Cortical Bone Fusion

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

Spinal fusion is categorized into three different categories: cervical, thoracic, and lumbar, in conjunction with the different segments of the spine. Each type of spinal fusion has a different goal depending on the purpose of the surgery. Most surgeries involve fusing vertebrae together to limit its range of motion, thereby hopefully reducing the pain or correcting any physical deformities. Depending on the levels of fusion, spinal fusion surgeries tend to last a few hours. Complications may arise during surgery, and they greatly increase depending the location of the fusion, levels of fusion, and if the surgery crosses any important nerve sites. Levels of spinal fusion are known as the fusion between two different vertebrae. If there is a fusion between L1 and L2, that is known as one level of fusion. If there is another site of fusion at L3 and L4, than there will be two levels of spinal fusion. Lumbar fusion are further complicated when more then one level of performed. By limiting one segment’s range of motion, other segments of the spine will have to compensate and create greater range of motion. With lumbar fusion, most doctors will need to be able to identify why a patient needs lumbar fusion, and being able to identify if lumbar fusion will help alleviate the pain. Most cases of lumbar fusion involve spondylolisthesis, fractures, spinal stenosis, scoliosis, and possibly herniated disk if no other further treatment has proven successful. Most physicians will order an

Imagine that you have been called to an area where bones have been found. What would you do at this spot to help you better understand what happened?

This was then measured and 85 mm was found to be the appropriate length. The core was cut for the sliding screw without complication using a pre-set reamor set at 85 mm. The tap was then used to tap the way for the proximal screw and an 85 mm sliding screw was inserted across the fracture sight into the head and neck without complication. A four hole 135 degree side plate was then attached. We slid it over the depwheeze sliding screw and attached it to the proximal femur using a lommen turkey claw clamp. With the fixation in place AP and lateral fluoroscopic images throughout the fracture sight and hardware position confirmed good reduction and good placement of the hardware. At this point the side plate was then secured to the proximal femur using the 3-2 drill bit to drill a hole measuring the approximate length with the depth gauge and placing 4-5 cortical screws of the appropriate length without complication. At this point the compression screw was inserted. All traction was left off and the compression screw was tightened impacting the fracture nicely. All screws were then tightened with the screwdriver. The lommen was removed, as was all hardware. Multiple views in the AP and lateral plains of the fracture

My neurosurgeon, husband, daughter, and I agreed to a plan. On February 18, he will be removing the right side of my hardware from my skull down to C-2/3 where he will saw the rod in half and leave the rest of my fusion. The right side of my fusion has failed. While removing the fusion, he will be taking four screws out of my brain and one out of my neck. My fusion was placed nine years and two months ago; therefore, it has been in my body for a long time. He is leaving in the left side of my fusion, which is from my skull to C-5 because my neck is not stable enough without it. After he removes the titanium hardware, he will be taking a cadaver bone as well as removing bone marrow from my hip to rebuild my skull. He has to cut down the

Plan includes and restarting PT. trigger point injections was administered on this visit at the bilateral L3-5 paravertebral and sacroiliac joint muscles.

• You will talk with an anesthesiologist. This is the person who will be in charge of the anesthesia during the procedure. Spinal fusion usually requires that you are asleep during the procedure (general anesthesia).

Generally, bone can be classified into two categories according to its structure, cortical (compact) and trabecular (cancellous or spongy) bone. Cortical bone is stiff, with 5–10% porosity, and it makes up approximately 80% of skeletal bone, including cuboidal bones, flat bones, and the ends of long bones. Cortical bone is much denser, stiffer, and stronger than trabecular bone. The average strength of a compact human bone was 105 MPa in a longitudinal compression test, and was 131 MPa in a transversal compression test. In the same experiment, the average longitudinal strength in tension was 53 MPa [39]. In contrast, the porosity of trabecular bone is approximately 50–95%, which is higher than that of cortical bones. The surface area of the

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

12/01/15 Progress Report noted that the patient has cervical spine pain. Examination of the cervical spine revealed tenderness noted over the paraspinal and trapezius muscles. However, the exam revealed no discrete tender points or twitch responses on palpation over the neck. In addition, the latest report does not show any sensory or motor deficits. Furthermore, the PT reports available for review indicate that the therapy was done for bilateral hands and wrists. There is no documentation of the attempt of physical therapy of the cervical spine. There is no clear documentation of the failure of aggressive conservative treatment around the cervical spine. In addition, the request is for 15 injections and the guidelines do not support more than 3-4 injections per session. Therefore, the medical necessity of trigger point injections X 15 has not been substantiated. Recommend

Objectives: Proprioception was studied after TKA, in both posterior cruciate ligament (PCL)-retaining and posterior stabilizing (PS) prosthetic designs.

Pedicle screw fixation is the preferred technique for number of spinal disorders, there are a lot complications with this technique during surgery, like hardware failure, pseudarthrosis, screw misplacement [9,10]. Pedicle Screw failure occurs even after surgery from breakage, screw loosening, pullout [2,9,11-14]

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

Locoregional anesthesia was routinely used in non-fasting, cooperative or unfit patients while general anesthesia was the routine in patients who are uncooperative, irritable or medically fit. Pneumatic tourniquet was routinely applied at the midarm with pressure that was 70-100 mmHg above systolic blood pressure. Place the patient supine on the operating table with the arm on an arm board in 90° abduction, full extension of the elbow and forearm pronation. A straight longitudinal dorsal incision was used for exposure of metacarpals; however, proximal phalanges were exposed through a mid-lateral approach. The extensor apparatus was drawn aside and the periosteum was longitudinally incised and elevated to expose the fracture site preventing

Several surgical techniques have been described for stabilization of the atlantoaxial complex. Each technique differs in its biomechanical properties, advantages and disadvantages. In this series, we describe our experience with a combined four-point fixation technique that combines C1-C2 transarticular with C1 lateral mass fixation for atlanto-axial instability.