Conservative treatment of pediatric thoracic and lumbar spinal fractures: outcomes in the sagittal plane.

To assess sagittal plane spinopelvic balance and functional outcomes in a pediatric cohort of patients with a thoracic and/or a lumbar fracture treated conservatively. A multicentric study retrospectively reviewed radiological and functional outcomes (mean follow-up 49 months) of 48 patients (mean age 12 years) with thoracic and/or lumbar spinal fractures that occurred between 1996 and 2014. Demographic data and radiological spinopelvic parameters were analyzed.

Bone morphogenetic protein use in spine surgery-complications and outcomes: a systematic review.

Purpose: Because of significant complications related to the use of autologous bone grafts in spinal fusion surgery, bone substitutes and growth factors such as bone morphogenetic protein (BMP) have been developed. One of them, recombinant human (rh) BMP-2, has been approved by the Food and Drug Administration (FDA) for use under precise conditions. However, rhBMP-2-related side effects have been reported, used in FDA-approved procedures, but also in off-label use.

Prospective study using anterior approach did not show association between Modic 1 changes and low grade infection in lumbar spine.

Introduction: The modern literature is producing a rapidly growing number of articles which highlight the relationship between infection and lumbar disc degeneration. However, the means by which samples are collected is questionable. Posterior approach surgery is not free from skin contamination.

Role of a collagen membrane in adhesion prevention strategy for complex spinal surgeries.

Purpose: Following lumbar spine surgery, postoperative complications can appear, including epidural adhesions. The formation of fibrosis around the dura mater can, on the one hand, lead to compression of the nerve roots with recurrent radicular pain and, on the other hand, can increase the risks of specific complications at spinal re-intervention (haematomas and dural breaches). The aim of this prospective monocentric study was to assess the safety of a new collagen antiadhesion membrane in vertebral osteotomy surgery where scar tissue and adhesions are important.

Post-trauma scoliosis after conservative treatment of thoracolumbar spinal fracture in children and adolescents: results in 48 patients.

Purpose: Authors examined a case series of patients younger than 18 years old who had sustained a traumatic thoracolumbar spine fracture to evaluate radiological and clinical findings of coronal spinal balance, after conservative treatment.

Methods: From 1996 to 2014, a tricentric cohort of 48 patients with an average age of 12 years was radiographically reviewed at 50 months. Cobb angle of fractured vertebra and regional Cobb angle were measured both at baseline and follow-up.

Evidence showing the relationship between sagittal balance and clinical outcomes in surgical treatment of degenerative spinal diseases: a literature review.

The measure of radiographic pelvic and spinal parameters for sagittal balance analysis has gained importance in reconstructive surgery of the spine and particularly in degenerative spinal diseases (DSD). Fusion in the lumbar spine may result in loss of lumbar lordosis (LL), with possible compensatory mechanisms: decreased sacral slope (SS), increased pelvic tilt (PT) and decreased thoracic kyphosis (TK). An increase in PT after surgery is correlated with postoperative back pain.

Lumbo-pelvic related indexes: impact on adult spinal deformity surgery.

Purpose: Lumbo-pelvic indexes appeared recently in the literature taking advantage from the relationship between pelvic incidence (PI) and lumbar lordosis (LL). Schwab proposed to subtract LL from PI (PI-LL) as Boissière proposed the lumbar lordosis index (LLI), which is the ratio between LL and PI (LL/PI). Both indexes have been described to weight LL by a constant parameter not affected by degenerative processes, the PI.

Global analysis of sagittal spinal alignment in major deformities: correlation between lack of lumbar lordosis and flexion of the knee.

Introduction: It has become well recognised that sagittal balance of the spine is the result of an interaction between the spine and the pelvis. Knee flexion is considered to be the last compensatory mechanism in case of sagittal imbalance, but only few studies have insisted on the relationship between spino-pelvic parameters and lower extremity parameters. Correlation between the lack of lumbar lordosis and knee flexion has not yet been established.

