scholarly journals BASIC PRINCIPLES IN THE CORRECTION OF SEVERE SCOLIOTIC DEFORMITIES USING PEDICLE SCREW FIXATION

2018 ◽  
Vol 17 (4) ◽  
pp. 293-299
Author(s):  
Andrey Baklanov ◽  
Sergey Kolesov ◽  
Ilya Shavyrin ◽  
Andrey Panteleyev
Keyword(s):  
Comparative Study ◽  
Pedicle Screw ◽  
Screw Fixation ◽  
Pedicle Screw Fixation ◽  
Vertebral Rotation ◽  
Loss Of Correction ◽  
Apical Vertebral Rotation ◽  
Group A ◽  
Group B ◽  
Retrospective Comparative Study

ABSTRACT Objective: To determine the effectiveness of surgical treatment of patients with idiopathic scoliosis who have severe spinal deformity, using either all pedicle screw or hybrid constructs. Methods: A retrospective analysis of the results of treatment of 34 patients aged 15 to 27 years with severe scoliosis, operated on using pedicle screws. A comparison group consisted of 22 patients who were operated on using hybrid constructs. Patients from both groups were compared according to the following parameters: pre/postoperative Cobb angle, mobility according to the traction test, global sagittal/frontal balance, apical vertebral rotation, operative time, intraoperative blood loss, number of instrumented vertebrae, and loss of correction within 24 months. Results: In group A (pedicle screw fixation) compared to group B (hybrid spinal fixation), patients had better results in the following parameters: postoperative correction was 48% and 41%, apical vertebral rotation decreased from 78° to 55° (30%) and from 74° to 59° (21%), correction of global frontal/sagittal balance from 39/25 mm to 14/12 mm (64%/52%) and 35/26 mm to 16/15 mm (55%/43%) between treatment groups, respectively. These results suggest a better trunk balance and greater postoperative correction in patients submitted to the all pedicle screw fixation. Smaller values were found for loss of correction of the major curve, and there was a slight increase in thoracic kyphosis in the postoperative period (24 months) 3.8%/4.3% in group A vs. 6.2%/7.5% in group B, indicating greater reliability and stability of the metal with the «all screw» fixation. This was a Level III retrospective comparative study. Conclusion: All the pedicle screw constructs enabled better postoperative correction, derotation, global sagittal and frontal balance, as well as a shorter fixation, compared to hybrid fixation of the spine. Level of Evidence III, Retrospective comparative study.

scholarly journals Application of 3-Dimensional Printing Guide Template and Pointed Lotus-Style Regulator in Percutaneous Pedicle Screw Fixation for Thoracolumbar Fractures

2021 ◽  
Author(s):  
Ming Zhang ◽  
Jiayi Li ◽  
Tao Fang ◽  
Jing Yan ◽  
Lungang Wu ◽  
...  
Keyword(s):  
3D Printing ◽  
Pedicle Screw ◽  
Screw Fixation ◽  
Pedicle Screw Fixation ◽  
3 Dimensional ◽  
Percutaneous Pedicle Screw ◽  
Group A ◽  
Group B ◽  
Percutaneous Pedicle Screw Fixation ◽  
First Time

Abstract This study aims to analysis the efficacy of the 3D printing percutaneous guide template in combination with the pointed lotus-style regulator in percutaneous pedicle screw fixation.60thoracolumbar fractures patients receiving percutaneous pedicle screw fixation (PPSF) were enrolled and randomly divided into 3 groups. Patients in Group A received traditional PPSF, while patients in Group B received PPSF with flat end lotus-style regulator and patients in Group C received PPSF with pointed lotus-style regulator. The experimental results showed that the highest number of pedicle screw successfully inserted by the first time was in group C, while lowest in group A (P<0.05). The total time of fluoroscopy and operation were lower in group C, and higher in group A (P<0.05). VAS and ODI scores were all lower after surgery than before surgery in 3groups. VAS and ODI scores were lower in group B and C, compared with group A at day 1 ,7 after surgery (P<0.05). KA decreased significantly in 3 groups after surgery and no difference in KA change between 3 groups (P>0.05). Taken together, Application of the 3D printing guide template in combination with pointed lotus-style regulator improved the accuracy of pedicle insertion.Trial registration: ClinicalTrials.gov Identifier: NCT04980131. Registered 18/07/2021.

Treatment of Thoracolumbar Burst Fractures with Polymethyl Methacrylate Vertebroplasty and Short-segment Pedicle Screw Fixation

Neurosurgery ◽  
2003 ◽  
Vol 53 (6) ◽  
pp. 1354-1361 ◽  
Author(s):  
Der-Yang Cho ◽  
Wuen-Yen Lee ◽  
Pon-Chun Sheu
Keyword(s):  
Pedicle Screw ◽  
Screw Fixation ◽  
Pedicle Screw Fixation ◽  
Vertebral Height ◽  
Short Segment ◽  
Thoracolumbar Burst Fractures ◽  
Kyphosis Correction ◽  
Burst Fractures ◽  
Group A ◽  
Group B

