Objectives: To evaluate the feasibility of computed tomography (CT)- and fluoroscopy-guided percutaneous screw fixation for the treatment of low-grade isthmic spondylolisthesis in adults.
Methods: Ten consecutive adult patients (four men and six women; mean age: 57.1 [range, 44-78 years]) were prospectively treated by percutaneous screw fixation for low-grade (six grade 1 and four grade 2) isthmic spondylolisthesis of L5. For each patient, two 4.0-mm Asnis III cannulated screws were placed to fix the pars interarticularis defects. All procedures were performed under local anaesthesia by using CT and fluoroscopy guidance. Post-operative outcome was assessed using the visual analogue scale and Oswestry Disability Index (ODI) scores.
Results: The procedure time ranged from 45 to 60 min. The mean screw length was 27 mm (range, 24-32 mm). The VAS and ODI measurements ± SD decreased from 7.8 ± 0.9 preoperatively to 1.5 ± 1.1 at the last 2-year follow-up, and from 62.3 ± 17.2 to 15.1 ± 6.0, respectively (P < 0.001 in both cases). Neither slip progression nor screw failure was noted.
Conclusions: This feasibility study showed that CT- and fluoroscopy-guided percutaneous screw fixation could be a rapid, safe and effective method of treating low-grade isthmic spondylolisthesis.
Key Points: CT- and fluoroscopy-guided percutaneous screw fixation of isthmic spondylolisthesis is feasible. It could become an effective method to treat low-grade isthmic spondylolisthesis. Percutaneous trans-isthmic screw fixation can be performed under local anaesthesia. This new technique can be performed as an outpatient procedure.
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http://dx.doi.org/10.1007/s00330-012-2536-9 | DOI Listing |
Case Rep Womens Health
March 2025
Department of Surgery, Port-of-Spain General Hospital, Port of Spain, Trinidad and Tobago.
Avascular necrosis (AVN) of the hip, a rare cause of pelvic pain in the third trimester of pregnancy, often presents with nonspecific symptoms that resemble common musculoskeletal conditions. This ambiguity, coupled with concerns about the safety of magnetic resonance imaging (MRI) during pregnancy, can hinder timely diagnosis. We report a unique case of a 32-year-old primigravida diagnosed with a hip fracture and bilateral AVN of the femoral head in the immediate postpartum period, a complication seemingly not previously documented in pregnant patients.
View Article and Find Full Text PDFCureus
December 2024
Trauma and Orthopaedics, Northwick Park Hospital, London, GBR.
Distal fibula fractures involving the ankle are one of the most common fractures, often requiring open reduction and internal fixation with plates and screws. The increased incidence of potential wound complications arising from open reduction methods led to a rejuvenated interest in the application of minimally invasive methods like intramedullary nailing of the fibula in the management of ankle fractures and isolated distal fibular fractures. A literature search was performed using Medline, Cochrane, and Embase from 1993 to 2023.
View Article and Find Full Text PDFAsian Spine J
December 2024
Department of Radiology, Advantage Imaging and Research Institute, Chennai, India.
Study Design: Matched case-control study.
Purpose: To evaluate the midterm outcomes of unilateral pedicle screw fixation (UPSF) versus bilateral pedicle screw fixation (BPSF) in transforaminal lumbar interbody fusion (TLIF) procedure, ascertain efficacy of UPSF in adequately decompressing contralateral foramen+spinal canal and reducing rate of adjacent segment degeneration (ASD) at 4-8-year follow-up (FU).
Overview Of Literature: Previous meta-analyses found no significant differences between UPSF and BPSF regarding fusion rates, clinical and radiological outcomes; however, few studies have reported higher rates of cage migration/subsidence and pseudoarthrosis in the UPSF.
BMC Surg
January 2025
Department of orthopedics, Shanghai Pudong New Area People's Hospital, Shanghai, P.R. China.
Background: The incidence rate of subsequent refracture after removal of the implant in mid-shaft clavicle fracture patients is relatively high. This can lead to additional medical costs and cause doctor-patient dispute. This study tries to introduce a new method to predict the refracture risk of the clavicle after hardware removal.
View Article and Find Full Text PDFSci Rep
January 2025
Department of Orthopaedics, The Fourth Affiliated Hospital of Zhejiang University School of Medicine, Yiwu, China.
The purpose of this study was to present the surgical technique of Unilateral Biportal Endoscopic (UBE) decompression combined with percutaneous pedicle screws for the treatment of thoracolumbar burst fractures with secondary spinal stenosis. Thoracolumbar burst fracture is a common traumatic disease in spinal surgery. In the Arbeitsgemeinschaft für Osteosynthesefragen (AO) classification of thoracolumbar fractures, Type A fractures have the highest incidence, accounting for about 70%, with A1 and A3 types being the most common.
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