Spine
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Comparative Study
Angular stable anterior plating following thoracolumbar corpectomy reveals superior segmental stability compared to conventional polyaxial plate fixation.
Biomechanical in vitro testing of primary and secondary stability in 12 human thoracolumbar spinal specimens using a spine simulator. ⋯ Anterior angular stable fixation showed higher primary and secondary stability following thoracolumbar corpectomy. In specimens with lower BMD the use of angular stable systems substantially increased stability. Angular stable systems, however, differ in the way of construct failure.
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A retrospective study of complications with minimal 5-year follow-up of 50 adults with scoliosis with fusion from T10 or higher to S1. ⋯ Long fusions to the sacrum in adults with scoliosis continue to have a high complication rate. As compared to the original publications in the 1980s (Kostuik and Hall, Spine 1983;8:489-500; Balderston et al, Spine 1986;11:824-9) the more recent articles have shown a reduction, but not elimination of the pseudarthrosis problem using segmental instrumentation and anterior fusion of the lumbar spine coupled with structural interbody grafting at L4-L5 and L5-S1. Two-year follow-up is inadequate as pseudarthrosis and painful implants often are detected later. Only 3 of the 12 patients with pseudarthrosis were detected within the first 2 years after surgery.
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A retrospective investigation of patients who underwent decompressive surgery for cervical ossification of the posterior longitudinal ligament (OPLL). ⋯ Patients having cervical surgery for OPLL should also undergo simultaneous studies of the thoracic spine looking for tandem OPLL and/or OLF. The frequency of tandem lesions in this series was 23 of 68, with 6 requiring subsequent surgery for an evolving thoracic myelopathic deficit.
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A technical report of fluoroscopy guided placement of augmented iliosacral screws in osteoporotic insufficiency fractures of the sacrum. ⋯ In general, fractures are treated by reduction and fixation to restore the biomechanical function of the injured bone. These principles should be applied to elderly patients with osteoporotic fractures as well. The technique reported here is adapted to the special demands of the elderly patient, i.e., minimally invasive, support of the weakened bone by cement augmentation, bone protective screw positioning and safety due to navigation support.