Abstract OBJECTIVES We aimed to evaluate the efficacy of reinforcing short-segment pedicle screw fixation with polymethyl methacrylate (PMMA) vertebroplasty in patients with thoracolumbar burst fractures. METHODS We enrolled 70 patients with thoracolumbar burst fractures for treatment with short-segment pedicle screw fixation. Fractures in Group A (n = 20) were reinforced with PMMA vertebroplasty during surgery. Group B patients (n = 50) were not treated with PMMA vertebroplasty. Kyphotic deformity, anterior vertebral height, instrument failure rates, and neurological function outcomes were compared between the two groups. RESULTS Kyphosis correction was achieved in Group A (PMMA vertebroplasty) and Group B (Group A, 6.4 degrees; Group B, 5.4 degrees). At the end of the follow-up period, kyphosis correction was maintained in Group A but lost in Group B (Group A, 0.33-degree loss; Group B, 6.20-degree loss) (P = 0.0001). After surgery, greater anterior vertebral height was achieved in Group A than in Group B (Group A, 12.9%; Group B, 2.3%) (P &lt; 0.001). During follow-up, anterior vertebral height was maintained only in Group A (Group A, 0.13 ± 4.06%; Group B, −6.17 ± 1.21%) (P &lt; 0.001). Patients in both Groups A and B demonstrated good postoperative Denis Pain Scale grades (P1 and P2), but Group A had better results than Group B in terms of the control of severe and constant pain (P4 and P5) (P &lt; 0.001). The Frankel Performance Scale scores increased by nearly 1 in both Groups A and B. Group B was subdivided into Group B1 and B2. Group B1 consisted of patients who experienced instrument failure, including screw pullout, breakage, disconnection, and dislodgement (n = 11). Group B2 comprised patients from Group B who did not experience instrument failure (n = 39). There were no instrument failures among patients in Group A. Preoperative kyphotic deformity was greater in Group B1 (23.5 ± 7.9 degrees) than in Group B2 (16.8 ± 8.40 degrees), P &lt; 0.05. Severe and constant pain (P4 and P5) was noted in 36% of Group B1 patients (P &lt; 0.001), and three of these patients required removal of their implants. CONCLUSION Reinforcement of short-segment pedicle fixation with PMMA vertebroplasty for the treatment of patients with thoracolumbar burst fracture may achieve and maintain kyphosis correction, and it may also increase and maintain anterior vertebral height. Good Denis Pain Scale grades and improvement in Frankel Performance Scale scores were found in patients without instrument failure (Groups A and B2). Patients with greater preoperative kyphotic deformity had a higher risk of instrument failure if they did not undergo reinforcement with vertebroplasty. PMMA vertebroplasty offers immediate spinal stability in patients with thoracolumbar burst fractures, decreases the instrument failure rate, and provides better postoperative pain control than without vertebroplasty.

scholarly journals Vertebroplasty and vertebroplasty in combination with intermediate bilateral pedicle screw fixation for OF4 in osteoporotic vertebral compression fractures: a retrospective single-Centre cohort study

BMC Surgery ◽  
2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Weiyang Zhong ◽  
Xinjie Liang ◽  
Xiaoji Luo ◽  
Zhengxue Quan
Keyword(s):  
Pedicle Screw ◽  
Screw Fixation ◽  
Pedicle Screw Fixation ◽  
Vertebral Compression Fractures ◽  
Osteoporotic Vertebral Compression Fractures ◽  
Compression Fractures ◽  
Group A ◽  
Group B ◽  
Bilateral Pedicle Screw

Abstract Background Although various studies have described the outcomes and complications of each treatment for OF 4 in osteoporotic vertebral compression fractures (OVCFs), there is still no consensus on the optimal treatment regimen. This study aimed to investigate the clinical effect of OF 4 in patients with OVCFs treated with percutaneous vertebroplasty (PV) compared with PV in combination with intermediate bilateral pedicle screw fixation (IBPSF). Methods A total of 110 patients with OF 4 in OVCFs from January 2011 to December 2013 were reviewed retrospectively and divided into two groups (group A: PV, group B: PV + IBPSF). According to the guidelines of the German Society for Orthopaedics and Trauma (DGOU), OF 4 consists of 3 fracture types. The clinical and radiographic assessments were observed preoperatively, postoperatively, and during follow-up. Results The patients were followed for an average of 60.50 ± 15.20 months (group A) and 58.20 ± 17.60 months (group B) without significant differences. No significant differences were found in BMD, BMI and cement volume between the two groups, but differences were found for operation time, blood loss, and hospitalization time. The VAS and ODI scores improved better significantly at the final follow-up in group B but not in group A. Compared with the preoperative values, the postoperative kyphosis angle and loss of fractured segment height significantly improved, but the difference between the groups was significant after 3 months postoperatively. The loss of angular correction and fractured segment height in group A were greater than those in group B. A total of 15 cases of cement leakage were observed in group A and 8 cases in group B, and no complications or revision surgeries were observed in either group. Thirteen new fractures occurred (11 in group A and 2 in group B), which was significant. Conclusion PV with IBPSF could provide effective restoration and maintenance of fractured segment height and segment alignment as well as a lower rate of complications of OF 4 in OVCFs.

