• Title/Summary/Keyword: Fusion procedure

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Fusion Criteria for Posterior Lumbar Interbody Fusion with Intervertebral Cages : The Significance of Traction Spur

  • Kim, Kyung-Hoon;Park, Jeong-Yoon;Chin, Dong-Kyu
    • Journal of Korean Neurosurgical Society
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    • v.46 no.4
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    • pp.328-332
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    • 2009
  • Objective : The purpose of this study was to establish new fusion criteria to complement existing Brantigan-Steffee fusion criteria. The primary purpose of intervertebral cage placement is to create a proper biomechanical environment through successful fusion. The existence of a traction spur is an essential predictable radiologic factor which shows that there is instability of a fusion segment. We studied the relationship between the existence of a traction spur and fusion after a posterior lumbar interbody fusion (PLIF) procedure. Methods : This study was conducted using retrospective radiological findings from patients who underwent a PLIF procedure with the use of a cage without posterior fixation between 1993 and 1997 at a single institution. We enrolled 183 patients who were followed for a minimum of five years after the procedure, and used the Brantigan-Steffee classification to confirm the fusion. These criteria include a denser and more mature bone fusion area than originally achieved during surgery, no interspace between the cage and the vertebral body, and mature bony trabeculae bridging the fusion area. We also confirmed the existence of traction spurs on fusion segments and non-fusion segments. Results : The PLIF procedure was done on a total of 251 segments in 183 patients (71 men and 112 women). The average follow-up period was $80.4{\pm}12.7$ months. The mean age at the time of surgery was $48.3{\pm}11.3$ years (range, 25 to 84 years). Among the 251 segments, 213 segments (84.9%) were fused after five years. The remaining 38 segments (15.1%) were not fused. An analysis of the 38 segments that were not fused found traction spur formation in 20 of those segments (52.6%). No segments had traction spur formation with fusion. Conclusion : A new parameter should be added to the fusion criteria. These criteria should be referred to as 'no traction spur formation' and should be used to confirm fusion after a PLIF procedure.

Investigation on the thermal butt fusion performance of the buried high density polyethylene piping in nuclear power plant

  • Kim, Jong-Sung;Oh, Young-Jin;Choi, Sun-Woong;Jang, Changheui
    • Nuclear Engineering and Technology
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    • v.51 no.4
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    • pp.1142-1153
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    • 2019
  • This paper presents the effect of fusion procedure on the fusion performance of the thermal butt fusion in the safety class III buried HDPE piping per various tests performed, including high speed tensile impact, free bend, blunt notched tensile, notched creep, and PENT tests. The suitability of fusion joints and qualification procedures was evaluated by comparing test results from the base material and buttfusion joints. From the notched tensile test result, it was found that the fused joints have much lower toughness than the base material. It was also identified that the notched tensile test is more desirable than the high speed tensile impact and free bend tests presented in the ASME Code Case N-755-3 as a fusion qualification test method. In addition, with regard to the single low-pressure fusion joint performances, the procedure given by the ISO 21307 was determined to be better that the one specified in the Code Case N-755-3.

Minimally Invasive Posterior Lumbar Interbody Fusion with Threaded Fusion Cage(TFC) (Threaded Fusion Cage(TFC)를 이용한 최소 침습적 요추체 후방융합술)

  • Kim, Hyeok Joon;Cho, Ki Hong;Shin, Yong Sam;Yoon, Soo Han;Cho, Kyung Gi
    • Journal of Korean Neurosurgical Society
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    • v.30 no.sup2
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    • pp.247-253
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    • 2001
  • Objective : In general, to perform posterior lumbar interbody fusion(PLIF), it has been used more invasive procedure than simple discectomy. However we try to perform PLIF with TFC with smaller invasion almost same as in simple discectomy. This study is about its procedure and clinical results. Materials and Methods : The authors retrospectively analyzed 43 cases of minimally invasive PLIF with TFC from July 1998 to May 2000. Operative procedure, operative complication, change of disc height, blood loss, ambulation time, hospitalization period, clinical success rate, and bony fusion rate were analyzed. Results : 40 patients were capable to walk on the 2nd day of the post-operation. The average hospitalization period is 5.6 days. The average blood loss was 0.19L/level with no transfusion or wound drainage. The height of disc changed from 8.84mm to 13.54mm. Clinical success rate is 95% when evaluated by the Prolo's scale. The complication was delayed wound infection(2) and transient paresthesis(1). The bony fusion was shown in 17 patients (94.4%) out of 18 patients who passed one year. Conclusion : As a result of minimally invasive PLIF, pain was decreased and early ambulation and short hospitalization was possible. Complication was similar or lower than other studies, and the bony fusion rate and clinical success rate were also similar during follow-up.

