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Sample records for screw augmentation techniques

  1. Minimally Invasive Technique for PMMA Augmentation of Fenestrated Screws

    PubMed Central

    Kogias, Evangelos; Sircar, Ronen; Krüger, Marie T.; Volz, Florian; Scheiwe, Christian; Hubbe, Ulrich

    2015-01-01

    Purpose. To describe the minimally invasive technique for cement augmentation of cannulated and fenestrated screws using an injection cannula as well as to report its safety and efficacy. Methods. A total of 157 cannulated and fenestrated pedicle screws had been cement-augmented during minimally invasive posterior screw-rod spondylodesis in 35 patients from January to December 2012. Retrospective evaluation of cement extravasation and screw loosening was carried out in postoperative plain radiographs and thin-sliced triplanar computed tomography scans. Results. Twenty-seven, largely prevertebral cement extravasations were detected in 157 screws (17.2%). None of the cement extravasations was causing a clinical sequela like a new neurological deficit. One screw loosening was noted (0.6%) after a mean follow-up of 12.8 months. We observed no cementation-associated complication like pulmonary embolism or hemodynamic insufficiency. Conclusions. The presented minimally invasive cement augmentation technique using an injection cannula facilitates convenient and safe cement delivery through polyaxial cannulated and fenestrated screws during minimally invasive screw-rod spondylodesis. Nevertheless, the optimal injection technique and design of fenestrated screws have yet to be identified. This trial is registered with German Clinical Trials DRKS00006726. PMID:26075297

  2. Ridge augmentation with titanium screws and guided tissue regeneration: technique and report of a case.

    PubMed

    Fugazzotto, P A

    1993-01-01

    A technique is described for augmenting an edentulous ridge buccally with a mixture of freeze-dried bone and resorbable tricalcium phosphate covered with a Gore-Tex membrane. Titanium screws are used to prevent the collapse of the regenerative materials. In the patient described, the buccolingual dimensions of the edentulous mandibular ridge more than doubled, thus allowing the placement of two implant cylinders. The rationale for such a procedure is discussed. PMID:8225470

  3. [Cement augmentation of pedicle screws : Pros and cons].

    PubMed

    Schnake, K J; Blattert, T R; Liljenqvist, U

    2016-09-01

    Cement augmentation of pedicle screws biomechanically increases screw purchase in the bone. However, clinical complications may occur. The pros and cons of the technique are discussed from different clinical perspectives. PMID:27514827

  4. Pullout strength of pedicle screws with cement augmentation in severe osteoporosis: A comparative study between cannulated screws with cement injection and solid screws with cement pre-filling

    PubMed Central

    2011-01-01

    Background Pedicle screws with PMMA cement augmentation have been shown to significantly improve the fixation strength in a severely osteoporotic spine. However, the efficacy of screw fixation for different cement augmentation techniques, namely solid screws with retrograde cement pre-filling versus cannulated screws with cement injection through perforation, remains unknown. This study aimed to determine the difference in pullout strength between conical and cylindrical screws based on the aforementioned cement augmentation techniques. The potential loss of fixation upon partial screw removal after screw insertion was also examined. Method The Taguchi method with an L8 array was employed to determine the significance of design factors. Conical and cylindrical pedicle screws with solid or cannulated designs were installed using two different screw augmentation techniques: solid screws with retrograde cement pre-filling and cannulated screws with cement injection through perforation. Uniform synthetic bones (test block) simulating severe osteoporosis were used to provide a platform for each screw design and cement augmentation technique. Pedicle screws at full insertion and after a 360-degree back-out from full insertion were then tested for axial pullout failure using a mechanical testing machine. Results The results revealed the following 1) Regardless of the screw outer geometry (conical or cylindrical), solid screws with retrograde cement pre-filling exhibited significantly higher pullout strength than did cannulated screws with cement injection through perforation (p = 0.0129 for conical screws; p = 0.005 for cylindrical screws). 2) For a given cement augmentation technique (screws without cement augmentation, cannulated screws with cement injection or solid screws with cement pre-filling), no significant difference in pullout strength was found between conical and cylindrical screws (p >0.05). 3) Cement infiltration into the open cell of the test block led to

  5. Percutaneous Sacroiliac Screw Technique.

    PubMed

    Tidwell, John; Cho, Rosa; Reid, J Spence; Boateng, Henry; Copeland, Carol; Sirlin, Edward

    2016-08-01

    Remembering that preoperative planning, surgical indications, and fracture reduction are paramount for this procedure, presented here is our technique for performing percutaneous sacroiliac screws, both transiliac-transsacral and sacral style. A combination of video, still pictures, and fluoroscopy images will guide the viewer through the process we routinely use highlighting specific details. Patient positioning and intraoperative fluoroscopy imaging are critical to a successful procedure. Although inlet and outlet films remain important, we find the procedure best started on the lateral sacral view to reduce the need for start site, trajectory, and imaging position changes during the case. A cannulated pig sticker (drill guide) used with long drill tip guide wires provide improved manual control to both finding a good start site and directing the trajectory. For patient safety, sacral anatomy and safe zones are discussed as well. Using these technical points will help make this a successful procedure. PMID:27441927

  6. Cement leakage in pedicle screw augmentation: a prospective analysis of 98 patients and 474 augmented pedicle screws.

    PubMed

    Mueller, Jan U; Baldauf, Joerg; Marx, Sascha; Kirsch, Michael; Schroeder, Henry W S; Pillich, Dirk T

    2016-07-01

    OBJECTIVE Loosening and pullout of pedicle screws are well-known problems in pedicle screw fixation surgery. Augmentation of pedicle screws with bone cement, first described as early as 1975, increases the pedicle-screw interface and pullout force in osteoporotic vertebrae. The aim of the present study was to identify cement leakage and pulmonary embolism rates in a large prospective single-center series of pedicle screw augmentations. METHODS All patients who underwent cement-augmented pedicle screw placement between May 2006 and October 2010 at the authors' institution were included in this prospective cohort study. Perivertebral cement leakage and pulmonary cement embolism were evaluated with a CT scan of the area of operation and with a radiograph of the chest, respectively. RESULTS A total of 98 patients underwent placement of cement-augmented pedicle screws; 474 augmented screws were inserted in 237 vertebrae. No symptomatic perivertebral cement leakage or symptomatic pulmonary cement embolism was observed, but asymptomatic perivertebral cement leakage was seen in 88 patients (93.6%) and in 165 augmented vertebrae (73.3%). Cement leakage most often occurred in the perivertebral venous system. Clinically asymptomatic pulmonary cement embolism was found in 4 patients (4.1%). CONCLUSIONS Perivertebral cement leakage often occurs in pedicle screw augmentation, but in most cases, it is clinically asymptomatic. Cement augmentation should be performed under continuous fluoroscopy to avoid high-volume leakage. Alternative strategies, such as use of expandable screws, should be examined in more detail for patients at high risk of screw loosening. PMID:26943258

  7. A Biomechanical Comparison of Expansive Pedicle Screws for Severe Osteoporosis: The Effects of Screw Design and Cement Augmentation.

    PubMed

    Tai, Ching-Lung; Tsai, Tsung-Ting; Lai, Po-Liang; Chen, Yi-Lu; Liu, Mu-Yi; Chen, Lih-Huei

    2015-01-01

    Expansive pedicle screws significantly improve fixation strength in osteoporotic spines. However, the previous literature does not adequately address the effects of the number of lengthwise slits and the extent of screw expansion on the strength of the bone/screw interface when expansive screws are used with or without cement augmentation. Herein, four designs for expansive pedicle screws with different numbers of lengthwise slits and different screw expansion levels were evaluated. Synthetic bones simulating severe osteoporosis were used to provide a comparative platform for each screw design. The prepared specimens were then tested for axial pullout failure. Regardless of screw design, screws with cement augmentation demonstrated significantly higher pullout strength than pedicle screws without cement augmentation (p < 0.001). For screws without cement augmentation, solid screws exhibited the lowest pullout strength compared to the four expansive groups (p < 0.01). No significant differences in pullout strength were observed between the expansive screws with different designs (p > 0.05). Taken together, our results show that pedicle screws combined with cement augmentation may greatly increase screw fixation regardless of screws with or without expansion. An increase in both the number of slits and the extent of screw expansion had little impact on the screw-anchoring strength. Cement augmentation is the most influential factor for improving screw pullout strength. PMID:26720724

  8. A Biomechanical Comparison of Expansive Pedicle Screws for Severe Osteoporosis: The Effects of Screw Design and Cement Augmentation

    PubMed Central

    Tai, Ching-Lung; Tsai, Tsung-Ting; Lai, Po-Liang; Chen, Yi-Lu; Liu, Mu-Yi; Chen, Lih-Huei

    2015-01-01

    Expansive pedicle screws significantly improve fixation strength in osteoporotic spines. However, the previous literature does not adequately address the effects of the number of lengthwise slits and the extent of screw expansion on the strength of the bone/screw interface when expansive screws are used with or without cement augmentation. Herein, four designs for expansive pedicle screws with different numbers of lengthwise slits and different screw expansion levels were evaluated. Synthetic bones simulating severe osteoporosis were used to provide a comparative platform for each screw design. The prepared specimens were then tested for axial pullout failure. Regardless of screw design, screws with cement augmentation demonstrated significantly higher pullout strength than pedicle screws without cement augmentation (p < 0.001). For screws without cement augmentation, solid screws exhibited the lowest pullout strength compared to the four expansive groups (p < 0.01). No significant differences in pullout strength were observed between the expansive screws with different designs (p > 0.05). Taken together, our results show that pedicle screws combined with cement augmentation may greatly increase screw fixation regardless of screws with or without expansion. An increase in both the number of slits and the extent of screw expansion had little impact on the screw-anchoring strength. Cement augmentation is the most influential factor for improving screw pullout strength. PMID:26720724

  9. Hydroxyapatite composite resin cement augmentation of pedicle screw fixation.

    PubMed

    Turner, Alexander W L; Gillies, R Mark; Svehla, Martin J; Saito, Masanobu; Walsh, William R

    2003-01-01

    Pedicle screw stability is poor in osteopenic vertebrae attributable, in part, to low screw-bone interface strength. The current authors examined cement augmentation using a low curing temperature hydroxyapatite and bis-phenol-A glycidol methacrylate-based composite resin. This cement may stiffen the screw-bone interface and reduce the harmful effects associated with polymethylmethacrylate regarding temperature and toxic monomer. Thirty-five lumbar vertebrae from human cadavers were instrumented with pedicle screws, with one pedicle previously injected with cement and the other as the control. Caudocephalad toggling of +/- 1 mm for 1600 cycles was applied to the pedicle screws, and the resulting forces supported by the implant-bone interface were captured by a load cell. A curve was constructed from the peak caudal load for each cycle and three mechanical measures parameterized this curve: (1) initial load; (2) rate of load decay during the first 400 cycles; and (3) final load. The initial load increased by 16% as a result of cement augmentation, the final load increased by 65%, and the rate of load decay decreased by 59%. Cement augmentation of pedicle screws increased the stiffness and stability of the screw-bone interface. PMID:12579026

  10. True anteroposterior view pedicle screw insertion technique

    PubMed Central

    Bai, Jia-yue; Zhang, Wei; An, Ji-long; Sun, Ya-peng; Ding, Wen-yuan; Shen, Yong

    2016-01-01

    Background The wide use of minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) surgery in the treatment of degenerative disc disease of lumbar spine in spinal surgery highlights the gradual decrease in the use of traditional pedicle screw insertion technology. This study aims to analyze the accuracy of the true anteroposterior view pedicle screw insertion technique in MIS-TLIF surgery, compare it with conventional pedicle screw insertion technology, and discuss its clinical application value. Methods Fifty-two patients undergoing true anteroposterior view (group A) and 87 patients undergoing conventional pedicle screw insertion (group B) were diagnosed with lumbar disc herniation or lumbar spinal stenosis. Time for screw placement, intraoperative irradiation exposure, accuracy rate of pedicle screw insertion, and incidence of neurovascular injury were compared between the two groups. Results The time for screw placement and intraoperative irradiation exposure was significantly less in group A. Penetration rates of the paries lateralis of vertebral pedicle, medial wall of vertebral pedicle, and anterior vertebral wall were 1.44%, 0%, and 2.40%, respectively, all of which were significantly lower than that in group B. No additional serious complications caused by the placement of screw were observed during the follow-up period in patients in group A, but two patients with medial penetration underwent revision for unbearable radicular pain. Conclusion The application of true anteroposterior view pedicle screw insertion technique in MIS-TLIF surgery shortens time for screw placement and reduces the intraoperative irradiation exposure along with a higher accuracy rate of screw placement, which makes it a safe, accurate, and efficient technique. PMID:27418828

  11. Polymethylmethacrylate-augmented screw fixation for stabilization in metastatic spinal tumors. Technical note.

    PubMed

    Jang, Jee Soo; Lee, Sang Ho; Rhee, Chang Hun; Lee, Seung Hoon

    2002-01-01

    Screw fixation augmented with polymethylmethacrylate (PMMA) or some other biocompatible bone cement has been used in patients with osteoporosis requiring spinal fusion. No clinical studies have been conducted on PMMA-augmented screw fixation for stabilization of the vertebral column in patients with metastatic spinal tumors. The purpose of this study was to determine whether screw fixation augmented with PMMA might be suitable in patients treated for multilevel metastatic spinal tumors. Ten patients with metastatic spinal tumors involving multiple vertebral levels underwent stabilization procedures in which PMMA was used to augment screw fixation after decompression of the spinal cord. Within 15 days, partial or complete relief from pain was obtained in all patients postoperatively. Two of four patients in whom neurological deficits caused them to be nonambulatory before surgery were able to ambulate postoperatively. Neither collapse of the injected vertebral bodies nor failure of the screw fixation was observed during the mean follow-up period of 6.7 months. Screw fixation augmented with PMMA may offer stronger stabilization and facilitate the instrumentation across short segments in the treatment of multilevel metastatic spinal tumors. PMID:11795702

  12. Minifragment screw fixation of oblique metacarpal fractures: a biomechanical analysis of screw types and techniques.

    PubMed

    Liporace, Frank A; Kinchelow, Tosca; Gupta, Salil; Kubiak, Erik N; McDonnell, Matthew

    2008-12-01

    The lag screw technique has historically been a successful and accepted way to treat oblique metacarpal fractures. However, it does take additional time and involve multiple steps that can increase the risk of fracture propagation or comminution in the small hand bones of the hand. An alternate fixation technique uses bicortical interfragmentary screws. Other studies support the clinical effectiveness and ease of this technique. The purpose of this study is to biomechanically assess the strength of the bicortical interfragmentary screw versus that of the traditional lag screw. Using 48 cadaver metacarpals, oblique osteotomies were created and stabilized using one of four methods: 1.5 mm bicortical interfragmentary (IF) screw, 1.5 mm lag technique screw, 2.0 mm bicortical IF screw, or 2.0 mm lag technique screw. Biomechanical testing was performed to measure post cyclic displacement and load to failure. Data was analyzed using one-way analysis of variance (ANOVA). There was no significant difference among the fixation techniques with regard to both displacement and ultimate failure strength. There was a slight trend for a higher load to failure with the 2.0 mm IF screw and 2.0 mm lag screw compared to the 1.5 mm IF and 1.5 mm lag screws, but this was not significant. Our results support previously established clinical data that bicortical interfragmentary screw fixation is an effective treatment option for oblique metacarpal fractures. This technique has clinical importance because it is an option to appropriately stabilize the often small and difficult to control fracture fragments encountered in metacarpal fractures. PMID:18780019

  13. Loosening torque of Universal Abutment screws after cyclic loading: influence of tightening technique and screw coating

    PubMed Central

    Regalin, Alexandre; Bhering, Claudia Lopes Brilhante; Alessandretti, Rodrigo; Spazzin, Aloisio Oro

    2015-01-01

    PURPOSE The purpose of this study was to evaluate the influence of tightening technique and the screw coating on the loosening torque of screws used for Universal Abutment fixation after cyclic loading. MATERIALS AND METHODS Forty implants (Titamax Ti Cortical, HE, Neodent) (n=10) were submerged in acrylic resin and four tightening techniques for Universal Abutment fixation were evaluated: A - torque with 32 Ncm (control); B - torque with 32 Ncm holding the torque meter for 20 seconds; C - torque with 32 Ncm and retorque after 10 minutes; D - torque (32 Ncm) holding the torque meter for 20 seconds and retorque after 10 minutes as initially. Samples were divided into subgroups according to the screw used: conventional titanium screw or diamond like carbon-coated (DLC) screw. Metallic crowns were fabricated for each abutment. Samples were submitted to cyclic loading at 106 cycles and 130 N of force. Data were analyzed by two-way ANOVA and Tukey's test (5%). RESULTS The tightening technique did not show significant influence on the loosening torque of screws (P=.509). Conventional titanium screws showed significant higher loosening torque values than DLC (P=.000). CONCLUSION The use of conventional titanium screw is more important than the tightening techniques employed in this study to provide long-term stability to Universal Abutment screws. PMID:26576253

  14. Short segment pedicle screw instrumentation and augmentation vertebroplasty in lumbar burst fractures: an experience.

    PubMed

    Afzal, Suhail; Akbar, Saleem; Dhar, Shabir A

    2008-03-01

    To assess the efficacy and feasibility of vertebroplasty and posterior short-segment pedicle screw fixation for the treatment of traumatic lumbar burst fractures. Short-segment pedicle screw instrumentation is a well described technique to reduce and stabilize thoracic and lumbar spine fractures. It is relatively a easy procedure but can only indirectly reduce a fractured vertebral body, and the means of augmenting the anterior column are limited. Hardware failure and a loss of reduction are recognized complications caused by insufficient anterior column support. Patients with traumatic lumbar burst fractures without neurologic deficits were included. After a short segment posterior reduction and fixation, bilateral transpedicular reduction of the endplate was performed using a balloon, and polymethyl methacrylate cement was injected. Pre-operative and post-operative central and anterior heights were assessed with radiographs and MRI. Sixteen patients underwent this procedure, and a substantial reduction of the endplates could be achieved with the technique. All patients recovered uneventfully, and the neurologic examination revealed no deficits. The post-operative radiographs and magnetic resonance images demonstrated a good fracture reduction and filling of the bone defect without unwarranted bone displacement. The central and anterior height of the vertebral body could be restored to 72 and 82% of the estimated intact height, respectively. Complications were cement leakage in three cases without clinical implications and one superficial wound infection. Posterior short-segment pedicle fixation in conjunction with balloon vertebroplasty seems to be a feasible option in the management of lumbar burst fractures, thereby addressing all the three columns through a single approach. Although cement leakage occurred but had no clinical consequences or neurological deficit. PMID:18193300

  15. Designs and techniques that improve the pullout strength of pedicle screws in osteoporotic vertebrae: current status.

    PubMed

    Shea, Thomas M; Laun, Jake; Gonzalez-Blohm, Sabrina A; Doulgeris, James J; Lee, William E; Aghayev, Kamran; Vrionis, Frank D

    2014-01-01

    Osteoporosis is a medical condition affecting men and women of different age groups and populations. The compromised bone quality caused by this disease represents an important challenge when a surgical procedure (e.g., spinal fusion) is needed after failure of conservative treatments. Different pedicle screw designs and instrumentation techniques have been explored to enhance spinal device fixation in bone of compromised quality. These include alterations of screw thread design, optimization of pilot hole size for non-self-tapping screws, modification of the implant's trajectory, and bone cement augmentation. While the true benefits and limitations of any procedure may not be realized until they are observed in a clinical setting, axial pullout tests, due in large part to their reproducibility and ease of execution, are commonly used to estimate the device's effectiveness by quantifying the change in force required to remove the screw from the body. The objective of this investigation is to provide an overview of the different pedicle screw designs and the associated surgical techniques either currently utilized or proposed to improve pullout strength in osteoporotic patients. Mechanical comparisons as well as potential advantages and disadvantages of each consideration are provided herein. PMID:24724097

  16. Designs and Techniques That Improve the Pullout Strength of Pedicle Screws in Osteoporotic Vertebrae: Current Status

    PubMed Central

    Shea, Thomas M.; Laun, Jake; Gonzalez-Blohm, Sabrina A.; Doulgeris, James J.; Lee, William E.; Vrionis, Frank D.

    2014-01-01

    Osteoporosis is a medical condition affecting men and women of different age groups and populations. The compromised bone quality caused by this disease represents an important challenge when a surgical procedure (e.g., spinal fusion) is needed after failure of conservative treatments. Different pedicle screw designs and instrumentation techniques have been explored to enhance spinal device fixation in bone of compromised quality. These include alterations of screw thread design, optimization of pilot hole size for non-self-tapping screws, modification of the implant's trajectory, and bone cement augmentation. While the true benefits and limitations of any procedure may not be realized until they are observed in a clinical setting, axial pullout tests, due in large part to their reproducibility and ease of execution, are commonly used to estimate the device's effectiveness by quantifying the change in force required to remove the screw from the body. The objective of this investigation is to provide an overview of the different pedicle screw designs and the associated surgical techniques either currently utilized or proposed to improve pullout strength in osteoporotic patients. Mechanical comparisons as well as potential advantages and disadvantages of each consideration are provided herein. PMID:24724097

  17. Sacroiliac screw fixation: A mini review of surgical technique

    PubMed Central

    Alvis-Miranda, Hernando Raphael; Farid-Escorcia, Hector; Alcalá-Cerra, Gabriel; Castellar-Leones, Sandra Milena; Moscote-Salazar, Luis Rafael

    2014-01-01

    The sacral percutaneous fixation has many advantages but can be associated with a significant exposure to X-ray radiation. Currently, sacroiliac screw fixation represents the only minimally invasive technique to stabilize the posterior pelvic ring. It is a technique that should be used by experienced surgeons. We present a practical review of important aspects of this technique. PMID:25336831

  18. Biomechanical analysis of different types of pedicle screw augmentation: a cadaveric and synthetic bone sample study of instrumented vertebral specimens.

    PubMed

    Chao, Kuo-Hua; Lai, Yu-Shu; Chen, Wen-Chuan; Chang, Chia-Ming; McClean, Colin J; Fan, Chang-Yuan; Chang, Chia-Hao; Lin, Leou-Chyr; Cheng, Cheng-Kung

    2013-10-01

    This study aims to determine the pull-out strength, stiffness and failure pull-out energy of cement-augmented, cannulated-fenestrated pedicle screws in an osteoporotic cadaveric thoracolumbar model, and to determine, using synthetic bone samples, the extraction torques of screws pre-filled with cement and those with cement injected through perforations. Radiographs and bone mineral density measurements from 32 fresh thoracolumbar vertebrae were used to define specimen quality. Axial pull-out strength of screws was determined through mechanical testing. Mechanical pull-out strength, stiffness and energy-to-failure ratio were recorded for cement-augmented and non-cement-augmented screws. Synthetic bone simulating a human spinal bone with severe osteoporosis was used to measure the maximum extraction torque. The pull-out strength and stiffness-to-failure ratio of cement pre-filled and cement-injected screws were significantly higher than the non-cement-augmented control group. However, the cement pre-filled and cement-injected groups did not differ significantly across these values (p=0.07). The cement pre-filled group had the highest failure pull-out energy, approximately 2.8 times greater than that of the cement-injected (p<0.001), and approximately 11.5 times greater than that of the control groups (p<0.001). In the axial pull-out test, the cement-injected group had a greater maximum extraction torque than the cement pre-filled group, but was statistically insignificant (p=0.17). The initial fixation strength of cannulated screws pre-filled with cement is similar to that of cannulated screws injected with cement through perforations. This comparable strength, along with the heightened pull-out energy and reduced extraction torque, indicates that pedicle screws pre-filled with cement are superior for bone fixation over pedicle screws injected with cement. PMID:23669371

  19. The treatment of metastasis to the femoral neck using percutaneous hollow perforated screws with cement augmentation.

    PubMed

    Kang, H G; Roh, Y W; Kim, H S

    2009-08-01

    We have developed a hollow perforated cannulated screw. One or more of these was implanted percutaneously in 11 patients with an osteolytic metastasis in the femoral neck and multiple metastases elsewhere. They were supplemented by one or two additional standard 6.5 mm cannulated screws in nine patients. Polymethylmethacrylate bone cement was injected through the screw into the neck of the femur using small syringes, as in vertebroplasty. The mean amount of cement injected was 23.2 ml (17 to 30). Radiotherapy was started on the fourth post-operative day and chemotherapy, on average, was resumed a day later. Good structural stability and satisfactory relief from pain were achieved in all the patients. This technique may be useful in the palliation of metastases in the femoral neck. PMID:19651838

  20. A technique for removal of a fractured implant abutment screw.

    PubMed

    Kurt, Murat; Güler, Ahmet Umut; Duran, İbrahim

    2013-12-01

    The aim of this technique report was to present a procedure for removal of a fractured implant abutment screw. Whatever the cause, when an abutment fracture has occurred, the fractured screw segment inside the implant must be removed. The methods used by the clinicians may include the use of an endo-explorer self-made screwdriver and the use of implant repair kit available for some implant systems. The advantage of the presented method is that it may be extended to other implant systems that do not have a special repair kit and also that the technique is simple and does not require special equipment. PMID:21905898

  1. Quantitative comparison between the straight-forward and anatomical insertion technique for pedicle screw placement

    NASA Astrophysics Data System (ADS)

    Knez, Dejan; Mohar, Janez; Likar, Boštjan; Pernuš, Franjo; Vrtovec, Tomaž

    2016-03-01

    Spinal deformity correction with vertebral fixation is nowadays the preferred surgical treatment, where pedicle screws are inserted through pedicles into corresponding vertebral bodies and afterwards connected with rods. In clinical practice, the straight-forward and anatomical insertion technique are currently being used for pedicle screw placement surgery. However, it is difficult to quantitatively compare both techniques and determine which technique is more adequate for each planned pedicle screw before surgery (i.e. preoperatively). In this paper, we therefore describe a framework for quantitative comparison between the straight-forward and anatomical insertion technique for pedicle screw placement surgery by evaluating the screw fastening strength. Quantitative comparisons were performed on computed tomography images of 11 patients with 74 manually planned pedicle screws, who underwent the vertebral fixation procedure. The first quantitative comparison was performed between the straight-forward and anatomical pedicle screw insertion technique, which resulted in a relatively high agreement with mean absolute difference of 0.0mm in screw diameter, 2.9mm in screw length, 1.2mm in pedicle crossing point and 6.5° in screw inclinations. The second quantitative comparison was performed between the best resulting pedicle screw insertion technique and manually obtained pedicle screw plans, which again resulted in a relatively high agreement with mean absolute difference of 0.5mm in screw diameter, 4.7mm in screw length, 2.4mm in pedicle crossing point and 6.0° in screw inclinations. Both the straight-forward and anatomical insertion technique proved approximately equal in terms of the screw fastening strength.

