Database : MEDLINE
Search on : Pseudarthrosis [Words]
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[PMID]: 29508007
[Au] Autor:Tateen A; Bogert J; Koller H; Hempfing A
[Ad] Address:Zentrum für Wirbelsäulenchirurgie, Werner-Wicker-Klinik, Im Kreuzfeld 4, 34537, Bad Wildungen - Reinhardshausen, Deutschland. tateen@werner-wicker-klinik.de.
[Ti] Title:Komplikationen des lumbosakralen Übergangs bei Korrektur von Erwachsenendeformitäten : Indikation und Technik dorsaler und ventraler Revisionsoperationen. [Complications of the lumbosacral junction in adult deformity surgery : Indications and technique for posterior and anterior revision surgery].
[So] Source:Orthopade;, 2018 Mar 05.
[Is] ISSN:1433-0431
[Cp] Country of publication:Germany
[La] Language:ger
[Ab] Abstract:BACKGROUND: Surgical correction of ASD can be challenging. The indication for surgery is individual and after specification of the therapeutic goals, detailed planning of the surgery is essential to achieve a good postoperative result. COMPLICATIONS AND INDICATION: The reasons for the comparatively high complication rate are well investigated and are often located at the lumbosacral junction. In addition to negative general factors like osteoporosis, especially undercorrection of the sagittal profile and insufficient lumbo-pelvic stabilization are causative. The main indications for revision surgery are a loss of lordosis due to progressive degeneration of the unfused segment L5/S1 or implant loosening and pseudarthrosis of a failed lumbosacral fusion. TREATMENT: The goals of revision surgery are restoration of the spinal balance as well as stable fixation and fusion in consideration of the general condition of the patient. Besides osteotomies in a previously fused region, especially reinstrumentation of the lumbosacral region can be challenging, although ala-ilium and ilium screws give the greatest stability. Additional anterior intersomatic cages allow for a better fusion rate, and, moreover they provide better lordozation. Each PLIF, TLIF, and ALIF cage has its own specific advantages. This article summarizes the reasons for complications of the lumbosacral junction after ASD correction and describes surgical principles for revision surgery.
[Pt] Publication type:ENGLISH ABSTRACT; JOURNAL ARTICLE; REVIEW
[Em] Entry month:1803
[Cu] Class update date: 180306
[Lr] Last revision date:180306
[St] Status:Publisher
[do] DOI:10.1007/s00132-018-3534-7

  2 / 6060 MEDLINE  
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[PMID]: 29351095
[Au] Autor:Li J; Ajiboye RM; Orden MH; Sharma A; Drysch A; Pourtaheri S
[Ad] Address:Department of Orthopaedic Surgery, UCLA Medical Center, Los Angeles.
[Ti] Title:The Effect of Ketorolac on Thoracolumbar Posterolateral Fusion: A Systematic Review and Meta-Analysis.
[So] Source:Clin Spine Surg;31(2):65-72, 2018 Mar.
[Is] ISSN:2380-0194
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:STUDY DESIGN: Systematic review and meta-analysis. OBJECTIVE: The purpose of this study was to evaluate the effect of postoperative ketorolac administration (ie, dosage and duration of use) on pseudarthrosis following thoracolumbar posterolateral spinal fusions. SUMMARY OF BACKGROUND DATA: Ketorolac is a nonsteroidal anti-inflammatory drug often administered for pain control after spine surgery. The main concern with ketorolac is the risk of pseudarthrosis following fusion. MATERIALS AND METHODS: A systematic search of multiple medical reference databases was conducted for studies detailing postoperative ketorolac use in lumbar fusion and scoliosis surgery in adult and pediatric patients, respectively. Meta-analysis was performed using the random-effects model for heterogeneity as this study analyzes heterogenous patient populations undergoing variable approaches to fusion and variable numbers of levels with variable means of detection of pseudarthrosis. Outcome measure was pseudarthrosis. RESULTS: Overall, 6 studies totaling 1558 patients were reviewed. Pseudarthrosis was observed in 119 (7.6%) patients. Pseudarthrosis were observed in adults with ketorolac administered for >2 days [odds ratio (OR), 3.44, 95% confidence interval (95% CI), 1.87-6.36; P<0.001], adults with doses of ≥120 mg/d (OR, 2.93, 95% CI, 1.06-8.12; P=0.039), and adults with ketorolac administered for >2 days and at doses ≥120 mg/d (OR, 4.75, 95% CI, 2.34-9.62; P<0.001). Ketorolac use in smokers was associated with pseudarthrosis (OR, 8.71, 95% CI, 2.23-34.0; P=0.002). CONCLUSION: Ketorolac, when administered for >2 days and/or at a dose of ≥120 mg/d, is associated with pseudarthrosis in adults after posterolateral lumbar fusion. Ketorolac use in smokers is also associated with pseudarthrosis.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1801
[Cu] Class update date: 180302
[Lr] Last revision date:180302
[St] Status:In-Data-Review
[do] DOI:10.1097/BSD.0000000000000613

