Aims. We compared decompression alone to decompression with
Aims. There is evidence that prior lumbar
Aims. We compared the clinical and radiological outcomes of using a
polyetheretherketone cage with (TiPEEK) and without a titanium coating
(PEEK) for instrumented transforaminal lumbar interbody
Transarticular screw fixation with autograft
is an established procedure for the surgical treatment of atlantoaxial instability.
Removal of the posterior arch of C1 may affect the rate of
Whether to combine spinal decompression with
fusion in patients with symptomatic lumbar spinal stenosis remains
controversial. We performed a cohort study to determine the effect
of the addition of
The purpose of this study was to determine whether
patients with a burst fracture of the thoracolumbar spine treated
by short segment pedicle screw fixation fared better clinically
and radiologically if the affected segment was fused at the same
time. A total of 50 patients were enrolled in a prospective study
and assigned to one of two groups. After the exclusion of three
patients, there were 23 patients in the
Background. Open or arthroscopic ankle
Recurrence of back or leg pain after discectomy
is a well-recognised problem with an incidence of up to 28%. Once conservative
measures have failed, several surgical options are available and
have been tried with varying degrees of success. In this study,
42 patients with recurrent symptoms after discectomy underwent less
invasive posterior lumbar interbody fusion (LI-PLIF). Clinical outcome
was measured using the Oswestry Disability Index (ODI), Short Form
36 (SF-36) questionnaires and visual analogue scales for back (VAS-BP)
and leg pain (VAS-LP). There was a statistically significant improvement
in all outcome measures (p <
0.001). The debate around which
procedure is the most effective for these patients remains controversial. Our results show that LI-PLIF is as effective as any other surgical
procedure. However, given that it is less invasive, we feel that
it should be considered as the preferred option.
Aims. Whether a combined anteroposterior
Aims. When a total ankle arthroplasty (TAA) fails, it can be converted to a
Aims. The aims of this study were first, to determine if adding
We carried out a prospective study to determine whether the addition of a recombinant human bone morphogenetic protein (rhBMP-2) to a machined allograft spacer would improve the rate of intervertebral body
We evaluated the efficacy of anterior
The primary objective is to compare revision rates for lumbar disc replacement (LDR) and
Introduction.
Aims. Historically, patients undergoing surgery for adolescent idiopathic scoliosis (AIS) have been nursed postoperatively in a critical care (CC) setting because of the challenges posed by prone positioning, extensive exposures, prolonged operating times, significant blood loss, major intraoperative fluid shifts, cardiopulmonary complications, and difficulty in postoperative pain management. The primary aim of this paper was to determine whether a scoring system, which uses Cobb angle, forced vital capacity (FVC), forced expiratory volume in one second (FEV1), and number of levels to be fused, is a valid method of predicting the need for postoperative critical care in AIS patients who are to undergo scoliosis correction with posterior spinal fusion (PSF). Methods. We retrospectively reviewed all AIS patients who had undergone PSF between January 2018 and January 2020 in a specialist tertiary spinal referral centre. All patients were assessed preoperatively in an anaesthetic clinic. Postoperative care was defined as ward-based (WB) or critical care (CC), based on the preoperative FEV1, FVC, major curve Cobb angle, and the planned number of instrumented levels. Results. Overall, 105 patients were enrolled. Their mean age was 15.5 years (11 to 25) with a mean weight of 55 kg (35 to 103). The mean Cobb angle was 68° (38° to 122°). Of these, 38 patients were preoperatively scored to receive postoperative CC. However, only 19% of the cohort (20/105) actually needed CC-level support. Based on these figures, and an average paediatric intensive care unit stay of one day before stepdown to ward-based care, the potential cost-saving on the first postoperative night for this cohort was over £20,000. There was no statistically significant difference between the Total Pathway Score (TPS), the numerical representation of the four factors being assessed, and the actual level of care received (p = 0.052) or the American Society of Anesthesiologists grade (p = 0.187). Binary logistic regression analysis of the TPS variables showed that the preoperative Cobb angle was the only variable which significantly predicted the need for critical care. Conclusion. Most patients undergoing posterior
Posterior instrumented
Lumbar
Aims. Tibiotalocalcaneal (TTC)
