scholarly journals A Modified Triangular Osteosynthesis Protocol for the Rod and Pedicle Screw Fixation of Vertical Unstable Sacral Fractures

10.14444/8070 ◽  
2021 ◽  
pp. 8070
Author(s):  
Dawei Tian ◽  
Xiaojun Guo ◽  
Na Liu ◽  
Bo Wang ◽  
Hongsheng He ◽  
...  
Keyword(s):  
Pedicle Screw ◽  
Screw Fixation ◽  
Pedicle Screw Fixation ◽  
Sacral Fractures ◽  
Triangular Osteosynthesis

Sacral fractures following stand-alone L5–S1 anterior lumbar interbody fusion for isthmic spondylolisthesis

2010 ◽  
Vol 13 (2) ◽  
pp. 288-293 ◽  
Author(s):  
Jeffrey F. Lastfogel ◽  
Thomas J. Altstadt ◽  
Richard B. Rodgers ◽  
Eric M. Horn
Keyword(s):  
Pedicle Screw ◽  
Interbody Fusion ◽  
Screw Fixation ◽  
High Stress ◽  
Pedicle Screw Fixation ◽  
Anterior Lumbar Interbody Fusion ◽  
Integrated System ◽  
Lumbar Interbody Fusion ◽  
Isthmic Spondylolisthesis ◽  
Sacral Fractures

Recent studies have demonstrated excellent results in treating isthmic spondylolisthesis via an anterior lumbar interbody fusion (ALIF). The authors describe 3 patients with isthmic spondylolisthesis at L5–S1 who experienced sacral fractures after insertion of a unique, stand-alone anterior interbody fixation device. Three consecutive patients at a single institution were treated for Grade I spondylolisthesis at L5–S1 via a standalone ALIF with insertion of a novel biomechanical interbody device. This device is made of polyetheretherketone and has an integrated system for internal fixation into the vertebral bodies. In each patient a bone morphogenetic protein–soaked sponge was placed for the fusion. The indications for treatment in each patient were back and radicular pain that had been unsuccessfully treated with conservative measures. All 3 patients had reduction of their spondylolisthesis and resolution of their unilateral radiculopathies immediately postoperatively. Within 1 month of surgery, all 3 patients had failure of the device and recurrence of their symptoms. In each case the failure was due to fracture of the anterior portion of the S-1 body. Each patient underwent reduction and pedicle screw fixation at L5–S1. In all cases, there was successful reduction in their recurrent spondylolisthesis and resolution of their radiculopathies. Treatment of Grade I isthmic spondylolisthesis at L5–S1 with stand-alone ALIF and fixation can lead to sacral fracture from high stress loads at that level in the spine, and consideration should be made either for supplemental pedicle screw fixation or a completely posterior approach.

scholarly journals S2 Alar Iliac Screw and S1 Pedicle Screw Fixation for the Treatment of Sacral Fractures : A Finite Element Study

2021 ◽  
Author(s):  
Jianxiong Zheng ◽  
Xiaoreng Feng ◽  
Jie Xiang ◽  
Fei Liu ◽  
Frankie K L Leung ◽  
...  
Keyword(s):  
Finite Element ◽  
Pedicle Screw ◽  
Screw Fixation ◽  
Relative Displacement ◽  
Pedicle Screw Fixation ◽  
Fe Model ◽  
Type I ◽  
Vertical Stiffness ◽  
Fixation Methods ◽  
Sacral Fractures

Abstract Background: Five different sacral fracture fixation methods were compared using finite element (FE) analysis to study their biomechanical characteristics.Methods: Denis type I sacral fractures were created by FE modeling. Five different fixation methods for the posterior pelvic ring were simulated: sacroiliac screw (SIS), lumbopelvic fixation (LPF), transiliac internal fixator (TIFI), S2-alar-iliac (S2AI) screw and S1 pedicle screw fixation (S2AI-S1), and S2AI screw and contralateral S1 pedicle screw fixation (S2AI-CS1). Four different loading methods were implemented in sequence to simulate the force in standing, flexion, right bending, and left twisting, respectively. Vertical stiffness, relative displacement, and change in relative displacement were recorded and analyzed.Results: As predicted by the FE model, the vertical stiffness of the five groups in descending order were S2AI-S1, SIS, S2AI-CS1, LPF, TIFI. In terms of relative displacement, S2AI-S1 and S2AI-CS1 groups displayed a smaller mean relative displacement, although the S2AI-CS1 group exhibited greater displacement in the upper sacrum than the S2AI-S1 group. The SIS group displayed a moderate mean relative displacement, although the displacement of the upper sacrum was smaller than that of the S2AI-CS1 group. The LPF and TIFI groups displayed larger mean relative displacements. In terms of change in relative displacement, the TIFI and LPF groups displayed the greatest fluctuations in their motion, while the SIS, S2AI-S1, and S2AI-CS1 groups displayed smaller fluctuations.Conclusion: Compared with SIS, unilateral LPF and TIFI, S2AI-S1 displayed the greatest biomechanical stability of the FE models and can be used as a new method for the treatment of sacral fractures. When the S1 pedicle screw insertion point on the affected side is damaged, S2AI-CS1 can be used as a good alternative to S2AI-S1.

scholarly journals S2-alar-iliac screw and S1 pedicle screw fixation for the treatment of non-osteoporotic sacral fractures: a finite element study

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Jianxiong Zheng ◽  
Xiaoreng Feng ◽  
Jie Xiang ◽  
Fei Liu ◽  
Frankie K. L. Leung ◽  
...  
Keyword(s):  
Finite Element ◽  
Pedicle Screw ◽  
Screw Fixation ◽  
Relative Displacement ◽  
Pedicle Screw Fixation ◽  
Sacral Fracture ◽  
Type I ◽  
Vertical Stiffness ◽  
Fixation Methods ◽  
Sacral Fractures

