Journal of spinal disorders & techniques
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J Spinal Disord Tech · Jul 2014
Cortical Bone Trajectory for Thoracic Pedicle Screws: A Technical Note.
A morphometric measurement of new thoracic pedicle screw trajectory using computed tomography (CT) and a biomechanical study on cadaveric thoracic vertebrae using insertional torque. ⋯ The detailed morphometric measurement and favorable screw fixation stability of thoracic CBT are reported. The insertional torque using thoracic CBT technique was 53.8% higher than that of the traditional technique.
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J Spinal Disord Tech · Jul 2014
Clinical TrialIntraoperative computed tomography with an integrated navigation system in stabilization surgery for complex craniovertebral junction malformation.
This study was designed to report our preliminary experience with stabilization procedures for complex craniovertebral junction malformation (CVJM) using intraoperative computed tomography (iCT) with an integrated neuronavigation system (NNS). ⋯ iCT scanning with integrated NNS was found to be both feasible and beneficial in the stabilization procedures for complex CVJM. In this unusual patient population, the technique seemed to be of value for negotiating complex anatomy and for achieving more control over screw placement.
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J Spinal Disord Tech · Jul 2014
Comparative StudySagittal alignment after lumbar interbody fusion: comparing anterior, lateral, and transforaminal approaches.
Retrospective radiographic analysis. ⋯ After lumbar interbody fusion, improvement of lordosis was significant for both the anterior and lateral groups, but not the transforaminal group. Intergroup analysis showed the anterior group had significantly improved lordosis compared to both the other groups. The anterior and lateral groups had significantly increased disk height compared to the transforaminal group. All the 3 groups significantly reduced spondylolisthesis, with no difference between the groups.
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J Spinal Disord Tech · Jul 2014
Risk factors for L5-S1 disk height reduction after lumbar posterolateral floating fusion surgery.
This is a retrospective study. ⋯ In posterolateral floating fusion surgery, there was a higher risk of L5-S1 disk height reduction and consequent foraminal stenosis in patients with multiple-level fusion. Surgical methods and fusion levels should be chosen after considering their association with L5-S1 disk height reduction.
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J Spinal Disord Tech · Jul 2014
Review Meta Analysis Comparative StudyLumbar fusion versus nonoperative management for treatment of discogenic low back pain: a systematic review and meta-analysis of randomized controlled trials.
Systematic review and meta-analysis of randomized controlled trials (RCTs). ⋯ Despite the significant improvement in ODI in the lumbar fusion groups in 3 studies, pooled data revealed no significant difference when compared with the nonoperative group. Although there was an overall improvement of 7.39 points in the ODI in favor of lumbar fusion, it is unclear that this change in ODI would lead to a clinically significant difference. Prospective randomized trials comparing a specific surgical technique versus a structured physical therapy program may improve evidence quality. Until then, either operative intervention by lumbar fusion or nonoperative management and physical therapy remain 2 acceptable treatment methods for intractable low back pain.