Clinical orthopaedics and related research
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Clin. Orthop. Relat. Res. · Mar 1998
Assessment of neuroforaminal decompression in degenerative spinal stenosis.
Surgical decompression of spinal stenosis is a balance between adequate removal of bone and soft tissue for an effective decompression of neural structures and a sufficient retention of bone to maintain mechanical stability of the spine. To develop an objective, reproducible technique for the assessment of neuroforaminal decompression in the adult lumbar spine, facet sparing laminectomies were performed from L1-S1 on the lumbar spines of 59 human cadavers. A series of semirigid probes in 0.5-mm increments were passed into each successive intervertebral foramen bilaterally, beginning at L2-L3. ⋯ There were no significant differences in interobserver or intraobserver measurements. There were no complications related to passage of the probes. This study provides a method for the intraoperative determination of the adequacy of neuroforaminal decompression.
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Clin. Orthop. Relat. Res. · Mar 1998
Norian SRS cement augmentation in hip fracture treatment. Laboratory and initial clinical results.
Bone quality, initial fracture displacement, severity of fracture comminution, accuracy of fracture reduction, and the placement of the internal fixation device are important factors that affect fixation stability. New high strength cements that are susceptible to remodeling and replacement for fracture fixation may lead to improved clinical outcome in the treatment of hip fractures. Norian SRS is an injectable, fast setting cement that cures in vivo to form an osteoconductive carbonated apatite of high compressive strength (55 MPa) with chemical and physical characteristics similar to the mineral phase of bone. ⋯ Use of this material potentially could improve fracture stability, retain anatomy during fracture healing and improve hip function, thus achieving better clinical outcomes. In vivo animal studies have shown the material's biocompatibility, and cadaveric studies have shown the biomechanical advantage of its use in hip fractures. Initial clinical experience (in 52 femoral neck fractures and 39 intertrochanteric fractures) showed the potential clinical use of this innovative cement in the treatment of hip fractures.