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Zoltán Papp, Miklós Marosfői, István Szikora, and Péter Banczerowski

vertebral body. 1 , 10 Vertebroplasty can be combined with posterior fixation. 3 , 4 , 9 , 11 The purpose of this retrospective study was to evaluate the safety and efficacy of simultaneous intraoperative transoral or transpedicular vertebroplasty and posterior occipitocervical fixation in cases of C-2 metastatic disease. Methods Within our hospital database, we searched for cases of C-2 metastatic tumor in the period from January 2009 to December 2012. We included only those patients with histologically confirmed metastatic disease but excluded those with

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Fubing Liu, Zhenzhou Feng, Tianze Liu, Qinming Fei, Chun Jiang, Yuanchao Li, Xiaoxing Jiang, and Jian Dong

L umbar spinal instrumentation is a commonly performed surgical procedure, which is indicated for a variety of lumbar pathologies such as degenerative disease, trauma, tumor, and deformities. The main reason for the application of internal instrumentation is that it plays an essential role in establishing a mechanically stable environment to promote the formation of a fusion mass. There are various posterior fixation techniques used to assist in spinal fusion, among which the bilateral pedicle screw (BPS) technique is deemed to be the “gold standard” of

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Hisanori Ikuma, Tomohiko Hirose, Shinichiro Takao, Masataka Ueda, Kazutaka Yamashita, Kazutoshi Otsuka, and Keisuke Kawasaki

T he treatment for spinal thoracolumbar fractures with ankylosing spinal disorder (ASD), such as ankylosing spondylitis (AS) and diffuse idiopathic skeletal hyperostosis (DISH), recommends posterior fixation as early as possible because of its instability. 1–5 Often associated with kyphosis of the spine, 2 , 6 , 7 the fracture site may be unintentionally displaced like a “fish mouth” due to the extension force when the patient is prone during surgery. Such poor reduction of the fracture site causes instability of the site and increases the possibility of

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Azad Sait, Nadipi Reddy Prabhav, Vijay Sekharappa, Reshma Rajan, N. Arunai Nambi Raj, and Kenny Samuel David

biomechanical stability achieved by short-segment posterior fixation including the fractured level (SSPI) to circumferential fixation. Methods Study Design: Experimental Comparative Study Specimen Collection and Preparation Institutional review board and ethics committee approvals were obtained. Ten spine specimens including the last two thoracic and first three lumbar vertebrae were harvested fresh from dairy calves of 4 to 6 months age. Specimens were obtained from a local slaughterhouse. Plain radiographs were obtained to rule out any gross pathology

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Eric M. Horn, Nicholas Theodore, Neil R. Crawford, Nicholas C. Bambakidis, and Volker K. H. Sonntag

S urgery of the cervicothoracic junction presents a biomechanical challenge due to the transition between the mobile cervical and immobile thoracic vertebrae. Another complicating feature of this transition is the disparate anatomy between the cervical and thoracic posterior elements. The differences in anatomy are the substrate for the different styles of internal fixation devices utilized for stabilization and/or fusion. In the subaxial cervical spine, the most common type of posterior fixation is the use of lateral mass screws coupled with top

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Ahmed S. Mohamed, Jung Yoo, Robert Hart, Brian T. Ragel, Jayme Hiratzka, D. Kojo Hamilton, Penelope D. Barnes, and Alexander C. Ching

infections has involved aggressive debridement of the infected area with structural reconstruction. 1 This technique is effective but can result in increased morbidity in this patient population. The reported mortality after surgical treatment is between 8% and 14%. 1 , 11 We present a case series of patients managed with posterior fixation and decompression, without formal debridement of the infected area. The rationale for this approach is that rigid stabilization across the infected involved vertebral body and disc space will allow better antibiotic penetration and

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Jonathan S. Hott, James J. Lynch, Robert H. Chamberlain, Volker K. H. Sonntag, and Neil R. Crawford

: Biomechanical comparison of C1-C2 posterior fixations. Cable, graft, and screw combinations. Spine 23 : 1946 – 1955 , 1998 Naderi S, Crawford NR, Song GS, Sonntag VK, Dickman CA: Biomechanical comparison of C1-C2 posterior fixations. Cable, graft, and screw combinations. Spine 23: 1946–1955, 1998 15. Paramore CG , Dickman CA , Sonntag VK : The anatomical suitability of the C1–2 complex for transarticular screw fixation. J Neurosurg 85 : 221 – 224 , 1996 Paramore CG, Dickman CA, Sonntag VK: The anatomical

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Kenzo Uchida, Hideaki Nakajima, Takafumi Yayama, Tsuyoshi Miyazaki, Takayuki Hirai, Shigeru Kobayashi, Kebing Chen, Alexander Rodriguez Guerrero, and Hisatoshi Baba

the ethics review committee of our university medical faculty, and a written informed consent for this study design was obtained from all patients. F ig . 2. Representative radiographs obtained at follow-up ( a–c , anteroposterior view; d–f , lateral view). a and d: Group A—posterior decompression, posterior fixation (PSs and PLF), and vertebroplasty. b and e: Group B—posterior decompression and posterior fixation (PSs and PLF). c and f: Group C—anterior decompression and reconstruction. Surgical Technique The surgery in Group A was performed

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Hiroshi Uei, Yasuaki Tokuhashi, Masashi Oshima, Masafumi Maseda, Masahiro Nakahashi, and Enshi Nakayama

radiographic parameters in each group. In group U, there was no significant change in thoracic kyphosis (p = 0.8) or thoracic kyphosis of the decompression site (p = 0.1) between the preoperative and postoperative parameters. In group O, there was no significant change in thoracic kyphosis (p = 0.3) or thoracic kyphosis of the decompression site (p = 0.8) between the preoperative and postoperative parameters. A beaked-type OPLL at the middle thoracic level in a 47-year-old woman is shown in Fig. 2 . The minimum OKA was 28°. Posterior fixation (T4–12) and posterior

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Alexander A. Theologis, Ehsan Tabaraee, Paul Toogood, Abbey Kennedy, Harjus Birk, R. Trigg McClellan, and Murat Pekmezci

wide “rectangular” footprint (D and E) . The construct showed no signs of hardware failure, loss of focal angulation, or cage subsidence at the 12-month postoperative visit (D and E) . TABLE 2. Intraoperative and hospital data for patients with single-level lumbar burst fractures who underwent anterior lumbar corpectomy via a mini-open, extreme lateral, transpsoas approach and short-segment posterior fixation * Variable Average (range) Intraoperative data  Incision length (cm) 6.4 (5–8)  Length of surgery (mins) 288