  2. Ridge augmentation utilizing guided tissue regeneration, titanium screws, freeze-dried bone, and tricalcium phosphate: clinical report.

    PubMed

    Hempton, T J; Fugazzotto, P A

    1994-01-01

    A mixture of demineralized freeze-dried human cortical bone and resorbable tricalcium phosphate was used in conjunction with an expanded polytetrafluoroethylene membrane to promote deposition of bone for ridge augmentation. A titanium screw was used to prevent collapse of the regenerative materials. A clinical report is presented in which an atrophic ridge was reconstructed buccolingually, permitting the placement of a root form implant in a previously untenable site. PMID:7920387

  3. Biopolymer augmentation of the lag screw in the treatment of femoral neck fractures--a biomechanical in-vitro study.

    PubMed

    Paech, A; Wilde, E; Schulz, A P; Heinrichs, G; Wendlandt, R; Queitsch, C; Kienast, B; Jürgens, Ch

    2010-04-01

    The cut-out of the sliding screw is one of the most common complications in the treatment of intertrochanteric fractures. The reasons for the cut-out are: a suboptimal position of the hip-screw in the femoral head, the type of fracture and poor bone quality. The aim of this study was to reproduce the cut-out event biomechanically and to evaluate the possible prevention of this event by the use of a biopolymer augmentation of the hip screw. Concerning the density and compression force of osteoporotic femoral bone polyurethane foam according to the terms of the Association for Standard Testing Material (ASTMF 1839-97) was used as test material. The polyurethane foam Lumoltan 200 with a compression force of 3.3 Mpa and a density of 0.192 g/cm(3) was used to reproduce the osteoporotic bone of the femoral fragment (density 12 lbm/ft(3)). A cylinder of 50 mm of length and 50 mm of width was produced by a rotary splint raising procedure with planar contact. The axial load of the system was performed by a hydraulic force cylinder of a universal test machine type Zwick 1455, Ulm, Germany. The CCD-angle of the used TGN-System was preset at 130 degrees. The migration pattern of the hip screw in the polyurethane foam was measured and expressed as a curve of the distance in millimeter (mm) against the applied load in Newton (N) up to the cut-out point. During the tests the implants reached a critical changing point from stable to unstable with an increased load progression of steps of 50 Newton. This unstable point was characterized by an increased migration speed in millimeters and higher descending gradient in the migration curve. This peak of the migration curve served as an indicator for the change of the hip screw position in the simulated bone material. The applied load in the non-augmented implant showed that in this group for a density degree of 12 (0,192 g/cm(3)) the mean force at the failure point was 1431 Newton (+/- 52 Newton). In the augmented implant we found that

  4. Biopolymer augmentation of the lag screw in the treatment of femoral neck fractures - a biomechanical in-vitro study

    PubMed Central

    2010-01-01

    The cut-out of the sliding screw is one of the most common complications in the treatment of intertrochanteric fractures. The reasons for the cut-out are: a suboptimal position of the hip-screw in the femoral head, the type of fracture and poor bone quality. The aim of this study was to reproduce the cut-out event biomechanically and to evaluate the possible prevention of this event by the use of a biopolymer augmentation of the hip screw. Concerning the density and compression force of osteoporotic femoral bone polyurethane foam according to the terms of the Association for Standard Testing Material (ASTMF 1839-97) was used as test material. The polyurethane foam Lumoltan 200 with a compression force of 3.3 Mpa and a density of 0.192 g/cm3 was used to reproduce the osteoporotic bone of the femoral fragment (density 12 lbm/ft3). A cylinder of 50 mm of length and 50 mm of width was produced by a rotary splint raising procedure with planar contact. The axial load of the system was performed by a hydraulic force cylinder of a universal test machine type Zwick 1455, Ulm, Germany. The CCD-angle of the used TGN-System was preset at 130 degrees. The migration pattern of the hip screw in the polyurethane foam was measured and expressed as a curve of the distance in millimeter [mm] against the applied load in Newton [N] up to the cut-out point. During the tests the implants reached a critical changing point from stable to unstable with an increased load progression of steps of 50 Newton. This unstable point was characterized by an increased migration speed in millimeters and higher descending gradient in the migration curve. This peak of the migration curve served as an indicator for the change of the hip screw position in the simulated bone material. The applied load in the non-augmented implant showed that in this group for a density degree of 12 (0,192 g/cm3) the mean force at the failure point was 1431 Newton (± 52 Newton). In the augmented implant we found that the

  5. Extended overview techniques for outdoor augmented reality.

    PubMed

    Veas, Eduardo; Grasset, Raphaël; Kruijff, Ernst; Schmalstieg, Dieter

    2012-04-01

    In this paper, we explore techniques that aim to improve site understanding for outdoor Augmented Reality (AR) applications. While the first person perspective in AR is a direct way of filtering and zooming on a portion of the data set, it severely narrows overview of the situation, particularly over large areas. We present two interactive techniques to overcome this problem: multi-view AR and variable perspective view. We describe in details the conceptual, visualization and interaction aspects of these techniques and their evaluation through a comparative user study. The results we have obtained strengthen the validity of our approach and the applicability of our methods to a large range of application domains. PMID:22402683

  6. In vitro biomechanical study of pedicle screw pull-out strength based on different screw path preparation techniques

    PubMed Central

    Moldavsky, Mark; Salloum, Kanaan; Bucklen, Brandon; Khalil, Saif; Mehta, Jwalant S

    2016-01-01

    Background: Poor screw-to-bone fixation is a clinical problem that can lead to screw loosening. Under-tapping (UT) the pedicle screw has been evaluated biomechanically in the past. The objective of the study was to determine if pedicle preparation with a sequential tapping technique will alter the screw-to-bone fixation strength using a stress relaxation testing loading protocol. Materials and Methods: Three thoracolumbar calf spines were instrumented with pedicle screws that were either probed, UT, standard-tapped (ST), or sequential tapped to prepare the pedicle screw track and a stress relaxation protocol was used to determine pull-out strength. The maximum torque required for pedicle screw insertion and pull-out strength was reported. A one-way ANOVA and Tukeys post-hoc test were used to determine statistical significance. Results: The pedicle screw insertion torques for the probed, UT, ST and sequentially tapped (SQT) techniques were 5.09 (±1.08) Nm, 5.39 (±1.61) Nm, 2.93 (±0.43) Nm, and 3.54 (±0.67) Nm, respectively. There is a significant difference between probed compared to ST (P ≤ 0.05), as well as UT compared to both ST and SQT (P ≤ 0.05). The pull-out strength for pedicle screws for the probed, UT, ST and SQT techniques was 2443 (±782) N, 2353(±918) N, 2474 (±521) N, and 2146 (±582) N, respectively, with no significant difference (P ≥ 0.05) between techniques. Conclusions: The ST technique resulted in the highest pull-out strength while the SQT technique resulted in the lowest. However, there was no significant difference in the pull-out strength for the various preparation techniques and there was no correlation between insertion torque and pull-out strength. This suggests that other factors such as bone density may have a greater influence on pull-out strength. PMID:27053808

  7. Hollow Mill for Extraction of Stripped Titanium Screws: An Easy, Quick, and Safe Technique

    PubMed Central

    Gupta, Ravi; Singh, Harpreet; Singh, Amit; Garg, Sudhir

    2014-01-01

    Removal of jammed titanium screws can be difficult due to the problem of stripping of the hexagonal heads of the screws. We present a technique of extraction of stripped screws with the use of a standard 4.5 mm stainless steel hollow mill in a patient of peri-implant fracture of the radius fixed with a titanium locking plate 2 years back. The technique is quick, safe, and cost effective. PMID:25013544

  8. Revision characteristics of cement-augmented, cannulated-fenestrated pedicle screws in the osteoporotic vertebral body: a biomechanical in vitro investigation. Technical note.

    PubMed

    Blattert, Thomas R; Glasmacher, Stefan; Riesner, Hans-Joachim; Josten, Christoph

    2009-07-01

    In generalized osteoporosis, instrumentation with cement-augmented pedicle screws is an amplification of the therapeutic spectrum. Early clinical results are promising for both solid and cannulated screws; however, there are concerns regarding the revision characteristics of these screws, especially for the cannulated-fenestrated type with its continuous cement interconnection from the core of the screw to surrounding bone tissue. In a human cadaver model, bone mineral density (BMD) was assessed radiographically. Spinal levels T9-L4 were instrumented left unilaterally, transpedicularly by using cannulated-fenestrated pedicle screws with the dimensions 6.5 x 45 mm. Polymethylmethacrylate cement (1.5 ml) was injected through the screws into each vertebra. After polymerization of the cement, the extraction torque was recorded. For both implantation and explantation of the screws, a fluoroscope was used to guarantee correct screw and cement positioning and to observe possible co-movements-that is, any movement of the cement mass within the vertebral body upon removal of the screw. For comparison, the extraction torque of same-dimension pedicle screws was recorded in a nonosteoporotic, non-cement-augmented instrumentation. The BMD was 0.60 g/cm2, a level that corresponds to a severe grade of osteoporosis. For removal of the screws, the median and mean extraction torques were 34 and 49 +/- 44 Ncm, respectively. No co-movements of the cement mass occurred within the vertebral body. In the nonosteoporotic control, BMD was 1.38 g/cm2. The median and mean extraction torques were 123 and 124 +/- 12 Ncm, respectively. Thus, the revision characteristics of cement-augmented, cannulated-fenestrated pedicle screws are not problematic, even in cases of severe osteoporosis. The winglike cement interconnection between the screw core and surrounding bone tissue is fragile enough to break off in the event of an extraction torque and to release the screw. There is no proof to support

  9. A simplified technique of distal femoral screw insertion for the Grosse-Kempf interlocking nail.

    PubMed

    MacMillan, M; Gross, R H

    1988-01-01

    Failure accurately to determine distal femoral screw hole position can sometimes prolong operating time for placing an interlocking Grosse-Kempf rod. The described technique allows the distal femoral screw holes to be localized accurately with minimal radiation exposure. This technique utilizes readily available instruments and is not technically demanding. PMID:3335100

  10. Comparison of oil refining and biodiesel production process between screw press and n-hexane techniques from beauty leaf feedstock

    NASA Astrophysics Data System (ADS)

    Bhuiya, M. M. K.; Rasul, M. G.; Khan, M. M. K.; Ashwath, N.

    2016-07-01

    The Beauty Leaf Tree (Callophylum inophyllum) is regarded as an alternative source of energy to produce 2nd generation biodiesel due to its potentiality as well as high oil yield content in the seed kernels. The treating process is indispensable during the biodiesel production process because it can augment the yield as well as quality of the product. Oil extracted from both mechanical screw press and solvent extraction using n-hexane was refined. Five replications each of 25 gm of crude oil for screw press and five replications each of 25 gm of crude oil for n-hexane were selected for refining as well as biodiesel conversion processes. The oil refining processes consists of degumming, neutralization as well as dewaxing. The degumming, neutralization and dewaxing processes were performed to remove all the gums (phosphorous-based compounds), free fatty acids, and waxes from the fresh crude oil before the biodiesel conversion process carried out, respectively. The results indicated that up to 73% and 81% of mass conversion efficiency of the refined oil in the screw press and n-hexane refining processes were obtained, respectively. It was also found that up to 88% and 90% of biodiesel were yielded in terms of mass conversion efficiency in the transesterification process for the screw press and n-hexane techniques, respectively. While the entire processes (refining and transesterification) were considered, the conversion of beauty leaf tree (BLT) refined oil into biodiesel was yielded up to 65% and 73% of mass conversion efficiency for the screw press and n-hexane techniques, respectively. Physico-chemical properties of crude and refined oil, and biodiesel were characterized according to the ASTM standards. Overall, BLT has the potential to contribute as an alternative energy source because of high mass conversion efficiency.

  11. Learning retention of thoracic pedicle screw placement using a high-resolution augmented reality simulator with haptic feedback1

    PubMed Central

    Luciano, Cristian J.; Banerjee, P. Pat; Bellotte, Brad; Lemole, G. Michael; Oh, Michael; Charbel, Fady T.; Roitberg, Ben

    2011-01-01

    Background We evaluated the use of a part-task simulator with 3D and haptic feedback as a training tool for a common neurosurgical procedure – placement of thoracic pedicle screws. Objective To evaluate the learning retention of thoracic pedicle screw placement on a high-performance augmented reality and haptic technology workstation. Methods Fifty-one fellows and residents performed thoracic pedicle screw placement on the simulator. The virtual screws were drilled into a virtual patient’s thoracic spine derived from a computed tomography data set of a real patient. Results With a 12.5% failure rate, a two-proportion z-test yielded P= 0.08. For performance accuracy, an aggregate Euclidean distance deviation from entry landmark on the pedicle and a similar deviation from the target landmark in the vertebral body yielded P=0.04 from a two-sample t-test in which the rejected null hypothesis assumes no improvement in performance accuracy from the practice to the test sessions, and the alternative hypothesis assumes an improvement. Conclusion The performance accuracy on the simulator was comparable to the accuracy reported in literature on recent retrospective evaluation of such placements. The failure rates indicated a minor drop from practice to test sessions, and also indicated a trend (P=0.08) towards learning retention resulting in improvement from practice to test sessions. The performance accuracy showed a 15% mean score improvement and over 50% reduction in standard deviation from practice to test. It showed evidence (P=0.04) of performance accuracy improvement from practice to test session. PMID:21471846

  12. Lumbosacral fixation using sacroiliac buttress screws: a modification to the Jackson technique with intrasacral rods

    PubMed Central

    2014-01-01

    Background The use of intrasacral rods has been previously reported for posterior lumbosacral fixation. However, problems associated with this technique include poor stability of the rod in the sacrum, difficulty in contouring the rod to fit the lateral sacral mass, and the complicated assembly procedure for the rod and pedicle screws in the thoracolumbar segments after insertion of the rod into the sacrum. Methods We used a screw with a polyaxial head instead of an intrasacral rod, which was inserted into the lateral sacral mass and assembled to the rod connected cephalad to pedicle screws. The dorsal side of the screw was stabilized by the sacral subchondral bone at the sacroiliac joint with iliac buttress coverage, and the tip of the screw was anchored by the sacral cortex. Results Three different cases were used to illustrate lumbosacral fixation using intrasacral screws as an anchor for the spinal instrumentation. Effective resistance of flexural bending moment and fusion were achieved in these patients at the lumbosacral level. Conclusions An intrasacral screw can be stabilized by subchondral bone with iliac buttress coverage at the dorsal and ventral sacral cortex. Posterior spinal fusion with this screw technique enables easier assembly of the instrumentation and presents better stabilization than that provided by the previously reported intrasacral rod technique for correction and fusion of thoracolumbar kyphoscoliosis. PMID:25050132

  13. A new technique for lag screw placement in the dynamic hip screw fixation of intertrochanteric fractures: decreasing radiation time dramatically

    PubMed Central

    Sheng, Wei-Chao; Li, Jia-Zhen; Chen, Sheng-Hua

    2008-01-01

    The goal of this study was to confirm the decrease in radiation time required for a new technique to place dynamic hip screws (DHS) in intertrochanteric fractures. Seventy-six patients were treated with DHS by either the new technique (NT) or the conventional technique (CT). The width of femoral shaft, the length of the hip screw to be implanted into the injured side, and the distance between the tip of the greater trochanter and the entry point of the guide wire were measured at the uninjured side on the anteroposterior pelvic radiograph preoperatively, and the actual width of the injured femoral shaft was measured intra-operatively. Finally, the entry point and the length of hip screw were obtained through an equation. Mean radiation time of the NT patients (24.57 ± 7.80 s) was significantly shorter than the CT patients (54.2 ± 18.26 s) (P  < 0.001). The new technique decreased radiation time dramatically in DHS fixation. PMID:18265981

  14. Percutaneous Pedicle Screw Fixation with Polymethylmethacrylate Augmentation for the Treatment of Thoracolumbar Intravertebral Pseudoarthrosis Associated with Kummell's Osteonecrosis

    PubMed Central

    2016-01-01

    Purpose. The purpose of our study is to evaluate the therapeutic efficacy of short-segment percutaneous pedicle screw fixation with polymethylmethacrylate (PMMA) augmentation for the treatment of osteoporotic thoracolumbar compression fracture with osteonecrosis. Methods. Osteoporotic thoracolumbar compression fractures with avascular necrosis were treated by short-segment PPF with PMMA augmentation. Eighteen were followed up for more than 2 years. The kyphotic angle, compression ratio, visual analog scale (VAS) score for back pain, and the Oswestry Disability Index (ODI) were analyzed. In addition, radiologic and clinical parameters of PPF group were compared with percutaneous vertebroplasty (PVP) group. Results. Vertebral height and kyphotic angle of the compressed vertebral bodies were significantly corrected after the operation (P < 0.05). Further, restored vertebral height was maintained during the 2 or more years of postoperative follow-up. Compared to the PVP group the postoperative compression ratio and kyphotic angle were significantly lower in the PPF group (P < 0.05). The postoperative ODI and VAS of the PVP group were significantly higher than the PPF (P < 0.05). Conclusions. According to our results, short-segment PPF with PMMA augmentation may be an effective minimally invasive treatment for osteoporosis in cases of osteoporotic vertebral compression fractures with Kummell's osteonecrosis. PMID:27595101

  15. Percutaneous Pedicle Screw Fixation with Polymethylmethacrylate Augmentation for the Treatment of Thoracolumbar Intravertebral Pseudoarthrosis Associated with Kummell's Osteonecrosis.

    PubMed

    Kim, Hyeun-Sung; Heo, Dong-Hwa

    2016-01-01

    Purpose. The purpose of our study is to evaluate the therapeutic efficacy of short-segment percutaneous pedicle screw fixation with polymethylmethacrylate (PMMA) augmentation for the treatment of osteoporotic thoracolumbar compression fracture with osteonecrosis. Methods. Osteoporotic thoracolumbar compression fractures with avascular necrosis were treated by short-segment PPF with PMMA augmentation. Eighteen were followed up for more than 2 years. The kyphotic angle, compression ratio, visual analog scale (VAS) score for back pain, and the Oswestry Disability Index (ODI) were analyzed. In addition, radiologic and clinical parameters of PPF group were compared with percutaneous vertebroplasty (PVP) group. Results. Vertebral height and kyphotic angle of the compressed vertebral bodies were significantly corrected after the operation (P < 0.05). Further, restored vertebral height was maintained during the 2 or more years of postoperative follow-up. Compared to the PVP group the postoperative compression ratio and kyphotic angle were significantly lower in the PPF group (P < 0.05). The postoperative ODI and VAS of the PVP group were significantly higher than the PPF (P < 0.05). Conclusions. According to our results, short-segment PPF with PMMA augmentation may be an effective minimally invasive treatment for osteoporosis in cases of osteoporotic vertebral compression fractures with Kummell's osteonecrosis. PMID:27595101

  16. The Effect of Polymethyl Methacrylate Augmentation on the Primary Stability of Cannulated Bone Screws in an Anterolateral Plate in Osteoporotic Vertebrae: A Human Cadaver Study.

    PubMed

    Rüger, Matthias; Sellei, Richard M; Stoffel, Marcus; von Rüden, Christian

    2016-02-01

    Study Design Cohort study. Objective Expandable anterolateral plates facilitate the reduction of posttraumatic deformities of thoracolumbar spine injuries and are commonly used in cases of unstable injuries or compromised bone quality. In this in vitro study, the craniocaudal yield load of the osseous fixation of an anterior angular stable plate fixation system and the effect of polymethyl methacrylate (PMMA) screw augmentation on the primary stability of the screw-bone interface during kyphosis reduction was evaluated in 12 osteoporotic human thoracolumbar vertebrae. Methods The anterolateral stabilization device used for this study is comprised of two swiveling flanges and an expandable midsection. It facilitates the controlled reduction of kyphotic deformities in situ with a geared distractor. Single flanges were attached to 12 thoracolumbar vertebrae. Six specimens were augmented with PMMA by means of cannulated bone screws. The constructs were subjected to static, displacement-controlled craniocaudal loading to failure in a servohydraulic testing machine. Results The uncemented screws cut out at a mean 393 ± 66 N, whereas the cemented screws showed significantly higher yield load of 966 ± 166 N (p < 0.02). We detected no significant correlation between bone mineral density and yield load in this setting. Conclusion Our results indicate that PMMA augmentation is an effective method to increase two- to threefold the primary stability of the screw-bone interface of an anterolateral spine stabilization system in osteoporotic bone. We recommend it in cases of severely compromised bone quality to reduce the risk of screw loosening during initial kyphosis correction and to increase long-term construct stability. PMID:26835201

  17. COMPLICATIONS OF THE SCREW/WASHER TIBIAL FIXATION TECHNIQUE FOR KNEE LIGAMENT RECONSTRUCTION

    PubMed Central

    Almeida, Alexandre; Roveda, Gilberto; Valin, Márcio Rangel; Almeida, Nayvaldo Couto de; Sartor, Vanderlei; Alves, Soraya Melina

    2015-01-01

    To evaluate the presence of pain at the site of the surgical incision and the need to remove the tibial fixation screw in anterior cruciate ligament (ACL) reconstruction, in relation to sex and body mass index (BMI). Methods: A group of 265 patients who underwent ACL reconstruction with ipsilateral flexor tendon grafts from the thigh in which the tibial fixation technique consisted of using a cortical screw and metal washer, between July 2000 and November 2007, were evaluated. Results: 176 patients were evaluated for an average of 33.3 ± 19.5 months; median of 29.5 months; IIQ: 17-45 months; minimum of 8 and maximum of 87 months. There was no statistical difference regarding complaints of pain at the site of the screw (p = 0.272) and the need to remove the tibial screw (p = 0.633) between sexes. There was no statistical difference regarding complaints of pain at the site of the screw (p = 0.08) and the need to remove the tibial screw (p = 0.379) according to BMI. Conclusion: The pain complaint rate at the screw site from the screw and metal washer method used for tibial fixation in ACL reconstruction was of the order of 25%, and the screw had to be removed in 10.8% of the cases. There was no predominance of pain complaints at the surgical wound between the sexes. There was a greater tendency to complain about pain among patients with BMI < 25. There was no predominance of screw and washer removal between the sexes or between individuals with different BMIs. PMID:27022587

  18. A new free-hand pedicle screw placement technique with reference to the supraspinal ligament

    PubMed Central

    Li, Juming; Zhao, Hong; Xie, Hao; Yu, Lipeng; Wei, Jifu; Zong, Min; Chen, Feng; Zhu, Ziqiang; Zhang, Ning; Cao, Xiaojian

    2014-01-01

    We sought to compare the safety and accuracy of a new free-hand pedicle screw placement technique to that of the conventional technique. One hundred fifty-three consecutive adult patients with simple fracture in the thoracic or/and lumbar spine were alternately assigned to either the new free-hand or the conventional group. In the new free-hand technique group, preoperative computerized tomography (CT) images were used to calculate the targeted medial-lateral angle of each pedicle trajectory and the pedicle screw was inserted perpendicular to the correspond-ing supraspinal ligament. In the conventional technique group, the medial-lateral and cranial-caudal angle of each pedicle trajectory was determined by intraoperatively under fluoroscopic guidance. The accuracy rate of pedicle screw placement, the time of intraoperative fluoroscopy, the operating time and the amount of blood loss during operation were respectively compared. All screws were analyzed by using intraoperative radiographs, intraoperative triggered electromyography (EMG) monitoring data, postoperative CT data and clinical outcomes. The accuracy rate of pedicle screw placement in the new free-hand technique group and the conventional technique group was 96.3% and 94.2% (P < 0.05), respectively. The intraoperative fluoroscopy time of the new technique group was less than that of the conventional technique group (5.37 seconds vs. 8.79 seconds, P < 0.05). However, there was no statistical difference in the operating time and the amount of blood loss during operation (P > 0.05). Pedicle screw placement with the free-hand technique which keeps the screw perpendicular to the supraspinal ligament is an accurate, reliable and safe technique to treat simple fracture in the thoracic or lumbar spine. PMID:24474966

  19. Vertical bone augmentation procedures: basics and techniques in dental implantology.

    PubMed

    Draenert, F G; Huetzen, D; Neff, A; Mueller, W E G

    2014-05-01

    An appropriate bony situation is essential for dental implant placement and bony support of soft tissues (pink esthetic). Loss of teeth often results in complex horizontal and vertical alveolar ridge defects. They demand advanced bone augmentation techniques for reconstruction. We present the different techniques and materials used in complex bone augmentation. Clinical cases show the application of the methods in the clinical setting. We present current techniques and materials used in complex bone augmentations. Clinical cases show the application of the methods in the clinical setting. Applied techniques include stabilized-guided bone regeneration (GBR), autologous local block augmentation, modified techniques such as Gellrich shell technique including piezosurgery, pelvic bone blocks, complex materials such as graft-derived bone blocks and their unique handling problems. Successful basic principles are reduction of cortical bone healing due to long remodeling time and possible late loss; extended application of materials with interconnecting porous system and particulate material resulting in fast healing analogous to cancellous bone; mechanical stabilization of the augmentation to allow bony healing in vertical defect situations. GBR and autologous bone blocks with minimal cortical thickness and a high volume of particulated material are most favorable techniques. PMID:23733418

  20. Less invasive reduction and fusion of fresh A2 and A 3 traumatic L 1-L 4 fractures with a novel vertebral body augmentation implant and short pedicle screw fixation and fusion.

