Pre-operative Assessment of Shoulder Pathologies on MRI by a Radiologist and an Orthopaedic Surgeon.

Introduction: Pathologies of the shoulder, i.e. rotator cuff tears and labral injuries are very common.

Effectiveness of Mud-Pack Therapy and Mud-Bath Therapy in Osteoarthritis: A Systematic Review.

Objectives: Osteoarthritis has a tremendous socioeconomic impact in terms of drug spending, hospital admissions, work productivity, and temporary or permanent incapacity. Mud therapy has been discussed as potential conservative treatment options for osteoarthritis. However, findings from several trials still remain controversial.

Does the interfacing angle between pedicle screws and support rods affect clinical outcomes after posterior thoracolumbar fusion? A retrospective clinical study.

Background Context: Proper alignment and tightening of the pedicle screw/rod assembly after instrumented posterior fusion of the lower spine is known to be crucial in order to achieve satisfactory clinical results. Such interfacing angle mismatches indicate stress overloading of the implant system.

Purpose: The objective of this study is to investigate the incidence of postoperative screw/rod interfacing angle mismatch and to analyze the impact of mismatches on clinical outcome in terms of (1) revision surgery, (2) adjacent segment degeneration (ASD), and (3) pain.

Bony hip reconstruction for displaced hips in patients with cerebral palsy: Is postoperative immobilization indicated?

Purpose: Decisions for postoperative immobilization after bony hip reconstructive surgery in cerebral palsy are controversial in current practice. The aim of this study was to check if choosing not to use any kind of postoperative immobilization is a safe practice.

Methods: A retrospective cohort study was conducted in a pediatric orthopedic tertiary referral center.

Measuring hip migration percentage in cerebral palsy using the HipScreen app.

Aims: Reimers migration percentage (MP) is a key measure to inform decision-making around the management of hip displacement in cerebral palsy (CP). The aim of this study is to assess validity and inter- and intra-rater reliability of a novel method of measuring MP using a smart phone app (HipScreen (HS) app).

Methods: A total of 20 pelvis radiographs (40 hips) were used to measure MP by using the HS app.

Retrospective Comparison of Minimally Invasive and Open Monosegmental Lumbar Fusion, and Impact of Virtual Reality on Surgical Planning and Strategy.

Background And Study Aims:  Spinal fusion for symptomatic lumbar spondylolisthesis can be accomplished using an open or minimally invasive surgical (MIS) technique. Evaluation of segmental spondylolisthesis and instabilities and review of their therapies are inseparably connected with lumbar tomographic imaging. We analyzed a cohort of patients who underwent MIS or open monosegmental dorsal fusion and compared surgical outcomes along with complication rates.

Comparison of stand-alone cage and cage-with-plate for monosegmental cervical fusion and impact of virtual reality in evaluating surgical results.

Objectives: After ventral decompression of monosegmental cervical spondylotic stenosis, a stand-alone cage (SC) or cage-with-plate (CP) can be inserted for fusion. Postoperative radiological evaluation can be achieved using different imaging modalities. We retrospectively compared complications, as well as clinical and radiological outcomes for both fusion techniques, and analyzed the possible role of virtual reality (VR) in evaluating the postoperative results.

Association between intervertebral disc degeneration and the Oswestry Disability Index.

Background: Low back pain and lumbar intervertebral disc degeneration (IDD) are common findings. Valid data on correlation between clinical pain scores and grades of IDD are not available.

Objective: To investigate the correlation of intervertebral disc degeneration (IDD) at lumbar levels L4/5 and L5/S1 and the Oswestry Disability Index (ODI).

Expression of NO Synthase Under Medication with Cyclosporine A, Mycophenolate Mofetil, and Tacrolimus during Development of Transplant Vasculopathy on Rat Cardiac Allograft.

Objective: The transplant vasculopathy as a sign of chronic graft rejection affects both the epicardial and the intramyocardial arteries of the graft. This is at least partially mediated by NO synthases. The aim of this study was to assess possible protective effects of cyclosporine A (CsA), tacrolimus (FK506), and mycophenolate mofetil (MMF) on the expression of NO synthases in an experimental transplant rat model.

Axial pullout strength comparison of different screw designs: fenestrated screw, dual outer diameter screw and standard pedicle screw.

Background: The pullout strength of pedicle screws is influenced by many factors, including diameter of the screws, implant design, and augmentation with bone cement such as PMMA. In the present study, the pullout strength of an innovative fenestrated screw augmented with PMMA was investigated and was compared to unaugmented fenestrated, standard and dual outer diameter screw.

Methods: Twenty four thoracolumbar vertebrae (T10-L5, age 60 to 70 years) from three cadavers were implanted with the four different pedicle screws.

Quantitative dual-energy CT for phantomless evaluation of cancellous bone mineral density of the vertebral pedicle: correlation with pedicle screw pull-out strength.

Objectives: To evaluate quantitative dual-energy computed tomography (DECT) for phantomless analysis of cancellous bone mineral density (BMD) of vertebral pedicles and to assess the correlation with pedicle screw pull-out strength.

Methods: Twenty-nine thoracic and lumbar vertebrae from cadaver specimens were examined with DECT. Using dedicated post-processing software, a pedicle screw vector was mapped (R1, intrapedicular segment of the pedicle vector; R2, intermediate segment; R3, intracorporal segment; global, all segments) and BMD was calculated.

