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Sinan Yilar - One of the best experts on this subject based on the ideXlab platform.
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comparison of the accuracy of cannulated Pedicle Screw versus conventional Pedicle Screw in the treatment of adolescent idiopathic scoliosis a randomized retrospective study
Medicine, 2019Co-Authors: Sinan YilarAbstract:BACKGROUND Pedicle Screws are commonly used to treat adolescent idiopathic scoliosis (AIS). Many studies have discussed the rates and effects of Pedicle Screw misplacement. In this study, to increase the accuracy rate, cannulated Pedicle Screws were inserted into the periapical vertebrae, highly rotated vertebrae, and vertebrae with very thin Pedicles in a single patient group. We compared these results with those of a patient group who underwent conventional Pedicle Screw placement. METHODS Twenty-eight AIS patients treated surgically between 2015 and 2017 with cannulated Pedicle Screws or conventional Pedicle Screws were included. Group 1 (n = 15) received cannulated Pedicle Screws, whereas group 2 (n = 13) received conventional Pedicle Screws. Postoperative computed tomography scans were used to evaluate Pedicle Screw position. Pedicle perforation was assessed using the classification by Rao et al: grade 0, no perforation; grade 1, only the threads outside the Pedicle (less than 2 mm); grade 2, core Screw diameter outside the Pedicle (2-4 mm); and grade 3, Screw entirely outside the Pedicle. Medial Screw malposition was measured between the medial Pedicle wall and the medial margin of the Screw. Lateral Screw malposition was measured between the lateral corpus wall and lateral Screw margin. RESULTS Placement accuracy of 703 Screws (group 1, 376; group 2, 327) was evaluated. A total of 142 (20.1%) Pedicle Screw perforations occurred: 63 (17.1%) in group 1 and 79 (25%) in group 2 (P < .05). There was no statistically significant intergroup difference in medial perforation (group 1, 34 [9%] vs group 2, 31 [10%]). Lateral perforation was significantly less common in group 1 (n = 29; 7.7%) than in group 2 (n = 4; 14.7%) (P = .0002). CONCLUSIONS The use of cannulated Screws to treat AIS decreases perforation and complication rates. Although it did not significantly lower the medial perforation rate, it dramatically reduced the lateral perforation rate. The use of cannulated Screws enables intraoperative confirmation of placement accuracy. Our data suggest that cannulated Pedicle Screw use to treat AIS is safer and more efficient.
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Comparison of the accuracy of cannulated Pedicle Screw versus conventional Pedicle Screw in the treatment of adolescent idiopathic scoliosis: A randomized retrospective study.
Medicine, 2019Co-Authors: Sinan YilarAbstract:BACKGROUND Pedicle Screws are commonly used to treat adolescent idiopathic scoliosis (AIS). Many studies have discussed the rates and effects of Pedicle Screw misplacement. In this study, to increase the accuracy rate, cannulated Pedicle Screws were inserted into the periapical vertebrae, highly rotated vertebrae, and vertebrae with very thin Pedicles in a single patient group. We compared these results with those of a patient group who underwent conventional Pedicle Screw placement. METHODS Twenty-eight AIS patients treated surgically between 2015 and 2017 with cannulated Pedicle Screws or conventional Pedicle Screws were included. Group 1 (n = 15) received cannulated Pedicle Screws, whereas group 2 (n = 13) received conventional Pedicle Screws. Postoperative computed tomography scans were used to evaluate Pedicle Screw position. Pedicle perforation was assessed using the classification by Rao et al: grade 0, no perforation; grade 1, only the threads outside the Pedicle (less than 2 mm); grade 2, core Screw diameter outside the Pedicle (2-4 mm); and grade 3, Screw entirely outside the Pedicle. Medial Screw malposition was measured between the medial Pedicle wall and the medial margin of the Screw. Lateral Screw malposition was measured between the lateral corpus wall and lateral Screw margin. RESULTS Placement accuracy of 703 Screws (group 1, 376; group 2, 327) was evaluated. A total of 142 (20.1%) Pedicle Screw perforations occurred: 63 (17.1%) in group 1 and 79 (25%) in group 2 (P
Kuniyoshi Abumi - One of the best experts on this subject based on the ideXlab platform.
