@article{ConradsGrunzHuflageetal.2023, author = {Conrads, Nora and Grunz, Jan-Peter and Huflage, Henner and Luetkens, Karsten Sebastian and Feldle, Philipp and Grunz, Katharina and K{\"o}hler, Stefan and Westermaier, Thomas}, title = {Accuracy of pedicle screw placement using neuronavigation based on intraoperative 3D rotational fluoroscopy in the thoracic and lumbar spine}, series = {Archives of Orthopaedic and Trauma Surgery}, volume = {143}, journal = {Archives of Orthopaedic and Trauma Surgery}, number = {6}, doi = {10.1007/s00402-022-04514-1}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-324966}, pages = {3007-3013}, year = {2023}, abstract = {Introduction In spinal surgery, precise instrumentation is essential. This study aims to evaluate the accuracy of navigated, O-arm-controlled screw positioning in thoracic and lumbar spine instabilities. Materials and methods Posterior instrumentation procedures between 2010 and 2015 were retrospectively analyzed. Pedicle screws were placed using 3D rotational fluoroscopy and neuronavigation. Accuracy of screw placement was assessed using a 6-grade scoring system. In addition, screw length was analyzed in relation to the vertebral body diameter. Intra- and postoperative revision rates were recorded. Results Thoracic and lumbar spine surgery was performed in 285 patients. Of 1704 pedicle screws, 1621 (95.1\%) showed excellent positioning in 3D rotational fluoroscopy imaging. The lateral rim of either pedicle or vertebral body was protruded in 25 (1.5\%) and 28 screws (1.6\%), while the midline of the vertebral body was crossed in 8 screws (0.5\%). Furthermore, 11 screws each (0.6\%) fulfilled the criteria of full lateral and medial displacement. The median relative screw length was 92.6\%. Intraoperative revision resulted in excellent positioning in 58 of 71 screws. Follow-up surgery due to missed primary malposition had to be performed for two screws in the same patient. Postsurgical symptom relief was reported in 82.1\% of patients, whereas neurological deterioration occurred in 8.9\% of cases with neurological follow-up. Conclusions Combination of neuronavigation and 3D rotational fluoroscopy control ensures excellent accuracy in pedicle screw positioning. As misplaced screws can be detected reliably and revised intraoperatively, repeated surgery for screw malposition is rarely required.}, language = {en} } @article{DomokosBeerReutheretal.2023, author = {Domokos, Bruno and Beer, Lisa and Reuther, Stefanie and Raschka, Christoph and Spang, Christoph}, title = {Immediate effects of isolated lumbar extension resistance exercise (ILEX) on spine posture and mobility measured with the IDIAG Spinal Mouse System}, series = {Journal of Functional Morphology and Kinesiology}, volume = {8}, journal = {Journal of Functional Morphology and Kinesiology}, number = {2}, issn = {2411-5142}, doi = {10.3390/jfmk8020060}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-319334}, year = {2023}, abstract = {Posture and mobility are important aspects for spinal health. In the context of low back pain, strategies to alter postural anomalies (e.g., hyper/hypolordosis, hyper/hypokyphosis) and mobility deficits (e.g., bending restrictions) have been of interest to researchers and clinicians. Machine-based isolated lumbar extension resistance exercise (ILEX) has been used successfully for rehabilitation of patients suffering from low back pain. The aim of this study was to analyse the immediate effects of ILEX on spinal posture and mobility. In this interventional cohort study, the posture and mobility measures of 33 healthy individuals (m = 17, f = 16; mean age 30.0 years) were taken using the surface-based Spinal Mouse system (IDIAG M360©, Fehraltdorf, Switzerland). Individuals performed one exercise set to full exhaustion with an ILEX-device (Powerspine, Wuerzburg, Germany) in a standardized setup, including uniform range of motion and time under tension. Scans were made immediately before and after the exercise. There was an immediate significant decrease in standing lumbar lordosis and thoracic kyphosis. No change could be observed in standing pelvic tilt. Mobility measures showed a significant decrease in the lumbar spine and an increase in the sacrum. The results show that ILEX alters spine posture and mobility in the short-term, which may benefit certain patient groups.}, language = {en} }