    PubMed

    Korovessis, Panagiotis; Vardakastanis, Konstantinos; Repantis, Thomas; Vitsas, Vasilios

    2014-04-01

    The aim of this clinical study was to report on the efficacy in reduction and safety in PMMA leakage of a novel vertebral augmentation technique with PEEK and PMMA, together with pedicle screws in the treatment of fresh vertebral fractures in young adults. Twenty consecutive young adults aged 45 ± 11 years with fresh burst A3/AO or severely compressed A2/AO fractures underwent via a less invasive posterior approach one-staged reduction with a novel augmentation implant and PMMA plus 3-vertebrae pedicle screw fixation and fusion. Radiologic parameters as segmental kyphosis (SKA), anterior (AVBHr) and posterior vertebral body height ratio (PVBHr), spinal canal encroachment (SCE), cement leakage and functional parameters as VAS, SF-36 were measured pre- and post-operatively. Hybrid construct restored AVBHr (P < 0.000), PVBHr (P = 0.02), SKA (P = 0.015), SCE (P = 0.002) without loss of correction at an average follow-up of 17 months. PMMA leakage occurred in 3 patients (3 vertebrae) either anteriorly to the fractured vertebral body or to the adjacent disc, but in no case to the spinal canal. Two pedicle screws were malpositioned (one medially, one laterally to the pedicle at the fracture level) without neurologic sequelae. Solid posterolateral spinal fusion occurred 8-10 months post-operatively. Pre-operative VAS and SF-36 scores improved post-operatively significantly. This study showed that this novel vertebral augmentation technique using PEEK implant and PMMA reduces and stabilizes via less invasive technique A2 and A3 vertebral fractures without loss of correction and leakage to the spinal canal. PMID:24170266

  1. A Novel Surgical Technique for Removing Buried Cannulated Screws Using a Guidewire and Countersink: A Report of Two Cases

    PubMed Central

    Chen, Yongsheng; Giri, Krishna Prasad; Pearce, Christopher Jon

    2015-01-01

    Removal of metal implants is a common procedure that is performed for a variety of indications. However, problems such as a buried screw head may occasionally arise and render hardware removal difficult or even impossible. The problem is further compounded when the initial screw was inserted percutaneously or via a minimally-invasive (MIS) technique. In the present paper, we introduce a novel, minimally invasive technique to remove buried cannulated screws which obviates the need for excessive extension of the skin incision, surgical exploration, soft tissue dissection or excess bone removal, which surgeons may otherwise have to undertake to uncover the buried screw head. This technique is especially useful in removing cannulated screws which have been inserted using small stab incisions and MIS techniques initially. This technique can be applied to the removal of buried cannulated screws which are placed into any bone in the body. PMID:26161159

  2. Comparison Between Gearshift And Drill Techniques For Pedicle Screw Placement By Resident Surgeons

    PubMed Central

    Allen, Jonathan; Akpolat, Yusuf T.; Kishan, Shyam; Peppers, Tim; Asgarzadie, Farbod

    2015-01-01

    Background Various techniques have been described for pedicle screw placement with established clinical and radiological success. Suboptimal screw trajectories can compromise bony purchase and, worse yet, cause neurological and vascular injuries. Thus, it is of paramount importance to achieve maximum accuracy of screw placement. Our objective is to evaluate the accuracy of pedicle screw placement in the thoracolumbar spine by resident surgeons. Two popular techniques, gearshift versus drill, were compared. Methods This is a a cadaveric surgical technique comparison study. Six resident surgeons instrumented the spine from T1 to S1 using both gearshift and drill techniques. Each pedicle was randomly assigned to either of the techniques. Pedicle screws were placed freehand without radiographic guidance. Violations (medial, lateral, anterior, superior and inferior) were recorded by studying the computerized tomographic scans of instrumented cadavers by blinded observers. Critical perforations were defined as greater than 2mm breach of the pedicle wall. Results A total of 100 vertebrae (200 pedicles) were instrumented in the six cadavers. 103 pedicles were breached (51.5% of total pedicles). Lateral violations were the most encountered (65% of violations, 67 total, 48 critical, 19 noncritical) followed by medial (24%, 25 total, 13 critical, 12 noncritical), and the rest were anterior (3%), superior (4%) and inferior (4%). There was no overall difference in violations comparing the gearshift technique (49.5%, 51 total, 37 critical, 14 noncritical) with drill technique (50.5%, 52 total, 33 critical, 19 noncritical). Analyzing the breaches at individual vertebra indicated most violations at T6 (11), T5 (10), followed by T3 (9) and T4 (9), decreasing towards the lumbosacral vertebrae. Conclusion The results of this study suggest that the gearshift and drill techniques for placement of pedicle screws in the thoracolumbar spine fare similarly with regards to risk of breach

  3. Computer Augmented Lectures (CAL): A New Teaching Technique for Chemistry.

    ERIC Educational Resources Information Center

    Masten, F. A.; And Others

    A new technique described as computer augmented lectures (CAL) is being used at the University of Texas at Austin. It involves the integration of on-line, interactive, time sharing computer terminals and theater size video projectors for large screen display. This paper covers the basic concept, pedagogical techniques, experiments conducted,…

  4. Computer-assisted periacetabular screw placement: Comparison of different fluoroscopy-based navigation procedures with conventional technique.

    PubMed

    Ochs, Björn Gunnar; Gonser, Christoph; Shiozawa, Thomas; Badke, Andreas; Weise, Kuno; Rolauffs, Bernd; Stuby, Fabian Maria

    2010-12-01

    The current gold standard for operatively treated acetabular fractures is open reduction and internal fixation. Fractures with minimal displacement may be stabilised by minimally invasive methods such as percutaneous periacetabular screws. However, their placement is a demanding procedure due to the complex pelvic anatomy. The aim of this study was to evaluate the accuracy of periacetabular screw placement assessing pre-defined placement corridors and comparing different fluoroscopy-based navigation procedures and the conventional technique. For each screw an individual periacetabular placement corridor was preoperatively planned using the planning software iPlan CMF(©) 3.0 (BrainLAB). 210 screws (retrograde anterior column screws, retrograde posterior column screws, supraacetabular ilium screws) were placed in an artificial Synbone pelvis model (30 hemipelves) and in human cadaver specimen (30 hemipelves). 2D- and 3D-fluoroscopy-based navigation procedures were compared to the conventional technique. Insertion time and radiation exposure to specimen were also recorded. The achieved screw position was postoperatively assessed by an Iso-C(3D) scan. Perforations of bony cortices or articular surfaces were analysed and the screw deviation severity (difference of the operatively achieved screw position and the preoperatively planned screw position in reference to the pre-defined corridors) was determined using image fusion. Using 3D-fluoroscopy-based navigation, the screw perforation rate (7%) was significantly lower compared to 2D-fluoroscopy-based navigation (20%). For all screws, the deviation severity was significantly lower using a 3D- compared to a 2D-fluoroscopy-based navigation and the conventional technique. Analysing the posterior column screws, the screw deviation severity was significantly lower using 3D- compared to 2D-fluoroscopy-based navigation. However, for the anterior column screw, the screw deviation severity was similar regardless of the imaging

  5. The Effect of Polymethyl Methacrylate Augmentation on the Primary Stability of Cannulated Bone Screws in an Anterolateral Plate in Osteoporotic Vertebrae: A Human Cadaver Study

    PubMed Central

    Rüger, Matthias; Sellei, Richard M.; Stoffel, Marcus; von Rüden, Christian

    2015-01-01

    Study Design Cohort study. Objective Expandable anterolateral plates facilitate the reduction of posttraumatic deformities of thoracolumbar spine injuries and are commonly used in cases of unstable injuries or compromised bone quality. In this in vitro study, the craniocaudal yield load of the osseous fixation of an anterior angular stable plate fixation system and the effect of polymethyl methacrylate (PMMA) screw augmentation on the primary stability of the screw–bone interface during kyphosis reduction was evaluated in 12 osteoporotic human thoracolumbar vertebrae. Methods The anterolateral stabilization device used for this study is comprised of two swiveling flanges and an expandable midsection. It facilitates the controlled reduction of kyphotic deformities in situ with a geared distractor. Single flanges were attached to 12 thoracolumbar vertebrae. Six specimens were augmented with PMMA by means of cannulated bone screws. The constructs were subjected to static, displacement-controlled craniocaudal loading to failure in a servohydraulic testing machine. Results The uncemented screws cut out at a mean 393 ± 66 N, whereas the cemented screws showed significantly higher yield load of 966 ± 166 N (p < 0.02). We detected no significant correlation between bone mineral density and yield load in this setting. Conclusion Our results indicate that PMMA augmentation is an effective method to increase two- to threefold the primary stability of the screw–bone interface of an anterolateral spine stabilization system in osteoporotic bone. We recommend it in cases of severely compromised bone quality to reduce the risk of screw loosening during initial kyphosis correction and to increase long-term construct stability. PMID:26835201

  6. Current trends in pedicle screw stimulation techniques: lumbosacral, thoracic, and cervical levels.

    PubMed

    Isley, Michael R; Zhang, Xiao-Feng; Balzer, Jeffrey R; Leppanen, Ronald E

    2012-06-01

    Unequivocally, pedicle screw instrumentation has evolved as a primary construct for the treatment of both common and complex spinal disorders. However an inevitable and potentially major complication associated with this type of surgery is misplacement of a pedicle screw(s) which may result in neural and vascular complications, as well as impair the biomechanical stability of the spinal instrumentation resulting in loss of fixation. In light of these potential surgical complications, critical reviews of outcome data for treatment of chronic, low-back pain using pedicle screw instrumentation concluded that "pedicle screw fixation improves radiographically demonstrated fusion rates;" however the expense and complication rates for such constructs are considerable in light of the clinical benefit (Resnick et al. 2005a). Currently, neuromonitoring using free-run and evoked (triggered) electromyography (EMG) is widely used and advocated for safer and more accurate placement of pedicle screws during open instrumentation procedures, and more recently, guiding percutaneous placement (minimally invasive) where the pedicle cannot be easily inspected visually. The latter technique, evoked or triggered EMG when applied to pedicle screw instrumentation surgeries, has been referred to as the pedicle screw stimulation technique. As concluded in the Position Statement by the American Society of Neurophysiological Monitoring (ASNM), multimodality neuromonitoring using free-run EMG and the pedicle screw stimulation technique was considered a practice option and not yet a standard of care (Leppanen 2005). Subsequently, the American Association of Neurological Surgeons/Congress of Neurological Surgeons (AANS/CNS) Joint Section on Disorders of the Spine and Peripheral Nerves published their "Guidelines for the Performance of Fusion Procedures for Degenerative Disease of the Lumbar Spine" (Heary 2005, Resnick et al. 2005a, Resnick et al. 2005b). It was concluded that the "primary

  7. Percutaneous Pedicle Screw Fixation Technique in the Thoracic and Lumbar Spine-Tips and Tricks.

    PubMed

    Gazzeri, Roberto

    2016-04-01

    The need for spinal fixation in patients who cannot tolerate classical open surgery has led in recent years to the development of minimally invasive approaches. The use of percutaneous pedicle screw fixation offers several advantages, such as less blood loss and postoperative pain due to blunt separation of the muscles with reduction of soft tissue dissection. Medical records and demographic information, diagnosis, and preoperative pain levels of 63 patients who underwent percutaneous minimally invasive thoracolumbar spine stabilization using the Illico® Fixation System (Alphatec Spine, Carlsbad, California) were analysed: a total of 344 screws were implanted. Preoperative and postoperative clinical assessment of the patients were based on a visual analogue scale. Because percutaneous techniques do not allow gross visualization of the vertebra and erroneous placement of the screw may be high in the initial cases, we discuss the techniques for a safe implantation of pedicle screws using a single or double intraoperative fluoroscopy. We report tips and tricks for technical challenges including fixation in osteoporotic patients, percutaneous insertion of long rods, compression/distraction using multiaxial screws turning into monoaxial, and use of minimally invasive retractror for interbody fusion. Recently, indications for minimally invasive percutaneous fixation have expanded and my results support that it may be considered a safe and effective option for the treatment of degenerative and traumatic thoracolumbar spinal diseases. PMID:27121407

  8. Biomechanical evaluation of four different posterior screw and rod fixation techniques for the treatment of the odontoid fractures

    PubMed Central

    Li, Lei; Liu, Wen-Fei; Jiang, Hong-Kun; Li, Yun-Peng

    2015-01-01

    Problems that screw cannot be inserted may occur in screw-rod fixation techniques such as Harms technique. We compared the biomechanical stability imparted to the C-2 vertebrae by four designed posterior screw and rod fixation techniques for the management of odontoid fractures. A three-dimensional finite element model of the odontoid fracture was established by subtracting several unit structures from the normal model from a healthy male volunteer. 4 different fixation techniques, shown as follows: ① C-1 lateral mass and C-2 pedicle screw fixation (Harms technique); ② C-1 lateral mass and unilateral C-2 pedicle screw fixation combined with ipsilateral laminar screw fixation; ③ Unilateral C-1lateral mass combined with ipsilateral C-1 posterior arch, and C-2 pedicle screw fixation; and ④ Unilateral C1 lateral mass screw connected with bilateral C2 pedicle screw fixation was performed on the odontoid fracture model. The model was validated for axial rotation, flexion, extension, lateral bending, and tension for 1.5 Nm. Changes in motion in flexion-extension, lateral bending, and axial rotation were calculated. The finite element model of the odontoid fracture was established in this paper. All of the four screw-rod techniques significantly decreased motion in flexion-extension, lateral bending, and axial rotation, as compared with the destabilized odontoid fracture complex (P<0.05). There was no statistically significant difference in stability among the four screw techniques. We concluded that the first three fixation techniques are recommended to be used as surgical intervention for odontoid fracture, while the last can be used as supplementary for the former three methods. PMID:26309508

  9. Biomechanical evaluation of four different posterior screw and rod fixation techniques for the treatment of the odontoid fractures.

    PubMed

    Li, Lei; Liu, Wen-Fei; Jiang, Hong-Kun; Li, Yun-Peng

    2015-01-01

    Problems that screw cannot be inserted may occur in screw-rod fixation techniques such as Harms technique. We compared the biomechanical stability imparted to the C-2 vertebrae by four designed posterior screw and rod fixation techniques for the management of odontoid fractures. A three-dimensional finite element model of the odontoid fracture was established by subtracting several unit structures from the normal model from a healthy male volunteer. 4 different fixation techniques, shown as follows: ① C-1 lateral mass and C-2 pedicle screw fixation (Harms technique); ② C-1 lateral mass and unilateral C-2 pedicle screw fixation combined with ipsilateral laminar screw fixation; ③ Unilateral C-1lateral mass combined with ipsilateral C-1 posterior arch, and C-2 pedicle screw fixation; and ④ Unilateral C1 lateral mass screw connected with bilateral C2 pedicle screw fixation was performed on the odontoid fracture model. The model was validated for axial rotation, flexion, extension, lateral bending, and tension for 1.5 Nm. Changes in motion in flexion-extension, lateral bending, and axial rotation were calculated. The finite element model of the odontoid fracture was established in this paper. All of the four screw-rod techniques significantly decreased motion in flexion-extension, lateral bending, and axial rotation, as compared with the destabilized odontoid fracture complex (P<0.05). There was no statistically significant difference in stability among the four screw techniques. We concluded that the first three fixation techniques are recommended to be used as surgical intervention for odontoid fracture, while the last can be used as supplementary for the former three methods. PMID:26309508

  10. The use of augmentation techniques in osteoporotic fracture fixation.

    PubMed

    Kammerlander, Christian; Neuerburg, Carl; Verlaan, Jorrit-Jan; Schmoelz, Werner; Miclau, Theodore; Larsson, Sune

    2016-06-01

    There are an increasing number of fragility fractures, which present a surgical challenge given the reduced bone quality of underlying osteoporosis. Particularly in aged patients, there is a need for early weight bearing and mobilization to avoid further complications such as loss of function or autonomy. As an attempt to improve fracture stability and ultimate healing, the use of biomaterials for augmentation of osseous voids and fracture fixation is a promising treatment option. Augmentation techniques can be applied in various locations, and fractures of the metaphyseal regions such as proximal humerus, femur, tibia and the distal radius remain the most common areas for its use. The current review, based on the available mechanical and biological data, provides an overview of the relevant treatment options and different composites used for augmentation of osteoporotic fractures. PMID:27338226

  11. Computer-vision-based registration techniques for augmented reality

    NASA Astrophysics Data System (ADS)

    Hoff, William A.; Nguyen, Khoi; Lyon, Torsten

    1996-10-01

    Augmented reality is a term used to describe systems in which computer-generated information is superimposed on top of the real world; for example, through the use of a see- through head-mounted display. A human user of such a system could still see and interact with the real world, but have valuable additional information, such as descriptions of important features or instructions for performing physical tasks, superimposed on the world. For example, the computer could identify and overlay them with graphic outlines, labels, and schematics. The graphics are registered to the real-world objects and appear to be 'painted' onto those objects. Augmented reality systems can be used to make productivity aids for tasks such as inspection, manufacturing, and navigation. One of the most critical requirements for augmented reality is to recognize and locate real-world objects with respect to the person's head. Accurate registration is necessary in order to overlay graphics accurately on top of the real-world objects. At the Colorado School of Mines, we have developed a prototype augmented reality system that uses head-mounted cameras and computer vision techniques to accurately register the head to the scene. The current system locates and tracks a set of pre-placed passive fiducial targets placed on the real-world objects. The system computes the pose of the objects and displays graphics overlays using a see-through head-mounted display. This paper describes the architecture of the system and outlines the computer vision techniques used.

  12. Easy and Inexpensive Technique for Removal of Round Headed, Jammed Locking Screws in Distal Tibial Interlocking Plate

    PubMed Central

    Singh, Harpreet; Sharma, Rohit; Gupta, Sachin; Singh, Narinderjit; Singh, Simarpreet

    2015-01-01

    Introduction: The advent of locking plates has brought new problems in implant removal. Difficulty in removing screws from a locking plate is well-known. These difficulties include cold welding between the screw head and locking screw hole, stripping of the recess of the screw head for the screwdriver, and cross-threading between threads in the screw head and screw hole. However, there are cases in which removal is difficult. We describe a new technique for removing a round headed, jammed locking screws from a locking plate. Case Report: 55 years old male patient received a locking distal tibial plate along with distal fibular plate 3years back from UAE. Now patient came with complaint of non-healing ulcer over medial aspect of lower 1/3rd of right leg from past 1 year. Non operative management did not improve the symptoms. The patient consented to implant removal, with the express understanding that implant removal might be impossible because already one failed attempt had been performed at some other hospital six months back. We then decided to proceed with the new technique. The rest of the proximal screws were removed using a technique not previously described. We used stainless steel metal cutting blades that are used to cut door locks or pad locks to cut the remaining stripped headed screws. Conclusion: This technique is very quick, easy to perform and inexpensive because the metal cutting blades which are used to cut the screws are very cheap. Yet it is very effective technique to remove the stripped headed or jammed locking screws. It is also very less destructive because of very less heat production during the procedure there is no problem of thermal necrosis to the bone or the surrounding soft tissue. PMID:27299064

  13. Biomechanical Comparison of Pedicle Screw Augmented with Different Volumes of Polymethylmethacrylate in Osteoporotic and Severely Osteoporotic Synthetic Bone Blocks in Primary Implantation: An Experimental Study

    PubMed Central

    Liu, Da; Zhang, Xiao-jun; Liao, Dong-fa; Zhou, Jiang-jun; Li, Zhi-qiang; Zhang, Bo; Wang, Cai-ru; Lei, Wei; Kang, Xia; Zheng, Wei

    2016-01-01

    This study was designed to compare screw stabilities augmented with different volumes of PMMA and analyze relationship between screw stability and volume of PMMA and optimum volume of PMMA in different bone condition. Osteoporotic and severely osteoporotic synthetic bone blocks were divided into groups A0-A5 and B0-B5, respectively. Different volumes of PMMA were injected in groups A0 to A5 and B0 to B5. Axial pullout tests were performed and Fmax was measured. Fmax in groups A1-A5 were all significantly higher than group A0. Except between groups A1 and A2, A3 and A4, and A4 and A5, there were significant differences on Fmax between any other two groups. Fmax in groups B1-B5 were all significantly higher than group B0. Except between groups B1 and B2, B2 and B3, and B4 and B5, there were significant differences on Fmax between any other two groups. There was significantly positive correlation between Fmax and volume of PMMA in osteoporotic and severely osteoporotic blocks. PMMA can significantly enhance pedicle screw stability in osteoporosis and severe osteoporosis. There were positive correlations between screw stability and volume of PMMA. In this study, injection of 3 mL and 4 mL PMMA was preferred in osteoporotic and severely osteoporotic blocks, respectively. PMID:26885525

  14. Double-Step Image Superimposition Technique for Fabricating a Drilling Guide to Access the Abutment Screw in Implant Prostheses.

    PubMed

    Mai, Hang-Nga; Kim, Kyung-Rok; Lee, Du-Hyeong

    2016-01-01

    Limited retrievability is a major disadvantage of cement-retained implant restorations. Despite great progress in locating the abutment screw within crowns, the existing techniques are based on prior data or prefabricated devices and require significant work. This study introduces a new procedure for fabricating a guide template to drill a screw access hole using a double-step superimposition technique that incorporates intraoral optical scanning, cone beam computed tomography, and dental design software. The double-step superimposition technique with computer-aided design/computer-assisted manufacturing technology can enhance the convenience and accuracy of drilling the screw-access hole. PMID:27479352

  15. A laboratory investigation to assess the influence of cement augmentation of screw and plate fixation in a simulation of distal femoral fracture of osteoporotic and non-osteoporotic bone.

    PubMed

    Wähnert, D; Lange, J H; Schulze, M; Gehweiler, D; Kösters, C; Raschke, M J

    2013-10-01

    The augmentation of fixation with bone cement is increasingly being used in the treatment of severe osteoporotic fractures. We investigated the influence of bone quality on the mechanics of augmentation of plate fixation in a distal femoral fracture model (AO 33 A3 type). Eight osteoporotic and eight non-osteoporotic femoral models were randomly assigned to either an augmented or a non-augmented group. Fixation was performed using a locking compression plate. In the augmented group additionally 1 ml of bone cement was injected into the screw hole before insertion of the screw. Biomechanical testing was performed in axial sinusoidal loading. Augmentation significantly reduced the cut-out distance in the osteoporotic models by about 67% (non-augmented mean 0.30 mm (sd 0.08) vs augmented 0.13 mm (sd 0.06); p = 0.017). There was no statistical reduction in this distance following augmentation in the non-osteoporotic models (non-augmented mean 0.15 mm (sd 0.02) vs augmented 0.15 mm (sd 0.07); p = 0.915). In the osteoporotic models, augmentation significantly increased stability (p = 0.017). PMID:24078541

  16. Augmented PMMA distribution: improvement of mechanical property and reduction of leakage rate of a fenestrated pedicle screw with diameter-tapered perforations.

    PubMed

    Tan, Quan-Chang; Wu, Jian-Wei; Peng, Fei; Zang, Yuan; Li, Yang; Zhao, Xiong; Lei, Wei; Wu, Zi-Xiang

    2016-06-01

    OBJECTIVE This study investigated the optimum injection volume of polymethylmethacrylate (PMMA) to augment a novel fenestrated pedicle screw (FPS) with diameter-tapered perforations in the osteoporotic vertebral body, and how the distribution characteristics of PMMA affect the biomechanical performance of this screw. METHODS Two types of FPSs were designed (FPS-A, composed of 6 perforations with an equal diameter of 1.2 mm; and FPS-B, composed of 6 perforations each with a tapered diameter of 1.5 mm, 1.2 mm, and 0.9 mm from tip to head. Each of 28 human cadaveric osteoporotic vertebrae were randomly assigned to 1 of 7 groups: FPS-A1.0: FPS-A+1.0 ml PMMA; FPS-A1.5: FPS-A+1.5 ml PMMA; FPS-A2.0: FPS-A+2.0 ml PMMA; FPS-B1.0: FPS-B+1.0 ml PMMA; FPS-B1.5: FPS-B+1.5 ml PMMA; FPS-B2.0: FPS-B+2.0 ml PMMA; and conventional pedicle screws (CPSs) without PMMA. After the augmentation, 3D CT was performed to assess the cement distribution characteristics and the cement leakage rate. Axial pullout tests were performed to compare the maximum pullout force thereafter. RESULTS The CT construction images showed that PMMA bone cement formed a conical mass around FPS-A and a cylindrical mass around FPS-B. When the injection volume was increased from 1.0 ml to 2.0 ml, the distribution region of the PMMA cement was enlarged, the PMMA was distributed more posteriorly, and the risk of leakage was increased. When the injection volume reached 2.0 ml, the risk of cement leakage was lower for screws having diameter-tapered perforations. The pullout strengths of the augmented FPS-A groups and FPS-B groups were higher than that of the CPS group (p < 0.0001). All FPS-B groups had a higher pullout strength than the FPS-A groups. CONCLUSIONS The diameter of the perforations affects the distribution of PMMA cement. The diameter-tapered design enabled PMMA to form larger bone-PMMA interfaces and achieve a relatively higher pullout strength, although statistical significance was not reached. Study

  17. Cortical and Standard Trajectory Pedicle Screw Fixation Techniques in Stabilizing Multisegment Lumbar Spine with Low Grade Spondylolisthesis

    PubMed Central

    İnceoğlu, Serkan

    2015-01-01

    Background Cortical screw (CS) fixation has been recently proposed as an alternative to the standard pedicle screw (PS) fixation technique. Biomechanical studies involving individual screw pullout and single level motion segment stabilization showed comparable performance of both techniques. However, whether this new fixation technique can be applied to the stabilization of multilevel lumbar segments with significant destabilization has been unclear. Purpose To compare stability of CS fixation to the traditional PS fixation in an unstable 3 level spondylolisthesis model. Study Design This is a biomechanical study comparing cortical trajectory pedicle screw fixation to traditional trajectory pedicle screw fixation in an unstable cadaveric model using nondestructive flexibility test. Methods Eight fresh frozen cadaveric lumbar spines (T12- S1) were obtained. After intact baseline testing, a 3-level lowgrade spondylolisthesis was simulated at the L1-4. Each specimen was instrumented with the PS and CS fixation systems. Standard nondestructive flexibility test was performed. Range of motion at each level was compared between the constructs during flexion-extension, lateral bending, and axial rotation. Results The destabilization model significantly increased the ROM in all planes (P<0.05). Both fixation techniques provided significant reduction in the ROM (P<0.05). There was no significant difference in ROM between the PS and CS groups in any of planes (P>0.05). Conclusions Cortical trajectory pedicle screw fixation provided stabilization to multilevel lumbar segment with low-grade spondylolisthesis comparable to the standard trajectory pedicle screw construct. PMID:26484009

  18. Unilateral lag-screw technique for an isolated anterior 1/4 atlas fracture

    PubMed Central

    Keskil, Semih; Göksel, Murat; Yüksel, Ulaş

    2016-01-01

    Study Design: Fractures of the atlas are classified based on the fracture location and associated ligamentous injury. Among patients with atlas fractures treated using external immobilization, nonunion of the fracture could be seen. Objective: Ideally, treatment strategy for an unstable atlas fracture would involve limited fixation to maintain the fracture fragments in a reduced position without restricting the range of motion (ROM) of the atlantoaxial and atlantooccipital joints. Summary of Background Data: Such a result can be established using either transoral limited internal fixation or limited posterior lateral mass fixation. However, due to high infection risk and technical difficulty, posterior approaches are preferred but none of these techniques can fully address anterior 1/4 atlas fractures such as in this case. Materials and Methods: A novel open and direct technique in which a unilateral lag screw was placed to reduce and stabilize a progressively widening isolated right-sided anterior 1/4 single fracture of C1 that was initially treated with a rigid cervical collar is described. Results: Radiological studies made after the surgery showed no implant failure, good cervical alignment, and good reduction with fusion of C1. Conclusions: It is suggested that isolated C1 fractures can be surgically reduced and immobilized using a lateral compression screw to allow union and maintain both C1-0 and C1-2 motions, and in our knowledge this is the first description of the use of a lag screw to achieve reduction of distracted anterior 1/4 fracture fragments of the C1 from a posterior approach. This technique has the potential to become a valuable adjunct to the surgeon's armamentarium, in our opinion, only for fractures with distracted or comminuted fragments whose alignment would not be expected to significantly change with classical lateral mass screw reduction. PMID:27041886

  19. Lateral Ridge Augmentation with Autogenous Bone Harvested Using Trephine Drills: A Noninvasive Technique

    PubMed Central

    Arab, H. R.; Moeintaghavi, A.; Taheri, M.; Sargolzaie, N.; Aghasizadeh, D.; Shiezadeh, F.

