European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society
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Reduced strength and stiffness of lumbar spinal motion segments following laminectomy may lead to instability. Factors that predict shear biomechanical properties of the lumbar spine were previously published. The purpose of the present study was to predict spinal torsion biomechanical properties with and without laminectomy from a total of 21 imaging parameters. ⋯ Vertebral bone content and geometry, i.e. intervertebral disc width, frontal area and facet joint tropism, were found to be strong predictors of ETS, LTS and TMF following laminectomy, suggesting that these variables could predict the possible development of post-operative rotational instability following lumbar laminectomy. Proposed diagnostic parameters might aid surgical decision-making when deciding upon the use of instrumentation techniques.
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The ultrasonic BoneScalpel is a tissue-specific device that allows the surgeon to make precise osteotomies while protecting collateral or adjacent soft tissue structures. The device is comprised of a blunt ultrasonic blade that oscillates at over 22,500 cycles/s with an imperceptible microscopic amplitude. The recurring impacts pulverize the noncompliant crystalline structure resulting in a precise cut. The more compliant adjacent soft tissue is not affected by the ultrasonic oscillation. The purpose of this study is to report the experience and safety of using this ultrasonic osteotome device in a variety of spine surgeries. ⋯ Overall, the ultrasonic scalpel was safe and performed as desired when used as a bone cutting device to facilitate osteotomies in a variety of spine surgeries. However, caution should be taken to avoid potential thermal injury and dural tear. If used properly, this device may decrease the risk of soft tissue injury associated with the use of high speed burrs and oscillating saws during spine surgery.
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Cervical spine pyogenic infections are unusual compared to other vertebral segments, but they can be associated to worse clinical outcomes. We compared all patients with cervical spine pyogenic infections to those with thoracolumbar involvement in terms of epidemiology, prognostic factors and clinical outcomes. ⋯ An early diagnosis and prompt treatment should be the goal treating cervical PSI, considering the potential devastating complications and increased mortality.
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Vertebral body defects represent one of the most common orthopedic challenges. In order to advance the transfer of stem cell therapies into orthopedic clinical practice, we performed this study to evaluate the safety and efficacy of a composite bioartificial graft based on a hydroxyapatite bone scaffold (CEM-OSTETIC(®)) combined with human mesenchymal stem cells (MSCs) in a rat model of vertebral body defects. ⋯ MSCs in combination with a hydroxyapatite scaffold improved the repair of a model bone defect and might represent a safe and effective alternative in the treatment of vertebral bone defects.