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"Instrumentation"

Original Articles

Comparison of Single or Double Titanium Mesh Cage for Anterior Reconstruction After Total En Bloc Spondylectomy for Thoracic and Lumbar Spinal Tumors
Ao Leng, Qi Wang, Jiacheng Li, Yu Long, Song Shi, Lingzhi Meng, Mingming Guo, Hailong Yu, Liangbi Xiang
Neurospine 2024;21(2):656-664.   Published online June 30, 2024
DOI: https://doi.org/10.14245/ns.2448052.026

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Comparison of Single or Double Titanium Mesh Cage for Anterior Reconstruction After Total En Bloc Spondylectomy for Thoracic and Lumbar Spinal Tumors
Neurospine. 2024;21(2):656-664.   Published online June 30, 2024
DOI: https://doi.org/10.14245/ns.2448052.026
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Comparison of Single or Double Titanium Mesh Cage for Anterior Reconstruction After Total En Bloc Spondylectomy for Thoracic and Lumbar Spinal Tumors
Neurospine. 2024;21(2):656-664.   Published online June 30, 2024
DOI: https://doi.org/10.14245/ns.2448052.026
Close
Objective
To compare the clinical efficacy of anterior column reconstruction using single or double titanium mesh cage (TMC) after total en bloc spondylectomy (TES) of thoracic and lumbar spinal tumors.
Methods
A retrospective cohort study was performed involving 39 patients with thoracic or lumbar spinal tumors. All patients underwent TES, followed by anterior reconstruction and screw-rod instrumentation via a posterior-only procedure. Twenty-two patients in group A were treated with a single TMC to reconstruct the anterior column, whereas 17 patients in group B were reconstructed with double TMCs.
Results
The overall follow-up is 20.5 ± 4.6 months. There is no significant difference between the 2 groups regarding age, sex, body mass index, tumor location, operative time, and intraoperative blood loss. The time for TMC placement was significantly shortened in the double TMCs group (5.2 ± 1.3 minutes vs. 15.6 ± 3.3 minutes, p = 0.004). Additionally, postoperative neural complications were significantly reduced with double TMCs (5/22 vs. 0/17, p = 0.046). The kyphotic Cobb angle and mean intervertebral height were significantly corrected in both groups (p ≤ 0.001), without obvious loss of correction at the last follow-up in either group. The bone fusion rates for single TMC and double TMCs were 77.3% and 76.5%, respectively.
Conclusion
Using 2 smaller TMCs instead of a single large one eases the placement of TMC by shortening the time and avoiding nerve impingement. Anterior column reconstruction with double TMC is a clinically feasible, and safe alternative following TES for thoracic and lumbar tumors.

Citations

Citations to this article as recorded by  Crossref logo
  • 3D-printed tantalum artificial vertebral body or titanium mesh in anterior column reconstruction post-spondylectomy for thoracic vertebral tumors: a retrospective comparative cohort study and finite element analysis
    Hui Lv, Meitao Xu, Qiuchi Ai, Fuyou Wang, Zhongrong Zhang, Tianyong Hou
    Journal of Orthopaedic Surgery and Research.2025;[Epub]     CrossRef
  • 5,661 View
  • 82 Download
  • 1 Web of Science
  • 1 Crossref

Regular Issue

Freehand Juxtapedicular Screws Placed in the Apical Concavity of Adult Idiopathic Scoliosis Patients: Technique, Computed Tomography Confirmation, and Radiographic Results
Alexander J. Schupper, James D. Lin, Joseph A. Osorio, Nathan J. Lee, Jeremy M Steinberger, Joseph M. Lombardi, Ronald A. Lehman, Lawrence G. Lenke
Neurospine 2022;19(4):1116-1121.   Published online December 31, 2022
DOI: https://doi.org/10.14245/ns.2244798.399

