Advances in Orthopedics最新文献

{"title":"Fixation of Olecranon Fractures Using a Hybrid Intramedullary Screw and Tension Band Construct.","authors":"Kaitlin Rush, John Fisher, Neil Jain, Caleb Gottlich, Cyrus Caroom","doi":"10.1155/2024/6471544","DOIUrl":"10.1155/2024/6471544","url":null,"abstract":"<p><strong>Introduction: </strong>Olecranon fractures are common injuries that require surgical intervention for optimal outcomes. Various fixation methods have been described in the literature, including the use of intramedullary proximal ulna screws in combination with tension band augmentation. Limited research has compared this hybrid technique to other established methods of fixation. This study compared complication and reoperation rates between multiple groups.</p><p><strong>Methods: </strong>A retrospective review was conducted on patients with olecranon fractures who underwent internal fixation at a level 1 trauma center between January 1st, 2013, and April 22nd, 2023. Data was collected using CPT codes, and patients were categorized into five groups based on the method of fixation received: no implant, tension band only, locking olecranon plate, intramedullary screw and tension band hybrid, and others. Variables such as patient demographics, Mayo fracture classification, open vs. closed injury, implant type, reoperation rates, and postoperative complications were recorded.</p><p><strong>Results: </strong>A total of 217 patients were included in the study. No difference was found with implant choice and reoperation rate (<i>p</i> = 0.461). There was a significant difference found with reoperation and fracture type (<i>p</i> = 0.027) and open fracture (<i>p</i> = 0.002).</p><p><strong>Conclusion: </strong>The primary findings of this study indicate no significant difference in implant choice and reoperation rates among the various fixation methods used for olecranon fractures. These findings suggest that the hybrid fixation technique, utilizing intramedullary proximal ulna screws in combination with tension band augmentation, is a viable and comparable treatment option when evaluated against other well-documented methods of fixation. This study also reiterates that severity of initial injury is often the most important factor related to poorer outcomes. Further discussion and analysis of the data will provide a comprehensive understanding of implications and recommendations for olecranon fracture fixation.</p>","PeriodicalId":7358,"journal":{"name":"Advances in Orthopedics","volume":"2024 ","pages":"6471544"},"PeriodicalIF":1.3,"publicationDate":"2024-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11156510/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141282673","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Postoperative Hemoglobin Drop and the Associated Factors among Elective Orthopedic Surgeries in Northern Tanzania.","authors":"Abdel Ashir, Elifuraha G Maya, Shahnoor Ruhulamin Saiyed, Taher Muslim Alimohamed, Mubashir Alavi Jusabani, Kulthum A Abdel, Abid M Sadiq, Ali Mohamed Ali, Faiton Ndesanjo Mandari","doi":"10.1155/2024/4145592","DOIUrl":"10.1155/2024/4145592","url":null,"abstract":"<p><strong>Background: </strong>Having an estimated level of Hb drop in different orthopedic surgeries would help plan for surgery from pre- to postoperative periods. The aim of this study was to assess the Hb drop and the associated factors during the intraoperative period among elective orthopedic surgeries.</p><p><strong>Methods: </strong>This was an analytic cross-sectional study conducted between October 2022 and March 2023, which included all patients admitted for elective orthopedic surgery who met the inclusion criteria. Data were collected before and after the patient was operated on. Information was analyzed using <i>t</i>-tests and ANOVA to establish the statistical significance of the Hb drop.</p><p><strong>Results: </strong>A total of 195 participants were enrolled. The majority of the participants were male (62.1%), with the main etiology of symptoms being motor traffic accidents (31.8%). The most affected site was the femur (36.4%), followed by the spine (23.6%). The highest mean Hb drop was in total hip replacement surgeries (4.19 g/dL), with the overall mean Hb drop being 2.75 g/dL. A statistically significant difference was identified in diathermy use, duration of surgery, and patients with chronic illnesses.</p><p><strong>Conclusion: </strong>With a mean Hb drop of 2.75 g/dL, the application of diathermy and surgeries with shorter durations resulted in a reduced Hb drop. These factors should be incorporated to minimize the drop in Hb in orthopedic surgeries. Accounting for differences in surgeries, there should not be delays in patients who have a preoperative Hb level that can sustain the mean Hb drop recorded in the study.