A comparison of biomechanical stability and pullout strength of two C1-C2 fixation constructs.

Background Context: Several fusion techniques are used to treat atlantoaxial instability. Recent literature suggests that intralaminar screw (LS) fixation and pedicle screw (PS) fixation offer similar stability and comparable pullout strength. No studies have compared these characteristics after cyclic loading.

Coil embolization of a lumbar artery to control vascular injury during intradiscal surgery.

Study Design: Case study.

Objective: To emphasize the role that interventional radiology can perform in stemming bleeding to vascular structures injured during spine surgery without altering patient position.

Summary And Background Data: Injury to the lumbar artery or aorta may occur during lumbar disc surgery.

Volumetric analysis of thoracic and lumbar vertebral bodies.

Background Context: During the last decade, vertebral augmentation techniques with cement (kyphoplasty and vertebroplasty) have revealed that 75% to 100% of individuals with osteoporotic vertebral compression fractures have good to moderate pain relief postoperatively, as well as adequate restoration of the vertebral body height. The volume of cement injected into a vertebra varied in different reports. To our knowledge, there are no studies that report on the physiological distribution of thoracic and lumbar vertebrae body volumes.

Load sharing properties of cervical pedicle screw-rod constructs versus lateral mass screw-rod constructs.

Lateral mass screws have a history of successful clinical use, but cannot always be used in the subaxial cervical spine. Despite safety concerns, cervical pedicle screws have been proposed as an alternative. Pedicle screws have been shown to be biomechanically stronger than lateral mass screws.

Evaluation of the intrinsic properties of pedicle screws: do diameter, manufacturing and screw design affect resistance and/or resistivity.

The pedicle screw diameter, composite and design are variables that can affect the threshold of intraoperative electromyographic monitoring. Even though we know that larger diameter objects tend to have less resistance, no study documented the effect that this variable could have on pedicle screw resistance. Using high quality equipment, resistance and resistivity of ten pedicle screws (from four manufacturers) were calculated based on known constant current and measured voltage.

Preoperative imaging of cervical pedicles: comparison of accuracy of oblique radiographs versus axial CT scans.

In spite of concerns about safety during their insertion, cervical spine pedicle screws have demonstrated biomechanical superiority over lateral mass screws in several biomechanical studies. One of the concerns for placement of cervical pedicle screws is their small size. Preoperative planning with computed tomography to assess pedicle width has been shown to be extremely accurate and is recommended by several authors.

Cervical pedicle screws vs. lateral mass screws: uniplanar fatigue analysis and residual pullout strengths.

Background Context: Although successful clinical use of cervical pedicle screws has been reported, anatomical studies have shown the possibility for serious iatrogenic injury. However, there are only a limited number of reports on the biomechanical properties of these screws which evaluate the potential benefits of their application.

Purpose: To investigate if the pull-out strengths after cyclic uniplanar loading of cervical pedicle screws are superior to lateral mass screws.

Extracorporeal shock wave therapy in orthopaedic diseases.

The application of extracorporeal shock wave therapy (ESWT) as a treatment for different orthopaedic conditions has experienced a rapid increase over the last several years. However the mechanism of action and the therapeutic effect is not clear. The aim of this study was to review the literature about the efficacy of ESWT in the treatment of plantar fasciitis, lateral epicondylitis, shoulder painful disorders and non-union fractures.

Treatment options for thoracolumbar spine fractures.

A decision for operative versus nonoperative management of thoracolumbar fractures should NEVER be based solely on one factor. Only after a thorough physical, neurological, and spinal examination, and an assessment of a patient's prior activity, social and educational background and patient's expectations, one should review the patient's radiographs and CT scans to determine risks and benefits of operative versus nonoperative care. Both treatment options are discussed in this paper.

Thoracic pedicle screw instrumentation using the "Funnel Technique": part 2. Clinical experience.

This study is a retrospective review of the clinical results of patients treated with thoracic pedicle screws using the "funnel technique." The objective is to report the clinical results of patients treated with thoracic pedicle screws using the funnel technique for screw placement. A total of 115 patients treated with the use of at least one thoracic pedicle screw were retrospectively identified.

The accuracy of pedicle screw placement in the thoracic spine using the "Funnel Technique": part 1. A cadaveric study.

A cadaveric study using the "funnel technique" to probe thoracic pedicles was conducted. The results (location, level, and perforation rate) of three spine surgeons of varying experience were compared. The objectives were to evaluate the reliability and accuracy of the funnel technique for the placement of thoracic pedicle screws and to describe the technique.

Possible complications of anterior perforation of the vertebral body using cervical pedicle screws.

No previous studies have analyzed the possible complications of anterior perforation of the cervical vertebral body with pedicle screws. The objective of this study was to identify the possible implications of an anterior vertebral body perforation. Ten consecutive Euro-American cadavers (C2-C7) were used.