Percutaneous Pedicle Screw Stabilization: Surgical Technique, Fracture Reduction, and Review of Current Spine Trauma Applications.

Percutaneous pedicle screw fixation has evolved as a useful tool in the management of spinal trauma. As a minimally invasive approach, it provides the stability of open instrumentation while limiting blood loss, avoiding excessive muscle/soft-tissue insult, and improving postoperative pain and mobilization. Muscle-dilating techniques also preserve greater paraspinal muscle volume and strength compared with open midline approaches.

Lemierre Disease: A Case With Multilevel Epidural Abscess and Aggressive Neurological Weakness: Case Report and Literature Review.

Background: Lemierre disease is a rare postanginal sepsis caused by the anaerobe Fusobacterium necrophorum. It is associated with a pharyngitis that progresses quickly to thrombophlebitis of the internal jugular vein and metastatic abscesses to pulmonary, soft tissue, articular, and organ systems. It is rarely associated with spinal epidural abscesses.

Complication with removal of a lumbar spinal locking plate.

Introduction. The use of locking plate technology for anterior lumbar spinal fusion has increased stability of the vertebral fusion mass over traditional nonconstrained screw and plate systems. This case report outlines a complication due to the use of this construct.

Effect of body mass index on early outcomes of minimally invasive degenerative lumbar surgery.

This retrospective study examined the early outcomes of healthy weight and severely obese subjects who underwent minimally invasive (MI) fusion and decompression surgery for degenerative lumbar disease at one to two spinal levels. A single surgeon (D.A.

Comparative reliability of 3 thoracolumbar fracture classification systems.

Study Design: Prospective study of 3 spine surgeons, 3 spine fellows, 3 nonspine orthopedists, and 12 orthopedic residents classifying 97 thoracolumbar fractures using the Denis, Association for Osteosynthesis (AO), and Thoracolumbar Injury Severity Score (TLISS) systems and reclassifying them 3 months later.

Objective: To compare the reliability of the Denis, AO, and TLISS classification systems and evaluate the skills necessary for their use.

Summary Of Background Data: The Denis and AO systems are the traditional methods of classification of thoracolumbar fractures.

Radiographic assessment of lumbar facet distance spacing and pediatric spondylolysis.

Study Design: Retrospective radiographic review.

Objective: The purpose of this article was to explore the relationship between interfacet spacing and pediatric spondylolysis.

Summary Of Background Data: Recent literature suggests that a potential cause of spondylolytic defects in adults is a narrowed interfacet spacing in the lower lumbar spine.

An in vitro biomechanical investigation: variable positioning of leopard carbon fiber interbody cages.

Study Design: This study is a biomechanical analysis of intervertebral cage placement, using a biomechanical model that has the appropriate matching geometry of the lumbar spine at the level of L4-L5 based upon prior morphometric studies.

Objective: The goal of this in vitro biomechanical analysis of interbody cages is to determine the effect of interbody cage position on the mechanics of posterior spinal instrumentation. This biomechanical analysis can potentially be used to guide surgical technique for placement of interbody cage devices.

Radiographic assessment of lumbar facet distance spacing and spondylolysis.

Study Design: Spondylolytic defects at L5 are influenced by insufficient differential spacing between the inferior articular facets of L4 and superior facets of S1. These structures then impinge on the intervening L5 pars interarticularis during hyperlordosis, contributing to fracture and resorption of the pars.

Objectives: Articular facet spacing was evaluated on clinical radiographs of normal and spondylolytic patients.

Innovations in the treatment of low back pain.

Nonoperative care of the low back pain patient has changed little over the past 15 years. However, injections to localize pain have become increasingly more sophisticated for both diagnosis and treatment. Advances in surgical treatment have been dramatic.

Intermediate-term outcome of cervical spinal cord-injured patients older than 50 years of age.

Study Design: This study retrospectively reviewed the intermediate-term clinical outcome of patients who were 50 years of age or older at the time they experienced their cervical spinal cord injury.

Objectives: To establish reasonable expectations for the functional outcome in the older patient with cervical spinal cord injury.

Background Data: The long-term morbidity and mortality of large groups of patients with spinal cord injury have been reported.

Burst fractures of the second through fifth lumbar vertebrae. Clinical and radiographic results.

Fifty-five patients who had sustained a burst fracture of the lumbar spine were followed for a mean of seventy-nine months (range, twenty-four to 192 months) after the injury. Thirty patients had been managed non-operatively with a short period of bed rest followed by protected mobilization. The remaining twenty-five patients had been managed operatively: eight, with posterior arthrodesis with long-segment hook-and-rod fixation; eight, with posterior arthrodesis with short-segment transpedicular fixation; six, with posterior arthrodesis and instrumentation followed by anterior decompression and arthrodesis; and three, with anterior decompression and arthrodesis.

Gelfoam-induced acute quadriparesis after cervical decompression and fusion.

Study Design: Case report.

Objective: To acknowledge a potential serious complication of Gelfoam use in enclosed space.

Summary Of Background Data: The gelatin sponge has been used for hemostasis in spine surgery.

Early outcome in cervical spinal cord injured patients older than 50 years of age.

Study Design: This study retrospectively reviewed consecutive spinal cord injured patients older than 50 years of age.

Objective: This study established reasonable expectations for the early clinical outcome of cervical spinal cord injured patients greater than 50 years of age.

Summary Of Background Data: Previous studies of cervical spinal cord injuries have concentrated on long-term morbidity and mortality.

The use of a grommet bone liner for flexible hinge implant arthroplasty of the great toe.

Press-fit titanium grommets were developed to shield flexible hinged silicone implants used for arthroplasty of the radiocarpal, metacarpophalangeal, and metatarsophalangeal joints. Since 1985, 179 titanium circumferential grommets were used in 90 first metatarsophalangeal joints with excellent, pain-free, functional results and favorable bone response around the implant stems and at the bone-grommet interface. There were no complications due to particulate reactivity, implant fracture, or grommet fracture.