</p>","PeriodicalId":7358,"journal":{"name":"Advances in Orthopedics","volume":"2024 ","pages":"4145592"},"PeriodicalIF":1.3,"publicationDate":"2024-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11142858/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141199246","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Translation and Linguistic Validation of the Patient's Knee Implant Performance (PKIP) into Japanese.","authors":"Fumiya Ohmasa, Yukihide Minoda, Daisuke Akahane, Kimberly A Dwyer, Jim Lesko, Hideharu Shimizu","doi":"10.1155/2024/6645361","DOIUrl":"10.1155/2024/6645361","url":null,"abstract":"<p><strong>Objective: </strong>The patient's knee implant performance (PKIP) is a patient-reported outcome measure, developed in the USA in English that evaluates knee functional performance before and after primary total knee arthroplasty (TKA). The PKIP assesses the level of satisfaction, confidence, and stability, while performing various activities, as well as the need for changing ways of doing activities. It comprises 24 items. The objective of this study was to present the methodology of the linguistic validation of the PKIP.</p><p><strong>Methods: </strong>The Japanese version of the PKIP was developed using a standard linguistic validation (LV) process. The LV involved the following steps: (1) conceptual analysis of the original version; (2) translation into Japanese using a dual forward/backward translation process; (3) review by an orthopaedics surgeon; (4) test on five respondents; and (5) proofreading.</p><p><strong>Results: </strong>The translation itself did not reveal major translatability issues, either cultural, semantic, or syntactic. Most of the activities listed (e.g., going up stairs, getting in/out of a car, and walking up a hill/ramp/incline) were easily translated. Only one activity was culturally sensitive and raised some discussion, i.e., \"sitting down on a toilet,\" since the style of Japanese toilets is different from the western style. Overall, the respondents well understood the questionnaire. However, the expression \"how your knee is working with your body\" used in the opening sentence was an issue for both the clinician and the respondents. A compromise was found by using a Japanese equivalent of \"how your knee functions with your legs.\"</p><p><strong>Conclusion: </strong>The rigorous translation process, which involved the collaboration of a minimum of thirteen people (sponsor, four translators, two coordinators (one in Japan and one in Europe), one clinician, and five respondents) enabled the production of a Japanese version of the PKIP conceptually equivalent to the USA English original.</p>","PeriodicalId":7358,"journal":{"name":"Advances in Orthopedics","volume":"2024 ","pages":"6645361"},"PeriodicalIF":1.3,"publicationDate":"2024-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11074845/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140875543","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PD-L1, STAT3, IL6, and EGFR Immunoexpressions in High-Grade Osteosarcoma.","authors":"Nayla Rahmadiani, Eviana Norahmawati, Agustina Tri Endharti, Ailen Oktaviana Hambalie, Satria Pandu Persada Isma","doi":"10.1155/2024/9036225","DOIUrl":"10.1155/2024/9036225","url":null,"abstract":"<p><strong>Introduction: </strong>Immunotherapy has been widely used in the treatment of various malignancies with satisfactory results. One of the agents for immunotherapy is an inhibitor of programmed cell death-1 and its ligands (PD-1 and PD-L1). However, attempts at utilizing PD-1/PD-L1 immunotherapy in osteosarcoma have not yielded favorable results. This may be due to differences in PD-L1 regulation and the immune landscape in osteosarcoma, as the mechanism is still poorly understood. Therefore, elucidating PD-L1 regulation in osteosarcoma is paramount in order to improve treatment results using immunotherapy.</p><p><strong>Methods: </strong>This is a cross-sectional study conducted in the Department of Anatomical Pathology of Saiful Anwar Hospital using 33 paraffin blocks of confirmed cases of osteosarcoma. Immunohistochemical staining using PD-L1, STAT3, IL6, and EGFR was performed. Statistical analyses were subsequently performed on the immunoexpression data of these antibodies.</p><p><strong>Results: </strong>PD-L1, STAT3, IL6, and EGFR expressions were found in 6 (18.2%), 6 (18.2%), 28 (84.8%), and 30 (90.9%) cases, respectively. There were significant correlations between PD-L1 and STAT3 (<i>r</i> = 0.620, <i>p</i>=<0.001), PD-L1 and EGFR (<i>r</i> = 0.449, <i>p</i>=0.009), as well as STAT3 and EGFR (<i>r</i> = 0.351, <i>p</i>=0.045).</p><p><strong>Conclusion: </strong>The existence of a correlation between PD-L1, STAT3, and EGFR indicates the potential role of STAT3 and EGFR in PD-L1 regulation in osteosarcoma, which may become the basis for targeted therapy.