Comparison of allograft and polyetheretherketone (PEEK) cage subsidence rates in anterior cervical discectomy and fusion (ACDF).

Structural allografts and PEEK cages are commonly used interbody fusion devices in ACDF. The subsidence rates of these two spacers have not yet been directly compared. The primary aim of this study was to compare the subsidence rate of allograft and PEEK cage in ACDF.

Response of Aneurysmal Bone Cyst to Denosumab.

Study Design: Case report and literature review.

Objective: To describe a unique case of large sacral aneurysmal bone cysts (ABCs) treated with denosumab and review the literature on this rare entity.

Summary And Background Data: ABCs are expansile osteolytic lesions that typically contain blood-filled spaces separated by fibrous septa.

Radiographic Comparison of Lateral Lumbar Interbody Fusion Versus Traditional Fusion Approaches: Analysis of Sagittal Contour Change.

Background: Lateral approach to lumbar fusion has been gaining popularity in recent years. With increasing awareness of the significance of sagittal balance restoration in spinal surgery, it is important to investigate the potential of this relatively new approach in correcting sagittal deformities in comparison to conventional approaches. The aim of this study was to evaluate sagittal contour changes seen in lateral lumbar interbody fusion and compare them with radiographic changes in traditional approaches to lumbar fusion.

Comparison of open and percutaneous lumbar pedicle screw revision rate using 3-D image guidance and intraoperative CT.

Complications arising from a malpositioned screw can be both devastating and costly. The incidence of neurologic injury secondary to a malpositioned screw is reported to be as high as 7% to 12%. The advancement of image-guided technology has allowed surgeons to place screws more accurately and confirm correct placement prior to leaving the operating room.

Comparison of nonnavigated and 3-dimensional image-based computer navigated balloon kyphoplasty.

Balloon kyphoplasty is a common treatment for osteoporotic and pathologic compression fractures. Advantages include minimal tissue disruption, quick recovery, pain relief, and in some cases prevention of progressive sagittal deformity. The benefit of image-based navigation in kyphoplasty has not been established.

New generation intraoperative three-dimensional imaging (O-arm) in 100 spine surgeries: does it change the surgical procedure?

The O-arm (Medtronic Sofamor Danek, Inc., Memphis, TN, USA), an intraoperative CT scan imaging system, may provide high-quality imaging information to the surgeon. To our knowledge, its impact on spine surgery has not been studied.

Neck-shoulder crossover: how often do neck and shoulder pathology masquerade as each other?

Cases of consecutive new patients seen at orthopedic spine and shoulder clinics were reviewed. Four percent of spine patients had significant shoulder pathology, and 3.6% of shoulder patients had significant spine pathology.

Adult Degenerative Scoliosis Surgical Outcomes: A Systematic Review and Meta-analysis.

Introduction: There is increasing awareness of adult degenerative or de novo scoliosis, and its surgical treatment when indicated can be challenging and resource intense. Surgical randomized controlled trials are rare, and observational studies pose limitations because of the heterogeneity of surgical practices, techniques, and patient populations. Pooled analysis of current literature may identify effective treatment strategies and guide future efforts at prospective clinical research.

Comparison of cranial facet joint violation rates between open and percutaneous pedicle screw placement using intraoperative 3-D CT (O-arm) computer navigation.

Study Design: Retrospective study comparing cranial facet joint violation rates of open and percutaneous pedicle screws inserted using 3-dimensional image-guidance.

Objective: To determine the rate of cranial facet joint violation in intraoperative computed tomography (CT) image-guided lumbar pedicle screw instrumentation and compare facet joint violation rates between CT image-guided open and percutaneous techniques.

Summary Of Background Data: Facet joint violation by pedicle screws can potentially result in a higher rate of adjacent segment degeneration.

The accuracy of navigation and 3D image-guided placement for the placement of pedicle screws in congenital spine deformity.

Background: Treatment of congenital spine deformity has high surgical risk due to abnormal anatomy and dysmorphic pedicles. We hypothesized that an image-guided navigation system would result in a low rate of screw revision due to malposition.

Methods: From 2007 to 2010, 142 screws were placed in 14 consecutive patients with congenital spine deformity using an intraoperative computer tomography (CT) (O-arm) and image-guided navigation system (Stealth).

Does prone repositioning before posterior fixation produce greater lordosis in lateral lumbar interbody fusion (LLIF)?

Study Design: Retrospective comparative radiographic review.

Objective: To determine if lateral to prone repositioning before posterior fixation confers additional operative level lordosis in lateral lumbar interbody fusion (LLIF) procedures.

Summary Of Background Data: In a review of 56 consecutive patients who underwent LLIF, there was no statistically significant change in segmental lordosis from lateral to prone once a cage is in place.

Segmental lumbar sagittal correction after bilateral transforaminal lumbar interbody fusion.

Object: In this paper the authors sought to determine the segmental lumbar sagittal contour change after bilateral transforaminal lumbar interbody fusion (TLIF).

Methods: Between March 2007 and October 2010, 42 consecutive patients (57 levels) underwent bilateral TLIF. Standard preoperative and 6-week postoperative standing lumbar spine radiographs were examined.

Intraoperative 3-dimensional imaging (O-arm) for assessment of pedicle screw position: Does it prevent unacceptable screw placement?

Background: Pedicle screws are biomechanically superior over other spinal fixation devices. When improperly positioned, they lose this advantage and put adjacent structures at risk. Accurate placement is therefore critical.