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Freehand Juxtapedicular Screws Placed in the Apical Concavity of Adult Idiopathic Scoliosis Patients: Technique, Computed Tomography Confirmation, and Radiographic Results
Neurospine. 2022;19(4):1116-1121.   Published online December 31, 2022
DOI: https://doi.org/10.14245/ns.2244798.399
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Freehand Juxtapedicular Screws Placed in the Apical Concavity of Adult Idiopathic Scoliosis Patients: Technique, Computed Tomography Confirmation, and Radiographic Results
Neurospine. 2022;19(4):1116-1121.   Published online December 31, 2022
DOI: https://doi.org/10.14245/ns.2244798.399
Close
Objective
The purpose of this study is to highlight our technique for freehand placement of juxtapedicular screws along with intraoperative computed tomography (CT) and radiographic results.
Methods
Consecutive patients with adult idiopathic scoliosis undergoing primary surgery by the senior author were identified. All type D (absent/slit like channel) pedicles were identified on preoperative CT. Three-dimensional visualization software was used to measure screw angulation and purchase. Radiographs were measured by a fellowship trained spine surgeon. The freehand technique was used to place all screws in a juxtapedicular fashion without any fluoroscopic, radiographic, navigational or robotic assistance.
Results
Seventy-three juxtapedicular screws were analyzed. The most common level was T7 (9 screws) on the left and T5 (12 screws) on the right. The average medial angulation was 20.7° (range, 7.1°–36.3°), lateral vertebral body purchase was 13.4 mm (range, 0–28.9 mm), and medial vertebral body purchase was 21.1 mm (range, 8.9–31.8 mm). More than half (53.4%) of the screws had bicortical purchase. Two screws were lateral on CT scan, defined by the screw axis lateral to the lateral vertebral body cortex. No screws were medial. There was a difference in medial angulation between screws with (n = 58) and without (n = 15) lateral body purchase (22.0 ± 4.9 vs. 15.5 ± 4.5, p < 0.001). Three of 73 screws were repositioned after intraoperative CT. There were no neurovascular complications. The mean coronal cobb corrections for main thoracic and lumbar curves were 83.0% and 80.5%, respectively, at an average of 17.5 months postoperative.
Conclusion
Freehand juxtapedicular screw placement is a safe technique for type D pedicles in adult idiopathic scoliosis patients.

Citations

Citations to this article as recorded by  Crossref logo
  • L-Point Entry, Juxtapedicular, and Endplate-Parallel Trajectory (L-JET) Screw Fixation: A Novel Technique in Thoracic Spinal Tumor Surgery
    Seunghoon Lee, Young Rak Kim, Chang-Hyun Lee, Jungbo Sim, Woojin Kim, Ho Sung Myeong, Hangeul Park, Jun-Hoe Kim, Chi Heon Kim
    Journal of Minimally Invasive Spine Surgery and Technique.2026; 11(1): 6.     CrossRef
  • Minimally Invasive Controlled Growing Rods for the Surgical Treatment of Early-Onset Scoliosis—A Surgical Technique Video
    Pawel Grabala
    Journal of Personalized Medicine.2024; 14(6): 548.     CrossRef
  • Long-term Outcomes of Posterior Multilevel Crack Osteotomy: Revisional Surgery for Scoliosis With a Fusion Mass
    Mi Hyun Song, Jae Hyuk Yang, Dong-Gune Chang, Yunjin Nam, Seung Woo Suh
    Neurospine.2023; 20(3): 989.     CrossRef
  • 5,916 View
  • 226 Download
  • 4 Web of Science
  • 3 Crossref
Impact of Radiation Therapy on Outcomes After Spinal Instrumentation for Craniocervical Junction Malignancies
Matthew Muir, Laurence Rhines, Franco Demonte, Claudio Tatsui, Shaan M. Raza
Neurospine 2022;19(2):434-440.   Published online May 15, 2022
DOI: https://doi.org/10.14245/ns.2244034.017

