• Title/Summary/Keyword: pedicle

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Biomechanical Comparison of Spinal Fusion Methods Using Interspinous Process Compressor and Pedicle Screw Fixation System Based on Finite Element Method

  • Choi, Jisoo;Kim, Sohee;Shin, Dong-Ah
    • Journal of Korean Neurosurgical Society
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    • v.59 no.2
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    • pp.91-97
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    • 2016
  • Objective : To investigate the biomechanical effects of a newly proposed Interspinous Process Compressor (IPC) and compare with pedicle screw fixation at surgical and adjacent levels of lumbar spine. Methods : A three dimensional finite element model of intact lumbar spine was constructed and two spinal fusion models using pedicle screw fixation system and a new type of interspinous devices, IPC, were developed. The biomechanical effects such as range of motion (ROM) and facet contact force were analyzed at surgical level (L3/4) and adjacent levels (L2/3, L4/5). In addition, the stress in adjacent intervertebral discs (D2, D4) was investigated. Results : The entire results show biomechanical parameters such as ROM, facet contact force, and stress in adjacent intervertebral discs were similar between PLIF and IPC models in all motions based on the assumption that the implants were perfectly fused with the spine. Conclusion : The newly proposed fusion device, IPC, had similar fusion effect at surgical level, and biomechanical effects at adjacent levels were also similar with those of pedicle screw fixation system. However, for clinical applications, real fusion effect between spinous process and hooks, duration of fusion, and influence on spinous process need to be investigated through clinical study.

Homodigital Reverse Pedicle Island Flap for Reconstruction of the Great Toe - A Case Report - (동측 역행성 유경 피판술을 이용한 무지의 재건 - 1예 보고 -)

  • Hwang, Jung-Chul;Chung, Duke-Whan
    • Archives of Reconstructive Microsurgery
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    • v.20 no.1
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    • pp.64-67
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    • 2011
  • Reconstruction of the distal portion of the great toe has always represented a difficult problem to surgeons. There are many methods of flap reconstruction described for foot defects, but none for tip of the great toe. We report a case of reconstruction of the great toe using a homodigital reverse pedicle island flap method. A 25-year-old man had a crushing injury at the distal phalanx of the left great toe. A homodigital reverse pedicle island flap was raised from the dorso-medial aspect of the proximal phalanx of the great toe based on the distal dorsal arcade. The flap covered the exposed distal phalanx and stump was closed without shortening. He made an uncomplicated recovery and when seen 6 months later he had a good cosmetic and functional result. A homodigital reverse pedicle island flap is described for the reconstruction of the distal part of the great toe. It involves only a single stage procedure with minimal donor site morbidity and provides a good cosmetic results.

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A new algorithm for minimization of metal artifact made on CT by pedicle screws (Pedicle screws에 의해 CT에 생성되는 metal artifact를 최소화하는 알고리즘 개발)

  • Lee, J.B.;Yeom, J.S.;Kim, N.K.;Lee, D.H.;Kim, J.H.;Kim, Y.
    • Proceedings of the KOSOMBE Conference
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    • v.1998 no.11
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    • pp.279-280
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    • 1998
  • A new algorithm is developed that can reduce the metal artifact on CT caused by pedicle screws. Metal artifact has been recognized as a major problem in precise reading of CT images. In particular, spine surgeons have been bothered with the artifact appearing on CT taken after pedicle screw insertion. To reduce the artifact, our new algorithm first finds the center line from CT images, and then overlays an exact size screw image on the CT. The exact screw is obtained from an actual design specifications of screw, and the CT images are processed to maximize bone margins while minimizing screw images through adjusting the window width and level. 실험 결과 단순한 Window W/L 조절로는 해결되지 않는군요. This algorithm provides spine surgeons with more accurate CT images and thus better interpretation of CT to ascertain the success or failure of pedicle screw insertion.

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Suprahilar Control of Glissonean Pedicle in the Open Anatomic Liver Resections: A Single Centre Experience

