scholarly journals Comparison of C2-3 Pedicle Screw Fixation With C2 Spinous Muscle Complex and Iliac Bone Graft for Instable Hangman Fracture

2021 ◽  
Vol 8 ◽  
Author(s):  
Dingli Xu ◽  
Kaifeng Gan ◽  
Yang Wang ◽  
Yulong Wang ◽  
Weihu Ma
Keyword(s):  
Bone Graft ◽  
Pedicle Screw ◽  
Screw Fixation ◽  
Operation Time ◽  
Pedicle Screw Fixation ◽  
Iliac Bone ◽  
Iliac Bone Graft ◽  
Significant Difference ◽  
Muscle Complex ◽  
The Mean

Purpose: To compare the effect between C2 spinous muscle complex graft and iliac bone graft in C2-3 pedicle screw fixation for instable Hangman fracture. Using axial spinous muscle complex instead of iliac bone for instable Hangman fracture can decrease neck pain, bone donor site complication, and operation time.Method: The outcomes of C2-3 pedicle screw fixation with C2 spinous muscle complex were compared with iliac bone graft in 18 and 21 patients with instable Hangman fracture. The mean age was 49.1 ± 15.8 years in the complex group and 55.3 ± 12.2 years in the Iliac group, and the mean time to surgery of the patients was 3.3 ± 0.6 days in the complex group and 3.6 ± 0.9 days in the iliac group. Outcome measures including operation time, blood loss, visual analog scale (VAS) for pain, Japanese orthopedic association score (JOA), American spine injure association classification (ASIA), and bone fusion time were collected from medical records. In addition, the postoperative complications were also recorded.Results: There were significant differences in operation time and interoperative blood loss between the two groups (P < 0.01). Also a significant difference was found in VAS score and JOA score between the two groups (P = 0.0012 and P < 0.001, respectively) at 1-month follow-up, whereas, no significant difference was found at other visit time. In the final visit, all patients showed good bone fusion, and two patients shows incision edema and exudation in the iliac group.Conclusion: C2-3 pedicle screw fixation with C2 spinous muscle complex graft maybe a feasible and safe procedure for instable Hangman fracture.

scholarly journals Unilateral versus bilateral Pedicle Screw Fixation associated with interbody fusion in degenerative Lumbar spine diseases

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
E E A Emara ◽  
S H Morad ◽  
A R Farghaly ◽  
O E Ahmed ◽  
M K Khalil
Keyword(s):  
Lumbar Spine ◽  
Pedicle Screw ◽  
Interbody Fusion ◽  
Screw Fixation ◽  
Operation Time ◽  
Fusion Rate ◽  
Pedicle Screw Fixation ◽  
Bilateral Group ◽  
Significant Difference

Abstract Background Lumbar interbody fusion is a recognized surgical technique in treatment of degenerative lumbar instability. Interbody fusion supplemented with pedicle screw fixation has several advantages over posterolateral fusion and has been advocated to improve fusion rates and clinical outcomes. Interbody fusion places the bone graft in the loadbearing position of the anterior and middle spinal columns thereby enhancing the potential for fusion. In addition, the interbody space has more vascularity than the posterolateral space, also increasing the potential for a solid fusion mass to form. Aim of the Work to assess safety and efficacy of unilateral pedicle screw fixation associated with interbody fusion in Lumbar spine degenerative diseases and to evaluate and compare outcomes of unilateral versus bilateral pedicle screw fixation associated with interbody fusion in lumbar spine degenerative diseases, as regard the operation time, bleeding, postoperative stay, cost, and the clinical and biomechanical results. Material & Methods This observational prospective comparative study of the 2 groups who were operated either unilateral (Group A /25 patients) or bilateral (Group B/25 patients) pedicle screw fixation with interbody fusion was done. Patients were followed up for 1, 6, 12 months. This study occurred at Ain Shams University hospitals. Results No differences were observed between the two groups with respect to demographic data. The patients of the two groups had significant improvement in functional outcome compared to preoperatively, except in early postoperative VAS back and ODI in unilateral group which is better than bilateral group. However, no significant difference noticed in the further follow up. There was no significant difference comparing fusion rate, complication rate and duration of hospital stay between the two groups at postoperative follow-up. There was significantly less blood loss, shorter postoperative pain killer use and significantly shorter operation time in the unilateral PS fixation group as compared with the bilateral PS fixation group in our study. Conclusion Our study suggested TLIF with unilateral PS fixation was as safe and effective as that with bilateral PS fixation. Unilateral PS fixation may significantly reduce the intraoperative blood loss and shorten the operation time, somewhat improve the clinical outcome scores of ODI and VAS Back without significant difference comparing fusion rate, complication rate and duration of hospital stay between the two groups at postoperative follow-up. BPSF with TLIF likely causes more degeneration at the cranial adjacent segment compared with UPSF techniques. However, the long-term follow up is required to demonstrate the impact of these findings.