</p>","PeriodicalId":7358,"journal":{"name":"Advances in Orthopedics","volume":"2024 ","pages":"9036225"},"PeriodicalIF":1.3,"publicationDate":"2024-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10907101/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140020743","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reconsidering \"Critical\" Bone Loss in Shoulder Instability: 17-Year Follow-Up Study following Arthroscopic Bankart Repair.","authors":"Lawrence Chun-Man Lau, Wai-Wang Chau, Randy Ng, Jonathan Patrick Ng, Elvis Chun-Sing Chui, Michael Tim-Yun Ong, James Francis Griffith, Patrick Shu-Hang Yung","doi":"10.1155/2024/5598107","DOIUrl":"10.1155/2024/5598107","url":null,"abstract":"<p><strong>Background: </strong>Glenoid bone loss is a risk factor leading to the failure of arthroscopic Bankart repair. While 20-25% glenoid bone loss has long been considered the level to necessitate bony augmentation, recent studies indicate that 13.5% has a \"subcritical\" glenoid bone loss level, which is associated with decreased short- and medium-term functional scores. Few researchers worked on the long-term effect of \"subcritical\" or even less severe degrees of glenoid bone loss on redislocation rates and functional outcomes after arthroscopic Bankart repair. This study aimed to evaluate the effect of subcritical or less severe glenoid bone loss on redislocation rates and function after arthroscopic Bankart repair.</p><p><strong>Methods: </strong>A patient cohort who had undergone computed tomography (CT) of glenoid bone loss and arthroscopic Bankart repair over 15 years ago was reviewed. Western Ontario Shoulder Instability (WOSI) score, Single Assessment Numeric Evaluation (SANE) score, redislocation after operation, mechanism of recurrence, and revision details were reviewed.</p><p><strong>Results: </strong>Seventy-five patients were reassessed 17.6 ± 1.9 years following initial surgery. The age at enrolment was 26.8 ± 8.3 years. Twenty-two (29%) patients of the 75 patients had a redislocation on long-term follow-up, though this was not related to glenoid bone loss severity. The impaired functional score was found in patients with initial glenoid bone loss of 7% or more on long-term follow-up: WOSI (physical symptoms): 0.98 ± 2.00 vs 2.25 ± 4.01, <i>p</i>=0.04 and WOSI (total): 0.79 ± 1.43 vs 1.88 ± 3.56, <i>p</i>=0.04.</p><p><strong>Conclusions: </strong>At a mean of 17.5 years following arthroscopic Bankart repair, redislocation occurs in over a quarter of 75 patients, and they are not related to initial glenoid bone loss severity. Impaired functional outcome is apparent in patients with initial glenoid bone loss of >7%, though this impairment does not seem sufficiently severe to warrant an alternative treatment approach.</p>","PeriodicalId":7358,"journal":{"name":"Advances in Orthopedics","volume":"2024 ","pages":"5598107"},"PeriodicalIF":1.3,"publicationDate":"2024-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10849799/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139704419","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Outcomes between Open and Arthroscopic Rotator Cuff Repair.","authors":"Serdar Menekse","doi":"10.1155/2024/5575404","DOIUrl":"10.1155/2024/5575404","url":null,"abstract":"<p><strong>Objective: </strong>The objective of this retrospective cohort study is to evaluate the long-term clinical and functional outcomes of two surgical techniques for rotator cuff repair, namely, open and arthroscopic methods.</p><p><strong>Methods: </strong>A total of 100 patients diagnosed with rotator cuff tears and treated at Seyhan State Hospital in the past five years were enrolled, considering the same inclusion criteria for both groups. The study groups consisted of 50 patients who underwent open rotator cuff repair and 50 patients who underwent arthroscopic rotator cuff repair. We used the SPSS programme to analyse the data, focusing on parameters such as postoperative recovery time, functional capacity scores, pain levels measured by the VAS scale, quality of life evaluated by the SF-36 scores, and complication rates.</p><p><strong>Results: </strong>Both methods resulted in similar recovery times and functional capacity scores, but patients treated with the open method reported slightly lower pain levels (average VAS score: 2.8) compared to those treated with the arthroscopic method (average VAS score: 3.1). The study also found slightly better quality of life scores in the arthroscopic group (average SF-36 score: 71.4) compared to the open surgery group (average SF-36 score: 68.7). The complications rates were lower in the arthroscopic group (2%) than in the open surgery group (4%), but these differences were not statistically significant.</p><p><strong>Conclusions: </strong>The study suggests that, while there are no significant differences in terms of clinical outcomes between the two surgical methods, short-term pain levels may be influenced by the more frequent application of acromioplasty in arthroscopic methods. Therefore, the choice of the surgical method should be made based on the unique characteristics, including the location and size, the patient's overall health status, and the surgeon's experience. These findings should be used as a guide and not as absolute results.