scholarly journals Multi‐modal Neuroelectrophysiological Monitoring in the Treatment of Thoracic Tuberculosis with Debridement and Bone Grafting and Posterior Pedicle Screw Fixation via Costal Transverse Process Approach

2021 ◽  
Author(s):  
Chen‐wei Zhang ◽  
Shi‐yuan Shi ◽  
Xiao Tao ◽  
Jin‐ping Hu ◽  
Tian‐yi Cao ◽  
...  
Keyword(s):  
Pedicle Screw ◽  
Bone Grafting ◽  
Screw Fixation ◽  
Transverse Process ◽  
Pedicle Screw Fixation ◽  
Process Approach ◽  
Thoracic Tuberculosis

scholarly journals Clinical Effect of a New Type of Transpedicular Reducer for Fracture Reduction via Pedicle and Bone Grafting Combined With Pedicle Screw Fixation for Thoracolumbar Burst Fractures

2021 ◽  
Author(s):  
menghan cai ◽  
Zhijun Xin ◽  
Weijun Kong ◽  
Qian Du ◽  
Wenjun Ji ◽  
...  
Keyword(s):  
Pedicle Screw ◽  
Vertebral Body ◽  
Bone Grafting ◽  
Clinical Effect ◽  
Screw Fixation ◽  
Pedicle Screw Fixation ◽  
Fracture Reduction ◽  
Thoracolumbar Burst Fractures ◽  
New Type ◽  
Vertebral Bodies

Abstract BackgroundShort-segment transpedicular screw fixation is a common method for the treatment of thoracolumbar burst fractures (TBFs). When it is used, the anterior middle columns of the fractured vertebral body lack good support, resulting in fractured vertebral bodies decreased height and difficult to reduct.Therefore,the purpose of this study was to evaluate the clinical effect of a new type of transpedicular reducer that we designed for fractured vertebral body reduction and bone grafting in the treatment of TBFs.MethodsA total of 9 patients with TBFs who agreed to be treated with the new transpedicular reducer for fracture reduction via pedicle and bone grafting combined with pedicle screw fixation were retrospectively analysed. We measured the anterior and middlel heights of the injured vertebrae, the ratios of the anterior and middlel heights of the injured vertebral body to the respective heights of the adjacent uninjured vertebral bodies (AVBHr and MVBHr, respectively), and the Cobb angle of patients at different stages before and after surgery, and evaluated the distribution of bone grafts and bone healing 3 days and 12 months after the operation.ResultsThe anterior height of the injured vertebrae before the operation; after application of the transpedicular reducer; and 3 days, 3 months, 6 months and 12 months after the operation were 17.56±3.74 mm; 27.70±2.53 mm; and 29.08±2.52 mm, 28.36±1.93 mm, 28.12±1.42 mm, and 27.96±0.72 mm, respectively. The mid-heights of the injured vertebrae were 21.36±4.20 mm; 26.74±1.00 mm; and 27.70±2.01 mm, 27.05±2.45 mm, 26.94±1.84 mm, and 26.83 ±2.45 mm, respectively. The Cobb angles of the injured vertebrae were 3.80±1.44°; 1.26±1.00°; and 0.72±0.70°, 1.03±0.65°, 1.12±0.63°, and 1.34±0.56°, respectively. The allogeneic bones were distributed in the anterior and middle columns 3 days after the operation, and the bone had healed well 12 months after the operation.ConclusionThe new transpedicular reducer has a good reduction, allogeneic bone support, and clinical treatment effect for TBFs through pedicle fracture reduction and bone grafting combined with pedicle screw fixation.

