The importance of the sagittal profile in spinal deformity surgery
|
|
|
- Conrad Arnold
- 5 years ago
- Views:
Transcription
1 The importance of the sagittal profile in spinal deformity surgery FRCS (Orth), MCh (Orth), D (Orth), MS (Orth) Consultant Spine Deformity Surgeon The Royal Orthopaedic Hospital, Birmingham Childrens Hospital BMI Healthcare Spire Healthcare
2 Outline Understanding & measuring the sagittal profile Pathological changes in sagittal profile Surgical reconstruction options Clinical evidence / cases
3 Sagittal plane: divides into right & left halves
4 Balance: Head over heels!
5 The spinal fingerprint
6 Cone of economy J. Dubousset
7 Sagittal Plane Alignment More Than Just the Spine Thoracic kyphosis Lumbar lordosis Pelvic morphology/ version Global Alignment Lower extremity Biospace / LBM
8 Sagittal vertical axis
9 C7
10 Radiographic measures Lumbar lordosis L1 S1 TL junction T10 L2 Thoracic kyphosis T4 T12
11 Thoracic kyphosis: 38 ± 18 Lumbar lordosis: 48 ± 18
12 TL Junction T10 L2
13 Pelvic measures Sacral slope (SS) Pelvic tilt (PT) Pelvic incidence (PI)
14 Sacral slope Horizontal & cranial sacral end plate tangent 41 ± 8.4 (Vialle JBJS 2005)
15 Pelvic tilt Vertical line between 1) middle of cranial sacral end plate 2) centre of the bicoxo-femoral axis 13 ± 6 (Vialle JBJS 2005)
16 Significance of pelvic tilt Centre of gravity over LL Maintains sacral plate posterior to the hip Increases with age
17 Pelvic incidence Key parameter Perpendicular to: the middle of the sacral end plate mid-point of femoral heads 55 ± 10.6 (Vialle JBJS 2005)
18 Spino-pelvic compensation PI regulates PT Higher PI Better compensation
19
20 PI = PT + SS
21 Schwab et al. SPINE 2011 Curve types Modifiers
22 The sagittal plane deformity
23 The coronal plane deformity
24 Spino-pelvic pathology patterns Progressive kyphosis Gravity line drifts forwards Pelvis rotates backwards Sacral slope decreases Knee flexion
25 Type 1: Non-harmonious spine Thoraco lumbar disc Junctional listhesis Eurospine 2007 Bruxelles
26 Type 2: Harmonious but Flat Back Early disc degeneration
27 Type 3:The most harmonious ( probably a good back )
28 Type 4: Harmonious but hyper-curved. When young: very strong High PI Good lordosis With aging will lose lordosis pelvic tilt increases to compensate for anterior imbalance Lumbar stenosis + spondylolisthesis
29
30 Disc degeneration
31
32
33 Facet joint changes Joint capsule Inferior articular process Superior articular process Increased axial rotation in disc degeneration Courtesy Bronek Boszczyk
34 Facet joint changes Joint capsule Inferior articular process Superior articular process Increased axial rotation in disc degeneration results in shear of the enthesis and direct pressure upon the capsule Courtesy Bronek Boszczyk
35 Facet joint changes Inferior articular process Superior articular process Encompassing joint formation develops through direct contact of enthesophytes in advanced degeneration Courtesy Bronek Boszczyk
36 Facet joint changes In contrast to other joints, reactions of the joint capsule / enthesis are seen before permanent cartilage damage Early restoration of disc biomechanics may prevent progression to stage of permanent damage Vernon-Roberts & Pirie Rheumatol Rehabil 1977 Fujiwara et al. Eur Spine J 1999 Courtesy Bronek Boszczyk
37 Facet joint degeneration Joint width Articular erosions Sub-chondral sclerosis Osteophytes
38 Facet joint changes
39 Two views of a typical facet joint contact space object (for a normal spine) Volume (mm3) ) Surface area (mm
40 Surface area of the facet joint contact space (mean ± stdev) Surface area (mm2) L1-2-R L1-2-L L2-3-R L2-3-L L3-4-R L3-4-L Jwalant S.L4-5-L Mehta L4-5-R L5-S1-R L5-S1-L 49
41 Volume of the facet joint contact space (mean ± stdev) Volume (mm3) L1-2-R L1-2-L L2-3-R L2-3-L L3-4-R L3-4-L Jwalant S.L4-5-L Mehta L4-5-R L5-S1-R L5-S1-L 50
42 59 / F AP Cobb CSL 26º 7 cm Pelvic: PI SS PT 55º 20º 35º LL 44º TL 66º TK 56º SVA 11 cm
43 Clinical effects of plumb-line shifts Glassman, Bridwell et al. Spine 2005
44 deformity
45
46 Standing lat Hyperext lat
47 Aim 1: achieve fusion Good pain relief; 69 87% Kostuik Clin Orthop 1973 Swank JBJS Am 1981 Improvement in the lumbar lordosis Anterior column load sharing
48 Aim 2: adaptation of lordosis Excise facet joints Open degenerate disc spaces LL=PI ± 90 Measure the PI, and build in the lordosis
49 Adult Deformity: Surgical goals Normalize & balance contours Fuse the least number of segments Neural decompression Obtain solid biological fusion
