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Spinal Cord Disease
Published in Philip B. Gorelick, Fernando D. Testai, Graeme J. Hankey, Joanna M. Wardlaw, Hankey's Clinical Neurology, 2020
Age: Young and middle-aged adults predominantly.Intramedullary tumors are more common in children.Extramedullary tumors are more common in adults.
Surgery of the Knee
Published in Timothy W R Briggs, Jonathan Miles, William Aston, Heledd Havard, Daud TS Chou, Operative Orthopaedics, 2020
Alexander D Liddle, Lee A David, Timothy WR Briggs
Femoral preparation is undertaken with the knee flexed and the patella everted. A large drill bit is used to create an entry point in the distal femoral canal at a point approximately 1 cm anterior to the insertion of the PCL within the trochlear notch. The intramedullary rod should be inserted into the canal with care, especially if a previous total hip replacement has been performed. The distal femoral cutting jig is positioned over the rod and adjusted so that the distal cut is set at a 5°–9° valgus angle to the appropriate side of the knee to be replaced (Figure 11.3). Ideally, this should be chosen to match the anatomical axis of the contralateral limb, if normal.
Animal Models of Bone Fracture or Osteotomy
Published in Yuehuei H. An, Richard J. Friedman, Animal Models in Orthopaedic Research, 2020
Yuehuei H. An, Richard J. Friedman, Robert A. Draughn
Intramedullary nailing is a successful procedure which allows some motion and loading at the bone ends (a less rigid fixation) and is usually associated with external callus formation. Intramedullary reaming causes circulatory disturbances in the inner 2/3 of the cortex, but it does not impede the formation of external callus and the damaged parts will be revascularized.
Influence of sequential opening/closing of interface gaps and texture density on bone growth over macro-textured implant surfaces using FE based mechanoregulatory algorithm
Published in Computer Methods in Biomechanics and Biomedical Engineering, 2022
Rajdeep Ghosh, Souptick Chanda, Debabrata Chakraborty
Intramedullary implant fixation is a standard surgical procedure which is extensively used in re-establishing fractured bones and joints, further aiding to the treatment of various joint diseases such as osteoarthritis (OA), rheumatoid arthritis (RA), femoral fractures etc. Contributing to the sedentary lifestyle among youth, increase in road accidents and ageing population in developed nations, there is a tremendous increase in need for joint replacements globally (Holzwarth and Cotogno 2012; Cilla et al. 2017; Sánchez, Schilling, Grupp, Giurea, Wyers, et al. 2021). There are primarily two types of intramedullary implantation widely used presently. Cemented fixation, in which bone cement, commercially known as poly (methyl methacrylate) or PMMA, is used to adhere the implant to the host bone by drilling a canal of required diameter into the healthy bone. On the other hand, in uncemented fixation, the implant is forced (press-fit or interference-fit) into the healthy bone canal without the use of bone cement. Primary fixation of such implants is achieved by the interference-fit and frictional conditions of the surface, which further aids to the enhancement of biologic fixation of bone to the implant, also referred to as secondary stability (Ghosh et al. 2020; Sánchez, Schilling, Grupp, Giurea, Wyers, et al. 2021). A proper combination of both primary stability and secondary fixation is crucial for long-term success of such intramedullary fixation devices (Ghosh et al. 2020).
Primary spinal primitive neuroectodermal tumor: A single center series with literature review
Published in The Journal of Spinal Cord Medicine, 2020
Jun Ma, Shunchang Ma, Jun Yang, Guijun Jia, Wang Jia
Neuro-radiology examinations always showed iso- to hypo-intense on T1-weighted image and iso- to hyper-intense on T2-weighted image, with enhancement. In those cases extending out through the interspinal foramen a typical dumbbell shape could be observed. Pre-operative diagnosis was not easy due to its rare incidence. None of our cases were suspected as PNET before surgery. The differentiated diagnosis included both malignancies and non-malignant neoplasms. When located intramedullary it might be considered as glioma, lymphoma, sarcoma, or ependymoma, etc. When located extramedullary with interspinal foramen invasion, most were suspected as Schwannoma or neurofibroma, much more commonly seen that had typical dumbbell shape. The whole CNS image examination involving the brain and whole spinal cord were performed for these eight patients, either before or after surgery, to exclude secondary spinal cord lesion.
Dumbell atypical teratoid/rhabdoid tumour (AT/RT) of the cervical spine
Published in British Journal of Neurosurgery, 2020
Amit Amit, Atul Vats, Alireza Shoakazemi, Brian Herron, Anthony McCarthy, Robert Scott McConnell
The present case is a rare detailed report of paraspinal extension of AT/RT and raises questions about optimal management. AT/RT in the spine although rare should be considered in the differential diagnosis of spinal canal tumours in children. The tumour can occur anywhere along the spinal axis and may be intramedullary or intradural extramedullary in origin. Imaging findings consistent with the diagnosis and histology supported by immunochemistry and genetic analysis are essential clinching the final diagnosis. Intense multimodality treatment and close surveillance imaging is recommended following tumour resection. As diagnostic techniques including more widespread use of genetic markers improve the rate of recognition and differentiation from other CNS tumours in children is increasing. We have noted an increase in the proportion of AT/RT diagnoses and expect other centres share this experience.