    2016-01-01

    Purpose: The aim of this pilot study was to evaluate the success rate of a chairside ridge augmentation procedure using bone autografts harvested with trephine drills and placed without the use of screws. Methods: Thirty patients were recruited for the study. After the surgical site was anesthetized and a crestal incision was made, an envelope flap was retracted using blunt dissection limited to the graft site, and the periosteum was raised intact and undamaged from the bone. The flap was extended laterally to obtain sufficient space for the bone graft. At the donor site, bone was obtained from the external oblique ridge area. A #5 or #6 trephine drill was used to harvest one or two pieces of bone. The bone blocks were placed inside the envelope flap at the recipient site, which was then sutured and covered with periodontal dressing. Antibiotics, analgesics, and mouthwash were prescribed. Measurements of ridge width were performed using CBCT before and 3 months after surgery. The pre- and post operative results were compared using paired t test. Results: Pre- and post-operative mean ridge widths were 2.23 ± 0.79 and 5.16 ± 0.68 mm, respectively. The mean increase in width was 2.92 ± 0.89 mm(P < 0.001). Conclusion: This non-invasive and simple technique provided an acceptable increase in ridge width. As the sample was small, we recommend further clinical investigation with larger samples to confirm that this technique may be used successfully as an alternative to current invasive augmentation methods. PMID:27006718

  20. A comparative study of pedicle screw fixation in dorsolumbar spine by freehand versus image-assisted technique: A cadaveric study

    PubMed Central

    Agarwal, Archit; Chauhan, Vijendra; Singh, Deepa; Shailendra, Raghuvanshi; Maheshwari, Rajesh; Juyal, Anil

    2016-01-01

    Background: New and expensive technology such as three-dimensional computer assisted surgery is being used for pedicle screw fixation in dorsolumbar spine. Their availability, expenses and amount of radiation exposure are issues in a developing country. On the contrary, freehand technique of pedicle screw placement utilizes anatomic landmarks and tactile palpation without fluoroscopy or navigation to place pedicle screws. The purpose of this study was to analyze and compare the accuracy of freehand and image-assisted technique to place pedicle screws in the dorsolumbar spine of cadavers by an experienced surgeon and a resident. Evaluation was done using dissection of pedicle and computed tomography (CT) imaging. Materials and Methods: Ten cadaveric dorsolumbar spines were exposed by a posterior approach. Titanium pedicle screws were inserted from D5 to L5 vertebrae by freehand and image-assisted technique on either side by an experienced surgeon and a resident. CT was obtained. A blinded radiologist reviewed the imaging. The spines were then dissected to do a macroscopic examination. Screws, having evidence of cortical perforation of more than 2 mm on CT, were considered to be a significant breach. Results: A total of 260 pedicle screws were placed. The surgeon and the resident placed 130 screws each. Out of 130 screws, both of them placed 65 screws each by freehand and image- assisted technique each. The resident had a rate of 7.69% significant medial and 10.76% significant lateral breach with freehand technique while with image-assisted had a rate of 3.07% significant medial and 9.23% significant lateral breach. The expert surgeon had a rate of 6.15% significant medial and 1.53% significant lateral breach with freehand technique while with image-assisted had a rate of 3.07% significant medial and 6.15% significant lateral breach on CT evaluation. Conclusion: Freehand technique is as good as the image-assisted technique. Under appropriate supervision, residents

  1. The Use of MMF Screws: Surgical Technique, Indications, Contraindications, and Common Problems in Review of the Literature

    PubMed Central

    Cornelius, Carl-Peter; Ehrenfeld, Michael

    2010-01-01

    Mandibulo-maxillary fixation (MMF) screws are inserted into the bony base of both jaws in the process of fracture realignment and immobilisation. The screw heads act as anchor points to fasten wire loops or rubber bands connecting the mandible to the maxilla. Traditional interdental chain-linked wiring or arch bar techniques provide the anchorage by attached cleats, hooks, or eyelets. In comparison to these tooth-borne appliances MMF screws facilitate and shorten the way to achieve intermaxillary fixation considerably. In addition, MMF screws help to reduce the hazards of glove perforation and wire stick injuries. On the downside, MMF screws are attributed with the risk of tooth root damage and a lack of versatility beyond the pure maintenance of occlusion such as stabilizing loose teeth or splinting fragments of the alveolar process. The surgical technique of MMF screws as well as the pros and cons of the clinical application are reviewed. The adequate screw placement to prevent serious tooth root injuries is still an issue to rethink and modify conceptual guidelines. PMID:22110819

  2. New Technique for C1 Double-Door Laminoplasty Using Allograft Spacers and Titanium Miniplate Screw Fixation: Technical Report.

    PubMed

    Kim, Seok Woo; Lee, Jae-Hoo; Lee, Ho-Won; Oh, Jae-Keun; Kwak, Yoon-Hae

    2016-03-01

    Although conventional C1 laminectomy is the gold standard for decompression at the atlas, it provides little space for the bone graft to fuse. The fusion area can be extended cranially up to the occipital bone, but it requires sacrificing the function of the craniocervical junction. To date, no reports have focused on surgical techniques for successful decompression and fusion without disruption of the posterior C1 arch while providing enough room for the bone graft to fuse. This study introduces a new technique for C1-C2 fusion and C1 double-door laminoplasty in patients with C1-C2 instability, canal stenosis, and cervical spondylotic myelopathy. A 66-year-old man who had undergone C1-C2 fusion at a local clinic 2 years earlier visited our hospital due to progressive myelopathy. A preoperative computed tomography (CT) scan showed the tip of the odontoid process, extending into the spinal canal. On the axial view of T2-weighted magnetic resonance images, the tip of the odontoid process significantly compressed the spinal cord on the left side. The atlantodental interval was 7 mm on radiography; however, C1-C2 instability was not evident on flexion-extension X-rays due to the previous screw fixation. The patient underwent C1-C2 decompression and fusion surgery with our new surgical technique. The segmental screws were repositioned at C1 and C2, and we performed C1 double-door laminoplasty augmented with an allograft spacer and a titanium miniplate. A marked reduction was seen at postoperative radiograph and CT scan. Neurologic symptoms were relieved dramatically after surgery without any discomfort. No complications were noted. We introduced a new surgical technique that allows bone grafting, decompression, and fusion to be performed without disruption of the posterior C1 arch in the event of C1-C2 canal stenosis combined with instability. This technique may be indicated for other conditions that cause instability and stenosis at the C1-C2 area. PMID:26689563

  3. The transosseous ACL Refixation and biological Augmentation "TARBA". Preliminary Results of a new Operation Technique

    PubMed Central

    Hinterwimmer, Stefan; Achten, Manfred; Bathish, Einal

    2016-01-01

    Aims and Objectives: Differentiated gradings of anterior cruciate ligament (ACL) tear-types allow us to perform a more and more differentiated treatment of this injury. Especially in the tears close to the insertion ACL preserving techniques like "healing response" together with growth factors or synthetic augmentations of the original ACL like the "dynamic intraligamentous stabilization DIS" have increasing importance. Disadvantages of the mentioned techniques are the limited indications and the high need of material. That led us to the development of the "transosseous ACL refixation and biological augmentation TARBA", in which the original ACL is refixed to the femoral insertion and augmented with the patient’s doubled gracilis tendon. In the following we will present the first results with this technique. Materials and Methods: From 12/2013 to 02/2015 we used this technique in 56 patients (28x m, 28x f, age 30.7years). All patients had ACL tears in the proximal third close to the femoral insertion. The original ACL was fixed arthroscopically with 2 PDS fibres. Those were pulled out of the femur through a 5mm channel. The original-ACL was augmented with a doubled ipsilateral gracilis tendon. This tendon graft was pulled into the joint via another tibial 5mm channel and fixed at the femur with an endobutton and at the tibia with a cortical anchor screw. Both channels were placed exactly adjacent to the centre of the femoral and tibial anatomic insertion sites. The treatment result was controlled after 3, 6, 9 and 12 months with clinical examination and various scores (patient satisfaction, VAS, Lysholm, Tegner, Activity Rating Scale). After 6 months an instrumented stability test (Rolimeter) was performed. All patients were matched with 47 patients who had a complete ACL tear treated with 4-strand stemitendinosus tendon (control group). Results: Until now all patients with "TARBA" were satisfied with their operation. The range of motion was equal to the healthy

  4. Clear Zone Formation around Screws in the Early Postoperative Stages after Posterior Lumbar Fusion Using the Cortical Bone Trajectory Technique

    PubMed Central

    Iwatsuki, Koichi; Ohnishi, Yu-Ichiro; Ohkawa, Toshika; Yoshimine, Toshiki

    2015-01-01

    Study Design Retrospective study. Purpose To evaluate the initial fixation using the cortical bone trajectory (CBT) technique for posterior lumbar fusion through assessment of the clear zones around the screws and the risk factors involved. Overview of Literature Postoperative radiolucent zones (clear zones) are an indicator of poor conventional pedicle screw fixation. Methods Between January 2013 and April 2014, 19 patients (8 men and 11 women) underwent posterior lumbar interbody fusion or posterior lumbar fusion using the CBT technique. A total of 109 screws were used for evaluation with measurement of the maximum insertional torque of last two screw rotations. Clear zone-positivity on plain radiographs was investigated 6 months after surgery. The relation between intraoperative insertional torque and clear zone-positivity was investigated by one-way analysis of variance. In addition, the correlation between clear zone-positivity and gender, age (<75 years old or >75 years old), or operative stabilization level (<2 or >3 vertebral levels) was evaluated using the chi-square test. Results Clear zones were observed around six screws (5.50%) in five patients (26.3%). The mean insertional torque (4.00±2.09 inlbs) of clear zone-positive screws was lower than that of clear zone-negative screws (8.12±0.50 in-lbs), but the difference was not significant. There was a significant correlation between clear zone-positivity and operative level of stabilization. Conclusions The low incidence of clear zone-positive screws indicates good initial fixation using the CBT technique. Multilevel fusions may be risk factors for clear zone generation. PMID:26713120

  5. Node Augmentation Technique in Bayesian Network Evidence Analysis and Marshaling

    SciTech Connect

    Keselman, Dmitry; Tompkins, George H; Leishman, Deborah A

    2010-01-01

    Given a Bayesian network, sensitivity analysis is an important activity. This paper begins by describing a network augmentation technique which can simplifY the analysis. Next, we present two techniques which allow the user to determination the probability distribution of a hypothesis node under conditions of uncertain evidence; i.e. the state of an evidence node or nodes is described by a user specified probability distribution. Finally, we conclude with a discussion of three criteria for ranking evidence nodes based on their influence on a hypothesis node. All of these techniques have been used in conjunction with a commercial software package. A Bayesian network based on a directed acyclic graph (DAG) G is a graphical representation of a system of random variables that satisfies the following Markov property: any node (random variable) is independent of its non-descendants given the state of all its parents (Neapolitan, 2004). For simplicities sake, we consider only discrete variables with a finite number of states, though most of the conclusions may be generalized.

  6. An Arthroscopic Technique for Long Head of Biceps Tenodesis With Double Knotless Screw.

    PubMed

    Su, Wei-Ren; Ling, Florence Y; Hong, Chih-Kai; Chang, Chih-Hsun; Chung, Kai-Chen; Jou, I-Ming

    2015-08-01

    Tenodesis of the long head of the biceps (LHB) is a frequently performed procedure during shoulder arthroscopy for the treatment of degenerative, traumatic, or inflammatory lesions of the LHB tendon. Arthroscopic techniques for LHB tenodesis using knotless screw techniques offer the advantage of circumventing the need for arthroscopic knot tying. In 2012 Song and Williams described a novel tenodesis technique that does not require any knot-tying procedures by using a knotless anchor. However, a single-anchor configuration may not offer adequate stabilization of the LHB tendon. Therefore we propose a modified method that uses a double knotless anchor that offers advantages over the single knotless anchor, such as an increase in the contact area between the tendon and bone to facilitate tendon-to-bone healing and strengthening of the tenodesis construct. PMID:26759780

  7. An Arthroscopic Technique for Long Head of Biceps Tenodesis With Double Knotless Screw

    PubMed Central

    Su, Wei-Ren; Ling, Florence Y.; Hong, Chih-Kai; Chang, Chih-Hsun; Chung, Kai-Chen; Jou, I-Ming

    2015-01-01

    Tenodesis of the long head of the biceps (LHB) is a frequently performed procedure during shoulder arthroscopy for the treatment of degenerative, traumatic, or inflammatory lesions of the LHB tendon. Arthroscopic techniques for LHB tenodesis using knotless screw techniques offer the advantage of circumventing the need for arthroscopic knot tying. In 2012 Song and Williams described a novel tenodesis technique that does not require any knot-tying procedures by using a knotless anchor. However, a single-anchor configuration may not offer adequate stabilization of the LHB tendon. Therefore we propose a modified method that uses a double knotless anchor that offers advantages over the single knotless anchor, such as an increase in the contact area between the tendon and bone to facilitate tendon-to-bone healing and strengthening of the tenodesis construct. PMID:26759780

  8. A technique for fabricating single screw-retained implant-supported interim crowns in conjunction with implant surgery.

    PubMed

    McRory, M Eric; Cagna, David R

    2014-06-01

    This article presents an intraoral technique for fabricating single screw-retained implant-supported interim crowns immediately after surgical implant placement in extraction sites. The technique may be used with any implant system that provides a provisional abutment or an open-tray impression coping that can be modified for use as a provisional abutment. PMID:24461941

  9. Capstan screw rotator cuff repair: a novel two-row mini-open technique

    PubMed Central

    Goubran, Alex; Jaques, Aishling; Smith, Christopher; Bunker, Tim

    2014-01-01

    Background Prospective data collection occurred between 2000 and 2010 on 143 consecutive patients with symptomatic rotator cuff tears, aiming to examine the end-result of a new technique of mini-open double row repair: the Capstan screw technique. Methods All patients had a pre- and postoperative Oxford Shoulder Score (OSS), American Shoulder and Elbow Surgeons (ASES) score and range of movement measurements. All were followed up for a minimum of 1 year with an exit questionnaire. Subscapularis repairs, small (<1 cm) and massive (>5 cm) supraspinatus repairs were excluded. Ninety-nine patients fitted the inclusion and exclusion criteria of whom 87 had a complete data set. Results The mean (SD) pre-operative OSS was 21.85 (8.6) and the mean (SD) postoperative OSS was 44.58 (5.2) (p < 0.0001). The mean (SD) pre-operative ASES score was 51.5 (19.4) and the mean (SD) postoperative ASES score was 86.42 (17.06) (p < 0.0001). Flexion improved from a mean of 119° to 170° (p < 0.0001). The clinical re-tear rate was 3.4% and the imaged re-tear rate was 6.8%. In total, 91% of patients were satisfied with the procedure. There were no deep infections and two (2%) minor wound infections. There was no single instance of deltoid dysfunction. Conclusions The Capstan screw technique represents a simple, rapid, strong and reliable mini-open technique.

  10. Technique and nuances of an S-2 alar iliac screw for lumbosacral fixation in patients with transitional and normal anatomy.

    PubMed

    Ohya, Junichi; Vogel, Todd D; Dhall, Sanjay S; Berven, Sigurd; Mummaneni, Praveen V

    2016-07-01

    S-2 alar iliac (S2AI) screw fixation has recently been recognized as a useful technique for pelvic fixation. The authors demonstrate two cases where S2AI fixation was indicated: one case was a sacral insufficiency fracture following a long-segment fusion in a patient with a transitional S-1 vertebra; the other case involved pseudarthrosis following lumbosacral fixation. S2AI screws offer rigid fixation, low profile, and allow easy connection to the lumbosacral rod. The authors describe and demonstrate the surgical technique and nuances for the S2AI screw in a case with transitional S-1 anatomy and in a case with normal S-1 anatomy. The video can be found here: https://youtu.be/Sj21lk13_aw . PMID:27364429

  11. Percutaneous Transpedicular Interbody Fusion Technique in Percutaneous Pedicle Screw Stabilization for Pseudoarthrosis Following Pyogenic Spondylitis

    PubMed Central

    Masuda, Keigo; Yonekura, Yutaka; Kitamura, Takahiro; Senba, Hideyuki; Shidahara, Satoshi

    2016-01-01

    This report introduces a percutaneous transpedicular interbody fusion (PTPIF) technique in posterior stabilization using percutaneous pedicle screws (PPSs). An 81-year-old man presented with pseudoarthrosis following pyogenic spondylitis 15 months before. Although no relapse of infection was found, he complained of obstinate low back pain and mild neurological symptoms. Radiological evaluations showed a pseudoarthrosis following pyogenic spondylitis at T11–12. Posterior stabilization using PPSs from Th9 to L2 and concomitant PTPIF using autologous iliac bone graft at T11–12 were performed. Low back pain and neurological symptoms were immediately improved after surgery. A solid interbody fusion at T11–12 was completed 9 months after surgery. The patient had no restriction of daily activity and could play golf at one year after surgery. PTPIF might be a useful option for perform segmental fusion in posterior stabilization using PPSs. PMID:27114777

  12. Percutaneous Transpedicular Interbody Fusion Technique in Percutaneous Pedicle Screw Stabilization for Pseudoarthrosis Following Pyogenic Spondylitis.

    PubMed

    Ikuta, Ko; Masuda, Keigo; Yonekura, Yutaka; Kitamura, Takahiro; Senba, Hideyuki; Shidahara, Satoshi

    2016-04-01

    This report introduces a percutaneous transpedicular interbody fusion (PTPIF) technique in posterior stabilization using percutaneous pedicle screws (PPSs). An 81-year-old man presented with pseudoarthrosis following pyogenic spondylitis 15 months before. Although no relapse of infection was found, he complained of obstinate low back pain and mild neurological symptoms. Radiological evaluations showed a pseudoarthrosis following pyogenic spondylitis at T11-12. Posterior stabilization using PPSs from Th9 to L2 and concomitant PTPIF using autologous iliac bone graft at T11-12 were performed. Low back pain and neurological symptoms were immediately improved after surgery. A solid interbody fusion at T11-12 was completed 9 months after surgery. The patient had no restriction of daily activity and could play golf at one year after surgery. PTPIF might be a useful option for perform segmental fusion in posterior stabilization using PPSs. PMID:27114777

  13. Treatment of Unstable Thoracolumbar Fractures through Short Segment Pedicle Screw Fixation Techniques Using Pedicle Fixation at the Level of the Fracture: A Finite Element Analysis

    PubMed Central

    Li, Changqing; Zhou, Yue; Wang, Hongwei; Liu, Jun; Xiang, Liangbi

    2014-01-01

    Objective To compare the von Mises stresses of the internal fixation devices among different short segment pedicle screw fixation techniques to treat thoracic 12 vertebral fractures, especially the mono-segment pedicle screw fixation and intermediate unilateral pedicle screw fixation techniques. Methods Finite element methods were utilised to investigate the biomechanical comparison of the four posterior short segment pedicle screw fixation techniques (S4+2: traditional short-segment 4 pedicle screw fixation [SPSF]; M4+2: mono-segment pedicle screw fixation; I6+2: intermediate bilateral pedicle screw fixation; and I5+2: intermediate unilateral pedicle screw fixation). Results The range of motion (ROM) in flexion, axial rotation, and lateral bending was the smallest in the I6+2 fixation model, followed by the I5+2 and S4+2 fixation models, but lateral bending was the largest in the M4+2 fixation model. The maximal stress of the upper pedicle screw is larger than the lower pedicle screw in S4+2 and M4+2. The largest maximal von Mises stress was observed in the upper pedicle screw in the S4+2 and M4+2 fixation models and in the lower pedicle screw in the I6+2 and I5+2 fixation models. The values of the largest maximal von Mises stress of the pedicle screws and rods during all states of motion were 263.1 MPa and 304.5 MPa in the S4+2 fixation model, 291.6 MPa and 340.5 MPa in the M4+2 fixation model, 182.9 MPa and 263.2 MPa in the I6+2 fixation model, and 269.3 MPa and 383.7 MPa in the I5+2 fixation model, respectively. Comparing the stress between different spinal loadings, the maximal von Mises stress of the implants were observed in flexion in all implanted models. Conclusion Additional bilateral pedicle screws at the level of the fracture to SPSF may result in a stiffer construct and less von Mises stress for pedicle screws and rods. The largest maximal von Mises stress of the pedicle screws during all states of motion were observed in the mono-segment pedicle

  14. Soft tissue fixation with a cortical button and interference screw: a novel technique in foot and ankle surgery.

    PubMed

    Shinabarger, Andrew B; Manway, Jeffrey M; Nowak, Jessica; Burns, Patrick R

    2015-02-01

    Tendon transfers are commonly performed procedures in the foot and ankle. They have been described for multiple tendons and a myriad of pathologies. One issue with these procedures has always been inadequate fixation with several methods available to the surgeon. In this report, we describe a novel technique in foot and ankle surgery using a cortical button and an interference screw. PMID:25534315

  15. A Technique Elucidating the Retrieval of an Adhered Cover Screw in a Dental Implant – A Case Report

    PubMed Central

    Bhuvaneswarri, J.; Chandrasekaran, S.C.

    2013-01-01

    Dental implants have become one of the most popular and rapidly growing techniques for replacing missing teeth. While their predictability, functionality, and durability make them an attractive option for patients and clinicians alike, complications can arise at any stage from patient assessment to maintenance of therapy. Failure of dental implants not only occurs due to biological factors, like unsuccessful osseointegration or peri-implantitis but may also occur due to technical complications like, failures of implant-supported restorations relating those from the implant components, and those relating to the prosthesis. Technical problems related to implant components include abutment screw fractures and cover screw fractures. In this case report we have elucidated an adhered cover screw in an implant. PMID:24392429

  16. Biomechanical Comparison Between Bashti Bone Plug Technique and Biodegradable Screw for Fixation of Grafts in Ligament surgery

    PubMed Central

    Bashti, Kaveh; Tahmasebi, Mohammad N; Kaseb, Hasan; Farahmand, Farzam; Akbar, Mohammad; Mobini, Amir

    2015-01-01

    Background: Ligament reconstruction is a common procedure in orthopedic surgery. Although several popular techniques are currently in use, new methods are proposed for secure fixation of the tendon graft into the bone tunnel. Purposes: We sought to introduce our new technique of Bashti bone plug for fixation of soft tissue graft in anterior cruciate ligament (ACL) reconstruction and to compare its biomechanical features with conventional absorbable interference screw technique in a bovine model. Methods: Twenty pairs of bovine knees were harvested after death. Soft tissue was removed and the Achilles tendon was harvested to be used as an ACL graft. It was secured into the bone tunnel on the tibial side via two different methods: Bashti Bone Plug technique and conventional screw method. Biomechanical strength was measured using 200 N and 300 N cyclic loading on the graft. Pull out strength was also tested until the graft fails. Results: No graft failure was observed after 200 N and 300 N cyclic loading in either fixation methods. When testing for pull out failure, 21 tendons (53%) were torn and 19 tendons (48%) slipped out. No fixation failure occurred, which did not reveal a significant difference between the bone plug or interference screw group (P=0.11). The mean pull out force until failure of the graft was 496±66 N in the screw group and 503±67 N in the bone plug group (P=0.76). Conclusions: Our suggested fixation technique of Bashti bone plug is a native, cheap, and feasible method that provides comparable biomechanical strength with interference screw when soft tissue fixation was attempted in bovine model. PMID:25692166

  17. Feasibility Study of Free-Hand Technique for Pedicle Screw Insertion at C7 without Fluoroscopy-Guidance

    PubMed Central

    Lee, Gun Woo; Kim, Ho-Joong; Yeom, Jin S.; Uh, Jae-Hyung; Park, Jong-Ho; Lee, Ji-Hoon; Kim, Dong-Wook

    2016-01-01

    Study Design Retrospective interventional study. Purpose To introduce a free-hand pedicle screw (PS) insertion technique without fluoroscopic guidance in the C7 vertebra and evaluate the procedure's feasibility and radiologic outcomes. Overview of Literature Although PS insertion at C7 has been recognized as a critical procedure in posterior cervical fusion surgery, conventional techniques for C7 PS have several limitations. Methods Thirty two patients (64 screws) who underwent PS insertion in C7 with the novel technique were included in this study. Postoperative clinical and radiological outcomes were evaluated. Special attention was paid to the presence of any problems in the screw position including cortical breaches of the PS and encroachment of the PS into the spinal canal or the vertebral foramen. This novel technique for PS insertion in C7 without fluoroscopy guidance had three key elements. First, the ideal PS entry point was chosen near the C6–7 facet joint using preoperative images. Second, the convergent angle distance was measured at axial computed tomography (CT) imaging, which defined the distance between the tip of C7 spinous process and the extended line passing through the pedicle axis from the ideal entry point. Third, the cranial-caudal angle distance was measured in sagittal CT images, which defined the distance between the tip of the C7 spinous process and the extended line passing through the pedicle axis. Results Cortical breach on postoperative CT images was observed in three screws. All violated only the lateral wall of the affected pedicle. The breached screws occurred in the initial five cases. Postoperative neurologic deterioration was not observed in any patient, regardless of cortical breaching. Conclusions The novel technique successfully allows for C7 PS to be placed and is associated with a low rate of cortical breach. PMID:26949456

  18. Detecting Syntactic Ambiguity: Three Augmented Transition Network Techniques.

    ERIC Educational Resources Information Center

    Herman, L. Russell, Jr.