50 Adult Deformity: principles of surgery Traction + erect full spine films Measure parameters Levels to instrument Levels to decompress Anterior column management
51 MM 86Y
52
53
54
55 Advanced surgical strategies
56 Osteotomies 1. partial facet joint 2. complete facet joints 3. partial body# 4. partial body and disc # 5. complete body + discs # 6. >1 body, adjacent # # posterior vs. anterior/posterior Courtesy Frank Schwab
57 Grade I - Partial Facet Resection Best suited when anterior column flexibility Inferior facet resection + capsule Courtesy Frank Schwab
58 Grade II - Complete facetectomy Anterior column mobility necessary Superior and inferior facet resection Spinous processes Courtesy Frank Schwab
59 Grade III - Partial body resection Most suited when >20 segmental correction needed Appropriate even through fusion All levels of spine possible Preferable below conus Courtesy Frank Schwab
60 Grade IV - partial vertebra + disc Permits limited 3-plane correction Rib resection necessary in thoracic spine Add anterior support/cage when marked shortening Courtesy Frank Schwab
61 Grade V - Complete vertebra + discs Permits 3-plane correction Rib resection necessary in thoracic spine Add anterior support/cage Courtesy Frank Schwab
62 Grade VI - More than 1 Vertebra + discs Permits 3-plane correction Rib resection necessary in thoracic spine Add anterior support/cage Courtesy Frank Schwab
63 Facetectomy
64 Facetectomy
65 Instrumentation related strategies
66 Screws; alternative bone anchors Rods Reduction strategies Connector options Anterior column
67 Pedicle Screw Pullout Strength of Four Different Screw Hole Preparation Techniques Jwalant Mehta, FRCS (Orth), M.D.; Mark Moldavsky M.S.; Kanaan Salloum; Brandon Bucklen PhD; Saif Khalil PhD
68 CoCr Stiffness/Modulus Firebird 5.5mm Cobalt Chrome Rods offer a 100% increase in stiffness compared to 5.5mm Titanium rods
69 CoCr Strength/Yield Firebird 5.5mm Cobalt Chrome Rods offer a 25% increase in strength compared to 5.5mm Titanium rods
70 Firebird Deformity Correction System Iliac Fixation Hook Fixation Thoracic Fixation Reduction/Rotation
71 Iliac Bone Screws Iliac Bone Screws mm diameters mm lengths (10mm inc.) 2 of each per tray Utilize all Firebird modular bodies
72 Mono Axial Lateral Offset Connector Available in lengths from 15-35mm, 5mm incr. Utilize modular head holders for insertion 80mm length for intra-op customization Gripping features
73 Low Profile Offset Heads Lowest profile option Modular bone screw compatible Now with an integrated set screw over the bone screw connection point Lengths: 8 35mm, 3mm increments
74 Firebird Hooks Implant Angled Hook Laminar Hook Offset Hook Pedicle Hook Thoracic Hook Image Size / Style Left, Right Small, Medium (throat) Small, Medium, Large (throat) Narrow, Wide (blade) Left, Right Medium, Large (throat) Small, Medium, Large (throat) Small, Medium (throat) Narrow, Wide (blade) Features / Use Supralaminar Ramped base reduces the potential for canal encroachment by blade Inframlaminar or supralaminar In the canal or as a transverse process hook Inframlaminar or supralaminar Permits medialization of the rod when used on the transverse process Inframlaminar Bifid tip engages pedicle of thoracic vertebra Inframlaminar or supralaminar Ramped base of hook reduces the potential for canal encroachment by the blade
75 Thoracic Fixation Rods, 5.5 X 450mm Cobalt Chrome Titanium Uniplanar Screws Diameter = mm Length = 25 45mm
76 Uni-Planar Screws C / C Cephalad/Caudad Allows Cephalad/Caudad movement Assist with rod placement in kyphotic deformities Medial/Lateral M/L Prevents Medial / Lateral movement Correction Capability of Mono Screw
77 Reduction/Rotation Instruments Linear Rod Reducer Coronal Benders Reduction/Rotation Tube Ratcheting Connector Rotation Handle Rod Gripper Driver Hex Wrench Set Screw Driver
78 Direct Vertebral Rotation Instrument Bi-Lateral Ratcheting Connector Secures to Reduction Towers and Handle to Complete DVR facilitate DVR maneuvers Instrument Small 66 91mm Expansion Large mm Expansion
79 Direct Vertebral Rotation Technique After rod reduction is complete, place Tubular Rod Reducers bilaterally on the pedicles of the same vertebral body. Attach Ratcheting Connector to Tubular Rod Reducers. Adjust instrument to accommodate to medial lateral separation and pedicle screw trajectory. Lock Tubular Rod Reducer orientation by actuating central lock (medial lateral orientation)
80
81 Problems Realistic expectations Medical co-morbidites Osteoporosis Junctional problems
82
83
84
85