Background. It has become increasingly important to conduct studies assessing clinical outcomes, reoperation rates, and revision rates to better define the indications and efficacy of lumbar spinal procedures and its association with symptomatic adjacent segment degeneration (sASD). Adjacent segment degeneration (ASD) is defined as the radiographic change in the intervertebral discs adjacent to the surgically treated spinal level. SASD represents adjacent segment degeneration which causes pain or numbness due to post-operative spinal instability or nerve compression at the same level. The most common reason for early reoperation and late operation is sASD, therefore is in our best interest to understand the causes of ASD and make steps to limit the occurrence. Method. A comprehensive literature search was performed selecting Randomized controlled trials (RCTs) and retrospective or prospective studies published up to December 2023. Meta-analysis was performed on 38 studies that met the inclusion criteria and included data of clinical outcomes of patients who had degenerative disc disease, disc herniation, radiculopathy, and spondylolisthesis and underwent lumbar
The purpose of the study was to determine the effectiveness of rhBMP-2 when applied to an absorbable collagen sponge for interbody
Arthrodesis of the 1st metatarsophalangeal joint (MTPJ) is a common procedure used for the treatment of end stage arthritis. We studied a cohort of patients who underwent an isolated 1st MTPJ Fusion for the treatment of hallux rigidus. Here we report the 10-year clinical outcomes, complication rate, requirement for further surgery and patient experience. All patients, who underwent an isolated 1st MTPJ Fusion for osteoarthritis from June 2008 until November 2011 were included. Demographics, clinical outcome data and subsequent procedures performed were collected from a departmental database (Bluespier). Patients were contacted and asked to complete the MOxFQ questionnaire and rate their satisfaction using pain, function and if they would undergo the surgery again. Mean follow up was 10.85 (range 9–12) years. A total of 161 patients (183 feet) underwent an isolated 1st MTPJ fusion during this time period. 156 of the feet showed a successful arthrodesis (85.2%
Aims. Symptomatic spinal stenosis is a very common problem, and decompression surgery has been shown to be superior to nonoperative treatment in selected patient groups. However, performing an instrumented
Aims. Improvements in functional results and long-term survival are variable following conversion of hip
Abstract. Background. Tibiotalocalcaneal (TTC)
Background. Total ankle replacements (TARs) are becoming increasingly more common in the treatment of end stage ankle arthritis. As a consequence, more patients are presenting with the complex situation of the failing TAR. The aim of this study was to present our case series of isolated ankle
Study design. Prospective randomized study. Objective. Primary aim of this study was to compare clinical and radiological results of transforaminal lumbar interbody
RhBMP2 was used in thirty-six consecutive patients requiring interbody
Introduction. Circular frames for ankle
Aim. Acute post-surgical infection is one of the most serious complications after instrumented thoracolumbar
Aims. There is inconsistent evidence on whether prior spinal fusion surgery adversely impacts outcomes following total hip arthroplasty (THA). We conducted a systematic review and meta-analysis to assess the association between pre-existing spinal fusion surgery and the rate of complications following primary THA. Methods. We searched MEDLINE, Embase, Web of Science, and Cochrane Library up to October 2019 for randomized controlled trials (RCTs) and observational studies comparing outcomes of dislocation, revision, or reasons for revision in patients following primary THA with or without pre-existing spinal fusion surgery. Furthermore, we compared short (two or less levels) or long (three or more levels) spinal fusions to no
Aims. Chronic low back pain due to degenerative disc disease is sometimes treated with
The paper describes various surgical techniques and devices for: nucleus pulpous replacement and total lumbar disc arthroplasty/L TDR, as well as other dynamic-system preservation motion stabilization/fixation without
Introduction Circumferential
Objectives: The aim of this study was to determine the outcome of posterior lumbar
Background: Abnormal sagittal plane configuration should be considered as one of the risk factors contributing to development of ASD. Study design: Retrospective comparative randomised radiologic and clinical study. Purpose: To analyse the relationship between sagittal plane configuration of the lumbosacral spine in comparison with rigid versus dynamic instrumentation and TDR and ASD. Material: Study compared 4 groups of patients, who underwent primary monosegmental surgery for spondy-lolisthesis (Group A and B) or DDD (Group C and B) in lumbar spine between 1990–2005. Group A included 35 patients with ASD after 360°