Comparison of Pedicle Screw Fixation With or Without Cement Augmentation Combined With Single-segment Isthmic Spondylolisthesis in Osteoporotic Spine

2021 ◽  
Author(s):  
Jian-cheng Peng ◽  
Hui-zhi Guo ◽  
Chen-guang Zhan ◽  
Hua-sheng Huang ◽  
Yan-huai Ma ◽  
...  
Keyword(s):  
Pedicle Screw ◽  
Screw Fixation ◽  
Operation Time ◽  
Cement Leakage ◽  
Fusion Rate ◽  
Pedicle Screw Fixation ◽  
Isthmic Spondylolisthesis ◽  
Screw Loosening ◽  
Single Segment ◽  
Significant Difference

Abstract PurposeThis study aims to investigate the necessity of cement-augmented pedicle screw fixation in single-segment isthmic spondylolisthesis with osteoporosis.MethodFifty-nine cases were reviewed retrospectively. Thirty-three cases were in the polymethylmethacrylate-augmented pedicle screw (PMMA-PS) group, and the other 26 cases were in the conventional pedicle screw (CPS) group. Evaluation data included operation time, intraoperative blood loss,hospitalization cost, hospitalization days, rates of fusion, screw loosening, bone cement leakage, visual analog scores (VAS) , Oswestry disability index (ODI) , Lumbar Lordosis（LL）, Pelvic Tilt（PT） and Sacral Slope（SS）. ResultsThe operation time and blood loss in the CPS group decreased significantly compared to the PMMA-PS group (P < 0.05). The average hospitalization cost of the PMMA group was significantly higher than that of the CPS group (P < 0.05). There was no significant difference for the average hospital stay between the 2 groups (P > 0.05). The initial and the last follow-up postoperative VAS and ODI improved significantly in the two groups (P < 0.05). There were no significant differences in VAS and ODI at each time point between the 2 groups (P > 0.05). The last postoperative spine-pelvic parameters were significantly improved compared with preoperation (P < 0.05). In the PMMA-PS group, the fusion rate was 100%. The fusion rate was 96.15% in the CPS group. No significant difference was found between the two groups for the fusion rate (P > 0.05). Nine cases in the PMMA-PS group had bone cement leakage (27.27%). There was not screw loosening in the PMMA-PS group. There were 2 cases of screw loosening in the CPS group. There were no significant differences in screw loosening, postoperative adjacent segment fractures, postoperative infection or postoperative revision between the 2 groups (P > 0.05). ConclusionsThe use of PMMA-PS on a regular basis is not recommended for posterior lumbar interbody fusion for the treatment of single-segment isthmic spondylolisthesis with osteoporosis.

scholarly journals Comparison of radiological changes after single- position versus dual- position for lateral interbody fusion and pedicle screw fixation

2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Akihiko Hiyama ◽  
Hiroyuki Katoh ◽  
Daisuke Sakai ◽  
Masato Sato ◽  
Masahiro Tanaka ◽  
...  
Keyword(s):  
Pedicle Screw ◽  
Interbody Fusion ◽  
Screw Fixation ◽  
Degenerative Spondylolisthesis ◽  
Operation Time ◽  
Pedicle Screw Fixation ◽  
Position Change ◽  
Dural Sac ◽  
Significant Difference ◽  
Indirect Decompression