  3 / 6060 MEDLINE  
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[PMID]: 29189218
[Au] Autor:Miller J; Sasso R; Anderson P; Riew KD; McPhilamy A; Gianaris T
[Ad] Address:Indiana Spine Group, Carmel, IN.
[Ti] Title:Adjacent Level Degeneration: Bryan Total Disc Arthroplasty Versus Anterior Cervical Discectomy and Fusion.
[So] Source:Clin Spine Surg;31(2):E98-E101, 2018 Mar.
[Is] ISSN:2380-0194
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:STUDY DESIGN: Prospective randomized, 2-center, clinical trial. OBJECTIVE: To prospectively compare adjacent level degeneration between the Bryan Cervical Disc Prosthesis and anterior cervical discectomy and fusion (ACDF), and assess the reliability of our measurements utilizing a method not previously described. SUMMARY OF BACKGROUND DATA: ACDF is a reliable and proven procedure for the treatment of radiculopathy and/or myelopathy. Despite a successful track record several limitations including adjacent segment degeneration/disease, loss of viscoelastic disc properties, perioperative immobilization, graft site morbidity, pseudarthrosis, and plating complications have been identified. An original driving force and theoretical basis for total disc arthroplasty was prevention of adjacent level degeneration. MATERIALS AND METHODS: Seventy-nine patients were enrolled and followed prospectively at 2 centers in a multicenter, Food and Drug Administration Investigational Device Exemption trial for the Bryan Cervical Disc arthroplasty. Neutral lateral radiographs were obtained preoperatively and postoperatively, and at 1-, 2-, 4-, and out to 7-year follow-up after surgery. The cephalad, adjacent level above the blinded procedure level was analyzed for all patients and time points by measuring the anteroposterior distance and the vertical disc height. A ratio was created using disc height/anteroposterior distance. RESULTS: Seventy patients (Bryan Cervical Disc N=34 and ACDF N=36) met inclusion criteria. Both fusion and arthroplasty groups showed a significant (P=0.001) decrease in disc height over time, indicative of adjacent level degeneration. Overall change in disc height between groups was not significantly different. Using our measurement technique, the overall interreviewer reliability was good [intrareviewer correlation coefficients (95% confidence interval)=0.77 (0.55-0.85)] and intrareviewer reliability was excellent [0.93 (0.91-0.94) and 0.85 (0.81-0.87)]. CONCLUSIONS: Adjacent level degeneration occurs in a similar manner in both the ACDF and total disc arthroplasty group. Our measurement technique is reliable and to the best of our knowledge not previously reported in the literature.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1712
[Cu] Class update date: 180302
[Lr] Last revision date:180302
[St] Status:In-Data-Review
[do] DOI:10.1097/BSD.0000000000000598

