Which is the Preferred Revision Technique for Loosened Iliac Screw?

Yu, Bo; Yang, Zhan-Kun; Li, Zemin; Zeng, Li-Wen; Wang, Libing; Lu, William W.

doi:10.1097/bsd.0b013e318224e55a

Cited by 7 publications

(2 citation statements)

References 16 publications

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“…However, the rod fracture above or below the osteotomy site could be con- sidered in the multiple-rod group [27]. We could observe that the multiple-rod constructs had a higher potential to prevent rod breakage (OR, 0.28; p<0.001) and pseudarthrosis (OR, 0.30; p<0.001), than the 2-rod construct, which was consistent with the previous results [19,28]. Furthermore, the pooled results found a lower revision risk in the multiple-rod group (OR, 0.…”

Section: Discussionsupporting

confidence: 89%

Multiple-Rod Constructs in Adult Spinal Deformity Surgery: A Systematic Review and Meta-Analysis

Zhao,

Nie,

Zhang

et al. 2023

Asian Spine J

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The purpose of this research was to compare the therapeutic efficacy of multiple-rod constructs vis-a-vis 2-rod constructs in the treatment of adult spinal deformity. A systematic review and meta-analysis were performed to determine whether the multiple-rod construct outperformed the 2-rod construct. We initially retrieved 357 papers, but only 12 were chosen for further meta-analysis. The rod breakage rates in the multiple-rod and the 2-rod groups were 10.66% and 29.87%, respectively. The multiple-rod construct inhibited rod breakage (odds ratio [OR], 0.28; 95% confidence interval [CI], 0.19–0.41; p<0.001), pseudarthrosis (OR, 0.30; 95% CI, 0.18–0.50; p<0.001) and rod fracture at the osteotomy site (OR, 0.34; 95% CI, 0.13–0.89; p=0.03). Furthermore, the multiple-rod construct reduces the risk of revision surgery (OR, 0.38; 95% CI, 0.20–0.73; p=0.04) as well as the revision risk of pseudarthrosis/rod fracture in the multiple- rod group (OR, 0.31; 95% CI, 0.18–0.52; p<0.001), but increases the risk of caudal screw loosening (OR, 4.99; 95% CI, 1.87–13.30; p=0.001). There was no statistically significant difference in proximal junctional kyphosis (PJK) parameters (p=0.85), cerebrospinal fluid leakage (p=0.09), wound infection (p =0.71), age at surgery (p=0.62), gender distribution (p=0.93), body mass index (p =0.86), smoking status (p=0.05), hospital stay (p=0.09), osteoporosis (p=0.95), CoCr rod material (p=0.15), bone morphogenetic protein-2 (p=0.58), L5/S1 interbody fusion (p=0.07), high-grade osteotomies (p=0.07), the number of fusion levels (p=0.11), operation time (p=0.30), and blood loss volume (p=0.34). Regarding radiographic parameters, only preoperative sagittal vertical axis was found to be higher (weight means difference [WMD], 25.60; 95% CI, 15.43–35.77; p<0.001) in the multiple-rod group. There was no difference in preoperative Oswestry Disability Index (ODI) (WMD, −3.32; 95% CI, −7.38 to 0.73; p=0.11), but the multiple-rod group had a lower ODI at follow-up (WMD, −7.71; 95% CI, −11.62 to −3.86; p<0.001). Multiple-rod constructs could prevent rod breakage and pseudarthrosis while also lowering the revision rate, resulting in a better clinical outcome than the 2-rod construct. Nonetheless, due consideration should be given to PJK and screw loosening in multiple-rod constructs, possibly due to the increased stiffness caused by the multiple-rod structure.

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Section: Discussionsupporting

confidence: 89%

Multiple-Rod Constructs in Adult Spinal Deformity Surgery: A Systematic Review and Meta-Analysis

Zhao,

Nie,

Zhang

et al. 2023

Asian Spine J

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“…Poly(methyl methacrylate), PMMA, was first used into clinics, as dental device, for the fabrication of complete denture bases [ 1 ]. Due to its biocompatible characteristics, its reliability, ease manipulation and low toxicity, the usage of PMMA was extended into other medical applications such as bone cements [ 2 ], contact and intraocular lenses [ 3 ], screw fixation in bone [ 4 ], skull defects reparation [ 5 ], stabilization of vertebrae in osteoporotic patients [ 6 ], intradermal fillers [ 7 ] and mandibular reconstruction [ 8 ]. Although numerous new biomaterials have appeared on the market, the versatility and reliability of PMMA cause it to remain a popular and frequently used material [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

Biomolecular functionalization for enhanced cell–material interactions of poly(methyl methacrylate) surfaces

et al. 2015

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The integration of implants or medical devices into the body tissues requires of good cell–material interactions. However, most polymeric materials used for these applications lack on biological cues, which enhanced mid- and long-term implant failure due to weak integration with the surrounding tissue. Commonly used strategies for tissue–material integration focus on functionalization of the material surface by means of natural proteins or short peptides. However, the use of these biomolecules involves major drawbacks such as immunogenic problems and oversimplification of the constructs. Here, designed elastin-like recombinamers (ELRs) are used to enhance poly(methyl methacrylate) surface properties and compared against the use of short peptides. In this study, cell response has been analysed for different functionalization conditions in the presence and absence of a competing protein, which interferes on surface–cell interaction by unspecific adsorption on the interface. The study has shown that ELRs can induce higher rates of cell attachment and stronger cell anchorages than short peptides, being a better choice for surface functionalization.

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