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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A resorbable composite material (40% PLLA and 60% beta TCP) with a high breaking strength and capacity to withstand plastic and elastic strain has been developed for cervical interbody fusion. This is a prospective study to evaluate clinical and radiological results of 20 patients implanted with 27 cages (mean follow-up, 27 months). Clinical (neck disability index, VAS, neurological evaluation) and radiological (anteroposterior, lateral, bending X-rays) data were assessed before and after surgery. ⋯ This demonstrates a biological activity and changing bone mineral content of this tissue. The new composite cage under investigation provides long-term fusion without loss of correction or inflammatory reaction. The ceramic block guarantees the maintenance of the disc height and its slow resorption allows long-term fusion and stability with good and reliable clinical and radiological outcomes.
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Comparative Study
Biomechanical analysis of expansion screws and cortical screws used for ventral plate fixation on the cervical spine.
Compared to bicortical screws, the surgical risk of injuring intraspinal structures can be minimized with the use of monocortical screws. However, this reduction should not be achieved at the expense of the stability of the fixation. With monocortical stabilization, the expansion screws have the potential of absorbing high loads. ⋯ Both plates revealed similar primary stability. Revision surgeries with secondary instrumentation achieve a high stiffness of the screwed up segments. Monocortical expansion screws combined with a trapezoidal plate allow ventral stabilization of the cervical spine that is comparable to the plate fixation using bicortical screws.
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Previous studies have shown the safety and effectiveness of balloon kyphoplasty in the treatment of osteoporotic vertebral compression fractures (OVCFs). MRI and particularly the short tau inversion recovery (STIR) sequence are very sensitive for detecting vertebral edema as a result of fresh fractures or micro-fractures. Therefore, it has a great therapeutic relevance in differentiating vertebral deformities seen by conventional X-ray and CT scans. ⋯ This study confirms the diagnostic benefits of an MRI scan before performing a kyphoplasty. For 16 out of 28 patients, the therapeutic plan was changed because of the information obtained by preoperative MRI. Preoperative MRI helped to generate the correct surgical strategy, by demonstrating the correct location of injury and by detecting concomitant diseases.
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The design of the study includes case series, technical note and review of the literature. Autogenous bone graft (autograft) harvest from the iliac crest remains the gold standard substrate for spinal fusion. Persistent donor-site pain is the most common cause of morbidity after autograft harvest, occurring in one-third of patients. ⋯ Twelve patients underwent autograft harvest with iliac spine reconstruction using Calcium Phosphate Cement. 42% (5) had persistent donor-site pain (after 3 months). All pain scores were less than or equal to 2 out of 10 (mean 1.25). In conclusion, iliac spine reconstruction using Calcium Phosphate Cement following autogenous bone graft harvest is a relatively simple procedure which failed to decrease the incidence of donor-site morbidity in our patient population.