Effect of sagittal spinal balance, levels of posterior instrumentation, and length of follow-up on low back pain in patients undergoing posterior decompression and instrumented fusion for degenerative lumbar spine disease: a multifactorial analysis.

Study Design: Prospective controlled clinical study on low back pain (LBP).

Objective: To investigate the possible effects of radiographic and other related parameters on LBP in patients underwent decompression and posterolateral instrumented fusion for degenerative lumbar spine disease.

Summary Of Background Data: Sagittal balance of the spine after spine surgery has gained increasing interest regarding its correlation with LBP and fusion rate.

Factors affecting low back pain in adolescents.

Study Design: Prospective multifactorial study on low back pain (LBP) in adolescents.

Background Data: Most studies on LBP have focused on adults although many investigations have shown that the roots of LBP lie in adolescence. Several mechanical, physical, and behavioral factors have been associated with nonspecific LBP in adolescents.

Immunologic adverse reaction associated with low-carbide metal-on-metal bearings in total hip arthroplasty.

Background: An increased incidence of periprosthetic osteolysis, resulting in loss of biologic fixation, has been reported in contemporary THAs with low-carbide metal-on-metal compared with metal-on-polyethylene couple bearings. Although a hypersensitivity reaction attributable to Co and Cr debris is reportedly a potential cause for failure of THAs with high-carbide bearings, there are no evidence-based data for this reaction in low-carbide metal-on-metal bearings, although such hypersensitivity might be related to osteolysis.

Questions/purposes: We investigated whether there were differences in immunologic hypersensitivity reactions in retrievals from revised THAs with ceramic-on-polyethylene versus metal-on-metal bearing couples.

Does Wallis implant reduce adjacent segment degeneration above lumbosacral instrumented fusion?

Delayed complications following lumbar spine fusion may occur amongst which is adjacent segment degeneration (ASD). Although interspinous implants have been successfully used in spinal stenosis to authors' knowledge such implants have not been previously used to reduce ASD in instrumented lumbar fusion. This prospective controlled study was designed to investigate if the implantation of an interspinous implant cephalad to short lumbar and lumbosacral instrumented fusion could eliminate the incidence of ASD and subsequently the related re-operation rate.

High medium-term survival of Zweymüller SLR-plus stem used in femoral revision.

Unlabelled: Revision after failed THA resulting from loosening of the femoral component can be challenging even for experienced surgeons. Aseptic loosening usually is associated with some degree of bone loss. We asked whether the Zweymüller SLR-Plus((R)), along with allograft reconstruction of the deficient femoral bone stock, would provide survivorship, osseointegration, and stability similar to or better than previously reported implants for femoral revision.

Investigating differentiation mechanisms of the constituent cells of sex cord-stromal tumours of the ovary.

SOX-9, an essential factor for male sexual development, can be induced by prostaglandin D2 in a Sry-independent mechanism. Recent data suggest that the hedgehog pathway is involved in the differentiation of normal Sertoli and Leydig cells. The purpose of our study was to investigate the mechanisms involved in the differentiation of ovarian sex cord-stromal tumour (SCST) cells.

Beneficial influence of titanium mesh cage on infection healing and spinal reconstruction in hematogenous septic spondylitis: a retrospective analysis of surgical outcome of twenty-five consecutive cases and review of literature.

Study Design: Single institution, single surgeon retrospective review.

Objective: To investigate if the use of titanium mesh cage on the site of infection could be beneficial for successful outcome of the operative treatment for pyogenic spondylitis.

Summary Of Background Data: There is a controversy concerning the optimal treatment for pyogenic spondylitis regarding approach, instrumentation and staging.

Evolution of bone mineral density after percutaneous kyphoplasty in fresh osteoporotic vertebral body fractures and adjacent vertebrae along with sagittal spine alignment.

Study Design: Prospective controlled cohort study of 27 adult osteoporotic patients who underwent kyphoplasty for fresh osteoporotic spinal fractures.

Objectives: To define the evolution of vertebral bone mineral density (BMD) at kyphoplasty and adjacent levels along with sagittal spinal alignment to contribute to the etiology of adjacent vertebral fractures after augmentation.

Summary Of Background Data: Osteoporotic compression fractures can be effectively treated with methylmethacrylate vertebral augmentation.

Minimal invasive short posterior instrumentation plus balloon kyphoplasty with calcium phosphate for burst and severe compression lumbar fractures.

Study Design: Prospective consecutive series.

Objective: To evaluate the efficacy of minimal invasive surgery for acute lumbar fractures by means of balloon kyphoplasty with calcium phosphate plus segmental short posterior instrumented fusion.

Summary Of Background Data: In the surgical treatment of lumbar fractures with short pedicle screw instrumentation, the failure to support the anterior spinal column often results in loss of correction.