    When a grammar is expressed in augmented transition network (ATN) form, the problem of detecting syntactic ambuguity reduces to finding all possible paths through the ATNs. Each successfully terminating path through the ATN generates an acceptable parsing of the input string. Two ATN forms, minimal-node and pseudo-tree, are described along with…

  19. All-Arthroscopic Patch Augmentation of a Massive Rotator Cuff Tear: Surgical Technique

    PubMed Central

    Chalmers, Peter N.; Frank, Rachel M.; Gupta, Anil K.; Yanke, Adam B.; Trenhaile, Scott W.; Romeo, Anthony A.; Bach, Bernard R.; Verma, Nikhil N.

    2013-01-01

    Surgical management of massive rotator cuff tears remains challenging, with failure rates ranging from 20% to 90%. Multiple different arthroscopic and open techniques have been described, but there is no current gold standard. Failure after rotator cuff repair is typically multifactorial; however, failure of tendon-footprint healing is often implicated. Patch augmentation has been described as a possible technique to augment the biology of rotator cuff repair in situations of compromised tendon quality and has shown promising short-term results. The purpose of this article is to describe our preferred surgical technique for arthroscopic rotator cuff repair with patch augmentation. PMID:24400198

  20. Comparison of pullout strength of the thoracic pedicle screw between intrapedicular and extrapedicular technique: a meta-analysis and literature review

    PubMed Central

    Wang, Hua; Wang, Huafeng; Sribastav, Shilabant Sen; Ye, Fubiao; Liang, Chunxiang; Li, Zemin; Wang, Jianru; Liu, Hui; Wang, Xin; Zheng, Zhaomin

    2015-01-01

    Background: Intrapedicular fixation in thoracic spine is often limited, because of high risk of complication, especially in scoliosis patients. Extrapedicular screws fixation techniques provide an alternate solution for extremely small or abnormal thoracic pedicles deformity. However, the pullout resistance of extrapedicular screws has not been clearly defined. The aim of our study was to systematically review the existing evidence regarding the pullout resistance of thoracic extrapedicular screws compared with intrapedicular screws. Methods: A systematic search of all studies published through Nov 2014 was performed using Medline, EMBASE, OVID and other databases. All studies that compared the pullout resistance of thoracic extrapedicular screws with intrapedicular screws were selected. The data from the included studies were extracted and analyzed regarding pullout resistance force. Forest plots were constructed to summarize the data and compare the biomechanical stability achieved. Results: Five studies were included, with a total of 27 cadaveric specimens and 313 screws. The vertebral levels of the cadavers potted were T1-T8, T2-T12, T7-T9, T6-T11 and T4-T12 respectively. Overall, the results demonstrated that there was no significant difference in ultimate pullout strength between intrapedicular screws and extrapedicular screws (95% CI=-63.73 to 27.74; P=0.44); extrapedicular screws significantly increased the length of placements by a mean of 6.24 mm (95% CI=5.38 to 7.10; P<0.001); while the stiffness in intrapedicular screws was significantly stronger by a mean of 45.82 N/mm compared with extrapedicular screws (95% CI=-70.09 to -21.56; P<0.001). Conclusions: Meta-analysis of the existing literature showed that thoracic extrapedicular screws provided comparable but slightly lower pullout strength compared with intrapedicular screws, extrapedicular screws placement is much safer than intrapedicular screws. So thoracic extrapedicular screws offer a good

  1. Use of a Percutaneous Pointed Reduction Clamp Before Screw Fixation to Prevent Gapping of a Fifth Metatarsal Base Fracture: A Technique Tip.

    PubMed

    Tan, Eric W; Cata, Ezequiel; Schon, Lew C

    2016-01-01

    Intramedullary screw fixation has become widely accepted as the standard of care for operative treatment of Jones fractures, allowing not only accelerated rehabilitation but also reduction of the risk of repeat fracture. The unique anatomy of the fifth metatarsal--mainly its inherent lateral curvature--makes fixation technically challenging. In general, surgical fixation should be performed with the largest screw possible, in both diameter and length, which will provide the strongest possible construct. However, an increased screw length and width have been associated with complications, including lateral gapping and distraction of the fracture site and malreduction of the fracture. The use of a pointed reduction clamp is a simple, yet effective, method of preventing iatrogenic displacement and gapping at the fracture site during placement of an intramedullary screw. Percutaneous reduction and stabilization of the fracture using this technique could help limit the complications associated with large screw fixation of Jones fractures. PMID:26188626

  2. Ultrafast bandgap technique: light-induced semiconductor augmentation

    NASA Astrophysics Data System (ADS)

    Zakharova, I. K.; Rafailov, M. K.

    2014-06-01

    Bleaching by ultra-short pulses is discussed as an opportunity for semiconductor optical augmentation. The ability of ultra-short laser pulse to excite and remove electrons in-bulk from valence band may be used to prevent generation of thermal electrons for extended period of time. That time is correlated with recombination time. Diminishing the number of electrons that are available for thermal excitation leads to thermal noise reduction in the same way as semiconductor cooling. Technology based on the effect may be used as effective alternative to thermal cooling, and may allow some semiconductors effectively be exploited at ambient temperatures. Specifically, high sensitive and fast detectors as well as semiconductor lasers covering long and very long-wavelengths may actually work without extra cooling., needed to reduce thermal noise. In this paper, we will consider the effects caused by relatively low pulse energy ultra-short pulse lasers.

  3. The Use of On Line Video Projection Techniques in Computer Augmented Lectures.

    ERIC Educational Resources Information Center

    Muller, M. T.; And Others

    A new technique called computer augmented lectures (CAL) now in use at the University of Texas at Austin is discussed in this report. The technique is described as involving the integration of on-line interactive time-sharing computer terminals and theater-size video projectors for large screen display, the goal being to promote student learning…

  4. The bone lamina technique: a novel approach for lateral ridge augmentation--a case series.

    PubMed

    Wachtel, Hannes; Fickl, Stefan; Hinze, Marc; Bolz, Wolfgang; Thalmair, Tobias

    2013-01-01

    The goal of this case series is to present a novel treatment approach for lateral ridge augmentation. Four systemically healthy patients (aged 48 to 59 years) with inadequate dental alveolar ridge widths were selected for inclusion. All ridge defects were augmented using a xenogeneic cortical bone shield in combination with particulated bone substitutes and a thin collagen barrier. At baseline and after 6 months, digital cone beam computed tomography scans were performed. Biopsy specimens were harvested at reentry surgery and processed for histologic analysis. The results revealed a sufficient amount of bone structure for implant placement without additional augmentation procedures. The histologic analysis demonstrated that new bone formation had taken place and the bone shield had resorbed entirely. This case series indicates that the bone lamina technique has the biologic and mechanical properties to successfully achieve hard tissue augmentation of deficient ridges. PMID:23820709

  5. Improving IRT Parameter Estimates with Small Sample Sizes: Evaluating the Efficacy of a New Data Augmentation Technique

    ERIC Educational Resources Information Center

    Foley, Brett Patrick

    2010-01-01

    The 3PL model is a flexible and widely used tool in assessment. However, it suffers from limitations due to its need for large sample sizes. This study introduces and evaluates the efficacy of a new sample size augmentation technique called Duplicate, Erase, and Replace (DupER) Augmentation through a simulation study. Data are augmented using…

  6. Explosively driven hypervelocity launcher: Second-stage augmentation techniques

    NASA Technical Reports Server (NTRS)

    Baum, D. W.

    1973-01-01

    The results are described of a continuing study aimed at developing a two-stage explosively driven hypervelocity launcher capable of achieving projectile velocities between 15 and 20 km/sec. The testing and evaluation of a new cylindrical impact technique for collapsing the barrel of two-stage launcher are reported. Previous two-stage launchers have been limited in ultimate performance by incomplete barrel collapse behind the projectile. The cylindrical impact technique explosively collapses a steel tube concentric with and surrounding the barrel of the launcher. The impact of the tube on the barrel produces extremely high stresses which cause the barrel to collapse. The collapse rate can be adjusted by appropriate variation of the explosive charge and tubing parameters. Launcher experiments demonstrated that the technique did achieve complete barrel collapse and form a second-stage piston. However, jetting occurred in the barrel collapse process and was responsible for severe projectile damage.

  7. Injectable Filler Techniques for Facial Rejuvenation, Volumization, and Augmentation.

    PubMed

    Bass, Lawrence S

    2015-11-01

    Multiple fillers are available: various hyaluronic acid products, calcium hydroxylapatite, and a few others that are biocompatible with good duration and a variety of mechanical properties allowing intradermal, subdermal, and supraperiosteal injection. Facial features can be reshaped with great control using these fillers. Aging changes, including facial volume loss, can be well-corrected. These treatments have become a mainstay of rejuvenation in the early facial aging patient. Injection technique is critical to obtaining excellent results. Threading, fanning, cross-hatching, bleb, and pillar techniques must be mastered. Technical execution can only measure up to, but not exceed, the quality of the aesthetic analysis. PMID:26505544

  8. Chin augmentation using minimally invasive technique and bioplastique.

    PubMed

    Ersek, R A; Stovall, R B; Vazquez-Salisbury, A

    1995-05-01

    The plethora of problematic techniques for improving minor chin recessions has left the plastic surgeon inevitably uncertain of the most effective remedy. Research we began in 1968 has led us to the development of a new biphasic polymer and minimally invasive implantation techniques aimed at solving the soft-tissue deficiency dilemma. Bioplastique consists of inert, textured particles of critical dimension dispersed within a bioexcretable gel vehicle. Previous experimentation in rabbit ears has shown that the gel component is rapidly phagocytosed, excreted, and replaced by a fibrin matrix within 3 days. The matrix is then replaced by host collagen, gradually forming a stable encasement around each microparticle. Further evaluation has revealed that the implant resists migration and absorption. Based on these encouraging results, a clinical phase was initiated. Thirteen patients lacking chin prominence have subsequently been improved with Bioplastique implants. The infection rate was 0 percent, and other complications were minor. At 26 months, no evidence of migration or absorption has been observed, and the aesthetic results remain. PMID:7732146

  9. Arthroscopic technique for patch augmentation of rotator cuff repairs.

    PubMed

    Labbé, Marc R

    2006-10-01

    The patient is placed in the lateral position, and an arthroscopic cuff repair is performed according to standard techniques. The line of repair is usually in the shape of a "T" or an "L." The repair is viewed through the lateral portal, with fluid inflow through the scope. Mattress sutures are placed in the anterior and posterior portions of the cuff, with respect to the line of repair, just medial to the most medial point of the tear. The sutures are placed in accordance with margin convergence suture passing methods. Next, 2 double-stranded suture anchors are placed into the lateral aspect of the greater tuberosity, which can be used to secure the anterior and posterior portions of the rotator cuff as well as the patch. The cuff sutures are tied first; then, the patch is addressed. The graft is sized by placement of a ruled probe or similar device into the subacromial space. The length of each side of the "rectangle" is measured to obtain the dimensions of the patch. The patch is then cut to fit the measurements. If the patch material is elastic, a slightly smaller than measured graft is cut to provide tension on the repair. The arthroscope is then moved to the posterior portal, and a large (8 mm) cannula, with a dam, is placed into the lateral portal. All sutures are brought out of the lateral cannula, and corresponding ends of each suture are held together in a clamp. The sutures are placed in their respective orientations once outside the cannula (e.g., anterior-medial, anterior-lateral), covering all 4 quadrants. Care is taken to ensure that the sutures have no twists and are not wrapped around one another. The sutures are passed through the graft, in mattress fashion, with a free needle, in their respective corners and clamped again. The graft is then grasped with a small locking grasper on its medial edge and is passed through the cannula into the subacromial space. The clamps holding the sutures are then gently pulled to remove the slack. A smaller (5 mm

  10. Gluteal augmentation with fat grafting: the Brazilian buttock technique: 30 years' experience.

    PubMed

    Toledo, Luiz S

    2015-04-01

    The author started injecting large quantities of fat in the breasts, thighs, and buttocks in 1985. The Brazilian Buttock technique was first presented in 1987; since then, The author has been writing and lecturing about it worldwide. In the past few years, the technique became very popular; it has changed the ideal of beauty in many countries. Recently, The author started using adipose-derived stem cell-based therapies for buttock augmentation to improve the results of fat graft survival. PMID:25827567

  11. CT-based morphometric analysis of C1 laminar dimensions: C1 translaminar screw fixation is a feasible technique for salvage of atlantoaxial fusions

    PubMed Central

    Yew, Andrew; Lu, Derek; Lu, Daniel C.

    2015-01-01

    Background: Translaminar screw fixation has become an alternative in the fixation of the axial and subaxial cervical spine. We report utilization of this approach in the atlas as a salvage technique for atlantoaxial stabilization when C1 lateral mass screws are precluded. To assess the feasibility of translaminar fixation at the atlas, we have characterized the dimensions of the C1 lamina in the general adult population using computed tomography (CT)-based morphometry. Methods: A 46-year-old male with symptomatic atlantoaxial instability secondary to os odontoideum underwent bilateral C1 and C2 translaminar screw/rod fixation as C1 lateral mass fixation was precluded by an anomalous vertebral artery. The follow-up evaluation 2½ years postoperatively revealed an asymptomatic patient without recurrent neck/shoulder pain or clinical signs of instability. To better assess the feasibility of utilizing this approach in the general population, we retrospectively analyzed 502 consecutive cervical CT scans performed over a 3-month period in patients aged over 18 years at a single institution. Measurements of C1 bicortical diameter, bilateral laminar length, height, and angulation were performed. Laminar and screw dimensions were compared to assess instrumentation feasibility. Results: Review of CT imaging found that 75.9% of C1 lamina had a sufficient bicortical diameter, and 63.7% of C1 lamina had sufficient height to accept bilateral translaminar screw placement. Conclusions: CT-based measurement of atlas morphology in the general population revealed that a majority of C1 lamina had sufficient dimensions to accept translaminar screw placement. Although these screws appear to be a feasible alternative when lateral mass screws are precluded, further research is required to determine if they provide comparable fixation strength versus traditional instrumentation methods. PMID:26005585

  12. A minimally invasive technique for percutaneous lumbar facet augmentation: Technical description of a novel device

    PubMed Central

    Smith, Zachary A.; Armin, Sean; Raphael, Dan; Khoo, Larry T.

    2011-01-01

    Background: We describe a new posterior dynamic stabilizing system that can be used to augment the mechanics of the degenerating lumbar segment. The mechanism of this system differs from other previously described surgical techniques that have been designed to augment lumbar biomechanics. The implant and technique we describe is an extension-limiting one, and it is designed to support and cushion the facet complex. Furthermore, it is inserted through an entirely percutaneous technique. The purpose of this technical note is to demonstrate a novel posterior surgical approach for the treatment of lumbar degenerative. Methods: This report describes a novel, percutaneously placed, posterior dynamic stabilization system as an alternative option to treat lumbar degenerative disk disease with and without lumbar spinal stenosis. The system does not require a midline soft-tissue dissection, nor subperiosteal dissection, and is a truly minimally invasive means for posterior augmentation of the functional facet complex. This system can be implanted as a stand-alone procedure or in conjunction with decompression procedures. Results: One-year clinical results in nine individual patients, all treated for degenerative disease of the lower lumbar spine, are presented. Conclusions: This novel technique allows for percutaneous posterior dynamic stabilization of the lumbar facet complex. The use of this procedure may allow a less invasive alternative to traditional approaches to the lumbar spine as well as an alternative to other newly developed posterior dynamic stabilization systems. PMID:22145084

  13. Pullout performance comparison of pedicle screws based on cement application and design parameters.

    PubMed

    Tolunay, Tolga; Başgül, Cemile; Demir, Teyfik; Yaman, Mesut E; Arslan, Arslan K

    2015-11-01

    Pedicle screws are the main fixation devices for certain surgeries. Pedicle screw loosening is a common problem especially for osteoporotic incidents. Cannulated screws with cement augmentation are widely used for that kind of cases. Dual lead dual cored pedicle screw has already given promising pullout values without augmentation. This study concentrates on the usage of dual lead dual core with cement augmentation as an alternative to cannulated and standard pedicle screws with cement augmentation. Five groups (dual lead dual core, normal pedicle screw and cannulated pedicle screw with augmentation, normal pedicle screw, dual lead dual cored pedicle screw) were designed for this study. Healthy bovine vertebrae and synthetic polyurethane foams (grade 20) were used as embedding test medium. Test samples were prepared in accordance with surgical guidelines and ASTM F543 standard testing protocols. Pullout tests were conducted with Instron 3300 testing frame. Load versus displacement values were recorded and maximum pullout loads were stated. The dual lead dual cored pedicle screw with poly-methyl methacrylate augmentation exhibited the highest pullout values, while dual lead dual cored pedicle screw demonstrated similar pullout strength as cannulated pedicle screw and normal pedicle screw with poly-methyl methacrylate augmentation. The dual lead dual cored pedicle screw with poly-methyl methacrylate augmentation can be used for osteoporotic and/or severe osteoporotic patients according to its promising results on animal cadaver and synthetic foams. PMID:26503840

  14. Radiological Evaluation of the Initial Fixation between Cortical Bone Trajectory and Conventional Pedicle Screw Technique for Lumbar Degenerative Spondylolisthesis

    PubMed Central

    Iwatsuki, Koichi; Ohnishi, Yu-Ichiro; Yoshimine, Toshiki

    2016-01-01

    Study Design Retrospective study. Purpose To compare initial fixation using the cortical bone trajectory (CBT) technique versus conventional pedicle screws (PS) in radiographs of postsurgical lumbar degenerative spondylolisthesis. Overview of Literature Few reports have documented the holding strength of CBT technique for spondylolisthesis cases. Methods From October 2009 to June 2014, 21 cases of degenerative spondylolisthesis were surgically treated in our institution. Ten were treated with conventional PS technique and 11 of with CBT technique. Mean lumbar lordosis and percent slippage were evaluated preoperatively, immediately after surgery, and 6 months and 1 year postoperatively using radiographs. We also investigated percent loss of slip reduction. Results There were statistically significant differences between preoperative percent slippage and postoperative slippage in both PS and CBT procedures over 1 year, and both techniques showed good slip reduction. On the other hand, lumbar lordosis did not change significantly in either the PS or CBT groups over 1 year. Conclusions CBT technique showed similarly good initial fixation compared with the PS procedure in the treatment of lumbar degenerative spondylolisthesis. PMID:27114765

  15. Experimental trial on surgical treatment for transverse fractures of the proximal phalanx: technique using intramedullary conical compression screw versus lateral compression plate☆

    PubMed Central

    Ibanez, Daniel Schneider; Rodrigues, Fabio Lucas; Salviani, Rafael Salmeron; Roberto, Fernando Augusto Reginatto; Pengo Junior, Jose Roberto; Aita, Marcio Aurelio

    2015-01-01

    Objective To compare the mechanical parameters between two methods for stabilization through compression: 1.5 mm axial compression plate versus conical compression screw used as an intramedullary tutor. Methods Polyurethane models (Sawbone®) that simulated transverse fractures of the proximal phalanx were used. The models were divided into three groups: lateral plate, conical screw and no implant. Results Greater force was needed to result in fatigue in the synthesis using an intramedullary plate. Thus, this model was proven to be mechanically superior to the model with the lateral plate. Conclusion Stabilization using the Acutrak® screw for treating fractures in the model used in this trial presents mechanical results that are statistically significantly superior to those from the axial compression technique using the lateral plate (Aptus Hand®). PMID:26535195

  16. Vertical ridge augmentation using the modified shell technique--a case series.

    PubMed

    Stimmelmayr, Michael; Beuer, Florian; Schlee, Markus; Edelhoff, Daniel; Güth, Jan-Frederik

    2014-12-01

    Vertical defects of the alveolar crest often restrict the placement of implants. The outcome of vertical augmentation is unpredictable so we aimed to develop a technique that has predictable results. We used autogenous grafts trimmed to shells less than 1mm thick to rebuild the vertical dimensions of the alveolar ridge. The shells were fixed with microscrews and the vertical space between the shell and the residual bone was filled with autogenous particulate bone. Vertical dimensions before and after augmentation were measured and descriptive statistics calculated. A total of 17 patients (10 female, 7 male, mean (SD) age 46 (17) years) had 18 sites augmented (2 sites in one patient). In 2 cases the wound dehisced and healing was by secondary intention. The rest healed uneventfully. The mean (SD) vertical defect was 4.7 (1.4) mm and mean (SD) resorption during consolidation was 0.5 (0.7) mm. All 30 previously planned implants were placed, and none failed during the first year. Loading was monitored for a mean (SD) period of 14.6 (10.5) months. The technique showed promising results and could be an alternative to procedures that use extraoral donor sites. PMID:25266138

  17. Assessment of the stress transmitted to dental implants connected to screw-retained bars using different casting techniques.

    PubMed

    Haselhuhn, Klaus; Marotti, Juliana; Tortamano, Pedro; Weiss, Claudia; Suleiman, Lubna; Wolfart, Stefan

    2014-12-01

    Passive fit of the prosthetic superstructure is important to avoid complications; however, evaluation of passive fit is not possible using conventional procedures. Thus, the aim of this study was to check and locate mechanical stress in bar restorations fabricated using two casting techniques. Fifteen patients received four implants in the interforaminal region of the mandible, and a bar was fabricated using either the cast-on abutment or lost-wax casting technique. The fit accuracy was checked according to the Sheffield's test criteria. Measurements were recorded on the master model with a gap-free, passive fit using foil strain gauges both before and after tightening the prosthetic screws. Data acquisition and processing was analyzed with computer software and submitted to statistical analysis (ANOVA). The greatest axial distortion was at position 42 with the cast-on abutment technique, with a mean distortion of 450 μm/m. The lowest axial distortion occurred at position 44 with the lost-wax casting technique, with a mean distortion of 100 μm/m. The minimal differences between the means of axial distortion do not indicate any significant differences between the techniques (P = 0.2076). Analysis of the sensor axial distortion in relation to the implant position produced a significant difference (P < 0.0001). Significantly higher measurements were recorded in the axial distortion analysis of the distal sensors of implants at the 34 and 44 regions than on the mesial positions at the 32 and 42 regions (P = 0.0481). The measuring technique recorded axial distortion in the implant-supported superstructures. Distortions were present at both casting techniques, with no significant difference between the sides. PMID:23270308

  18. Horizontal posterior ridge augmentation: the use of a collagen membrane over a bovine particulate graft: technique note.

    PubMed

    Block, Michael S; Kelley, Brian

    2013-09-01

    The purpose of this technique note is to describe an improvement of a previously published method to augment the thin posterior mandibular ridge. The technique uses a subperiosteal tunnel to place a collagen membrane within the tunnel to maintain the shape of the augmentation. After the collagen membrane has been placed, a sintered xenograft is packed as an onlay graft, with implant placement 6 to 9 months later. PMID:23948364

  19. Sinus floor augmentation at the time of maxillary molar extraction: technique and report of preliminary results.

    PubMed

    Fugazzotto, P A

    1999-01-01

    A technique is described for accomplishing both localized sinus augmentation and guided bone regeneration at the time of maxillary molar extraction. One hundred nine sites were treated in 92 patients. Of these, 102 procedures (94.0%) were successful and 7 (6.0%) were partially successful. Success was defined as the ability to ideally position an implant at least 10 mm in length and 4.8 mm in width without perforating the floor of the sinus or generating an implant fenestration or dehiscence. Partially successful procedures required an additional osteotome sinus lift at the time of implant placement. PMID:10453669

  20. Comparison of the Mechanical Characteristics of a Universal Small Biplane Plating Technique Without Compression Screw and Single Anatomic Plate With Compression Screw.