Pediatric pedicle screw placement using intraoperative computed tomography and 3-dimensional image-guided navigation.

Study Design: A retrospective cohort study reporting the use of intraoperative computed tomography (CT) and image-guided navigation system for the placement of pedicle screws in pediatric compared with adult patients.

Objective: To evaluate the accuracy of open pedicle screw placement in pediatric patients using intraoperative CT and 3-dimensional (3D) image-guided navigation.

Summary Of Background Data: Pedicle screws are widely used in children for the correction of spinal deformity.

The accuracy of intraoperative O-arm images for the assessment of pedicle screw postion.

Study Design: Human cadaveric study.

Objective: The objective of the study was to determine the accuracy of intraoperative O-arm images in determining pedicle screw position using open dissection as the gold standard.

Summary Of Background Data: Pedicle screws are widely used in the treatment of various spinal disorders.

Validity of surgeon perception of navigated pedicle screw position: a cadaveric study.

Study Design: Human Cadaveric Experimental Study.

Objective: To determine the validity of surgeon perception of pedicle screw position inserted using intraoperative three-dimensional (O-arm) image-guided screw insertion.

Summary Of Background Data: A surgeon's ability to detect pedicle wall violations intraoperatively is crucial for optimal pedicle screw placement.

Optimizing iliac screw fixation: a biomechanical study on screw length, trajectory, and diameter.

Object: The authors performed a study to determine the optimal iliac screw size, length, and trajectory that produce the highest insertional torques.

Methods: Ten fresh cadavers were used and 7.5 × 140-mm and 9.

Mobile and fixed-bearing (all-polyethylene tibial component) total knee arthroplasty designs. A prospective randomized trial.

Background: Proponents of mobile-bearing total knee arthroplasty believe that it has potential advantages over a fixed-bearing design in terms of diminished wear and improved motion and/or function, but these advantages have not been demonstrated in a randomized clinical comparison to our knowledge. We conducted a patient-blinded, prospective, randomized clinical trial to compare mobile-bearing and fixed-bearing cruciate-substituting total knee arthroplasties of the same design.

Methods: Patients between the ages of sixty and eighty-five years were prospectively randomized to receive a cruciate-substituting rotating-platform design or a fixed-bearing design with an all-polyethylene tibial component.

Revision lumbar arthrodesis for the treatment of lumbar cage pseudoarthrosis: complications.

Study Design: A study documenting major complications encountered in revision procedures for lumbar cage pseudoarthrosis.

Objective: To document the perioperative complications associated with revision surgery for threaded cylindrical cage pseudoarthrosis.

Summary Of Background Data: Pseudoarthrosis after cylindrical cage placement manifests as persistent or recurrent pain and disability after surgery.

Spinopelvic fixation in deformity: a review.

Spinopelvic fixation techniques are evolving and now seem to be converging. Good S1 pedicle fixation is the initial key anchor point. The tricortical technique tests out as the best.

All-polyethylene and metal-backed tibias have similar outcomes at 10 years: a randomized level I [corrected] evidence study.

The advantages of a monoblock design and lower cost have generated renewed interest in all-polyethylene tibial components for total knee arthroplasty (TKA). We hypothesized an all-polyethylene design would function equivalently to a metal-backed modular design at lower cost and at long-term followup. We report the 8- to 12-year followup of our earlier reported prospective randomized comparison of a modern congruent all-polyethylene tibial component with a modular metal-backed tibial component of the same design.

Magnetic resonance imaging 20 years after anterior lumbar interbody fusion.

Study Design: A 20-year magnetic resonance imaging (MRI) and functional outcome follow-up study was performed on patients who had undergone anterior lumbar interbody fusion.

Objectives: The objectives of the present study are to determine whether or not degeneration is related to adjacent level fusion and the clinical significance of this degeneration.

Summary Of Background Data: There are concerns that lumbar fusion leads to increase stress at the adjacent levels.

Socioeconomic issues and demographics of total knee arthroplasty revision.

Unlabelled: Despite rising numbers of total knee arthroplasty revision (TKAR) procedures there remains a paucity of information regarding the relationships between total knee arthroplasty failure and socioeconomic and educational status, demographics, general health and functional disability. We performed a multicenter prospective study of 290 consecutive TKAR patients in order to determine whether they differed from the population they were drawn from in terms of socioeconomic or educational status, race or gender. Secondary aims were to establish the relative comorbid status of this population, social supports and their general health status compared to national norms and their modes of failure.

Surgical treatment for the painful motion segment: matching technology with the indications: posterior lumbar fusion.

Study Design: A convenience literature-based review of the different techniques of posterior lumbar fusion.

Objective: To describe the history, specific techniques, and outcomes of different methods of posterior lumbar fusion. The specific methods that were described include 1) uninstrumented posterior, posterolateral, and facet fusion, and 2) instrumented fusion using pedicle screws or facet screws.

Total knee arthroplasty in juvenile rheumatoid arthritis.

Background: There is a paucity of reports regarding the long-term results of total knee arthroplasty in patients with juvenile rheumatoid arthritis. The purpose of this study was to evaluate the outcome of total knee arthroplasty in patients with juvenile rheumatoid arthritis who had been followed for a minimum of twelve years.

Methods: Eight consecutive patients (fifteen knees) with juvenile rheumatoid arthritis underwent total knee arthroplasty at an average age of 16.