</p>","PeriodicalId":7358,"journal":{"name":"Advances in Orthopedics","volume":"2024 ","pages":"5575404"},"PeriodicalIF":1.3,"publicationDate":"2024-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10796185/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139511560","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Systematic Review of Total Hip Arthroplasty Outcomes in Cerebral Palsy Patients and a Comparative Analysis with Rheumatoid Arthritis","authors":"Christos Costa, F. Moniati, M. Chatzimatthaiou, Christos Papaioannou, Sapfo Athanasakopoulou, Marios Chatzimatthaiou","doi":"10.1155/2023/8696116","DOIUrl":"https://doi.org/10.1155/2023/8696116","url":null,"abstract":"Background. Total hip arthroplasty (THA) is considered a successful treatment option for patients with degenerative hip arthritis. However, in the setting of neuromuscular diseases, patients with cerebral palsy (CP) are considered high-risk due to instability, contractures, and altered muscle tone. The purpose of this systematic review is to analyse the data in the setting of THA in CP patients including indications, types of implants, revision rates, and patient-reported outcomes and compare these with those of a cohort requiring THA due to degenerative arthritis unrelated to neuromuscular disorders. Methods. PubMed, Embase, and Cochrane Library were searched from inception until June 10, 2023, to identify the relevant studies for THA on CP patients. The methodological quality of the studies was evaluated using the Newcastle–Ottawa Quality Assessment Scale (NOS). Results. The initial search generated 190 studies out of which 21 met the inclusion criteria. The most frequently reported indication was painful hip dislocation or subluxation due to failure of prior nonoperative treatment. The most frequently reported complication was dislocation affecting overall 7.5% (0–28%) of all patients, while other complications included periprosthetic fractures and heterotrophic ossification. The survival rates of primary THAs ranged from 85% to 100% at 5 years and from 73% to 86% at 10 years. Patients with CP who undergo total hip arthroplasty experience a greater overall rate of complications compared to patients with rheumatoid arthritis (RA) that undergo the same procedure. Conclusion. The current literature suggests that THA is a beneficial procedure for patients with CP through pain reduction and functional improvement. However, the increased rates of potential complications compared to the general population require careful consideration. We suggest that further investigations on the most appropriate time of procedure, implant type, and procedure are needed.","PeriodicalId":7358,"journal":{"name":"Advances in Orthopedics","volume":" 7","pages":""},"PeriodicalIF":1.3,"publicationDate":"2023-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139138430","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Using Piezosurgery in Anterior Cervical Discectomy and Fusion to Treat Complex Cervical Spondylotic Myelopathy Is Safe and Effective.","authors":"Yu-Wei Li, Hao-Jie Chen, Shi-Xin Zhao, Xiu-Zhi Li, Hai-Jiao Wang, Peng Zhou, Wei Cui, Wei Xiao, Fan Li, Bingtao Hu","doi":"10.1155/2023/5306445","DOIUrl":"10.1155/2023/5306445","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the safety and efficacy of piezosurgery in anterior cervical discectomy and fusion (ACDF) for cervical spondylotic myelopathy (CSM).</p><p><strong>Methods: </strong>47 patients with complex CSM (cCSM) underwent ACDF surgery from 2014 to 2017. Among these patients, 26 underwent ACDF using piezosurgery (group A) and 21 underwent ACDF by using traditional tools such as high-speed air drill, bone curette, and Kerrison bone punch (group B). Average surgical time, intraoperative blood loss, surgical complications, preoperative and postoperative Japanese Orthopaedic Association (JOA) scores, and improvement rate were measured.</p><p><strong>Results: </strong>Average surgical time and intraoperative blood loss were significantly lower in group A than those in group B (<i>P</i> < 0.01). The incidences of surgical complications were 3.8% and 23.8% in the A and B groups (<i>P</i> < 0.05), respectively. There were no significant differences in JOA scores and improvement rates between data collection periods at preoperative, 3-day postoperative, and 1-year postoperative follow-ups (<i>P</i> > 0.05).</p><p><strong>Conclusion: </strong>For treating cCSM, both the piezosurgery and traditional tools led to significant neurological improvement. However, the piezosurgery was superior to the traditional tools in terms of surgical time, blood loss, and complication rate. Hence, piezosurgery was a safe and effective adjunct for ACDF treating cCSM.