Cement Augmented Pedicle Screw Instrumentation in Pediatric Spine Surgery.

Background: Osteoporosis in pediatric patients is rare. Osteomalacia and osteoporosis are known to develop in syndromic or neuromuscular scoliosis children. Spinal deformity surgery for pediatric patients with osteoporosis is challenging, associated with pedicle screw (PS) failure and compression fractures.

Transdiscal Screw Fixation in L5-S1 Adult Spondylolisthesis: Technical Note and Midterm Outcomes of a Case Series.

Background: Spondylolisthesis changes the pelvic morphology and sagittal spinopelvic alignment with abnormality compared to individuals with similar pelvic morphology. There are many treatment options including a combination of decompression and fusion. In spondylolisthesis patients with high-grade spondylolisthesis, bone to bone contact (closed intradiscal space), and high-grade disc degeneration with disc collapse, fusion is challenging.

Segmental Zoster Paresis of the Unilateral Lower Extremity With Neuritis MRI Findings: A Case Report and Literature Review.

Herpes zoster (HZ) is a common clinical condition caused by the reactivation of the latent varicella-zoster virus (VZV). Neurological complications after HZ have been described, including a rare condition of segmental zoster paresis (SZP), which results in unilateral motor impairment in the extremities. Only two cases of HZ patients with radiculopathy and MRI findings of neuritis have been reported.

Anterior-to-Posterior Epidural Migration of a Lumbar Disc Herniation at L1-L2: A Case Report.

Protruded disc fragments that penetrate the posterior longitudinal ligament (PLL) migrate rostral or caudal in the vertical plane, some laterally in the horizontal plane, or into the foramina involving the anterior aspect of the spinal canal. Often, there is migration to the ventral epidural space. However, posterior epidural migration of a lumbar disc herniation (PEMLDH) is a rare phenomenon that makes the differential diagnosis challenging.

Resolution of the lumbosacral fractional curve and evaluation of the risk for adding on in 101 patients with posterior correction of Lenke 3, 4, and 6 curves.

Objective: In double and triple major adolescent idiopathic scoliosis curves it is still controversial whether the lowest instrumented vertebra (LIV) should be L3 or L4. Too short a fusion can impede postoperative distal curve compensation and promote adding on (AON). Longer fusions lower the chance of compensation by alignment changes of the lumbosacral curve (LSC).

The Importance of Lumbar Curve Flexibility and Apical Vertebral Rotation for the Prediction of Spontaneous Lumbar Curve Correction in Selective Thoracic Fusion for Lenke Type 1 and 2 C Curves: Retrospective Cohort Study with a Mean Follow-Up of More than 10 years.

Study Design: Retrospective analysis of a prospectively collected data.

Objective: Lumbar flexibility(LF) is generally defined with preoperative side bending films;it is not clear what percentage of LF predicts the spontaneous lumbar curve correction (SLCC) at long term follow up. Aim of this study was to find out cut-off value of preoperative LF,apical vertebra rotation(AVR) and apical vertebral translation(AVT);which may predict more than 50%SLCC.

Clinical, radiological and HRQoL outcomes after selective thoracic fusion with minimum 15-year follow-up.

Introduction: The purpose of the study was to provide a 15-year natural history evaluation of the radiographic appearance of uninstrumented compensatory lumbar curves in patients who had undergone selective thoracic fusion (STF) for scoliosis, measure any changes in health-related quality of life scores (HRQoL) and compare them with controls matched for age, gender and body-mass index (BMI).

Methods: STF group included 43 female adolescent idiopathic scoliosis (AIS) patients who underwent STF with mean age 33(27-42) years and a mean follow-up of 18.7 (15-28) years, mean BMI 22(18-29).

Relationship of Patellofemoral Angles and Tibiofemoral Rotational Angles With Jumper's Knee in Professional Dancers: An MRI Analysis.

Background: Jumper's knee is a type of tendinopathy affecting the distal insertion of the quadriceps tendon (25% of cases) or the patellar tendon. It has been shown that frontal-plane measurements, such as genu valgum, genu varum, an increased quadriceps angle, a protuberant tibial tuberosity, patella alta, and short hamstring muscles, may be related to jumper's knee.

Purpose: To investigate the effects of tibiofemoral rotational angles and patellofemoral (PF) angles on the development of jumper's knee in professional folk dancers.

Single-Stage Posterior Vertebral Column Resection With Circumferential Reconstruction for Thoracic/Thoracolumbar Burst Fractures With or Without Neurological Deficit: Clinical Neurological and Radiological Outcomes.