    PubMed

    Dayton, Paul; Ferguson, Joe; Hatch, Daniel; Santrock, Robert; Scanlan, Sean; Smith, Bret

    2016-01-01

    To better understand the mechanical characteristics of biplane locked plating in small bone fixation, the present study compared the stability under cyclic cantilever loading of a 2-plate locked biplane (BPP) construct without interfragmentary compression with that of a single-plate locked construct with an additional interfragmentary screw (SPS) using surrogate bone models simulating Lapidus arthrodesis. In static ultimate plantar bending, the BPP construct failed at significantly greater load than did the SPS construct (556.2 ± 37.1 N versus 241.6 ± 6.3 N, p = .007). For cyclic failure testing in plantar bending at a 180-N starting load, the BPP construct failed at a significantly greater number of cycles (158,322 ± 50,609 versus 13,718 ± 10,471 cycles) and failure load (242.5 ± 25.0 N versus 180.0 ± 0.0 N) than the SPS construct (p = .002). For cyclic failure testing in plantar bending at a 120-N starting load, the results were not significantly different between the BPP and SPS constructs for the number of cycles (207,646 ± 45,253 versus 159,334 ± 69,430) or failure load (205.0 ± 22.4 N versus 185.0 ± 33.5 N; p = .300). For cyclic testing with 90° offset loading (i.e., medial to lateral bending) at a 120-N starting load, all 5 BPP constructs (tension side) and 2 of the 5 SPS constructs reached 250,000 cycles without failure. Overall, the present study found the BPP construct to have superior or equivalent stability in multiplanar orientations of force application in both static and fatigue testing. Thus, the concept of biplane locked plating, using 2 low profile plates and unicortical screw insertion, shows promise in small bone fixation, because it provides consistent stability in multiplanar orientations, making it universally adaptable to many clinical situations. PMID:26872521

  1. The modified trephine/osteotome sinus augmentation technique: technical considerations and discussion of indications.

    PubMed

    Fugazzotto, P A

    2001-01-01

    A technique is presented, which uses trephines of various external diameters followed by an osteotome to implode a core of maxillary posterior alveolar bone before placement of regenerative materials, in anticipation of subsequent implant placement. A mathematical formula is presented, which relates the depth of core displacement to the apico-occlusal dimension of alveolar bone coronal to the floor of the sinus presurgically. Seventy-one sites have been treated. All sites exhibited sufficient regeneration for implant placement. Two of the sites required additional augmentation at the time of implant placement. Fifty-one of the implants have been restored and are in function for up to 3 years. All are functioning successfully, as defined by the Albrektsson criteria. The technique and its indications and contraindications are described in detail. PMID:11813667

  2. Comparison of 2D and 3D navigation techniques for percutaneous screw insertion into the scaphoid: results of an experimental cadaver study.

    PubMed

    Catala-Lehnen, Philip; Nüchtern, Jakob V; Briem, Daniel; Klink, Thorsten; Rueger, Johannes M; Lehmann, Wolfgang

    2011-01-01

    Navigation in hand surgery is still in the process of development. Initial studies have demonstrated the feasibility of 2D and 3D navigation for the palmar approach in scaphoid fractures, but a comparison of the possibilities of 2D and 3D navigation for the dorsal approach is still lacking. The aim of the present work was to test navigation for the dorsal approach in the scaphoid using cadaver bones. After development of a special radiolucent resting splint for the dorsal approach, we performed 2D- and 3D-navigated scaphoid osteosynthesis in 12 fresh-frozen cadaver forearms using a headless compression screw (Synthes). The operation time, radiation time, number of trials for screw insertion, and screw positions were analyzed. In six 2D-navigated screw osteosyntheses, we found two false positions with an average radiation time of 5 ± 2 seconds. Using 3D navigation, we detected one false position. A false position indicates divergence from the ideal line of the axis of the scaphoid but without penetration of the cortex. The initial scan clearly increased overall radiation time in the 3D-navigated group, and for both navigation procedures operating time was longer than in our clinical experience without navigation. Nonetheless, 2D and 3D navigation for non-dislocated scaphoid fractures is feasible, and navigation might reduce the risk of choosing an incorrect screw length, thereby possibly avoiding injury to the subtending cortex. The 3D navigation is more difficult to interpret than 2D fluoroscopic navigation but shows greater precision. Overall, navigation is costly, and the moderate advantages it offers for osteosynthesis of scaphoid fractures must be considered critically in comparisons with conventional operating techniques. PMID:21991920

  3. Four lateral mass screw fixation techniques in lower cervical spine following laminectomy: a finite element analysis study of stress distribution

    PubMed Central

    2014-01-01

    Background Lateral mass screw fixation (LSF) techniques have been widely used for reconstructing and stabilizing the cervical spine; however, complications may result depending on the choice of surgeon. There are only a few reports related to LSF applications, even though fracture fixation has become a severe complication. This study establishes the three-dimensional finite element model of the lower cervical spine, and compares the stress distribution of the four LSF techniques (Magerl, Roy-Camille, Anderson, and An), following laminectomy -- to explore the risks of rupture after fixation. Method CT scans were performed on a healthy adult female volunteer, and Digital imaging and communication in medicine (Dicom) data was obtained. Mimics 10.01, Geomagic Studio 12.0, Solidworks 2012, HyperMesh 10.1 and Abaqus 6.12 software programs were used to establish the intact model of the lower cervical spines (C3-C7), a postoperative model after laminectomy, and a reconstructive model after applying the LSF techniques. A compressive preload of 74 N combined with a pure moment of 1.8 Nm was applied to the intact and reconstructive model, simulating normal flexion, extension, lateral bending, and axial rotation. The stress distribution of the four LSF techniques was compared by analyzing the maximum von Mises stress. Result The three-dimensional finite element model of the intact C3-C7 vertebrae was successfully established. This model consists of 503,911 elements and 93,390 nodes. During flexion, extension, lateral bending, and axial rotation modes, the intact model’s angular intersegmental range of motion was in good agreement with the results reported from the literature. The postoperative model after the three-segment laminectomy and the reconstructive model after applying the four LSF techniques were established based on the validated intact model. The stress distribution for the Magerl and Roy-Camille groups were more dispersive, and the maximum von Mises stress

  4. Comparison of Surgical Outcomes Between Short-Segment Open and Percutaneous Pedicle Screw Fixation Techniques for Thoracolumbar Fractures.

    PubMed

    Fu, Zhiguo; Zhang, Xi; Shi, Yaohua; Dong, Qirong

    2016-01-01

    BACKGROUND This study aimed to compare the surgical outcomes between open pedicle screw fixation (OPSF) and percutaneous pedicle screw fixation (PPSF) for the treatment of thoracolumbar fractures, which has received scant research attention to date. MATERIAL AND METHODS Eight-four patients with acute and subacute thoracolumbar fractures who were treated with SSPSF from January 2013 to June 2014 at the Changzhou Hospital of Traditional Chinese Medicine (Changzhou, China) were retrospectively reviewed. The patients were divided into 4 groups: the OPSF with 4 basic screws (OPSF-4) group, the OPSF with 4 basic and 2 additional screws (OPSF-6) group, the PPSF with 4 basic screws (PPSF-4) group, and the PPSF with 4 basic and 2 additional screws (PPSF-6) group. The intraoperative, immediate postoperative, and over 1-year follow-up outcomes were evaluated and compared among these groups. RESULTS Blood loss in the PPSF-4 group and the PPSF-6 group was significantly less than in the OPSF-4 group and the OPSF-6 group (P<0.05). The OPSF-6 group exhibited significantly higher immediate postoperative correction percentage of anterior column height of fractured vertebra than the other 3 groups (P<0.05), and higher correction of sagittal regional Cobb angle and kyphotic angle of injured vertebra than in the PPSF-4 and -6 groups (P<0.05). In addition, there was no significant difference in the correction loss of percentage of anterior column height, and loss of sagittal Cobb angle and kyphotic angle of fractured vertebrae at final follow-up among the 4 groups (P>0.05). CONCLUSIONS OPSF with 6 screws had an advantage in the correction of injured vertebral height and kyphosis, and PPSF reduced the intraoperative blood loss of patients. PMID:27602557

  5. Transpedicular vertebral body augmentation reinforced with pedicle screw fixation in fresh traumatic A2 and A3 lumbar fractures: comparison between two devices and two bone cements.

    PubMed

    Korovessis, Panagiotis; Vardakastanis, Konstantinos; Repantis, Thomas; Vitsas, Vasilios

    2014-07-01

    This retrospective study compares efficacy and safety of balloon kyphoplasty (BK) with calcium phosphate (Group A) versus KIVA implant with PMMA (Group B) reinforced with three vertebrae pedicle screw constructs for A2 and A3 single fresh non-osteoporotic lumbar (L1-L4) fractures in 38 consecutive age- and diagnosis-matched patient populations. Extracanal leakage of both low-viscosity PMMA and calcium phosphate (CP) as well as the following roentgenographic parameters: segmental kyphosis (SKA), anterior (AVBHr) and posterior (PVBHr) vertebral body height ratio, spinal canal encroachment (SCE) clearance, and functional outcome measures: VAS and SF-36, were recorded and compared between the two groups. All patients in both groups were followed for a minimum 26 (Group A) and 25 (Group B) months. Extracanal CP and PMMA leakage was observed in four (18 %) and three (15 %) vertebrae/patients of group A and B, respectively. Hybrid fixation improved AVBHr, SKA, SCE, but PVBHr only in group B. VAS and SF-36 improved postoperatively in the patients of both groups. Short-segment construct with the novel KIVA implant restored better than BK-fractured lumbar vertebral body, but this had no impact in functional outcome. Since there was no leakage difference between PMMA and calcium phosphate and no short-term adverse related to PMMA use were observed, we advice the use of PMMA in fresh traumatic lumbar fractures. PMID:23982115

  6. Knee Extensor Mechanism Repairs: Standard Suture Repair and Novel Augmentation Technique.

    PubMed

    Meyer, Zachary; Ricci, William M

    2016-08-01

    Patellar and quadriceps tendon ruptures are relatively common injuries. Rupture of the knee extensor mechanism may occur because of a forceful eccentric contraction of the quadriceps against a resisted flexed knee, though atraumatic cases have also been described. Patients at higher than normal risk for knee extensor mechanism rupture include those with systemic co-morbidities, fluoroquinolone use, and chronic tendinopathy. Early operative treatment and mobilization of acute extensor mechanism ruptures has proven effective, and numerous techniques have been described. A 46-year-old male on anastrozole therapy simultaneously ruptured his left patellar and right quadriceps tendons during a deadlift attempt. Diagnosis was by history and physical examination. Repair of both injuries was performed 5 days after injury. Described within and shown in the accompanying video is a standard technique for primary repair using Krackow stitches through the ruptured tendon that are passed through patellar bone tunnels and tied over a bone bridge. The finer points of this technique are emphasized. Also included is a technique to augment the standard repair with a figure-of-8 stitch passed through additional oblique patellar bone tunnels. The mechanical advantage of the adjuvant figure-of-8 stitch provides additional compression, which nicely reapproximates the tendon edges. PMID:27441933

  7. Engine Yaw Augmentation for Hybrid-Wing-Body Aircraft via Optimal Control Allocation Techniques

    NASA Technical Reports Server (NTRS)

    Taylor, Brian R.; Yoo, Seung-Yeun

    2011-01-01

    Asymmetric engine thrust was implemented in a hybrid-wing-body non-linear simulation to reduce the amount of aerodynamic surface deflection required for yaw stability and control. Hybrid-wing-body aircraft are especially susceptible to yaw surface deflection due to their decreased bare airframe yaw stability resulting from the lack of a large vertical tail aft of the center of gravity. Reduced surface deflection, especially for trim during cruise flight, could reduce the fuel consumption of future aircraft. Designed as an add-on, optimal control allocation techniques were used to create a control law that tracks total thrust and yaw moment commands with an emphasis on not degrading the baseline system. Implementation of engine yaw augmentation is shown and feasibility is demonstrated in simulation with a potential drag reduction of 2 to 4 percent. Future flight tests are planned to demonstrate feasibility in a flight environment.

  8. Lordoplasty: midterm outcome of an alternative augmentation technique for vertebral fractures.

    PubMed

    Hoppe, Sven; Budmiger, Mathias; Bissig, Philipp; Aghayev, Emin; Benneker, Lorin M

    2016-06-01

    OBJECTIVE Vertebroplasty and balloon kyphoplasty are effective treatment options for osteoporotic vertebral compression fractures but are limited in correction of kyphotic deformity. Lordoplasty has been reported as an alternative, cost-effective, minimally invasive, percutaneous cement augmentation technique with good restoration of vertebral body height and alignment. The authors report on its clinical and radiological midterm results. METHODS A retrospective review was conducted of patients treated with lordoplasty from 2002 to 2014. Inclusion criteria were clinical and radiological follow-up evaluations longer than 24 months. Radiographs were accessed regarding initial correction and progressive loss of reduction. Complications and reoperations were recorded. Actual pain level, pain relief immediately after surgery, autonomy, and subjective impression of improvement of posture were assessed by questionnaire. RESULTS Sixty-five patients (46 women, 19 men, age range 38.9-86.2 years old) were treated with lordoplasty for 69 vertebral compression and insufficiency fractures. A significant correction of the vertebral kyphotic angle (mean 13°) and segmental kyphotic angle (mean 11°) over a mean follow-up of 33 months (range 24-108 months) was achieved (p < 0.001). On average, pain was relieved to 90% of the initial pain level. In 24% of the 65 patients a second spinal intervention was necessary: 16 distant (24.6%) and 7 adjacent (10.8%) new osteoporotic fractures, 4 instrumented stabilizations (6.2%), 1 new adjacent traumatic fracture (1.5%), and 1 distant microsurgical decompression (1.5%). Cement leakage occurred in 10.4% but was only symptomatic in 1 case. CONCLUSIONS Lordoplasty appeared safe and effective in midterm pain alleviation and restoration of kyphotic deformity in osteoporotic compression and insufficiency fractures. The outcomes of lordoplasty are consistent with other augmentation techniques. PMID:26895528

  9. Posterior cervical arthrodesis and stabilization: an early report using a novel lateral mass screw and rod technique

    PubMed

    Horgan; Kellogg; Chesnut

    1999-06-01

    OBJECTIVE: Posterior cervical arthrodesis and stabilization with lateral mass plates is a biomechanically sound construct in multiple planes of motion. It is reproducible and especially useful when the posterior elements are missing or fractured. Unfortunately, it is difficult to use in patients with severe degenerative spondylosis because the plate is malleable only in the sagittal plane and the screw positions are dictated by the plate's entry holes. METHODS: A novel system of lateral mass screws that can be positioned before placement of a lateral construct was used in nine patients. Their outcomes as well as the technical applications of this system were reviewed. RESULTS: A total of 52 screws were placed in nine patients who underwent posterior cervical arthrodesis with the Cervifix system (Synthes USA, Paoli, PA). Diagnoses included trauma in four patients, degenerative spondylosis in three, and tumor in two. Rods were molded individually according to the patient's anatomy. Compression, distraction, and lateral rotation, if indicated, were performed. Follow-up averaged 36 weeks. Lateral and anteroposterior radiographs, obtained at progressive intervals, revealed excellent fixation and screw purchase without pull-out. There were no cases of spinal cord, nerve root, or vertebral artery injury. CONCLUSION: The Cervifix system accommodates variation in anatomic size and spacing of the lateral masses, potentiating precise screw placement. The rods can be molded in multiple planes, and selective application of compressive, distractive, or lateral rotatory forces is allowed. The system is very straightforward and simple to use, and we have had good success without pseudarthrosis or complications from screw placement in our series. PMID:10371626

  10. Combined Percutaneous Iliosacral Screw Fixation With Sacroplasty Using Resorbable Calcium Phosphate Cement for Osteoporotic Pelvic Fractures Requiring Surgery.

    PubMed

    Collinge, Cory A; Crist, Brett D

    2016-06-01

    Osteoporotic sacral fractures, including acute and chronic insufficiency fractures, are increasing in frequency and present a number of management problem. Many of these patients are treated nonoperatively with relative immobility (eg, bedrest, wheelchair, or weight-bearing restrictions) and analgesics, which likely make the osteoporotic component worse. Surgery in this patient population may be desirable in some cases with the goals of improving mobility, relieving pain, and healing in an aligned position while minimizing deformity progression. However, internal fixation of the osteoporotic pelvis can be difficult. Large unicortical lag screws are the workhorse of posterior pelvic fixation, and yet fixation in cancellous bone corridors of an osteoporotic sacrum seems unlikely to achieve optimal fixation. As a result, the operative management and clinical results of these difficult injuries may not be uniformly successful. The authors present a technique for treating osteoporotic patients with a sacral fracture when operative treatment is indicated using percutaneous screw fixation combined with screw augmentation using a resorbable calcium phosphate bone substitute or "cement." The guide wire for a 7.3-mm or other large cannulated lag screw is fully inserted along the desired bony sacral corridor as is standard. The lag screw is then inserted over the wire to the depth where cement is desired. The guide wire is removed, and the aqueous calcium phosphate is injected through the screw's cannulation. For acute fractures, cement was applied to the areas distant to the fracture; whereas in insufficiency fractures, the cement was inserted along most of the screw path. The guide wire then can be reinserted and the lag screw fully inserted. The rationale for using these 2 modalities is their synergistic effect: the cannulated screw provides typical screw fixation and also a conduit for cement application. The cement augments the lag screw's purchase in osteoporotic bone

  11. Soft Tissue Augmentation Techniques in Implants Placed and Provisionalized Immediately: A Systematic Review

    PubMed Central

    Prados-Frutos, Juan Carlos; Manchón, Ángel; Rodríguez-Molinero, Jesús; Sammartino, Gilberto; Calvo Guirado, José Luis; Gómez-de Diego, Rafael

    2016-01-01

    The aim of this study was to evaluate the effectiveness of techniques for soft tissue augmentation in the placement of immediate implants with and without provisionalization and to assess the quality of the reports in the literature. Randomized clinical trials, prospective clinical trials, and case series were included in this review. Clinical questions were formulated and organised according to the PICOS strategy. An electronic search was performed in PubMed, Cochrane Central Register of Controlled Trials, Scopus, and ISI Web up until June 2016. Interexaminer agreement on eligibility (k = 0.842; p = 0.103) and quality (k = 0.933; p < 0.001) was high. Methodological approaches were assessed using criteria based on design related forms designed by the Dutch Cochrane Collaboration. Finally, 14 papers were identified. In two studies, the implant survival was 90%; for the rest of the studies it was 100%. All studies reported favourable aesthetic, biological, and radiographic outcomes. Surgical and biomechanical complications of this technique were not relevant. This technique effectively compensates for the expected loss of volume of the oral soft tissues and maintains high success rates with good aesthetic results over time. PMID:27517046

  12. Preventing proximal junctional failure in long segmental instrumented cases of adult degenerative scoliosis using a multilevel stabilization screw technique

    PubMed Central

    Sandquist, Lee; Carr, Daniel; Tong, Doris; Gonda, Roger; Soo, Teck M.

    2015-01-01

    Background: The authors sought to demonstrate the safety and effectiveness of the multilevel stabilization screw (MLSS) technique in decreasing the incidence of proximal junctional failure in long segmental instrumented fusions for adult degenerative scoliosis. Methods: Institutional review board approval was obtained and all patients with adult spinal deformity who underwent the MLSS technique were analyzed. A neuro-radiologist and spine-focused neurosurgeon not involved with the surgical treatment performed radiographic analysis. Proximal junctional angle was defined as the caudal endplate of the upper instrumented vertebra (UIV) to the cephalad endplate of two supradjacent vertebrae above the UIV. The UIV is defined as the most cephalad vertebra completed captured by the instrumentation. Abnormal proximal junctional kyphosis (PJK) was defined as proximal junctional sagittal Cobb angle >10 degrees and proximal junction sagittal Cobb angle at least 10 degrees greater than the preoperative measurement. The presence of both is criteria necessary to be considered abnormal. Results: Twenty patients with degenerative scoliosis underwent the MLSS technique with the upper-instrumented vertebrae in the proximal thoracic spine. Fifteen patients met inclusion criteria with greater than 12 months radiographic and clinical follow up. Three patients were excluded due to lack of follow up imaging and two patients were excluded due to the inability to measure the UIV. Age range was 44–84 years with a mean of 66. Eleven of the 15 patients were over the age of 60 at the time of surgery. The male-to-female ratio was 4:11. Body mass index (BMI) range was 24–44 with a mean of 31.5 units. The follow up period ranged from 14 to 58 months with an average follow up of 30 months. The mean change in Cobb angle at the proximal junction was 4.00 degrees with a range from -0.92 to 9.13 degrees. There were no fractures or instrumentation failures at or near the proximal junction. There was

  13. Orientation of the "Lisfranc screw".

    PubMed

    Panchbhavi, Vinod K

    2012-11-01

    The reduction and stabilization of diastases between the medial cuneiform and the base of second metatarsal after a Lisfranc ligament injury is a crucial objective in the open reduction and internal fixation of these injuries. To achieve this objective, a single screw is used. The present practice is to insert the screw directed from the medial cuneiform bone into the base of the second metatarsal. This technique trick describes an easier method of insertion of the screw and one that possibly provides a better fixation. PMID:22549028

  14. Pedicle Screw Instrumentation for Adolescent Idiopathic Scoliosis: The Insertion Technique, the Fusion Levels and Direct Vertebral Rotation

    PubMed Central

    2011-01-01

    The pedicle is a power nucleus of the vertebra and offers a secure grip of all 3 columns. Pedicle screw instrumentation has advantages of rigid fixation with improved three-dimensional (3D) correction and it is accepted as a reliable method with a high margin of safety. Accurate placement of the pedicle screws is important to reduce possible irreversible complications. Many methods of screw insertion have been reported. The author has been using the K-wire method coupled with the intraoperative single posteroanterior and lateral radiographs, which is the most safe, accurate and fast method. Identification of the curve patterns and determining the fusion levels are very important. The ideal classification of adolescent idiopathic scoliosis should address the all patterns, predict the extent of accurate fusion and have good inter/intraobserver reliability. My classification system matches with the ideal classification system, and it is simple and easy to learn; and my classification system has only 4 structural curve patterns and each curve has 2 types. Scoliosis is a 3D deformity; the coronal and sagittal curves can be corrected with rod rotation, and rotational deformity has to be corrected with direct vertebral rotation (DVR). Rod derotation and DVR are true methods of 3D deformity correction with shorter fusion and improved correction of both the fused and unfused curves, and this is accomplished using pedicle screw fixation. The direction of DVR is very important and it should be opposite to the direction of the rotational deformity of the vertebra. A rigid rod has to be used to prevent rod bend-out during the derotation and DVR. PMID:21629468

  15. Efficacy and Safety of Augmenting the Preclose Technique with a Collagen-Based Closure Device for Percutaneous Endovascular Aneurysm Repair

    SciTech Connect

    Patel, Rafiuddin; Juszczak, Maciej T.; Bratby, Mark J.; Sideso, Ediri; Anthony, Susan; Tapping, Charles R.; Handa, Ashok; Darby, Christopher R.; Perkins, Jeremy; Uberoi, Raman

    2015-08-15

    PurposeTo report our experience of selectively augmenting the preclose technique for percutaneous endovascular aneurysm repair (p-EVAR) with an Angio-Seal device as a haemostatic adjunct in cases of significant bleeding after tensioning the sutures of the suture-mediated closure devices.Materials and MethodsProspectively collected data for p-EVAR patients at our institute were analysed. Outcomes included technical success and access site complications. A logistic regression model was used to analyse the effects of sheath size, CFA features and stent graft type on primary failure of the preclose technique necessitating augmentation and also on the development of complications.Resultsp-EVAR was attempted via 122 CFA access sites with a median sheath size of 18-French (range 12- to 28-French). Primary success of the preclose technique was 75.4 % (92/122). Angio-Seal augmentation was utilised as an adjunct to the preclose technique in 20.5 % (25/122). The overall p-EVAR success rate was 95.1 % (116/122). There was a statistically significant relationship (p = 0.0093) between depth of CFA and primary failure of preclose technique. CFA diameter, calcification, type of stent graft and sheath size did not have significant effects on primary preclose technique failure. Overall 4.9 % (6/122) required surgical conversion but otherwise there were no major complications.ConclusionAugmentation with an Angio-Seal device is a safe and effective adjunct to increase the success rate of the preclose technique in p-EVAR.

  16. The Delay Fill Technique: A Safer Approach to Combination Augmentation Mastopexy

    PubMed Central

    Patronella, Christopher K.; Mentz, Henry A.; Johnson-Alviza, Jaclyn

    2015-01-01

    Combining breast augmentation with mastopexy is a challenging procedure that has a relatively high revision rate in the literature. Some surgeons prefer a two-stage procedure to avoid the potential for skin flap or nipple–areolar complex necrosis that can occur with a one-stage procedure. The authors compared 101 patients who had subpectoral breast augmentation with immediate implant fill and mastopexy with 203 patients who had subpectoral breast augmentation with delayed (10–14 days) implant fill and mastopexy. They found the revision rate for immediate implant fill was 24%; in the delayed implant fill group, the revision rate was 10.3%. Patients had soft tissue-related complications in 16% of the immediate fill group and in 2% of the delayed fill group. Delaying implant fill in combined breast augmentation mastopexy significantly reduces the risk of soft tissue-related complications and revision procedures; the delay flap phenomenon is responsible for fewer wound-healing complications when implant fill is delayed during a combined augmentation mastopexy procedure. PMID:26528084

  17. Arthroscopic-Assisted Acromioclavicular Joint Reconstruction Using the TightRope Device With Allograft Augmentation: Surgical Technique

    PubMed Central

    Frank, Rachel M.; Trenhaile, Scott W.

    2015-01-01

    Surgical management of acromioclavicular (AC) joint separations remains challenging, especially in the revision setting. Most commonly, Rockwood type I and II injuries are managed nonoperatively whereas type IV, V, and VI injuries are managed with surgery. Type III separations are more controversial, with evidence supporting both nonoperative and operative treatment options. Multiple different arthroscopic techniques have been described; however, there is no current gold standard. AC joint reconstruction with the TightRope device (Arthrex, Naples, FL) with the patient in the lateral decubitus position is a method of restoring joint stability that allows for a minimally invasive, low-profile fixation construct using a single drill hole through the clavicle. Allograft augmentation of this fixation construct helps to eliminate the stress risers potentially created by this device while increasing overall repair construct stability. The purpose of this article is to describe the surgical technique for arthroscopic AC joint reconstruction using a TightRope device with allograft augmentation. PMID:26759765

  18. New Techniques for Augmenting Saliva Collection: Bacon Rules and Lozenge Drools

    PubMed Central

    Miočević, Olga; Warner, Melissa C.; Slowey, Paul D.; Shirtcliff, Elizabeth A.

