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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Disadvantages of thoracic posterior implants and developments in rod contouring in situ led to the design of a new spinal implant: the bipedicular spinal fixation device (BSF). The BSF is composed of two bifid hooks linked by a compression transverse connector and inserted into the costo-vertebral and costo-transverse joints. The aim of this biomechanical study was to determine the loading tolerance of the BSF. ⋯ The mean BMD estimated by DEXA was 0.557 g/cm(2). The BSF loading tolerance was compatible with the in situ rod contouring technique requirements when we considered posterior and lateral pull-out tests. The transversal compression test determined the appropriate and efficient BSF tightening force.
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Insertion of pedicle screws in the thoracic spine is technically difficult and may lead to major complications. Although many computer-assisted systems have been developed to optimize pedicle screw insertion, these systems are expensive, not user-friendly and involve significant radiation from pre-operative computed tomographic (CT) scan imaging. This study describes and evaluates a transpedicular drill guide (TDG) designed to assist in the proper placement of pedicle screws in the thoracic spine. ⋯ No screw penetrated the superior or inferior pedicle wall. The TDG is easy to use and can decrease the incidence of misplaced thoracic pedicle screws. The TDG could be used as a complement to fluoroscopy in certain applications, especially for training surgeons.
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Pinealectomy frequently produces spinal deformity in some animal models, but the precise biological mechanism of this phenomenon remains obscure. The current study investigated the effects of an autograft pineal body on the development of spinal deformity and serum melatonin (MLT) concentration after pinealectomy in the chicken. Thirty-six chickens (2 days of age) were divided into three equal groups. ⋯ Interestingly, there were no significant differences in either serum MLT levels or development of scoliosis between groups B and C. From the results of the current study, it is evident that the intramuscular pineal gland transplantation following pinealectomy in young Hybro Broiler chickens has no significant effect on the development of spinal deformity and serum MLT level. In the light of this result, the role of MLT in the development of spinal deformity in chickens after pinealectomy remains controversial, and further investigations are warranted.
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Review Case Reports
Calcifying pseudo-tumor of the spine: description of a case and review of the literature.
A case of calcifying pseudo-tumor of the thoracic spine, a rare lesion with tumor-like behavior and a probable inflammatory-reactive origin, is described. The clinical-pathological and neuro-radiological aspects of this lesion are discussed in relation to surgical treatment. In accordance with the other cases reported in the literature, the case observed confirmed the benign behavior of the lesion and the effectiveness of surgical treatment for achieving complete resolution of clinical symptoms without any recurrences, even when removal is only subtotal.
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Bony metastases are a frequent problem in elderly patients affected by cancer, and those with bony metastases involve the spine in approx. 50%. The most frequent spinal metastases (60%) are from breast, lung, or prostate cancer. The chance that an elderly patient (60-79 years old) is affected by bony metastases is four times higher in men and three times higher in women than a middle-aged patient (40-59 years old). ⋯ Surgical management shows the greatest improvement in pain reduction, but also in other domains of quality of life. Since prospective randomized studies comparing different treatment modalities for spinal metastases including surgery are not available and are ethically difficult to achieve, each case remains an interdisciplinary, shared decision making process for what is considered best for a patient or elderly patient. However, whenever surgery is an option, it should be planned before irradiation since surgery after irradiation has a significant higher complication rate.