Direct reduction of thoracolumbar burst fractures by means of balloon kyphoplasty with calcium phosphate and stabilization with pedicle-screw instrumentation and fusion.

Study Design: Prospective consecutive series.

Objective: To evaluate the outcomes of the treatment of acute thoracolumbar burst fractures by transpedicular balloon kyphoplasty with calcium phosphate cement and posterior instrumented fusion.

Summary Of Background Data: In the surgical treatment of thoracolumbar fractures, the major problem after posterior correction and transpedicular instrumentation is failure to support the anterior spinal column, leading to the loss of correction and instrumentation failure.

Treatment of acute thoracolumbar burst fractures with kyphoplasty and short pedicle screw fixation: Transpedicular intracorporeal grafting with calcium phosphate: A prospective study.

Background: In the surgical treatment of thoracolumbar fractures, the major problem after posterior correction and transpedicular instrumentation is failure to support the anterior spinal column, leading to loss of correction and instrumentation failure with associated complaints. We conducted this prospective study to evaluate the outcome of the treatment of acute thoracolumbar burst fractures by transpedicular balloon kyphoplasty, grafting with calcium phosphate cement and short pedicle screw fixation plus fusion.

Materials And Methods: Twenty-three consecutive patients of thoracolumbar (T(9) to L(4)) burst fracture with or without neurologic deficit with an average age of 43 years, were included in this prospective study.

Evolution of anterior chest wall blood supply in female adolescents with progressive right-convex thoracic idiopathic scoliosis.

Breast asymmetry was believed to be related to the asymmetry of anterior chest wall blood supply and subsequently to etiology of idiopathic thoracic scoliosis in female adolescents. Recent investigations on the anterior chest wall blood supply with colour Doppler ultrasonography in such individuals did not show anatomic and hemodynamic abnormalities. The present study investigated the evolution of anterior chest wall blood supply in these individuals over a 2-year period.

Asymmetric evolution of anterior chest wall blood supply in female adolescents with progressive right-convex thoracic idiopathic scoliosis.

Breast asymmetry was believed to be related to asymmetry of anterior chest wall blood supply and subsequently to aetiology of idiopathic thoracic scoliosis in female adolescents. Recent investigations on the anterior chest wall blood supply with Colour Doppler Ultrasonography (CDU) in such individuals did not show anatomical and hemodynamic abnormalities. The present study investigated the evolution of anterior chest wall blood supply in these individuals over a 2-year period.

Biomechanical evaluation of conventional internal contemporary spinal fixation techniques used for stabilization of complete sacroiliac joint separation: a 3-dimensional unilaterally isolated experimental stiffness study.

Study Design: Comparative 3-dimensional biomechanical testing.

Objective: To compare 5 fixation techniques, 3 using screws or screw and plates and 2 spinal, used for stabilization of complete unilateral sacroiliac dislocation in composite models.

Summary Of Background Data: Harrington compression rods have been used for posterior iliosacral stabilization.

Comparative multifactorial analysis of the effects of idiopathic adolescent scoliosis and Scheuermann kyphosis on the self-perceived health status of adolescents treated with brace.

Bracing is the most effective non-operative treatment for mild progressive spinal deformities in adolescence but it has shown a considerable impact on several aspects of adolescents' functioning. This cross-sectional study investigated the self-perceived health status of adolescents with the two most common deformities, treated with body orthosis. Seventy-nine adolescents with spinal deformities (idiopathic adolescent scoliosis, thoracic Scheuermann kyphosis) and 62 adolescents without spinal deformities were asked to complete the Quality of Life profile for Spine Deformities Instrument.

Metallosis after contemporary metal-on-metal total hip arthroplasty. Five to nine-year follow-up.

Background: Authors of recent studies have reported early periprosthetic osteolysis in patients who have been treated with a contemporary metal-on-metal total hip arthroplasty and have suggested that metal hypersensitivity associated with an immunologic response to metal may be of etiologic importance. We evaluated the results and histologic findings in patients who had undergone revision of a failed contemporary metal-on-metal total hip arthroplasty.

Methods: Two hundred and seventeen total hip arthroplasties (SL-Plus stem and Bicon-Plus cup) with a Sikomet metal-on-metal articulation were implanted in 194 consecutive patients, and the results were retrospectively reviewed at a mean of seventy-seven months postoperatively.

Anterior surgery with insertion of titanium mesh cage and posterior instrumented fusion performed sequentially on the same day under one anesthesia for septic spondylitis of thoracolumbar spine: is the use of titanium mesh cages safe?

Study Design: Retrospective study.

Objective: To evaluate the outcome on patients with pyogenic spondylitis of the thoracolumbar spine following combined anterior and posterior surgery.

Summary And Background Data: Several methods of surgical treatment of pyogenic spondylitis have been reported.