Thoracic transfacet pedicle screw fixation: a new instrumentation technique

2005 ◽  
Vol 3 (3) ◽  
pp. 224-229 ◽  
Author(s):  
Atilla Akbay ◽  
Serkan İnceoğlu ◽  
Ryan Milks ◽  
Richard Schlenk ◽  
Selcuk Palaoglu ◽  
...  
Keyword(s):  
Pedicle Screw ◽  
Screw Fixation ◽  
Pedicle Screws ◽  
Transverse Process ◽  
Pedicle Screw Fixation ◽  
Content Type ◽  
Thoracic Surgical Procedures ◽  
Flexion Extension ◽  
Fixation Techniques ◽  
Fine Print

Object. Pedicle screw instrumentation of the thoracic spine remains technically challenging. Transverse process and costotransverse screw fixation techniques have been described as alternatives to pedicle screw fixation (PSF). In this study, the authors introduce thoracic transfacet PSF and compare its experimental biomechanical results with those of standard PSF in short-term cyclic loading in cadaveric thoracic specimens. Methods. Specimens were tested intact for six cycles at compressive loads of 250 N offset by 1 cm along appropriate axes to induce flexion, extension, and left and right lateral bending. The specimens were then fixed with either a pedicle screw/rod construct or transfacet pedicle screws and retested in the same fashion. After this sequence, specimens were loaded until failure in flexion mode at a rate of 5 mm/minute was observed. Both fixation constructs provided significantly greater stiffnesses than that demonstrated when the specimen was intact (p < 0.05, two-way analysis of variance). Additionally, the two constructs were statistically equivalent in terms of stiffness and load-to-failure values (p < 0.05, two-tailed nonpaired t-test). The only difference observed was that the low midthoracic region (T7–9) was biomechanically weaker than the upper midthoracic and lower thoracic areas in flexion after the destabilization and instrumentation-augmented stabilization procedures. Conclusions. In selected thoracic surgical procedures, transfacet PSF may, after analysis of long-term biomechanical data, potentially become a reasonable alternative to conventional PSF.

scholarly journals Clinical effect of a novel transpedicular reducer for reduction and bone grafting combined with pedicle screw fixation for thoracolumbar burst fractures

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Menghan Cai ◽  
Zhijun Xin ◽  
Weijun Kong ◽  
Qian Du ◽  
Wenjun Ji ◽  
...  
Keyword(s):  
Pedicle Screw ◽  
Vertebral Body ◽  
Bone Grafting ◽  
Screw Fixation ◽  
Pedicle Screw Fixation ◽  
Control Group ◽  
Observation Group ◽  
Thoracolumbar Burst Fractures ◽  
Transpedicular Screw ◽  
Transpedicular Screw Fixation

Abstract Background Short-segment transpedicular screw fixation is a common method for the treatment of thoracolumbar burst fractures (TBFs),but this technique has many problems. Therefore,the purpose of this article is to observe and evaluate the clinical efficacy of a novel transpedicular reducer that we designed for fractured vertebral body reduction and bone grafting in the treatment of TBFs. Methods From July 2018 to November 2020, 70 cases of TBFs were included. Thirty-five patients were treated with the novel transpedicular reducer for reduction and bone grafting combined with pedicle screw fixation (observation group), and 35 patients were treated with short-segment transpedicular screw fixation (control group). Before the operation, after reduction, and 3 days, 3 months,and 12 months after the operation, the two groups were assessed, and compared with respect to the anterior and middle heights of the injured vertebrae, the ratios of the anterior and middle heights of the injured vertebral body to the respective heights of the adjacent uninjured vertebral bodies (AVBHr and MVBHr, respectively), and the Cobb angle of the patients. We compared the pain VAS score and quality of life GQOL-74 score at the last follow-up. Finally,we evaluated the distribution of bone grafts and bone healing 12 months after the operation. Results The anterior height, middle height, AVBHr, MVBHr, and Cobb angle of the injured vertebral body in the observation after reduction, and 3 days, 3 months and 12 months post-operatively were compared with those of the injured vertebral body before operation. All of these parameters were improved, and the difference was statistically significant (p < 0.05). These parameters in the observation group at the above time points were significantly better than thoes in the control group at the corresponding time points (p < 0.05). The VAS scores at the last follow-up were significantly better than those of the control group (p < 0.05), but the GQOL-74 score differences were not statistically significant (p > 0.05). The observation group showed no obvious defects on CT at 12 months after the operation, and the bone healing was good. Conclusion The novel transpedicular reducer for reduction and bone grafting combined with pedicle screw fixation for TBFs has good clinical efficacy.