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Impact of Radiation Therapy on Outcomes After Spinal Instrumentation for Craniocervical Junction Malignancies
Neurospine. 2022;19(2):434-440.   Published online May 15, 2022
DOI: https://doi.org/10.14245/ns.2244034.017
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Impact of Radiation Therapy on Outcomes After Spinal Instrumentation for Craniocervical Junction Malignancies
Neurospine. 2022;19(2):434-440.   Published online May 15, 2022
DOI: https://doi.org/10.14245/ns.2244034.017
Close
Objective
Spinal reconstruction after resection of invasive craniocervical junction malignancies is fraught with technical and management considerations as well as a paucity of data in the existing literature. In this study, we describe our experience with craniocervical junction malignancies, especially the influence of radiation on the need for revision spinal instrumentation.
Methods
We performed a retrospective chart review of all patients who underwent occipitocervical fixation between 2011 and 2019 at The University of Texas MD Anderson Cancer Center.
Results
Twenty-five patients had primary malignancies and 12 (30%) had metastatic tumors. Thirteen (33%) underwent a staged resection in multiple operations during their hospital stay. Tumor resection was performed in 19 patients (48%), while only stabilization was performed in 21 patients (52%). Nine patients (23%) underwent expanded endoscopic transclival approaches for tumor resection, 10 patients (25%) an extreme lateral approach, and 2 patients (5%) an anterior open approach. Eleven patients underwent early postoperative radiation therapy (within 3 months) and 8 underwent delayed radiation therapy (between 3 months and 1 year in 7 patients). The revision rate was 8%, with a median time to revision surgery of 42 months. The administration and timing of adjuvant radiation therapy relative to surgery had no significant effect on the need for instrumentation revision on log-rank and Cox regression analyses (p < 0.05).
Conclusion
Revision surgery was needed infrequently in our patients. Postoperative radiation therapy was not associated with hardware failure, indicating that the timing of radiation therapy should be dictated by the diagnosis and can be initiated postoperatively without delay.
  • 7,041 View
  • 161 Download
Outcomes of Transforaminal Lumbar Interbody Fusion Using Unilateral Versus Bilateral Interbody Cages
Conor P. Lynch, Elliot D.K. Cha, Augustus J. Rush III, Caroline N. Jadczak, Shruthi Mohan, Cara E. Geoghegan, Kern Singh
Neurospine 2021;18(4):854-862.   Published online December 31, 2021
DOI: https://doi.org/10.14245/ns.2142248.124

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Outcomes of Transforaminal Lumbar Interbody Fusion Using Unilateral Versus Bilateral Interbody Cages
Neurospine. 2021;18(4):854-862.   Published online December 31, 2021
DOI: https://doi.org/10.14245/ns.2142248.124
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Outcomes of Transforaminal Lumbar Interbody Fusion Using Unilateral Versus Bilateral Interbody Cages
Neurospine. 2021;18(4):854-862.   Published online December 31, 2021
DOI: https://doi.org/10.14245/ns.2142248.124
Close
Objective
To assess the impact of bilateral versus unilateral interbody cages on outcomes for minimally invasive transforaminal lumbar interbody fusion (MIS TLIF) procedures.
Methods
A retrospective review for primary, elective, single-level MIS TLIF procedures with bilateral posterior instrumentation from 2008–2020 was performed. Patients were grouped according to unilateral or bilateral interbody cage use. Procedures performed without static interbody cages or indicated for trauma, infection, malignancy were excluded. Patient-reported outcomes (PROs) included visual analogue scale (VAS), Oswestry Disability Index, 12-item Short Form health survey physical composite score (SF-12 PCS), PatientReported Outcome Measurement Information System physical function (PROMIS-PF). PROs were collected preoperatively and postoperatively. Change in PROs (Δ) was calculated and compared between groups. Achievement of minimum clinically important difference (MCID) was calculated using established values from the literature. Achievement rates were compared between groups using logistic regression.
Results
The study included 151 patients, with 111 unilateral and 40 bilateral cage placements. Charlson Comorbidity Index, diabetes, and insurance status differed between groups (p < 0.050). Prevalence of degenerative and isthmic spondylolisthesis (both p ≤ 0.002), operative level (p = 0.003), and postoperative length of stay (p = 0.022) significantly differed between groups. The unilateral group had lower 1-year arthrodesis rates (p = 0.035). Preoperative VAS leg (p = 0.017) and SF-12 PCS (p = 0.045) were worse for the unilateral group. ΔPROMIS-PF was greater for the bilateral group at 2 years (p = 0.001). Majority of patients achieved an overall MCID for all PROs, except VAS leg (bilateral group).
Conclusion
While preoperative status and postoperative arthrodesis rates differed, patients achieved an MCID at similar rates regardless of use of unilateral or bilateral cages.

