A comparative cadaveric biomechanical study of bilateral FacetFuse transfacet pedicle screws versus bilateral or unilateral pedicle screw-rod construct.

Background: Achieving optimal immediate stability is crucial in lumbar fusion surgeries. Traditionally, four pedicle screws have been utilized to provide posterior stability at the L5-S1 level. However, the use of bilateral transfacet pedicle screws (TFPS) as an alternative construct has shown promising results in terms of biomechanical stability.

EXPANDABLE INTRAVERTEBRAL IMPLANTS IN POST-TRAUMATIC VERTEBRAL NECROSIS - NEW CLASSIFICATION SUGGESTION.

The progressive evolution of post-traumatic vertebral necrosis and consequent loss of structural integrity of the vertebral body along with neurological risk, makes it one of the most feared and unpredictable pathologies in spine traumatology. Several studies have addressed the role of vertebroplasty, kyphoplasty, and corpectomy in its treatment; however, it remains a controversial concept without a defined therapeutic algorithm. The recent emergence of expandable intravertebral implants, which allow, by a percutaneous transpedicular application, the capacity for intrasomatic filling and maintenance of the height of the vertebral body, makes them a viable option, not only in the treatment of acute vertebral fractures, but also in non-union cases.

INTRAVERTEBRAL EXPANDABLE IMPLANTS IN THORACOLUMBAR VERTEBRAL COMPRESSION FRACTURES.

Current scientific evidence enhances the importance of the anatomic restauration of vertebral bodies with compression fractures aiming, as with other human body joints, to obtain a biomechanic and functional spine as close as the one prior to the fracture as possible. We consider that anatomic reduction of these fractures is only completely possible using intravertebral expandable implants, restoring vertebral endplate morphology, and enabling a more adequate intervertebral disc healing. This enables avoiding disc and osteodegenerative changes to that vertebral segment and its adjacent levels, as well as the anterior overload of adjacent vertebral bodies in older adults - a consequence of post-traumatic vertebral flattening - thus minimizing the risk of adjacent vertebral fractures.

Evolution of vertebral posttraumatic necrosis to bone healing after self-stabilizing osteophytosis development-case report.

Post-traumatic vertebral necrosis and pseudarthrosis at the thoracolumbar transition level usually progresses to bone resorption, leading to vertebral collapse, sometimes with retropulsion of the posterior wall and neurological deficit. As such, the therapeutic goal is the interruption of this evolution, seeking to stabilize the vertebral body, preventing collapse progression and the risk of neurological deficits. We present a clinical case regarding the evolution of a vertebral pseudarthrosis that self-stabilized with the development of an exuberant anterior osteophyte mass, joining the anterolateral surfaces of the adjacent vertebrae bodies.

Expandable Intravertebral Implants: A Narrative Review on the Concept, Biomechanics, and Outcomes in Traumatology.

Expandable intravertebral implants are self-expanding devices applied percutaneously by the posterior transpedicular approach. These devices introduce the concept of anatomical restoration of vertebral body endplates and direct anatomical reduction performed from the interior of the vertebral body with a compression fracture. This paper aims to provide a narrative review on the concept, indications, biomechanical characteristics, as well as functional and radiographic outcomes of the main expandable intravertebral implants currently available, in terms of their application to thoracolumbar spine traumatology.

Multilevel Anterior Lumbar Interbody Fusion Combined with Posterior Stabilization in Lumbar Disc Disease-Prospective Analysis of Clinical and Functional Outcomes.

 This was a prospective controlled study with lumbar degenerative disc disease patients submitted to instrumented anterior lumbar interbody fusion (ALIF) combined with posterior stabilization.  A sample with 64 consecutive patients was operated by the same surgeons over 4 years. Half of the ALIFs occurred at 2 levels, 43.

Limiting fusion levels by combining anterior cervical decompression and fusion with posterior laminectomy: Technical note.

Background: Authors aim to report on the outcomes of combining selective anterior cervical decompression and fusion (ACDF) with laminectomy in patients with cervical spondylotic radiculomyelopathy (CSR).

Methods: 10 patients with ACDF and posterior laminectomy reviewed.

Results: 60% female population, mean age 61 ± 3 years, mean BMI 24.

Biomechanics of posterior instrumentation in L1-L3 lateral interbody fusion: Pedicle screw rod construct vs. transfacet pedicle screws.

Background: The use of pedicle screws is the gold standard for supplemental posterior fixation in lateral interbody fusion. Information about the performance of transfacet pedicle screws compared to standard pedicle screws and rods in the upper lumbar spine with or without a lateral interbody fusion device in place is limited.

Methods: Fifteen fresh frozen human cadaveric lumbar spine segments (T12-L4) were studied using standard pure moment flexibility tests.

Stability of transforaminal lumbar interbody fusion in the setting of retained facets and posterior fixation using transfacet or standard pedicle screws.

Background Context: The transforaminal lumbar interbody fusion (TLIF) technique supplements posterior instrumented lumbar spine fusion and has been tested with different types of screw fixation for stabilization. Transforaminal lumbar interbody fusion is usually placed through a unilateral foraminal approach after unilateral facetectomy, although extraforaminal entry allows the facet to be spared.

Purpose: To characterize the biomechanics of L4-L5 lumbar motion segments instrumented with bilateral transfacet pedicle screw (TFPS) fixation versus bilateral pedicle screw-rod (PSR) fixation in the setting of intact facets and native disc or after discectomy and extraforaminal placement of a TLIF technology graft.

Preoperative direct percutaneous embolization of spinal metastasis from renal cell carcinoma.

Preoperative direct percutaneous embolization has been very rarely used in hypervascular metastatic spinal tumors to decrease blood loss during the surgery. A patient is presented with solitary spinal metastasis due to renal cell carcinoma who underwent a two-stage spondylectomy. Transarterial tumor embolization with polyvinyl alcohol (PVA) particles and liquid coil placement, and percutaneous tumor embolization with PVA particles were used before the first and the second stage, respectively.

A novel crossed rod configuration incorporating translaminar screws for occipitocervical internal fixation: an in vitro biomechanical study.

Background Context: Occipitocervical (OC) spinal instrumentation involving the axis (C2) entails the use of transarticular screws through C1-C2 or lateral mass screws at C1 and pedicle screws at C2 to achieve fusion. Because of the anatomical complexity, interpatient anomalous variation, and danger to the vertebral artery injury, there has been an increased interest in alternate sites for fixation. Recent studies have involved the placement of screws bilaterally into the C2 lamina.

Degenerative spondylolisthesis of the cervical spine: analysis of 58 patients treated with anterior cervical decompression and fusion.

Background Context: Degenerative spondylolisthesis has been well described as a disorder of the lumbar spine. Few authors have suggested that a similar disorder occurs in the cervical spine. To our knowledge, the present study represents the largest series of patients with long-term follow-up who were managed surgically for the treatment of degenerative spondylolisthesis of the cervical spine.

The treatment of unstable thoracic spine fractures with transpedicular screw instrumentation: a 3-year consecutive series.

Study Design: The treatment of unstable thoracic spine fractures remains controversial. Theoretical biomechanical advantages of transpedicular screw fixation include three-column control of vertebral segments and fixation of a vertebral segment in the absence of intact posterior elements. Additionally, pedicle screw constructs may obviate the need for neural canal dissection and potential neural element impingement by intracanal instrumentation.