• Title/Summary/Keyword: Anterior plate

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New Technical Tip for Anterior Cervical Plating : Make Hole First and Choose the Proper Plate Size Later

  • Park, Jeong-Yoon;Zhang, Ho-Yeol;Oh, Min-Chul
    • Journal of Korean Neurosurgical Society
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    • v.49 no.4
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    • pp.212-216
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    • 2011
  • Objective : It is well known that plate-to-disc distance (POD) is closely related to adjacent-level ossification following anterior cervical plate placement. The study was undertaken to compare the outcomes of two different anterior cervical plating methods for degenerative cervical condition. Specifically, the new method involves making holes for plate screws first with an air drill and then choosing a plate size. The other method was standard, that is, decide on the plate size first, locate the plate on the anterior vertebral body, and then drilling the screw holes. Our hypothesis was that the new technical tip may increase POD as compared with the standard anterior cervical plating procedure. Methods : We retrospectively reviewed 49 patients who had a solid fusion after anterior cervical arthrodesis with a plate for the treatment of cervical disc degeneration. Twenty-three patients underwent the new anterior cervical plating technique (Group A) and 26 patients underwent the standard technique (Group B). POD and ratios between POD to anterior body heights (ABH) were measured using postoperative lateral radiographs. In addition, operating times and clinical results were reviewed in all cases. Results : The mean durations of follow-up were $16.42{\pm}5.99$ (Group A) and $19.83{\pm}6.71$ (Group B) months, range 12 to 35 months. Of these parameters mentioned above, cephalad POD (5.43 versus 3.46 mm, p=0.005) and cephalad POD/ABH (0.36 versus 0.23, p=0.004) were significantly greater in the Group A, whereas operation time for two segment arthrodesis (141.9 versus 170.6 minutes, p=0.047) was significantly lower in the Group A. There were no significant difference between the two groups in caudal POD (5.92 versus 5.06 mm), caudal POO/ABH (0.37 versus 0.32) and clinical results. Conclusion : The new anterior cervical plating method represents an improvement over the standard method in terms of cephalad plate-to-disc distance and operating time.

Follow-up Comparison of Two Different Types of Anterior Thoracolumbar Instrumentations in Trauma Cases : Z-plate vs. Kaneda Device

  • Park, Jung-Keun;Kim, Keun-Su
    • Journal of Korean Neurosurgical Society
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    • v.41 no.2
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    • pp.77-81
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    • 2007
  • Objective : In a variety of thoracolumbar diseases, corpectomy followed by interbody bone graft and anterior instrumentation has allowed direct neural decompression and reconstruction of the weight-bearing column by short segments fusion. In this study, we compared spinal stability of the two different anterior thoracolumbar instruments : Z-plate and Kaneda device representing plate and two-rods type, respectively. Methods : A retrospective review was performed for all the patients with thoracolumbar diseases or traumas treated with anterior corpectomy, autologous iliac bone graft, and fixation with instruments from 1996 to 2000. For the anterior instrumentation, Z-plate or Kaneda device was used for 24 [M:F=5:9, average age=37] and 12 [M:F=9:3, average age=41] patients, respectively. The plain AP and lateral flexion-extension films were taken immediately after surgery and at each follow-up. The sagittal and coronal Cobb's angles at the operation segments were used to observe the change of initial fixation status. The surgical time length and bleeding amount of the two groups were compared. Intra-operative and post-operative instrument associated complications were evaluated. Student t-test was used for statistical analysis and p-value less than 0.05 was considered to be significant. Results : Mean follow-up durations for Z-plate and Kaneda device were 24 and 21 months, respectively. The fusion rate was 91% for Z-plate and 100% for Kaneda device. Two cases of Z-plate group showed instrumentation failure during the follow up period, in which additional surgery was necessary. The mean differences of sagittal Cobb's angles among the AP images immediate after surgery and at follow-up were 7 and 2 degrees for Z-plate and Kaneda device, respectively [p<0.05]. The mean differences of coronal Cobb's angles were 5 and 2 degrees for Z-plate and Kaneda device, respectively [p<0.05]. No Intra-operative complication has occurred in both groups. There was no difference in surgery time and bleeding amount between two groups. Conclusion : We think that Kaneda device [rod type] is stronger than Z-plate [plate type] to keep the spinal stability after anterior thoracolumbar surgery.