Citations

Citations to this article as recorded by  Crossref logo
  • Impact of nonunion on patient-related outcomes after single level minimally invasive transforaminal lumbar interbody fusion for lumbar degenerative disease: A propensity score–matched analysis
    Tatsuya Yamamoto, Momotaro Kawai, Tomohisa Tabata, Yohei Takahashi, Jun Ogawa
    European Spine Journal.2026; 35(4): 1736.     CrossRef
  • Comparative outcomes of unilateral and bilateral cage placement in lumbar interbody fusion: a systematic review and meta-analysis of randomized controlled trials
    Stavros Stamiris, Dimitrios Stamiris, Elissavet Anestiadou, Athanasios Sarridimitriou, Angeliki Cheva, Antonia Loukousia, Vasilleios Vrangalas, Pavlos Christodoulou, Christos Karampalis
    Asian Spine Journal.2026; 20(2): 372.     CrossRef
  • Is there a difference in unilateral versus bilateral facetectomy in an open or minimally invasive surgery transforaminal lumbar interbody fusion? A systematic review and meta-analysis
    Mario Cyriac Tchaya Tcheukado, George Nageeb, Jonathan Hintz, Michael Steinmetz, Mohamed Macki
    Surgical Neurology International.2026; 17: 110.     CrossRef
  • Comparative analysis of single vs. double cage insertion in unilateral biportal endoscopic lumbar interbody fusion: clinical and radiological outcomes
    Guisi Xie, Yanli Pan, Zhongshu Shan, Chan Wang Lei, Lek Hang Cheang, Jiaming Liang, Junfeng Shen, Wei Zhang, Chengyue Zhu
    Frontiers in Surgery.2026;[Epub]     CrossRef
  • Letter re: Letter to the Editor Concerning ‘Long-Term Incidence of Adjacent Segmental Pathology after Minimally Invasive vs. Open Transforaminal Lumbar Interbody Fusion’
    Sitian Niu, Ranran Li, Jingzhi Wang
    Global Spine Journal.2025; 15(2): 1459.     CrossRef
  • Long-Term Incidence of Adjacent Segmental Pathology After Minimally Invasive vs Open Transforaminal Lumbar Interbody Fusion
    Jae-Won Shin, Yung Park, Sang-Ho Kim, Sung-Ryul Choi, Joong-Won Ha, Hak Sun Kim, Kyung-Soo Suk, Sung-Hwan Moon, Si-Young Park, Byung-Ho Lee, Ji-Won Kwon, Hee-Min Choi
    Global Spine Journal.2025; 15(2): 1457.     CrossRef
  • Cost-effectiveness analysis of extended endoscopic lumbar foraminotomy (EELF) and transforaminal lumbar interbody fusion (TLIF): a prospective observational study
    Jun-Hoe Kim, Hangeul Park, Chang-Hyun Lee, Chi Heon Kim
    Scientific Reports.2025;[Epub]     CrossRef
  • Long-Term Risk of Adjacent-Segment Disease in Isthmic Spondylolisthesis Treated with Posterior Interbody Fusion
    Delia Cannizzaro, Gabriele Capo, Matteo Gionso, Donato Creatura, Mario De Robertis, Carla Daniela Anania, Emanuele Stucchi, Emilia Bellina, Ali Baram, Carlo Brembilla, Massimo Tomei, Alessandro Ortolina, Emanuela Morenghi, Franco Servadei, Federico Pessin
    World Neurosurgery.2025; 196: 123822.     CrossRef
  • Biomechanical Comparison of Transforaminal Interbody Fusion Implants: Static vs Expandable Cages and Unilateral Versus Bilateral Cages
    Clayton L. Rosinski, Nicole A. D. Watson, Michael E. Kritikos, Kirill V. Nourski, Anthony J. Marincovich, Tyson S. Matern, Prabin Shrestha, Patrick W. Hitchon
    Operative Neurosurgery.2025;[Epub]     CrossRef
  • Unilateral Versus Bilateral Cages in Lumbar Interbody Fusions: A Meta-Analysis of Clinical and Radiographic Outcomes
