scholarly journals Technique and nuances of an S-2 alar iliac screw for lumbosacral fixation in patients with transitional and normal anatomy

2016 ◽  
Vol 41 (videosuppl1) ◽  
pp. 1 ◽  
Author(s):  
Junichi Ohya ◽  
Todd D. Vogel ◽  
Sanjay S. Dhall ◽  
Sigurd Berven ◽  
Praveen V. Mummaneni
Keyword(s):  
Screw Fixation ◽  
Insufficiency Fracture ◽  
The Other ◽  
Rigid Fixation ◽  
Normal Anatomy ◽  
Sacral Insufficiency Fracture ◽  
Pelvic Fixation ◽  
Low Profile ◽  
Iliac Screw ◽  
Lumbosacral Fixation

S-2 alar iliac (S2AI) screw fixation has recently been recognized as a useful technique for pelvic fixation. The authors demonstrate two cases where S2AI fixation was indicated: one case was a sacral insufficiency fracture following a long-segment fusion in a patient with a transitional S-1 vertebra; the other case involved pseudarthrosis following lumbosacral fixation. S2AI screws offer rigid fixation, low profile, and allow easy connection to the lumbosacral rod. The authors describe and demonstrate the surgical technique and nuances for the S2AI screw in a case with transitional S-1 anatomy and in a case with normal S-1 anatomy.The video can be found here: https://youtu.be/Sj21lk13_aw.

A biomechanical investigation of the sacroiliac joint in the setting of lumbosacral fusion: impact of pelvic fixation versus sacroiliac joint fixation

2019 ◽  
Vol 31 (4) ◽  
pp. 562-567 ◽  
Author(s):  
Harry Mushlin ◽  
Daina M. Brooks ◽  
Joshua Olexa ◽  
Bryan J. Ferrick ◽  
Stephen Carbine ◽  
...  
Keyword(s):  
Sacroiliac Joint ◽  
Screw Fixation ◽  
Intact Specimen ◽  
Lumbosacral Fusion ◽  
Pelvic Fixation ◽  
Biomechanical Investigation ◽  
Flexion Extension ◽  
Iliac Screw ◽  
Sacroiliac Fusion ◽  
Bending Modes

OBJECTIVEThe sacroiliac joint (SIJ) is a known source of low-back pain. Randomized clinical trials support sacroiliac fusion over conservative management for SIJ dysfunction. Clinical studies suggest that SIJ degeneration occurs in the setting of lumbosacral fusions. However, there are few biomechanical studies to provide a good understanding of the effect of lumbosacral fusion on the SIJ. In the present study, researchers performed a biomechanical investigation to discern the effect of pelvic versus SIJ fixation on the SIJ in lumbosacral fusion.METHODSSeven fresh-frozen human cadaveric specimens were used. There was one intact specimen and six operative constructs: 1) posterior pedicle screws and rods from T10 to S1 (PS); 2) PS + bilateral iliac screw fixation (BIS); 3) PS + unilateral iliac screw fixation (UIS); 4) PS + UIS + 3 contralateral unilateral SIJ screws (UIS + 3SIJ); 5) PS + 3 unilateral SIJ screws (3SIJ); and 6) PS + 6 bilateral SIJ screws (6SIJ). A custom-built 6 degrees-of-freedom apparatus was used to simulate three bending modes: flexion-extension (FE), lateral bending (LB), and axial rotation (AR). Range of motion (ROM) was recorded at L5–S1 and the SIJ.RESULTSAll six operative constructs had significantly reduced ROM at L5–S1 in all three bending modes compared to that of the intact specimen (p < 0.05). In the FE mode, the BIS construct had a significant reduction in L5–S1 ROM as compared to the other five constructs (p < 0.05). SIJ ROM was greatest in the FE mode compared to LB and AR. Although the FE mode did not show any statistically significant differences in SIJ ROM across the constructs, there were appreciable differences. The PS construct had the highest SIJ ROM. The BIS construct reduced bilateral SIJ ROM by 44% in comparison to the PS construct. The BIS and 6SIJ constructs showed reductions in SIJ ROM nearly equal to those of the PS construct. UIS and 3SIJ showed an appreciable reduction in unfused SIJ ROM compared to PS.CONCLUSIONSThis investigation demonstrated the effects of various fusion constructs using pelvic and sacroiliac fixation in lumbosacral fusion. This study adds biomechanical evidence of adjacent segment stress in the SIJ in fusion constructs extending to S1. Unilateral pelvic fixation, or SIJ fusion, led to an appreciable but nonsignificant reduction in the ROM of the unfused contralateral SIJ. Bilateral pelvic fixation showed the greatest significant reduction of movement at L5–S1 and was equivalent to bilateral sacroiliac fusion in reducing SIJ motion.