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[PMID]: 29496626
[Au] Autor:Lee DH; Cho JH; Lee CS; Hwang CJ; Choi SH; Hong CG
[Ad] Address:Department of Orthopedic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
[Ti] Title:A novel anterior decompression technique (vertebral body sliding osteotomy) for ossification of posterior longitudinal ligament of the cervical spine.
[So] Source:Spine J;, 2018 Feb 26.
[Is] ISSN:1878-1632
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:BACKGROUND CONTEXT: Conventional anterior decompression surgery for cervical myelopathy, including anterior corpectomy and fusion, is technically demanding and known to be associated with a higher incidence of surgery-related complications, including cerebrospinal fluid (CSF) leakage, neurologic deterioration, and graft failure compared with posterior surgery. PURPOSE: We introduce a novel anterior decompression technique (vertebral body sliding osteotomy; VBSO) for cervical myelopathy caused by ossification of posterior longitudinal ligament (OPLL) and evaluate the efficacy and safety of this procedure. STUDY DESIGN: This is a case series for novel surgical technique. PATIENT SAMPLE: Fourteen patients (M:F=11:3, mean age 56.9±10) with cervical myelopathy caused by OPLL who underwent VBSO by a single surgeon were included. OUTCOME MEASURES: The surgical outcome was evaluated according to the Japanese Orthopaedic Association score for cervical myelopathy (C-JOA score), and the recovery rate of the C-JOA score. Patients were also evaluated radiographically with plain and dynamic cervical spine radiographs and pre- and postoperative CT images. METHODS: Fourteen patients were followed for more than 24 months and operation time, estimated blood loss (EBL), neurologic outcomes, and surgery-related complications were investigated. Radiological measurements were also performed to analyze following parameters: (1) canal occupying ratio and postoperative canal widening, (2) Pre- and postoperative sagittal alignment. RESULTS: The mean recovery rate of C-JOA score at the final follow-up was 68.65 ± 17.8%. There were no perioperative complications, including neurologic deterioration, vertebral artery injury, esophageal injury, graft dislodgement, and CSF leaks, after surgery except for pseudarthrosis in 1 case. An average spinal canal compromised ratio by OPLL decreased from 61.5 ± 8.1% preoperatively to 16.5 ± 11.2% postoperatively. An average postoperative canal widening was 5.15 ± 1.39 mm, and improvement of cervical alignment was observed in all patients with average recovery angle of 7.3 ± 6.1° postoperatively. CONCLUSIONS: The VBSO allows sufficient decompression of spinal cord and provides excellent neurologic outcomes. Because surgeons do not need to manipulate the OPLL mass directly, this technique could significantly decrease surgery-related complications. Furthermore, as it is based on the multi-level discectomy and fusion technique, it would be more helpful to restore a physiologic lordosis.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180302
[Lr] Last revision date:180302
[St] Status:Publisher

  5 / 6060 MEDLINE  
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[PMID]: 29241817
[Au] Autor:Pollon T; Sales de Gauzy J; Pham T; Thévenin Lemoine C; Accadbled F
[Ad] Address:Département de chirurgie orthopédique, traumatologique et plastique, CHU de Toulouse, place du Dr-Baylac, 31059 Toulouse, France. Electronic address: tristan.pollon@gmail.com.
[Ti] Title:Salvage of congenital pseudarthrosis of the tibia by the induced membrane technique followed by a motorised lengthening nail.
[So] Source:Orthop Traumatol Surg Res;104(1):147-153, 2018 Feb.
[Is] ISSN:1877-0568
[Cp] Country of publication:France
[La] Language:eng
[Ab] Abstract:An 18-year-old male with neurofibromatosis type I was treated for congenital pseudarthrosis of the tibia using the Masquelet induced-membrane technique with internal fixation by retrograde implantation of a transplantar intramedullary nail. Bone healing was obtained at the expense of malunion with external rotation and 5.5cm of lower limb shortening. A motorised intramedullary-lengthening nail (Fitbone , Wittenstein, Igersheim, Germany) was implanted. This treatment was successful in correcting the rotational malalignment and limb length discrepancy. The motorised nail Fitbone may be a valid option for treating complex cases of limb length discrepancy, including those combined with limb deformities.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1712
[Cu] Class update date: 180225
[Lr] Last revision date:180225
[St] Status:In-Data-Review

  6 / 6060 MEDLINE  
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[PMID]: 29476998
[Au] Autor:Wang Y; Wang X
[Ti] Title:A Improved Bone Graft Method For Upper Cervical Surgery with Posterior Approach: Technical Description and report of 52 cases.
[So] Source:World Neurosurg;, 2018 Feb 21.
[Is] ISSN:1878-8769
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:PURPOSE: To report a minimum 12 months follow-up results of our improved bone graft method For upper cervica surgery with posterior approach. METHODS: 52 consecutive patients which included odontoid nonunion in 33 patients, atlantoaxial instability in 11 patients and occipito-cervical deformity in 8 patients who underwent posterior C1-C2 transarticular screw /screw-rod internal fixation ( 41 cases )and occipitocervical fusion ( 11 cases ) with the improved bone graft technique. Each surgical procedure was performed by the same senior spine surgeon. We took lateral cervical standing roentgenograms before surgery, after surgery immediately and took craniocerebral computed tomography (CT) examination with reconstruction at 3, 6, 12, and 24 months, and annually thereafter. The postoperative follow-up time are about 12 month to 38 month. RESULTS: All cases showed satisfactory screw fixation by radiographic examination and there were no postoperative neurologic complications. 1 case had postoperative retropharyngeal infection after the transoral release and posterior reduction by pedicle screw instrumentation. All patients got solid fusions, and no pseudarthrosis occurred. All the cases had solid fusion at the 3-month follow-up. CONCLUSION: In conclusion, good bone graft bed, enough bone graft material, solid local fixation and effective bone graft method are a prerequisite for successful bone graft. By analysing the postoperative follow-up in the consecutive cases in this study, our new bone graft method which discribed a new bone graft structure is a reliable posterior fusion technique. It is worth to be concern and the further research is needed.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180224
[Lr] Last revision date:180224
[St] Status:Publisher

