Complications with the Variable Spinal Plating System

Whitecloud, Thomas S.; Butler, James C.; Cohen, Jonathan; Candelora, Peter D.

doi:10.1097/00007632-198904000-00027

Cited by 119 publications

(36 citation statements)

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“…The importance of an anterior vertebral graft in short arthrodeses has been recently confirmed in experimental studies [20,24,34] as well as by the unsatisfactory results obtained for patients not submitted to anterior reconstruction of the spine [5,28,32]. Whitecloud and Shaw [32], Carl et al [5], and Stephens et al [28] reported a loss of correction, increased kyphosis, and implant breaks at the time of late evaluation in patients submitted only to posterior pedicular fixation. Although most patients presented a satisfactory clinical evolution, the authors believed that an anterior graft might have prevented the faults observed [20].…”

Section: Discussionmentioning

confidence: 93%

Treatment of fractures of the thoracolumbar spine by combined anteroposterior fixation using the Harms method

Defino

Rodriguez-Fuentes

1998

E Spine J

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Section: Discussionmentioning

confidence: 93%

Treatment of fractures of the thoracolumbar spine by combined anteroposterior fixation using the Harms method

Defino

Rodriguez-Fuentes

1998

E Spine J

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“…The criteria for choosing the most appropriate treatment have not been determined, though it would be important to identify which sub-group of patients may be treated with decompression alone, considering the morbidity associated with fusion [19,20], particularly when this is supplemented with internal fixation [4,23,31]. It has been suggested that patients with coronally oriented articular facets could undergo decompression alone, since in this situation partial facetectomy would not compromise the stabilizing action of the facets to a critical extent [11,13].…”

Section: Discussionmentioning

confidence: 99%

Predisposing factors in degenerative spondylolisthesis

Cinotti¹,

Postacchini

Fassari

et al. 1997

International Orthopaedics

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Summary. We report a prospective study analysing whether possible factors predisposing to degenerative spondylolisthesis (DS) must be present concomitantly in order to cause vertebral slipping. Standard and flexion-extension radiographs were obtained from 27 patients with DS and 27 without spondylolisthesis. The level of the intercrestal line, the lumbosacral angle, the presence of sacralization of L5 and vertebral motion at the L4 ± L5 level were assessed. Facet joint orientations were measured on CT scans. Only facet joint orientation and vertebral motion at the spondylolisthetic level were significantly different in patients with DS compared with controls. Facet joints were oriented more sagittally both at the spondylolisthetic level and at the levels above and below. An inverse linear correlation was found between the sagittal orientation of facet joints and the mobility of the slipped vertebra. Abnormal sagittal orientation of facet joints and hypermobility of the spondylolisthetic vertebra appear to play major roles among possible factors predisposing to DS. Both factors should be considered in the planning of surgical treatment.

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“…The same authors [160] reported on a series of 14 patients treated with anterior interbody fusion for the same condition, which resulted in a good outcome for 50% of patients and a non-union rate of 55%. The few articles [110,154,185] reporting on pedicular stabilization of iatrogenic instability do not subdivide the results further to allow a reasonable outcome assessment.…”

Section: Low-back Pain Disordersmentioning

confidence: 99%

Pedicle screw fixation in spinal disorders: A European view

1997

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Continuing controversy over the use of pedicular fixation in the United States is promoted by the lack of governmental approval for the marketing of these devices due to safety and efficacy concerns. These implants have meanwhile become an invaluable part of spinal instrumentation in Europe. With regard to the North American view, there is a lack of comprehensive reviews that consider the historical evolution of pedicle screw systems, the rationales for their application, and the clinical outcome from a European perspective. This literature review suggests that pedicular fixation is a relatively safe procedure and is not associated with a significantly higher complication risk than non-pedicular instrumentation. Pedicle screw fixation provides short, rigid segmental stabilization that allows preservation of motion segments and stabilization of the spine in the absence of intact posterior elements, which is not possible with non-pedicular instrumentation. Fusion rates and clinical outcome in the treatment of thoracolumbar fractures appear to be superior to that achieved using other forms of treatment. For the correction of spinal deformity (i.e., scoliosis, kyphosis, spondylolisthesis, tumor), pedicular fixation provides the theoretical benefit of rigid segmental fixation and of facilitated deformity correction by a posterior approach, but the clinical relevance so far remains unknown. In low-back pain disorders, a literature analysis of 5,600 cases of lumbar fusion with different techniques reveals a trend that pedicle screw fixation enhances the fusion rate but not clinical outcome. The most striking finding in the literature is the large range in the radiological and clinical results. For every single fusion technique poor and excellent results have been described. This review argues that European spine surgeons should begin to back up the evident benefits of pedicle screw systems for specific spinal disorders by controlled prospective clinical trials. This may prevent forthcoming medical licensing authorities from restricting the use of pedicle screw devices and dictating the practice of spinal surgery in Europe in the near future.

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Complications with the Variable Spinal Plating System

Cited by 119 publications

References 0 publications

Treatment of fractures of the thoracolumbar spine by combined anteroposterior fixation using the Harms method

Treatment of fractures of the thoracolumbar spine by combined anteroposterior fixation using the Harms method

Predisposing factors in degenerative spondylolisthesis

Pedicle screw fixation in spinal disorders: A European view

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