1997 Volvo Award Winner in Clinical Studies

Thomsen, Karsten; Christensen, Finn Kjær; Eiskjær, Søren Peter; Hansen, Ebbe Stender; Fruensgaard, Søren; Bünger, Cody

doi:10.1097/00007632-199712150-00004

Cited by 381 publications

(59 citation statements)

References 41 publications

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“…Standard techniques for pedicle screw placement require extensive tissue dissection to expose entry points and to provide lateral-to-medial orientation for optimal screw trajectory. Open pedicle screw and rod fi xation have been associated with wide paraspinal muscle dissection, extensive blood loss, lengthy hospital stays, and high cost 3 . Mager…”

Section: 2mentioning

confidence: 99%

Percutaneous Pedicle Screw and Rod Insertion for the Treatment of Thoracic and Lumbar Spine Fracture

Chaudhary

Karn

Shrestha

et al. 2013

Nepal Ortho. Assoc. J.

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Introduction: Standard techniques for lumbar pedicle screw and rod fi xation involve open exposure and extensive muscle dissection. Percutaneous pedicle screw system minimises the morbidity associated with traditional open approaches without compromising the quality of spinal fi xation. A preliminary experience with this device has been encouraging. The purpose of this study was to demontrate operative techniques and experiences with percutaneous lumbar pedicle screw and rod insertion for internal fi xation of the lumbar spine without use of Zig.Methods: It was hospital based retrospective interventional study done at the department of Orthopaedics, B.P.Koirala Institute of Health Sciences, Dharan,Nepal over a period of 2 and half years. The study enrolled 30 patients aged 18-55 years who had presented with traumatic fracture of thoracic and lumbar spine. All thirty patients underwent percutaneous pedicle screw and rod fi xation and successful percutaneous single/two level fusions. The follow up period ranged from 6 to 24 months. Results:The study comprised of 25 males and 5 females. Average patient's age was 36.5 years (range 18-55 years). The common mode of injury was fall from height, road traffi c accident, physical assault followed by sports related injury. All patients were having unstable spine fracture without neurological defi cit. Operation time, loss of blood, post operative pain was less in percutaneous method. Post operative rehabilitation was easier. Spinal fusion was achieved in all patients in 6 months to 1 year time. There was no post-operative neurological defi cit, infection, implant failure. Conclusion:Our early experiance suggests that Minimally invasive approaches for performing lumbar fusion, is able to achieve the same clinical results as conventional open procedures.

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Section: 2mentioning

confidence: 99%

Percutaneous Pedicle Screw and Rod Insertion for the Treatment of Thoracic and Lumbar Spine Fracture

Chaudhary

Karn

Shrestha

et al. 2013

Nepal Ortho. Assoc. J.

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“…In general, randomized trials comparing fusion with bone grafting alone to fusion with pedicle screws have shown no clinical advantage in terms of pain relief or function for those with instrumentation, although instrumentation does slightly increase the rate of solid fusion [3,[25][26][27][28][29]. Thus, it seems likely that any efficacy advantage of instrumentation in terms of clinical outcomes is small.…”

Section: The Choice Of Surgical Proceduresmentioning

confidence: 99%

“…In contrast, with regard to complications, randomized trials show that patients with instrumentation have a substantially higher likelihood of repeat surgery, higher rates of nerve injury, greater blood loss, longer operative time, and a higher rate of overall complications [3,23,29]. Because implants also are expensive, their use may have the net effect of diverting resources from more highly effective clinical services to less effective clinical services.…”

Section: The Choice Of Surgical Proceduresmentioning

confidence: 99%

The case for restraint in spinal surgery: does quality management have a role to play?

Deyo

Mirza

2009

Eur Spine J

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Most quality improvement efforts in surgery have focused on the technical quality of care provided, rather than whether the care was indicated, or could have been provided with a safer procedure. Because risk is inherent in any procedure, reducing the number of unnecessary operations is an important issue in patient safety. In the case of lumbar spine surgery, several lines of evidence suggest that, in at least some locations, there may be excessively high surgery rates. This evidence comes from international comparisons of surgical rates; study of small area variations within countries; increasing surgical rates in the absence of new indications; comparisons of surgical outcomes between geographic areas with high or low surgical rates; expert opinion; the preferences of wellinformed patients; and increasing rates of repeat surgery. From a population perspective, reducing unnecessary surgery may have a greater impact on complication rates than improving the technical quality of surgery that is performed. Evidence suggests this may be true for coronary bypass surgery in the US and hysterectomy rates in Canada. Though similar studies have not been done for spine surgery, wide geographic variations in surgical rates suggest that this could be the case for spine surgery as well. We suggest that monitoring geographic variations in surgery rates may become an important aspect of quality improvement, and that rates of repeat surgery may bear special attention. Patient registries can help in this regard, if they are very complete and rigorously maintained. They can provide data on surgical rates; offer post-marketing surveillance for new surgical devices and techniques; and help to identify patient subgroups that may benefit most from certain procedures.

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“…3,4 However, the classical (open) surgical approach with pedicle fixation (short or long segment) involves extensive exposure and dissection, which is generally associated with a high rate of morbidity: high intraoperative blood loss, and significant infection and muscle injury rates. 5,6 Minimally invasive surgery, in particular percutaneous pedicle fixation, has become increasingly popular in spinal surgery.…”

Section: Introductionmentioning

confidence: 99%

Fixação pedicular percutânea de fraturas vertebrais toracolombares sem compromisso neurológico

et al. 2013

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Objective: To evaluate the efficacy and safety of percutaneous pedicle fixation in thoracolumbar fractures without neurologic compromise. Methods: The study included patients aged between 18 and 70 with AO thoracolumbar fracture type (A.3) and kyphosis >30° or reduction of vertebral body height >50% or >50% of spinal canal compromise, who underwent surgery with percutaneous pedicle fixation in the first ten days after fracture. Radiological parameters were evaluated: Cobb angle, vertebral collapse, anterior wedging and spinal canal compromise preoperatively, postoperatively and at the end of follow-up. The clinical and functional outcome was assessed by the Oswestry Disability Index (ODI

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1997 Volvo Award Winner in Clinical Studies

Cited by 381 publications

References 41 publications

Percutaneous Pedicle Screw and Rod Insertion for the Treatment of Thoracic and Lumbar Spine Fracture

Percutaneous Pedicle Screw and Rod Insertion for the Treatment of Thoracic and Lumbar Spine Fracture

The case for restraint in spinal surgery: does quality management have a role to play?

Fixação pedicular percutânea de fraturas vertebrais toracolombares sem compromisso neurológico

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