61 results match your criteria cortex breached


Lateral mass intra-pedicular screw fixation for subaxial cervical spines - An alternative surgical technique.

J Craniovertebr Junction Spine 2021 Apr-Jun;12(2):165-169. Epub 2021 Jun 10.

Spine and Spinal Cord Center, Makita General Hospital, Tokyo, Japan.

Background: Lateral mass screw (LMS) and transpedicular screw (TPS) techniques are the two major options for performing posterior cervical fusion of the subaxial cervical spine. Although these two techniques can cover the vast majority of patients who require posterior fixation of the cervical spine, they are not without their limitations.

Objective: The objective of this study is to introduce a novel technique, lateral mass intrapedicular screw (LMIS) fixation, for posterior subaxial cervical spine (C3-C6) fixation. Read More

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Arthroscopic Biceps Tenodesis by Bicortical Drilling Technique.

Arthrosc Tech 2021 Apr 2;10(4):e941-e948. Epub 2021 Mar 2.

Department of Orthopaedics, Faculty of Medicine, Thammasat University Hospital, Pathumthani, Thailand.

Pain arising from the long head of biceps tendon can cause significant disability of the shoulder. In young and physically demanding patients, biceps tenodesis is advised, in which the biceps tendon is cut from the native origin and fixed distally. Many methods have been proposed for this. Read More

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Accuracy of cervical pedicle screw placement with four different designs of rapid prototyping navigation templates: a human cadaveric study.

Comput Assist Surg (Abingdon) 2021 12;26(1):49-57

Department of Orthopedics, Xi'an Jiaotong University Second Affiliated Hospital, Xincheng District, Shannxi, People's Republic of China.

Purpose: Due to the high perforation rate of cervical pedicle screw placement, we have designed four different types of rapid prototyping navigation templates to enhance the accuracy of cervical pedicle screw placement.

Methods: Fifteen human cadaveric cervical spines from C2 to C7 were randomly divided into five groups, with three specimens in each group. The diameter of pedicle screw used in this study was 3. Read More

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December 2021

Corridor-diameter-dependent angular tolerance for safe transiliosacral screw placement: an anatomic study of 433 pelves.

Eur J Orthop Surg Traumatol 2021 Mar 1. Epub 2021 Mar 1.

Value Initiative, Minneapolis, MN, USA.

Background: The purpose of this study was to determine the angular tolerance of the S1 and S2 segments to accommodate a transiliosacral screw across both sacroiliac joints.

Hypothesis: We hypothesized that the angular tolerance for transiliosacral screw placement would be more constrained than the angular tolerance for iliosacral fixation in pelves where a safe osseous corridor was measured.

Materials And Methods: The cortical boundaries of the S1 and S2 sacral segments in 433 pelvic CTs were digitally mapped. Read More

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Plunging Dangerously: A Quantitative Assessment of Drilling the Clavicle.

Orthopedics 2021 Jan 7;44(1):e36-e42. Epub 2020 Dec 7.

Bicortical drilling of the clavicle is associated with risk of iatrogenic damage from plunging given the close proximity of neurovascular structures. This study determined plunge depth during superior-to-inferior clavicle drilling using a standard drill vs drill-sensing technology. Two orthopedic surgeons drilled 10 holes in a fresh cadaveric clavicle with drill-sensing technology in freehand mode (functions as standard orthopedic drill) and another 10 holes with drill-sensing technology in bicortical mode (drill motor stops when the second cortex is breached and depth is measured in real time). Read More

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January 2021

Design, application, and evaluation of a novel method for determining optimal trajectory of thoracic pedicle screws.

Ann Transl Med 2020 Aug;8(16):1012

Department of Orthopedics, the Affiliated Hospital of Putian University, Putian, China.

Background: This is an experimental study performed on 15 adult cadavers. In this cadaveric study, we designed and evaluated a novel methodology for determining the optimal trajectory for the placement of thoracic pedicle screws. The accuracy of thoracic pedicle screw placement is critical to the spinal surgery. Read More

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Surgical Technique and Accuracy of S2 Alar-Iliac Screw Insertion Using Intraoperative O-Arm Navigation: An Analysis of 120 Screws.

World Neurosurg 2020 12 22;144:e326-e330. Epub 2020 Aug 22.