  • Aleksandar Karamarkovic;Milos Bracanovic;Bojan Jovanovic;Sanja Tomanovic Vujadinovic
    • Journal of Digestive Cancer Research
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    • v.4 no.2
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    • pp.113-121
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    • 2016
  • Background: We evaluated technique of hepatic resections using suprahilar-extrafascial dissection of Glissonean pedicle with vascular stapling device for pedicle transection with intent to minimize operative time and blood loss. Methods: We analyzed the clinical records of 326 patients who underwent anatomic liver resection by suprahilar-extrafascial pedicle isolation with vascular stapling division technique. Results: The minor liver resections were associated with significantly shorter surgery duration (105.1±21.1 vs. 225.6±75.6) and transection time (40.1±14.5 vs. 96.3±55.2) than major hepatectomies (p<0.0001 for all). The mean blood loss was 350.8±100.5 mL in minor resection and 485.4±250.2 mL in major resection (p=0.001). The mean blood transfusion requirement was 400.8±109.5 mL for minor resections and 550.9±100.0 mL for major hepatectomy (p=0.072). There was no significant difference in morbidity and mortality between groups (p=0.980; p=0.945). Major as well as minor liver resection were oncology superior with no significant difference in the 5-year overall survival rates. Conclusion: Suprahilar-extrafascial dissection of Glissonean pedicle represents an effective and safe technique of liver resection. Presented approach allows early and easy ischemic delineation of appropriate liver territory to be removed with selective inflow vascular control. It is not time consuming and it is very useful in re-resection, as well as oncological reasonable.

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Congenital Absence of a Cervical Spine Pedicle : Report of Two Cases and Review of the Literature

  • Oh, Young-Min;Eun, Jong-Pil
    • Journal of Korean Neurosurgical Society
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    • v.44 no.6
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    • pp.389-391
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    • 2008
  • Congenital absence of a cervical spine pedicle is a rare clinical entity, and it is usually found incidentally on radiological studies performed after trauma in patients with cervical pain. We report two cases of congenital absence of a cervical spine pedicle and present a review of the literature.

Nerve-Muscle Pedicle Reinnervation in Bilateral Vocal Cord Palsy (양측성 성대마비에서의 신경-근 이식 수술)

  • 우훈영;김영기;정현수
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.6 no.1
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    • pp.5-8
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    • 1995
  • Bilateral vocal cord palsy is uncommon but is serious because of airway obstruction. Treatments of bilateral vocal cord palsy are initially tracheotomy, vocal cord lateralization and vocal cord reinnervation. Recently, we experienced nerve-muscle pedicle reinnervation in 3 cases of bilateral vocal cord palsy, so reported it with a review of literature.

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Simplified FE Analysis for the Design of Pedicle Screw System (척추경 나사못 시스템의 설계를 위한 단순 유한요소해석)

  • 정일섭;안면환
    • Journal of Biomedical Engineering Research
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    • v.21 no.6
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    • pp.559-566
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    • 2000
  • Methodology for finite element analysis of vertebral column and pedicle screw system, which circumvents the tremendous difficulties in geometric, material, and structural modeling, is proposed. The simplification is focused on the modeling of the cancellous bone in vertebral body the intervertebral disc. and the instrumented internal fixation devices. Each proposed modeling technique is justified to result in reasonable accuracy. These methods are believed to be suitable for the development of pedicle screw systems, not only because modeling itself is much simpler. but also because reliable empirical data for disc stiffness may be incorporated with little additional effort, and presumably frequent design change may be easily reflected on the analysis.

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Unilateral Pedicle Fracture Accompanying Spondylolytic Spondylolisthesis

  • Kim, Hyeun Sung;Kim, Seok Won;Ju, Chang Il;Kim, Yun Sung
    • Journal of Korean Neurosurgical Society
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    • v.57 no.6
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    • pp.484-486
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    • 2015
  • Unilateral pedicle stress fracture accompanying spondylolytic spondylolisthesis is rare even in the elderly. Most are associated with major trauma, previous spine surgery, or stress-related activity. Here, the authors describe an unique case of unilateral pedicle fracture associated with spondylolytic spondylolisthesis at the L5 level, which was successfully treated by posterior lumbar interbody fusion with screw fixation at the L5-S1 level. As far as the authors' knowledge, no such case has been previously reported in the literature. The pathophysiological mechanism of this uncommon entity is discussed and a review of relevant literature is included.

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 finite element analysis and machining methods for optimum design of pedicle screw system (척추경나사의 최적설계를 위한 유한요소해석과 형성가공에 관한 연구)

  • 남기우;장성민;이성희;조명우
    • Proceedings of the Korean Society of Precision Engineering Conference
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    • 1997.10a
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    • pp.634-638
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    • 1997
  • The objectives of this research are to develop lumber and lower-thoracic pedicle fixation system for Korean patients. To achieve the aimed goals, first, optimized shape design process is performed, and finite element methods are applied to evaluate the mechanical strength of the developed fixation system. Second, appropriate machining experiments are carried out to develop optimum machining conditions for titan~um alloys those are known as one of the most difficult-to-cut material. As the results of this research, new pedicle screw system, considering the morphological characteristics of Korean patients, is developed by applying the finite element analysis, optimum shape processing method and optimize design algorithm.

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