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12 recordsLinked to original sources
PubMed2026

Comparative efficacy of percutaneous vertebroplasty combined with minimally invasive pedicle screw fixation versus percutaneous vertebroplasty alone in the treatment of elderly osteoporotic vertebral compression fractures.

The study aimed to assess the comparative efficacy of percutaneous vertebroplasty (PVP) combined with minimally invasive pedicle screw fixation versus PVP alone in elderly patients with osteoporotic vertebral compression fractures (OVCF). Ninety-four elderly patients with OVCF were randomly classified into the control (47 patients) and combined (47 patients) groups. The control group received PVP, while the combined group received PVP combined with minimally invasive pedicle screw fixation. Perioperative indicators such as intraoperative blood lose, operative time, and hospitalization time were recorded. Pain was assessed using the VAS before and at baseline and 1, 3, and 7 days postoperatively. At 1 and 3 days postoperatively, Serum CRP levels, WBC, and neutrophil counts were measured postoperatively. Radiographic outcomes (vertebral height ratio and Cobb angle), ADL scores, JOA scores, and ODI were evaluated preoperatively and at 3 months post-operation. Postoperative complications were documented. Baseline characteristics were comparable. The combined group showed superior pain relief, vertebral height restoration, Cobb angle correction, functional recovery, and reduced inflammatory markers (CRP, WBC, neutrophils) postoperatively (all P&#x2009;<&#x2009;0.05). Blood loss and hospital stay were shorter in the combined group, though operative time was longer (P&#x2009;<&#x2009;0.05). Complication rates did not differ significantly (P&#x2009;>&#x2009;0.05). PVP combined with minimally invasive pedicle screw fixation yields better outcomes in elderly OVCF patients by enhancing pain control, vertebral height, and functional recovery without increasing perioperative risk.

Humans↗
PubMed2026

Safety and Stability of a Combined C2 Screw Placement Strategy With Vertebral Artery Mobilization.

BACKGROUND: Although C2 pedicle screws are considered the gold standard for atlantoaxial fixation, the optimal fixation strategy for patients with high-riding vertebral arteries (HRVA) or narrow C2 pedicles (NC2P) remains controversial because of the increased risk of vertebral artery injury and the limitations of alternative fixation techniques. OBJECTIVE: To evaluate the safety, stability, and clinical efficacy of an individualized C2 screw fixation strategy incorporating vertebral artery mobilization for complex upper cervical anatomy. METHODS: A retrospective study was conducted in 312 patients who underwent C2 fixation between 2017 and 2025. Patients were categorized according to fusion method, screw laterality, and VA transposition requirement. Bone fusion rates and screw accuracy (Gertzbein-Robbins grading) were compared across groups using &#x3c7;2, Fisher's exact, and multivariate logistic regression analyses to control confounders. RESULTS: All procedures were successfully completed without permanent neurovascular injury. At 6&#x2009;months, the fusion rate with an atlantoaxial fusion cage was significantly higher than with interlaminar bone grafting (92.3% vs. 51.0%, p&#x2009;<&#x2009;0.001). Unilateral C2 pedicle screw fixation combined with a contralateral alternative screw achieved comparable stability to bilateral fixation (p&#x2009;>&#x2009;0.05). Screw placement accuracy was 100% clinically acceptable in normal anatomy and 60% in cases requiring VA mobilization, with no VA injury or blood flow compromise. CONCLUSION: The proposed multi-strategy C2 screw placement protocol-integrating fusion cage support and VA mobilization-achieves superior fusion, reliable fixation, and high safety, even in anatomically challenging conditions. This approach provides a reproducible and versatile solution for C2 instrumentation in complex craniovertebral junction surgery.

Humans↗
PubMedDate not supplied

[Arthrodesis of the sub-occipital spine by screwed occipito-cervical plate. Clinical case and technical notes].

The authors report a new technique in arthrodesis of the sub-occipital spine which has been experienced since 1973 in case of metastases at CI-C2 level. An occipitovertebral metal plate, inverted Y shaped has been realised after anatomical and biomecanical studies. It is adapted to the occipito-vertebral curvature and screwed in the articular processes of C3 and C4 (14 mm screw), and in the pedicles of C2 (32 mm screw). At the upper part, the occiptal ridge offers fixation by 12 and 14 mm Muller's screw. In addition CI is attached to the plate, by a nylon thread. After the report of the first clinical case with a nine month period of follow up technical features of the material as well as practical problems are exposed. Tomograms of the cervical spine as well as bilateral brachial angiography are of paramount value. The latter investigation may reveal anomalies of the vertebral artery that can hinder of forbid the pedicular fixation. Finally the authors discuss the extension of this technique to complexe trauma of the suboccipital column.