Department of Orthopedic Surgery, Tokyo Women's Medical University, Tokyo, Japan.

Objective: To evaluate the surgical technique and accuracy of S2 alar-iliac (SAI) screw placement using intraoperative O-arm-based 3-dimensional navigation (O-arm).

Methods: This study involved 60 patients who underwent SAI screw placement using the O-arm system between September 2013 and September 2019. These surgeries were performed by 5 different surgeons. Read More

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December 2020

Acetabular Subchondral and Cortical Perforation During Labral Repair With Suture Anchors: Influence of Portal Location, Curved Versus Straight Drill Guides, and Drill Starting Point.

Arthroscopy 2019 08;35(8):2349-2354

Department of Orthopaedic Surgery, University of South Carolina School of Medicine, Columbia, South Carolina, U.S.A.

Purpose: To evaluate the impact of the portal used for drilling, the position of the drill guide on the acetabular rim, and the use of straight versus curved drill guides on drill perforation of the acetabular subchondral bone and the outer cortex of the acetabulum.

Methods: Sixty acetabular models were marked at the 3-, 2-, 1-, 12-, and 11-o'clock positions. Simulated anterior, anterolateral, and distal anterolateral accessory (DALA) portals were created. Read More

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The impact of modulating the blood-brain barrier on the electrophysiological and histological outcomes of intracortical electrodes.

J Neural Eng 2019 08 2;16(4):046005. Epub 2019 May 2.

School of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, GA, United States of America.

Objective: Successful application of chronic intracortical electrodes remains highly variable. The biological mechanisms leading to electrode failure are still being explored. Recent work has shown a correlation between blood-brain barrier (BBB) integrity and long-term recordings. Read More

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Is the Cranial and Posterior Screw of the "Inverted Triangle" Configuration for Femoral Neck Fractures Safe?

J Orthop Trauma 2019 Jul;33(7):331-334

Departments of Orthopedic Surgery, and.

Objectives: To determine the frequency where a posterior and cranial screw in a femoral neck that appeared contained on fluoroscopy violates the cortex.

Methods: Ten specimens including the hemipelvis with the proximal femur were obtained from unidentified embalmed specimens that were to be cremated after an institutional review board waiver was granted. Under fluoroscopy, the posterior and cranial screw of the inverted triangle configuration for the femoral neck was placed using standard technique with a cannulated 6. Read More

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Accurate placement of cervical pedicle screws using 3D-printed navigational templates : An improved technique with continuous image registration.

Orthopade 2018 05;47(5):428-436

Department of Orthopedics, Affiliated Hospital of Putian University Teaching Hospital of Fujian Medical University, Affiliated Putian Hospital of Southern Medical University, Affiliated Hospital of Putian University, 351100, Putian, Fujian, China.

Objective: Accurate placement of cervical pedicle screws remains a surgical challenge. This study aimed to test the feasibility of using a novel three-dimensional (3D-)printed navigational template to overcome this challenge.

Methods: Cervical spines were scanned using computed tomography (CT). Read More

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Effect of Transosseous Tunnels on Patella Fracture Risk After Medial Patellofemoral Ligament Reconstruction: A Cadaveric Study.

Arthroscopy 2018 02;34(2):513-518

Department of Orthopaedics and Rehabilitation, Milton S. Hershey Medical Center, Penn State Health, Hershey, Pennsylvania, U.S.A.. Electronic address:

Purpose: To determine whether (1) tunnels that breach the anterior cortex of the patella result in increased fracture risk and (2) transosseous tunnels drilled across the patella significantly reduce the tensile force needed to fracture the patella.

Methods: Twenty-six fresh-frozen cadaveric human patellas were randomized to 1 of 3 groups: a control group with unmodified patellas, a group with 2 transverse tunnels (TT) that did not breach the anterior cortex, and a group with 2 TT that breached the anterior cortex of the patella (PA). Patellas were connected in series to a load cell via freeze clamp attachments to the quadriceps and patellar tendons. Read More

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February 2018

Accuracy of minimally invasive percutaneous thoracolumbar pedicle screws using 2D fluoroscopy: a retrospective review through 3D CT analysis.

J Spine Surg 2017 Jun;3(2):193-203

School of Medicine Sydney, The University of Notre Dame Australia, Darlinghurst 2010, Australia.