First Metatarsalphalangeal Joint Arthrodesis: Evaluation of Plate and Screw Fixation

2009 ◽  
Vol 30 (8) ◽  
pp. 752-757 ◽  
Author(s):  
Gordon L. Bennett ◽  
James Sabetta
Keyword(s):  
Screw Fixation ◽  
Ease Of Use ◽  
The Other ◽  
High Rate ◽  
Fusion System ◽  
Hardware Failure ◽  
Low Profile ◽  
Final Followup ◽  
Implant System ◽  
Very High

Background: First metatarsalphalangeal joint (MTPJ) arthrodesis is a commonly performed procedure for the treatment of a variety of conditions affecting the hallux. There are several different methods to accomplish the fusion. We utilized a method incorporating a ball and cup preparation of the joint, followed by stabilization of the arthrodesis site utilizing the Accutrak congruent first MTPJ fusion set. Materials and Methods: We prospectively evaluated two hundred consecutive patients who underwent first MTPJ arthrodeses utilizing the Accutrak congruent first MTPJ fusion set. Patients were evaluated preoperatively, postoperatively, and at a final followup, utilizing the AOFAS forefoot scoring system. Results: Two hundred consecutive patients underwent first MTPJ arthrodeses by the same surgeon. All but three feet (230/233) (98.7%) went on to solidly fuse. Three of the patients did not fuse solidly. One patient broke two of the screws, and the other two patients did not have hardware failure. All patients dramatically improved their AOFAS scores compared with pre-surgical values. There were three minor hardware problems in the group of patients who solidly fused their joint. Conclusion: We concluded that a solid first MTPJ fusion results in excellent function and pain relief. The Accutrak first MTPJ fusion system would appear to be an ideal implant system to accomplish a fusion because of its low profile, strength, and ease of use. Compared to other methods we have used, this procedure results in a very high rate of fusion, with minimal complications and excellent patient satisfaction.

Maximizing Heat Transfer Through Joint Fin Systems

2005 ◽  
Vol 128 (2) ◽  
pp. 203-206 ◽  
Author(s):  
A.-R. A. Khaled
Keyword(s):  
Heat Transfer ◽  
Thermal Conductivity ◽  
Thermal Performance ◽  
Critical Length ◽  
The Other ◽  
Rigid Fixation ◽  
Convection Coefficient ◽  
Heat Transfer Characteristics ◽  
Cold Side ◽  
Transfer Characteristics

Heat transfer through joint fins is modeled and analyzed analytically in this work. The terminology “joint fin systems” is used to refer to extending surfaces that are exposed to two different convective media from its both ends. It is found that heat transfer through joint fins is maximized at certain critical lengths of each portion (the receiver fin portion which faces the hot side and the sender fin portion that faces the cold side of the convective media). The critical length of each portion of joint fins is increased as the convection coefficient of the other fin portion increases. At a certain value of the thermal conductivity of the sender fin portion, the critical length for the receiver fin portion may be reduced while heat transfer is maximized. This value depends on the convection coefficient for both fin portions. Thermal performance of joint fins is increased as both thermal conductivity of the sender fin portion or its convection coefficient increases. This work shows that the design of machine components such as bolts, screws, and others can be improved to achieve favorable heat transfer characteristics in addition to its main functions such as rigid fixation properties.