scholarly journals Extreme lateral interbody fusion and percutaneous pedicle screw fixation in the minimally invasive treatment of thoracic tuberculosis

2020 ◽  
Vol 48 (5) ◽  
pp. 030006052092599
Author(s):  
Liang Deng ◽  
Yuan-Wei Zhang ◽  
Liang-Yu Xiong ◽  
Su-Li Zhang ◽  
Wen-Yan Ni ◽  
...  
Keyword(s):  
Back Pain ◽  
Pedicle Screw ◽  
Interbody Fusion ◽  
Screw Fixation ◽  
Pedicle Screw Fixation ◽  
Percutaneous Pedicle Screw ◽  
Extreme Lateral Interbody Fusion ◽  
Percutaneous Pedicle Screw Fixation ◽  
Lateral Interbody ◽  
Thoracic Tuberculosis

Objective As a minimally invasive intervertebral fusion technique popularized in recent years, extreme lateral interbody fusion (XLIF) has various advantages. In this study, we describe the application and efficacy of XLIF for the treatment of thoracic tuberculosis (TB), as this may be an emerging treatment option for thoracic TB in the future. Methods We present the case of a 75-year-old man who had suffered from chest and back pain for 1 month. Imaging studies showed destruction of the T12 and L1 vertebral bodies and the T12–L1 intervertebral disc, accompanied by formation of a paravertebral abscess. After 2 weeks of standard anti-TB treatment, the patient underwent debridement of the lesions, XLIF, and percutaneous pedicle screw fixation. Results The patient’s chest and back pain were significantly alleviated after the operation. The patient recovered well, and as of the most recent follow-up had no obvious limitation in thoracolumbar spine function. Conclusions XLIF combined with percutaneous pedicle screw fixation for the treatment of thoracic TB can allow for TB lesion debridement, discectomy, and interbody fusion under direct visualization, and can effectively improve patient prognosis.

scholarly journals Outcome of pedicle screw fixation with transpedicular bone grafting in fracture of thoracolumbar vertebrae

2020 ◽  
Vol 6 (3) ◽  
pp. 587
Author(s):  
Harpreet Singh ◽  
Aliasgar J. Rampurwala ◽  
Tej S. Rudani ◽  
Malay P. Gandhi
Keyword(s):  
Pedicle Screw ◽  
Bone Grafting ◽  
Screw Fixation ◽  
Body Height ◽  
Pedicle Screw Fixation ◽  
Vertebral Body Height ◽  
Cobb’S Angle ◽  
The Mean ◽  
Transpedicular Bone Grafting

<p class="abstract"><strong>Background:</strong> Posterior short segment instrumentation for thoracolumbar fracture is known for high implant failure rate because of the lack of anterior support. Anterior body augmentation by transpedicular bone grafting has been developed as an alternative to overcome this failure. In this study, we have evaluated the outcome of the cases of the unstable thoracolumbar spine injuries managed surgically with pedicle screws and transpedicular bone grafting.</p><p class="abstract"><strong>Methods:</strong> 20 patients were included in this study and were followed up for up to 6 months postoperatively. We assessed the outcome of each patient with Frankel scale and visual analog score (VAS) post-operatively clinically and radio logically by measuring Cobb’s angle and anterior vertebral body height post-operatively on follow-up at 6 weeks, 12 weeks, and 24 weeks.<strong></strong></p><p class="abstract"><strong>Results:</strong> We found that males had higher incidence with most common mode of injury was fall from height. D12 was single most involved vertebrae. The average Cobb’s angle during preoperative stage was 12 degrees and 22.05 degrees at 6th week and this was maintained till 24th week. The mean difference of anterior vertebral body height between pre-operative and 24th post-operative week was 7.15 mm. The mean VAS pre-operatively was 9.8 which changed to 0.75 at 24 weeks follow up. These were statistically highly significant.</p><p class="abstract"><strong>Conclusions:</strong> Our study established that Pedicle screw fixation with transpedicular bone grafting has a satisfactory result and can restore vertebral height, increase the stability of the injured vertebrae and leads to a significant improvement in the patient’s quality of life.</p>

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