Biomechanical stability of transverse connectors in the setting of a thoracic pedicle subtraction osteotomy.

Background Context: Transverse connectors (TCs) are often used to improve the rigidity of posterior spinal instrumentation as previous investigations have suggested that TCs enhance torsional rigidity in long-segment thoracic constructs. Posterior osteotomies, such as pedicle subtraction osteotomy (PSO), are used in severe thoracic deformities and provide a significant amount of correction; as a consequence, however, PSOs also induce three-column spinal instability. In theory, augmentation of longitudinal constructs with TC after a thoracic PSO may provide additional rigidity, but the concept has not been previously evaluated.

Do stand-alone interbody spacers with integrated screws provide adequate segmental stability for multilevel cervical arthrodesis?

Background Context: Some postoperative complications after anterior cervical fusions have been attributed to anterior cervical plate (ACP) profiles and the necessary wide operative exposure for their insertion. Consequently, low-profile stand-alone interbody spacers with integrated screws (SIS) have been developed. Although SIS constructs have demonstrated similar biomechanical stability to the ACP in single-level fusions, their role as a stand-alone device in multilevel reconstructions has not been thoroughly evaluated.

Cervical hybrid arthroplasty with 2 unique fusion techniques.

Objective: Multilevel cervical arthroplasty achieved using the Prestige ST disc can be challenging and often unworkable. An alternative to this system is a hybrid technique composed of alternating total disc replacements (TDRs) and fusions. In the present study, the authors review the safety and radiological outcomes of cervical hybrid arthroplasty in which the Prestige ST disc is used in conjunction with 2 unique fusion techniques.

Approach-related complications after decompression for cervical ossification of the posterior longitudinal ligament.

The surgical management of compressive cervical ossification of the posterior longitudinal ligament (OPLL) can be challenging. Traditionally, approach indications for decompression of cervical spondylotic myelopathy have been used. However, the postoperative complication profile after cervical OPLL decompression is unique and may require an alternative approach paradigm.

Structures at risk from pedicle screws in the proximal thoracic spine: computed tomography evaluation.

Background Context: Pedicle screw placement in the proximal thoracic spine may result in unwanted bicortical breach. An understanding of the potential structures at risk is paramount to safe screw placement.

Purpose: To assess the anatomic location of structures at risk with the placement of bicortical pedicle screw fixation in the proximal thoracic spine.

Does catastrophic midline failure of upper thoracic lamina screws violate the spinal canal? A cadaveric biomechanical analysis using two lamina screw techniques.

Background Context: Lamina screws have been reported to be a biomechanically sound alternative to pedicle screws in the proximal thoracic spine. However, concerns have been raised that midline failure may result in a spinal canal breach.

Purpose: To evaluate the catastrophic failure of proximal thoracic lamina screws using two techniques for lamina screw purchase.

Does the Wilson frame assist with optimizing surgical exposure for minimally invasive lumbar fusions?

Object: Minimally invasive lumbar spine surgery has dramatically evolved over the last decade. Minimally invasive techniques and transforaminal lumbar interbody fusion (TLIF) often require a steep learning curve. Surgical techniques require pre-positioning the patient in maximal kyphosis to optimize visualization of the disc space and prevent unnecessary retraction of neural structures.

Multilevel cervical arthroplasty with artificial disc replacement.

Object: In this study, the authors review the technique for inserting the Prestige ST in a contiguous multilevel cervical disc arthroplasty in patients with radiculopathy and myelopathy. They describe the preoperative planning, surgical technique, and their experience with 10 patients receiving a contiguous Prestige ST implant. They present contiguous multilevel cervical arthroplasty as an alternative to multilevel arthrodesis.

Effect of teriparatide [rhPTH(1,34)] and calcitonin on intertransverse process fusion in a rabbit model.

Study Design: Randomized, double-blinded, placebo controlled animal study.

Objective: To evaluate the effect of teriparatide and calcitonin after an intertransverse process spinal fusion in a rabbit model.

Summary Of Background Data: It is widely recognized that some osteoporosis medications, including bisphosphonates, can interfere with bone healing.

Using lamina screws as a salvage technique at C-7: computed tomography and biomechanical analysis using cadaveric vertebrae. Laboratory investigation.

Object: Transpedicular instrumentation at C-7 has been well accepted, but salvage techniques are limited. Lamina screws have been shown to be a biomechanically sound salvage technique in the proximal thoracic spine, but have not been evaluated in the lower cervical spine. The following study evaluates the anatomical feasibility of lamina screws at C-7 as well as their bone-screw interface strength as a salvage technique.

810 nm Wavelength light: an effective therapy for transected or contused rat spinal cord.

Background And Objectives: Light therapy has biomodulatory effects on central and peripheral nervous tissue. Spinal cord injury (SCI) is a severe central nervous system trauma with no effective restorative therapies. The effectiveness of light therapy on SCI caused by different types of trauma was determined.

Does superior-segment facet violation or laminectomy destabilize the adjacent level in lumbar transpedicular fixation? An in vitro human cadaveric assessment.

Study Design: This is an in vitro biomechanical study.

Objective: The current investigation was performed to evaluate adjacent level kinematic change following unilateral and bilateral facet violation and laminectomy following 1-, 2-, and 3-level reconstruction.

Summary Of Background Data: The incidence of superior-segment facet violation with lumbar transpedicular fixation has been reported as high as 35%; however, its contribution to biomechanical instability at the supradjacent level is unknown.

Computed tomography and biomechanical evaluation of screw fixation options at the cervicothoracic junction: intralamina versus intrapedicular techniques.

Study Design: In vitro cadaveric biomechanical analysis.

Objective: Define the T1 and T2 anatomic lamina size and evaluate the bone-screw interface strength of various pedicle screw options and intralamina techniques.

Summary Of Background Data: Transpedicular instrumentation is well accepted, but salvage techniques in the proximal thoracic spine are limited.

Biomechanical contribution of transverse connectors to segmental stability following long segment instrumentation with thoracic pedicle screws.

Study Design: An in vitro biomechanical cadaver study of long segment thoracic pedicle screw constructs with transverse connectors (TC).

Objective: To determine the resultant degree of motion of the instrumented thoracic spine after segmental pedicle screw instrumentation with and without TC. SUMMARY OF BACKGROUND DATA.