Abstract Background There have been few comparisons between dual positions, which require a position change, and a single position, which does not require position change, and it is not clear whether there is a difference in indirect decompression achieved by the two procedures. Therefore, the purpose of this study was to compare perioperative and radiographic outcomes following lateral lumbar interbody fusion (LLIF) in two cohorts of patients who underwent surgery in a single position or dual position. Methods This study involved 45 patients who underwent indirect decompression at 68 levels, with LLIF and percutaneous pedicle screw (PPS) fixation for lumbar degenerative spondylolisthesis with spinal canal stenosis. Patient demographics and perioperative data were compared between two groups: patients who remained in the lateral decubitus position for pedicle screw fixation (SP group) and those turned to the prone position (DP group). Results A total of 26 DP and 19 SP patients were analyzed. The operation time was approximately 31 min longer for the DP group (129.7 ± 36.0 min) than for the SP group (98.4 ± 41.3 min, P < 0.01). We also evaluated the pre- and postoperative image measurements, there was no significant difference for lumbar lordosis, segmental disc angle, slipping length, and disc height between the groups. The CSA of the dural sac (DP group, from 55.3 to 78.4 mm2; SP group, from 54.7 to 77.2 mm2) and central canal diameter (DP group, from 5.9 to 7.9 mm; SP group, from 5.6 to 7.7 mm) was significantly larger after surgery in both groups. However, there were no statistically significant differences between the two groups (P = 0.684). Conclusions SP surgery could reduce the average surgery time by about 31 min. We found that the effect of indirect decompression by SP-PPS fixation following LLIF was considered to be a useful technique with no difference in dural sac enlargement or disc angle obtained compared with DP-PPS fixation.

scholarly journals Clinical outcomes of posterior laminectomy and pedicle screw fixation for upper cervical intraspinal tumors: a case series

2020 ◽  
Vol 48 (10) ◽  
pp. 030006052096031
Author(s):  
Zhida Chen ◽  
Hui Yu ◽  
Chao Song ◽  
Li Zhang ◽  
Jin Wu ◽  
...  
Keyword(s):  
Pedicle Screw ◽  
Screw Fixation ◽  
Japanese Orthopaedic Association ◽  
Case Series ◽  
Operation Time ◽  
Pedicle Screw Fixation ◽  
Upper Cervical Spine ◽  
Upper Cervical ◽  
The Mean ◽  
Posterior Laminectomy

Objective This study was performed to introduce posterior laminectomy and pedicle screw fixation for the treatment of upper cervical spinal cord tumors and investigate the curative effects. Methods Eighteen patients (11 men, 7 women) who underwent surgical treatment of an upper cervical intraspinal tumor from January 2008 to June 2013 were reviewed. Clinical parameters including age, sex, affected spinal levels, lesion location, duration and type of symptoms, and pathological features were retrospectively investigated. Results The mean operation time was 181.9 ± 25.5 minutes (range, 135–240 minutes), and the mean blood loss volume was 1038.9 ± 284.2 mL (range, 750–1530 mL). The Frankel grade, Japanese Orthopaedic Association score, and Karnofsky performance status score were significantly better postoperatively than preoperatively. The radiographic examination revealed good bone graft fusion. Two patients developed tumor recurrence, while four patients developed intraoperative or postoperative complications. Conclusions Management of upper cervical intraspinal tumors by posterior laminectomy and pedicle screw fixation can relieve compression of the cervical cord and nerve root, thoroughly remove the tumor lesion, reconstruct the stability of the upper cervical spine, and improve patients’ quality of life.

A comparison of long-term outcomes of translaminar facet screw fixation and pedicle screw fixation: a prospective study

2007 ◽  
Vol 7 (3) ◽  
pp. 287-292 ◽  
Author(s):  
Jayshree Tuli ◽  
Sagun Tuli ◽  
Marc E. Eichler ◽  
Eric J. Woodard
Keyword(s):  
Prospective Study ◽  
Pedicle Screw ◽  
Screw Fixation ◽  
Pedicle Screw Fixation ◽  
Long Term Outcomes ◽  
Time To Surgery ◽  
Significant Difference ◽  
The Mean ◽  
Mean Time

Object In this paper, the authors compare the long-term outcomes of translaminar facet screw fixation (TFSF) and pedicle screw fixation (PSF) in the treatment of degenerative lumbosacral disease. Methods This prospective analytical study was performed to compare the long-term outcomes of TFSF and PSF for degenerative lumbosacral disease. Outcomes were defined as the need for reoperation for the development of a nonunion, end-fusion degeneration, or for explantation of hardware. Results A total of 77 patients were analyzed. Thirty-seven patients underwent PSF and 40 received TFSF. Twenty-three of the 77 patients required a reoperation: 13 (32.5%) of the 40 patients in the TFSF group and 10 (27%) of the 37 the patients in the PSF group. The overall mean time to reoperation (regardless of outcome) was 4.05 years. For patients in the TFSF group the mean time to reoperation was 2.94 years, whereas it was 4.35 years in the PSF group (p = 0.34). Nonunion was noted in seven of the 40 patients in the TFSF group and one of 37 in the PSF group. The mean time to surgery for nonunion for patients in the TFSF group was 3.46 years and for those in the PSF group it was 6.27 years (p = 0.04). Surgery for end-fusion degeneration was performed in two patients in the TFSF group and five in the PSF group (p = 0.43). Explantation of hardware was performed in two patients with TFSF and four patients with PSF. Multivariable analysis revealed a statistically significant difference in the time to surgery for nonunion between PSF and TFSF (p = 0.048), with a hazard ratio of 0.097 (95% confidence interval 0.01–0.98). Conclusions Findings from the current prospective study suggest that there is an increased risk of requirement for a reoperation for nonunion among TFSF cases compared with PSF cases.