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Cervical spondylotic myelopathy: posterior decompression and Pedicle Screw fixation
European Spine Journal, 2015Co-Authors: Kuniyoshi AbumiAbstract:Introduction Posterior decompression by laminoplasty and anterior decompression/fixation have been widely accepted, and they provide sufficient results for cervical spondylotic myelopathy. However, combined procedure of posterior decompression and reconstruction is favorable for some patients accompanying local kyphosis, segmental instability, previously operated conditions on the cervical spine, etc. Discussion Among posterior cervical instrumentations, Pedicle Screw fixation is a strong tool of stabilization of unstable segment and correction of deformities in sagittal and/or coronal planes for the patient with cervical spondylotic myelopathy. On the other hand, neurovascular complications including injury to the vertebral artery and nerve root cannot be completely eliminated. Even after surgeons became familiar with placement of cervical Pedicle Screws, Screw malposition rate by freehand technique is high for patients with severe spondylotic condition. Surgeons must especially be careful for inserting Pedicle Screw in the cervical spine associating marked degenerative changes by spondylosis, and must obtain preoperatively sufficient anatomical information of the Pedicle and surrounding structures. Conclusion Combined procedure of posterior reconstructive surgery using a Pedicle Screw fixation provides better clinical outcomes than laminoplasty alone for cervical spondylotic myelopathy accompanying local kyphosis or segmental instability. Further development of supporting tools for cervical Pedicle Screw insertion including aiming device, navigation system and neuromonitoring procedure are expected for safer Screw insertion.
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complications of Pedicle Screw fixation in reconstructive surgery of the cervical spine
Spine, 2000Co-Authors: Kuniyoshi Abumi, Yasuhiro Shono, Manabu Ito, Hiroshi Taneichi, Yoshihisa Kotani, Kiyoshi KanedaAbstract:Study Design. Retrospective evaluation of complications in 180 consecutive patients with cervical disorders who had been treated by using Pedicle Screw fixation systems.Objectives.To determine the risks associated with Pedicle Screw fixation in the cervical spine and to emphasize the importance of p
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Pedicle Screw fixation for nontraumatic lesions of the cervical spine
Spine, 1997Co-Authors: Kuniyoshi Abumi, Kiyoshi KanedaAbstract:Study design This retrospective study was conducted to analyze the clinical results in 45 patients with nontraumatic lesions of the cervical spine treated by Pedicle Screw fixation. Objectives To evaluate the effectiveness of Pedicle Screw fixation in reconstructive surgery for nontraumatic cervical spinal disorders. Summary of background data Pedicle Screw fixation for hangman's fracture of the axis and traumatic lesions of the middle and lower cervical spine has been reported; however, there have been no reports on Pedicle Screw fixation for nontraumatic lesions of the cervical spine. Methods Forty-five patients with nontraumatic lesions of the cervical spine underwent reconstructive surgery including Pedicle Screw fixation and fusion. Five patients underwent occipitocervical fixation for the lesion of the upper cervical spine, and one patient underwent separate occipitocervical fixation and cervicothoracic fixation. Cervical or cervicothoracic fixation was performed in 39 patients. Twenty-six of these patients underwent simultaneous laminectomy or laminoplasty. Supplemental anterior surgery was conducted for 15 patients. Results Solid fusion was obtained in all patients except eight with metastatic vertebral tumors who did not receive bone graft. Correction of kyphosis was adequate. There were no neurovascular complications, except one case of transient radiculopathy caused by Screw threads. Conclusions Pedicle Screw fixation is a useful procedure for posterior reconstruction of the cervical spine. This procedure does not require the lamina for stabilization, and should be especially valuable for simultaneous posterior decompression and fusion. The risk to neurovascular structures, however, cannot be completely eliminated.
Robert W. Gaines - One of the best experts on this subject based on the ideXlab platform.
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the use of Pedicle Screw internal fixation for the operative treatment of spinal disorders
Journal of Bone and Joint Surgery American Volume, 2000Co-Authors: Robert W. GainesAbstract:Pedicle Screws have dramatically improved the outcomes of spinal reconstruction requiring spinal fusion. Short-segment surgical treatments based on the use of Pedicle Screws for the treatment of neoplastic, developmental, congenital, traumatic, and degenerative conditions have been proved to be practical, safe, and effective. The Funnel Technique provides a straightforward, direct, and inexpensive way to very safely apply Pedicle Screws in the cervical, thoracic, or lumbar spine. Carefully applied Pedicle-Screw fixation does not produce severe or frequent complications. Pedicle-Screw fixation can be effectively and safely used wherever a vertebral Pedicle can accommodate a Pedicle Screw - that is, in the cervical, thoracic, or lumbar spine. Training in Pedicle-Screw application should be standard in orthopaedic training programs since Pedicle-Screw fixation represents the so-called gold standard of spinal internal fixation. Pedicle Screws have revolutionized the surgical treatment of spinal disorders, although their introduction and widespread adoption by spinal surgeons has created one of the most difficult regulatory problems ever seen in orthopaedics. Hadra65 first used silver-wire internal fixation for the treatment of a cervical fracture-dislocation and tuberculous spondylitis in 1891. Later, King84 introduced facet Screws for the treatment of degenerative lumbar conditions. Although Boucher17 has been widely credited with the first use of Pedicle Screws in North America, his report suggests that his innovation was a longer facet Screw that occasionally obtained oblique purchase across the Pedicle. His Screws were not aimed down the long axis of the Pedicle. Thus, it seems that Harrington and Tullos68 deserve credit for the first deliberate attempt to put Pedicle Screws through the isthmus of the Pedicle. Their report, published in 1969, described the attempted reduction of two cases of high-grade spondylolisthesis. Pioneering the use of Pedicle-Screw internal fixation proceeded in France and Switzerland during the 1970s. Clinical success with the Screws was …
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The use of Pedicle-Screw internal fixation for the operative treatment of spinal disorders.