Background: In the literature, there is a large variation in the reported misplacement rates of pedicle screws. The use of minimally invasive surgical techniques is increasing and as such there has only been a small amount of data to look at the misplacement rate of percutaneously inserted thoracic and lumbar pedicle screws.

Methods: A retrospective analysis of post-operative computed tomography (CT) scans were performed on 108 patients who underwent minimally invasive percutaneously inserted thoracic and lumbar pedicle screws by a single surgeon. Read More

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The accuracy and the safety of individualized 3D printing screws insertion templates for cervical screw insertion.

Comput Assist Surg (Abingdon) 2016 12;21(1):143-149

a Department of Orthopaedics , The Third Hospital of Changsha , Changsha , China.

Study Design: Clinical trial for cervical screw insertion by using individualized 3-dimensional (3D) printing screw insertion templates device.

Objective: The objective of this study is to evaluate the safety and accuracy of the individualized 3D printing screw insertion template in the cervical spine.

Materials And Methods: Ten patients who underwent posterior cervical fusion surgery with cervical pedicle screws, laminar screws or lateral mass screws between December 2014 and December 2015 were involved in this study. Read More

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December 2016

Prenatal interventions for congenital diaphragmatic hernia for improving outcomes.

Cochrane Database Syst Rev 2015 Nov 27(11):CD008925. Epub 2015 Nov 27.

Discipline of Obstetrics and Gynaecology, Robinson Research Institute, The University of Adelaide, Women's and Children's Hospital, 72 King William Road, Adelaide, South Australia, Australia, SA 5006.

Background: Congenital diaphragmatic hernia (CDH), is an uncommon but severe condition in which there is a developmental defect in the fetal diaphragm, resulting in liver and bowel migrating to the chest cavity and impairing lung development and function for the neonate. This condition can be diagnosed during pregnancy and as such, is potentially amenable to in-utero prenatal intervention. Neonatal surgical repair is possible, but even with early surgical repair and improving neonatal management, neonatal morbidity and mortality is high. Read More

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November 2015

Dorsal Screw Penetration With the Use of Volar Plating of Distal Radius Fractures: How Can You Best Detect?

J Orthop Trauma 2015 Oct;29(10):e408-13

Department of Orthopaedic Surgery, Saint Louis University, St. Louis, MO.

Objectives: To evaluate the most vulnerable position at which volar plate screws may penetrate the dorsal cortex of the radius and to determine which specific intraoperative fluoroscopic images (lateral, 45 degrees supination, 45 degrees pronation, and dorsal tangential) are most useful to detect dorsal cortex penetration.

Methods: Four 2.5-mm locking screws were inserted distally using 18-, 20-, or 22-mm screws in 7 cadaveric specimens apiece. Read More

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October 2015

Comparing Accuracy of Cervical Pedicle Screw Placement between a Guidance System and Manual Manipulation: A Cadaver Study.

Med Sci Monit 2015 Sep 8;21:2672-7. Epub 2015 Sep 8.

Department of Orthopedics, Jinling Hospital, School of Medicine, Nanjing University, Nanjing, Jiangsu, China (mainland).

Background: The aim of this study was to compare the accuracy of cervical pedicle screw placement between a three-dimensional guidance system and manual manipulation.

Material And Methods: Eighteen adult cadavers were randomized into group A (n=9) and group B (n=9). Ninety pedicle screws were placed into the C3-C7 under the guidance of a three-dimensional locator in group A, and 90 screws were inserted by manual manipulation in group B. Read More

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September 2015

Awake Craniotomy in Arteriovenous Malformation Surgery: The Usefulness of Cortical and Subcortical Mapping of Language Function in Selected Patients.

World Neurosurg 2015 Nov 2;84(5):1394-401. Epub 2015 Jul 2.

Department of Neurosurgery, Cushing Neuroscience Institute, Hofstra North Shore-LIJ School of Medicine, North Shore University Hospital, Manhasset, New York, USA.

Objective: Awake craniotomy for removal of intra-axial lesions is a well-established procedure. Few studies, however, have investigated the usefulness of this approach for resection of arteriovenous malformations adjacent to eloquent language areas. We demonstrate our experience by using cortical stimulation mapping and report for the first time on the usefulness of subcortical stimulation with interrogation of language function during resection of arteriovenous malformations (AVMs) located near language zones. Read More

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November 2015

Comparative assessment of different reconstructive techniques of distal femur in revision total knee arthroplasty.