Outcome Analysis of the Patients with and without Anterior Plating in Multi-Level Degenerative Cervical Diseases (다분절 퇴행성 경추질환에서의 전방 금속판 사용 유무에 따른 환자의 예후분석)

  • Kim, Sang Woo;Kim, Sung Min;Shin, Dong Ik;Cho, Yong Jun;Shim, Young Bo;Choi, Sun Kil
    • Journal of Korean Neurosurgical Society
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    • v.30 no.12
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    • pp.1369-1374
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    • 2001
  • Objectives : The rates of pseudarthrosis for two- and three level fusion have been reported to be 17-63 and 50% without anterior cervical plating. The purpose of this study is to assess the effects of anterior cervical plating in the treatment of multilevel degenerative cervical disease such mostly the additional risks associated with hardware implants and its benefits, fusion rate and radiographic results, and clinical outcomes. Methods : Forty-seven patients who underwent operations between 1993 and 1997 were retrospectively reviewed. The technique for operation was same for both groups(Smith Robinson with autologous iliac bone graft). Group I consisted of 35 consecutive patients treated with anterior cervical decompression and fusion with anterior cervical plate fixation. Group II consisted of 12 consecutive patients treated without plate fixation. We compared clinical outcomes by Prolo score, radiographic results in the rate of fusion, cervical lordosis by Gore angle, disc height by Farfan method, and surgical complications between two groups. Results : The favorable clinical outcomes(excellent and good) by Prolo score were observed with the use of anterior cervical plate fixation(89% vs 75%). The successful fusion rate of multilevel cervical fusion was as seen with anterior cervical plate fixation(97% vs 75%). The overall graft complication rate in multilevel fusions was decreased, with anterior cervical plate fixation, and the hardware related complications were relatively minimal without serious consequences. Conclusion : Anterior cervical plate fixation in the treatment of multilevel cervical disorders is an effective stabilizing method which provides increased bony fusion rate, decreased graft complications, maintained cervical lordosis, early mobilization of the these patients without serious hardware related complications.

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Long-term Effects on the Cervical Spine after Anterior Locking Plate Fixation (경추 전방 잠금식 금속판이 장기적으로 경추에 미치는 영향)

  • Kim, Keun Su
    • Journal of Korean Neurosurgical Society
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    • v.30 no.4
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    • pp.493-500
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    • 2001
  • Objective : Anterior cervical locking plates are the devices for achieving anterior cervical spinal fusion. This study was conducted to evaluate the locking plate system regarding its long-term advantages and disadvantages in the view of interbody fusion rate, hardware-related failures, vertebral change close to the fusion segment and postoperative complications. Method : Eight-six patients, operated from Jan., 1996 to Jun. 1998, were followed-up for more than two years. All of the cases were fused with iliac bone graft and ORION locking plate(Sofamor Danek USA, Inc., Memphis, TN) fixation. The patients were discharged or transferred to rehabilitation department 2-7 days after operation. A comprehensive evaluation of the interbody fusion state, instrument failure, vertebral change and postoperative complications were made by direct interview and cervical flexion-extension lateral plain films. Results : There were 55 male and 31 female with a mean age of 45 years(18-75 years). The mean follow-up period was 29 months(24-43 months). Various disorders that were operated were 40 cervical discs, 6 cervical stenosis including OPLL, 2 infections, and 38 traumas. Fusion level was single in 59 cases, two levels of each disc space in 15 cases, and two levels after one corpectomy in 12 cases. There was no instrument failure. Pseudoarthrosis was observed in two cases(2%) without radiological instability. The other patients(98%) showed complete cervical fusion with stable instrument. Mild settling of interbody graft with upward migration of screws was found in 12 cases(14%). Anterior bony growth at the upper segment was found in 5 cases(6%). Postoperative foreign body sensation or dysphagia was observed in 12 cases(4%), and disappeared within one month in 7 cases and within six months in 4 cases. One patient complained for more than six months and required reoperation to remove paraesophageal granulation tissue. Conclusion : The results show that Orion cervical locking plate has some disadvantages of upward migration of screws, anterior bony growth at the upper segment, or possibility of esophageal compression even though it has advantages of high interbody fusion rate or low instrument failure. Author believe that anterior cervical locking plate in the future should be thinner, and should have short end from the screw hole, and movable screw with adequate stability.