Loss of correction in spinal cord injury-related scoliosis after pedicle screw fixation

2013 ◽  
Vol 30 (4) ◽  
pp. 673-680
Author(s):  
Mina G. Safain ◽  
Steven Hwang ◽  
Joseph King ◽  
Patrick Cahill ◽  
Amer Samdani
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Pedicle Screw ◽  
Screw Fixation ◽  
Pedicle Screw Fixation ◽  
Loss Of Correction ◽  
Cord Injury

scholarly journals Vacuum Phenomenon as a Predictor of Kyphosis After Implant Removal Following Posterior Pedicle Screw Fixation Without Fusion for Thoracolumbar Burst Fracture: a Single-center Retrospective Study

2021 ◽  
Author(s):  
Masahiro Hirahata ◽  
Tomoaki Kitagawa ◽  
Youichi Yasui ◽  
Hiroyuki Oka ◽  
Iwao Yamamoto ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Pedicle Screw ◽  
Old Age ◽  
Screw Fixation ◽  
Burst Fracture ◽  
Pedicle Screw Fixation ◽  
Implant Removal ◽  
Thoracolumbar Burst Fracture ◽  
Loss Of Correction ◽  
Vacuum Phenomenon

Abstract Background: Posterior pedicle screw fixation without fusion has been commonly applied for thoracolumbar burst fracture. Implant removal is performed secondarily after bone union. However, the occurrence of secondary kyphosis has recently attracted attention. Secondary kyphosis results in poor clinical outcomes. The purpose of this was to determine predictors of kyphosis after implant removal following posterior pedicle screw fixation without fusion for thoracolumbar burst fracture.Methods: This retrospective study reviewed 60 consecutive patients with thoracolumbar burst fracture who underwent implant removal following posterior pedicle screw fixation without fusion. Inclusion criteria were non-osteoporotic fracture and T11-L4 burst fracture. Old age, sex, initial severe wedge deformity, initial severe kyphosis, and vacuum phenomenon were examined as factors potentially associated with final kyphotic deformity (defined as kyphotic angle greater than 25°) or loss of correction. Logistic regression analysis was performed using propensity score matching.Results: Among the 31 female and 29 male patients (mean age 39 years), final kyphotic deformity was found in 17 cases (28%). Multivariate analysis showed a significant association with the vacuum phenomenon. Loss of correction was found in 35 cases (58%) and showed a significant association with the vacuum phenomenon. There were no significant associations with other factors.Conclusions: The findings of this study suggest that the vacuum phenomenon before implant removal may be a predictor of secondary kyphosis of greater than 25° after implant removal following posterior pedicle screw fixation without fusion for thoracolumbar burst fracture, but that old age, sex, initial severe kyphosis, and initial severe wedge deformity may not be predictors.

scholarly journals A retrospective comparative study to evaluate the efficacy and safety of mifepristone with misoprostol over misoprostol alone in induction in labor

2018 ◽  
Vol 7 (12) ◽  
pp. 5140
Author(s):  
Reena Sharma ◽  
B. R. Sharma ◽  
Poojan Dogra
Keyword(s):  
Comparative Study ◽  
Induction Of Labour ◽  
Cervical Ripening ◽  
Efficacy And Safety ◽  
Group A ◽  
The Mean ◽  
Group 2 ◽  
Group B ◽  
Retrospective Comparative Study ◽  
Group 1

Background: The aim is to compare the improvement in pre-induction Bishop’s score, proportion of patients going in labor and induction–delivery interval after using the Misoprostol versus Mifepristone and Misoprostol as cervical ripening and labor inducing agent.Methods: It is retrospective comparative study conducted on 110 women. Women were randomized in group A and in group B of 55 patients in each group. Group A received tab Mifepristone 200 mg orally on day 1 followed by Misoprostol 25 ug after 48 hours and continued 6 hourly till maximum four tablets and group B patients received tablet Misoprostol 25ug and continued 25ug 6hrly maximum 4 doses. Women observed for improvement in Bishop‟s score, induction-delivery interval and requirement of subsequent doses of Misoprostol.Results: Present study concluded that tablet Mifepristone is an efficient cervical ripening and inducing agent of labor as pre-induction Bishop’s score was improved. 36.4%patients went into labor only with tablet Mifepristone. The mean induction-delivery interval was,19±12.2hrs in Group 1 as compare to 13.1±13.0 hrs in Group 2. Mean Bishop’s score observed in Group 1 were 2.5±1.78 and 1.67±1.25 in Group 2. It was observed that there was significant improvement in the Bishop’s score after giving Mifepristone to the patients; mean Bishop’s 24hrs after mifepristone were 4.03±1.80. Repeated dose of Misoprostol required in Group 1 was observed to be higher than group 2 as shown in table 8. Mean misoprostol doses required in group 1 was 2.56±1.15 as compared to 1.71±1.58 in group 2.Conclusions: Mifepristone with Misoprostol reduce the induction delivery interval and more potent in combination for induction of labour as compared to Misoprostol alone.

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