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Nitin Agarwal, Robert F. Heary and Prateek Agarwal

been found to result in lower complication rates and better 3D correction and enables shorter fusion lengths than the use of hooks. 4 , 7 , 8 , 28 , 59 For the past several decades, pedicle screws have been used in the lumbar spine and yield numerous clinical benefits. 7 , 8 , 11 , 18 , 20 , 27 , 28 , 33 , 43 , 47 , 59 , 66 Also, pedicle screw fixation has become a favorable alternative to hook and/or wire/cable fixation in the thoracic spine. 5 , 50 , 57 , 58 , 68 First proposed by Suk et al. 58 in 1995 for the treatment of adolescent idiopathic scoliosis

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Prithvi Narayan, Regis W. Haid, Brian R. Subach, Christopher H. Comey and Gerald E. Rodts

T he first use of pedicle screw fixation for lumbar arthrodesis is credited to Boucher 3 in 1959. This technique gained widespread acceptance in the 1980s because of the independent efforts of Roy-Camille and colleagues 14, 15 and Steffe, et al. 19 Assessment of prospective 26 and retrospective 7, 13, 17, 21, 25 data indicates that rates of successful arthrodesis are improved when segmental pedicle screw fixation is performed in conjunction with a transverse process fusion. Factors considered to have an adverse effect on osseous fusion include smoking

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Kuniyoshi Abumi, Kiyoshi Kaneda, Yasuhiro Shono and Masanori Fujiya

also in patients undergoing posterior reconstruction after previous laminectomy of the cervical spine. In pedicle screw fixation procedures in the cervical spine, direct screw fixation of C-2 pedicles in hangman's fracture has been performed by a few surgeons. 5 Roy-Camille, et al., 37 have described C2–3 posterior screw plate fixation by connecting C-2 pedicle screws and C-3 lateral mass screws in hangman's fracture. Abumi and colleagues 1 first reported the use of pedicle screw fixation to stabilize unstable traumatic lesions in the middle and lower cervical

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Daryl R. Fourney, Dima Abi-Said, Frederick F. Lang, Ian E. McCutcheon and Ziya L. Gokaslan

tumor-related spinal instability. Pedicle screw fixation offers several advantages over systems in which sublaminar wires or hooks are used. 36, 44 Pedicle fixation can be used at levels where a laminectomy or partial pedicle resection is required and provides rigid fixation over shorter segments, precluding the need to fuse vertebral levels. Despite the reported use of a variety of methods to stabilize the spine following tumor resection, 4, 24, 26, 40, 47, 52 few authors have selectively studied the use of pedicle screws in cancer-related spinal instability. 26

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Kemal Yücesoy, K. Zafer Yüksel, Seungwon Baek, Volker K. H. Sonntag and Neil R. Crawford

unstable thoracic and lumbar spine . J Neurosurg 82 : 11 – 16 , 1995 3 Boos N , Webb JK : Pedicle screw fixation in spinal disorders: a European view . Eur Spine J 6 : 2 – 18 , 1997 4 Brodke DS , Bachus KN , Mohr RA , Nguyen BK : Segmental pedicle screw fixation or cross-links in multilevel lumbar constructs. A biomechanical analysis . Spine J 1 : 373 – 379 , 2001 5 Chen HH , Cheung HH , Wang WK , Li A , Li KC : Biomechanical analysis of unilateral fixation with interbody cages . Spine 30 : E92 – E96 , 2005 6

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Yutong Gu, Feng Zhang, Xiaoxing Jiang, Lianshun Jia and Robert McGuire

PVP or PKP has not yet been found. Clinical studies have shown that combining PKP and pedicle screw osteosynthesis to treat thoracic and lumbar burst fractures could achieve maintenance of sagittal curve and vertebral height correction in the injured vertebrae. 14 , 32 , 51 In this report we introduce a technique of minimally invasive pedicle screw fixation combined with PVP for treatment of thoracolumbar osteoporotic VCFs. The feasibility and safety of this method for preventing the occurrence of new VCFs after PVP were evaluated. Methods Patient

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Yasutsugu Yukawa, Fumihiko Kato, Hisatake Yoshihara, Makoto Yanase and Keigo Ito

P edicle screw fixation has emerged as a safe and effective form of posterior spinal instrumentation for spinal arthrodesis in the lumbar spine. Abumi and colleagues 1 introduced the concept of PSF in cervical spine surgery and have applied PSs to the mid- and lower cervical spine since 1994. They have reported good clinical results and low rates of complications associated with cervical PSF in the treatment of cervical disorders. 1–3 Pedicle screw fixation, however, has been generally considered too risky to be applied to the cervical spine because it

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Marin F. Stančić, Vladimir Mićcović and Mark Potočnjak

satisfactory level. The greatest disadvantage of a laminectomy procedure is that it destabilizes the spine by exaggerating spinal deformity. 9 Failure of pedicle screw fixation techniques, even in cases in which a laminectomy has not been performed, has been observed. 10 These hardware failures are related primarily to excessive preload forces introduced at the time of surgery, as well as to excessive flexion loading. 1 We hypothesized that a hook—rod distraction system could be a suitable adjunct to pedicle screw fixation in load bearing. The proposed fixation system is

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Atilla Akbay, Serkan İnceoğlu, Ryan Milks, Richard Schlenk, Selcuk Palaoglu and Edward C. Benzel

increase dead space, which could be minimized using thoracic transfacet pedicle screws instead. Transfacet pedicle screw placement, which has been studied extensively in the lumbar spine, is an alternative to PSF. The authors of biomechanical studies have shown that lumbar FSF is biomechanically equivalent to PSF; 10, 22 however, the efficacy of FSF has not been previously defined in thoracic spine. In the present study, we demonstrated that transfacet pedicle screw fixation is biomechanically applicable in the thoracic region and that it might offer an alternative to

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Bruce M. Frankel, Sabino D'Agostino and Chiang Wang

. 5 , 7 , 9 , 11–14 , 16–18 Data from the latter several laboratory studies with cadaver spines 7 , 11 , 13 , 14 , 17 and sawbones 5 have demonstrated significantly increased axial pullout force and transverse bending stiffness in bone cement–augmented pedicle screw fixation. Here, we report on a comprehensive laboratory analysis of bone cement pedicle screw augmentation in osteoporotic cadaveric spines. Screw augmentation procedures were performed using a novel and effective technique for cement delivery: a fenestrated bone tap system. With this device, tap