Correlative analysis of the results of surgical treatment of thoracolumbar injuries with long Texas Scottish rite hospital construct: is the use of pedicle screws versus hooks advantageous in the lumbar spine?

This is a prospective, randomized study to compare the efficacy of two similar "long-segment" Texas Scottish Rite Hospital instrumentations with the use of hooks in the thoracic spine and pedicle screws versus laminar hook claw in the lumbar spine for thoracolumbar A3, B, and C injuries. Forty consecutive patients with such thoracolumbar fractures (T11-L1) associated with spinal canal encroachment underwent early operative postural reduction and stabilization. The patients were randomly sampled into two groups: Twenty patients received hooks in "claw configuration" in both the thoracic and the lumbar spine (group A), and 20 patients received hooks in the thoracic vertebrae and pedicle screws in the lumbar vertebrae (group B).

Rigid, semirigid versus dynamic instrumentation for degenerative lumbar spinal stenosis: a correlative radiological and clinical analysis of short-term results.

Study Design: Prospective comparative randomized clinical and radiologic study.

Objective: This study was conducted to compare the short-term effects of rigid versus semirigid and dynamic instrumentation on the global and segmental lumbar spine profile, subjective evaluation of the result, and the associated complications.

Background Data: Lumbar spine fusion with rigid instrumentation for degenerative spinal disorders seems to increase the fusion rate.

Efficacy of brimonidine 0.2% in controlling acute postoperative intraocular pressure elevation after phacoemulsification.

Purpose: To determine the efficacy of brimonidine tartrate 0.2% drops given 2 times a day in reducing intraocular pressure (IOP) spikes during the first 24 hours after phacoemulsification cataract surgery.

Setting: Department of Ophthalmology, General Hospital of Patras Agios Andreas, Patras, Greece.

Color Doppler ultrasonography for evaluation of internal mammary artery application in adolescent female patients with right-convex thoracic idiopathic scoliosis.

Study Design: Prospective comparative study.

Objective: To establish the use of Color Doppler Ultrasonography to investigate internal mammary artery.

Summary Of Background Data: Breast asymmetry in female adolescents with right convex idiopathic scoliosis was supposed to be linked with anatomic and functional asymmetry of the internal mammary artery that is the main supplier to the mammary gland.

Zweymueller with metal-on-metal articulation: clinical, radiological and histological analysis of short-term results.

Background: This is a prospective study.

Method: . A total of 266 consecutive patients, who received 350 third-generation Zweymueller-SL total hip arthroplasties with metal-on-metal articulation for primary or secondary osteoarthritis, was followed and evaluated clinically, radiologically and histologically.

Neurological deterioration due to cord and cauda compression at the site of laminar hook insertion : Immediate complication of Texas Scottish Rite Hospital instrumentation for lumbar vertebral fracture.

We report an unusual case of a 71-year-old female patient with incomplete paraplegia who experienced neurological deterioration a few hours after the insertion of TSRH (Texas Scottish Hospital Rite) laminar hooks for correction and stabilisation of a fracture of the first lumbar vertebra. Combined CT-myelography revealed significant encroachment of the hooks on the spinal canal, associated with compression of the spinal cord and cauda. The hardware was removed a few hours after the first operation.

Correlative analysis of lateral vertebral radiographic variables and medical outcomes study short-form health survey: a comparative study in asymptomatic volunteers versus patients with low back pain.

This prospective comparative study was designed to investigate the possible link between SF-36 functional status and lateral roentgenographic variables of the standing lumbar spine in patients with low back pain (LBP) versus asymptomatic volunteers. To the authors' knowledge, no previous studies have correlated SF-36 scores and sagittal roentgenographic variables in patients with LBP versus asymptomatic individuals. A total of 100 male volunteers, used as controls, and an equal number of age-, height-, and weight-comparable patients of the same ethnicity with chronic LBP were compared on the basis of roentgenographic and SF-36 data.

Comparative strength measurements of five different fixation systems applied on an in vitro model of femoral midshaft osteotomy.

Oblique midshaft fractures of long bones can be stabilized using either plates and screws, lag screws, wires, cerclages, or a combination of these methods. Fractures at the distal tip of a well-fixed femoral prosthesis are difficult to stabilize with plates and screws because of the underlying intramedullary stem, polymethylmetacrylate (PMMA) cement, and thin periprosthetic femoral cortex. In this study we compared in vitro the mechanical performance of five different osteosynthesis techniques applied on an oak femoral model obliquely oscillated to mimic a short oblique fracture: (a) Double stainless steel wiring; (b) two 4.

Posterior compact Cotrel-Dubousset instrumentation for occipitocervical, cervical and cervicothoracic fusion.