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Anterior inferior reconstruction plate on acute midshaft clavicle fvacture (쇄골 간부골절의 전하방 부착 재구성 금속판을 이용한 치료)

  • Kang, Jae-Do;Kim, Kwang-Ryul;Kim, Hyung-Chun;Lim, Moon-Sup;Kim, Seong-Hoon;Kweon, Jun-Hyung
    • Clinics in Shoulder and Elbow
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    • v.6 no.1
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    • pp.44-49
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    • 2003
  • Purpose: Many different operative technique of mid-shaft clavicle fracture have been reported. The aim of this prospective study was to compare the results of anterior or anterior-inferior plating with superior plating on the acute mid-shaft fracture of clavicle Materials and Methods: From February1997 to February 2002, thirty-eight consecutive open reduction and internal fixation with reconstruction plates were performed in thirty-eight patients. from August 1999, anterior or anterior-inferior plating was mainly used, prospectively. The duration of follow-up averaged 17 months (range,23 to 43 months). The mean age was 38 years old (range,21 to 57 years old) on anterior or anterior-inferior plating group and 35 years old (range,24 to 55 years old) on superior plating group. The physician progress note, VAS patient complement score, Roentgenogram and ASES score was evaluated. Results: Four patients were lost to follow-up. There was no statistical difference on mean radiological bone union time (8.7 weeks vs. 8.6 weeks) and ASES score (92 vs 94) at inferior and superior plating groups (P > 0.05). VAS patient complement score was very good or excellent on anterior or anterior-inferior group, average score was 1.1 (ranger,0 to 2) compare with superior plating group (P < 0.05). There were two cases of infection, 1 case of failed fixation on superior plating group and 1 case of delayed union on anterior inferior plating group. Conclusion: Anterior inferior plating on acute clavicle midshaft fracture results in excellent patient complement score compare with conventional superior reconstruction plate.

A comparison of fixation methods using three-dimensional finite element analysis following anterior segmental osteotomy

  • Yun, Kyoung In;Park, Min-Kyu;Park, Myung-Kyun;Park, Je Uk
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.38 no.6
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    • pp.332-336
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    • 2012
  • Objectives: This study sought to evaluate fixation methods and determine the best method for the postoperative stabilization of maxillary osteotomy. For our analysis we performed a three-dimensional finite element analysis of stress distribution on the plate, screw, and surrounding bone, as well as displacement onto the plate. Materials and Methods: We generated a model using synthetic skull scan data; an initital surface model was changed to a solid model using software. Modified anterior segmental osteotomy (using Park's method) was made using the program, and four different types of fixation methods were used. An anterior load of 100 N was applied on the palatal surface of two central incisors. Results: The Type 1 (L-shaped) fixation method gave stresses of 187.8 MPa at the plate, 45.8 MPa at the screw, and 15.4 MPa at the bone around the plate. The Type 2 (I-shaped) fixation method gave stresses of 186.6 MPa at the plate, 75.7 MPa at the screw, and 13.8 MPa at the bone around the plate. The Type 3 (inverted L-shaped) fixation method gave stresses of 28.6 MPa at the plate, 29.9 MPa at the screw, and 15.3 MPa at the bone around the plate. The Type 4 (I-shaped) fixation method gave stresses of 34.8 MPa at the plate, 36.9 MPa at the screw, and 14.9 MPa at the bone around the plate. The deflection of the plates for the four fixation methods was 0.014 mm, 0.022 mm, 0.017 mm, and 0.018 mm, respectively. Conclusion: The Type 3 (inverted L-shaped) fixation method offers more stability than the other fixation methods. We therefore recommend this method for the postoperative stabilization of maxillary osteotomy.

FINITE ELEMENT ANALYSIS OF RECONSTRUCTION OF MANDIBULAR SYMPHYSIS DEFECTS USING RECONSTRUCTION PLATES (유한 요소법을 이용한 하악골 이부 결손수복에 사용된 재건용 금속판의 응력분포에 관한 연구)

