Abstract：
BACKGROUND:The ideal pedicle entry point for the thoracic spine is described as the base of the superior facet at the junction of the lateral and middle thirds of the pedicle. Investigators have reported its accuracy in curves less than 90 degrees . QUESTIONS/PURPOSES:Our aim was to measure the accuracy of this entry point for pedicle screw insertion in severe and rigid scoliotic curves. PATIENTS AND METHODS:We retrospectively measured the accuracy of thoracic pedicle screws in 26 patients with severe and rigid scoliosis (Cobb angle > or = 90 degrees ) inserted using the free-hand technique and the ideal pedicle entry point. Placements of thoracic pedicle screws were reviewed on postoperative CT scans, and the incidence and severity of penetration were determined. Screws penetrating medially up to 2 mm and laterally up to 4 mm were considered within the safe zone. RESULTS:One hundred sixty-eight (34.8%) of 482 inserted screws breached pedicle walls; 64 (13.2%) and 104 (21.6%) screws breached pedicle walls medially and laterally, respectively. Four hundred thirty-seven screws were within the safe zone, representing an accuracy rate of 90.7%. The accuracy rates of inserted screws in upper, middle, and lower thoracic pedicles were 93.4%, 87.7%, and 92%, respectively. CONCLUSIONS:Use of the ideal pedicle entry point is safe and accurate for thoracic pedicle screw placement in rigid curves of 90 degrees or greater. LEVEL OF EVIDENCE:Level II, prognostic study. See the Guidelines for Authors for a complete description of levels of evidence.
journal_name
Clin Orthop Relat Resjournal_title
Clinical orthopaedics and related researchauthors
Modi HN,Suh SW,Hong JY,Yang JHdoi
10.1007/s11999-010-1280-1subject
Has Abstractpub_date
2010-07-01 00:00:00pages
1830-7issue
7eissn
0009-921Xissn
1528-1132journal_volume
468pub_type
杂志文章abstract：:Indwelling prosthetic joints may become colonized by microbial biofilms, although the biofilm structure, composition of the microbial community, and physiologic activity of the organisms in these devices are not well understood. New approaches that rely on the use of fluorescent stain technology can be used to charact...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,评审
doi：10.1097/01.blo.0000175120.66051.29
更新日期：2005-08-01 00:00:00
abstract：BACKGROUND:There is growing interest in value-based health care in the United States. Statistical analysis of large databases can inform us of the factors associated with and the probability of adverse events and unplanned readmissions that diminish quality and add expense. For example, increased operating time and hig...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-016-5147-y
更新日期：2017-12-01 00:00:00
abstract：:Twenty consecutive cases of infected total knee replacements surgically treated between 1990 and 1993 in which complete clinical and financial data were available were reviewed to determine the resources required of the hospital and the surgeon. These results were compared with a similar analysis of a stratified, unse...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/00003086-199610000-00019
更新日期：1996-10-01 00:00:00
abstract：:Mesenchymal neoplasms are a heterogeneous group of tumors comprising more than 200 benign entities and approximately 100 sarcomas. Large intraobserver and interobserver variability mandates improvements in diagnostic criteria. Gene expression microarrays are one tool in an evolving field of technology that permits the...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/01.blo.0000093897.12372.88
更新日期：2003-10-01 00:00:00
abstract：:To clarify metastatic patterns, and histologic and radiologic features in skeletal metastases from gastric cancer, 48 patients were retrospectively analyzed. The mean age of the patients at the time of diagnosis of gastric cancer was 59 years. In 31 patients with a history of the radical surgery, the mean interval bet...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/01.blo.0000129159.65684.b3
更新日期：2004-06-01 00:00:00
abstract：:From July 1988 to June 1991, 110 complex acetabular fractures were operatively treated. A triradiate approach was used in 38 patients and an extended iliofemoral approach in 21. The mean patient age was 32 years (range, 15-80 years). These 59 patients were followed for a minimum of 36 months postoperatively. The posto...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1994-08-01 00:00:00
abstract：:Between 1976 and 1980, 81 knees in 59 patients 75 years of age or older, underwent primary total knee arthroplasty with a cemented, condylar femoral component and a cemented, moderately conforming, all polyethylene tibial component. All patients were followed up until death, revision surgery, or for a minimum of 10 ye...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1999-10-01 00:00:00