</p>","PeriodicalId":7358,"journal":{"name":"Advances in Orthopedics","volume":"2023 ","pages":"5306445"},"PeriodicalIF":1.3,"publicationDate":"2023-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10754634/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139058024","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How Safe and Technical Is Modified Dunn Osteotomy in the Management of Patients with SCFE: A Clinical Trial with Short-Term Follow-Up","authors":"Amro Elsiofy, Mahmoud Elsherif, Moawed F. Eladawy, Tarek Abdel Mahmoud, Ahmed F. Sakr","doi":"10.1155/2023/2742083","DOIUrl":"https://doi.org/10.1155/2023/2742083","url":null,"abstract":"Objective. Over the last decade, modified Dunn osteotomy has been widely used in the management of slipped capital femoral epiphysis (SCFE) with varying degrees of complications. Different conclusions have been adopted. Our study represented our experience in using such a technique in stable and unstable SCFE and tried to determine its safety and applicability for routine practice. Methods. Our study adopted an interventional prospective design performed on 24 hips divided evenly between both sexes with a mean age of 13.25. On the Southwick classification, the cases were distributed between moderate and severe, which constituted 41.7% and 58.33%, respectively. Three quarters of the study subjects were stable according to the Loder classification. Each underwent modified Dunn osteotomy after a safe surgical hip dislocation. Results. Over the period of about 1-year follow-up, clinical evaluation was performed by examining the surgical site and assessing the legs’ length, range of hip movement, Harris hip score, and iHOT-12 score. Radiological assessment was performed by calculation of slip angle from the frog lateral view, assessment of union, and occurrence of any complications. The study showed that there was significant improvement in patients in terms of radiological and clinical outcomes, with the occurrence of AVN in 16.7% of cases (4 out of 24). All cases of AVN occurred in unstable hips. Conclusion. Despite the complication of AVN, we believe the results of this study add to the current literature which suggests that modified Dunn osteotomy is an effective and safe technique for the management of moderate and severe SCFE. This trial is registered with PACTR202312819351504.","PeriodicalId":7358,"journal":{"name":"Advances in Orthopedics","volume":"27 4","pages":""},"PeriodicalIF":1.3,"publicationDate":"2023-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138594378","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Protocol for Electrical Conductivity Signal Collection and Processing in Scoliosis Surgery","authors":"Elie Saghbiny, Jimmy Da Silva, Celia Chaimi, Thibault Chandanson, Raphael Vialle","doi":"10.1155/2023/9955520","DOIUrl":"https://doi.org/10.1155/2023/9955520","url":null,"abstract":"Introduction. Pedicle screw placement is a common procedure in spinal surgery. The misplacement rate with lateral and medial cortical perforation is 5–11%. Several techniques are used to decrease this rate. Many studies proved that electrical conductivity increases accuracy during pedicle screw placement but no study has interpreted conductivity values. Methods. The data are collected from patients operated for scoliosis in a single university hospital. After the posterior surgical approach is made, each pedicle is prepared classically. Instead of the classic curved pedicle probe, the surgeon uses a probe with the same shape that measures the conductivity at its tip. Conductivity values are recorded through a Bluetooth application. Each pedicle trajectory is then qualified after manual palpation with a feeler. A trajectory is qualified as optimal when palpation shows a bone tunnel without any breach, breached when there was a breach, and a modification of the probe direction was needed. A trajectory that does not meet the abovementioned definitions is excluded from the statistical analysis. Results. 21 patients with 457 pedicles are recorded. The average age of the population is 14.71 ± 1.86 years. 17 patients (81%) have idiopathic adolescent scoliosis. One patient has Rett syndrome, one has hypotonia, one has cerebral palsy, and one has congenital malformation. The depth of the instrument is measured semiautomatically. This technique is validated when compared with the manual technique using the Bland–Altman agreement method (mean differences = −0.279 mm, upper limit = 2.2 mm, and lower limit = −2.7 mm) and Deming regression (slope = 1.06 ± 0.004). Conclusion. This study establishes a protocol to collect electrical conductivity signals in spine surgery with synchronization to the depth of the instrument. Real-time conductivity signal feedback alerts the surgeon of a probable breach in the spinal canal, so he can change the direction of the pedicle aim.","PeriodicalId":7358,"journal":{"name":"Advances in Orthopedics","volume":"13 6","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135474636","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}