  7 / 6060 MEDLINE  
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[PMID]: 29476935
[Au] Autor:Goyal A; Kerezoudis P; Alvi MA; Goncalves S; Bydon M
[Ad] Address:Mayo Clinic Neuro-Informatics Laboratory, Mayo Clinic, Rochester, MN, USA; Department of Neurologic Surgery, Mayo Clinic, Rochester, MN, USA.
[Ti] Title:Outcomes following minimally invasive lateral transpsoas interbody fusion for degenerative low grade lumbar spondylolisthesis: A systematic review.
[So] Source:Clin Neurol Neurosurg;167:122-128, 2018 Feb 16.
[Is] ISSN:1872-6968
[Cp] Country of publication:Netherlands
[La] Language:eng
[Ab] Abstract:A variety of surgical approaches have been described to treat low grade lumbar degenerative spondylolisthesis (DS). Minimally invasive spinal fusion techniques were first introduced to minimize morbidities associated with invasive surgical treatments. Minimally invasive lateral transpsoas interbody fusion, also known as lateral lumbar interbody fusion (LLIF), is a relatively new method of lumbar arthrodesis that avoids various approach related complications compared to its posterior and anterior counterparts. A systematic and critical review of recent literature was conducted in accordance with PRISMA guidelines. The sources of the data were PubMed, MEDLINE, Embase, Cochrane and Scopus. Key search terms were "transpsoas", "interbody fusion", "LLIF", "XLIF" and "spondylolisthesis". Papers included in the review were original research articles in peer-reviewed journals. The articles were thoroughly examined and compared on the basis of study design, outcomes, and results. Only studies which met the eligibility criteria were included. Eight studies were included in the qualitative and quantitative analysis (three retrospective, four prospective, one randomized controlled trial). A total of 308 patients (227 females) (pooled age 64.5 years) and a total of 353 operated levels were analyzed. Mean follow up time ranged from 6.2 to 24 months. There were no reported cases of durotomies or pseudarthrosis in any study. All neurologic complications were reported to be transient with no permanent deficits. Mean improvement in ODI scores ranged between 19.5 (38.6%) to 36 (54.5%). Mean improvement in slip ranged from 47 to 67.5%. Three studies also reported that patient satisfaction and willingness to undergo the procedure again approached 90%. Minimally invasive transpsoas interbody fusion possibly leads to favorable clinical and radiological outcomes while avoiding the possible complications of its more traditional open and minimally invasive counterparts. Further studies are needed to better establish its role in the management of low grade degenerative lumbar spondylolisthesis.
[Pt] Publication type:JOURNAL ARTICLE; REVIEW
[Em] Entry month:1802
[Cu] Class update date: 180224
[Lr] Last revision date:180224
[St] Status:Publisher

