Journal of spinal disorders & techniques
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J Spinal Disord Tech · Jun 2009
Clinical TrialAnatomic determination of optimal entry point and direction for C1 lateral mass screw placement.
Anatomic study of C1 osteology using computerized tomography. ⋯ C1 lateral mass screws are best placed beneath the posterior arch, parallel with the arch in the sagittal plan. The entry point is the medial border of the neural arch at its junction with the lateral mass. Straight ahead screw direction is safe in the axial plane, but up to 20 degrees of medial angulation will increase the safety margin from the vertebral artery foramen, and this technique avoids vertebral artery damage and optimizes lateral mass screw purchase. We suggest that this is the preferred method of entry into the lateral mass of C1.
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J Spinal Disord Tech · Jun 2009
Clinical TrialFuzzy-logic-assisted surgical planning in adolescent idiopathic scoliosis.
Selection of appropriate curve fusion levels for surgery in adolescent idiopathic scoliosis (AIS) is a complex and difficult task and, despite numerous publications, still remains a highly controversial topic. ⋯ Given the same information, the fuzzy-logic-assisted recommendation of the curve to be instrumented compared favorably with the collective decision of the surgeons. The findings thus suggest that a fuzzy-logic approach is helpful in assisting surgeons with the preoperative selection of curve instrumentation and fusion levels in AIS.
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J Spinal Disord Tech · Jun 2009
Clinical TrialThe effect of surgical approaches on pulmonary function in adolescent idiopathic scoliosis.
Retrospective study. ⋯ Scoliosis approaches that violate the chest wall demonstrate a significant decline in postoperative pulmonary function. Documented return of pulmonary function did not occur until 3 months for posterior fusion with thoracoplasty, 3 months for open anterior fusion and 1 year for video-assisted thoracoscopic surgery.
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J Spinal Disord Tech · Jun 2009
Preventing distal pullout of posterior spine instrumentation in thoracic hyperkyphosis: a biomechanical analysis.
An in vitro biomechanical study. ⋯ Posterior dual rod constructs fixed distally using pedicle screws were stiffer and stronger in resisting forward flexion compared with cables or hooks alone. Augmenting these screws with either infralaminar hooks or sublaminar cables provided additional resistance to failure.
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J Spinal Disord Tech · Jun 2009
Anterior decompression and interbody fusion with BAK/C for cervical disc degenerative disorders.
A retrospective clinical study of 64 patients who underwent anterior cervical discectomy and fusion (ACDF) with BAK/C for disc degenerative disorders. ⋯ Although BAK/C technique was generally effective and safe in the treatment of cervical disc degenerative disorders, the pitfalls of cage design resulted in the disability of maintenance of cervical lordosis and intervertebral height in the long-term follow-up. Cage subsidence, which tended to develop in the patients with 2-level fusion, was possibly responsible for the recurrence of neck pain.