Posterior lumbar interbody fusion (PLIF) is a common surgical procedure and widely used in the treatment of lumbar degenerative disc disorders. Traditionally, posterior lumbar interbody fusion is done by using the traditional pedicle screw (PS) which offers great advantages, but at the same time it has some disadvantages which include the risk of superior facet joint violation and muscle damage. Recently, an alternative method of screw insertion via cortical bone trajectory (CBT) has been invented which has less invasive process and can be placed without the drawbacks associated with the traditional pedicle screw. However, it has to remain an interest whether CBT will provide similar or greater clinical outcomes compared to PS in PLIF. So the main aim of this review is to compare the clinical outcomes of cortical bone trajectory and traditional pedicle screw fixation in posterior lumbar interbody fusion based on the articles published on this topic. Compared to the traditional pedicle screw fixation, PLIF with CBT has similar clinical outcome based on pain intensity, ODI status and JOA score, as well as similar fusion rate and radiological evaluated complication such as loosening of screw. In addition PLIF with CBT has advantages of less facet joint violation, less blood loss, less intraoperative muscle damage and perioperative pain. On the basis of this study, we can suggest that PLIF with CBT can be considered as a reasonable alternative to PS in PLIF.
Background Titanium Elastic Nail (TEN) is used for fixation of diaphyseal fractures of paediatric long bone, where the medullary canal is thin or flexibility of the implant is a chief concern. These are used for biologically and minimally invasive fracture treatment that delivers accurate reduction and stabilization in appropriate paediatric age group Methods A hospital based 18 months (from December 2020 to July 2022), retrospective study was conducted at Devdaha Medical College and Research Institute, Rupandehi, Nepal with the patients of paediatric long bone fractures who were operated with an elastic titanium intramedullary nail for diaphyseal fractures. Records of the surgical procedure and the follow-up outcomes were all recorded and the data was collected and tabulated in excel sheet for statistical analysis. The total number of patients in the study were 25 wherein, 20 were male and 5 were female. Results Children ranging from age 4 to 15 years of age were included with mean age of 9.44 years. Average hospital stay was 4 days having standard deviation of 1.68. Statistical analysis yielded z value of 2.97 and p-value of 0.003 which was significant. Most of the patients reported injury in the left side 17(68%) than right side 8(32%). Majority of the injury was sustained in forearm 18(72%) followed by femur 4(16%) and tibia 3(12%). Fall on the ground 14(56%) was commonest mode of injury followed by road traffic accident (RTA) 5(20%), fall from tree 3(12%), fall from bicycle 2(8%) and sports injury 1(4%) respectively. The average time to fracture union was 9.84 ± 2.93 weeks. Only 4 patients had complication, in which 2 had superficial surgical site infection and nopatient had Limb Length Discrepancy or non-union. Conclusion TENS for diaphyseal fracture is not only a safe, minimally invasive technique with shorter operating time but also helps in preservation of accurate bone alignment and encourages quicker bone healing.
Posterior malleolus fractures are quite common and usually result from rotational ankle injuries. For the management of posterior malleolus fractures, more studies are still required, though it is already well-recognized for medial and lateral structure. Therefore, fracture of posterior malleolus is striking subject of study among orthopedic surgeons. Most orthopedic surgeons recommend fixing the posterior malleolus fracture if it is larger than 25% to 33% of the distal articular surface. Further attention is required for the reduction and fixation of fractures involving posterior malleolus. Several approaches and methods for fixation of posterior malleolus have been defined in the literature. Previously, the most common method of fixation of the posterior malleolus is by indirect reduction and anteroposterior screws, it is minimally invasive, the anterior incision does not allow satisfactory visualization of the fragment, so good anatomical reduction is difficult to achieve thorough this approach. Operative management goals to reach a stable ankle with maximal function, decrease the risk of post-traumatic degenerative changes, and diminish the risk of complication. Nowadays, posterolateral approach is gaining the popularity due to adequate visualization and accurate anatomic reduction.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.