Minimum 5-year follow-up results of skipped pedicle screw fixation for flexible idiopathic scoliosis

2011 ◽  
Vol 15 (2) ◽  
pp. 146-150 ◽  
Author(s):  
Chang Ju Hwang ◽  
Choon-Ki Lee ◽  
Bong-Soon Chang ◽  
Min-Seok Kim ◽  
Jin S. Yeom ◽  
...  
Keyword(s):  
Blood Loss ◽  
Idiopathic Scoliosis ◽  
Pedicle Screw ◽  
Sagittal Balance ◽  
Screw Fixation ◽  
Operation Time ◽  
Pedicle Screw Fixation ◽  
Correction Loss ◽  
The Mean

Object The aim of this study was to evaluate after more than 5 years the outcome of surgical treatment for flexible idiopathic scoliosis using skipped pedicle screw fixation. Methods For patients with spine curves < 90° and flexibility > 20%, pedicle screws had been inserted into every other segment on the corrective side and 2–4 screws per curve had been inserted on the supportive side. The authors analyzed the results in 57 patients, including the correction rate of coronal curvature and rotational deformity, correction loss, sagittal balance, complications, blood loss, operation time, and implant costs. Results The mean Cobb angle was 54° preoperatively and 17° immediately after surgery (69% correction). At the last follow-up, the mean Cobb angle was 18° (2% correction loss). Rotation of the apical vertebra was corrected by 50% on average and showed only a 6% correction loss at the last follow-up. None of the patients had problems in maintaining sagittal balance. An adding-on phenomenon was detected in 4 patients (7%). Twelve of 14 patients with coronal decompensation showed improvement after surgery, whereas postoperative decompensation developed in 3 patients. Four patients had implant failures, and 4 had postoperative infections. The mean blood loss during surgery was 832 ml, and the mean operation time was 167 minutes. Compared with conventional methods, the authors' method used up to 48% fewer screws. Conclusions Skipped pedicle screw fixation of flexible idiopathic scoliosis showed satisfactory results. This method has several advantages, including reduced blood loss, shorter operation time, and reduced cost.

scholarly journals Comparison of radiological changes after single- position versus dual- position for lateral interbody fusion and pedicle screw fixation

2019 ◽  
Author(s):  
Akihiko Hiyama ◽  
Hiroyuki Katoh ◽  
Daisuke Sakai ◽  
Masato Sato ◽  
Masahiro Tanaka ◽  
...  
Keyword(s):  
Pedicle Screw ◽  
Interbody Fusion ◽  
Screw Fixation ◽  
Degenerative Spondylolisthesis ◽  
Operation Time ◽  
Pedicle Screw Fixation ◽  
Position Change ◽  
Dural Sac ◽  
Significant Difference ◽  
Indirect Decompression

Abstract Background: There have been few comparisons between dual positions, which require a position change, and a single position, which does not require position change, and it is not clear whether there is a difference in indirect decompression achieved by the two procedures. Therefore, the purpose of this study was to compare perioperative and radiographic outcomes following lateral lumbar interbody fusion (LLIF) in two cohorts of patients who underwent surgery in a single position or dual position. Methods: This study involved 45 patients who underwent indirect decompression at 68 levels, with LLIF and percutaneous pedicle screw (PPS) fixation for lumbar degenerative spondylolisthesis with spinal canal stenosis. Patient demographics and perioperative data were compared between two groups: patients who remained in the lateral decubitus position for pedicle screw fixation (SP group) and those turned to the prone position (DP group). Results: A total of 26 DP and 19 SP patients were analyzed. The operation time was approximately 31 min longer for the DP group (129.7 ± 36.0 min) than for the SP group (98.4 ± 41.3 min, P < 0.01). We also evaluated the pre- and postoperative image measurements, there was no significant difference for lumbar lordosis, segmental disc angle, slipping length, and disc height between the groups. The CSA of the dural sac (DP group, from 55.3 to 78.4 mm2; SP group, from 54.7 to 77.2 mm2) and central canal diameter (DP group, from 5.9 to 7.9 mm; SP group, from 5.6 to 7.7 mm) was significantly larger after surgery in both groups. However, there were no statistically significant differences between the two groups (P = 0.684). Conclusions: SP surgery could reduce the average surgery time by about 31 min. We found that the effect of indirect decompression by SP-PPS fixation following LLIF was considered to be a useful technique with no difference in dural sac enlargement or disc angle obtained compared with DP-PPS fixation.

