Spine
-
A case report about transoral osteosynthesis C1 as a function-preserving option in the treatment of bipartite atlas deformity. ⋯ We described a rare association of an anterior arch midline defect, posterior arch midline aplasia. The natural history of patients with bipartite atlas deformity suggests that these people have a potentially precarious existence. Transoral osteosynthesis of the anterior ring and the lateral masses of C1 is a new technique that allows maintenance of rotatory mobility in the C1-C2 joint and restoration of congruency in the atlanto-occipital and atlantoaxial joints.
-
An IACUC-approved study to create a scoliotic deformity representative of adolescent idiopathic scoliosis. ⋯ This study establishes a porcine scoliosis model. With placement of a unilateral ligamentous spinal tether combined with concave ribcage ligament tethering a three-dimensional (frontal, sagittal, and axial) spinal deformity can be obtained. The speed of the progressive deformity leaves significant remaining skeletal growth to assess growth modulating therapies for correction. This work forms the basis for a number of investigative efforts at developing new fusionless therapies for patients suffering from adolescent scoliosis.
-
The risk for transection of the medial branch nerve (MBN) after minimally invasive insertion of pedicle screws was evaluated in a human cadaver model. ⋯ Using a percutaneous technique for pedicle screw insertion significantly reduces the risk of injury to the MBN. We therefore recommend using this technique especially at the most cephalic levels to minimize the risk of denervating the multifidus muscle fascicles that originate from the adjacent mobile level.
-
Comparative Study
Comparison of selective anterior versus posterior screw instrumentation in Lenke5C adolescent idiopathic scoliosis.
Retrospective review of anterior and posterior fusions for treatment of Lenke5C adolescent idiopathic scoliosis (AIS). ⋯ Selective anterior and posterior screw instrumentation both achieved good surgical lumbar and subsequent spontaneous thoracic correction. There was no statistically significant difference between the 2 groups in lumbar correction or thoracic correction, but fusion levels were shorter in the anterior group. Patients with late thoracic curve decompensation had smaller thoracolumbar/lumbar-thoracic Cobb ratios and less preoperative flexibility than those who did not decompensate.
-
A prospective study. ⋯ The results suggest that the loss of cervical ROM is time-dependent and plateaus by 18 months after surgery, with no further decreases thereafter.