Posterior lumbar interbody fusion (PLIF) is a common surgical procedure and widely used in the treatment of lumbar degenerative disc disorders. Traditionally, posterior lumbar interbody fusion is done by using the tra...Posterior lumbar interbody fusion (PLIF) is a common surgical procedure and widely used in the treatment of lumbar degenerative disc disorders. Traditionally, posterior lumbar interbody fusion is done by using the traditional pedicle screw (PS) which offers great advantages, but at the same time it has some disadvantages which include the risk of superior facet joint violation and muscle damage. Recently, an alternative method of screw insertion via cortical bone trajectory (CBT) has been invented which has less invasive process and can be placed without the drawbacks associated with the traditional pedicle screw. However, it has to remain an interest whether CBT will provide similar or greater clinical outcomes compared to PS in PLIF. So the main aim of this review is to compare the clinical outcomes of cortical bone trajectory and traditional pedicle screw fixation in posterior lumbar interbody fusion based on the articles published on this topic. Compared to the traditional pedicle screw fixation, PLIF with CBT has similar clinical outcome based on pain intensity, ODI status and JOA score, as well as similar fusion rate and radiological evaluated complication such as loosening of screw. In addition PLIF with CBT has advantages of less facet joint violation, less blood loss, less intraoperative muscle damage and perioperative pain. On the basis of this study, we can suggest that PLIF with CBT can be considered as a reasonable alternative to PS in PLIF.展开更多
Treatment of children with cervical spine disorders requiring fusion is a challenging endeavor for a variety of reasons. The size of the patients, the corresponding abnormal bony anatomy, the inherent ligamentous laxi...Treatment of children with cervical spine disorders requiring fusion is a challenging endeavor for a variety of reasons. The size of the patients, the corresponding abnormal bony anatomy, the inherent ligamentous laxity of children, and the relative rarity of the disorders all play a part in difficulty of treatment. The benefits of modern posterior cervical instrumentation in children, defined as rigid screw–rod systems, have been shown to be many including: improved arthrodesis rates, diminished times in halo-vest immobilization, and improved reduction of deformities. The anatomy of children and the corresponding pathology seen frequently is at the upper cervical spine and craniocervical junction given the relatively large head size of children and the horizontal facets at these regions predisposing them to instability or deformity. Posterior screw fixation, while challenging, allows for a rigid base to allow for fusion in these upper cervical areas which are predisposed to pseudarthrosis with non-rigid fixation. A thorough understanding of the anatomy of the cervical spine, the morphology of the cervical spine, and the available screw options is paramount for placing posterior cervical screws in children. The purpose of this review is to discuss both the anatomical and clinical descriptions re-lated to posterior screw placement in the cervical spine in children.展开更多
Objectives: To explore the treatment and related prognosis of elderly patients with Anderson II odontoid fracture with posterior pedicle screw fixation combined with iliac bone grafting. Methods: Retrospective analysi...Objectives: To explore the treatment and related prognosis of elderly patients with Anderson II odontoid fracture with posterior pedicle screw fixation combined with iliac bone grafting. Methods: Retrospective analysis of 17 cases of elderly patients with Anderson II odontoid fracture who underwent posterior pedicle screw fixation combined with iliac bone grafting from January 2013 to December 2016. 17 patients had a history of trauma before surgery, and they all have varying degrees of atlantoaxial instability or subluxation and varying degrees of neck occipital pain and limited mobility. Result: No spinal cord or vertebral artery injury occurred during surgery. Follow-up information is complete. The follow-up period was 6 to 48 months (mean 27.4 ± 12.4 months). Postoperative imaging review prompted a good reduction of cervical spine, stable sequence;no pedicle screw loosening, fracture, iliac bone graft at the location of the situation, odontoid fracture and bone healing at the good, the patient after cervical rotation are limited to varying degrees. Conclusion: Posterior pedicle screw fixation combined with iliac bone grafting in elderly patients with Anderson II odontoid fracture can achieve good stability, and the prognosis is good, but long-term cervical rotation function may be affected to varying degrees.展开更多
文摘Posterior lumbar interbody fusion (PLIF) is a common surgical procedure and widely used in the treatment of lumbar degenerative disc disorders. Traditionally, posterior lumbar interbody fusion is done by using the traditional pedicle screw (PS) which offers great advantages, but at the same time it has some disadvantages which include the risk of superior facet joint violation and muscle damage. Recently, an alternative method of screw insertion via cortical bone trajectory (CBT) has been invented which has less invasive process and can be placed without the drawbacks associated with the traditional pedicle screw. However, it has to remain an interest whether CBT will provide similar or greater clinical outcomes compared to PS in PLIF. So the main aim of this review is to compare the clinical outcomes of cortical bone trajectory and traditional pedicle screw fixation in posterior lumbar interbody fusion based on the articles published on this topic. Compared to the traditional pedicle screw fixation, PLIF with CBT has similar clinical outcome based on pain intensity, ODI status and JOA score, as well as similar fusion rate and radiological evaluated complication such as loosening of screw. In addition PLIF with CBT has advantages of less facet joint violation, less blood loss, less intraoperative muscle damage and perioperative pain. On the basis of this study, we can suggest that PLIF with CBT can be considered as a reasonable alternative to PS in PLIF.
文摘Treatment of children with cervical spine disorders requiring fusion is a challenging endeavor for a variety of reasons. The size of the patients, the corresponding abnormal bony anatomy, the inherent ligamentous laxity of children, and the relative rarity of the disorders all play a part in difficulty of treatment. The benefits of modern posterior cervical instrumentation in children, defined as rigid screw–rod systems, have been shown to be many including: improved arthrodesis rates, diminished times in halo-vest immobilization, and improved reduction of deformities. The anatomy of children and the corresponding pathology seen frequently is at the upper cervical spine and craniocervical junction given the relatively large head size of children and the horizontal facets at these regions predisposing them to instability or deformity. Posterior screw fixation, while challenging, allows for a rigid base to allow for fusion in these upper cervical areas which are predisposed to pseudarthrosis with non-rigid fixation. A thorough understanding of the anatomy of the cervical spine, the morphology of the cervical spine, and the available screw options is paramount for placing posterior cervical screws in children. The purpose of this review is to discuss both the anatomical and clinical descriptions re-lated to posterior screw placement in the cervical spine in children.
文摘Objectives: To explore the treatment and related prognosis of elderly patients with Anderson II odontoid fracture with posterior pedicle screw fixation combined with iliac bone grafting. Methods: Retrospective analysis of 17 cases of elderly patients with Anderson II odontoid fracture who underwent posterior pedicle screw fixation combined with iliac bone grafting from January 2013 to December 2016. 17 patients had a history of trauma before surgery, and they all have varying degrees of atlantoaxial instability or subluxation and varying degrees of neck occipital pain and limited mobility. Result: No spinal cord or vertebral artery injury occurred during surgery. Follow-up information is complete. The follow-up period was 6 to 48 months (mean 27.4 ± 12.4 months). Postoperative imaging review prompted a good reduction of cervical spine, stable sequence;no pedicle screw loosening, fracture, iliac bone graft at the location of the situation, odontoid fracture and bone healing at the good, the patient after cervical rotation are limited to varying degrees. Conclusion: Posterior pedicle screw fixation combined with iliac bone grafting in elderly patients with Anderson II odontoid fracture can achieve good stability, and the prognosis is good, but long-term cervical rotation function may be affected to varying degrees.