Arthrodesis↗
PubMed1976

[Anatomical study of the vertebral pedicles. Surgical application].

The author think that the use of plates screwed in the vertebral pedicles is the most fiable osteosynthesis at thoracic and lumbar spine level. This opinion is based on an anatomical study detailing the measurements and orientations of the pedicles. A series of 56 clinical cases treated by this method is briefly analysed.

Fracture Fixation, Internal↗
PubMed1979

Transarticular (transpedicular) metal plate fixation for stabilization of the lumbar and thoracic spine.

The operation of metal plate fixation of the articular column with the screws traversing the anterior vertebral arch (ventral pedicles) and anchored within the vertebral body is described in detail. The method can be recommended as easy to perform. It gives sufficiently stable fixation in cases where instability of the thoracic or lumbar spine can be expected during an operation from the dorsal approach. Four cases are presented to illustrate the indications and method.

Adult↗
PubMed1975

[The hypermobile skin- and soft-tissue tube in thumb reconstruction].

Reconstruction of an amputated thumb using a bone graft covered by a tubed skin pedicle gives good results if sufficient vascular supply and sensory innervation is transferred to the reconstructed thumb by a neruovascular island pedicle flap and if the skin and soft tissue tube is fixed well enough to the bone graft. Hypermobility of the skin prevents firm and accurate gripping. Fixation of the skin tube to the bone is best achieved at the time of neurovascular pedicle transfer. At the margin of the skin incision a strip of dermis is left and screwed to the periosteum. This method has been described by CHASE. If hypermobility of the skin persists after the neurovascular pedicle has been transferred the skin can be fixed to the bone using strips of fascia, dermis or lyodura. The operative technique of this procedure is described in detail.

Amputation, Traumatic↗
PubMed1975

[Posterior osteosynthesis in the treatment of spinal cord tumors].

Prognosis of cancerous tumors of the spine depends above all on their neurological consequences. The authors have wondered whether osteosynthesis of the spine -- in addition to decompressive surgery -- can improve patient's survival and fonctional results. 23 patients, 20 with a metastatic tumor and 3 with a plasmocytoma were treated in this way. All of them had neurological deficits, 4 had isolated radicular symptoms, 1 a cauda equina syndrome and 18 a spinal cord compression (7 of which were complete). 20 of these patients suffered intractable pain of the spine. All the patients underwent decompressive surgical removal of tumor through laminectomy, associated with a bilateral posterior metallic osteosynthesis. The type of osteosynthesis consisted of two metallic plates placed along each articular column and screwed into the articular processes and the vertebral body through the pedicles of the adjacent normal vertebrae. Cobaltotherapy was added in 14 cases, hormonotherapy in one case and radioactive 131 1 in one another patient. Selective spinal angiography, performed in one case of thoracolumbar tumor was found useful in the location and avoidance of Adamkiedwicz's artery. With regard to the complication, there were two operative wound infections requiring reoperation. Our series -- in comparaison with others -- prove the effectiveness of the combined procedure. Patients without complete spinal deficit had a 20 months survival average. Patients with complete deficit had the same survival as in comparative group. But all the 20 patients suffering pain in the spine were substantially relieved. Such a combined procedure is indicated in cases of tumors involving the vertebrae, whether or not the epidural space is invaded especially when there are riskes of unstable fracture and only partial neurological deficits. The technique may be extended even to complete paraplegia because of its worth while antalgic effects. Thus this method -- by consolidating the spine -- relieving pain and consequently allowing kinesitherapy to be resumed earlier is able to improve the functionnal status and increase survival of the patients.

Adult↗
PubMedDate not supplied

[Odontoid process fractures associated with fractures of the pedicles of the axis (author's transl)].

The authors report their experience concerning eleven cases of that original and frequent association of fractures. The ligamentous lesions associated with those fractures are considered, justifying the necessary dynamic X rays. The eleven cases are reviewed and a classification supported by an iconography is given, according to the unstability of the odontoid or of the pedicles. The complications after orthopaedic or surgical treatment are analysed and the authors give their conclusions. The proposed treatment is conservative when the fractures are neither displaced nor unstable, and surgical when one of the two fractures is unstable. The best procedure is bi-pedicular screwing associated with C1/C2 wiring.

Aged↗