Association between facet joint osteoarthritis and the Oswestry Disability Index.

Aim: To investigate the correlation of facet joint osteoarthritis (FJOA) at lumbar levels L4/L5 and L5/S1 and the Oswestry Disability Index (ODI).

Methods: The study involved lumbar MRIs of 591 patients with a mean age of 47.3 years.

Kümmell's Disease: Clarifying the Mechanisms and Patients' Inclusion Criteria.

The three major causes of vertebral body collapse include infection, malignant neoplasia, and trauma and it may be difficult to distinguish between them, particularly in the presence of severe osteoporosis. In 1891, however, Dr Hermann Kümmell, further added another possibility of vertebral body crush; the delayed posttraumatic collapse. As originally described, this rare clinical entity includes patients, who after a trivial trauma and an asymptomatic clinical course they develop a progressive vertebral body collapse and a painful kyphosis.

Is tartrate-resistant acid phosphatase 5b a potent bio-marker for late stage aseptic implant loosening?

Purpose: Aseptic loosening is a serious complication after total joint arthroplasty. Plain radiography, along with clinical signs of prosthesis loosening, is the technique of first choice to evaluate loosening of joint replacements. Nevertheless, radiographical signs of osteolysis may not be apparent until progressed stages of loosening.

Dual-energy CT-based phantomless in vivo three-dimensional bone mineral density assessment of the lumbar spine.

Purpose: To evaluate the feasibility of phantomless in vivo dual-energy computed tomography (CT)-based three-dimensional (3D) bone mineral density (BMD) assessment in comparison with dual x-ray absorptiometry (DXA).

Materials And Methods: This retrospective study was approved by the institutional review board, and the requirement to obtain informed consent was waived. Data from clinically indicated dual-energy CT and DXA examinations within 2 months, comprising the lumbar spine of 40 patients, were included.

Operations in spinal surgery are not always needed. Do we operate more than we should?

Lumbar disc herniation and low back pain are the main cause of sickness during labor life. The decision for operation is thought to be taken easily and as a result a lot of money is being spent for treatment and rehabilitation. The aim of this study was to evaluate whether conservative treatment is sufficient for treatment of lumbar disc herniation and low back pain and what percentage of the patients operated are satisfied with social and everyday life two years after operation.

[Minimally invasive cement augmentation of osteoporotic vertebral compression fractures with the new radiofrequency kyphoplasty].

Objective: Minimally invasive cement augmentation of painful osteoporotic vertebral compression fractures in elderly patients.

Indications: Painful osteoporotic vertebral compression fractures in elderly patients (> 65 years of age) after conservative therapy failure. Painful aggressive primary tumors of the spine or osteolytic metastases to the spine with high risk of vertebral fracture in the palliative care setting.

Dual-energy CT-based assessment of the trabecular bone in vertebrae.

Background: Osteoporosis can cause severe fractures of bone structures. One important indicator for pathology is a lowered bone mineral density (BMD) - conventionally assessed by dual-energy X-ray absorptiometry (DXA). Dual-energy CT (DECT) - being an alternative that is increasingly used in the clinics - allows the computation of the spatial BMD distribution.

Kümmell's disease: pathophysiology, diagnosis, treatment and the role of nuclear medicine. Rationale according to our experience.

Kümmell's disease (KD) is a rare clinical entity and includes patients, who after a trivial trauma and an asymptomatic period, develop a progressive vertebral body collapse and a painful kyphosis. The main pathologic eliciting event still remains unclear. Vertebral body collapse can be the result of infection, malignant neoplasia or trauma.

The quality of applied bone cement depends on the chemical composition of the application system.

Unlabelled: The exothermal reaction of polymethylmethacrylate leads to an extensive interaction between bone cement and the synthetic material of the application system. This chemical reaction changes the structure of the cement and might generate air inclusions.

Methods And Materials: Two application systems for bone cement made of polycarbonate (PC) and polypropylene (PP) were evaluated.

Direct implantation of VX-2 carcinoma: a new rabbit bone model using a three-dimensional matrix as a carrier for the tumor cells.

Background: Animal bone models are inevitable for musculoskeletal research. The induction of a local bone tumor is complex and time consuming. In this study a new model is presented using a direct implantation of tumor cells into the bone without a preliminary passaging of the cells.

Anterior vertebroplasty of adjacent levels after vertebral body replacement.

The aim of this study was to evaluate the feasibility of a new method, which should help to avoid cage subsidence after vertebrectomy in short fusions. After implantation of an extendable vertebral body replacement (VBR) the two adjacent endplates to the fractured or destroyed vertebra were augmented with bone cement using the anterior approach in 20 patients with short circumferential fusion. All patients were followed up for 2 years clinically and radiographically.

Functional results after giant cell tumor operation near knee joint and the cement radiolucent zone as indicator of recurrence.

Background: Giant cell tumor of bone near the knee joints is a dilemma for the operating surgeon. Curettage and bone grafting have a high recurrence, whereas wide resection has a reduced recurrence rate with the compromise of limb function.

Materials And Methods: Thirty-eight patients with histologically proven giant cell tumor near the knee joint were treated.