Conversion of a stripped lateral mass screw to an alternate trajectory appears to offer no biomechanical advantage over placement of an increased diameter salvage screw using the same trajectory. Pedicle screw fixation provides superior biomechanical fixation but was associated with a significant breech rate.

Transsacral rod fixation provides strong ligamentotaxis due to intact annulus. Standalone transsacral rod is able to reduce ROM significantly and achieve indirect decompression by distracting L5-S1 disc space. However, additional posterior fixation, such as facet screws or pedicle screws, is required to achieve better construct stability for successful fusion.

The critical ratio correlates more closely with the presence or absence of postoperative symptoms than measures of hematoma volume, and is consistent with the clinical expectation that greater thecal sac compression may result in more severe symptoms. Few guidelines exist for postoperative lumbar MRI interpretation. The critical ratio is an important contribution.

This study showed elevated levels of TNF-alpha, collagenase, and TIMP-1 due to the presence of ruptured ACL. Our findings showed how these levels changed in the acute postoperative period.

ObjectiveThis study was performed to compare the clinical and radiological outcomes of displaced femoral neck fractures (FNFs) treated with either hemiarthroplasty or total hip arthroplasty (THA) in elderly patients. Morbidity and mortality were also evaluated.MethodsTwenty-two patients who underwent hemiarthroplasty and 16 patients who underwent THA for treatment of Garden type 3–4 FNFs from 2012 to 2015 were enrolled in this study. All patients were >65 years of age. Cox regression analysis was performed for mortality evaluation.ResultsThe postoperative blood loss volume, decrease in the hemoglobin level, and transfusion rate were significantly higher in the THA group. The univariate mortality risk was higher in patients with a Charlson comorbidity score of >4, American Society of Anesthesiologists score of >2, Singh index of <3, and postoperative hospitalization of >1 week.ConclusionThis study revealed no significant difference in the short-term clinical and radiological results between cementless hemiarthroplasty and THA in elderly patients with displaced FNFs. However, morbidity and mortality were associated with the presence of additional systemic diseases. THA is the preferred surgical technique in patients with displaced FNFs and low comorbidities.