86 Pre-op standing lateral 53.8 Hyper-extension lateral Post-op standing lateral
87 Re-create lordosis
88 Aims of intervention Restore balance without stressing junction Adaptation of the lordosis Restore plumb line
89 The new
Respecting and restoring the sagittal. profile in spinal surgery
Respecting and restoring the sagittal profile in spinal surgery Jwalant S. Mehta MBBS, D Orth, MCh (Orth), FRCS (Tr & Orth) Consultant Spine Surgeon Swansea Spinal Unit ABMU Health Board Outline Why this
Flatback Syndrome. Pathologic Loss of Lumbar Lordosis
Flatback Syndrome Pathologic Loss of Lumbar Lordosis Robert P. Norton, MD Florida Spine Specialists Orthopaedic Spine Surgery Clinical Associate Professor, FAU College of Medicine Boca Raton, FL Courtesy
As edited by Dr. Oheneba Boachie-Adjei, Dr. Matthew Cunningham, Dr. John Kostuik, Dr. Raymund Woo and the Complex Spine Study Group et al
As edited by Dr. Oheneba Boachie-Adjei, Dr. Matthew Cunningham, Dr. John Kostuik, Dr. Raymund Woo and the Complex Spine Study Group et al RANGE Spinal System A fusion of DENALI and MESA, offering a complete
5/27/2016. Sagittal Balance What is It and How Did We Get Here? Sagittal Balance. Steven J. Tresser, MD Tampa, FL. Concept:
Sagittal Balance What is It and How Did We Get Here? Steven J. Tresser, MD Tampa, FL Number of Articles Published on Sagittal Balance/Alignment by Year 350 300 250 200 150 100 50 0 Sagittal Balance Concept:
The Influence of Spinal Deformities on Acetabular Orientation in Total Hip Arthroplasty
The Influence of Spinal Deformities on Acetabular Orientation in Total Hip Arthroplasty S. SAMUEL BEDERMAN MD PhD FRCSC Scoliosis & Spine Tumor Center S. SAMUEL BEDERMAN MD PhD FRCSC disclosures October
Surgical Technique FOR U.S. DOMESTIC USE ONLY
Surgical Technique FOR U.S. DOMESTIC USE ONLY Polyaxial Screws HA Coated Polyaxial Screws Uniplanar Screws Reduction Screws Reduction Uniplanar Screws Modular Screws TABLE OF CONTENTS Reform Pedicle Screw
Disclosures. Outline. General Guideline 6/4/2011. Consultant Medtronic, Stryker, Depuy. Osteotomy Planning and the Impact of Reciprocal Changes
Disclosures Consultant Medtronic, Stryker, Depuy Osteotomy Planning and the Impact of Reciprocal Changes Christopher Ames MD Associate Professor Director of Spine Tumor and Deformity Surgery UCSF Department
L8 Spine System SURGICAL TECHNIQUE. Add: No.1-8, Tianshan Road, Xinbei District, Changzhou, Jiangsu, China
Add: No.-8, Tianshan Road, Xinbei District, Changzhou, Jiangsu, China 23022 Tel: 0086 59 8595556 Fax: 0086 59 859555 Http://www.kanghui.com Add: F25, Shanghai International Pharmaceutical Trad & Exhibition
Implementation of Pre-operative Planning:
Implementation of Pre-operative Planning: 1-Year Results Using Patient-Specific UNiD Rods in Adult Deformity C.J. Kleck, MD 06/16/2017 Pre-operative Planning In the fields of observation chance favors
Thoracic Lumbar Pelvic Posterior Anterior. Universal Spine System (USS). A versatile side-loading system portfolio.
Thoracic Lumbar Pelvic Posterior Anterior Universal Spine System (USS). A versatile side-loading system portfolio. Universal Spine System (USS) The Synthes USS product portfolio is based on more than
Adult Spinal Deformity: Principles of Surgical Correction
Adult Spinal Deformity: Principles of Surgical Correction S. Samuel Bederman, MD PhD FRCSC Department of Orthopaedic Surgery California Orthopaedic Association, Indian Wells, CA April 25, 2015 2 3 4 Adult
SURGICAL TECHNIQUE. Standard Reduction HA Coated Modular. Discover the Difference
SURGICAL TECHNIQUE Standard Reduction HA Coated Modular Discover the Difference TABLE OF CONTENTS REFORM PEDICLE SCREW SYSTEM OVERVIEW 3 TRAY IMAGES & CONTENT 14 SURGICAL TECHNIQUE 34 1. Preoperative Planning
Xia 3 Spinal System. AIS surgical technique
Xia 3 Spinal System Table of contents Surgical technique Key design features.... 4 Patient positioning.... 8 Hook selection... 9 Hook insertion... 10 Preparing the pedicle.... 14 Screw insertion... 19
Sagittal Balance 5/19/2017. Disclosures. Radiographic Assessment And Surgical Goals
Sagittal Balance Radiographic Assessment And Surgical Goals Steven J. Tresser, MD Disclosures Nuvasive consultant, royalties, speaking K2M consultant, royalties Centinel Spine consultant, speaking CTL
Surgical treatment for adult spinal deformity: Conceptual approach and surgical strategy
REVIEW ARTICLE SPINE SURGERY AND RELATED RESEARCH Surgical treatment for adult spinal deformity: Conceptual approach and surgical strategy Yukihiro Matsuyama Department of Orthopedic Surgery, Hamamatsu
