The role of spinal injections towards optimizing patient selection for spinal surgery: A proof-of-concept study in 176 lower back pain patients.

Background: Managing degenerative lumbar diseases is challenging due to the complexity of identifying symptom causes, especially when multiple pathologies coexist. This study evaluated the impact of patient-specific lumbar spine infiltrations on therapeutic strategies in patients with multiple spinal pathologies (MSP) or specific spinal pathologies (SSP).

Methods: A retrospective cohort of 176 patients treated for subacute or chronic lumbar pain with targeted spinal infiltrations was analyzed.

Characteristics and outcomes of inpatients aged 85 and older with thoracolumbar vertebral fractures: impact on hospital stay and mortality.

Background: There is a gap in evidence about medical outcomes in oldest-old patients (aged 85 and older) with vertebral fractures (VFs). The aim of this study was to evaluate the impact of patient and fracture characteristics on "short-term" hospital outcomes.

Methods: All patients aged ≥ 85 presenting an acute or subsequent VF at our single level I spine center between 2019 and 2021 requiring hospital treatment were included.

Proof of Concept of a New Revision Procedure for Ceramic Inlays of Acetabular Cups Using a Shape-Memory Alloy Actuator System.

The revision of ceramic inlays of acetabular cups is a challenging surgical procedure. The mechanical impact during the inlay extraction process can damage the ceramic or metal cup rim. To avoid these risks, a concept for a new revision procedure was developed.

Side specific differences of Hounsfield-Units in the osteoporotic lumbar spine.

Background: Gold standard for determining bone density as a surrogate parameter of bone quality is measurement of bone mineral density (BMD) by dual energy X-ray absorptiometry (DXA), most commonly performed on the lumbar spine (L1-L4). Computed tomography (CT) data are often available for surgical planning prior to spine procedures, but currently this information is not standardized for bone quality assessment. Besides, measuring the Hounsfield-Units (HU) is also of great importance in the context of biomechanical studies.

As fast as an X-ray: real-time magnetic resonance imaging for diagnosis of idiopathic scoliosis in children and adolescents.

Background: Idiopathic scoliosis is common in adolescence. Due to the rapid growth of the spine, it must be monitored closely with radiographs to ensure timely intervention when therapy is needed. As these radiographs continue into young adulthood, patients are repeatedly exposed to ionizing radiation.

Influence of a Modified Procedure of Joining Ceramic Head and Adapter Sleeve on the Stem Taper in Revision: An Experimental Study.

In revision operations, ceramic heads of modular hip implants can be replaced. As the surface of the stem taper can be damaged, additional adapter sleeves are applied. The components are usually connected manually by the surgeon in a one-step procedure by hammer impacts.

Feasibility of a Shape-Memory-Alloy-Actuator System for Modular Acetabular Cups.

Hip implants have a modular structure which enables patient-specific adaptation but also revision of worn or damaged friction partners without compromising the implant-bone connection. To reduce complications during the extraction of ceramic inlays, this work presents a new approach of a shape-memory-alloy-actuator which enables the loosening of ceramic inlays from acetabular hip cups without ceramic chipping or damaging the metal cup. This technical in vitro study exam-ines two principles of heating currents and hot water for thermal activation of the shape-memory-alloy-actuator to generate a force between the metal cup and the ceramic inlay.

The validity of the distress thermometer in patients with musculoskeletal tumors.

Background: Visits to an outpatient cancer clinic represent a challenging situation for patients, which can trigger anxiety and helplessness in those affected. It is important to identify patients with high psychological distress as early as possible in order to provide them with supportive psychological interventions. The aim of this study was to validate the Distress Thermometer (DT), a widely used screening for distress, in a cohort of patients with musculoskeletal tumors and to explore associations between distress, treatment satisfaction and health literacy.

Evaluating the Feasibility and Reproducibility of a Novel Insertion Method for Modular Acetabular Ceramic Liners.

Modern hip implants have a modular design. In case of wear or other damage it allows surgeons to change the tribological partners, i.e.

Improving Home-Based Scoliosis Therapy: Findings From a Web-Based Survey.

