Mini Screws for Improving Accuracy in Navigation-assisted Spine Surgery.

Study Design: Presentation of a surgical technique with accompanying video (Supplemental Digital Content 1, http://links.lww.com/CLINSPINE/A67) of an illustrative case.

Does kyphotic deformity correlate with functional outcomes in fractures at the thoracolumbar junction treated by 360° instrumented fusion?

Sagittal balance and its relationship with back pain and functional outcomes has become an important factor in the management of thoracolumbar fractures. The kyphosis threshold at the thoracolumbar junction (TLJ) that produces a significant functional impairment remains unclear. Ninety-four patients who were treated surgically for TLJ fractures were evaluated after a follow-up period of 2-10 years.

Epithelioid hemangioma of the spine: a case series of six patients and review of the literature.

Background Context: Epithelioid hemangioma (EH) of bone is a benign vascular tumor that can be locally aggressive. It rarely arises in the spine, and the optimum management of EH of the vertebrae is not well delineated.

Purpose: The report describes our experience treating six patients with EH of the spine in an effort to document the treatment of the rare spinal presentation.

Rasterstereographic evaluation of interobserver and intraobserver reliability in postsurgical adolescent idiopathic scoliosis patients.

Study Design: Evaluation of rasterstereographic examinations in postsurgical adolescent scoliosis patients: a reliability study.

Objective: To investigate the interobserver and intraobserver reliability of rasterstereographic 3-dimensional back surface analysis and reconstruction of spine parameters including trunk length, trunk inclination, lateral deviation, kyphotic and lordotic angles in adolescent idiopathic scoliosis patients after scoliosis surgery.

Summary Of Background Data: The rasterstereography device formetric III 4D has been in routine clinical use for patients with scoliosis and other spinal deformities, reducing the patients' radiation exposure considerably.

Efficacy of hemivertebra resection for congenital scoliosis: a multicenter retrospective comparison of three surgical techniques.

Study Design: Multicenter, retrospective study.

Objective: To compare the outcomes of three surgical treatments for congenital spinal deformity due to a hemivertebra.

Summary Of Background Data: Congenital anomalies of the spine can cause significant and progressive scoliosis and kyphosis.

Ventral cancellous bone augmentation of the dens and temporary instrumentation C1/C2 as a function-preserving option in the treatment of dens pseudarthrosis.

Study Design: An innovative function preserving technique for the treatment of odontoid nonunion via ventral cancellous bone augmentation of the dens is described. A retrospective clinical study of 17 patients, thus treated by this technique is reported.

Objectives: Assessment of a new method, which preserves the rotational mobility of the C1/C2 joint.

Adolescent idiopathic scoliosis treated with open instrumented anterior spinal fusion: five-year follow-up.

Study Design: A multicenter prospective database was queried for patients who underwent open instrumented anterior spinal fusion (OASF) for treatment of primary thoracic (Lenke 1) adolescent idiopathic scoliosis (AIS).

Objectives: To present the intermediate radiographic and pulmonary function testing (PFT) data from patients who underwent OASF using modern, rigid instrumentation.

Summary Of Background Data: Anterior spinal fusion is an excellent method to correct the 3-dimensional deformity produced by AIS.

Outcome of 132 operations in 97 patients with chordomas of the craniocervical junction and upper cervical spine.

Objective: To study the outcomes of surgery for chordomas of the craniocervical junction and upper cervical spine as well as complication rates, survival, and associated adverse factors.

Methods: Retrospective review of patients (1982-2007) at 2 European centers who underwent transoral, transfacial, transmandibular, and anterior cervical approaches for excision of chordomas of the craniocervical junction and cervical spine. The chi test and Fisher exact test were used to determine significant adverse factors (P < .

Hemivertebra resection and osteotomies in congenital spine deformity.

Study Design: Retrospective study of posterior hemivertebra resection and osteotomies with transpedicular instrumentation in very young children.

Objective: Assessment of early intervention in congenital scoliosis with almost complete correction of the main deformity.

Summary Of Background Data: There is a trend to early correction of congenital deformities, however, there is a lack of long-term follow-up.

Biomechanics and materials of reconstruction after tumor resection in the spinal column.

We initially review the general biomechanical principles that should be considered in surgical reconstruction of spinal tumors. This will be further clarified by more detailed descriptions for individual spinal regions in the subsequent part of the article. In the case of patients with spinal metastases, especially in patients with a median survival time less than a few months, a thorough review of the risks and benefits regarding surgical intervention must be discussed with the patient.

Axial plane lumbar responses after anterior selective thoracic fusion for main thoracic adolescent idiopathic scoliosis.

Study Design: A retrospective radiographic study.

Purpose: To evaluate the axial plane lumbar responses after anterior selective thoracic fusion (STF) in patients with main thoracic adolescent idiopathic scoliosis (MT-AIS).

Overview Of Literature: Anterior scoliosis surgery induces more MT derotation through disc preparation than posterior surgery.

Does spinal surgery improve the quality of life for those with extradural (spinal) osseous metastases? An international multicenter prospective observational study of 223 patients. Invited submission from the Joint Section Meeting on Disorders of the Spine and Peripheral Nerves, March 2007.

Object: Opinions vary widely as to the role of surgery (from none to wide margin excision) in the management of spinal metastases. In this study the authors set out to ascertain if surgery improves the quality of remaining life in patients with spinal metastatic and tumor-related systemic disease.

Methods: The authors included 223 patients in this study who were referred by oncologists and physicians over a 2-year period.

Sagittal plane lumbar responses after anterior selective thoracic fusion for main thoracic adolescent idiopathic scoliosis.

Study Design: A retrospective radiographic study.

Purpose: To verify the correlation of sagittal and coronal plane changes after selective thoracic fusion in main thoracic (MT) adolescent idiopathic scoliosis (AIS).