4.5 System. Surgical Technique. This publication is not intended for distribution in the USA.
4.5 System Surgical Technique This publication is not intended for distribution in the USA. Contents EXPEDIUM 4.5 Spine System 2 Features and Benefits 3 Surgical Technique Extended Tandem Connector 4 Placement
The Most Reliable Spinal Solution
MFG : 09.02.20 REV : 1 4CIS VANE introduces you the reliable pedicle screw The Most Reliable Spinal Solution Non-slip threaded joint Ergonomic design Wedged trapezoid thread Superior locking mechanism
EXPEDIUM 5.5 Spine System Family Product Catalogue
EXPEDIUM 5.5 Spine System Family Product Catalogue Including: EXPEDIUM EXPEDIUM Vertebral Body Derotation Universal Connector Set Cobalt Chromium Rods INTRODUCTION Contents EXPEDIUM Spine System is a comprehensive
VERTEX SELECT. surgical technique. adjustability. Flexibility. adaptability. Reconstruction System
VERTEX SELECT Reconstruction System surgical technique adjustability. Flexibility. adaptability. adjustability. Flexibility. adaptability. The VERTEX SELECT Reconstruction System is a comprehensive set
A U X I L I A R Y C O N N E C T O R S Surgical Technique
A U X I L I A R Y C O N N E C T O R S Surgical Technique AUXILIARY CONNECTORS ISSYS LP Auxiliary Connectors The ISSYS LP auxiliary connectors were designed to provide medial-lateral variability for the
Dorsal Cervical Surgeries and Techniques
Dorsal Cervical Approaches Dorsal Cervical Surgeries and Techniques Gregory R. Trost, MD Professor and Vice Chair of Neurological Surgery University of Wisconsin-Madison Advantages Straightforward Easily
Spinal Deformity Pathologies and Treatments
Spinal Deformity Pathologies and Treatments Scoliosis Spinal Deformity 3-dimensional deformity affecting all 3 planes Can be difficult to visualize with 2-dimensional radiographs Kyphosis Deformity affecting
Polaris Deformity System Trivium Derotation System
Polaris Deformity System Trivium Derotation System A Three Dimensional Approach to Deformity Correction The Polaris Deformity System in combination with the Trivium Derotation System incorporates Enbloc
Spinal deformities, such as increased thoracic
An Original Study Clinical and Radiographic Evaluation of Sagittal Imbalance: A New Radiographic Assessment Hossein Elgafy, MD, MCh, FRCS Ed, FRCSC, Rick Bransford, MD, Hassan Semaan, MD, and Theodore
AOSpine Advances Symposium Spinal Deformity
AOSpine Advances Symposium Spinal Deformity December 03-04, 2010 Istanbul, Türkiye Proper radiographic evaluation, parameters, clinical relevance and importance Dr. Alpaslan Şenköylü Session: Sagittal
USS Variable Axis Screw (VAS) System. For posterior fixation of the lumbar spine.
USS Variable Axis Screw (VAS) System. For posterior fixation of the lumbar spine. Technique Guide Instruments and implants approved by the AO Foundation Table of Contents Introduction USS Variable Axis
Solitaire Anterior Spinal System
Surgical Technique Solitaire Anterior Spinal System Independent Stabilization for the Anterior Column Available in Titanium and Contents Introduction... Page 1 Design Features... Page 2 Instruments...
Ref: Q400-09T1 EBI Spine. September 05/VS02. c/o BIOMET Spain Orthopaedics, S.L.
Ref: Q400-09T1 EBI Spine. September 05/VS02 c/o BIOMET Spain Orthopaedics, S.L. www.ebimedical.com EBI Omega 21 TM LP Since its introduction in 1996, and with thousands of patients treated so far, the
Cervical Osteotomies: Choosing the Right Surgical Approach
Cervical Osteotomies: Choosing the Right Surgical Approach Todd J. Albert, MD Surgeon-in-Chief and Medical Director Korein-Wilson Professor Hospital for Special Surgery Chairman, Department of Orthopaedic
It consist of two components: the outer, laminar fibrous container (or annulus), and the inner, semifluid mass (the nucleus pulposus).
Lumbar Spine The lumbar vertebrae are the last five vertebrae of the vertebral column. They are particularly large and heavy when compared with the vertebrae of the cervical or thoracicc spine. Their bodies
Biomet Omega21 TM Spinal Fixation System
Biomet Omega21 TM Spinal Fixation System Surgical Technique Coronal Angulation 50% Axial Angulation Infinite Sagittal Angulation Contents Introduction... Page 1 System Design Features And Benefits... Page
The Kickstand Rod technique for correction of coronal imbalance in patients with adult spinal deformity: theory and technical considerations
Case Report The Kickstand Rod technique for correction of coronal imbalance in patients with adult spinal deformity: theory and technical considerations Melvin C. Makhni 1, Meghan Cerpa 2, James D. Lin
Update on Assessment of Normal Sagittal Spinal Alignment
3 rd Annual International Spinal Deformity Symposium November 3-4, 2017 Update on Assessment of Normal Sagittal Spinal Alignment Justin S. Smith, MD, PhD Harrison Distinguished Professor Department of
Surgical Technique. Available In Titanium And Stainless Steel
Surgical Technique Available In Titanium And Stainless Steel Contents Introduction... Page 1 System Design Features... Page 2 Implants... Page 3 Standard Instruments... Page 7 Degenerative Surgical Technique...
Thoracolumbar Spine Locking Plate (TSLP) System. A low-profile plating system for anterior stabilization of the thoracic and lumbar spine.