Polytetrafluoroethylene membrane (Gore Preclude Vessel Guard) for vessel protection during anterior lumbar surgery: a preliminary study in pigs.

Study Design: The effects of implanting a polytetrafluoroethylene (PTFE) membrane (Gore Preclude Vessel Guard, WL Gore and Associates, Flagstaff, AZ) during anterior lumbar surgery were studied in a pig model.

Objective: We investigated whether placement of a PTFE membrane between the great vessels and anterior surface of the lumbar spine would minimize adhesions.

Summary Of Background Data: Anterior lumbar procedures continue to increase, as do revision operations.

Hybrid construct for two levels disc disease in lumbar spine.

Prospective study. To study the validity of Hybrid construction (Anterior Lumbar Interbody Fusion) ALIF at one level and total disc arthroplasty (TDA) at adjacent, for two levels disc disease in lumbar spine as surgical strategy. With growing evidence that fusion constructs in the treatment of degenerative disc disease (DDD) may alter sagittal balance and contribute to undesirable complications in the long-term, total disc arthroplasty (TDA) slowly becomes an accepted treatment option for a selected group of patients.

Lumbar decompression and fusion in elderly osteoporotic patients: a prospective study using less rigid titanium rod fixation.

Type Of Study: A 2 to 4-year clinical and radiologic prospective study was conducted for 39 patients over the age of 65 treated by lumbar arthrodesis.

Objectives: Evaluate the quality of lumbar arthrodesis results in elderly patients, in which the bone osteoporosis (poor quality of the spine's anatomic components) and general factors (frequent comorbidity) are likely to make this surgery difficult if not dangerous and evaluate a dedicated instrumentation for osteoporotic bone.

Materials And Methods: Thirty-nine patients over 65 years of age (average 73 y) underwent arthrodesis surgery in 2001 and 2002 and were followed for at least 2 years.

Video-assisted ALIF with cage and anterior plate fixation for L5-S1 spondylolisthesis.

Introduction: Spondylolysis and spondylolisthesis grade 0, 1, and 2 are mainly asymptomatic but with aging process and different factors some back pain can occur and lead to chronic low back pain. The conservative treatment with physiotherapy and steroid injection is the gold standard but in some cases is not efficient enough and a surgical treatment is proposed.

Objectives: The goal of this study is to propose a new technique to treat grade 0, 1, and 2 spondylolisthesis with an anterior video-assisted fusion and stabilization.

Acute knee trauma: role of ultrasound.

The purpose of this study was to determine the diagnostic accuracy of high spatial resolution ultrasonography (US) in the detection of lipohemarthrosis of the knee and to evaluate this sign as criteria of intra-articular fracture. Forty-eight patients with clinical suspicion of knee fracture were prospectively examined by conventional radiography, sonography examination and computed tomography (CT) within 48 h after trauma in order to depict direct (fracture line) and indirect (lipohemarthrosis) signs of intra-articular fracture. Lipohemarthrosis was defined as a multi-layered collection in the subquadricipital recess.

Biological performance of a new beta-TCP/PLLA composite material for applications in spine surgery: in vitro and in vivo studies.

The objective of this research was to carry out an in vitro and in vivo study of the biological performance of PLLA/beta-TCP composite materials, to estimate the scope of their potential applications in bone surgery. Samples with increasing beta-TCP (0-60% w/w) contents were processed by injection molding. The in vitro study consisted of an evaluation of inflammatory potential by assaying the IL-1alpha secreted by monocytes, and then cell proliferation (counting) and phenotype expression (PAL and I collagen) in human osteogenous cells.

Influence of facet and posterior muscle degeneration on clinical results of lumbar total disc replacement: two-year follow-up.

Objective: There has been little analysis assessing the correlation between the clinical functional result of total disc replacement and the arthrosis of the posterior facets or the fatty degeneration of the spinal muscles. However, such knowledge is essential for understanding the long-term outcome of devices in functional terms. This prospective study reports the outcome of 64 Maverick (Medtronic) devices implanted between January 2002 and November 2003.