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Background Context: Cortical bone trajectory (CBT) technique for pedicle screw placement in the lumbar spine has become more popular since its introduction in 2009. The distinct advantages of using the CBT technique involve increased screw purchase within the cortical bone and reduced surgical dissection. However, contrary to several favorable biomechanical results, there were anecdotal reports of clinical complications associated with CBT.
Purpose: This study aimed (1) to report on two unique pars and pedicle fracture cases involving the use of the CBT technique and (2) to perform a cadaveric pilot study to determine the possible mechanism for this fracture pattern.
Study Design/setting: A case report and cadaveric study were carried out.
Methods: After presenting two clinical cases, 19 fresh-frozen lumbar vertebrae were obtained from 8 cadavers. Pedicle screws were instrumented on each level using CBT under video recording. After the instrumentation, X-ray images were obtained, and anatomical dissections were performed.
Results: To be able to reach a necessary angle for medial to lateral CBT trajectory, 13 out of 19 (68%) spinous processes had to be removed. There were a total of seven complications. One pars and pedicle fracture out of 37 trajectories (2.7%) and 6 out of 37 trajectory deviations (16.2%), which resulted in gross loosening, were observed.
Conclusions: The head of the pedicle screw impinging on the base of spinous process and lamina was observed in our cadaveric model. This mechanism could potentially explain both screw loosening and fractures associated with the CBT technique.
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http://dx.doi.org/10.1016/j.spinee.2015.09.046 | DOI Listing |
Khirurgiia (Mosk)
December 2024
Petrovsky National Research Center of Surgery, Moscow, Russia.
Objective: To analyze the effectiveness of cognitive-behavioral therapy (CBT) combined with pharmacotherapy for treatment and prevention postoperative pain syndrome.
Material And Methods: The study included 62 patients after cardiac surgery. In the main group (=31), patients underwent standard therapy combined with CBT including cognitive restructuring, behavioral activation and exposure therapy.
The objective of this study was to conduct a randomized control trial investigating the effectiveness of acceptance and commitment therapy (ACT) compared to a trauma-focused cognitive behavior therapy (TF-CBT) in treating symptoms of posttraumatic stress symptoms (PTSS) in female Afghan adolescents. Participants were randomly assigned to the ACT (20 participants; M = 14.8 [SD = 1.
View Article and Find Full Text PDFChronic Stress (Thousand Oaks)
December 2024
Department of Surgery and Perioperative Care, Dell Medical School, Austin, TX, USA.
Background: Greater unhelpful thinking is associated with greater musculoskeletal discomfort and incapability. Cognitive-behavioral therapy (CBT) fosters healthy thinking to help alleviate symptoms.
Questions: In a meta-analysis of randomized control trials (RCT) of CBT for unhelpful thinking among people with musculoskeletal symptoms, we asked: 1) Does CBT reduce unhelpful thinking and feelings of distress, and improve capability, in individuals with musculoskeletal symptoms? 2) Are outcomes affected by CBT delivery methods?
Methods: Following QUOROM guidelines, we searched databases using keywords of pain catastrophizing, kinesiophobia, cognitive-behavioral therapy, musculoskeletal and variations.
Cureus
November 2024
Department of Medicine, University of Calgary, Calgary, CAN.
Atopic dermatitis (AD) is a common inflammatory skin condition characterized by a history of recurring pruritic lesions that are worsened by scratching. Therapeutic outcomes may be optimized by minimizing the scratching of pruritic AD lesions, which is often particularly challenging for pediatric populations. Alongside topical and systemic therapies, research supports the use of habit reversal therapy for AD to mitigate the urge to scratch.
View Article and Find Full Text PDFJ Cancer Res Clin Oncol
December 2024
Department of Oncology, the Second Affiliated Hospital of Anhui Medical University, Hefei, 230601, Anhui, China.
Background: Colorectal cancer (CRC) patients frequently experience sleep disturbances, significantly impacting their quality of life. Cognitive behavioral therapy for insomnia (CBT-I) is considered the first-line treatment but is often complex, costly, and requires highly trained therapists. Behavioral activation (BA), derived from cognitive behavioral therapy (CBT), offers a flexible, simple, and cost-effective alternative.
View Article and Find Full Text PDFEnter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!