Thoracolumbar Spine Locking Plate (TSLP) System. A low-profile plating system for anterior stabilization of the thoracic and lumbar spine. Technique Guide Instruments and implants approved by the AO Foundation
2. The vertebral arch is composed of pedicles (projecting from the body) and laminae (uniting arch posteriorly).
VERTEBRAL COLUMN 2018zillmusom I. VERTEBRAL COLUMN - functions to support weight of body and protect spinal cord while permitting movements of trunk and providing for muscle attachments. A. Typical vertebra
I. II. SPINAL SYSTEM SURGICAL TECHNIQUE GUIDE
I. GS1 II. SPINAL SYSTEM SURGICAL TECHNIQUE GUIDE Introduction The Gold Standard Orthopaedics, LLC GS1 Spinal System designed in conjunction with Richard Holt, M.D. incorporates both strength and function
Spinologics.com. Scoliosis Surgery Simulation
Scoliosis Surgery Simulation Finite Element (FE) Models Finite element model: mathematical method widely used in traditional engineering fields (aeronautics, car industry, civil engineering). Principle:
Y o u r Id e a s En g i n e e r e d t o Li f e
ISSYS LP Spinal Fixation System Surgical Guide Y o u r Id e a s En g i n e e r e d t o Li f e In t r o d u c t i o n ISSYS LP Sp i n a l Fixation System The foundation of the ISSYS LP Spinal Fixation System
Technique Guide. NFlex. Semi-rigid rods for posterior lumbar stabilization.
Technique Guide NFlex. Semi-rigid rods for posterior lumbar stabilization. Table of Contents Introduction NFlex 2 Indications and Contraindications 4 NFlex Principles 6 Surgical Technique Preoperative
3D titanium interbody fusion cages sharx. White Paper
3D titanium interbody fusion cages sharx (SLM selective laser melted) Goal of the study: Does the sharx intervertebral cage due to innovative material, new design, and lordotic shape solve some problems
Module: #15 Lumbar Spine Fusion. Author(s): Jenni Buckley, PhD. Date Created: March 27 th, Last Updated:
Module: #15 Lumbar Spine Fusion Author(s): Jenni Buckley, PhD Date Created: March 27 th, 2011 Last Updated: Summary: Students will perform a single level lumbar spine fusion to treat lumbar spinal stenosis.
Royal Oak Cervical Plate System
Royal Oak Cervical Plate System Manufactured by Nexxt Spine, Inc. Royal Oak Cervical Plate System INTRODUCTION FEATURES AND BENEFITS Table of Contents SURGICAL TECHNIQUE Step 1. Patient Positioning Step
CSS Combined Spine System
CSS Combined Spine System H- CSS Combined Spine System H- CSS Combined Spinal System : 800000 H-3 CSS Combined Spinal System : 800000 Ref.Number Description Pieces Ref.Number Description Pieces 00000 Open
PRODUCT SUMMARY Cobalt Chrome Tulip Multiple Options Triple Lead Thread
PRODUCT SUMMARY Cobalt Chrome Tulip Multiple Options Triple Lead Thread Screws Low Profile 2.72 Footprint x 2.5 Height Square Threaded Locking Cap Geometry reduces risk of cross threading Hexalobular Drive
Clinical Biomechanics in Spinal Surgery
Disclosure Clinical Biomechanics in Spinal Surgery Joseph S. Cheng, M.D., M.S. Associate Professor of Neurological Surgery and Orthopedic Surgery Director, Neurosurgery Spine Program I have no relevant
EXCELLA ll. Spinal System
EXCELLA ll Spinal System Excella II Spinal System INDICATIONS FOR USE The Innovasis Excella II Spinal System is intended for use in the non-cervical area of the spine. WARNING: The safety and effectiveness
X-spine Surgical Technique
X-spine Surgical Technique The X90 Pedicle Screw System Revolutionary Design and Function This document is intended exclusively for experts in the field, particularly physicians, and is not intended for
Simultaneous anterior vertebral column resection-distraction and posterior rod contouring for restoration of sagittal balance: report of a technique
Case Report Simultaneous anterior vertebral column resection-distraction and posterior rod contouring for restoration of sagittal balance: report of a technique Shaishav Bhagat 1, Alexander Z. E. Durst
Adolescent Idiopathic Scoliosis
Adolescent Idiopathic Scoliosis Surgical Treatment Comparisons By: Dr. Alex Rabinovich and Dr. Devin Peterson Options 1. Pedicle Screws versus Hooks 2. Posterior versus Anterior Instrumentation 3. Open
ESSENTIALS OF PLAIN FILM INTERPRETATION: SPINE DR ASIF SAIFUDDIN
ESSENTIALS OF PLAIN FILM INTERPRETATION: SPINE DR ASIF SAIFUDDIN Consultant Musculoskeletal Radiologist Royal National Orthopaedic Hospital Stanmore,UK. INTRODUCTION 2 INTRODUCTION 3 INTRODUCTION Spinal
Handling instructions. USS Low Profile. Thoracolumbar posterior fixation system.