  • Oh, Jung-Hwan;Han, Jung-Soo;Min, Jee-Hyun;Mun, Sung-Jun;Lee, Baek-Su
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.30 no.6
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    • pp.513-517
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    • 2008
  • Purpose: This study aimed to evaluate distribution and maximal value of mechanical stresses on the reconstruction plate, bridging mandibular symphysis defect, and to optimize the most appropriate locations of the plate to distribute the stress causing the fracture of the plate. Materials and methods: Four types of reconstruction were constructed by different number and location of the reconstruction plates on the 3 D finite element model (FEM) of a human edentulous mandible; Type I: one plate on the inferior border of the anterior mandible, Type II: one plate on the middle of the anterior mandible, Type III: one plate on the superior border of the anterior mandible, and Type IV: two plates on the inferior and superior border of the anterior mandible. Results: The results showed that the maximal stress of type I (234.29 Mpa) was lower than that of type II (260.91 Mpa) and type III (247.37 Mpa), but higher than that of type IV (186.64 Mpa). We could also observe that the stresses are tending to focus on the inner side and inferior part of the plate which connected proximal segment from the vertical load. Conclusions: On the basis of the findings, it was concluded that using a plate on the inferior border of mandible or two plates on the inferior and superior border of mandible are more favorable to distribute mechanical stresses, which could reduce the fracture of the plate.

Analysis of Noninstrumented Anterior Cervical Discectomy and Interbody Fusion in Degenerative Cervical Disease (퇴행성 경추질환에서 전방경유 추간판 절제술 및 골유합술의 결과분석)

  • Lee, Sang Weon;Song, Geun Sung
    • Journal of Korean Neurosurgical Society
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    • v.30 no.2
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    • pp.180-185
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    • 2001
  • Objectives : We retrospectively studied the efficacy of anterior cervical discectomy and interbody fusion without plate fixation in degenerative cervical disease. Methods : Thirty two consecutive patients with degenerative cervical disease treated by decompression and interbody fusion(Smith-Robinson technique) without anterior cervical plating were studied for postoperative complication rate as well as the clinical and radiologic outcomes and were compared the result of ours with other reported series where the anterior cervical plating was used. Results : All cases were reviewed after average period of 13 months for the purpose of this study. There were 4 postoperative complications related to grafting. A solid fusion was obtained in all cases with single-level fusion(n=21) and 81.8 % of the cases with a two-level fusion(n=11). The overall fusion rate was 93.8 % and fusion rate per level fused was 95.3%. The clinical outcome of the patients was comparable with that in the literature, with one patient having a poor result. Comparing the result of this study with others of the anterior cervical plating, clinical outcome and fusion rate were not superior in plate fixation group in single-level fusion, but increased fusion rate and decreased graft-related complication rate were noted in multilevel fusion with plate fixation. However, the clinical outcome was not superior to noninstrumented fusion group of this study. Conclusion : These results demonstrate that anterior cervical discectomy and interbody fusion(Smith-Robinson technique) without instrumentation is safe and reliable method of single-level fusion in degenerative cervical disease. Plate fixation system doesn't seem necessary in single level fusion in degenerative cervical disease.

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Two Arenicolus Species of Actacarus (Acari, Halacaridae) from South Korea

  • Jong Hak Shin;Cheon Young Chang;Jimin Lee
    • Animal Systematics, Evolution and Diversity
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    • v.40 no.1
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    • pp.21-34
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    • 2024
  • Two arenicolus halacarid species, Actacarus ornatus n. sp. and A. pacificus Bartsch, 1979, are recorded from sandy intertidal sediment along the coast of South Korea. Actacarus ornatus n. sp. closely resembles A. karoensis Abé, 1990, recorded from Japan, in having chaetotaxy of the idiosoma, legs, palps of gnathosoma, and perigenital setae in both males and females. However, it differs from A. karoensis by a slightly convex tectum, the presence of a row of foveae on the mid-ventral surfaces of the anterior epimeral plate and genitoanal plate, and the absence of areolae on both the anterior and posterior dorsal plates as well as microplatelets on the membranous cuticle alongside the anterior and posterior dorsal plates. Actacarus pacificus Bartsch, 1979, which is widely distributed in the Indo-Pacific region, is characterized by separated plates, a truncated tectum, the anterior epimeral plate with four pairs of setae, the posterior epimeral plate with one dorsal and two ventral setae, and three pairs of subgenital setae in males. A comparative analysis of the morphological characteristics of A. pacificus was conducted within regional populations, including the Korean population. Moreover, a key to Actacarus species from the northwestern Pacific, including a new species, is provided. The genus Actacarus is reported for the first time from Korea.

Anterior tympanic plate fracture following extraction of the lower molar

  • Kim, Yeon-Ho;Kim, Moon-Key;Kang, Sang-Hoon
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.42 no.1
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    • pp.51-54
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    • 2016
  • The present case report describes an external auditory canal injury following extraction of the lower molar. The external auditory canal was torn in the same fashion that occurs in an anterior tympanic plate fracture. This case demonstrates one of the rare complications associated with dental extractions.