Knee Surg Sports Traumatol Arthrosc 2017 Aug 30;25(8):2559-2566. Epub 2015 May 30.

Department of Mechanical Engineering, University of Aveiro, 3810-193, Aveiro, Portugal.

Purpose: Bone loss is often encountered in revision total knee arthroplasty. In particular, when the cortex of distal femur is breached, the surgical decision on the reconstructive options to be taken is challenging due to the variety of defects and the lack of data from clinical or experimental studies that can support it. The aim of the present work was to test the hypothesis that for an identical defect and bone condition, each reconstructive technique option has a dissimilar stress and stability behaviour, which may be related to differing longevity of the revision procedure. Read More

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K-Wire fracture during minimally invasive transforaminal lumbar interbody fusion: Report of six cases and recommendations for avoidance and management.

Surg Neurol Int 2014 30;5(Suppl 15):S520-2. Epub 2014 Dec 30.

Department of Neurological Surgery, Rush University School of Medicine, Chicago, IL, 60611, USA.

Background: Although rare, minimally invasive spine techniques do have the risk of intraoperative device failure. Kirschner wire (K-wire) fractures during minimally invasive transforaminal lumbar interbody fusion (MI-TLIF) have not been previously reported. This report focuses on the incidence of k-wire fractures following MI-TLIF and describes techniques to help avoid and treat these fractures when they occur. Read More

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January 2015

Periosteum: characteristic imaging findings with emphasis on radiologic-pathologic comparisons.

Skeletal Radiol 2015 Mar 1;44(3):321-38. Epub 2014 Oct 1.

Service de Radiologie Ostéo-Articulaire, Hôpital Lariboisière, AP-HP, 2 Rue Ambroise-Paré, 75010, Paris, France,

The periosteum covers most bone structures. It has an outer fibrous layer and an inner cambial layer that exhibits osteogenic activity. The periosteum is a dynamic structure that plays a major role in bone modeling and remodeling under normal conditions. Read More

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[Intraoperative CT-based spinal navigation: the initial 295 implants experience].

Rozhl Chir 2014 Jan;93(1):16-20

Introduction: The authors describe the system of spinal navigation based on intraoperative CT imaging and the results of an initial series of patients.

Material And Methods: Spinal screws inserted during 50 surgical procedures in the period between November 2012 and October 2013 were evaluated for insertion accuracy, intraoperative complications and the accessibility of the method for the selected spinal level.

Results: Out of the total of 295 screws inserted throughout all the spinal levels from C0 to S1, only 4 (1. Read More

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January 2014

Occam paradox? A variation of tapia syndrome and an unreported complication of guidewire-assisted pedicle screw insertion.

Evid Based Spine Care J 2013 Oct;4(2):132-6

Center for Spine and Spinal Cord Injury, Regions Hospital, St. Paul, Minnesota, United States ; Department of Orthopaedic Surgery, University of Minnesota, Minneapolis, Minnesota, United States.

Study Design Case report. Clinical Question The clinical aim is to report on a previously unknown association between guidewire-assisted pedicle screw insertion and neuropraxia of the recurrent laryngeal nerve (RLN), and how this may overlap with the signs of Tapia syndrome; we also report our approach to the clinical management of this patient. Methods A 17-year-old male patient with idiopathic scoliosis experienced Tapia syndrome after posterior instrumentation and arthrodesis at the level of T1-L1. Read More

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October 2013

Fibroblastic osteosarcoma in a lion (Panthera leo).

Open Vet J 2014 5;4(1):1-3. Epub 2014 Jan 5.

Dipartimento di Scienze Biopatologiche e Igiene delle Produzioni Animali e Alimentari, Università degli Studi di Perugia, Italy.

This report describes a case of spontaneous fibroblastic osteosarcoma in the humerus of a lion from a private park in Perugia, Italy. The tumor had an irregular, smooth, brown surface and a generally firm, rubbery consistence with gritty to hard areas interspersed. The mass was poorly vascularized with areas of necrosis at the periphery. Read More

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December 2015

GPR56 functions together with α3β1 integrin in regulating cerebral cortical development.