    2015-01-01

    -matched control samples correlated significantly with concentrations from the lozenge and bacon conditions. Implications These results indicate that both the lozenge and smelling bacon improve saliva collection times and that neither technique interferes with salivary hormone concentrations. This study reveals new methods to augment saliva collection strategies. PMID:25773460

  19. Lip augmentation.

    PubMed

    Byrne, Patrick J; Hilger, Peter A

    2004-02-01

    Lip augmentation has become increasingly popular in recent years as a reflection of cultural trends emphasizing youth and beauty. Techniques to enhance the appearance of the lips have evolved with advances in biotechnology. An understanding of lip anatomy and aesthetics forms the basis for successful results. We outline the pertinent anatomy and aesthetics of the preoperative evaluation. A summary of various filler materials available is provided. Augmentation options include both injectable and open surgical techniques. The procedures and materials currently favored by the authors are described in greater detail. PMID:15034811

  20. Accuracy of Percutaneous Pedicle Screw Insertion Technique with Conventional Dual Fluoroscopy Units and a Retrospective Comparative Study Based on Surgeon Experience.

    PubMed

    Nakahara, Masayuki; Yasuhara, Takao; Inoue, Takafumi; Takahashi, Yuichi; Kumamoto, Shinji; Hijikata, Yasukazu; Kusumegi, Akira; Sakamoto, Yushi; Ogawa, Koichi; Nishida, Kenki

    2016-06-01

    Study Design Retrospective comparative study. Objective To evaluate the accuracy of percutaneous pedicle screw (PPS) placement and intraoperative imaging time using dual fluoroscopy units and their differences between surgeons with more versus less experience. Methods One hundred sixty-one patients who underwent lumbar fusion surgery were divided into two groups, A (n = 74) and B (n = 87), based on the performing surgeon's experience. The accuracy of PPS placement and radiation time for PPS insertion were compared. PPSs were inserted with classic technique under the assistance of dual fluoroscopy units placed in two planes. The breach definition of PPS misplacement was based on postoperative computed tomography (grade I: no breach; grade II: <2 mm; grade III: ≤2 to <4 mm). Results Of 658 PPSs, only 21 screws were misplaced. The breach rates of groups A and B were 3.3% (grade II: 3.4%, grade III: 0%) and 3.1% (grade II: 2.6%, grade III: 0.6%; p = 0.91). One patient in grade III misplacement had a transient symptom of leg numbness. Median radiation exposure time during PPS insertion was 25 seconds and 51 seconds, respectively (p < 0.01). Conclusions Without using an expensive imaging support system, the classic technique of PPS insertion using dual fluoroscopy units in the lumbar and sacral spine is fairly accurate and provides good clinical outcomes, even among surgeons lacking experience. PMID:27190733

  1. Cardiac Limited Ultrasound Examination Techniques to Augment the Bedside Cardiac Physical Examination.

    PubMed

    Kimura, Bruce J; Shaw, David J; Amundson, Stan A; Phan, James N; Blanchard, Daniel G; DeMaria, Anthony N

    2015-09-01

    The current practice of physical diagnosis is dependent on physician skills and biases, inductive reasoning, and time efficiency. Although the clinical utility of echocardiography is well known, few data exist on how to integrate 2-dimensional screening "quick-look" ultrasound applications into a novel, modernized cardiac physical examination. We discuss the evidence basis behind ultrasound "signs" pertinent to the cardiovascular system and elemental in synthesis of bedside diagnoses and propose the application of a brief cardiac limited ultrasound examination based on these signs. An ultrasound-augmented cardiac physical examination can be taught in traditional medical education and has the potential to improve bedside diagnosis and patient care. PMID:26269293

  2. Fixation Strength of Caudal Pedicle Screws after Posterior Lumbar Interbody Fusion with the Modified Cortical Bone Trajectory Screw Method

    PubMed Central

    Miwa, Toshitada; Yamashita, Tomoya; Kuroda, Yusuke; Ohwada, Tetsuo

    2016-01-01

    Study Design Clinical case series. Purpose In the posterior lumbar interbody fusion (PLIF) procedure in our institute, the cephalad screw trajectory follows a mediolateral and caudocephalad directed path according to the original cortical bone trajectory (CBT) method. However, the starting point of the caudal screw is at the medial border of the pedicle on an articular surface of the superior articular process, and the trajectory takes a mediolateral path parallel to the cephalad endplate. The incidence of caudal screw loosening after PLIF with this modified CBT screw method was investigated, and significant risk factors for caudal screw loosening were evaluated. Overview of Literature A biomechanical study of this modified caudal screw trajectory using the finite element method reported about a 20% increase in uniaxial yield pullout load compared with the traditional trajectory. However, there has been no clinical study concerning the fixation strength of this modified caudal screw trajectory. Methods The subjects were 193 consecutive patients who underwent single-level PLIF with modified CBT screw fixation. Caudal screw loosening was checked in computed tomography at 6 months after surgery, and screw loosening was defined as a radiolucency of 1 mm or more at the bone-screw interface. Results The incidence of caudal screw loosening after lumbosacral PLIF (46.2%) was significantly higher than that after floating PLIF (6.0%). No significant differences in sex, brand of the instruments, and diameter and length of the caudal screw were evident between patients with and without caudal screw loosening. Patients with caudal screw loosening were significantly older at the time of surgery than patients without caudal screw loosening. Conclusions Fixation strength of the caudal screw after floating PLIF with this modified CBT screw technique was sufficiently acceptable. Fixation strength after the lumbosacral procedure was not. PMID:27559442

  3. Effects of Repeated Screw Tightening on Implant Abutment Interfaces in Terms of Bacterial and Yeast Leakage in Vitro: One-Time Abutment Versus the Multiscrewing Technique.

    PubMed

    Calcaterra, Roberta; Di Girolamo, Michele; Mirisola, Concetta; Baggi, Luigi

    2016-01-01

    Screw loosening can damage the interfaces of implant components, resulting in susceptibility to contamination of the internal parts by microorganisms. The aim of this study was to investigate the impact of abutment screw retightening on the leakage of two different types of bacteria, Streptococcus sanguinis and Fusobacterium nucleatum, and of the yeast Candida albicans. Two types of implant-abutment systems with tube-in-tube interfaces were tested. Groups A and B each used a different type of system that consisted of 20 different pieces that were assembled according to the manufacturer's torque recommendations; four samples in each group were closed just one time, four samples three times, four samples five times, four samples seven times, and four samples nine times. The implants of groups A and B were contaminated with 0.1 μL of microbial solution just before being assembled for the last time to minimize the possibility of contamination. Results showed a direct correlation between the number of colony-forming units grown in the plates and the closing/opening cycles of the implant-abutment systems. Within the limitations of this study, the results indicate the possibility that repeated closing/opening cycles of the implant-abutment unit may influence bacterial/yeast leakage, most likely as a consequence of decreased precision of the coupling between the abutment and the internal part of the dental implant. These findings suggest that a one-time abutment technique may avoid microbiologic leakage in cases of implant-abutment systems with tube-in-tube interfaces. PMID:26901305

  4. Antibacterial effects of the povidone-iodine vacuum impregnation technique in expanded polytetrafluoroethylene augmentation rhinoplasty.

    PubMed

    Lee, Jung Min; Lee, Joong Seob; Kim, Dong-Kyu; Lee, Jun Ho; Park, Hae Sang; Lee, Ho Jun; Bae, Sung Hee; Jang, Ji Su; Lee, Jae Jun; Park, Chan Hum

    2016-06-01

    Expanded polytetrafluoroethylene (e-PTFE) is a popular graft material for augmentation rhinoplasty. Gore-Tex and Surgiform are two types of e-PTFE; Surgiform has thicker fibrils and is more compact than Gore-Tex. We conducted an ex vivo study to evaluate the ability of povidone-iodine (PVP-I) vacuum pretreatment to prevent infection with these two types of e-PTFE. Gore-Tex and Surgiform specimens were cut into 2-mm(3) pieces, which were separated into two groups. One group for each e-PTFE was disinfected with vacuum PVP-I impregnation and the other group was not disinfected. Using the pieces of implant material, swabs were obtained from the nasal cavities of 20 healthy adults, and the specimens were incubated on agar plates and viewed by scanning electron microscopy (SEM). We found that PVP-I treatment significantly reduced the bacterial colony counts in both the Gore-Tex and Surgiform groups. In the SEM images, bacterial colonies were observed both inside and outside the untreated Gore-Tex; on the untreated Surgiform, they were found primarily on the surface. Few bacteria were detected in the PVP-I-treated Gore-Tex and Surgiform groups. Our findings suggest that PVP-I pretreatment can reduce the risk of infection associated with e-PTFE. PMID:27304448

  5. Enhanced Lighting Techniques and Augmented Reality to Improve Human Task Performance

    NASA Technical Reports Server (NTRS)

    Maida, James C.; Bowen, Charles K.; Pace, John W.

    2005-01-01

    One of the most versatile tools designed for use on the International Space Station (ISS) is the Special Purpose Dexterous Manipulator (SPDM) robot. Operators for this system are trained at NASA Johnson Space Center (JSC) using a robotic simulator, the Dexterous Manipulator Trainer (DMT), which performs most SPDM functions under normal static Earth gravitational forces. The SPDM is controlled from a standard Robotic Workstation. A key feature of the SPDM and DMT is the Force/Moment Accommodation (FMA) system, which limits the contact forces and moments acting on the robot components, on its payload, an Orbital Replaceable Unit (ORU), and on the receptacle for the ORU. The FMA system helps to automatically alleviate any binding of the ORU as it is inserted or withdrawn from a receptacle, but it is limited in its correction capability. A successful ORU insertion generally requires that the reference axes of the ORU and receptacle be aligned to within approximately 0.25 inch and 0.5 degree of nominal values. The only guides available for the operator to achieve these alignment tolerances are views from any available video cameras. No special registration markings are provided on the ORU or receptacle, so the operator must use their intrinsic features in the video display to perform the pre-insertion alignment task. Since optimum camera views may not be available, and dynamic orbital lighting conditions may limit viewing periods, long times are anticipated for performing some ORU insertion or extraction operations. This study explored the feasibility of using augmented reality (AR) to assist with SPDM operations. Geometric graphical symbols were overlaid on the end effector (EE) camera view to afford cues to assist the operator in attaining adequate pre-insertion ORU alignment.

  6. Decisive factor in increase of loading at adjacent segments after lumbar fusion: operative technique, pedicle screws, or fusion itself: biomechanical analysis using finite element

    NASA Astrophysics Data System (ADS)

    Park, Joon-Hee; Kim, Ho-Joong; Kang, Kyoung-Tak; Kim, Ka-yeon; Chun, Heoung-Jae; Moon, Seong-Hwan; Lee, Hwan-Mo

    2010-03-01

    The aim of this study is to investigate the change in biomechanical milieu following removal of pedicle screws or removal of spinous process with posterior ligament complex in instrumented single level lumbar arthrodesis. We developed and validated a finite element model (FEM) of the intact lumbar spine (L2-4). Four scenarios of L3-4 lumbar fusion were simulated: posterolateral fusion (PLF) at L3-4 using pedicle screw system with preservation of PLC (Pp WiP), L3-4 lumbar posterolateral fusion state after removal of pedicle screw system with preservation of PLC (Pp WoP), L3-4 using pedicle screw system without preservation PLC (Sp WiP), L3-4 lumbar posterolateral fusion state after removal of pedicle screw system without preservation of PLC (Sp WoP). For these models, we investigated the range of motion and maximal Von mises stress of disc in all segments under various moments. All fusion models demonstrated increase in range of motion at adjacent segments compared to the intact model.For the four fusion models, the WiP model s P had the largest increase in range of motion at each adjacent segment. This study demonstrated that removal of pedicle screw system and preservation of PLC after complete lumbar spinal fusion could reduce the stress of adjacent segments synergistically and might have beneficial effects in preventing ASD.

  7. Decisive factor in increase of loading at adjacent segments after lumbar fusion: operative technique, pedicle screws, or fusion itself: biomechanical analysis using finite element

    NASA Astrophysics Data System (ADS)

    Park, Joon-Hee; Kim, Ho-Joong; Kang, Kyoung-Tak; Kim, Ka-Yeon; Chun, Heoung-Jae; Moon, Seong-Hwan; Lee, Hwan-Mo

    2009-12-01

    The aim of this study is to investigate the change in biomechanical milieu following removal of pedicle screws or removal of spinous process with posterior ligament complex in instrumented single level lumbar arthrodesis. We developed and validated a finite element model (FEM) of the intact lumbar spine (L2-4). Four scenarios of L3-4 lumbar fusion were simulated: posterolateral fusion (PLF) at L3-4 using pedicle screw system with preservation of PLC (Pp WiP), L3-4 lumbar posterolateral fusion state after removal of pedicle screw system with preservation of PLC (Pp WoP), L3-4 using pedicle screw system without preservation PLC (Sp WiP), L3-4 lumbar posterolateral fusion state after removal of pedicle screw system without preservation of PLC (Sp WoP). For these models, we investigated the range of motion and maximal Von mises stress of disc in all segments under various moments. All fusion models demonstrated increase in range of motion at adjacent segments compared to the intact model.For the four fusion models, the WiP model s P had the largest increase in range of motion at each adjacent segment. This study demonstrated that removal of pedicle screw system and preservation of PLC after complete lumbar spinal fusion could reduce the stress of adjacent segments synergistically and might have beneficial effects in preventing ASD.

  8. Chin augmentation.

    PubMed

    Choe, K S; Stucki-McCormick, S U

    2000-01-01

    The primary goal of facial aesthetic surgery is to restore, enhance, and rejuvenate the aging face to a more youthful appearance, achieving balance and harmony. The mental area must be addressed in order to have a complete synthesis of the face. The concept of augmenting the mental area with implants has evolved so significantly that it now stands by itself as an important procedure. Various autogenous implants for chin augmentation have been in use for over 100 years but have complications. The advent of synthetic materials has given rise to various types of alloplastic implants: Gore-Tex, Medpor, Supramid, Silastic, and Mersilene. No one implant is perfect for every face. This article overviews several alloplastic implants--their advantages, disadvantages, and complications, in addition to the different techniques of preparing and delivering the implants. PMID:11802346

  9. Optically driven Archimedes micro-screws for micropump applications: multiple blade design

    NASA Astrophysics Data System (ADS)

    Baldeck, Patrice L.; Lin, Chih-Lang; Lin, Yu-Sheng; Lin, Chin-Te; Chung, Tien-Tung; Bouriau, Michel; Vitrant, Guy

    2011-10-01

    We study the rotation of photo-driven Archimedes screw with multiple blades. The micron-sized Archimedes screws are readily made by the two-photon polymerization technique. Free-floating screws that are trapped by optical tweezers align in the laser irradiation direction, and rotate spontaneously. In this study we demonstrate that the rotation speeds of two-blade-screws is twice the rotation speed of one-blade-screw. However, more complex 3-blade-screws rotate slower than 2-blade-screws due to their limited geometry resolution at this micron scale.

  10. The use of extrapolation concepts to augment the Frequency Separation Technique

    NASA Astrophysics Data System (ADS)

    Alexiou, Spiros

    2015-03-01

    The Frequency Separation Technique (FST) is a general method formulated to improve the speed and/or accuracy of lineshape calculations, including strong overlapping collisions, as is the case for ion dynamics. It should be most useful when combined with ultrafast methods, that, however have significant difficulties when the impact regime is approached. These difficulties are addressed by the Frequency Separation Technique, in which the impact limit is correctly recovered. The present work examines the possibility of combining the Frequency Separation Technique with the addition of extrapolation to improve results and minimize errors resulting from the neglect of fast-slow coupling and thus obtain the exact result with a minimum of extra effort. To this end the adequacy of one such ultrafast method, the Frequency Fluctuation Method (FFM) for treating the nonimpact part is examined. It is found that although the FFM is unable to reproduce the nonimpact profile correctly, its coupling with the FST correctly reproduces the total profile.

  11. Captive-rearing piping plovers: developing techniques to augment wild populations

    USGS Publications Warehouse

    Powell, A.N.; Cuthbert, F.J.; Wemmer, L.C.; Doolittle, A.

    1997-01-01

    Techniques for captive-rearing and releasing piping plovers (Charadrius melodus) were developed using a surrogate species, killdeer (Charadrius vociferus). We compared captive- and parent-reared killdeer, and parent-reared piping plovers and determined that growth and behavior were similar. After surrogate trials determined that captive-rearing was feasible, we used the same methods to raise piping plover chicks from salvaged eggs. For captive-reared chick of both species, survival to fledging was higher than and behaviors similar to parent-reared chicks in the wild. Rearing techniques were fine-tuned, and ten piping plover fledglings were released to the wild. Based on our results, we developed recommendations for captive-rearing piping plovers using salvaged eggs to enhance productivity of small populations.

  12. Captive-rearing piping plovers: Developing techniques to augment wild populations

    USGS Publications Warehouse

    Powell, A.N.; Cuthbert, F.J.; Wemmer, L.C.; Doolittle, A.W.; Feirer, S.T.

    1997-01-01

    Techniques for captive-rearing and releasing piping plovers (Charadrius melodus) were developed using a surrogate species, killdeer (Charadrius vociferus). We compared captive-and parent-reared killdeer, and parent-reared piping plovers and determined that growth and behavior were similar. After surrogate trials determined that captive-rearing was feasible, we used the same methods to raise piping plover chicks from salvaged eggs. For captive-reared chick of both species, survival to fledging was higher than and behaviors similar to parent-reared chicks in the wild. Rearing techniques were fine-tuned, and ten piping plover fledglings were released to the wild. Based on our results, we developed recommendations for captive-rearing piping plovers using salvaged eggs to enhance productivity of small populations. ?? 1997 Wiley-Liss, Inc.

  13. Two-stage closed sinus lift: a new surgical technique for maxillary sinus floor augmentation.

    PubMed

    Krasny, Kornel; Krasny, Marta; Kamiński, Artur

    2015-12-01

    Bone tissue atrophy may constitute a relative contraindication for implantation. The methods used in reconstruction of the alveolar ridge within the lateral section of the maxilla have been well known but not perfect. Presentation of the two-stage, closed sinus lift technique as well as efficacy evaluation of reconstruction of the alveolar ridge in the maxilla within its vertical dimension with the use of this technique. The total procedure was performed in 26 out of 28 patients qualified for the study. The height of the alveolar ridge at the site of the planned implantation was no <3 mm, the width of the ridge was no <5 mm. During the treatment stage 1 the sinus lift was performed for the first time. The created hollow was filled with allogeneic granulate. After 3-6 months stage 2 was performed consisting in another sinus lift with simultaneous implantation. The treatment was completed with prosthetic restoration after 6 months of osteointegration. In 24 out of 26 cases stage 1 was completed with the average ridge height of 7.2 mm. In stage 2, simultaneously with the second sinus lift, 26 implants were placed and no cases of sinusitis were found. In the follow-up period none of the implants were lost. The presented method is efficient and combines the benefits of the open technique-allowing treatment in cases of larger reduction of the vertical dimension and the closed technique-as it does not require opening of the maxillary sinus. PMID:25754426

  14. Screw-locking wrench

    NASA Technical Reports Server (NTRS)

    Vranish, John M. (Inventor)

    2007-01-01

    A tool comprises a first handle and a second handle, each handle extending from a gripping end portion to a working end portion, the first handle having first screw threads disposed circumferentially about an inner portion of a first through-hole at the working end portion thereof, the second handle having second screw threads disposed circumferentially about an inner portion of a second through-hole at the working end portion thereof, the first and second respective through-holes being disposed concentrically about a common axis of the working end portions. First and second screw locks preferably are disposed concentrically with the first and second respective through-holes, the first screw lock having a plurality of locking/unlocking screw threads for engaging the first screw threads of the first handle, the second screw lock having a plurality of locking/unlocking screw threads for engaging the second screw threads of the second handle. A locking clutch drive, disposed concentrically with the first and second respective through-holes, engages the first screw lock and the second screw lock. The first handle and the second handle are selectively operable at their gripping end portions by a user using a single hand to activate the first and second screw locks to lock the locking clutch drive for either clockwise rotation about the common axis, or counter-clockwise rotation about the common axis, or to release the locking clutch drive so that the handles can be rotated together about the common axis either the clockwise or counter-clockwise direction without rotation of the locking clutch drive.

  15. A New Technique for Patch Augmentation of Rotator Cuff Repairs

    PubMed Central

    Mihara, Shuzou; Ono, Teruyasu; Inoue, Hirofumi; Kisimoto, Tetsurou

    2014-01-01

    Massive rotator cuff tears defying primary repair have been treated with debridement, arthroscopic subacromial decompression, partial repair, muscle-tendon transfer, and joint prosthesis, among other techniques. However, the treatment results have not been satisfactory compared with those of small- to medium-sized rotator cuff tears; each procedure has its merits and demerits, and currently, there is no single established method. For massive rotator cuff tears defying primary repair, the arthroscopic patch graft procedure has been reported as an effective surgical procedure, and this procedure is chosen as the first-line treatment in our department. In this procedure, suture anchors are generally used to fix the patch graft to the footprint on the side of the greater tuberosity. However, tendon-to-bone healing is frequently difficult to achieve, and bone-to-bone healing seems more advantageous for the repair of the rotator cuff attachment site. To improve the results of treatment, a new patch graft procedure was developed, in which the iliotibial ligament with bone was collected at Gerdy's tubercle and the bone was anchored to the footprint on the side of the greater tuberosity. With this procedure, excellent results were obtained, although only short-term results are available at present. The technique and its results so far are reported. PMID:25126505

  16. Alveolar ridge augmentation by connective tissue grafting using a pouch method and modified connective tissue technique: A prospective study

    PubMed Central

    Agarwal, Ashish; Gupta, Narinder Dev

    2015-01-01

    Background: Localized alveolar ridge defect may create physiological and pathological problems. Developments in surgical techniques have made it simpler to change the configuration of a ridge to create a more aesthetic and more easily cleansable shape. The purpose of this study was to compare the efficacy of alveolar ridge augmentation using a subepithelial connective tissue graft in pouch and modified connective tissue graft technique. Materials and Methods: In this randomized, double blind, parallel and prospective study, 40 non-smoker individuals with 40 class III alveolar ridge defects in maxillary anterior were randomly divided in two groups. Group I received modified connective tissue graft, while group II were treated with subepithelial connective tissue graft in pouch technique. The defect size was measured in its horizontal and vertical dimension by utilizing a periodontal probe in a stone cast at base line, after 3 months, and 6 months post surgically. Analysis of variance and Bonferroni post-hoc test were used for statistical analysis. A two-tailed P < 0.05 was considered to be statistically significant. Results: Mean values in horizontal width after 6 months were 4.70 ± 0.87 mm, and 4.05 ± 0.89 mm for group I and II, respectively. Regarding vertical heights, obtained mean values were 4.75 ± 0.97 mm and 3.70 ± 0.92 mm for group I and group II, respectively. Conclusion: Within the limitations of this study, connective tissue graft proposed significantly more improvement as compare to connective tissue graft in pouch. PMID:26759591

  17. Effect of different radial hole designs on pullout and structural strength of cannulated pedicle screws.

    PubMed

    Chen, Hsin-Chang; Lai, Yu-Shu; Chen, Wen-Chuan; Chen, Jou-Wen; Chang, Chia-Ming; Chen, Yi-Long; Wang, Shih-Tien; Cheng, Cheng-Kung

    2015-08-01

    Cannulated pedicle screws are designed for bone cement injection to enhance fixation strength in severely osteoporotic spines. However, the screws commonly fracture during insertion. This study aims to evaluate how different positions/designs of radial holes may affect the pullout and structural strength of cannulated pedicle screws using finite element analysis. Three different screw hole designs were evaluated under torsion and bending conditions. The pullout strength for each screw was determined by axial pullout failure testing. The results showed that when the Von Mises stress reached the yield stress of titanium alloy the screw with four radial holes required a greater torque or bending moment than the nine and twelve hole screws. In the pullout test, the strength and stiffness of each screw with cement augmentation showed no significant differences, but the screw with four radial holes had a greater average pullout strength, which probably resulted from the significantly greater mean maximum lengths of cement augmentation. Superior biomechanical responses, with lower stress around the radial holes and greater pullout strength, represented by cannulated pedicle screw with four radial holes may worth recommending for clinical application. PMID:26054806

  18. Subfascial gluteal augmentation.

    PubMed

    de la Peña, J Abel; Rubio, Omar V; Cano, Jacobo P; Cedillo, Mariana C; Garcés, Miriam T

    2006-07-01

    Developing the concept of gluteal augmentation through the past 17 years has been an academic adventure. During these years my coworkers and I have progressively improved surgical technique and devised an anatomical system for gluteal augmentation that includes an ideal implant design and templates to assist in evaluating patients in the preoperative period and to identify the most appropriate implant size. PMID:16818097

  19. Improved Screw-Thread Lock

    NASA Technical Reports Server (NTRS)

    Macmartin, Malcolm

    1995-01-01

    Improved screw-thread lock engaged after screw tightened in nut or other mating threaded part. Device does not release contaminating material during tightening of screw. Includes pellet of soft material encased in screw and retained by pin. Hammer blow on pin extrudes pellet into slot, engaging threads in threaded hole or in nut.