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Posterior Atalntoaxial Fusion with C1 Lateral Mass Screw and C2 Pedicle Screw Supplemented with Miniplate Fixation for Interlaminar Fusion : A Preliminary Report

  • Yoon, Sang-Mok;Baek, Jin-Wook;Kim, Dae-Hyun
    • Journal of Korean Neurosurgical Society
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    • v.52 no.2
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    • pp.120-125
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    • 2012
  • Objective : To investigate the feasibility of C1 lateral mass screw and C2 pedicle screw with polyaxial screw and rod system supplemented with miniplate for interlaminar fusion to treat various atlantoaxial instabilities. Methods : After posterior atlantoaxial fixation with lateral mass screw in the atlas and pedicle screw in the axis, we used 2 miniplates to fixate interlaminar iliac bone graft instead of sublaminar wiring. We performed this procedure in thirteen patients who had atlantoaxial instabilities and retrospectively evaluated the bone fusion rate and complications. Results : By using this method, we have achieved excellent bone fusion comparing with the result of other methods without any complications related to this procedure. Conclusion : C1 lateral mass screw and C2 pedicle screw with polyaxial screw and rod system supplemented with miniplate for interlaminar fusion may be an efficient alternative method to treat various atlantoaxial instabilities.

A Study on the Design of Fusion Education Program - Fusion of ME and Kinesiology - (융합 교과목 개발방법에 관한 연구 - 기계공학과 인간운동과학의 융합 -)

  • Lee, Kunsang
    • Journal of Engineering Education Research
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    • v.21 no.1
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    • pp.66-76
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    • 2018
  • In order to facilitate the process of designing a fusion curriculum, this study used the learning outcomes presented in KEC2015 to design a fusion goal dimension. The three dimensions of fusion education in the fusion curriculum framework are fusion goals, fusion approach and fusion context. As a result of examining the curriculum learning activities in order to confirm that the developed curriculum meets these three dimensions, it can be confirmed that it contributes relatively evenly to the fusion goal, fusion approach and fusion context dimension. In addition, it provides a procedure to develop the fusion curriculum through the concrete procedures and examples from the design to implementation of the developed fusion curriculum, and to confirm the result of the fusion dimension.

Management of Andersson Lesion in Ankylosing Spondylitis Using the Posterior-Only Approach: A Case Series of 18 Patients

  • Shaik, Ismail;Bhojraj, Shekhar Yeshwant;Prasad, Gautam;Nagad, Premik Bhupendra;Patel, Priyank Mangaldas;Kashikar, Aaditya Dattatreya;Kumar, Nishant
    • Asian Spine Journal
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    • v.12 no.6
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    • pp.1017-1027
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    • 2018
  • Study Design: This retrospective study was conducted including 18 patients who underwent posterior-only stabilization and fusion procedure for pseudoarthrosis in the ankylosed spine from October 2007 to May 2015. Purpose: This study aimed to describe the treatment outcomes in 18 patients with Andersson lesion (AL) who were managed using the posterior-only approach. Literature Review: AL is an unstable, localized, vertebral, or discovertebral lesion of the spine. It is observed in patients with ankylosing spondylitis. The exact etiology of this disorder remains unclear, and the treatment guidelines are not clearly described. Methods: We analyzed 18 patients with AL who were treated with posterior long segment spinal fusion without any anterior interbody grafting or posterior osteotomy. Pre- and postoperative radiography, computed tomography, and recent follow-up images were examined. The pre- and postoperative Visual Analog Scale score and the Oswestry Disability Index score were evaluated for all patients. Whiteclouds' outcome analysis criteria were applied at the follow-up. Moreover, at study completion, patient feedback was collected; all the patients were asked to provide their opinion regarding the surgery and were asked whether they would recommend this procedure to other patients and them self undergo the same procedure again if required. Results: The most common site was the thoracolumbar junction. The symptom duration ranged from 1 month to 10 years preoperatively. Most patients experienced fusion by the end of 1 year, and the fusion mass could be observed as early as 4 months. Pseudoarthrosis void of up to 2.5 cm was noted to be healed in subsequent imaging. In addition, clinically, the patients reported good symptomatic relief. No patient required revision surgery. Whiteclouds' outcome analysis score at the latest follow-up revealed goodto-excellent outcomes in all patients. Conclusions: ALs can be treated using the posterior-only approach with long segment fixation and posterior spinal fusion. This is a safe, simple, and quick procedure that prevents the morbidity of anterior surgery.