PLoS One 2013 9;8(7):e68781. Epub 2013 Jul 9.

Division of Newborn Medicine, Department of Medicine, Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts, United States of America.

Loss of function mutations in GPR56, which encodes a G protein-coupled receptor, cause a specific human brain malformation called bilateral frontoparietal polymicrogyria (BFPP). Studies from BFPP postmortem brain tissue and Gpr56 knockout mice have previously showed that GPR56 deletion leads to breaches in the pial basement membrane (BM) and neuronal ectopias during cerebral cortical development. Since α3β1 integrin also plays a role in pial BM assembly and maintenance, we evaluated whether it functions together with GPR56 in regulating the same developmental process. Read More

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February 2014

Biomechanical evaluation of different reconstructive techniques of proximal tibia in revision total knee arthroplasty: An in-vitro and finite element analysis.

Clin Biomech (Bristol, Avon) 2013 Mar 16;28(3):291-8. Epub 2013 Jan 16.

Department of Mechanical Engineering, University of Aveiro, 3810-193 Aveiro, Portugal.

Background: Bone loss and subsequent defects are often encountered in revision total knee arthroplasty. In particular, when the cortical rim of proximal tibia is breached, the surgical decision on the reconstructive options to be taken is challenging due to the variety of defects and the lack of data from clinical or experimental studies that can support it. The purpose of this study is to assess how different reconstructive techniques, when applied to an identical defect and bone condition, can be associated to dissimilar longevity of the revision procedure, and the role of a stem in this longevity. Read More

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Total knee arthroplasty in a patient with skeletal fluorosis.

Orthopedics 2012 Nov;35(11):e1664-7

Philadelphia College of Osteopathic Medicine, Philadelphia, Pennsylvania, USA.

Published reports on patients with skeletal fluorosis undergoing total knee arthroplasty are rare. Skeletal fluorosis is a chronic condition that occurs secondary to the ingestion of food and water that contain high levels of fluoride. Although fluorosis may be described as osteosclerotic and marble-like in appearance, features may also include characteristics of osteomalacia and osteoporosis. Read More

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November 2012

An in vitro approach to assess the neurotoxicity of valproic acid-induced oxidative stress in cerebellum and cerebral cortex of young rats.

Neuroscience 2012 Dec 6;225:258-68. Epub 2012 Sep 6.

Department of Medical Elementology and Toxicology, Jamia Hamdard (Hamdard University), New Delhi 110 062, India.

Valproic acid (VPA), a branched short-chain fatty acid, is generally used as an antiepileptic drug and a mood stabilizer. VPA is a relatively safe drug, but its use in higher concentrations is associated with idiosyncratic neurotoxicity. Investigations involving cerebral cortex and cerebellum can shed light on whether neurotoxicity induced by branched chain fatty acids like VPA is mediated by oxidative stress. Read More

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December 2012

Intraosseous hemangioma of the appendicular skeleton: imaging features of 15 cases, and a review of the literature.

Skeletal Radiol 2012 Dec 27;41(12):1525-36. Epub 2012 Jun 27.

Department of Radiology, University Hospital of Patras, 26504, Rio, Patras, Greece.

Objective: We performed a retrospective study of the imaging findings of 15 patients (nine female, six male, mean age 43 years) with the histopathological diagnosis of hemangioma.

Materials And Methods: Radiographs, magnetic resonance imaging (MRI), computed tomography, and bone scan were performed.

Results: Lower extremity was involved in nine cases, upper extremity in three cases, the acetabulum in two cases and the ilium in one case. Read More

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December 2012

Pedicle screw placement with O-arm and stealth navigation.

Orthopedics 2012 Jan 16;35(1):e61-5. Epub 2012 Jan 16.

The Spine Center, Department of Orthopaedics, University of Colorado, Mail Stop B202, 12631 E 17th Ave, Aurora, CO 80045, USA.

Various navigation systems are available to aid pedicle screw placement. The O-arm replaces the need for fluoroscopy and generates a 3-dimensional volumetric dataset that can be viewed as transverse, coronal, and sagittal images of the spine, similar to computed tomography (CT) scanning. The dataset can be downloaded to the Stealth system (Medtronic Navigation, Louisville, Colorado) for real-time intraoperative navigation. Read More

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January 2012