Combined anterior plus posterior stabilization versus posterior short-segment instrumentation and fusion for mid-lumbar (L2-L4) burst fractures.

Study Design: Prospective randomized study. OBJECTIVES.: To compare the results of the combined anterior-posterior surgery (Group A) with posterior "short-segment" transpedicular fixation (SSTF) (Group B) in mid-lumbar burst fractures.

One-stage combined surgery with mesh cages for treatment of septic spondylitis.

Unlabelled: There is a controversy regarding most effective operative method for treatment of pyogenic spondylitis and whether to use metallic implants on the site of infection. This retrospective study reports on the outcome of 17 patients with persistent cervical and lumbar pyogenic spondylitis who had one-stage combined surgery and fusion with use of a titanium mesh cage for intractable pain, kyphosis, and neurologic impairment. All patients tolerated the combined operation and were followed up on for 45 months.

Posterior transcanal lumbar interbody fusion for septic vertebral fracture pseudarthrosis and sitting imbalance.

Study Design: Case report.

Objective: To describe a new method to treat septic pseudarthrosis of the lumbar spine via a transcanal approach.

Summary Of Background Data: Septic pseudarthrosis of the spine after multiple unsuccessful anterior and posterior surgeries for vertebral fracture represents a challenge for spine surgeons.

Correlative radiological, self-assessment and clinical analysis of evolution in instrumented dorsal and lateral fusion for degenerative lumbar spine disease. Autograft versus coralline hydroxyapatite.

This prospective longitudinal randomized clinical and radiological study compared the evolution of instrumented posterolateral lumbar and lumbosacral fusion using either coralline hydroxyapatite (CH), or iliac bone graft (IBG) or both in three comparable groups, A, B and C, which included 19, 18 and 20 patients, respectively, who suffered from symptomatic degenerative lumbar spinal stenosis and underwent decompression and fusion. The patients were divided randomly according to the graft used and the side that it was applied. The spines of group A received autologous IBG bilaterally; group B, IBG on the left side and hydroxyapatite mixed with local bone and bone marrow on the right side; group C, hydroxyapatite mixed with local bone and bone marrow bilaterally.

Backpacks, back pain, sagittal spinal curves and trunk alignment in adolescents: a logistic and multinomial logistic analysis.

Study Design: Cross-sectional study using logistic and multinomial logistic analysis.

Objectives: To investigate the influence of backpack carrying on spinal profile shoulder and trunk.

Summary Of Background Data: No similar investigations.

The role of rigid vs. dynamic instrumentation for stabilization of the degenerative lumbosacral spine.

Purpose Of The Study: This is a prospective comparative randomised study to compare the immediately postoperative effects of a rigid versus dynamic instrumentation for degenerative spine disease and stenosis on the standing sagittal lumbar spine alignment and to investigate if a dynamic spine system can replace the commonly used rigid systems in order to avoid the above mentioned disadvantages of rigid fixation.

Material & Methods: 15 randomly selected patients received the rigid instrumentation SCS and an equal number of randomly selected patients the dynamic TWINFLEX device for spinal stenosis associated degenerative lumbar disease. The age of the patients, who received rigid and dynamic instrumentation was 65 +/- 9 years and 62 +/- 10 years respectively.

Does coralline hydroxyapatite conduct fusion in instrumented posterior spine fusion?

Objectives: This study was conducted to investigate the course of incorporation of coralline hydroxyapatite in human spine.

Summary Of Background Data: Conventional techniques for surgical treatment of spine have a substantial failure rate and associated morbidity. Bone graft substitutes are an alternative technique to enhance fusion rates and limit the morbidity associated with spine fusion using autologous iliac crest bone graft.

Correlative analysis of reliability and validity of plain radiology, MOS short-form health survey and surgical examination in making decision for treatment of chronic low back pain patients.

The aim of this study was to determine inter- and intraobserver agreement between spine surgeons and orthopedic radiologists in recognizing distinct degenerative pathology on plain lumbosacral roentgenograms; to estimate the validity (sensitivity and specificity) to make a surgical decision by correlating Short form-36 Health Survey (SF-36) scores and roentgenographic degenerative pathology; and to determine the intra- and interobserver agreement between radiologists, surgeons, and authors in making a surgical decision for treatment on the basis of distinct roentgenographic pathology, SF-36 scores, clinical findings derived from physical examination, or combined. The authors followed three routes to objectively assess the reliability and validity of the surgical decision in chronic low back pain patients: First, 100 consecutive male patients who suffered from low back pain were examined by the authors physically, using imaging techniques (including plain roentgenograms, CT-scan, or/and MRI), and SF-36 survey. Two senior orthopedic radiologists and two senior spine surgeons were asked to read blinded a set of 100 roentgenograms of the lumbar spine in two sessions.