4A-6 Ultrasound Guided Placement of Pedicle Screws in Spinal Fusion Surgery

Author(s):  
M. Mujagic ◽  
H.J. Ginsberg ◽  
R.S.C. Cobbold
PeerJ ◽  
2019 ◽  
Vol 7 ◽  
pp. e7967 ◽  
Author(s):  
Ke Chen ◽  
Lizhen Wang ◽  
Meng Ning ◽  
Lianjie Dou ◽  
Wei Li ◽  
...  

Objective Ultrasound-guided lateral thoracolumbar interfascial plane block (US-TLIP block) is a novel regional technique for anesthesia or analgesia. However, there has been no prospective, randomized and controlled clinical trial investigating the perioperative analgesic effect of US-TLIP block on lumbar spinal fusion surgery. The aim of this study was to investigate the analgesic effect of bilateral single-shot US-TLIP in patients undergoing lumbar spinal fusion surgery. Methods A prospective and randomized comparative clinical study was conducted. A total of 60 patients (ASA classes: I–II), aged 21–74 years who were scheduled for lumbar spinal fusion surgery were randomized and divided into the TLIP group (Group T, n = 30) and control group (Group C, n = 30). The patients in Group T received preoperative bilateral single-shot US-TLIP with 30 ml of 0.375% ropivacaine at the third lumbar spine (L3) vertebral level, and the patients in Group C received an injection of 30 ml 0.9% saline through same technique. All patients received patient-controlled analgesia (PCA) after their operation. The frequency of PCA compressions and rescue analgesic administrations were recorded. Opioids (sufentanil and remifentanil), anesthetic consumption, the number of postoperative days spent in a hospital bed, overall hospital stay time and postoperative complications were recorded. The Visual Analogue Scale (VAS) and Bruggemann Comfort Scale (BCS) scores for pain and comfort assessment were recorded at 1, 12, 24, 36, and 48 hours postoperatively. Results Opioids and anesthetic consumption in the perioperative period decreased significantly in the TLIP group compared to the control group (P < 0.05). The VAS and BCS scores in the TLIP group were lower at 12, 24, and 36 hours postoperatively (P < 0.05). US-TLIP block has been shown to shorten postoperative hospital stays (P < 0.05). There was no significant difference in postoperative complications between the two groups. Conclusion Our study findings show that bilateral US-TLIP block exhibits significant analgesia and safety in patients undergoing lumbar spinal fusion surgery.


2020 ◽  
Vol 10 (14) ◽  
pp. 4746 ◽  
Author(s):  
Jiwoon Kwon ◽  
Myung Heon Ha ◽  
Moon Gu Lee

With the recent increase in the elderly population, many people suffer from spinal diseases, and, accordingly, spinal fusion surgery using pedicle screws has been widely applied to treat them. However, most research on pedicle screw design has been focused on the test results rather than the behavior of the screws and vertebrae. In this study, a design platform with a series of biomechanical tests and analyses were presented for pedicle screw improvement and evaluation. The platform was then applied to an alternative hybrid screw design with quadruple and double threads. An experimental apparatus was developed to investigate the bending strength of the screw, and several tests were performed based on the ASTM F1717 standard. In the experiments, it was confirmed that the alternative pedicle screw has the highest bending strength. To examine the stress distribution of pedicle screws, finite element models were established, through which it was found that the proposed pedicle screw has sufficient mechanical safety to make it acceptable for spinal fusion treatment. Finally, we conclude that the platform has good potential for the design and evaluation of pedicle screws, and the alternative dual screw design is one of the best options for spinal fusion surgery.


2006 ◽  
Vol 11 (2) ◽  
pp. 217-220 ◽  
Author(s):  
Yoshimasa Takahashi ◽  
Ken’ichiro Narusawa ◽  
Kenji Shimizu ◽  
Masakazu Takata ◽  
Toshitaka Nakamura

2004 ◽  
Vol 350 (7) ◽  
pp. 722-726 ◽  
Author(s):  
Richard A. Deyo ◽  
Alf Nachemson ◽  
Sohail K. Mirza

Spine ◽  
2015 ◽  
Vol 40 (19) ◽  
pp. 1527-1535 ◽  
Author(s):  
Daniel D. Bohl ◽  
Matthew L. Webb ◽  
Adam M. Lukasiewicz ◽  
Andre M. Samuel ◽  
Bryce A. Basques ◽  
...  

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