Handling instructions USS Low Profile. Thoracolumbar posterior fixation system. U Table of contents Introduction Indications and contraindications 3 USS Low Profile implants 4 Handling implants with stick
Postoperative Change of Thoracic Kyphosis after Corrective Surgery for Adult Spinal Deformity
ORIGINAL ARTICLE SPINE SURGERY AND RELATED RESEARCH Postoperative Change of Thoracic Kyphosis after Corrective Surgery for Adult Spinal Deformity Tatsuya Yasuda 1), Tomohiko Hasegawa 2), Yu Yamato 2),
Lumbo-sacral destruction fixation biomechanics
Lumbo-sacral destruction fixation biomechanics Amin Joukhar MSc * Jwalant S. Mehta FRCS Orth ^ David Marks FRCS Orth ^ Prof Vijay Goel PhD * ^ Birmingham Spine Centre, England *Engineering Centre for Orthopaedic
POLYAXIAL SPINE SYSTEM D E G E N E R A T I V E
S U R G I C A L T E C H N I Q U E En POLYAXIAL SPINE SYSTEM D E G E N E R A T I V E LOW PROFILE POLYAXIAL SPINE SYSTEM A01110050 Straight spatula A01110060 Curved spatula A01110070 Bone probe A01114500
VLIFT System Overview. Vertebral Body Replacement System
VLIFT System Overview Vertebral Body Replacement System VLIFT System System Description The VLIFT Vertebral Body Replacement System consists of a Distractible In Situ (DIS) implant, which enables the surgeon
Proximal junctional kyphosis in adult spinal deformity with long spinal fusion from T9/T10 to the ilium
Original Study Proximal junctional kyphosis in adult spinal deformity with long spinal fusion from T9/T10 to the ilium Tatsuya Yasuda, Tomohiko Hasegawa, Yu Yamato, Sho Kobayashi, Daisuke Togawa, Shin
Adult Spinal Deformity Robert Hart. Dept. Orthopaedics and Rehab OHSU
Adult Spinal Deformity 2010 Robert Hart Dept. Orthopaedics and Rehab OHSU What is Adult Spinal Deformity? Untreated Idiopathic Scoliosis Flat Back Syndrome Adjacent Segment Stenosis Non-Union Degenerative
OPERATIVE TECHNIQUE. anterior cervical plating system
OPERATIVE TECHNIQUE 3º anterior cervical plating system Introduction 1 Pre-Operative Technique 2 Oerative Technique 3 Instructions for Use 12 Part Numbers 16 The surgical technique shown is for illustrative
Lumbar-sacral Destruction Fixation Biomechanics
Lumbar-sacral Destruction Fixation Biomechanics PIs: Jwalant S. Mehta, MD and Vijay K. Goel, PhD, David S. Marks FRCS (Orth) Trainee: Amin Joukar, BS Birmigngham Spine Centre, England Engineering Center
EFSPINE CERVICAL COMBINED SET DISC PROTHESIS ORGANIZER BOX
EFSPINE CERVICAL COMBINED SET INSTRUMENTS CERVICAL CAGE & DISC PROTHESIS ORGANIZER BOX Cervical Thoracic Thoraco - Lumbar Sacral EFSPINE CERVICAL COMBINED SET CERVICAL IMPLANTS INTRODUCTION Cervical Disc
Trinica and Trinica Select Anterior Cervical Plate System
Surgical Technique Trinica and Trinica Select Anterior Cervical Plate System A New Twist to Anterior Cervical Plates Trinica and Trinica Select Surgical Technique 1 Trinica and Trinica Select Anterior
The CerviFix System. Including the StarLock Components. CerviFix Clamp and Screw. StarLock Clamp and Screw
The CerviFix System Including the StarLock Components CerviFix Clamp and Screw StarLock Clamp and Screw The CerviFix System The CerviFix System is a comprehensive set of implants, including clamps, screws,
VERTEBRAL COLUMN VERTEBRAL COLUMN
VERTEBRAL COLUMN FUNCTIONS: 1) Support weight - transmits weight to pelvis and lower limbs 2) Houses and protects spinal cord - spinal nerves leave cord between vertebrae 3) Permits movements - *clinical
Ligaments of the vertebral column:
In the last lecture we started talking about the joints in the vertebral column, and we said that there are two types of joints between adjacent vertebrae: 1. Between the bodies of the vertebrae; which
Structure and Function of the Vertebral Column
Structure and Function of the Vertebral Column Posture Vertebral Alignment Does it really matter? Yes it does! Postural Curves The vertebral column has a series of counterbalancing curves posterior anterior
operative technique Universal Application
operative technique Universal Application Introduction Introduction Building upon the design rationale of the Xia Spinal System, the new Xia Spinal System represents the latest advancement in spinal implant
SURGICAL TECHNIQUE. SECURIS Pedicle Screw System for Minimally Invasive Surgery. 2 I SECURIS Pedicle Screw System
Surgical Technique e Guide SECURIS Pedicle Screw System for Minimally Invasive Surgery Securis Pedicle Screw System has been engineered to provide temporary posterior stabilization of the thoracolumbar
Biomechanics of compensatory mechanisms in spinal-pelvic complex
Journal of Physics: Conference Series PAPER OPEN ACCESS Biomechanics of compensatory mechanisms in spinal-pelvic complex To cite this article: D V Ivanov et al 2018 J. Phys.: Conf. Ser. 991 012036 View