In a prospective observational study we compared the two-year outcome of lumbar
Aims. Concurrent hip and spine pathologies can alter the biomechanics of spinopelvic mobility in primary total hip arthroplasty (THA). This study examines how differences in pelvic orientation of patients with spine fusions can increase the risk of dislocation risk after THA. Patients and Methods. We identified 84 patients (97 THAs) between 1998 and 2015 who had undergone spinal fusion prior to primary THA. Patients were stratified into three groups depending on the length of lumbar
Patients with longstanding hip
Purpose of Study: To prospectively study the outcome of lumbar interbody
The use of antifibrinolytic drugs and many other agents have a critical importance in bleeding control. Tranexamic acid [4- (aminomethyl) cyclohexanecarboxylic acid] is a synthetic amino acid lysine derivative with antifibrinolytic activity in humans. There are many studies in the literature that show that it is effective and effective both systemically and locally in spinal surgery. However, all of these studies have investigated the effects of topical tranexamic acid on bleeding and its effect on
In multilevel posterior cervical instrumented
Aims. Osteoarthritis (OA) is the most prevalent systemic musculoskeletal disorder, characterized by articular cartilage degeneration and subchondral bone (SCB) sclerosis. Here, we sought to examine the contribution of accelerated growth to OA development using a murine model of excessive longitudinal growth. Suppressor of cytokine signalling 2 (SOCS2) is a negative regulator of growth hormone (GH) signalling, thus mice deficient in SOCS2 (Socs2. -/-. ) display accelerated bone growth. Methods. We examined vulnerability of Socs2. -/-. mice to OA following surgical induction of disease (destabilization of the medial meniscus (DMM)), and with ageing, by histology and micro-CT. Results. We observed a significant increase in mean number (wild-type (WT) DMM: 532 (SD 56); WT sham: 495 (SD 45); knockout (KO) DMM: 169 (SD 49); KO sham: 187 (SD 56); p < 0.001) and density (WT DMM: 2.2 (SD 0.9); WT sham: 1.2 (SD 0.5); KO DMM: 13.0 (SD 0.5); KO sham: 14.4 (SD 0.7)) of growth plate bridges in Socs2. -/-. in comparison with WT. Histological examination of WT and Socs2. -/-. knees revealed articular cartilage damage with DMM in comparison to sham. Articular cartilage lesion severity scores (mean and maximum) were similar in WT and Socs2. -/-. mice with either DMM, or with ageing. Micro-CT analysis revealed significant decreases in SCB thickness, epiphyseal trabecular number, and thickness in the medial compartment of Socs2. -/-. , in comparison with WT (p < 0.001). DMM had no effect on the SCB thickness in comparison with sham in either genotype. Conclusion. Together, these data suggest that enhanced GH signalling through SOCS2 deletion accelerates growth plate
Introduction: Autologous bone graft is currently considered the gold standard for anterior cervical discectomy and fusion (ACDF). However, the harvesting of bone graft from the ilac crest is frequently associated with significant patient morbidity. We report on the safety and efficacy of trabecular metal blocks for achieving a stable interbody
Aim. To assess the safety of Zero Profile Interbody
Summary: Radiographic and clinical outcomes of anterior thoraco-lumbar and posterior instrumented spinal fusion in patients with double major (AIS) curves are evaluated in this retrospective study. The average thoracic curve was 68 degrees before surgery and 29.2 degrees at follow-up (mean correction 58.3%). The average preoperative lumbar curve was 73 degrees, decreasing to 18 degrees postoperatively (mean correction 77.5%). Instrumented anterior lumbar
Due to well-known disadvantages of the autologous bone graft, many alternatives have been studied for a reliable spinal fusion. Herein, we aimed to investigate the effects of human recombinant epidermal growth factor (EGF) on posterolateral lumbar
There is a paucity of published Canadian literature comparing lumbar total disc arthroplasty (LDA) to
The main challenges in hip arthrodesis takedown include the decision to perform
The purpose of the study is to evaluate the outcome of two methods: Posterolateral
Aims. The aim of this study was to present a series of patients with
aseptic failure of a total ankle arthroplasty (TAA) who were treated
with
Introduction: The initial promise of stand-alone threaded anterior interbody
INTRODUCTION: The initial promise of stand-alone threaded anterior interbody
Aims: Aims of this study was to perform a quantitatively evaluation of newly formed bone, vascular density (VD) and their correlation in animal model of posterolateral spinal fusion based on skeletal stem cells (SSCs) combined with a coral. Methods: 15 rabbits received cell-material constructs, 15 rabbits were sham-operated (decortication of transverse apophyses), 15 rabbits received material alone. After 6 months the animals were sacrified. We performed a semi-quantitative and quantitative histologycal analysis of the
