Advantages And Disadvantages Of Pedicle Screw Anchorage

and long, thick pins are inserted lengthwise into the bone tissue. The pins are held in place by

The spine is one of the most important structures in the human body. The spine is located in the dorsal cavity and consists of 24 bones, called vertebrae. These vertebrae play a crucial role in protected the body’s command center, the spinal cord. But what happens when a disorder prevents the spinal column from functioning correctly? Scoliosis is a musculoskeletal disorder that causes abnormal lateral curvature of the spine and it effects millions of people in the US per year. I have chosen this disorder because I am aspiring to become a chiropractor and scoliosis is a typical condition that chiropractors help treat on a daily basis.

Of note, previous x-rays of the lumbar spine dated 01/14/16 showed a solid fusion at L4-5 with interbody graft at L4-5 as well as pedicle screw fixation in satisfactory alignment.

Only vertebral segments at rest and end range were analyzed for the purpose of this study. The intervertebral angle was measured using the National Institute of Health Image software. Intervertebral angles are defined as the distance between two end plates. The difference between end range and resting intervertebral angles was defined as segmental lumbar motion. An increase in spinal extension denoted a positive value, whereas a negative value was denoted by a decrease in spinal extension.

The insertion point is at the flat tendon 2 or 3 inches wide to the outer lip of the intertuberculer. The clavicular action of the pectoralis major is internal rotation, horizontal adduction, flexion abduction and adduction. The sternal pectoralis major has an origin on the anterior surfaces of costal cartilage of the first 6 ribs and adjacent portion of the sternum. The sternal insertion is the groove of the humerus. The intended action of the sternal pectoralis major is internal rotation, horizontal adduction, extension, and adduction of the glenohumeral joint. An example from the radioulnar joint is the brachialis. Its origin is the distal half of the anterior portion of the humerus, and the insertion point is the coronoid process of the ulna. The brachialis intended action is flexion of the elbow. The hip joint and pelvic girdle work with multiple muscles including gluteus maximus and semitendinosus muscle. The origin of the gluteus maximus is the posterior ¼ of the crest of the ilium, the posterior surface of the sacrum and coccyx near the illium, and fascia of the lumbar area. The point of insertion is the oblique ridge on the lateral surface of the greater trochanter and iliotibial band of fasciae. The intended action of

On examination of the lumbar spine, extension is 20 degrees, flexion is 45 degrees and bilateral lateral bending is 25 degrees. Motor strength testing shows 4+/5 to the right lower extremity and 4/5 to the left lower extremity. Straight leg raise is positive at

Moreover, now I learn most specific radiological techniques for different condition especially associated to spine. I learn importance of MRI and CT scan in different spinal pathological condition. To improved knowledge regarding types of MRI or CT scan method will most appropriate to condition, for instance, in the disc herniation condition, MRI will provide most appropriate result for soft tissue injury but in other cases CT myelogram is second choice techniques. Discography, is second last choice, before spinal surgery or fusion. I used to seen a 57 year old male patient with lower back pain, patient have improvement in pain with modality and strengthening exercises techniques but suddenly one day he was lifting trash pot and feel severe pain with radiating symptoms and feeling less sensation around inner thigh. Next day he came to me and complaining of this symptoms which are indicates for referral and further investigation. Afterwards, MRI reports revealed prolapsed intervertebral disc (PIVD-extrusion) at level lumbar 3 and 4 (L3-L4). I also learn certain condition (spinal stenosis), physical examination will helpful to detect pathological condition and which always should be confirmed by diagnostic imaging method and requirement for referral to appropriate

Search History: CINAHL complete: (cervical AND traction:ab) AND (manual AND therapy:ab), full text only, published between 2005 and 2014.

