scholarly journals Enhancing percutaneous pedicle screw fixation with hydroxyapatite granules: A biomechanical study using an osteoporotic bone model

PLoS ONE ◽  
2019 ◽  
Vol 14 (9) ◽  
pp. e0223106 ◽  
Author(s):  
Haruo Kanno ◽  
Toshimi Aizawa ◽  
Ko Hashimoto ◽  
Eiji Itoi
2021 ◽  
Vol 9 ◽  
pp. 2050313X2098779
Author(s):  
Shota Miyoshi ◽  
Tadao Morino ◽  
Haruhiko Takeda ◽  
Hiroshi Nakata ◽  
Masayuki Hino ◽  
...  

A 74-year-old man developed bilateral lower limb spastic paresis. He was diagnosed with thoracic spondylotic myelopathy presumably caused by mechanical stress that was generated in the intervertebral space (T1-T2) between a vertebral bone bridge (C5-T1) due to diffuse idiopathic skeletal hyperostosis after anterior fixation of the lower cervical spine and a vertebral bone bridge (T2-T7) due to diffuse idiopathic skeletal hyperostosis in the upper thoracic spine. Treatment included posterior decompression (T1-T2 laminectomy) and percutaneous pedicle screw fixation at the C7-T4 level. Six months after surgery, the patient could walk with a cane, and the vertebral bodies T1-T2 were bridged without bone grafting. For thoracic spondylotic myelopathy associated with diffuse idiopathic skeletal hyperostosis, decompression and percutaneous pedicle screw fixation are effective therapies.


2016 ◽  
Vol 02 (04) ◽  
pp. e131-e138 ◽  
Author(s):  
Nitin Agarwal ◽  
Phillip Choi ◽  
Raymond Sekula

Introduction Traumatic thoracolumbar burst fracture is a common pathology without a clear consensus on best treatment approach. Minimally invasive approaches are being investigated due to potential benefits in recovery time and morbidity. We examine long-term resolution of symptoms of traumatic thoracolumbar burst fractures treated with percutaneous posterior pedicle screw fixation. Methods Retrospective clinical review of seven patients with spinal trauma who presented with thoracolumbar burst fracture from July 2012 to April 2013 and were treated with percutaneous pedicle screw fixation. Electronic patient charts and radiographic imaging were reviewed for initial presentation, fracture characteristics, operative treatment, and postoperative course. Results The patients had a median age of 29 years (range 18 to 57), and 57% were men. The median Thoracolumbar Injury Classification and Severity Scale score was 4 (range 2 to 9). All patients had proper screw placement and uneventful postoperative courses given the severity of their individual traumas. Five of seven patients were reached for long-term follow-up of greater than 28 months. Six of seven patients had excellent pain control and stability at their last follow-up. One patient required revision surgery for noncatastrophic hardware failure. Conclusion Percutaneous pedicle screw fixation for the treatment of unstable thoracolumbar burst fracture may provide patients with durable benefits and warrants further investigation.


2018 ◽  
Vol 16 (4) ◽  
pp. E121-E121 ◽  
Author(s):  
Corey T Walker ◽  
Jakub Godzik ◽  
David S Xu ◽  
Nicholas Theodore ◽  
Juan S Uribe ◽  
...  

Abstract Lateral interbody fusion has distinct advantages over traditional posterior approaches. When adjunctive percutaneous pedicle screw fixation is required, placement from the lateral decubitus position theoretically increases safety and improves operative efficiency by obviating the need for repositioning. However, safe cannulation of the contralateral, down-side pedicles remains technically challenging and often prohibitive. In this video, we present the case of a 59-yr-old man with refractory back pain and bilateral lower extremity radiculopathy that was worse on the left than right side. The patient provided written informed consent before undergoing treatment. We performed minimally invasive single-position lateral interbody fusion with robotic (ExcelsiusGPS, Globus Medical Inc, Audubon, Pennsylvania) bilateral percutaneous pedicle screw fixation for the treatment of asymmetric disc degeneration, dynamic instability, and left paracentral disc herniation with corresponding stenosis at the L3-4 level. A left-sided minimally invasive transpsoas lateral interbody graft was placed with fluoroscopic guidance. Without changing the position of the patient or breaking the sterile field, an intraoperative cone-beam computed tomography image was obtained for navigational screw placement with stereotactic trackers in the iliac spine. Screw trajectories were planned using the robotic navigation software and were placed percutaneously in the bilateral L3 and L4 pedicles using the robotic arm. Concomitant lateral fluoroscopy may be used if desired to ensure the fidelity of the robotic guidance. The patient recovered well postoperatively and was discharged home within 36 h, without complication. Single-position lateral interbody fusion and percutaneous pedicle screw fixation can be accomplished using robotic-assisted navigation and pedicle screw placement. Used with permission from Barrow Neurological Institute.


2018 ◽  
Vol 140 (6) ◽  
Author(s):  
Shady S. Elmasry ◽  
Shihab S. Asfour ◽  
Francesco Travascio

Percutaneous pedicle screw fixation (PPSF) is a well-known minimally invasive surgery (MIS) employed in the treatment of thoracolumbar burst fractures (TBF). However, hardware failure and loss of angular correction are common limitations caused by the poor support of the anterior column of the spine. Balloon kyphoplasty (KP) is another MIS that was successfully used in the treatment of compression fractures by augmenting the injured vertebral body with cement. To overcome the limitations of stand-alone PPSF, it was suggested to augment PPSF with KP as a surgical treatment of TBF. Yet, little is known about the biomechanical alteration occurred to the spine after performing such procedure. The objective of this study was to evaluate and compare the immediate post-operative biomechanical performance of stand-alone PPSF, stand-alone-KP, and KP-augmented PPSF procedures. Novel three-dimensional (3D) finite element (FE) models of the thoracolumbar junction that describes the fractured spine and the three investigated procedures were developed and tested under mechanical loading conditions. The spinal stiffness, stresses at the implanted hardware, and the intradiscal pressure at the upper and lower segments were measured and compared. The results showed no major differences in the measured parameters between stand-alone PPSF and KP-augmented PPSF procedures, and demonstrated that the stand-alone KP may restore the stiffness of the intact spine. Accordingly, there was no immediate post-operative biomechanical advantage in augmenting PPSF with KP when compared to stand-alone PPSF, and fatigue testing may be required to evaluate the long-term biomechanical performance of such procedures.


Sign in / Sign up

Export Citation Format

Share Document