abstract：:A computer-assisted model has been developed to improve the results of surgical techniques for reconstruction of hip dysplasia. This method assesses the coverage and congruency of the femoral head by evaluating multiple factors that may influence surgical planning. It achieves a more reliable image because the measure...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1988-07-01 00:00:00
abstract：:Occupational radiation exposure was measured using three film badges and one ring thermoluminescent dosimeter. The radiation dose in the hospital but outside the operating room was measured as zero for the 12-month period. The measured trunk dose in the operating room was 5 mrem, and the measured dose to the head and ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1984-01-01 00:00:00
abstract：:The Total Condylar Prosthesis is a non-hinged unit designed to: replace the patellofemoral articulation; improve fixation of the tibial component by means of a stout central peg; permit accurate and reproducible insertion. The cruciate ligaments are excised to obtain better tibial fixation. Instability has not been a ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1976-10-01 00:00:00
abstract：:An analysis of the patellofemoral joint based on experimental determinations of pressure distributions on the patellar cartilage and vectorial calculations is presented. The extension torque of all quadriceps muscles is similar. The force transmitted to the patella by the retinacula is small in all knee positions. Bec...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1990-09-01 00:00:00
abstract：:The increasing number of hip and knee arthroplasties implies a greater likelihood of periprosthetic fractures and need for successful treatment options. We asked whether in situ effective lengthening of the indwelling prosthesis by a custom-made slotted hollow intramedullary nail provided a reasonable alternative to t...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/BLO.0b013e3181468b20
更新日期：2007-10-01 00:00:00
abstract：:Limb lengthening using callotasis needs careful preoperative planning and great care during the lengthening period. The most common method used to monitor limb lengthening is plain radiography, but the time of frame removal is still left to the judgment of the surgeon. This paper reviews some of the methods used exper...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,评审
doi：
更新日期：1994-11-01 00:00:00
abstract：:A rare case of anterior slip of the capital femoral epiphysis demonstrates that the mechanism of the posterior, inferior slip of the capital femoral epiphysis is a combination of weight bearing in the frontal plane and muscle pull in the horizontal plane. Sudden violent motions cause some of the unusual positions of a...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/00003086-197507000-00022
更新日期：1975-07-01 00:00:00
abstract：:Orthopedic management of the various complications resulting from musculo-skeletal bleeds in the hemophiliac, has now become standard and routine. However, the orthopedist should never minimize the threat of iatrogenic disease resulting from his surgery, or from the hemostatic control necessary for all operations. Ope...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1979-01-01 00:00:00
abstract：:Percutaneous fixation of hand fractures is a common technique that takes advantage of the subcutaneous nature of hand bones, their small size, and their limited loading potential for stress placed on hardware. Percutaneous wire fixation supplements cast fixation when plaster cannot hold particular reductions, and allo...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,评审
doi：10.1097/00003086-200006000-00014
更新日期：2000-06-01 00:00:00
abstract：BACKGROUND:Biopsies of musculoskeletal tumors lead to alterations in treatment in almost 20% of cases. Control charts are useful to ensure that a process is operating at a predetermined level of performance, although their use has not been demonstrated in assessing the adequacy of musculoskeletal biopsies. QUESTIONS/P...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-012-2544-8
更新日期：2013-03-01 00:00:00
abstract：:The combination of traumatic hip dislocation and multiple trauma have not been well documented in the medical literature to date. The role of surgery therefore has not been well defined in these patients. During a 12-year period, 29 consecutive patients with 31 traumatic hip dislocations with concomitant Injury Severi...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/00003086-200008000-00014
更新日期：2000-08-01 00:00:00