Overview Of Literature: Sagittal plane deformity is known to be essential in the evolution of scoliosis.

Operative management of Scheuermann's kyphosis in 78 patients: radiographic outcomes, complications, and technique.

Study Design: A retrospective multicenter review of 78 patients with Scheuermann's kyphosis treated operatively was conducted.

Objective: The purpose of this study was to evaluate correction of sagittal alignment, maintenance of correction, and occurrence of, and etiologic factors associated with, junctional kyphosis in patients managed operatively for Scheuermann's kyphosis.

Summary Of Background Data: There is a paucity of literature regarding the surgical treatment of Scheuermann's kyphosis using current implant systems and operative techniques.

C2 prosthesis: anterior upper cervical fixation device to reconstruct the second cervical vertebra.

Destruction of the second cervical vertebra leads to a highly unstable situation. Reconstruction is difficult because the axis plays a central role in rotatory movements and has a unique function in redistributing axial loads. The axis transfers the axial load of the two lateral masses of the atlas to three surfaces on the third cervical vertebra: the two articular facets and the vertebral body.

Treatment of vertebral osteomyelitis by radical debridement and stabilization using titanium mesh cages.

Study Design: A retrospective clinical and radiologic evaluation of patients with vertebral osteomyelitis treated via radical debridement and stabilization using titanium mesh cages.

Objective: To assess the efficacy of titanium mesh cages in the treatment of active vertebral osteomyelitis.

Summary Of Background Data: Although titanium mesh cages have proven to be superior in trauma and tumor reconstructions, there are few reports regarding the use of titanium mesh cages in the presence of active pyogenic or tuberculotic vertebral osteomyelitis.

Anatomic reduction and monosegmental fusion in high-grade developmental spondylolisthesis.

Study Design: A retrospective review of the clinical and radiographic outcomes of reduction by temporary instrumentation of L4 and monosegmental fusion of L5/S1 in patients with high-grade developmental spondylolisthesis.

Objective: To assess the efficacy of this technique in the reduction of local deformity and correction of overall sagittal profile.

Summary Of Background Data: In situ fusions as well as partial reduction with fusion L4-S1 via various approaches have been described previously.

Hemivertebra resection in the cervical spine.

Study Design: Retrospective study with clinical and radiologic evaluation of hemivertebra resection in children with congenital cervical scoliosis.

Objective: Assessment of hemivertebra resection in the treatment of congenital cervical scoliosis.

Summary Of Background Data: To our knowledge, this is the first report on hemivertebra resection in the midcervical spine.

Therapeutic options and results following fixed atlantoaxial rotatory dislocations.

Atlantoaxial rotatory dislocation (AARD) represents a rare pathological condition of the upper cervical spine that is frequently misdiagnosed, leading to a delay in therapy. In a long-term assessment of clinical and radiological results, three different therapeutic options with regard to the length of the dislocation-therapy interval (DTI) were evaluated. Twenty-six patients were treated for AARD from December 1988 until April 2000.

Transoral reduction and osteosynthesis C1 as a function-preserving option in the treatment of unstable Jefferson fractures.

Study Design: Retrospective study with clinical and radiologic evaluation of transoral reduction and osteosynthesis of C1 in the treatment of unstable Jefferson fractures.

Objective: Assessment of a new method, which preserves the function of the C1-C2 joint in young patients.

Summary Of Background Data: Unstable Jefferson fractures with rupture of the transverse ligament and high-grade dislocation of the lateral masses of C1 are usually treated conservatively by immobilization or traction or surgical by posterior fusion C1-C2.

Anterior single-rod instrumentation of the thoracic and lumbar spine: saving levels.

Study Design: To evaluate the ability of single-rod anterior instrumentation to save or preserve fusion levels and improve thoracic hypokyphosis in patients with adolescent idiopathic thoracic, thoracolumbar, or lumbar scoliosis.

Objective: To provide indications for single anterior rod instrumentation for the treatment of adolescent idiopathic scoliosis and demonstrate effectiveness in properly selected cases.

Summary Of Background Data: Posterior multisegmented dual rod instrumentation is the most commonly used instrumentation for the surgical treatment of adolescent idiopathic scoliosis.

Posterior hemivertebra resection with transpedicular instrumentation: early correction in children aged 1 to 6 years.

Study Design: Retrospective study with clinical evaluation of posterior hemivertebra resection with transpedicular instrumentation in very young children.

Objective: Assessment of early intervention in congenital scoliosis by posterior approach with transpedicular instrumentation.

Summary Of Background Data: Hemiepiphysiodesis and hemiarthrodesis are unpredictable in their effects.

Pedicle screws in 1- and 2-year-old children: technique, complications, and effect on further growth.

Study Design: A retrospective study of 19 consecutive cases (1991-2001) where 91 thoracic and lumbar pedicle screws were used in the treatment of various pediatric spinal disorders in 1- and 2-year-old children.

Objectives: To determine the effectiveness and safety of pedicle screw fixation in very young children and to evaluate the effect of pedicle screw insertion on further growth of the vertebra.

Summary Of Background Data: Although many studies exist about the use of pedicle screws and its advantages in spinal fixation in adults and older children, no study has been published about the use of pedicle screws in 1- and 2-year-old children.

Hemivertebra resection by a posterior approach: innovative operative technique and first results.

Study Design: A retrospective study was conducted, with clinical evaluation of hemivertebra resection using transpedicular instrumentation by a posterior approach in young children.

Objective: To assess a new method of early intervention in congenital scoliosis by a posterior approach.

Summary Of Background Data: Previously described surgical procedures are fusion in situ, hemiepiphyseodesis and arthrodesis, "growing" instrumentations, and hemivertebra resections performed by a combined anterior and posterior approach.