    Mohammad Daher, Marven Aoun, Pierre El-Sett, Gaby Kreichati, Khalil Kharrat, Amer Sebaaly
    World Neurosurgery.2024; 186: 158.     CrossRef
  • An evaluation of fusion status following lumbar fusion surgery utilizing multi-planar computed tomography
    Tariq Z. Issa, Yunsoo Lee, Jeremy Heard, Tyler W. Henry, Michael A. McCurdy, Nicholas Siegel, Caroline Zaworksi, Julia Dambly, Jose A. Canseco, Alan S. Hilibrand, Alexander R. Vaccaro, Gregory D. Schroeder, John Mangan, Mark Lambrechts, Christopher K. Kep
    European Spine Journal.2024; 33(9): 3545.     CrossRef
  • Postoperative urinary retention after oblique lumbar interbody fusion under the systematic management protocol
    Joonsoo Lim, Jangyeob Lim, Asfandyar Khan, Chang-Hyun Lee, Jun-Hoe Kim, Sejin Choi, Tae-Shin Kim, Yunhee Choi, Chun Kee Chung, Sangwook T. Yoon, Kyoung-Tae Kim, Chi Heon Kim
    Scientific Reports.2024;[Epub]     CrossRef
  • Commentary on “Three-Dimensional-Printed Titanium Versus Polyetheretherketone Cages for Lumbar Interbody Fusion: A Systematic Review of Comparative In Vitro, Animal, and Human Studies”
    Yanting Liu, Siravich Suvithayasiri, Jin-Sung Kim
    Neurospine.2023; 20(2): 464.     CrossRef
  • Comparison of Lumbosacral Fusion Grade in Patients after Transforaminal and Anterior Lumbar Interbody Fusion with Minimum 2‐Year Follow‐Up
    Jinping Liu, Rong Xie, Cynthia T. Chin, Priya Rajagopalan, Ping‐Guo Duan, Bo Li, Shane Burch, Sigurd H. Berven, Praveen V. Mummaneni, Dean Chou
    Orthopaedic Surgery.2023; 15(9): 2334.     CrossRef
  • A Comparison of Radiographic Alignment between Bilateral and Unilateral Interbody Cages in Patients Undergoing Transforaminal Lumbar Interbody Fusion
    Mark James Lambrechts, Jeremy Heard, Nicholas D’Antonio, John Bodnar, Gregory Schneider, Evan Bloom, Jose Canseco, Barrett Woods, Ian David Kaye, Mark Kurd, Jeffrey Rihn, Alan Hilibrand, Gregory Schroeder, Alexander Vaccaro, Christopher Kepler
    Asian Spine Journal.2023; 17(4): 666.     CrossRef
  • Morphometric Comparison of Interbody Fusion with Cage and Autograft at L4-L5 Levels versus Autograft Alone for Fusion
    Azmi Tufan, Feyza Karagöz Güzey, Abdurrahman Aycan
    Bagcilar Medical Bulletin.2023; 8(3): 293.     CrossRef
  • Lumbar interbody fusion with bilateral cages using a biportal endoscopic technique with a third portal
    Chengyue Zhu, Liangping Zhang, Hao Pan, Wei Zhang
    Acta Neurochirurgica.2022; 164(9): 2343.     CrossRef
  • Safety and efficacy of unilateral and bilateral pedicle screw fixation for lumbar degenerative diseases by transforaminal lumbar interbody fusion: An updated systematic review and meta-analysis
    Rui Zhong, Xiali Xue, Runsheng Wang, Jing Dan, Chuanen Wang, Daode Liu
    Frontiers in Neurology.2022;[Epub]     CrossRef
  • 9,383 View
  • 146 Download
  • 16 Web of Science
  • 18 Crossref
The Effect of Rod Pattern, Outrigger, and Multiple Screw-Rod Constructs for Surgical Stabilization of the 3-Column Destabilized Cervical Spine - A Biomechanical Analysis and Introduction of a Novel Technique
Sebastian Hartmann, Claudius Thomé, Anto Abramovic, Sara Lener, Werner Schmoelz, Juliane Koller, Heiko Koller
Neurospine 2020;17(3):610-629.   Published online September 30, 2020
DOI: https://doi.org/10.14245/ns.2040436.218

