Intraoperative Patellar Tendon Injuries during Total Knee Arthroplasty: A Comprehensive Review of Incidence, Risk Factors, and Management Strategies.

Patellar tendon rupture (PTR) is a rare and severe postoperative complication of total knee arthroplasty (TKA). Even rarer is the intraoperative occurrence of PTR during TKA. PTR is a major complication as it can lead to chronic disability, functional limitations, and postoperative morbidity.

Osteonecrosis of the Femoral Head: Core Decompression Systems.

Osteonecrosis of the femoral head (ONFH) is a chronic progressive debilitating disease that often affects young and active patients. It results from vascular interruption to the femoral head and can be caused by trauma, chronic corticosteroid use, chronic alcoholism, and coagulopathies. Treatment includes core decompression, a surgical procedure that may help delay or forestall disease progression if performed at the early stages of the disease.

Acetabular Component Removal Systems.

»: As primary total hip arthroplasty procedures continue to rise, acetabular revision surgery will be in increasing demand.

»: Treatment of acetabular component failure and associated bone defects depends on patient characteristics, the degree and location of bone loss, the ability of the columns to support biologic fixation, and the presence of pelvic discontinuity.

»: In revision total hip arthroplasty, technological advances have been made to address limitations of acetabular cup removal while preserving host bone stock.

An Anatomic Study Examining Lumbar Pars Interarticularis Distance and Spinal Canal Width in Relation to Lumbar Decompressive Surgery.

Background: Lumbar laminectomy is a surgical procedure allowing for decompression of neural structures. A wide laminectomy to adequately decompress neural elements without compromising the structural integrity of the spinal column is ideal. Pars interarticularis fractures with spinal instability after isolated laminectomy from overresection of the posterior elements have been reported.

Critical analysis of the evaluation of postoperative dysphagia following an anterior cervical discectomy and fusion.

Background And Purpose: Postoperative dysphagia is a known complication of anterior cervical discectomy and fusion (ACDF) with reported incidences ranging from 1 to 79%. No standardized guidelines exist for spine surgeons to evaluate postoperative dysphagia after ACDF. A systematic method may be beneficial in distinguishing transient postoperative dysphagia secondary to intubation from those with postoperative complications.

Single-Site Retrospective Assessment of Surgical Outcomes in Non-Ambulatory Patients with Degenerative Cervical Myelopathy.

Study Design: A retrospective study of surgical outcomes in patients with degenerative cervical myelopathy (DCM).

Objective: To better characterize outcomes following cervical decompression in those with severe, non-ambulatory forms of DCM.

Summary Of Background Data: DCM represents a collection of age-related degenerative processes of the cervical spine that can result in motor, sensory, and autonomic dysfunction, leading to significant reductions in quality of life.

Complications of a Unilateral Nondisplaced Cervical Facet Fracture in a Patient With Previously Noninstrumented Anterior Cervical Fusion.

Fused motion segments have been documented to alter the biomechanics of the cervical spine and compromise its stability. Current literature describes a growing association between the presence of prior noninstrumented fused cervical segments and the predisposition to acute, traumatic instability at adjacent levels. We present the case of a stable cervical spine fracture pattern in a patient with a history of multilevel noninstrumented anterior cervical spine fusion-initially presenting as a small, nondisplaced unilateral facet fracture that ultimately progressed to overt displacement with kyphosis resulting in acute cervical pain and instability.

Radiographic and Clinical Outcome of Silicate-substituted Calcium Phosphate (Si-CaP) Ceramic Bone Graft in Spinal Fusion Procedures.

Study Design: Retrospective cohort study.

Objective: To evaluate the radiographic and clinical outcome of silicate-substituted calcium phosphate (Si-CaP), utilized as a graft substance in spinal fusion procedures.

Summary Of Background Data: Specific properties of Si-CaP provide the graft with negative surface charge that can result in a positive effect on the osteoblast activity and neovascularization of the bone.

Correction: Minimally Invasive 2D Navigation-Assisted Treatment of Thoracolumbar Spinal Fractures in East Africa: A Case Report.

[This corrects the article DOI: 10.7759/cureus.507.

Unilateral tubular approach for bilateral laminotomy: effect on ipsilateral and contralateral buttock and leg pain.

Purpose: Tubular laminotomy is an effective procedure for treatment of lumbar spinal stenosis (LSS) and lateral recesses stenosis. Most surgeons familiar with the procedure agree that the tubular approach appears to afford a more complete decompression of the contralateral thecal sac and nerve root, as compared to the ipsilateral approach. With this study we sought to answer the question whether this is reflected in clinically significant differences between the ipsilateral and contralateral side pain improvements.

Anterior Cervical Discectomy and Fusion (ACDF): Comparison Between Zero Profile Implants and Anterior Cervical Plate and Spacer.

Introduction: Interposition grafts combined with anterior plating currently remain the gold standard for anterior cervical discectomy and fusion. The use of anterior plates increases fusion rates but may be associated with higher rates of postoperative dysphagia. The aim of the current study was to determine the clinical and radiological outcomes following anterior cervical discectomy and fusion (ACDF) using zero-profile anchored spacers versus standard interposition grafts with anterior plating.

Minimally Invasive 2D Navigation-Assisted Treatment of Thoracolumbar Spinal Fractures in East Africa: A Case Report.