GLOBAL SAGITTAL ANGLE (GSA): A NOVEL
GLOBAL SAGITTAL ANGLE (GSA): A NOVEL PARAMETERS TO ADDRESS SAGITTAL ALIGNMENT AND COMPENSATORY MECHANISMS IN THE BODY Bassel G. Diebo, Vincent Challier, Shaleen Vira, Matthew Spiegel, Bradley Harris, Renaud
SKELETAL AWARENESS & DEXTERITY. Update, Misnomers & Insights for Non-Specific Low Back Pain
SKELETAL AWARENESS & DEXTERITY Spondylolisthesis I: Update, Misnomers & Insights for Non-Specific Low Back Pain Robert Burgess BEd, PT, PhD, Huggins Hospital Newsletter# 7 January 2015 Isthmic Spondylolisthesis
ONE SYSTEM, MULTIPLE OPTIONS. Surgical Technique. Hip Knee Spine Navigation
ONE SYSTEM, MULTIPLE OPTIONS Surgical Technique Hip Knee Spine Navigation MUST MINI Surgical Technique Hip Knee Spine Navigation INTRODUCTION The M.U.S.T. Mini posterior cervical screw system is a modular
Am I eligible for the TOPS study? Possibly, if you suffer from one or more of the following conditions:
Am I eligible for the TOPS study? Possibly, if you suffer from one or more of the following conditions: Radiating leg pain Greater leg / buttock pain than back pain Severe pain sets in when walking as
Dr Ajit Singh Moderator Dr P S Chandra Dr Rajender Kumar
BIOMECHANICS OF SPINE Dr Ajit Singh Moderator Dr P S Chandra Dr Rajender Kumar What is biomechanics? Biomechanics is the study of the consequences of application of external force on the spine Primary
Prevention of PJF: Surgical Strategies to Reduce PJF. Robert Hart, MD Professor OHSU Orthopaedics Portland OR. Conflicts
Prevention of PJF: Surgical Strategies to Reduce PJF Robert Hart, MD Professor OHSU Orthopaedics Portland OR Conflicts Consultant Depuy Spine, Medtronic Royalties Seaspine, Depuy Research/Fellowship Support
When is Degenerative Disease Really Deformity
When is Degenerative Disease Really Deformity Cabo State of Spine Surgery Think Tank June 2017 Gurvinder S. Deol, MD Wake Orthopaedics/WakeMed Health and Hospitals Clinical Assistant Professor Department
Technique Guide. ECD Expandable Corpectomy Device. Continuously Expandable Vertebral Body Replacement for Tumour Cases.
Technique Guide ECD Expandable Corpectomy Device. Continuously Expandable Vertebral Body Replacement for Tumour Cases. Table of Contents Introduction Overview 2 AO ASIF Principles 4 Indications and Contraindications
PILLAR AL. Anterior Lumbar Interbody Fusion (ALIF) and Partial Vertebral Body Replacement (pvbr) PEEK Spacer System OPERATIVE TECHNIQUE
PILLAR AL PEEK Spacer System Anterior Lumbar Interbody Fusion (ALIF) and Partial Vertebral Body Replacement (pvbr) OPERATIVE TECHNIQUE Table of Contents 1 INTRODUCTION 2 PRE-OPERATIVE TECHNIQUE 3 OPERATIVE
Spinal Terminology Basics
Spinal Terminology Basics Anterior The front portion of the body. It is often used to indicate the position of one structure relative to another. Annulus Fibrosus The outer, fibrous, ring like portion
SUBAXIAL CERVICAL SPINE TRAUMA- DIAGNOSIS AND MANAGEMENT
SUBAXIAL CERVICAL SPINE TRAUMA- DIAGNOSIS AND MANAGEMENT 1 Anatomy 3 columns- Anterior, middle and Posterior Anterior- ALL, Anterior 2/3 rd body & disc. Middle- Posterior 1/3 rd of body & disc, PLL Posterior-
U.S. MARKET FOR MINIMALLY INVASIVE SPINAL IMPLANTS
U.S. MARKET FOR MINIMALLY INVASIVE SPINAL IMPLANTS idata_usmis15_rpt Published in December 2014 By idata Research Inc., 2014 idata Research Inc. Suite 308 4211 Kingsway Burnaby, British Columbia, Canada,
ASSESSMENT OF SPINO-PELVIC MORPHOMETRY, A PREDICTOR OF LUMBOSACRAL INSTABILITY
Research article 45 East African Orthopaedic Journal ASSESSMENT OF SPINO-PELVIC MORPHOMETRY, A PREDICTOR OF LUMBOSACRAL INSTABILITY J.M. Muthuuri, MBChB, MMed (Surg), H.Dip.Orth (SA), FCS (ECSA), Consultant
NewBridge. Laminoplasty Fixation INTERNATIONAL EDITION
NewBridge L A M I N O P L A S T Y F I X A T I O N S Y S T E M Laminoplasty Fixation INTERNATIONAL EDITION Table of Contents 1 INTRODUCTION 2 PRE-OPERATIVE 3 OPERATIVE 10 INSTRUCTIONS FOR USE 12 PART NUMBERS
SURGICAL TECHNIQUE GUIDE TRESTLE. Anterior Cervical Plating System
SURGICAL TECHNIQUE GUIDE TRESTLE Anterior Cervical Plating System 2 SURGICAL TECHNIQUE GUIDE SURGICAL TECHNIQUE GUIDE System Features Large window enables visualization of graft site and end plates Screw
Axial Skeleton: Vertebrae and Thorax
Axial Skeleton: Vertebrae and Thorax Function of the vertebral column (spine or backbone): 1) 2) 3) Composition of Vertebral column The vertebral column is formed by 33 individual vertebrae (some of which
Occipital Cervical Fusion System. Implants and instruments designed to optimize fixation to the occiput.