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The Effect of Rod Pattern, Outrigger, and Multiple Screw-Rod Constructs for Surgical Stabilization of the 3-Column Destabilized Cervical Spine - A Biomechanical Analysis and Introduction of a Novel Technique
Neurospine. 2020;17(3):610-629.   Published online September 30, 2020
DOI: https://doi.org/10.14245/ns.2040436.218
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The Effect of Rod Pattern, Outrigger, and Multiple Screw-Rod Constructs for Surgical Stabilization of the 3-Column Destabilized Cervical Spine - A Biomechanical Analysis and Introduction of a Novel Technique
Neurospine. 2020;17(3):610-629.   Published online September 30, 2020
DOI: https://doi.org/10.14245/ns.2040436.218
Close
Objective
Anterior-only reconstructions for cervical multilevel corpectomies are prone to fail under continuous mechanical loading. This study sought to define the mechanical characteristics of different constructs in reducing a range of motion (ROM) of the 3-column destabilized cervical spine, including posterior cobalt-chromium (CoCr)-rods, outrigger-rods (OGR), and a novel triple rod construct using lamina screws (6S3R). The clinical implications of biomechanical findings are discussed in depth from the perspective of the challenges surgeons face cervical deformity correction.
Methods
Three-column deficient cervical spinal models were produced based on reconstructed computed tomography scans. The corpectomy defect between C3 and C7 end-level vertebrae was restored with anterior titanium (Ti) mesh-cage. The ROM was evaluated in a customized 6-degree of freedom spine tester. Tests were performed with different rod materials (Ti vs. CoCr), varying diameter rods (3.5 mm vs. 4.0 mm), with and without anterior plating, and using different construct patterns: bilateral rod fixation (standard-group), OGRgroup, and 6S3R-Group. Construct stability was expressed in changes and differences of ROM (°).
Results
The largest reduction of ROM was noticed in the 6S3R-group compared to the standard- and the OGR-group. All differences observed were emphasized with an increasing number of corpectomy levels and if anterior plating was not added. For all simulated 1-, 2-, and 3-level corpectomy constructs, the OGR-group revealed decreased ROM for all motion directions compared to the standard-group. An increase of construct stiffness was also recorded for increased rod diameter (4.0 mm) and stiffer rod material (CoCr), though these effects lacked behind the more advanced construct pattern.
Conclusion
A novel reconstructive technique, the 6S3R-construct, was shown to outperform all other constructs and might resemble a new standard of reference for advanced posterior fixation.

