Kluger's ?Fixateur interne? for spinal instability

Sandvoss, G; Feldmann, H

doi:10.1007/bf00313035

Cited by 3 publications

(1 citation statement)

References 6 publications

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“…On the other hand, numerous authors have shown positive results with the inclusion of rigid transpeduncular posterior instrumentation in isthmic spondylolisthesis. [6][7][8][9][10][11][12] More recently, some authors have advocated including an interbody arthrodesis in these patients, citing the difficulty in achieving a reliable robust posterior fusion. [13][14][15] The addition of interbody fusion to PLF (PLIF) appears to improve one's ability to maintain correction and achieve solid union, 8,14,15 although this has not been clearly linked to improved patient function.…”

Section: Introductionmentioning

confidence: 99%

Segmental Stiffness Achieved by Three Types of Fixation for Unstable Lumbar Spondylolytic Motion Segments

Choma

Pfeiffer

Vallurupalli

et al. 2012

Global Spine Journal

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Objective The objective of this study was to compare the relative stability in lumbar spondylolysis (SP) of a rigid anterior plate (with a novel compression slot) versus traditional posterior pedicle screw (PS) fixation. Summary of Background Data Arthrodesis has been a mainstay of treatment for symptomatic isthmic spondylolisthesis in adults. Posterior PS fixation has become a commonly used adjunct. Some have advocated anterior lumbar interbody fixation (ALIF) plate as an alternative. The relative stability afforded by ALIF in SP has not been well characterized, nor has the contribution afforded by a compression screw slot in an ALIF plate. Methods Calf spine segments were characterized in the normal state, after sectioning the pars (SP model), then after reconstruction with an interbody spacer and either PS/rods, or an ALIF plate, or both. Results ALIF plate conferred stability on the spondylolytic segment only comparable to that of the normal functional spinal unit (FSU). Posterior fixation was more stable than anterior fixation in all testing modes. Addition of an ALIF plate conferred a significant additional stability in those that already had posterior fixation. The utilization of an anterior compression screw conferred additional stability in extension testing only. Conclusions ALIF plate reconstruction in the setting of SP may not confer enough segmental stability to predictably encourage fusion beyond that of the uninstrumented intact FSU. The utilization of an integral compression screw in an ALIF plate may not confer clinically significant additional construct stability in SP.

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Section: Introductionmentioning

confidence: 99%

Segmental Stiffness Achieved by Three Types of Fixation for Unstable Lumbar Spondylolytic Motion Segments

Choma

Pfeiffer

Vallurupalli

et al. 2012

Global Spine Journal

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Neurosurgical Management of Thoracic and Lumbar Vertebral Osteomyelitis and Discitis in Adults: A Review of 43 Consecutive Surgically Treated Patients

et al. 1996

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We report 43 consecutive surgically treated patients with pyogenic (37 patients) and tuberculous (6 patients) osteomyelitis of the thoracic and lumbar spine encountered within an 8-year period, including 1 with late recurrence after 15 months. There were 24 men and 18 women, ranging in age from 21 to 83 years. Twenty-six patients were in poor general condition because of associated illnesses, especially diabetes mellitus. Disease occurred at the thoracic level in 19 patients and on the lumbar spine in 24. After diagnosis, five patients were merely treated by posterior decompression; three of them, however, required further surgery for recurrent infection, spinal instability, and secondary neurological impairment. They are included in the 40 patients who underwent combined posterior débridement and internal fixation with transpedicular screw-rod systems. Autologous interbody bone grafting was performed simultaneously in 18 patients and in a second stage operation in 21 patients. One of them (tuberculous) experienced early recurrence and required anterior fusion. In two patients, methylmethacrylate packing was used for spine reconstruction; one of them had a late recurrence. Of the 26 patients with preoperative marked or severe neurological deficit (Frankel Grades A, 2 patients; B, 1 patient; C, 17 patients; and D, 6 patients), 23 (88%) had significant improvement of one grade (15 patients) or more (8 patients). There were no permanent complications. However, intensive care treatment was necessary in 20 of the 26 patients in reduced general condition (mean age, 72 yr). Two patients required further surgery because of postoperative epidural hematoma and pedicle screw malpositioning. In conclusion, most patients with thoracic and lumbar osteomyelitis can be successfully treated by combined débridement and internal fixation using only a posterior approach. Autogenous interbody bone grafting can be simultaneously performed and allows early mobilization of the patient.

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Ein vereinfachtes Verfahren zur mechanischen Prüfung von LWS-lmplantaten - A Simplified Procedure for the Mechanical Testing of Lumbar Spinal Fixation Implants

Hahn

Nassutt²,

Morlock³

et al. 1999

Biomedizinische Technik/Biomedical Engineering

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Schlüsselwörter: Wirbelsäule, interne Fixateure, Steifigkeit, Dauerschwingfestigkeit, Versagensanalyse. Es wird ein Prüfverfahren für Wirbelsäulenfixateure vorgestellt, das sich an den Normvorschlägen ASTM/ISO orientiert, aber im Aufwand deutlich reduziert ist. Die Prüfung umfaßt eine quasi-statische und eine dynamische Testung zur Beurteilung der Steifigkeit und Dauerschwingfestigkeit unterschiedlicher Fixateurmodelle. Die Fixierungsart der Pedikelschrauben an der Prüfvorrichtung hat entscheidenden Einfluß auf die mechanischen Kennwerte und den Versagensmechanismus eines Fixateurs. Es wurde eine Schraubenverankerung mit hoher Steifigkeit gewählt, da sich bei dieser Fixierungsart die Ausfallmechanismen weitgehend mit klinischen Beobachtungen decken. Die Leistungsfähigkeit des Prüfverfahrens wird am Beispiel von sieben internen LWS-Fixateurmodellen vorgestellt. Die gewählte Testkonfiguration erlaubt eine reproduzierbare Charakterisierung der einzelnen Fixateursysteme durch Erkennen der spezifischen Schwachstellen und den Vergleich der mechanischen Kennwerte. Die Biegesteifigkeit wird nicht nur durch das Implantatmaterial und die Dimensionierung eines Fixateurs, sondern vor allem durch das Design beeinflußt. Bei länger werdenden Verweilzeiten der Fixateure im Körper ist neben der mechanischen Prüfung eine Verschleiß-und Korrosionsuntersuchung zu erwägen.

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Kluger's ?Fixateur interne? for spinal instability

Cited by 3 publications

References 6 publications

Segmental Stiffness Achieved by Three Types of Fixation for Unstable Lumbar Spondylolytic Motion Segments

Segmental Stiffness Achieved by Three Types of Fixation for Unstable Lumbar Spondylolytic Motion Segments

Neurosurgical Management of Thoracic and Lumbar Vertebral Osteomyelitis and Discitis in Adults: A Review of 43 Consecutive Surgically Treated Patients

Ein vereinfachtes Verfahren zur mechanischen Prüfung von LWS-lmplantaten - A Simplified Procedure for the Mechanical Testing of Lumbar Spinal Fixation Implants

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