MRI Assessment of the Early Disc Degeneration Two Levels above Fused Lumbar Spine Segment: A Comparison after Unilateral and Bilateral Transforaminal Lumbar Interbody Fusion (TLIF) Procedure.

Background: Adjacent segment degeneration (ASD) has become a great concern as a late complication in patients following fusion spine surgery with a potential need for revision surgery. Segments above the fused spine have higher mobility and they are especially prone to accelerated disc degeneration. The purpose of our study is to investigate early disc degenerative changes two levels above a surgically fused lumbar spine segment and to compare MRI analyses after unilateral and bilateral TLIF procedures.

Two Single-Level Nonadjacent Corpectomies With Expandable Vertebral Body Replacements for Spinal Metastasis: A Case Report.

Case: The case describes a 59-year-old male patient who suffered from a solitary metastasis of unknown origin in the L1 vertebra. Owing to the instability, a corpectomy and posterior fixation with the expandable cage implantation was performed. However, the disease progressed, which required additional nonadjacent corpectomy and cranial elongation of the construct with implantation of the additional expandable cage at the level Th11.

Initial Experience Using Negative Pressure Wound Therapy With Instillation and Dwell Time for Postoperative Wound Treatment After Spinal Fusion Surgery: A Case Report.

Introduction: The advantages of using negative pressure wound therapy with instillation and dwell time (NPWTi-d) of a topical solution that dwells on the wound have been shown to include removal of fibrinous and bacterial exudate and increased granulation tissue formation. The treatment is best suited for chronic, complex wounds with areas of nonviable tissue on the wound surface.

Case Report: A 73-year-old female with spondylolisthesis and stenosis of the spinal canal experienced dehiscence formation of the postoperative wound with continuous exudate after fusion and decompression surgery (TLIF L4-L5) of the lumbar spine.

Lumbar and sacral pedicle screw placement using a template does not improve the midterm pain and disability outcome in comparison with free-hand method.

Background: The free-hand technique carries a higher risk of pedicle weakening and neurovascular injuries in comparison with pedicle screw placement using a drill guide. Due to this evidence and because of some variances in the surgical method, different outcome can be expected. The objective of the study was to evaluate the disability, the back and leg pain before and at least 3 years after the surgery between examined groups.

Porous tantalum in spinal surgery: an overview.

Porous tantalum is an open-cell metal structure that approximates the appearance of human cancellous bone. It has a low modulus of elasticity, close to that of subchondral and cancellous bones, leading to better load transfer and minimizing the stress-shielding phenomenon. Its coefficient of friction is one of the highest among biomaterials, allowing for sufficient primary stabilization of implants, possibly even without screw fixation.

Error rate of multi-level rapid prototyping trajectories for pedicle screw placement in lumbar and sacral spine.

Objective: Free-hand pedicle screw placement has a high incidence of pedicle perforation which can be reduced with fluoroscopy, navigation or an alternative rapid prototyping drill guide template. In our study the error rate of multi-level templates for pedicle screw placement in lumbar and sacral regions was evaluated.

Methods: A case series study was performed on 11 patients.

Porous tantalum shells and augments for acetabular cup revisions.

Purpose: The purpose of this study was to evaluate early functional results of revision hip arthroplasty with pelvic bone loss revised with porous tantalum (PT) acetabular components.

Methods: Twenty-five consecutive patients (25 hips) with loose acetabular components after total hip arthroplasty with a minimum of Paprosky IIa pelvic bone loss treated with PT cups with and without modular augments were retrospectively reviewed. Clinical outcomes were assessed using Harris hip score, and Western Ontario and McMaster Universities scores.

A multi-level rapid prototyping drill guide template reduces the perforation risk of pedicle screw placement in the lumbar and sacral spine.

Introduction: The method of free-hand pedicle screw placement is generally safe although it carries potential risks. For this reason, several highly accurate computer-assisted systems were developed and are currently on the market. However, these devices have certain disadvantages.

Influencing segmental balance in isthmic spondylolisthesis using transforaminal lumbar interbody fusion.

Study Design: Retrospective cohort study.

Objective: The objective of the study was to analyze segmental balance in patients with isthmic spondylolisthesis undergoing single-level transforaminal lumbar interbody fusion (TLIF).

Summary Of Background Data: Sagittal malalignment of the fused segment was suggested to be associated with degeneration of the adjacent segment.

The effect of platelet-derived growth factors on knee stability after anterior cruciate ligament reconstruction: a prospective randomized clinical study.

Background: Arthroscopic reconstruction is a standard surgical procedure in cases of symptomatic knee instability due to rupture of the anterior cruciate ligament. Bone-tendon-bone and hamstring tendon grafts are both in use for anterior cruciate ligament reconstruction. There are no significant differences between the two types of graft in relation to function scores, but there is a difference in anteroposterior stability when measured on the KT-2000 arthrometer: knee joints after reconstruction with bone-tendon-bone autografts are more stable than those reconstructed with hamstring tendon autografts.

Increased risk of knee injuries and osteoarthritis in the non-dominant leg of former professional football players.

The aim of the study was to evaluate differences in knee injuries and osteoarthritis between the dominant and non-dominant legs of former professional football players. The study cohort comprised 40 retired professional players with an average age of 49.2 years.

Association between sub-clinical acetabular dysplasia and a younger age at hip arthroplasty in idiopathic osteoarthritis.

This retrospective study was designed to investigate whether sub-clinical acetabular dysplasia, defined by a reduced centre-edge angle of Wiberg, was associated with a younger age at hip arthroplasty in patients with idiopathic osteoarthritis (OA). Fifty-four patients with 69 performed arthroplasties and no previous referral for hip dysplasia were selected from a list of consecutive recipients of hip endoprostheses due to idiopathic OA. The centre-edge angle was measured from standard pelvic radiographs taken a mean of 5.

The role of obesity, biomechanical constitution of the pelvis and contact joint stress in progression of hip osteoarthritis.

Objective: The aim of our study was to explore whether earlier hip arthroplasty for idiopathic osteoarthritis (OA) might be explained by enlarged contact stress in the hip joint, and to what amount can that be attributed to obesity and biomechanical constitution of the pelvis.

Method: Fifty subjects were selected from a list of consecutive recipients of hip endoprosthesis due to idiopathic OA; standard pelvic radiographs made years prior to surgery were the main selection criteria. For 65 hips resultant hip force and peak contact hip stress normalized to the body weight (R/Wb and p(max)/Wb) were determined from the radiographs with the HIPSTRESS method.

Higher peak contact hip stress predetermines the side of hip involved in idiopathic osteoarthritis.

Background: Biomechanical parameters of the hip have been suggested to have an important influence on the development of osteoarthritis. We aimed to find out whether higher stress is generated in a hip that subsequently results in earlier hip arthroplasty compared to the contralateral hip in the same subject.

Methods: Standard anterior-posterior pelvic radiographs with no or subtle radiological signs of hip osteoarthritis, of 59 female patients, who underwent hip arthroplasty for primary osteoarthritis years later, were selected from the archives.