The authors report on 32 consecutive patients with instability at the craniocervical, cervical and cervicothoracic regions suffering from various pathologies, who were treated with posterior instrumentation and fusion using the posterior hooks-rods-plate cervical compact Cotrel-Dubousset (CCD) instrumentation alone or, in three patients, in combination with anterior operation. The patients were observed postoperatively for an average of 31 months (range 25-44 months) and evaluated both clinically and radiographically using the following parameters: spine anatomy and reconstruction, sagittal profile, neurologic status, functional level, complications and status of arthrodesis. All patients but one (who died) achieved a solid arthrodesis based on plain and flexion/extension roentgenograms.

Treatment of dysplastic and congenitally dislocated hips with the Zweymueller total hip prosthesis.

Uncemented Zweymueller total hip prostheses were implanted in 35 dysplastic or dislocated hips in 33 patients. Sixteen hips were dislocated and 19 hips were dysplastic; in 12 hips, an intertrochanteric or pelvic osteotomy was performed in early childhood. In all cases, the titanium screw socket was implanted at the level of the original cotyloid cavity.

Effectiveness of transfixation and length of instrumentation on titanium and stainless steel transpedicular spine implants.

This study compares the effectiveness of transfixation on the stiffness of two pedicle screw-rod constructs of different manufacture, implant design, and alloy, applied in one-and two-level instability. Four screws composed of either stainless steel or Titanium were assembled in pairs to two polymethylmethacrylate blocks to resemble one-and two-level corpectomy models and the construct underwent nondestructive torsional, extension, and flexion loading. In every loading test, each construct was tested using stainless steel or titanium rods of 4.

Prediction of thoracic kyphosis using the Debrunner kyphometer.

The Debrunner kyphometer is an accepted tool for detecting and evaluating thoracic kyphosis. This prospective study was conducted to create a mathematical formula that provides, with high approximation, the roentgenographic angle of thoracic kyphosis (T4-T12) using only the kyphometer. Several clinical (kyphometer value, age, and sex) and radiographic (Cobb angle [T4-T12]) parameters from 90 consecutively screened adolescents (44 male and 46 female) were correlated using simple and multiple linear regression analyses.

Medium- and long-term results of open reduction and internal fixation for unstable pelvic ring fractures.

Over a 10-year period, 74 patients with unstable pelvic injuries were treated with open reduction and internal fixation. Radiographic and clinical follow-up averaged 71 months (range: 38-141 months). Satisfactory (ie, good and very good) radiographic results were obtained in 90% of patients.

Effects of thoracolumbosacral orthosis on spinal deformities, trunk asymmetry, and frontal lower rib cage in adolescent idiopathic scoliosis.

Study Design: Prospective study.

Objectives: To document immediate and late changes in shape and balance of the thoracic and lumbar spine and lower rib cage on the frontal plane induced by treatment with a thoracolumbosacral orthosis (TLSO).

Summary Of Background Data: The effect of TLSO on lateral plane of spinal deformity, frontal lower rib cage, trunk balance, and natural history are poorly understood.

Posterior stabilization of unstable sacroiliac injuries with the Texas Scottish Rite Hospital spinal instrumentation.

This article describes a new alternative technique for stabilization of unstable sacroiliac injuries using the Texas Scottish Rite Hospital (TSRH) instrumentation. The TSRH instrumentation was applied in 14 consecutive patients with unstable posterior pelvic ring disruptions. All patients underwent follow-up for an average of 29 months.

Correlative analysis of the sagittal profile of the spine in patients with beta-thalassemia and in healthy persons.

This prospective study compares several roentgenographic parameters of the thoracic and lumbar spine in patients with beta-thalassemia and in healthy persons who served as controls. Eighty-four patients with beta-thalassemia and 84 age- and gender-matched healthy persons were examined clinically and radiologically (thoracic kyphosis, lumbar lordosis, and vertebral and sacral inclination). Although there was a significant difference in the vertebral inclination from T6 to L1, L4, and L5 between patients and controls, thoracic kyphosis and lumbar lordosis did not differ in the two groups.

Factor analysis of the effectiveness of transfixation and rod characteristics on the TSRH screw-rod instrumentation.

The effects of Texas Scottish Rite Hospital (TSRH) hardware parameters (rod length and diameter and cross-link) and their interaction on the stiffness of the TSRH pedicle screw-rod construct were evaluated. Four TSRH screws were assembled in pairs to two polymethyl-methacrylate blocks to resemble a one-level or more corpectomy model and the construct underwent nondestructive torsional, extension, and flexion loading. In every loading test, each construct was tested using TSRH rods of different lengths (10, 15, and 20 cm) and diameters (4.