  8 / 6060 MEDLINE  
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[PMID]: 29452282
[Au] Autor:Ledet EH; Sanders GP; DiRisio DJ; Glennon JC
[Ad] Address:ReVivo Medical, 33 Old Niskayuna Road, Loudonville, NY 12211; Rensselaer Polytechnic Institute, Department of Biomedical Engineering, 110 8(th) Street, Troy, NY 12180; Stratton VA Medical Center, R&D Service, 113 Holland Avenue, Albany, NY, 12208. Electronic address: eledet@revivomedical.com.
[Ti] Title:Load-sharing through elastic micro-motion accelerates bone formation and interbody fusion.
[So] Source:Spine J;, 2018 Feb 13.
[Is] ISSN:1878-1632
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:BACKGROUND: Context: Achieving a successful spinal fusion requires the proper biologic and biomechanical environment. Optimizing load-sharing in the interbody space can enhance bone formation. For anterior cervical discectomy and fusion (ACDF), loading and motion are largely dictated by the stiffness of the plate which can facilitate a balance between stability and load-sharing. The advantages of load-sharing may be substantial for patients with comorbidities and in multi-level procedures where pseudarthrosis rates are significant. PURPOSE: To evaluate the efficacy of a novel elastically deformable, continuously load-sharing anterior cervical spinal plate for promotion of bone formation and interbody fusion relative to a translationally dynamic plate. STUDY DESIGN/SETTING: An in vivo animal model was used to evaluate the effects of an elastically deformable spinal plate on bone formation and spine fusion. METHODS: Fourteen goats underwent an ACDF and received either a translationally dynamic or elastically deformable plate. Animals were followed out to 18 weeks and were evaluated by plain x-ray, CT scan, and undecalcified histology to evaluate the rate and quality of bone formation and interbody fusion. RESULTS: Animals treated with the elastically deformable plate demonstrated statistically significantly superior early bone formation relative to the translationally dynamic plate. Trends in the data from 8 to 18 weeks post-operatively suggest that the elastically deformable implant enhanced bony bridging and fusion, but these enhancements were not statistically significant. CONCLUSIONS: Load-sharing through elastic micro-motion accelerates bone formation in the challenging goat ACDF model. The elastically deformable implant used in this study may promote early bony bridging and increased rates of fusion but future studies will be necessary to comprehensively characterize the advantages of load-sharing through micromotion.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180216
[Lr] Last revision date:180216
[St] Status:Publisher

  9 / 6060 MEDLINE  
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[PMID]: 29448993
[Au] Autor:Farah K; Graillon T; Dufour H; Fuentes S
[Ad] Address:Department of neurosurgery, Aix-Marseille university, Timone hospital, 264, rue Saint-Pierre, 13385 Marseille, France. Electronic address: kaissar.farah@ap-hm.fr.
[Ti] Title:Adjacent level spondylodiscitis in a patient with thoracic spondylodiscitis: A case report and review of the literature.
[So] Source:Neurochirurgie;, 2018 Feb 12.
[Is] ISSN:1773-0619
[Cp] Country of publication:France
[La] Language:eng
[Ab] Abstract:INTRODUCTION: Adjacent level spondylodiscitis (ALS) after primary surgery for thoracic spondylodiscitis is a very rare condition. CASE REPORT: We report the case of a 76-year-old man with this pathology. A first posterior minimally invasive approach combined with anterior approach to the thoracic spine was safely performed for thoracic spondylodiscitis. More than a year later, exploration of recurrent symptoms with FDG PET scan helped to diagnose ALS. Further surgery was performed. At 3-year follow-up examination showed no recurrence of the infection. DISCUSSION: ALS should be suspected during recurrent symptoms after spinal fusion surgery. Evaluation should be based on the results of FDG PET scan and surgery. CONCLUSION: Bacterial and histopathological analyses combined with an increase of spine fixation and adapted antimicrobial therapy are a safe management for ALS.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180216
[Lr] Last revision date:180216
[St] Status:Publisher

  10 / 6060 MEDLINE  
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[PMID]: 29410461
[Au] Autor:Carlier A; Vasilevich A; Marechal M; de Boer J; Geris L
[Ad] Address:Biomechanics Section, KU Leuven, Celestijnenlaan 300C, PB 2419, 3000 Leuven, Belgium and Biomechanics Research Unit, University of Liège, Chemin des Chevreuils 1 - BAT 52/3, 4000, Liège 1, Belgium.
[Ti] Title:In silico clinical trials for pediatric orphan diseases.
[So] Source:Sci Rep;8(1):2465, 2018 Feb 06.
[Is] ISSN:2045-2322
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:To date poor treatment options are available for patients with congenital pseudarthrosis of the tibia (CPT), a pediatric orphan disease. In this study we have performed an in silico clinical trial on 200 virtual subjects, generated from a previously established model of murine bone regeneration, to tackle the challenges associated with the small, pediatric patient population. Each virtual subject was simulated to receive no treatment and bone morphogenetic protein (BMP) treatment. We have shown that the degree of severity of CPT is significantly reduced with BMP treatment, although the effect is highly subject-specific. Using machine learning techniques we were also able to stratify the virtual subject population in adverse responders, non-responders, responders and asymptomatic. In summary, this study shows the potential of in silico medicine technologies as well as their implications for other orphan diseases.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180216
[Lr] Last revision date:180216
[St] Status:In-Data-Review
[do] DOI:10.1038/s41598-018-20737-y


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