Posterior wedge osteotomy assisted by O-arm navigation for treating ankylosing spondylitis with thoracolumbar fractures: an early clinical evaluation

Li, Bo; Guo, Rui; Jiang, Xu; Wu, Jionglin; Zhang, Di; Yang, Canchun; Zhao, Qiancheng; Zhang, Chi; Yan, Haolin; Wang, Zheyu; Wang, Qiwei; Huang, Renyuan; Zhang, Zhilei; Hu, Xumin; Gao, Liangbin

doi:10.21037/apm-21-1286

Cited by 7 publications

(3 citation statements)

References 56 publications

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“…Anterior discectomy is a muscle splitting approach with minimal blood loss and can be performed within a short timeframe with the help of O-arm guidance [22]. Pontes osteotomy and pedicle screw fixation can be performed with precision and in a shorter timeframe with O-arm guidance, which reduces blood loss and the risk of neurological injury [23].…”

Section: Discussionmentioning

confidence: 99%

New Spinal Shortening Technique for Tethered Cord Syndrome: A Technical Note

Tanaka,

Sonawane,

Arataki

et al. 2023

Medicina

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Background and Objectives: To present a new spinal shortening technique for tethered cord syndrome. Tethered cord syndrome (TCS) is a debilitating condition leading to progressive neurological decline. Surgical detethering for TCS is the gold standard of treatment. However, symptomatic retethering of TCS has been reported in 5%–50% of patients after initial release. To solve this problem, posterior spinal shortening osteotomy has been reported. This technique has risks of massive blood loss and neurological deterioration. The authors hereby report a new safe spinal shortening technique for tethered cord syndrome. Materials and Methods: A 31-year-old man with gait disturbance was referred to our hospital. After the delivery of treatment, he underwent surgical untethering of the spinal cord in another hospital. He had hyperreflexia of the Achilles tendon reflex and bilateral muscle weakness of the legs (MMT 3-4). He also had urinary and bowel incontinence, and total sensory loss below L5. An anteroposterior lumbar radiogram indicated partial laminectomy of L3 and L4. Lumbar MRI showed retethering of spinal cord. Results: The patient underwent a new spinal shortening technique for tethered cord syndrome under the guidance of O-arm navigation. First, from the anterior approach, disectomy from T12 to L3 was performed. Second, from the posterior approach, Ponte osteotomy was performed from T12 to L3, shortening the spinal column by 15 mm. The patient was successfully treated surgically. Postoperative lumbar MRI showed that the tension of the spinal cord was released. Manual muscle testing results and the sensory function of the left leg had recovered almost fully upon final follow-up at one year. Conclusions: A retethered spinal cord after initial untethering is difficult to treat. This new spinal shortening technique can represent another good option to release the tension of the spinal cord.

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Section: Discussionmentioning

confidence: 99%

New Spinal Shortening Technique for Tethered Cord Syndrome: A Technical Note

Tanaka,

Sonawane,

Arataki

et al. 2023

Medicina

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“…18 If the deformity is severe, then concomitant osteotomy can be considered after discussing risks and benefits with the patient. 18,46 Open posterior fixation three levels above and below the injury increases the length and invasiveness of the procedure which has been postulated to contribute to the high mortality rate associated with these surgical interventions. This has led to more recent attempts to utilize percutaneous pedicle screws in minimally invasive surgeries (MIS).…”

Section: Openmentioning

confidence: 99%

Management of Thoracolumbar Vertebral Fractures and Dislocations in Patients with Ankylosing Conditions of the Spine

Daher,

Rezk,

Baroudi

et al. 2024

Orthopedic Reviews

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Ankylosing spondylitis (AS) and diffuse idiopathic skeletal hyperostosis (DISH) are bone-forming spinal conditions which inherently increase spine rigidity and place patients at a higher risk for thoracolumbar fractures. Due to the long lever-arm associated with their pathology, these fractures are frequently unstable and may significantly displace leading to catastrophic neurologic consequences. Operative and non-operative management are considerations in these fractures. However conservative measures including immobilization and bracing are typically reserved for non-displaced or incomplete fractures, or in patients for whom surgery poses a high risk. Thus, first line treatment is often surgery which has historically been an open posterior spinal fusion. Recent techniques such as minimally invasive surgery (MIS) and robotic surgery have shown promising lower complication rates as compared to open techniques, however these methods need to be further validated.

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“…The following data were recorded: age, sex, body mass index (BMI), American Society of Anesthesiologists (ASA) score, the position of the hernia, surgery time, blood loss, conversion, postoperative hospital stay, follow-up time, complications, and hernia recurrence. The pain scores were checked 1 day after the surgery by a member of the team using a visual analog scale (VAS) (18,19). Some patients were followed up with outpatient visits, while…”

Section: Data Collectionmentioning

confidence: 99%

Application of a custom-made single-incision sealing device in laparoscopic surgery for totally extraperitoneal herniorrhaphy: initial experience

Wang¹,

Fei²,

Zhou³

2022

Ann Transl Med

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Background: In this research, the safety and feasibility of single-incision laparoscopic surgery for total intraperitoneal herniorrhaphy (SILS-TEP) was clarified through a customized single-port device.Methods: A 2.5 cm curved incision was made along the lower umbilical margin. The subcutaneous fatty tissue was removed by electrotomy or blunt dissection to form a 5.0 cm preperitoneal space under the posterior sheath. The Iconport single-hole device silicone sealing sleeve was wedged under the posterior rectus sheath and inflated with CO 2 to dilate the anterior peritoneal space toward the lower abdomen.According to the standard method of laparoscopic total peritoneal hernia repair, conventional laparoscopic instruments were used to complete the operation.Results: Successful SILS-TEP hernia repair was performed in 63 patients. The mean operative times for unilateral indirect hernia were 65.5 [40-110] minutes. The mean operative times for unilateral direct hernia, and femoral were 51.3 [36-83] minutes, respectively. Six seroma cases were seen during the 1-to 32-month follow-up periods, and all patients recovered after conservative treatment. No other major complications were observed. The mean postoperative hospital stay was 3.3 days. Conclusions:With the assistance of a suitable single-port laparoscopic device, SILS-TEP umbilical incision under the posterior rectus sheath is a safe and feasible method.

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Posterior wedge osteotomy assisted by O-arm navigation for treating ankylosing spondylitis with thoracolumbar fractures: an early clinical evaluation

Cited by 7 publications

References 56 publications

New Spinal Shortening Technique for Tethered Cord Syndrome: A Technical Note

New Spinal Shortening Technique for Tethered Cord Syndrome: A Technical Note

Management of Thoracolumbar Vertebral Fractures and Dislocations in Patients with Ankylosing Conditions of the Spine

Application of a custom-made single-incision sealing device in laparoscopic surgery for totally extraperitoneal herniorrhaphy: initial experience

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