Study Design: Retrospective study.

Objective: The aim of this study is to evaluate the clinical, neurological, and radiological outcomes of posterior vertebral column resection (PVCR) technique for treatment of thoracic and thoracolumbar burst fractures.

Methods: Fifty-one patients (18 male, 33 female) with thoracic/thoracolumbar burst fractures who had been treated with PVCR technique were retrospectively reviewed.

``Sandwich technique" with dual strut allograft in surgical treatment of femoral nonunion.

Objective: The treatment of femoral nonunion is challenging for both the surgeon and the patient. Strut allografts increase the bone stock, enhance fracture healing and increase stability by acting as a biological plate. In this study, we aimed to report the results of the sandwich technique with two-strut allograft in the treatment of oligotrophic or atrophic femoral nonunions.

Effect of cementing on pulmonary arterial pressure in vertebroplasty: A comparison of two techniques.

Background: Increase in intraosseous pressure and displacement of bone marrow contents leading to fat embolism and hypotension during cement injection in vertebroplasty (VP). We aimed to compare the effect of low and high viscosity cements during VP on pulmonary arterial pressure (PAP) with different cannula.

Materials And Methods: Fifty-two patients having multilevel VP due to osteoporotic vertebral compression fractures were randomly treated either by a high viscosity cement (group A, = 27 patients) and 2.

Clinical and Radiological Results of Oxford Phase-3 Medial Unicompartmental Knee Arthroplasty.

Purpose The aim of this retrospective study was to investigate the effectiveness of medial unicompartmental knee arthroplasty (UKA) by showing the results of the radiological and clinical outcomes of the patients. Materials and methods Seventy-two knees of 54 patients who underwent UKA between September 2005 and March 2011 for medial knee arthritis with a minimum follow-up of six months were evaluated. Range of motion (ROM), Hospital for Special Surgery (HSS) knee score, Knee Society Score (KSS), and Oxford Knee Score (OKS) were investigated both preoperatively and postoperatively.

Criteria for Ending the Distal Fusion at the L3 Vertebra vs. L4 in Surgical Treatment of Adolescent Idiopathic Scoliosis Patients with Lenke Type 3C, 5C, and 6C Curves: Results After Ten Years of Follow-up.

Introduction The selection of the most distal caudal vertebra in spinal fusion surgeries in adolescent idiopathic scoliosis patients with structural lumbar curvatures is still a matter of debate. The aim of this study was to determine the preoperative radiological criteria on the traction X-rays under general anesthesia (TrUGA) for selection between the L3 and L4 vertebrae and to assess the efficacy of these criteria via the long-term results of patients with Lenke Type 3C, 5C, and 6C curves. Methods Radiological data of 93 patients (84 females, 9 males) who met the inclusion criteria were retrospectively evaluated.

Recessive MYF5 Mutations Cause External Ophthalmoplegia, Rib, and Vertebral Anomalies.

MYF5 is member of the Myc-like basic helix-loop-helix transcription factor family and, in cooperation with other myogenic regulatory factors MYOD and MYF5, is a key regulator of early stages of myogenesis. Here, we report three consanguineous families with biallelic homozygous loss-of-function mutations in MYF5 who define a clinical disorder characterized by congenital ophthalmoplegia with scoliosis and vertebral and rib anomalies. The clinical phenotype overlaps strikingly with that reported in several Myf5 knockout mouse models.

Pulmonary cement embolism following cement-augmented fenestrated pedicle screw fixation in adult spinal deformity patients with severe osteoporosis (analysis of 2978 fenestrated screws).

Introduction: There is very limited information about pulmonary cement embolism (PCE) following cement-augmented fenestrated pedicle screw (CAFPS) fixation in the literature. The aim of this study to report the incidence of PCE following CAFPS fixation in adult deformity patients with severe osteoporosis and to identify risk factors such as; the number of levels, number of screws, and the cement volume used.

Methods: 281 patients (204F, 77M) in whom CAFPS fixation was used during deformity surgery were included.

The effect of mechanical aspiration of the vertebral body on pulmonary arterial pressure before cement injection in the vertebroplasty procedure.

Purpose: The aim of this study is to compare the efficacy of the mechanical aspiration technique just prior to cement application in the standard vertebroplasty (VP).

Methods: Forty patients were included in the study. In group A, mechanical aspiration of the cavity was done just before the cement injection and in group B aspiration of vertebral body did not perform, VP was done with the same size cannula, same injection force, same injection speed and same cement viscosity.

Cervicothoracic spine duplication: a 10-year follow up of a neurological intact boy.