Treatment plan includes urine toxicology screen, follow0-up in 4 weeks and replacement of LSO prefabricated off the shelf to provide stability, increase tolerance to standing, walking, exercise, improve adherence to physical methods. Goals were actualized with use of the original brace prior to dysfunction, greater than 1 year old. MD has inspected the brace and it is no longer functional due to failure of closure mechanism due to excessive wear. Patient does complain of instability and near falls with resultant marked limitation in regards to standing, walking and exercise. Brace will be used in conjunction with a rehabilitation program as patient is encouraged top continue and with brace, increase intensity of exercise as learned at PT. Patient is an excellent candidate for LSO replacement as patient complains of instability and correlated by lumbar spondylosis/facet

Fifty-two patients were included in study. On panoramic radiographs, root shortening of the maxillary and mandibular incisors was evaluated. Radiographs were taken before and after space closure, and were measured in millimeters. Special metal rods ligated to brackets were used to correct distortion of measurements caused by panoramic radiographs. It was observed that there is no difference in the amount of root shortening between two space closure

The modified position yielded a higher statistical significance post procedure.1 From the observation of each patients pain levels both before and after each treatment, it was determined that the traditional position was more successful at reducing pain symptoms. Traditional positioning also created a higher level of comfort and allowed for a more forceful level of traction.1

On examination of the lumbar spine, range of motion is full in flexion and limited in extension. Lumbar facet loading maneuvers are positive.

Knee chest is a specific upper cervical technique used by many upper cervical chiropractors. It is an articular based model that allows correction of subluxation by hand. According to Craniocervical Chiropractic Procedures – A Precis of Upper Cervical Chiropractic (2015), the knee chest technique relies heavily on thermography to establish a pattern for the patient.  In addition, a rest period post-adjustment is advocated. A typical knee chest adjustment begins with the doctor positioned in a fencer stance on the side of the listing. The patient is placed in a knee chest position with the upper cervical spine resting on the floating neck of the table and the patient’s head rotated towards the listing side. The doctor’s pisiform is the contact point and the segmental contact point is either the body, lamina pedicle junction, and lateral inferior portion of the axis spinous process or the posterior arch of atlas. The practitioner may also utilize a tissue pull. A base posterior film is imperative to determine the line of correction needed for the appropriate line of drive. Lastly, to execute the knee chest adjustment, the doctor may utilize a body drop and triceps extension perpendicular to the table

Scoliosis is an abnormal lateral curvature of the spine. Surgery and braces for scoliosis normally expensive. Spinal manipulation can help with AIS. The treatment of the teen goes to 18 months two times a week. In the before the treatment, Manipulative procedures was done on her using mechanical assist and mobilizing the spine. After the pretreatment, The regular treatment was the same, but it used a brace to possibly help stop the spine curve progression. Her treatment consisted of a 15-minute session of deep tissue therapy, two visits a week for six weeks and once a week visit for six weeks. The goal was to improve her spine and reduce her pain and symptoms, The girl reported of have problems that her defecation is less than two times a week. “at least, some severe and progressive cases of scoliosis, including spinal manipulation may decrease the need for surgery”(Chen, Chiu 749 web). After surgery for scoliosis, Complications might start. Blood loss, infection, and equipment failure where rods break, screws and hooks get lodged. On rare times, paraplegia will start to occur losing all feeling in the legs due to a spinal injury. She had a fear of surgical complications and went towards more conservative treatment. For the first three months, her progression stopped at a 34°. Her bowel movements were starting to improve. Spinal manipulation is relatively safe, but there is some association with disk herniation. After 18 months of treatment, 34° from a 30° spine angle and slowed or stopped curve progression. This shows the effectiveness of the treatment. Compared to surgery, Spinal manipulation is more effectiveness with much less complication. If the brace was only used as a treatment it could be more effective than spinal manipulation. However, in some cases, it shows that braces do not indeed slow or reduce the chance of surgery if worn.

Depending on the severity of the curvature, different treatment methods are implemented to attack this abnormality of the spine. Although the effectiveness of using plastic back braces to deter the curvature is still to be determined, doctors still generally use this method for smaller curves. In recent years, doctors have been employing a minimally invasive surgical approach for larger curves, one that requires surgeons to only make a few small incisions along the spine, rather than the traditional two-foot incision along the spine. This technique is by far the most radical treatment since the first scoliosis surgery took place in the early 1900s.