No abstract available.
Kyphosis*

No abstract available.
Kyphosis*

OBJECTIVE: In cervico-thoracic junction (CTJ), the use of strong fixation device such as pedicle screw-rod system is often required. Purpose of this study is to analyze the anatomical features of C7 and T1 pedicles related to screw insertion and to evaluate the safety of pedicle screw insertion at these levels. METHODS: Nineteen patients underwent posterior CTJ fixation with C7 and/or T1 included in fixation levels. Seventeen patients had tumorous conditions and two with post-laminectomy kyphosis. The anatomical features were analyzed for C7 and T1 pedicles in 19 patients using computerized tomography (CT). Pedicle screw and rod fixation system was used in 16 patients. Pedicle violation by screws was evaluated with postoperative CT scan. RESULTS: The mean values of the width, height, stable depth, safety angle, transverse angle, and sagittal angle of C7 pedicles were 6.9 +/- 1.34 mm, 8.23 +/- 1.18 mm, 30.93 +/- 4.65 mm, 26.42 +/- 7.91 degrees, 25.9 +/- 4.83 degrees, and 10.6 +/- 3.39 degrees. At T1 pedicles, anatomic parameters were similar to those of C7. The pedicle violation revealed that 64.1% showed grade I violation and 35.9% showed grade II violation, overall. As for C7 pedicle screw insertion, grade I was 61.5% and grade II 38.5%. At T1 level, grade I was 65.0% and grade II 35.0%. There was no significant difference in violation rate between the whole group, C7, and T1 group. CONCLUSION: C7 pedicles can withstand pedicle screw insertion. C7 pedicle and T1 pedicle are anatomically very similar. With the use of adequate fluoroscopic oblique view, pedicle screw can be safely inserted at C7 and T1 levels.
Humans ; Kyphosis

Over 100 years ago, Hermann Kummell described a clinical condition in which patients sustained a trivial trauma, had essentially asymptomatic period lasting weeks to months, then developed a painful, progressive angular kyphosis. Since then, many post-traumatic delayed kyphosis have been reported as a Kummell's disease. As a radiologic finding of intravertebral cleft sign was related to this delayed collapse, this abnormal gas or fluid signal in the involved vertebral body was considered as a pathognomic sign. However, recent evidences indicate this delayed progressive collapse and kyphosis of the spine is related to osteoporotic spine fracture in many reports. At this point, by defining and reviewing the definition and etiology of Kummell's disease, we have to look into whether Kummell's disease is a distinct or rare pathophysiologic entity or a complicated clinical result of osteoporotic spine fracture. In this review, author tried to clearly define the definition and diagnosis criteria to diagnose Kummell's disease as a complicated osteoporotic spine fracture and review treatment modalities for this complicated clinical condition.
Humans ; Kyphosis ; Spine

No abstract available.
Kyphosis* ; Spine* ; Tuberculosis*

No abstract available.
Catheterization ; Catheters ; Humans ; Kyphosis ; Pneumothorax

OBJECTIVE: The authors evaluate results of transfacet pedicle sparing approach for high lumbar disc herniation to avoid injury of nerve roots and the cauda equina. METHODS: Seven patients treated by transfacet pedicle sparing approach for high lumbar disc herniation were reviewed. Some thoracolumbar kyphotic patients on whom posterior procedures underwent additional posterior lumbar interbody fusion and posterolateral fusion using the mesh cage and spinal instrumentation. RESULTS: Clinical symptoms improved in all seven patients. Rigid spinal stability and correction of thoracolumbar kyphosis could be performed by the spinal instrumentation methods. CONCLUSION: The advantages of the transfacet pedicle sparing approach are less invasive, easy decompression the nerve root directly and avoidance of the risk of injury to the cauda equina while the dura is being retracted. Additionally, thoracolumbar kyphosis could be corrected. Transfacet pedicle sparing approach is an useful procedure in the surgical treatment of high lumbar disc herniation.
Cauda Equina ; Decompression ; Humans ; Kyphosis

OBJECTIVE: The purpose of this study was to determine the efficacy of bone cement-augmented short segment fixation using percutaneous screws for thoracolumbar burst fractures in a background of severe osteoporosis. METHODS: Sixteen patients with a single-level thoracolumbar burst fracture (T11-L2) accompanying severe osteoporosis treated from January 2008 to November 2009 were prospectively analyzed. Surgical procedures included postural reduction for 3 days and bone cement augmented percutaneous screw fixation at the fracture level and at adjacent levels without bone fusion. Due to the possibility of implant failure, patients underwent implant removal 12 months after screw fixation. Imaging and clinical findings, including involved vertebral levels, local kyphosis, canal encroachment, and complications were analyzed. RESULTS: Prior to surgery, mean pain score (visual analogue scale) was 8.2 and this decreased to a mean of 2.2 at 12 months after screw fixation. None of the patients complained of pain worsening during the 6 months following implant removal. The percentage of canal compromise at the fractured level improved from a mean of 41.0% to 18.4% at 12 months after surgery. Mean kyphotic angle was improved significantly from 19.8degrees before surgery to 7.8 at 12 months after screw fixation. Canal compromise and kyphotic angle improvements were maintained at 6 months after implant removal. No significant neurological deterioration or complications occurred after screw removal in any patient. CONCLUSION: Bone cement augmented short segment fixation using a percutaneous system can be an alternative to the traditional open technique for the management of selected thoracolumbar burst fractures accompanied by severe osteoporosis.
Humans ; Kyphosis ; Osteoporosis ; Prospective Studies

OBJECTIVE: We compared the radiological and clinical outcomes between patients who underwent posterior fixation alone and supplemented with fusion following the onset of thoracolumbar burst fractures. In addition, we also evaluated the necessity of posterolateral fusion for patients treated with posterior pedicle screw fixation. METHODS: From January 2007 to December 2009, 46 consecutive patients with thoracolumbar burst fracture were included in this study. On the basis of posterolateral fusion, we divided our patients into the non-fusion group and the fusion group. The radiological assessment was performed according to the Cobb's method, and results were obtained at immediately, 3, 6, 12 months after surgery. The clinical outcomes were evaluated using the modified Mcnab criteria at the final follow-up. RESULTS: The demographic data and the mean follow-up period were similar between the two groups. Patients of both groups achieved satisfactory clinical outcomes. The mean loss of kyphosis correction showed that patients of both groups experienced loss of correction with no respect to whether they underwent the posterolateral fusion. There was no significant difference in the degree of loss of correction at any time points of the follow-up between the two groups. In addition, we also compared the effect of fixed levels (i.e., short versus long segment) on loss of correction between the two groups and there was no significant difference. There were no major complications postoperatively and during follow-up period. CONCLUSION: We suggest that posterolateral fusion may be unnecessary for patients with thoracolumbar burst fractures who underwent posterior pedicle screw fixation.
Follow-Up Studies ; Humans ; Kyphosis

No abstract available.
Kyphosis* ; Laminectomy* ; Spinal Cord Diseases*