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Orthopaedic Proceedings
Vol. 94-B, Issue SUPP_XXVI | Pages 90 - 90
1 Jun 2012
Lakkol S Taranu R Raju P Trewhella M Dennis R Reddy G Friesem T
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Aim

The purpose of this study is to compare the pre and post-operative magnetic resonance image clarity of titanium and PEEK based cervical arthroplasty devices at the level of implantation and adjacent level discs.

Methodology and Results

This is a prospective, blinded, randomised study on imaging of cervical arthroplasty devices. The pre and postoperative MRI images of 16 patients who underwent cervical arthroplasty using Prestige LP(r) (Medtronic Sofamor Danek) and NuNec(tm) Cervical Arthroplasty System (Pioneer Surgical Technology, Marquette, Mich., USA) were assessed. Two independent radiologists who were blinded and provided with a sets of random images to score using a four point Jarvick grading system. Statistical analysis was completed using SPSS 16.0 statistical package (SPSS Inc, Chicago, IL) and analysis included comparing MR image quality before and after cervical arthroplasty at the operated and adjacent levels, and in between two types of implant.

The pre-operative MR image quality at operated and adjacent levels was excellent in both groups. In the post-operative images, the adjacent level visualisation was adequate in both groups without much difference in average scores. However, at operated level, the quality of MR images in the NuNec group (PEEK on PEEK articulating disc) was excellent and clear visualisation of the cord, central canal, foramen and disc.


Orthopaedic Proceedings
Vol. 88-B, Issue SUPP_III | Pages 401 - 401
1 Oct 2006
Ahmad M Trewhella M Bayliss N
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Aim: A study was done to investigate the range in size and morphological features of a series of human clavicles.

Method: A Phillips CT scanner was used to examine morphometric properties of 42 right and 36 left adult cadaveric clavicles. The resulting data was analysed with Voxar 3D software. The length of the s-shaped clavicle was measured and the planar cross-sectional geometry of the intramedullary canal and cortical thickness assessed at 10% increments along the length of the bone. MPR (multi-plane reformat) imaging allowed ‘fly-through’ reconstruction of cross-sectional morphology as one travels along the length of the bone.

Results: The sample studied followed a normal distribution with mean size= 136.2mm (range: 112.6– 172.0 mm). In general the sternal portion of the clavicle is circular or prismatic in cross-section where as the acromial portion is flatter on its superior and inferior surfaces. A spacious, variably shaped canal is observed at the sternal and acromial thirds in contrast to the denser, smaller, more circular shaped canal in the central third of the bone. Unlike most long bones, the clavicle was observed to have an extensive network of trabeculae along the entire length of the intramedullary canal. The central third of the clavicle has the thickest cortex. The mean cortical thickness (3.37mm; range: 1.8– 7.9mm) was greatest at a point 60% from the sternal end with the mean thinnest cortex (1.37 & 1.15mm) found at the extreme sternal and acromial ends of the bone respectively.

Conclusion: The clavicle is highly variable in shape and exhibits dramatic variations in both curvature and cross-sectional geometry along its length. Contrary to previous teaching, MPR reconstruction accurately demonstrates clear visualization of a distinct intra-medullary canal.