scholarly journals Short Segment versus Long Segment Pedicle Screws Fixation in Management of Thoracolumbar Burst Fractures: Meta-Analysis

2017 ◽  
Vol 11 (1) ◽  
pp. 150-160 ◽  
Author(s):  
Tarek Ahmed Aly
Keyword(s):  
Pedicle Screw ◽  
Screw Fixation ◽  
Meta Analysis ◽  
Pedicle Screw Fixation ◽  
Risk Of Bias ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Thoracolumbar Burst Fractures ◽  
Burst Fractures ◽  
Significant Difference

<p>Posterior pedicle screw fixation has become a popular method for treating thoracolumbar burst fractures. However, it remains unclear whether additional fixation of more segments could improve clinical and radiological outcomes. This meta-analysis was performed to evaluate the effectiveness of fixation levels with pedicle screw fixation for thoracolumbar burst fractures. MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials, Springer, and Google Scholar were searched for relevant randomized and quasirandomized controlled trials that compared the clinical and radiological efficacy of short versus long segment for thoracolumbar burst fractures managed by posterior pedicle screw fixation. Risk of bias in included studies was assessed using the Cochrane Risk of Bias tool. Based on predefined inclusion criteria, Nine eligible trials with a total of 365 patients were included in this meta-analysis. Results were expressed as risk difference for dichotomous outcomes and standard mean difference for continuous outcomes with 95% confidence interval. Baseline characteristics were similar between the short and long segment fixation groups. No significant difference was identified between the two groups regarding radiological outcome, functional outcome, neurologic improvement, and implant failure rate. The results of this meta-analysis suggested that extension of fixation was not necessary when thoracolumbar burst fracture was treated by posterior pedicle screw fixation. More randomized controlled trials with high quality are still needed in the future.</p>

Long-term efficacy and safety of bone cement-augmented pedicle screw fixation for stage III Kümmell diseaseLong-term efficacy and safety of bone cement-augmented pedicle screw fixation for stage III Kümmell disease

2020 ◽  
Author(s):  
Guo-ye Mo ◽  
Teng-peng Zhou ◽  
Yong-xian Li ◽  
Hui-zhi Guo ◽  
Dan-qing Guo ◽  
...  
Keyword(s):  
Cobb Angle ◽  
Bone Cement ◽  
Pedicle Screw ◽  
Screw Fixation ◽  
Operation Time ◽  
Pedicle Screw Fixation ◽  
Stage Iii ◽  
Efficacy And Safety ◽  
Sagittal Vertical Axis ◽  
Term Efficacy

Abstract Purpose This study aimed to evaluate the efficacy and safety of bone cement-augmented pedicle screw fixation for stage III Kümmell disease. Methods Twenty-five patients with stage III Kümmell disease who received bone cement-augmented pedicle screw fixation at the First Affiliated Hospital of Guangzhou University of Chinese Medicine between June 2009 and December 2015 were enrolled. All patients were females with a history of osteoporosis. The vertebral Cobb angle (V-Cobb angle), the fixed segment Cobb Angle (S-Cobb angle), pelvic parameters, visual Analogue Scale (VAS) score, and Oswestry Disability Index (ODI) were assessed preoperatively, postoperatively and at the final follow-up. Complications, loosening rate, operation time, and intraoperative bleeding were recorded. Results The average lumbar vertebral density T-value was -3.68 ± 0.71 SD, and the average age was 71.84 ± 5.39. The V-Cobb angle, S-Cobb angle, and Sagittal Vertical Axis（SVA） were significantly smaller postoperatively compared to the preoperative values. The VAS and ODI at 1 month after surgery were 3.60 ± 1.00 and 36.04 ± 6.12%, respectively, which were both significantly lower than before surgery (VAS: 8.56±1.04, ODI: 77.80 ± 6.57%). Conclusion Bone cement-augmented pedicle screw fixation is a safe and effective treatment for stage III Kümmell disease. It can effectively correct kyphosis, restore and maintain sagittal balance, and maintain spinal stability.

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