Longstanding un-united scaphoid fractures or scapholunate insufficiency can progress to degenerative wrist osteoarthritis (termed scaphoid non-union advanced collapse (SNAC) or scapho-lunate advanced collapse (SLAC) respectively). Scaphoid excision and partial wrist
Introduction. Aim was to compare the functional outcome of anterior cervical decompression and
Introduction. Aim was to compare the functional outcome of anterior cervical decompression and
Study Design: Compartative cohort study. Objective: To compare the safety and efficacy of conventional posterior instrumented
Aims. The aim of this study was to reassess the rate of neurological, psoas-related, and abdominal complications associated with L4-L5 lateral lumbar interbody
Purpose: To review the sagittal lumbar and clinical profile of the two surgical procedures: TLIF (transforaminal lumbar interbody
We report the clinical and radiological outcome of total ankle replacement performed in conjunction with hindfoot
Production of porous titanium bone implants is a highly promising research and application area due to providing high osseointegration and achieving the desired mechanical properties. Production of controlled porosity in titanium implants is possible with laser powder bed
Objectives. Pulsed electromagnetic field (PEMF) stimulation was evaluated after anterior cervical discectomy and fusion (ACDF) procedures in a randomized, controlled clinical study performed for United States Food and Drug Administration (FDA) approval. PEMF significantly increased
Introduction: Lumbar spine fusion is now an evidence based treatment principle of low back pain. However, much controversy still exists on the choice of surgical technique. Since the source of pain may be located in the intervertebral disc, a disc removal seems logical. Instrumented and non-instrumented
Introduction. We present a case of a 49-year-old patient who initially presented in May 2020 with an open pilon fracture. Managed with initial debridement, fixation and flap - who subsequently underwent circular frame application for failure of fixation, requiring a transport to
Hip
Purpose of the study: Surgical treatment of degenerative spondylolisthesis generally requires spinal fusion. Arthrodesis can be achieved via an anterior or posterior approach. Over the last ten years, minimally invasive methods have been developed to limit operative trauma secondary to the anterior approach. There have however been few studies comparing outcome after this new technique with classical open surgery. The aim of this work was to compare spinal fusion achieved with a cage implanted retroperitoneoscopically with conventional screw-plate fixation using open lombotomy. Material and methods: Sixty two patients with degenerative spondylolisthesis (L3-L4, L4-L5, L5-S1) were reviewed: 39 had had conventional spinal fusion (group 1) and 23 had undergone a minimally invasive procedure (group 2). Clinical (Beaujon score) and radiographic assessment was recorded at last follow-up. All patients in group 1 were operated on by the same surgeon via lombotomy (L3-L4 or L4-L5 fusion) or subumbilical laparotomy (L5-S1 fusion). An intersomatic graft was combined with screw-plate fixation in all cases. Patients in group 2 were also operated on by the same surgeon (different from group 1) who used a retroperitoneoscopic approach (L3-L4 or L4-L5 fusion). An intersomatic cage was filled with cancelous bone and screwed into the intersomatic space. Results: Mean follow-up was four years in group 1 and two years in group 2. Mean Beaujon score improved from 8 to 17 in group 1 and from 9 to 16.5 in group 2. All patients achieved bone healing at last follow-up without secondary displacement or disassembly of the osteosynthesis. There were no neurological complications and no infections of the operative site. One patient in group 2 developed a vascular complication requiring conversion to classical lombotomy. Blood loss was 1100 ml in group 1 and 200 ml in group 2. Conclusion: Anterior
Objective. Lumbar spinal stenosis (LSS) is a common spinal disorder mostly caused by the arthritic process. In cases with refractory complaints or significant neurologic deficit, decompressive surgery with or without instrumented
Background: Smaller versions of threaded lumbar cages were developed for cervical spine to obviate the need for allograft, iliac autograft use and to provide initial stability before
Intraoperative range of motion (ROM) radiographs are routinely taken during scaphoidectomy and four corner
In a retrospective cohort study we compared the
clinical outcome and complications, including dysphagia, following
anterior cervical
Introduction and Objective. Posterior and transforaminal lumbar interbody
The purpose of this study was to define the risk and incidence of eventual ankle arthroplasty or
