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S Mardjetko

Publications and source records attributed to S Mardjetko.

4 recordsLinked to original sources
PubMed2000

Pedicle morphology in thoracic adolescent idiopathic scoliosis: is pedicle fixation an anatomically viable technique?

STUDY DESIGN: A radiographic study of thoracic pedicle anatomy in a group of adolescent idiopathic scoliosis (AIS) patients. OBJECTIVE: To investigate the anatomic constraints of the thoracic pedicles and determine whether the local anatomy would routinely allow pedicle screw insertion at every level. SUMMARY OF BACKGROUND DATA: In spite of the clinical successes reported with limited thoracic pedicle screw-rod constructs for thoracic AIS, controversy exists as to the safety of this technique. MATERIAL AND METHODS: Twenty-nine patients with right thoracic AIS underwent preoperative thoracic CT scans and plain radiographs. Anatomic parameters were measured from T1 to T12. RESULTS: Information on 512 pedicles was obtained. The transverse width of the pedicles from T1 through T12 ranged from 4.6-8.25 mm. The medial pedicle to lateral rib wall transverse width from T1 through T2 ranged from 12.6 to 17.9 mm. Measured dimensions from the CT scans showed the actual pedicle width to be 1-2 mm larger than would have been predicted from the plain radiographs. Age, Risser grade, curve magnitude, and the amount of segmental axial rotation did not correlate with the morphology or size of the thoracic pedicles investigated. In no case would pedicle morphology have precluded the passage of a pedicle screw. CONCLUSION: Based on the data identified in this group of adolescent patients, it is reasonable to consider pedicle screw insertion at most levels and pedicle-rib fixation at all levels of the thoracic spine during the treatment of thoracic AIS.

Adolescent↗
PubMed1990

An evaluation of spinal deformity in metastatic breast cancer.

Between October 1984 and January 1988 31 magnetic resonance (MR) imaging studies were performed on 27 patients with metastatic vertebral breast cancer (MVBC). The MR images were reviewed to determine the extent and type of sagittal spinal deformity, and whether spinal canal compromise was present. Adjunct studies were compared to determine the pathogenesis of spinal deformity and the etiology of spinal canal compromise. An analysis of the data revealed that a consistent pattern of sagittal spinal deformity exists with MVBC, and a classification system was developed to describe the stages of vertebral deformity. Criteria are suggested for identifying metastatic spinal instability. A protocol is presented for treating patients with metastatic spinal involvement. By understanding the natural history of metastatic spinal deformity, instability and spinal canal compromise can be recognized and treated early, before the onset of progressive deformity and neurologic sequelae.

Breast Neoplasms↗
PubMedDate not supplied

Aneurysmal bone cysts of the spine: excision and stabilization.

The treatment of aneurysmal bone cysts (ABCs) of the spine remains controversial in the literature. Treatment options have included radiation, curettage and bone graft, extirpation, and various combinations of these. Conspicuously missing in previously published articles and texts are guidelines for dealing with the instability and deformity that often accompany ABCs of the spine. The index case in this report highlights the potentially devastating effects of treating the tumor in isolation without addressing the concomitant deformity and instability. The status of the structural integrity of the spine must be assessed before initiating treatment. If instability or deformity or both are already present or if the amount of osseous tissue to be resected may render the spine unstable, then instrumentation and fusion should be performed at the time of surgical resection or before other forms of therapy. We present three cases of ABCs of the spine in which the tumor itself was treated with surgical extirpation and the associated deformity and instability were treated with spinal instrumentation and long fusions.

Adolescent↗