A novel method for the reproducible production of thoracolumbar burst fractures in human cadaveric specimens.

Background Context: Currently, there is no reproducible method that produces thoracolumbar burst fractures in human cadavers wherein the fracture configuration mirrors that seen naturally, and soft tissues are maintained.

Purpose: To describe a novel method of burst fracture production.

Study Design: Biomechanical.

Security of knots tied with ethibond, fiberwire, orthocord, or ultrabraid.

Background: The security of several popular arthroscopic knots to prolonged, incremental, cyclic loads is unknown, as is the security of knots tied with newer, superstrong sutures.

Hypothesis: Some arthroscopic knots are as secure as openly tied square knots, and knots tied with superstrong sutures are more secure than those tied with braided polyester. Some arthroscopic knots are significantly bulkier than openly tied square knots.

Randomized trials and registries: a computer simulation to study the impact of surgeon/patient factors on outcomes.

Background Context: Patient factors (diabetes, osteoporosis, cardiopulmonary problems, previous surgery, smoking, worker's compensation, litigation) and surgeon factors (operative experience, patient selection, technical skill, setting) are known to significantly impact outcomes of spinal surgery. The impact of these factors is difficult to assess clinically given the volume of patients required to obtain statistically significant information, the costs involved, and ethical/equipoise considerations. Computer simulation offers a viable and useful alternative.