Citations

Citations to this article as recorded by  Crossref logo
  • Biomechanical Impact of Splint Rods in Posterior Cervicothoracic Fixation: A Finite Element Analysis
    Ian Polyzois, Jaskaran Singh, Sara Gustafson, Trevor Gascoyne, Michael Goytan
    Global Spine Journal.2026; 16(2): 1259.     CrossRef
  • C1 Posterior Arch Screws for the Additional Reinforcement of Upper Cervical Spine Fixation: Surgical Technique and Preliminary Case Series
    Guanyi Liu, Jing Wang, Lihua Hu, Miao Zhu, Jiayu Zhang, Weihu Ma, Yong Hu, Qing Li
    World Neurosurgery.2025; 195: 123680.     CrossRef
  • Triple-rod fixation with laminar screws for three-column cervical spine injury in ankylosing spondylitis: A case report
    Saurabh Rawall, Sean Taylor, Sakthivel Rajaram
    Journal of Clinical Orthopaedics and Trauma.2025; 67: 103066.     CrossRef
  • Application of deformity principles in the management of spinal neoplasms: A Primer
    Zach Pennington, Joseph H Schwab, Sheng-fu Larry Lo, C. Rory Goodwin, Matthew L Goodwin, Matthew Colman, Raphaële Charest-Morin, Nicolas Dea, Daniel Lubelski, Ali Ozturk, Jacob M. Buchowski, Wende Gibbs, Wesley Hsu, Ajit Krishnaney, Ilya Laufer, Mohamed M
    North American Spine Society Journal (NASSJ).2025; 23: 100779.     CrossRef
  • Posterior cervical spinal fusion in the pediatric population using modern adult instrumentation — clinical outcome and safety
    Alexander Spiessberger, Peter O. Newton, William Mackenzie, Amer Samdani, Firoz Miyanji, Joshua Pahys, Suken Shah, Paul Sponseller, Mark Abel, Jonathan Phillips, Michelle Marks, Burt Yaszay
    Child's Nervous System.2023; 39(6): 1573.     CrossRef
  • Mechanical Failure After Total En Bloc Spondylectomy and Salvage Surgery
    Shin Won Kwon, Chun Kee Chung, Young Il Won, Woon Tak Yuh, Sung Bae Park, Seung Heon Yang, Chang Hyun Lee, John M. Rhee, Kyoung-Tae Kim, Chi Heon Kim
    Neurospine.2022; 19(1): 146.     CrossRef
  • Surgical Strategies and Perioperative Considerations for Cervical Deformity With Cerebral Palsy: A Comprehensive Review of the Literature
    Hyung Cheol Kim, Sung Han Oh, Jae Keun Oh, Yoon Ha
    Neurospine.2022; 19(4): 868.     CrossRef
  • Factors Affecting Postoperative Complications and Outcomes of Cervical Spondylotic Myelopathy with Cerebral Palsy : A Retrospective Analysis
    Hyung Cheol Kim, Hyeongseok Jeon, Yeong Ha Jeong, Sangman Park, Seong Bae An, Jeong Hyun Heo, Dong Ah Shin, Seong Yi, Keung Nyun Kim, Yoon Ha, Sung-Rae Cho
    Journal of Korean Neurosurgical Society.2021; 64(5): 808.     CrossRef
  • Commentary on “Emerging Technologies in the Treatment of Adult Spinal Deformity”
    Seung-Jae Hyun
    Neurospine.2021; 18(3): 428.     CrossRef
  • 10,409 View
  • 152 Download
  • 8 Web of Science
  • 9 Crossref

Case Report

Migration of Rod into Retroperitoneal Region: A Case Report and Review of the Literature
Yaşar Bayri, Murat Sakir Eksi, Ramazan Doğrul, Demet Yalçinkaya Koç, Deniz Konya
Korean J Spine 2014;11(4):241-244.   Published online December 31, 2014
DOI: https://doi.org/10.14245/kjs.2014.11.4.241

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Migration of Rod into Retroperitoneal Region: A Case Report and Review of the Literature
Korean J Spine. 2014;11(4):241-244.   Published online December 31, 2014
DOI: https://doi.org/10.14245/kjs.2014.11.4.241
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Migration of Rod into Retroperitoneal Region: A Case Report and Review of the Literature
Korean J Spine. 2014;11(4):241-244.   Published online December 31, 2014
DOI: https://doi.org/10.14245/kjs.2014.11.4.241
Close

Spinal stabilization with fusion is the widely used method for traumatic or pathologic fracture of spine, spinal stenosis, and spondylolisthesis. Complications may emerge during or after the operations. Infection, hematoma and neurological deficits are early noticed findings. Screw and/or rod fractures present in long-term after surgery. Rod migration in out of the spinal column is a rare entity. A 67-year-old woman was visited our clinic for right leg pain. She had a previous spinal instrumentation surgery for spondylolisthesis in another center 6 years before. After radiological work-up, a distally migrated rod piece was observed in the retroperitoneal portion. The patient was operated for degenerative change; old instruments were replaced and extended to the L2 level with posterior spinal fusion. After the operation, her right leg pain improved. The asymptomatic migrated rod piece has regularly been followed clinically and radiologically, since then. Although it has rarely been reported, migration of the instrumentation material should be kept in mind. Spinal fixation without fusion makes the mechanical system vulnerable to motion effects of spine, especially in a degenerative and osteoporotic background. Long-term, even life-long follow-up is necessary for late term complications.