The Journal of bone and joint surgery. American volume, 2000Co-Authors: Robert W. GainesAbstract:Pedicle Screws have dramatically improved the outcomes of spinal reconstruction requiring spinal fusion. Short-segment surgical treatments based on the use of Pedicle Screws for the treatment of neoplastic, developmental, congenital, traumatic, and degenerative conditions have been proved to be practical, safe, and effective. The Funnel Technique provides a straightforward, direct, and inexpensive way to very safely apply Pedicle Screws in the cervical, thoracic, or lumbar spine. Carefully applied Pedicle-Screw fixation does not produce severe or frequent complications. Pedicle-Screw fixation can be effectively and safely used wherever a vertebral Pedicle can accommodate a Pedicle Screw--that is, in the cervical, thoracic, or lumbar spine. Training in Pedicle-Screw application should be standard in orthopaedic training programs since Pedicle-Screw fixation represents the so-called gold standard of spinal internal fixation.
Kiyoshi Kaneda - One of the best experts on this subject based on the ideXlab platform.
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complications of Pedicle Screw fixation in reconstructive surgery of the cervical spine
Spine, 2000Co-Authors: Kuniyoshi Abumi, Yasuhiro Shono, Manabu Ito, Hiroshi Taneichi, Yoshihisa Kotani, Kiyoshi KanedaAbstract:Study Design. Retrospective evaluation of complications in 180 consecutive patients with cervical disorders who had been treated by using Pedicle Screw fixation systems.Objectives.To determine the risks associated with Pedicle Screw fixation in the cervical spine and to emphasize the importance of p
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Pedicle Screw fixation for nontraumatic lesions of the cervical spine
Spine, 1997Co-Authors: Kuniyoshi Abumi, Kiyoshi KanedaAbstract:Study design This retrospective study was conducted to analyze the clinical results in 45 patients with nontraumatic lesions of the cervical spine treated by Pedicle Screw fixation. Objectives To evaluate the effectiveness of Pedicle Screw fixation in reconstructive surgery for nontraumatic cervical spinal disorders. Summary of background data Pedicle Screw fixation for hangman's fracture of the axis and traumatic lesions of the middle and lower cervical spine has been reported; however, there have been no reports on Pedicle Screw fixation for nontraumatic lesions of the cervical spine. Methods Forty-five patients with nontraumatic lesions of the cervical spine underwent reconstructive surgery including Pedicle Screw fixation and fusion. Five patients underwent occipitocervical fixation for the lesion of the upper cervical spine, and one patient underwent separate occipitocervical fixation and cervicothoracic fixation. Cervical or cervicothoracic fixation was performed in 39 patients. Twenty-six of these patients underwent simultaneous laminectomy or laminoplasty. Supplemental anterior surgery was conducted for 15 patients. Results Solid fusion was obtained in all patients except eight with metastatic vertebral tumors who did not receive bone graft. Correction of kyphosis was adequate. There were no neurovascular complications, except one case of transient radiculopathy caused by Screw threads. Conclusions Pedicle Screw fixation is a useful procedure for posterior reconstruction of the cervical spine. This procedure does not require the lamina for stabilization, and should be especially valuable for simultaneous posterior decompression and fusion. The risk to neurovascular structures, however, cannot be completely eliminated.
Lin Zhangxion - One of the best experts on this subject based on the ideXlab platform.
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Clinical Effect of Pedicle Screw versus Non-Pedicle Screw Treatment of Thoracolumbar Fractures in Injured Vertebra
Journal of Fujian Medical University, 2013Co-Authors: Lin ZhangxionAbstract:Objective To compare the clinical curative effect of Pedicle Screw reduction and fixation in or across the injured vertebra for the treatment of thoracolumbar fractures. Methods A retrospective study was performed on 84patients with thoracolumbar fractures admitted between October 2008 and October 2011. Of them,41patients were treated with Pedicle Screw fixation(Group A)and 43with short segment fixation across the injured vertebra(Group B). Measurements were made for the kyphosis(Cobb angle)and the height restoration of the injured vertebra. Results The mean follow-up period was 15.7months(range,12~36months). Group A made statistically significant and better improvements in post-op height correction of the injured vertebra,long-term height loss,Cobb angle change and loss,and failure of Pedicle Screw fixation than Group B(P0.05). Conclusion Pedicle Screw fixation for thoracolumbar fractures in the injured vertebra can help correct the kyphosis and restore the height of the injured vertebra. It can also help enhance the firmness of the internal fixation and maintain the reduction.