Background: Conservative scoliosis therapy in the form of assisted physiotherapeutic scoliosis exercises is supplemented by self-contained training at home, depending on the approach (eg, Schroth, the Scientific Exercises Approach to Scoliosis). Complex exercises, lack of awareness of the importance of training, and missing supervision by therapists often lead to uncertainty and reduced motivation, which in turn reduces the success of home-based therapy. Increasing digitalization in the health care sector offers opportunities to close this gap.

Approach to standardized material characterization of the human lumbopelvic system-Specification, preparation and storage.

The complexity of the osseo-ligamentous lumbopelvic system has made it difficult to perform both, the overall preparation as well as specimen harvesting and material testing with a reasonable amount of time and personnel. The logistics of such studies present a hurdle for reproducibility. A structured procedure was developed and proved, which allows all necessary steps to be carried out reproducibly and in a reasonable time.

Approach for Non-Intrusive Detection of the Fit of Orthopaedic Devices Based on Vibrational Data.

The soft tissues of residual limb amputees are subject to large volume fluctuations over the course of a day. Volume fluctuations in residual limbs can lead to local pressure marks, causing discomfort, pain and rejection of prostheses. Existing methods for measuring interface stress encounter several limitations.

Biomechanical comparative study of midline cortical vs. traditional pedicle screw trajectory in osteoporotic bone.

Introduction: In lumbar spinal stabilization pedicle screws are used as standard. However, especially in osteoporosis, screw anchorage is a problem. Cortical bone trajectory (CBT) is an alternative technique designed to increase stability without the use of cement.

Cervical spine fractures in ankylosing spondylitis patients: an analysis of the presentation and clinical results of 110 surgically managed patients in two spine centers.

Purpose: In this work, a two-center study was performed to study the clinical presentation of cervical spine fractures in ankylosing spondylitis (AS) patients and assess the surgical management of these fractures.

Methods: A retrospective analysis of prospectively collected data in two level-1 spine surgery centers was performed. Both spine centers have a standard database for all admitted patients.

Does the use of epicutaneous vacuum-assisted closure after revision surgery on the spine reduce further wound revision surgery?

Purpose: This study aimed to investigate the effect of epicutaneous vacuum therapy on the rate of unplanned spinal wound revisions compared with conventional wound dressing.

Methods: This retrospective study included patients who underwent unplanned revision spine surgery after primary aseptic spine surgery who were treated at a level I spine centre between December 2011 and December 2019. Patients with revision surgery who required a further unplanned revision surgery during the inpatient stay were considered a treatment failure.

Sacroiliac innervation.

Purpose: To investigate the innervation pattern of the sacroiliac region, especially with regard to the sacroiliac joint (SIJ). Dorsal SIJ innervation was analyzed and described. Our main hypothesis was that nerves reach the SIJ dorsally, passing ligamental compartments, as this would explain dorsal SIJ pain.

The sacrotuberous ligament is preloaded in situ.

The objective of this study was to evaluate the intrinsic preload of the sacrotuberous ligament. Preload measurements and anatomical experiments were performed on 20 specimens from 10 human cadavers and assessed to consider the thesis of the ligamentous tension band system as a possible load distribution. The result was an unexpectedly high preload force with an overall average of 118 N ± 74 N.

Primary stability of multi-hole cups compared to plate osteosynthesis in osteoporotic anterior column and posterior hemi-transverse acetabular fractures-A biomechanical comparison.

Introduction: Acetabular fractures pose high demands on the surgeon and in the case of osteosynthetic treatment, anatomical reconstruction has the highest priority to achieve a good outcome. However, especially in older patients with poor bone quality, even anatomical reconstruction is no guarantee for a good clinical outcome and may nevertheless end in early osteoarthritis. Primary arthroplasty therefore has an increasing importance in the treatment of these patients.

Convolutional Neural Networks in Spinal Magnetic Resonance Imaging: A Systematic Review.

Objective: Convolutional neural networks (CNNs) are being increasingly used in the medical field, especially for image recognition in high-resolution, large-volume data sets. The study represents the current state of research on the application of CNNs in image segmentation and pathology detection in spine magnetic resonance imaging.

Methods: For this systematic literature review, the authors performed a systematic initial search of the PubMed/Medline and Web of Science (Core collection) databases for eligible investigations.