Citations

Citations to this article as recorded by  Crossref logo
  • Migration of Spinal Hardware Into the Popliteal Vein
    Emily S. Eiel, Ryan D. DeAngelis, Stephen R. Barchick, Gregory T. Minutillo, Samir Mehta
    JBJS Case Connector.2026;[Epub]     CrossRef
  • Bilateral Rod Loosening and Sequential Distal Migration after Thoracolumbar Junction Fracture Stabilization
    Andreas K. Demetriades, Himanshu Shekhar
    Journal of Neurological Surgery Part A: Central European Neurosurgery.2025; 86(05): 486.     CrossRef
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Clinical Article

Prophylactic Intrawound Application of Vancomycin Powder in Instrumented Spinal Fusion Surgery
Hyun Su Kim, Sang Gu Lee, Woo Kyung Kim, Chan Woo Park, Seong Son
Korean J Spine 2013;10(3):121-125.   Published online September 30, 2013
DOI: https://doi.org/10.14245/kjs.2013.10.3.121

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Prophylactic Intrawound Application of Vancomycin Powder in Instrumented Spinal Fusion Surgery
Korean J Spine. 2013;10(3):121-125.   Published online September 30, 2013
DOI: https://doi.org/10.14245/kjs.2013.10.3.121
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Prophylactic Intrawound Application of Vancomycin Powder in Instrumented Spinal Fusion Surgery
Korean J Spine. 2013;10(3):121-125.   Published online September 30, 2013
DOI: https://doi.org/10.14245/kjs.2013.10.3.121
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Objective

We evaluated the effect of intrawound application of vancomycin powder for infection prophylaxis in wounds caused by instrumented spinal surgery.

Methods

From July 2012 to December 2012, 74 instrumented spinal fusion procedures were performed by 1 neurosurgeon at a single institute. We divided the patients into 2 groups, depending on the use of local application of vancomycin powder: Group A (intrawound application of vancomycin powder with perioperative intravenous cefazolin) and Group B (perioperative intravenous cefazolin alone). A retrospective cohort comparative study was conducted between the 2 groups. The age, sex, comorbidities, smoking, surgical procedure, and surgical site infection (SSI) of consecutive patients were analyzed.

Results

Among the 74 patients, 34 patients were assigned to group A and 40 patients to group B. No wound infections were found in group A. However, in group B, 5 cases of SSI (12.5%) were found. A statistically significant reduction in SSI incidence was observed in group A (p<0.033). The 5 cases of SSI in group B consisted of 3 cases of deep wound infection and 2 cases of superficial wound infection. All SSIs were found in cases of posterior approach surgery and tended to be more frequent in older patients.

Conclusion

Adjunctive intrawound local application of vancomycin powder is a simple uncomplicated procedure and can result in a significant reduction of SSI in instrumented spinal fusions. Furthermore, culture of the drainage tip is very important for confirmation of deep wound infection.

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Review

History of Spinal Deformity Surgery Part II: The Modern Era.
Samuel K Cho, Yongjung J Kim
Korean J Spine 2011;8(1):9-23.
DOI: https://doi.org/10.14245/kjs.2011.8.1.9

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History of Spinal Deformity Surgery Part II: The Modern Era.
Korean J Spine. 2011;8(1):9-23.
DOI: https://doi.org/10.14245/kjs.2011.8.1.9
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History of Spinal Deformity Surgery Part II: The Modern Era.
Korean J Spine. 2011;8(1):9-23.
DOI: https://doi.org/10.14245/kjs.2011.8.1.9
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Following Dwyer introduction of anterior spinal instrumented fusion surgery, Zielke, Moss-Miami, and Kaneda had made a significant progression on anterior spinal instrumented fusion which allowed excellent correction without significant loss of correction or implant failure. King and Moe deveoped classification of thoracic major curve following Harrington rod intrumentation. King classification presented a stable vertebra concept and selective fusion concept. Surgical classification of Adolescent Idiopathic Scoliosis (AIS) developed by Harms study group provided a more sophisticated two dimensional understanding of curve nature. Surgical intervention of adult scoliosis and sagittal imbalance is still challenging and evolving. Several evidences such as sacropelvic fixation and bone morphogenetic protein helped us to deal with adult deformity. The surgical decision making on spinal deformity surgery is still yet evolving.
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