Purpose: Spine duplication is a very rare condition with the literature being composed of only case reports. All previously reported cases were thoracolumbar spine duplications. Here, we report cervicothoracic spine duplication in a neurological intact male.

Paper #21: Posterior Vertebral Column Resection (PVCR) for Congenital Thoracic Lordoscoliosis in children under age of 10 with minimum 5 years follow-up.

Congenital thoracic lordosis or lordoscoliosis are rare deformities which causes severe cardiopulmonary problems in early ages. PVCR is effective in restoring thoracal kyphosis in treatment of these rare deformities and avoids morbidity of combined surgeries.

Does It Make a Difference to Stop Fusion at L3 Versus L4 in Terms of Disc and Facet Joint Degeneration: An MRI Study With Minimum 5 Years Follow-up.

Objectives: To compare the functional outcomes of patients with idiopathic scoliosis who had surgical correction and fusion with all pedicle screw construct down to L3 or L4 and to evaluate whether saving a mobile lumbar motion segment distally would demonstrate any difference in terms of disc degeneration (DD) and facet joint degeneration (FJD) after minimum 5 years follow-up.

Summary Of Background Data: Selection of lowest instrumented vertebra (LIV) is often difficult when lumbar curve was included into the fusion (L3 vs L4). Saving L4 is believed to be beneficial for preserving motion and preventing degeneration of unfused lumbar spine.

Does pedicle screw fixation under age 5 cause spinal canal narrowing? A CT study with minimum 5 years follow-up.

Purpose: The aim of this retrospective study was to evaluate the changes in the vertebral body and spinal canal area in a group of patients who had pedicle screw fixation under age 5 for the treatment of congenital spinal deformity at least 5 year follow-up.

Methods: 11 patients who had been operated due to spinal deformity under age 5 with who had a CT examination at least 5 years after the initial operation were included in the study. All patients underwent hemivertebrectomy and transpedicular fixation procedures at an average age of 3.

Selective Thoracic Fusion Provides Similar Health-Related Quality of Life but Can Cause More Lumbar Disc and Facet Joint Degeneration: A Comparison of Adolescent Idiopathic Scoliosis Patients With Normal Population 10 Years After Surgery.

Objectives: To evaluate the long-term behavior of the lumbar curve in patients with adolescent idiopathic scoliosis treated with selective thoracic fusion and to assess the clinical and radiologic outcomes in this fusion group compared with an age- and gender-matched group.

Summary Of Background Data: Selective thoracic fusion for the treatment of adolescent idiopathic scoliosis (AIS) preserves lumbar motion segments but leaves a residual deformity. By avoiding fusion of the lumbar spine, a greater mobility may be preserved, which may be an advantage in long-term follow-up in terms of degenerative changes in unfused segments.

Surgical treatment of cervical unilateral locked facet in a 9-year-old boy: A case report.

Most of the cervical spine injuries in the pediatric population are typically seen in the upper cervical region. Unilateral cervical facet dislocation (UFD) in subaxial region is a rare injury in pediatric population. In this paper, a rare case of delayed locked UFD in a 9-year-old boy with rare injury mechanism treated surgically is reported.

The radiological estimation of vertebral body volumes on the thoracic and lumbal spine.

The aim of this work is to radiologicaly estimate the width, height and depth of bodies of thoracic and lumbal vertebras. Charts of one hundred and seventeen patients with implanted internal fixateur on the thoracic and lumbal spine, between 01.01.

Apical and intermediate anchors without fusion improve Cobb angle and thoracic kyphosis in early-onset scoliosis.

Background: The main goal of treatment in early-onset scoliosis is to obtain and maintain curve correction while simultaneously preserving spinal, trunk, and lung growth. This study introduces a new surgical strategy, called the modified growing rod technique, which allows spinal growth and lung development while controlling the main deformity with apical and intermediate anchors without fusion. The use of intraoperative traction at the initial procedure enables spontaneous correction of the deformity and decreases the need for forceful correction maneuvers on the immature spine and prevents possible implant failures.

Computed tomography-guided bupivacaine and corticosteroid injection for the treatment of symptomatic calcification in the great toe tendon.

Background: Calcification in the great toe tendon is a rare disorder that is characterized by the deposition of calcium on degenerative collagen fibrils.

Case Presentations: IN THIS REPORT, WE PRESENT TWO CASES OF CALCIFIC TENDONITIS: one in the adductor hallucis and the other in the flexor hallucis longus tendon. We preferred computed tomography-guided steroid injection in our cases because of pain unresponsive to conservative treatment.