Occipital Cervical Fusion System. Implants and instruments designed to optimize fixation to the occiput. Technique Guide and implants approved by the AO Foundation Table of Contents Introduction Occipital
Technique Guide. Universal Spinal System (USS). Designed to achieve the goals of scoliosis surgery.
Technique Guide Universal Spinal System (USS). Designed to achieve the goals of scoliosis surgery. Table of Contents Introduction Universal Spinal System 2 AO ASIF Principles of Internal Fixation 3 Indications
Dorsal Fixation of the Thoracic and Lumbar Spine Techniques
Pedicle, Facet, Cortical, and Translaminar Screw Techniques Gregory R. Trost, MD Professor and Vice Chair of Neurological Surgery University of Wisconsin-Madison Dorsal Fixation of the Thoracic and Lumbar
Xiapedia Xiapedia_TLXIABR12100_US.indd 1 3/5/13 8:58 AM
Xiapedia 2.0 Xiapedia Introduction The Stryker Spine Thoracolumbar Brand Marketing Team is proud to introduce Xiapedia 2.0 the latest one stop resource for comprehensive information on the Xia, Xia 4.5,
Threshold Pedicular Fixation System Surgical Technique
Threshold Pedicular Fixation System Surgical Technique Table of Contents Patient Preparation and Positioning... 2 Determining Incision Location... 3 Assembling the Cannulated Awl... 4 Guide Wire Placement...
The vault bones Frontal Parietals Occiput Temporals Sphenoid Ethmoid
The Vertebral Column Head, Neck and Spine Bones of the head Some consider the bones of the head in terms of the vault bones and the facial bones hanging off the front of them The vault bones Frontal Parietals
Department of Neurosurgery, St. Elisabeth Hospital, Warsaw, Poland 3
Signature: Pol J Radiol, 2017; 82: 287-292 DOI: 10.12659/PJR.899975 CASE REPORT Received: 2016.06.08 Accepted: 2016.09.05 Published: 2017.05.28 Authors Contribution: A Study Design B Data Collection C
Radiographic Outcome and Complications after Single-level Lumbar Extended Pedicle Subtraction Osteotomy for Fixed Sagittal Malalignment:
Radiographic Outcome and Complications after Single-level Lumbar Extended Pedicle Subtraction Osteotomy for Fixed Sagittal Malalignment: Traditional A PSO Retrospective Analysis of 55 Adult Spinal Deformity
Copyright 2010 Pearson Education, Inc. Copyright 2010 Pearson Education, Inc. Figure Sectioned spinous process. Interspinous.
PowerPoint Lecture Slides prepared by Janice Meeking, Mount Royal College C H A P T E R 7 The Skeleton: Part B Vertebral Column Transmits weight of trunk to lower limbs Surrounds and protects spinal cord
ECD EXPANDABLE CORPECTOMY DEVICE Continuously Expandable Vertebral Body Replacement for Tumour Cases
ECD EXPANDABLE CORPECTOMY DEVICE Continuously Expandable Vertebral Body Replacement for Tumour Cases Instruments and implants approved by the AO Foundation. This publication is not intended for distribution
Thoracic or lumbar spinal surgery in patients with Parkinson s disease -A two-center experience of 32 cases-
Thoracic or lumbar spinal surgery in patients with Parkinson s disease -A two-center experience of 32 cases- Department of Orthopedic Surgery, Graduate School of Medicine, Kyoto university Hiroaki Kimura,
Change of Sagittal Spinopelvic Parameters after Selective and Non-Selective Fusion in Lenke Type 1 Adolescent Idiopathic Scoliosis Patients
DOI: 10.5137/1019-5149.JTN.22557-18.2 Received: 13.01.2018 / Accepted: 09.04.2018 Published Online: 24.04.2018 Turk Neurosurg, 2018 Original Investigation Change of Sagittal Spinopelvic Parameters after
L5-S1 Spondylolysis/listhesis in children & adolescents: When is surgery indicated? Hubert Labelle, MD
L5-S1 Spondylolysis/listhesis in children & adolescents: When is surgery indicated? Hubert Labelle, MD Wiltse, Newman and Macnab Classification Clin Orthop 1976;117:23-29 Type I: Congenital spondylolisthesis
Introduction. Our hope is that this Surgical Technique Guide enhances your knowledge and contributes to clinical success for your patients.
Surgical Technique Introduction DePuy Spine continues to support the goal of expanding the spine surgeon s options for the treatment of spinal disorders. Collaborating with renowned spine specialists,
Idiopathic scoliosis Scoliosis Deformities I 06
What is Idiopathic scoliosis? 80-90% of all scolioses are idiopathic, the rest are neuromuscular or congenital scolioses with manifest primary diseases responsible for the scoliotic pathogenesis. This