The main challenges in hip arthrodesis takedown include the decision to perform
Ankle
The presacral retroperitoneal approach for axial lumbar interbody
The use of lumbar
Surgical site infections (SSIs) after spinal fusion surgery increase healthcare costs, morbidity and mortality. Routine measures of obesity fail to consider site specific fat distribution. We aimed to assess the association between the spine adipose index and deep surgical site infection and determine a threshold value for spine adipose index that can assist in preoperative risk stratification in patients undergoing posterior instrumented lumbar
Background. Prospective study to compare patient reported outcome measures (PROM) for sacroiliac joint (SIJ)
Decreasing the bulk weight without losing the biomechanical properties of commercial pure titanium (Cp-Ti) medical implants is now possible by using Laser Powder Bed
The purpose of this study is to evaluate risk factors for distal construct failure (DCF) in posterior spinal instrumented
Pathologies such as Scapho-Lunate Advanced Collapse (SLAC), Scaphoid Non-union Advanced Collapse (SNAC) and Kienbock's disease can lead to arthritis in the wrist. Depending on the articular surfaces that are involved, motion preserving surgical procedures can be performed. Proximal Row Carpectomy (PRC) and Four Corner
7% of adolescent idiopathic scoliosis (AIS) patients also present with a pars defect. To date, there are no available data on the results of
We retrospectively compared wrist arthrodesis using the Mannerfelt technique in 19 or an AO-plate in 23 patients with long-standing rheumatoid arthritis. The mean follow-up was for 76 months. Compared with the Mannerfelt
Aims. A total of 30 patients with thoracolumbar/lumbar adolescent idiopathic
scoliosis (AIS) treated between 1989 and 2000 with anterior correction
and
Lateral lumbar interbody
Patients with longstanding hip
Aims. The purpose of this retrospective study was to investigate the
clinical relevance of increased facet joint distraction as a result
of anterior cervical decompression and
Numerous techniques are used for the
Objectives. Our objective was to perform a systematic review of the literature and conduct a meta-analysis to investigate the outcomes of open versus arthroscopic methods of ankle
Aims. The optimal procedure for the treatment of ossification of the posterior longitudinal ligament (OPLL) remains controversial. The aim of this study was to compare the outcome of anterior cervical ossified posterior longitudinal ligament en bloc resection (ACOE) with posterior laminectomy and
We present the results of ankle
Introduction. Low back pain is the leading cause of musculoskeletal disease and the biggest cause of morbidity worldwide. Approximately 40% of these are cases are caused by disease of the intervertebral discs (IVDs): the shock absorbing, flexible material located between the bones (vertebrae) along the length of the spine. In severe cases, the spine becomes unstable and it becomes necessary to immobilise or fix the joint in position using a lumbar cage spacer between in the IVD and metal pins with supporting plates in the vertebrae. This is a complex, expensive, major surgery and it is associated with complications, such as spinal fusion failure and inappropriate implant position. These complications have a dramatic impact on the quality of life of the affected patients and the burden to society and the healthcare system is exacerbated. Methods and Results. We present an in vitro study looking at the effect of our Bgel hydrogel on mesenchymal stem cells (MSCs) and their bone forming capacity within lumbar cages: devices used to space the bones apart in the
Abstract. Background. Prospective study to compare patient reported outcome measures (PROM) for sacroiliac joint (SIJ)
Aims. To compare the efficacy of decompression alone (DA) with i) decompression and
Background. PROMS and PREMS are a fundamental and essential part of the NHS. Chilectomy and
The clinical success of posterior lumbar interbody fusion (PLIF) may be limited by pseudarthrosis, defined as the absence of solid
Aims. We reviewed 34 consecutive patients (18 female-16 male) with
isthmic spondylolysis and grade I to II lumbosacral spondylolisthesis
who underwent in situ posterolateral arthodesis between the L5 transverse
processes and the sacral ala with the use of iliac crest autograft.
Ten patients had an associated scoliosis which required surgical correction
at a later stage only in two patients with idiopathic curves unrelated
to the spondylolisthesis. . Methods. No patient underwent spinal decompression or instrumentation
placement. Mean surgical time was 1.5 hours (1 to 1.8) and intra-operative
blood loss 200 ml (150 to 340). There was one wound infection treated
with antibiotics but no other complication. Radiological assessment
included standing posteroanterior and lateral, Ferguson and lateral flexion/extension
views, as well as CT scans. . Results. A solid posterolateral
Hip