Journal of spinal disorders & techniques
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J Spinal Disord Tech · Feb 2007
Caudal epidural injection for L4-5 versus L5-S1 disc prolapse: is there any difference in the outcome?
One hundred seventy-seven patients with radicular pain due to disc prolapse treated with caudal epidural injection were included in our study. All the injections were carried out between January 2000 and December 2004. Inclusion criteria include symptomatic disc prolapse diagnosed with magnetic resonance imaging scan, disc prolapse of 1 level only either L4-5 or L5-S1, leg pain for more than 4 wk and age more than 18. ⋯ The number of patients who required surgery were much less than the literature figures 3.05%. There is no significant difference in the response after caudal epidural injection considering the sex only. The longest the back pain before injection is associated with the worst Oswestry disability index.
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J Spinal Disord Tech · Feb 2007
PLIF with a titanium cage and excised facet joint bone for degenerative spondylolisthesis--in augmentation with a pedicle screw.
To determine the validity of posterior lumbar interbody fusion (PLIF) using a titanium cage filled with excised facet joint bone and a pedicle screw for degenerative spondylolisthesis. ⋯ PLIF using a titanium cage filled with excised facet joint bone and a pedicle screw provided a satisfactory clinical outcome and an excellent union rate without harvesting and grafting the autologous iliac bone.
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The authors report 4 cases of Charcot spine treated surgically. In the surgical treatment, combined anterior and posterior with extensive debridement, autogenous bone grafting, and posterior instrumentation is the main therapeutic modality. Some cases with mild bone destruction could be treated by posterior interbody fusion. For the unstable, symptomatic Charcot spine, surgical treatment can provide excellent results.
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J Spinal Disord Tech · Feb 2007
Thoracic pedicle screw insertion in scoliosis using posteroanterior C-arm rotation method.
Previous researches have emphasized the importance and difficulties in accurate thoracic pedicle screw insertion in scoliosis patients. However, there has been no report on accuracy of the insertion using posteroanterior C-arm fluoroscopy rotated to allow en face visualization of the pedicle in humans. This study aimed to evaluate the accuracy of the thoracic pedicle screw insertion technique using a C-arm fluoroscopy rotation method for the treatment of scoliosis. ⋯ Thoracic pedicle screw insertion in scoliosis patients using the posteroanterior C-arm rotation method allows en face visualization of both pedicles by rotating the C-arm to compensate for the rotational deformity, making it a practical, simple and safe method.
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J Spinal Disord Tech · Dec 2006
Comparative StudyBiomechanical comparison of a novel percutaneous transfacet device and a traditional posterior system for single level fusion.
Posterior spinal fusions are indicated for a variety of spinal disorders. Transfacet fixation minimizes soft tissue disruption and preserves the adjacent facet joint. This technique is uncommon due to concerns with biomechanical stability and proper implant placement. ⋯ Percutaneous transfacet fixation is an attractive surgical option for single-level spinal fusions. A biomechanical evaluation of a novel device for this application demonstrated similar stability to a pedicle screw system. The length adjustability of the device may alleviate concerns for precise device placement and the biomechanical stability may produce similar rates and quality of posterior spinal fusions.