Clinical, radiographic, and scintigraphic comparison of the mechanical stability of Mueller and Zweymueller total hip prostheses.

Twenty-two cemented Mueller and 25 uncemented Zweymueller total hip arthroplasties (THAs) were performed in the same period in 47 consecutive randomly selected patients with unilateral primary osteoarthritis. Patients were evaluated using the same clinical and radiographic protocol preoperatively; 3, 6, and 12 months postoperatively; and annually thereafter as well as with Tc 99m MDP three-phase bone scintigraphy 3, 6, 12, and 24 months postoperatively. At 11 periprosthetic regions of interest (ROIs) around the stem and socket of each prosthesis, several radiographic parameters and bone scintigram uptake grade were recorded and correlated to determine the significance of early scintigraphic uptake for prediction of the stability of cemented and uncemented THA components over time.

Mueller roof reinforcement rings. Medium-term results.

Short term results of cemented acetabular reconstruction with the use of the Mueller reinforcement ring in 30 hips in 29 patients have been reported previously. The indications for reinforcement were primary and postrevision segmental, cavitary, and combined acetabular deficiencies. The current study reports the medium term clinical and radiologic results of 20 of the 29 patients who were surgically treated (18 primary and eight postrevision hips) and who underwent followup with detailed clinical and radiographic analysis within an average of 9 years (range, 7-12 years).

Segmental roentgenographic analysis of vertebral inclination on sagittal plane in asymptomatic versus chronic low back pain patients.

Two homogenous groups of 120 volunteers and 120 low back pain (LBP) patients, age range 20-79 years, underwent a prospective roentgenographic segmental vertebral analysis of the thoracic and lumbar spine to compare several roentgenographic parameters useful for planning spine surgery. The following roentgenographic parameters were measured: thoracic kyphosis, lumbar lordosis, sacral inclination, distal lordosis (L4-S1), inclination of each vertebra from T4-S1, and relative vertebral inclination between adjacent vertebrae. Thoracic kyphosis increased (p < 0.

First experience with the use of compression cerclage Gundolf in orthopaedic and trauma surgery. A preliminary report.

In this prospective study we describe our experience with a new method of osteosynthesis of fissures, spiral and comminuted fractures of long bones of the extremities using the titanium compression cerclage of Gundolf (CCG). The operative technique is described in detail, and the results are presented for 50 operated patients who were followed up until fracture consolidation. The technique of application of the CCG is simple and quick and according to the results obtained ensures a permanent fixation at the site of the fracture.

Monoradiculopathy of the fifth lumbar nerve root due to lumbar disc herniation between lumbar one and lumbar two vertebrae.

An extremely rare case is reported of a 34-year-old man who had a drop foot due to a herniated disc between the first and second lumbar vertebrae with a monoradiculopathy of the fifth lumbar nerve root. The diagnosis was made on the basis of myelography and magnetic resonance imaging (MRI), which revealed a disc centrolateral herniation at the level between the first and second lumbar vertebrae. The patient underwent anterior discectomy and fusion with the use of iliac bone graft.

Augmentation of anterior transvertebral screws using threaded teflon anchoring.

This is a biomechanical study to investigate the effect of augmentation of single anterior transvertebral screws. Two subsequent experiments (pullout and caudal loading) were performed in 78 porcine vertebral bodies of equal bone mineral density using 6.5-mm transvertebral screws augmented or not with specially designed Teflon anchoring.

Reciprocal angulation of vertebral bodies in the sagittal plane in an asymptomatic Greek population.

Study Design: A prospective study conducted on several roentgenographic parameters of the standing sagittal profile of the spine in an asymptomatic Greek population.

Objectives: To perform segmental analysis of the sagittal plane alignment of the normal thoracic, lumbar, and lumbosacral spines and to compare the findings with those derived from similar populations.

Summary Of Background Data: Until recently, little attention has been paid to the sagittal segmental alignment of the spine, and there are only a few studies (in French and American populations) in which radiographic analysis of sagittal spinal alignment is investigated.

Unrecognized laceration of main bronchus caused by fracture of the T6 vertebra.

We report on an extremely rare case of a 58-year-old male polytraumatized patient who sustained a bursting fracture of the T6 vertebral body associated with laceration of the posterior wall of the right main bronchus from the spiculae of the vertebral body fragments. The patient was on admission asymptomatic until he underwent an endotracheal anesthesia for stabilization of associated fractures of the extremities, when he developed acute respiratory disturbances. The opening of the bronchus was repaired via a thoracotomy, while the spine was successfully supported with a custom-made brace for 3 months.