abstract：:The Hackethal technique of using stacked medullary pins for fixation of humeral shaft fractures is usually associated with relatively little blood loss; in addition, exposure of the fracture site and possible associated muscular trauma are avoided, and the risk of contusion of the radial nerve that may occur in fixati...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1983-10-01 00:00:00
abstract：:Patients with shoulder arthritis present to the orthopedic surgeon due to joint pain and loss of shoulder motion. A differential diagnosis is established, based on the history and physical examination and selected laboratory tests and roentgenograms. Synovial fluid analysis is often very helpful in the diagnosis of sh...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1983-03-01 00:00:00
abstract：:Limb salvage was previously described for patients with osteogenic sarcoma who had resectable lesions. In the very young child the usual methods of reconstruction are not applicable due to the resulting major leg-length inequality. One solution is to resect the lesion in accordance with good cancer surgery guidelines ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1984-09-01 00:00:00
abstract：BACKGROUND:Cementless fixation remains controversial in TKA due to the challenge of achieving consistent skeletal attachment. Factors predicting durable fixation are not clearly understood, but we presumed bone ingrowth could be enhanced by the quantity of host bone and application of autograft bone chips. QUESTIONS/P...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-011-2214-2
更新日期：2012-07-01 00:00:00
abstract：:Radiation therapy in the treatment of osteosarcoma has been considered with respect of the subclinical metastatic disease in the lung and the primary lesion. Emphasis is given to the necessity of coordinating the management plan of the primary lesion with an adjuvant program. Evaluation of the efficacy of a conservati...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,评审
doi：10.1097/00003086-197509000-00009
更新日期：1975-09-01 00:00:00
abstract：:The effects of fluoride (20 mumol/L) and bovine bone extract (17 micrograms/ml) were determined on cultures of human bone cells, embryonic chick bone cells, and human skin fibroblasts. The incorporation of [3H]thymidine into DNA was measured 16 hours after the addition of factors. After three to five days treatment, T...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1988-08-01 00:00:00
abstract：:Giant sacral schwannomas (GSS) are extremely rare. Complete resection of benign but neurologically devastating tumors has been recommended. A 48-year-old man with GSS had a tumor so large that a total sacrectomy was necessary. A special method of lumbar iliac fixation was devised. Two years and nine months after surge...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1993-09-01 00:00:00
abstract：UNLABELLED:Total knee replacement effectively relieves arthritis pain but improvement in physical function varies. A clearer understanding of the patient attributes associated with differing levels of functional gain after TKR is critical to surgical decision making. We reviewed 8050 primary, unilateral TKR patients en...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-008-0428-8
更新日期：2008-11-01 00:00:00
abstract：:A modified Ilizarov external fixator was used to transfix the stifle joint in 13 dogs. A 1-cm cortical cancellous bone plug was outlined in the intracondylar notch of the femur after excising the anterior (cranial) cruciate ligament (ACL). Hardware attached to the plug allowed controlled distraction of the plug into a...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1992-07-01 00:00:00
abstract：BACKGROUND:Combat-wounded service members are surviving battle injuries more than ever. Given different combat roles held by men and women, female service members should survive wounds at an unprecedented rate. QUESTIONS/PURPOSES:We determined whether the casualty rates for females differ from their male counterparts ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-011-1840-z
更新日期：2011-07-01 00:00:00
abstract：:Breast cancers frequently metastasize to the skeleton and cause bone destruction. Tumor cells secrete factors that stimulate osteoclasts. The consequent osteolytic resorption releases active factors from the bone matrix, in particular transforming growth factor-beta (TGF-beta). The released factors then stimulate tumo...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,评审
doi：10.1097/01.blo.0000093055.96273.69
更新日期：2003-10-01 00:00:00
abstract：:Load-bearing porous-surfaced implants in dogs which failed were not incorporated by bone ingrowth. The implants were incorporated only by fibrous tissue ingrowth. Collagen fiber orientation within this fibrous tissue and Sharpey's fiber-like features at the interface between the fibrous tissue and a surrounding layer ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1981-05-01 00:00:00