Spinal surgery under Eastern-African circumstances is technically demanding and associated with significant complications, such as blood loss, infection, and wound breakdown. We report a spinal trauma case that was performed using minimally invasive surgery (MIS) and navigation, and hypothesize that these newer techniques may enable surgeons to perform effective spinal surgery with minimal complications and good outcomes.  During the 2014 First Hands-on Neurotrauma Course held in Dar es Salaam, Tanzania, we successfully performed three minimally invasive and two-dimensional (2D) navigated spinal surgeries to decompress and stabilize patients with complete and incomplete spinal injuries.

Radiation-Induced Necrosis of the Temporal Bone: Diagnosis and Management.

Objective: To document our experience with osteoradionecrosis (ORN) of the temporal bone.

Study Design: Retrospective case review.

Setting: Tertiary care medical center.

Expandable Polyaryl-Ether-Ether-Ketone Spacers for Interbody Distraction in the Lumbar Spine.

Study Design Retrospective case series. Objective StaXx XD (Spine Wave, Inc., Shelton, CT, United States) is an expandable polyaryl-ether-ether-ketone (PEEK) wafer implant utilized in the treatment of lumbar degenerative disease.

Endoscopic lumbar foraminotomy.

Foraminal stenosis frequently causes radiculopathy in lumbar degenerative spondylosis. Endoscopic transforaminal techniques allow for foraminal access with minimal tissue disruption. However, the effectiveness of foraminal decompression by endoscopic techniques has yet to be studied.

Anterior cervical discectomy and fusion with a zero-profile integrated plate and spacer device: a clinical and radiological study: Clinical article.

Object: Anterior cervical plating decreases the risk of pseudarthrosis following anterior cervical discectomy and fusion (ACDF). Dysphagia is a common complication of ACDF, with the anterior plate implicated as a potential contributor. A zero-profile, stand-alone polyetheretherketone (PEEK) interbody spacer has been postulated to minimize soft-tissue irritation and postoperative dysphagia, but studies are limited.

Minimally invasive foraminotomy through tubular retractors via a contralateral approach in patients with unilateral radiculopathy.

Background: Radiculopathy caused by foraminal nerve root compression is a common pathology in the lumbar spine. Surgical decompression via a conventional open foraminotomy is the treatment of choice when surgery is indicated. Minimally invasive tubular foraminotomy through a contralateral approach is a potentially effective surgical alternative.

Assessment of intervertebral disc degeneration based on quantitative magnetic resonance imaging analysis: an in vivo study.

Study Design: Animal experimental study.

Objective: To evaluate a novel quantitative imaging technique for assessing disc degeneration.

Summary Of Background Data: T2-relaxation time (T2-RT) measurements have been used to assess disc degeneration quanti-tatively.

Traumatic brain injury in a rural and an urban Tanzanian hospital--a comparative, retrospective analysis based on computed tomography.

Background: In a resource-poor environment such as rural East Africa, expensive medical devices such as computed tomographic (CT) scanners are rare. The CT scanner at the rural Haydom Lutheran Hospital (HLH) in Tanzania therefore offers a unique chance to observe possible differences with urban medical centers in the disease pattern of trauma-related cranial pathologies. The purpose of this study was to compare traumatic brain injuries (TBIs) between a rural and an urban area of Tanzania.

Intrathecal pain pump infusions for intractable cancer pain: an algorithm for dosing without a neuraxial trial.

Background: Patients with pain from advanced cancer often have limited life expectancy. Undergoing an epidural trial for placement of an intrathecal pump in these selected patients can exhaust limited days of life. We sought to analyze historical data at our cancer center to develop an algorithm to predict initial intrathecal pump dosing based on the starting preimplant systemic opioid regimen, thus averting an epidural trial and minimizing hospital stay.

Does the type of tibial component affect mechanical alignment in unicompartmental knee replacement?

Purpose: There are a number of factors responsible for the longevity of unicompartmental knee replacements (UKR). These include the magnitude of postoperative alignment and the type of material used. The effect of component design and material on postoperative alignment, however, has not been explored.

Navigated guide tube for the placement of mini-open pedicle screws using stereotactic 3D navigation without the use of K-wires: technical note.

Object: Three-dimensional spinal navigation increases screw accuracy, but its implementation in clinical practice has been difficult, mainly because of surgeons' concerns about increased operative times, disturbance of workflow, and safety. The authors present a custom-designed navigated guide that addresses some of these concerns by allowing for drilling, tapping, and placing the final screw via a minimally invasive approach without the need for K-wires. In this paper, the authors' goal was to describe the technical aspects of the navigated guide tube as well as pedicle screw accuracy.

The role of the iliotibial band during the pivot shift test.

Purpose: Several studies have suggested that the iliotibial (IT) band plays a role in knee laxity and that it may affect the magnitude of the pivot shift observed. However, the extent of the role played by the IT band, as well as its mechanism of action, is not currently known. This cadaveric study aimed to quantify the effect of the IT band and the hip abduction angle on the magnitude of anterior tibial translation (ATT) during the pivot shift.

Silicate-substituted calcium phosphate ceramic bone graft replacement for spinal fusion procedures.

Study Design: Retrospective study.

Objective: To assess the clinical and radiographical outcomes in spinal fusion procedures using silicate-substituted calcium phosphate (Si-CaP).

Summary Of Background Data: Si-CaP is a newer-generation synthetic ceramic designed to maximize osteoinduction and osteoconduction.