Effective Heterogeneous Data Fusion procedure via Kalman filtering

  • Ravizza, Gabriele;Ferrari, Rosalba;Rizzi, Egidio;Chatzi, Eleni N.
    • Smart Structures and Systems
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    • v.22 no.5
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    • pp.631-641
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    • 2018
  • This paper outlines a computational procedure for the effective merging of diverse sensor measurements, displacement and acceleration signals in particular, in order to successfully monitor and simulate the current health condition of civil structures under dynamic loadings. In particular, it investigates a Kalman Filter implementation for the Heterogeneous Data Fusion of displacement and acceleration response signals of a structural system toward dynamic identification purposes. The procedure is perspectively aimed at enhancing extensive remote displacement measurements (commonly affected by high noise), by possibly integrating them with a few standard acceleration measurements (considered instead as noise-free or corrupted by slight noise only). Within the data fusion analysis, a Kalman Filter algorithm is implemented and its effectiveness in improving noise-corrupted displacement measurements is investigated. The performance of the filter is assessed based on the RMS error between the original (noise-free, numerically-determined) displacement signal and the Kalman Filter displacement estimate, and on the structural modal parameters (natural frequencies) that can be extracted from displacement signals, refined through the combined use of displacement and acceleration recordings, through inverse analysis algorithms for output-only modal dynamics identification, based on displacements.

Short Segment Fixation for Thoracolumbar Burst Fracture Accompanying Osteopenia : A Comparative Study

  • Kim, Hyeun Sung;Kim, Seok Won;Ju, Chang Il;Lee, Sung Myung;Shin, Ho
    • Journal of Korean Neurosurgical Society
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    • v.53 no.1
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    • pp.26-30
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    • 2013
  • Objective : The purpose of this study was to compare the results of three types of short segment screw fixation for thoracolumbar burst fracture accompanying osteopenia. Methods : The records of 70 patients who underwent short segment screw fixation for a thoracolumbar burst fracture accompanying osteopenia (-2.5< mean T score by bone mineral densitometry <-1.0) from January 2005 to January 2008 were reviewed. Patients were divided into three groups based on whether or not bone fusion and bone cement augmentation procedure 1) Group I (n=26) : short segment fixation with posterolateral bone fusion; 2) Group II (n=23) : bone cement augmented short segment fixation with posterolateral bone fusion; 3) Group III (n=21) : bone cement augmented, short segment percutaneous screw fixation without bone fusion. Clinical outcomes were assessed using a visual analogue scale and modified MacNab's criteria. Radiological findings, including kyphotic angle and vertebral height, and procedure-related complications, such as screw loosening or pull-out, were analyzed. Results : No significant difference in radiographic or clinical outcomes was noted between patients managed using the three different techniques at last follow up. However, Group I showed more correction loss of kyphotic deformities and vertebral height loss at final follow-up, and Group I had higher screw loosening and implant failure rates than Group II or III. Conclusion : Bone cement augmented procedure can be an efficient and safe surgical techniques in terms of achieving better outcomes with minimal complications for thoracolumbar burst fracture accompanying osteopenia.

The Change of Biomechanical Milieu after Removal of mstnnnentation in lrunbar Arthrodesis Stiffness of fusion Mass: Finite Element Analysis (척추 유합술 후, 인접 분절의 스트레스에 대한 척추경 나사못에 대한 영향)

  • Kang, Kyoung-Tak;Chun, Heoung-Jae;Son, Ju-Hyun;Kim, Ho-Joong
    • Proceedings of the KSME Conference
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    • 2008.11a
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    • pp.664-667
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    • 2008
  • Since the advent of pedicle screw fixation system, posterior spinal fusion has markedly increased This intemal fixation system has been reported to enhance the fusion rates, thereby becoming very popular procedure in posterior spinal arthrodesis. Although some previous studies have shown the complications of spinal instruments removal, i.e. loss of correction and spinal collapse in scoliosis or long spine fusion patients, there has been no study describing the benefit or complications in lumbar spinal fusion surgery of one or two level. In order to clarify the effect of removal of instruments on mechanical motion profile, we simulated a finite element model of instrumented posterolateral fused lumbar spine model, and investigated the change of mechanical motion profiles after the removal of instrumentation.

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