Abstract Background Five different sacral fracture fixation methods were compared using finite element (FE) analysis to study their biomechanical characteristics. Methods Denis type I sacral fractures were created by FE modeling. Five different fixation methods for the posterior pelvic ring were simulated: sacroiliac screw (SIS), lumbopelvic fixation (LPF), transiliac internal fixator (TIFI), S2-alar-iliac (S2AI) screw and S1 pedicle screw fixation (S2AI-S1) and S2AI screw and contralateral S1 pedicle screw fixation (S2AI-CS1). Four different loading methods were implemented in sequence to simulate the force in standing, flexion, right bending and left twisting, respectively. Vertical stiffness, relative displacement and change in relative displacement were recorded and analyzed. Results As predicted by the FE model, the vertical stiffness of the five groups in descending order was S2AI-S1, SIS, S2AI-CS1, LPF and TIFI. In terms of relative displacement, groups S2AI-S1 and S2AI-CS1 displayed a lower mean relative displacement, although group S2AI-CS1 exhibited greater displacement in the upper sacrum than group S2AI-S1. Group SIS displayed a moderate mean relative displacement, although the displacement of the upper sacrum was smaller than the corresponding displacement in group S2AI-CS1, while groups LPF and TIFI displayed larger mean relative displacements. Finally, in terms of change in relative displacement, groups TIFI and LPF displayed the greatest fluctuations in their motion, while groups SIS, S2AI-S1 and S2AI-CS1 displayed smaller fluctuations. Conclusion Compared with SIS, unilateral LPF and TIFI, group S2AI-S1 displayed the greatest biomechanical stability of the Denis type I sacral fracture FE models. When the S1 pedicle screw insertion point on the affected side is damaged, S2AI-CS1 can be used as an appropriate alternative to S2AI-S1.

scholarly journals Thoracic spondylotic myelopathy presumably caused by diffuse idiopathic skeletal hyperostosis in a patient who underwent decompression and percutaneous pedicle screw fixation

2021 ◽  
Vol 9 ◽  
pp. 2050313X2098779
Author(s):  
Shota Miyoshi ◽  
Tadao Morino ◽  
Haruhiko Takeda ◽  
Hiroshi Nakata ◽  
Masayuki Hino ◽  
...  
Keyword(s):  
Pedicle Screw ◽  
Screw Fixation ◽  
Diffuse Idiopathic Skeletal Hyperostosis ◽  
Pedicle Screw Fixation ◽  
Vertebral Bone ◽  
Bone Bridge ◽  
Percutaneous Pedicle Screw ◽  
Bilateral Lower Limb ◽  
Upper Thoracic ◽  
Percutaneous Pedicle Screw Fixation

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.

scholarly journals Posterior thoracolumbar hemivertebra resection and short-segment fusion in congenital scoliosis: surgical outcomes and complications with more than 5-year follow-up

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Beixi Bao ◽  
Qingjun Su ◽  
Yong Hai ◽  
Peng Yin ◽  
Yaoshen Zhang ◽  
...  
Keyword(s):  
Pedicle Screw ◽  
Surgical Outcomes ◽  
Screw Fixation ◽  
Congenital Scoliosis ◽  
Pedicle Screw Fixation ◽  
Rigid Fixation ◽  
Short Segment ◽  
Hemivertebra Resection ◽  
Main Curve

Abstract Background Treatment of congenital hemivertebra is challenging and data on long-term follow-up (≥ 5 years) are lacking. This study evaluated the surgical outcomes of posterior thoracolumbar hemivertebra resection and short-segment fusion with pedicle screw fixation for treatment of congenital scoliosis with over 5-year follow-up. Methods This study evaluated 27 consecutive patients with congenital scoliosis who underwent posterior thoracolumbar hemivertebra resection and short-segment fusion from January 2007 to January 2015. Segmental scoliosis, total main scoliosis, compensatory cranial curve, compensatory caudal curve, trunk shift, shoulder balance, segmental kyphosis, and sagittal balance were measured on radiographs. Radiographic outcomes and all intraoperative and postoperative complications were recorded. Results The segmental main curve was 40.35° preoperatively, 11.94° postoperatively, and 13.24° at final follow-up, with an average correction of 65.9%. The total main curve was 43.39° preoperatively, 14.13° postoperatively, and 16.06° at final follow-up, with an average correction of 60.2%. The caudal and cranial compensatory curves were corrected from 15.78° and 13.21° to 3.57° and 6.83° postoperatively and 4.38° and 7.65° at final follow-up, with an average correction of 69.2% and 30.3%, respectively. The segmental kyphosis was corrected from 34.30° to 15.88° postoperatively and 15.12° at final follow-up, with an average correction of 61.9%. A significant correction (p < 0.001) in segmental scoliosis, total main curve, caudal compensatory curves and segmental kyphosis was observed from preoperative to the final follow-up. The correction in the compensatory cranial curve was significant between preoperative and postoperative and 2-year follow-up (p < 0.001), but a statistically significant difference was not observed between the preoperative and final follow-up (p > 0.001). There were two implant migrations, two postoperative curve progressions, five cases of proximal junctional kyphosis, and four cases of adding-on phenomena. Conclusion Posterior thoracolumbar hemivertebra resection after short-segment fusion with pedicle screw fixation in congenital scoliosis is a safe and effective method for treatment and can achieve rigid fixation and deformity correction.

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