽

Anterior Plate ◽

Foraminal Height ◽

Flexion And Extension

Object An interspinous anchor (ISA) provides fixation to the lumbar spine to facilitate fusion. The biomechanical stability provided by the Aspen ISA was studied in applications utilizing an anterior lumbar interbody fusion (ALIF) construct. Methods Seven human cadaveric L3–S1 specimens were tested in the following states: 1) intact; 2) after placing an ISA at L4–5; 3) after ALIF with an ISA; 4) after ALIF with an ISA and anterior screw/plate fixation system; 5) after removing the ISA (ALIF with plate only); 6) after removing the plate (ALIF only); and 7) after applying bilateral pedicle screws and rods. Pure moments (7.5 Nm maximum) were applied in flexion and extension, lateral bending, and axial rotation while recording angular motion optoelectronically. Changes in angulation as well as foraminal height were also measured. Results All instrumentation variances except ALIF alone reduced angular range of motion (ROM) significantly from normal in all directions of loading. The ISA was most effective in limiting flexion and extension (25% of normal) and less effective in reducing lateral bending (71% of normal) and axial rotation (71% of normal). Overall, ALIF with an ISA provided stability that was statistically equivalent to ALIF with bilateral pedicle screws and rods. An ISA-augmented ALIF allowed less ROM than plate-augmented ALIF during flexion, extension, and lateral bending. Use of the ISA resulted in flexion at the index level, with a resultant increase in foraminal height. Compensatory extension at the adjacent levels prevented any significant change in overall sagittal balance. Conclusions When used with ALIF at L4–5, the ISA provides immediate rigid immobilization of the lumbar spine, allowing equivalent ROM to that of a pedicle screw/rod system, and smaller ROM than an anterior plate. When used with ALIF, the ISA may offer an alternative to anterior plate fixation or bilateral pedicle screw/rod constructs.

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P36. Characterization of graft subsidence in anterior cervical discectomy and fusion with rigid anterior plate fixation yielding high fusion rate and good clinical outcome

The Spine Journal ◽

10.1016/j.spinee.2004.05.143 ◽

2004 ◽

Vol 4 (5) ◽

pp. S72 ◽

Cited By ~ 3

Author(s):

Dino Samartzis ◽

Rex A.W. Marco ◽

Louis Jenis ◽

Nitin Khanna ◽

Robert Banco ◽

...

Keyword(s):

Clinical Outcome ◽

Plate Fixation ◽

Fusion Rate ◽

Anterior Cervical Discectomy ◽

Good Clinical Outcome ◽

Anterior Plate ◽

Cervical Discectomy ◽

Graft Subsidence ◽

High Fusion Rate

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Anterior Cervical Plating Enhances Arthrodesis after Discectomy and Fusion with Cortical Allograft

Neurosurgery ◽

10.1097/00006123-200202000-00001 ◽

2002 ◽

Vol 50 (2) ◽

pp. 229-238 ◽

Cited By ~ 31

Author(s):

Michael G. Kaiser ◽

Regis W. Haid ◽

Brian R. Subach ◽

Bryan Barnes ◽

Gerald E. Rodts

Keyword(s):

Complication Rate ◽

Cervical Spondylosis ◽

Plate Fixation ◽

Statistical Significance ◽

Dynamic Imaging ◽

Control Group ◽

Adjacent Segment ◽

Anterior Plate ◽

Cortical Allograft ◽

Cervical Plating

ABSTRACT OBJECTIVE Anterior plate fixation has gained widespread acceptance for the treatment of cervical spondylosis, theoretically enhancing the rate of arthrodesis. There are few studies comparing fusion rates after anterior cervical discectomy and fusion (ACDF) with and without a plate. The purpose of this study was to evaluate the efficacy of anterior cervical plating for fusion enhancement after one- and two-level ACDF with cortical allograft. METHODS A retrospective review was performed with 251 patients who underwent one- or two-level ACDF with cortical allograft and plate stabilization between 1993 and 1999. An independent surgeon reviewer determined fusion status and complications. A successful fusion was defined by the absence of lucency around the graft, evidence of bridging bone between the endplate and the graft, and the absence of movement on dynamic imaging scans. Follow-up data, ranging from 9 months to 3.6 years, were available for 233 patients. A control group of 289 patients who underwent ACDF without plating was described in a previously published report by the senior author (RWH). Therefore, a total of 540 patients were evaluated for determination of the efficacy of anterior cervical plating with cortical allograft bone. Statistical significance was determined by χ2 test. RESULTS The fusion rates for one- and two-level ACDF with anterior fixation were 96 and 91%, respectively, compared with 90 and 72% for one- and two-level ACDF without anterior fixation. The observed increases in fusion rates for both one- and two-level procedures proved to be statistically significant (P < 0.05). There were no recorded infectious, neurological, or graft-related complications among the cohort treated with anterior cervical plating. Compared with the results for the cohort treated without anterior cervical plates, there was a statistically significant decrease in the graft-related complication rate with the application of plates (P < 0.001). Two patients who received plates were noted to have adjacent-segment degenerative changes that required surgical intervention. No hardware fractures were noted; however, one patient was noted to have a single displaced screw, without clinical consequences. CONCLUSION The use of anterior cervical plating after one- and two-level ACDF with allograft cortical bone significantly enhanced arthrodesis. The improved fusion rate and negligible complication rate associated with anterior cervical plating are compelling factors justifying its use in the treatment of cervical spondylosis.

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