scholarly journals Posterior thoracolumbar hemivertebra resection and short-segment fusion in congenital scoliosis: surgical outcomes and complications with more than 5-year follow-up

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Beixi Bao ◽  
Qingjun Su ◽  
Yong Hai ◽  
Peng Yin ◽  
Yaoshen Zhang ◽  
...  
Keyword(s):  
Pedicle Screw ◽  
Surgical Outcomes ◽  
Screw Fixation ◽  
Congenital Scoliosis ◽  
Pedicle Screw Fixation ◽  
Rigid Fixation ◽  
Short Segment ◽  
Hemivertebra Resection ◽  
Main Curve

Abstract Background Treatment of congenital hemivertebra is challenging and data on long-term follow-up (≥ 5 years) are lacking. This study evaluated the surgical outcomes of posterior thoracolumbar hemivertebra resection and short-segment fusion with pedicle screw fixation for treatment of congenital scoliosis with over 5-year follow-up. Methods This study evaluated 27 consecutive patients with congenital scoliosis who underwent posterior thoracolumbar hemivertebra resection and short-segment fusion from January 2007 to January 2015. Segmental scoliosis, total main scoliosis, compensatory cranial curve, compensatory caudal curve, trunk shift, shoulder balance, segmental kyphosis, and sagittal balance were measured on radiographs. Radiographic outcomes and all intraoperative and postoperative complications were recorded. Results The segmental main curve was 40.35° preoperatively, 11.94° postoperatively, and 13.24° at final follow-up, with an average correction of 65.9%. The total main curve was 43.39° preoperatively, 14.13° postoperatively, and 16.06° at final follow-up, with an average correction of 60.2%. The caudal and cranial compensatory curves were corrected from 15.78° and 13.21° to 3.57° and 6.83° postoperatively and 4.38° and 7.65° at final follow-up, with an average correction of 69.2% and 30.3%, respectively. The segmental kyphosis was corrected from 34.30° to 15.88° postoperatively and 15.12° at final follow-up, with an average correction of 61.9%. A significant correction (p < 0.001) in segmental scoliosis, total main curve, caudal compensatory curves and segmental kyphosis was observed from preoperative to the final follow-up. The correction in the compensatory cranial curve was significant between preoperative and postoperative and 2-year follow-up (p < 0.001), but a statistically significant difference was not observed between the preoperative and final follow-up (p > 0.001). There were two implant migrations, two postoperative curve progressions, five cases of proximal junctional kyphosis, and four cases of adding-on phenomena. Conclusion Posterior thoracolumbar hemivertebra resection after short-segment fusion with pedicle screw fixation in congenital scoliosis is a safe and effective method for treatment and can achieve rigid fixation and deformity correction.

SACRAL INSUFFICIENCY FRACTURE

Orthopedics ◽  
1991 ◽  
Vol 14 (7) ◽  
pp. 817-820
Author(s):  
K Kayes ◽  
M Coscia ◽  
E Braunstein
Keyword(s):  
Insufficiency Fracture ◽  
Sacral Insufficiency Fracture

Sacral Insufficiency Fracture on 68Ga-DOTATATE PET/CT

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Nuh Filizoglu ◽  
Onur Bugdayci ◽  
Salih Ozguven
Keyword(s):  
Insufficiency Fracture ◽  
Sacral Insufficiency Fracture ◽  
Pet Ct

scholarly journals Sequential Sacral Insufficiency Fracture After Unilateral Pubic Fractures - A Case Report -

2012 ◽  
Vol 19 (1) ◽  
pp. 47 ◽  
Author(s):  
Kyung-Soon Park ◽  
Dong-Hyun Lee ◽  
Indra Peni ◽  
Taek-Rim Yoon
Keyword(s):  
Case Report ◽  
Insufficiency Fracture ◽  
Sacral Insufficiency Fracture
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