  20. Impact of screw configuration on the particle size distribution of granules produced by twin screw granulation.

    PubMed

    Vercruysse, J; Burggraeve, A; Fonteyne, M; Cappuyns, P; Delaet, U; Van Assche, I; De Beer, T; Remon, J P; Vervaet, C

    2015-02-01

    Twin screw granulation (TSG) has been reported by different research groups as an attractive technology for continuous wet granulation. However, in contrast to fluidized bed granulation, granules produced via this technique typically have a wide and multimodal particle size distribution (PSD), resulting in suboptimal flow properties. The aim of the current study was to evaluate the impact of granulator screw configuration on the PSD of granules produced by TSG. Experiments were performed using a 25 mm co-rotating twin screw granulator, being part of the ConsiGma™-25 system (a fully continuous from-powder-to-tablet manufacturing line from GEA Pharma Systems). Besides the screw elements conventionally used for TSG (conveying and kneading elements), alternative designs of screw elements (tooth-mixing-elements (TME), screw mixing elements (SME) and cutters) were investigated using an α-lactose monohydrate formulation granulated with distilled water. Granulation with only conveying elements resulted in wide and multimodal PSD. Using kneading elements, the width of the PSD could be partially narrowed and the liquid distribution was more homogeneous. However, still a significant fraction of oversized agglomerates was obtained. Implementing additional kneading elements or cutters in the final section of the screw configuration was not beneficial. Furthermore, granulation with only TME or SME had limited impact on the width of the PSD. Promising results were obtained by combining kneading elements with SME, as for these configurations the PSD was narrower and shifted to the size fractions suitable for tableting. PMID:25562758

  1. Development and Testing of X-Ray Imaging-Enhanced Poly-L-Lactide Bone Screws.

    PubMed

    Chang, Wei-Jen; Pan, Yu-Hwa; Tzeng, Jy-Jiunn; Wu, Ting-Lin; Fong, Tsorng-Harn; Feng, Sheng-Wei; Huang, Haw-Ming

    2015-01-01

    Nanosized iron oxide particles exhibit osteogenic and radiopaque properties. Thus, iron oxide (Fe3O4) nanoparticles were incorporated into a biodegradable polymer (poly-L-lactic acid, PLLA) to fabricate a composite bone screw. This multifunctional, 3D printable bone screw was detectable on X-ray examination. In this study, mechanical tests including three-point bending and ultimate tensile strength were conducted to evaluate the optimal ratio of iron oxide nanoparticles in the PLLA composite. Both injection molding and 3D printing techniques were used to fabricate the PLLA bone screws with and without the iron oxide nanoparticles. The fabricated screws were implanted into the femoral condyles of New Zealand White rabbits. Bone blocks containing the PLLA screws were resected 2 and 4 weeks after surgery. Histologic examination of the surrounding bone and the radiopacity of the iron-oxide-containing PLLA screws were evaluated. Our results indicated that addition of iron oxide nanoparticles at 30% significantly decreased the ultimate tensile stress properties of the PLLA screws. The screws with 20% iron oxide exhibited strong radiopacity compared to the screws fabricated without the iron oxide nanoparticles. Four weeks after surgery, the average bone volume of the iron oxide PLLA composite screws was significantly greater than that of PLLA screws without iron oxide. These findings suggested that biodegradable and X-ray detectable PLLA bone screws can be produced by incorporation of 20% iron oxide nanoparticles. Furthermore, these screws had significantly greater osteogenic capability than the PLLA screws without iron oxide. PMID:26466309

  2. Development and Testing of X-Ray Imaging-Enhanced Poly-L-Lactide Bone Screws

    PubMed Central

    Tzeng, Jy-Jiunn; Wu, Ting-Lin; Fong, Tsorng-Harn; Feng, Sheng-Wei; Huang, Haw-Ming

    2015-01-01

    Nanosized iron oxide particles exhibit osteogenic and radiopaque properties. Thus, iron oxide (Fe3O4) nanoparticles were incorporated into a biodegradable polymer (poly-L-lactic acid, PLLA) to fabricate a composite bone screw. This multifunctional, 3D printable bone screw was detectable on X-ray examination. In this study, mechanical tests including three-point bending and ultimate tensile strength were conducted to evaluate the optimal ratio of iron oxide nanoparticles in the PLLA composite. Both injection molding and 3D printing techniques were used to fabricate the PLLA bone screws with and without the iron oxide nanoparticles. The fabricated screws were implanted into the femoral condyles of New Zealand White rabbits. Bone blocks containing the PLLA screws were resected 2 and 4 weeks after surgery. Histologic examination of the surrounding bone and the radiopacity of the iron-oxide-containing PLLA screws were evaluated. Our results indicated that addition of iron oxide nanoparticles at 30% significantly decreased the ultimate tensile stress properties of the PLLA screws. The screws with 20% iron oxide exhibited strong radiopacity compared to the screws fabricated without the iron oxide nanoparticles. Four weeks after surgery, the average bone volume of the iron oxide PLLA composite screws was significantly greater than that of PLLA screws without iron oxide. These findings suggested that biodegradable and X-ray detectable PLLA bone screws can be produced by incorporation of 20% iron oxide nanoparticles. Furthermore, these screws had significantly greater osteogenic capability than the PLLA screws without iron oxide. PMID:26466309

  3. Finite Element Analysis of Osteosynthesis Screw Fixation in the Bone Stock: An Appropriate Method for Automatic Screw Modelling

    PubMed Central

    Wieding, Jan; Souffrant, Robert; Fritsche, Andreas; Mittelmeier, Wolfram; Bader, Rainer

    2012-01-01

    The use of finite element analysis (FEA) has grown to a more and more important method in the field of biomedical engineering and biomechanics. Although increased computational performance allows new ways to generate more complex biomechanical models, in the area of orthopaedic surgery, solid modelling of screws and drill holes represent a limitation of their use for individual cases and an increase of computational costs. To cope with these requirements, different methods for numerical screw modelling have therefore been investigated to improve its application diversity. Exemplarily, fixation was performed for stabilization of a large segmental femoral bone defect by an osteosynthesis plate. Three different numerical modelling techniques for implant fixation were used in this study, i.e. without screw modelling, screws as solid elements as well as screws as structural elements. The latter one offers the possibility to implement automatically generated screws with variable geometry on arbitrary FE models. Structural screws were parametrically generated by a Python script for the automatic generation in the FE-software Abaqus/CAE on both a tetrahedral and a hexahedral meshed femur. Accuracy of the FE models was confirmed by experimental testing using a composite femur with a segmental defect and an identical osteosynthesis plate for primary stabilisation with titanium screws. Both deflection of the femoral head and the gap alteration were measured with an optical measuring system with an accuracy of approximately 3 µm. For both screw modelling techniques a sufficient correlation of approximately 95% between numerical and experimental analysis was found. Furthermore, using structural elements for screw modelling the computational time could be reduced by 85% using hexahedral elements instead of tetrahedral elements for femur meshing. The automatically generated screw modelling offers a realistic simulation of the osteosynthesis fixation with screws in the adjacent

  4. Finite element analysis of osteosynthesis screw fixation in the bone stock: an appropriate method for automatic screw modelling.

    PubMed

    Wieding, Jan; Souffrant, Robert; Fritsche, Andreas; Mittelmeier, Wolfram; Bader, Rainer

    2012-01-01

    The use of finite element analysis (FEA) has grown to a more and more important method in the field of biomedical engineering and biomechanics. Although increased computational performance allows new ways to generate more complex biomechanical models, in the area of orthopaedic surgery, solid modelling of screws and drill holes represent a limitation of their use for individual cases and an increase of computational costs. To cope with these requirements, different methods for numerical screw modelling have therefore been investigated to improve its application diversity. Exemplarily, fixation was performed for stabilization of a large segmental femoral bone defect by an osteosynthesis plate. Three different numerical modelling techniques for implant fixation were used in this study, i.e. without screw modelling, screws as solid elements as well as screws as structural elements. The latter one offers the possibility to implement automatically generated screws with variable geometry on arbitrary FE models. Structural screws were parametrically generated by a Python script for the automatic generation in the FE-software Abaqus/CAE on both a tetrahedral and a hexahedral meshed femur. Accuracy of the FE models was confirmed by experimental testing using a composite femur with a segmental defect and an identical osteosynthesis plate for primary stabilisation with titanium screws. Both deflection of the femoral head and the gap alteration were measured with an optical measuring system with an accuracy of approximately 3 µm. For both screw modelling techniques a sufficient correlation of approximately 95% between numerical and experimental analysis was found. Furthermore, using structural elements for screw modelling the computational time could be reduced by 85% using hexahedral elements instead of tetrahedral elements for femur meshing. The automatically generated screw modelling offers a realistic simulation of the osteosynthesis fixation with screws in the adjacent

  5. Ball Screw Actuator Including a Compliant Ball Screw Stop

    NASA Technical Reports Server (NTRS)

    Wingett, Paul T. (Inventor); Hanlon, Casey (Inventor)

    2015-01-01

    An actuator includes a ball nut, a ball screw, and a ball screw stop. The ball nut is adapted to receive an input torque and in response rotates and supplies a drive force. The ball screw extends through the ball nut and has a first end and a second end. The ball screw receives the drive force from the ball nut and in response selectively translates between a retract position and a extend position. The ball screw stop is mounted on the ball screw proximate the first end to translate therewith. The ball screw stop engages the ball nut when the ball screw is in the extend position, translates, with compliance, a predetermined distance toward the first end upon engaging the ball nut, and prevents further rotation of the ball screw upon translating the predetermined distance.

  6. Titanium screw entered into maxillary sinus: a rare incident during rigid fixation of the porous polyethylene implant in enophthalmos correction.

    PubMed

    Fu, Xi; Liu, JianFeng; Zou, Chong; Rui, Lu; Gui, Lai

    2014-07-01

    Screw fixation is used for accurate augmentation by porous polyethylene implant in traumatic enophthalmos correction to avoid complications such as migration and protrusion. We report an incident of titanium screw entered into the maxillary sinus during enophthalmos correction with porous polyethylene implant. Such incident could be avoided by standard manipulation. We here present the rare case and offer proposals for the screw fixation of porous polyethylene implant during traumatic enophthalmos correction. PMID:25006927

  7. Coracoclavicular ligament reconstruction: biomechanical comparison of tendon graft repairs to a synthetic double bundle augmentation.

    PubMed

    Wellmann, Mathias; Kempka, Jan P; Schanz, Steffen; Zantop, Thore; Waizy, Hazibullah; Raschke, Michael J; Petersen, Wolf

    2009-05-01

    For currently presented anatomical coracoclavicular ligament repairs issues such as autologous tendon graft versus synthetic suture augmentation and the optimum fixation strategies for both types of reconstruction are not solved. The purpose of the study was to compare the biomechanical properties of different tendon graft repairs to the characteristics of a synthetic polyester augmentation. Four anatomical coracoclavicular ligament repairs were biomechanically tested: 5 mm coracoclavicular tendon loop with suture fixation, tendon loop with flip button fixation, tendon loop with interference screw fixation versus a double 1.0-mm polyester repair with flip button fixation. The biomechanical testing included cyclic superio-inferior loading and a subsequent load to failure protocol. The ultimate failure loads were significantly higher for the double polyester/flip button repair (927 N) compared to all tendon repair techniques (maximum 640 N). In contrast the stiffness level was higher for the tendon repairs compared to the polyester/flip button repair (68.7 N/mm) but strongly dependent on the fixation technique (interference screw 97.2 N/mm, flip button 84.9 N/mm, side to side suture 60.9 N/mm). A synthetic coracoclavicular augmentation using a polyester suture provides adequate structural properties compared to a tendon repair. Therefore the decision for a tendon graft should be made by the necessity of a biologic substrate rather than by the assumption of a biomechanical advantage. PMID:19225755

  8. A technique for in vitro fit assessment of multi-unit screw-retained implant restorations: Application of a triple-scan protocol

    PubMed Central

    Karl, Matthias; Wichmann, Manfred; Matta, Ragai E

    2012-01-01

    Recent advances in industrial non-contact scanners offer unprecedented opportunities for quality assessment of dental restorations. The majority of investigations published to date are limited to local two-dimensional results. A triple-scan protocol for virtual fit assessment of multi-unit screw-retained implant restorations is presented in this technical report. The advantages for application in biomechanical research include detailed three-dimensional information on internal component congruence in implant superstructures to be used in mathematical models. PMID:22924063

  9. Cement as a locking mechanism for screw heads in acetabular revision shells - a biomechanical analysis.

    PubMed

    Laflamme, G Y; Alami, G B; Zhim, F

    2008-01-01

    In acetabular revisions, polyethylene (PE) liners are often cemented into metal shells on top of acetabular screw heads. This study investigates the possibility of using this technique to obtain fixed-angle acetabular screws Eth a concept that has not yet been reported in the literature. Two groups of screws (n=8) were inserted into Trabecular Metal revision shells (Zimmer), into which PE liners were then cemented. Screws in Group 1, inserted in the shell's pre-fabricated holes, were countersunk, whereas screws in Group 2 were inserted in custom-drilled holes that make their heads protrude into, and interdigitate with, the overlying cement mantle. Perpendicular loading was then applied to the screw shafts both statically to failure and cyclically. A greater stiffness was observed for the protruding screws upon static loading; and while the countersunk screws all failed at the screw-cement junction (53.44 + or - 8.33 N), the protruding screws all failed at the screw shaft (1049.79 + or - 32.12 N) a 20-fold difference (p< 0.05). Under cyclic loading, only the protruding screw head specimen did not fail, undergoing an overall displacement within the limits of osseointegration.These results support the hypothesis that the protrusion of an acetabular screw head into an overlying cement mantle significantly increases its angular stability. Provided other variables are favorable, this locking effect may increase the initial stability of the whole implant, thus improving the ultimate success of complex acetabular revisions. PMID:18645971

  10. Twin screw wet granulation: Binder delivery.

    PubMed

    Saleh, Mohammed F; Dhenge, Ranjit M; Cartwright, James J; Hounslow, Michael J; Salman, Agba D

    2015-06-20

    The effects of three ways of binder delivery into the twin screw granulator (TSG) on the residence time, torque, properties of granules (size, shape, strength) and binder distribution were studied. The binder distribution was visualised through the transparent barrel using high speed imaging as well as quantified using offline technique. Furthermore, the effect of binder delivery and the change of screw configuration (conveying elements only and conveying elements with kneading elements) on the surface velocity of granules across the screw channel were investigated using particle image velocimetry (PIV). The binder was delivered in three ways; all solid binder incorporated with powder mixture, 50% of solid binder mixed with powder mixture and 50% mixed with water, all the solid binder dissolved in water. Incorporation of all solid binder with powder mixture resulted in the relatively longer residence time and higher torque, narrower granule size distribution, more spherical granules, weaker big-sized granules, stronger small-sized granules and better binder distribution compared to that in other two ways. The surface velocity of granules showed variation from one screw to another as a result of uneven liquid distribution as well as shown a reduction while introducing the kneading elements into the screw configuration. PMID:25869451

  11. Computer simulation of screw dislocation in aluminum

    NASA Technical Reports Server (NTRS)

    Esterling, D. M.

    1976-01-01

    The atomic structure in a 110 screw dislocation core for aluminum is obtained by computer simulation. The lattice statics technique is employed since it entails no artificially imposed elastic boundary around the defect. The interatomic potential has no adjustable parameters and was derived from pseudopotential theory. The resulting atomic displacements were allowed to relax in all three dimensions.

  12. Nylon screws make inexpensive coil forms

    NASA Technical Reports Server (NTRS)

    Aucoin, G.; Rosenthal, C.

    1978-01-01

    Standard nylon screws act as coil form copper wire laid down in spiral thread. Completed coil may be bonded to printed-circuit board. However, it is impossible to tune coil by adjusting spacing between windings, technique sometimes used with air-core coils.

  13. Helical screw viscometer

    DOEpatents

    Aubert, J.H.; Chapman, R.N.; Kraynik, A.M.

    1983-06-30

    A helical screw viscometer for the measurement of the viscosity of Newtonian and non-Newtonian fluids comprising an elongated cylindrical container closed by end caps defining a circular cylindrical cavity within the container, a cylindrical rotor member having a helical screw or ribbon flight carried by the outer periphery thereof rotatably carried within the cavity whereby the fluid to be measured is confined in the cavity filling the space between the rotor and the container wall. The rotor member is supported by axle members journaled in the end caps, one axle extending through one end cap and connectable to a drive source. A pair of longitudinally spaced ports are provided through the wall of the container in communication with the cavity and a differential pressure meter is connected between the ports for measuring the pressure drop caused by the rotation of the helical screw rotor acting on the confined fluid for computing viscosity.

  14. Screw-Retaining Allen Wrench

    NASA Technical Reports Server (NTRS)

    Granett, D.

    1985-01-01

    Steadying screws with fingers unnecessary. Crimp in uncompressed spring wire slightly protrudes from one facet of Allen wrench. Compressed spring retains Allen screw. Tool used with Allen-head screws in cramped spaces with little or no room for fingers to hold fastener while turned by wrench.

  15. Quantitative Anatomy of C7 Vertebra in Southern Chinese for Insertion of Lateral Mass Screws and Pedicle Screws

    PubMed Central

    Chan, Chi Hin; Wong, Kam Kwong; Wong, Wing Cheung

    2016-01-01

    Study Design Retrospective study. Purpose To analyze the quantitative anatomy of C7 vertebra for insertion of lateral mass screws and pedicle screws in Southern Chinese patients. Overview of Literature C7 lateral mass is smaller when compared to other subaxial cervical levels, which limits the length of lateral mass screws that can be used. Some studies have suggested pedicle screws for better fixation. But, this option is limited by the narrow pedicle width. Methods We have obtained computed tomography (CT) cervical spine data in 0.625 mm slices from our radiology department. The patients were adults. CTs were from May to August, 2015. The lateral mass screw length was measured using Margerl's technique and pedicle width and pedicle screw trajectory were determined in three-dimensional reformated images. Results CT scans of cervical spines of 94 patients were obtained and 188 lateral masses and pedicles of C7 vertebrae were measured. The mean lateral mass screw length was 13.2 mm (standard deviation [SD] 1.6 mm), mean outer pedicle width was 5.9 mm (SD 1.0 mm) and mean pedicle screw trajectory was 29.4 degrees (SD 3.6 degrees). Most (91.0%) of the pedicles had an outer diameter ≥4.5 mm. Conclusions The mean lateral mass screw length was longer when compared with other similar studies, while the mean outer pedicle width was narrower. Nearly 10% of the pedicles were unable to accommodate 3.5 mm screws. These findings favor the use of lateral mass screws to provide a safe and stable fixation for C7 vertebrae in Southern Chinese patients, while the final choice of fixation method should only be confirmed after careful preoperative planning with CT scan. PMID:27559451

  16. Bending strength and holding power of a prototype tibial locking screw.

    PubMed

    Lin, Jinn; Hou, Sheng-Mou

    2002-10-01

    To improve mechanical performance, a prototype tibial locking screw with two components was developed for the current study: a both-ends-threaded screw with a smooth shank and a small set screw inserted obliquely through the cap of the both-ends-threaded screw. The bending strength and holding power of this prototype screw were compared with that of five commercially available tibial locking screws: Synthes, Howmedica, Richards, Osteo AG, and Zimmer. To test bending strength, the screws were inserted into a polyethylene tube and loaded at their midpoint to simulate a three-point bending test. Single-loading yielding strength and cyclic-loading fatigue life then were measured. To test holding power, the screws were inserted into polyurethane foam tubes, and stripping torque and pushout strength were measured. The results showed that the yielding strength and the fatigue life were related closely to the inner diameter of the fully threaded screws. The stripping torque reflected the pushout strength, which also was estimated by the formula D[0.5 + 0.57735 (D - d)/2p] (D, outer diameter; d, inner diameter; p, pitch). Even though, among all of the tested screws, the prototype had the smallest outer diameter at its middle, it had the highest fatigue strength, and simultaneously preserved its high bone-holding power. A clinical trial using this prototype screw is warranted, one in which the difficult surgical technique of inserting the set screws should be investigated. PMID:12360032

  17. Comparison of the bending performance of solid and cannulated spinal pedicle screws using finite element analyses and biomechanical tests.

    PubMed

    Shih, Kao-Shang; Hsu, Ching-Chi; Hou, Sheng-Mou; Yu, Shan-Chuen; Liaw, Chen-Kun

    2015-09-01

    Spinal pedicle screw fixations have been used extensively to treat fracture, tumor, infection, or degeneration of the spine. Cannulated spinal pedicle screws with bone cement augmentation might be a useful method to ameliorate screw loosening. However, cannulated spinal pedicle screws might also increase the risk of screw breakage. Thus, the purpose of this study was to investigate the bending performance of different spinal pedicle screws with either solid design or cannulated design. Three-dimensional finite element models, which consisted of the spinal pedicle screw and the screw's hosting material, were first constructed. Next, monotonic and cyclic cantilever bending tests were both applied to validate the results of the finite element analyses. Finally, both the numerical and experimental approaches were evaluated and compared. The results indicated that the cylindrical spinal pedicle screws with a cannulated design had significantly poorer bending performance. In addition, conical spinal pedicle screws maintained the original bending performance, whether they were solid or of cannulated design. This study may provide useful recommendations to orthopedic surgeons before surgery, and it may also provide design rationales to biomechanical engineers during the development of spinal pedicle screws. PMID:26208430

  18. Biomechanical efficacy of monoaxial or polyaxial pedicle screw and additional screw insertion at the level of fracture, in lumbar burst fracture: An experimental study

    PubMed Central

    Wang, Hongwei; Li, Changqing; Liu, Tao; Zhao, Wei-dong; Zhou, Yue

    2012-01-01

    Background: Use of a pedicle screw at the level of fracture, also known as an intermediate screw, has been shown to improve clinical results in managing lumbar fracture, but there is a paucity of biomechanical studies to support the claim. The aim of this study was to evaluate the effect of adding intermediate pedicle screws at the level of a fracture on the stiffness of a short-segment pedicle fixation using monoaxial or polyaxial screws and to compare the strength of monoaxial and polyaxial screws in the calf spine fracture model. Materials and Methods: Flexibility of 12 fresh-frozen calf lumbar spine specimens was evaluated in all planes. An unstable burst fracture model was created at the level of L3 by the pre-injury and dropped-mass technique. The specimens were randomly divided into monoaxial pedicle screw (MPS) and polyaxial pedicle screw (PPS) groups. Flexibility was retested without and with intermediate screws (MPSi and PPSi) placed at the level of fracture in addition to standard screws placed at L2 and L4. Results: The addition of intermediate screws significantly increased the stability of the constructs, as measured by a decreased range of motion (ROM) in flexion, extension, and lateral bending in both MPS and PPS groups (P < 0.05). There was neither any significant difference in the ROM in the spines of the two groups before injury, nor a difference in the ROM between the MPSi and PPSi groups (P > 0.05), but there was a significant difference between MPS and PPS in flexion and extension in the short-segment fixation group (P < 0.05). Conclusions: The addition of intermediate screws at the level of a burst fracture significantly increased the stability of short-segment pedicle screw fixation in both the MPS and PPS groups. However, in short-segment fixation group, monoaxial pedicle screw exhibited more stability in flexion and extension than the polyaxial pedicle screw. PMID:22912513

  19. Noninvasive method for retrieval of broken dental implant abutment screw.

    PubMed

    Gooty, Jagadish Reddy; Palakuru, Sunil Kumar; Guntakalla, Vikram Reddy; Nera, Mahipal

    2014-04-01

    Dental implants made of titanium for replacement of missing teeth are widely used because of ease of technical procedure and high success rate, but are not free of complications and may fail. Fracturing of the prosthetic screw continues to be a problem in restorative practice and great challenge to remove the fractured screw conservatively. This case report describes and demonstrates the technique of using an ultrasonic scaler in the removal of the fracture screw fragment as a noninvasive method without damaging the hex of implants. PMID:24963261

  20. Noninvasive method for retrieval of broken dental implant abutment screw

    PubMed Central

    Gooty, Jagadish Reddy; Palakuru, Sunil Kumar; Guntakalla, Vikram Reddy; Nera, Mahipal

    2014-01-01

    Dental implants made of titanium for replacement of missing teeth are widely used because of ease of technical procedure and high success rate, but are not free of complications and may fail. Fracturing of the prosthetic screw continues to be a problem in restorative practice and great challenge to remove the fractured screw conservatively. This case report describes and demonstrates the technique of using an ultrasonic scaler in the removal of the fracture screw fragment as a noninvasive method without damaging the hex of implants. PMID:24963261

  1. The management of bone loss in revision total knee arthroplasty: rebuild, reinforce, and augment.

    PubMed

    Sculco, P K; Abdel, M P; Hanssen, A D; Lewallen, D G

    2016-01-01

    The treatment of bone loss in revision total knee arthroplasty has evolved over the past decade. While the management of small to moderate sized defects has demonstrated good results with a variety of traditional techniques (cement and screws, small metal augments, impaction bone grafting or modular stems), the treatment of severe defects continues to be problematic. The use of a structural allograft has declined in recent years due to an increased failure rate with long-term follow-up and with the introduction of highly porous metal augments that emphasise biological metaphyseal fixation. Recently published mid-term results on the use of tantalum cones in patients with severe bone loss has reaffirmed the success of this treatment strategy. PMID:26733657

  2. A capillary Archimedes' screw

    NASA Astrophysics Data System (ADS)

    Darbois Texier, Baptiste; Dorbolo, Stephane

    2014-11-01

    As used by Egyptians for irrigation and reported by Archimedes, a screw turning inside a hollow pipe can pull out a fluid againt gravity. At a centimetric scale, an analagous system can be found with a drop pending on a rotating spiral which is tilted toward the horizontal. The ascent of the drop to the top of the spiral is considered and a theoretical model based on geometrical considerations is proposed. The climb of the drop is limited by the fluid deposition on the screw at high capillary number and by a centrifugation phenomenon. We find out the range of fluid proprities and spiral characteristics for which an ascending motion of the drop is possible. Finally we discuss the efficiency of such system to extract a fluid from a bath at a centrimetric scale.

  3. NUT SCREW MECHANISMS

    DOEpatents

    Glass, J.A.F.

    1958-07-01

    A reactor control mechanism is described wherein the control is achieved by the partial or total withdrawal of the fissile material which is in the form of a fuel rod. The fuel rod is designed to be raised and lowered from the reactor core area by means of two concentric ball nut and screw assemblies that may telescope one within the other. These screw mechanisms are connected through a magnetic clutch to a speed reduction gear and an accurately controllable prime motive source. With the clutch energized, the fuel rod may be moved into the reactor core area, and fine adjustments may be made through the reduction gearing. However, in the event of a power failure or an emergency signal, the magnetic clutch will become deenergized, and the fuel rod will drop out of the core area by the force of gravity, thus shutting down the operation of the reactor.

  4. Stability of Uncemented Cups - Long-Term Effect of Screws, Pegs and HA Coating: A 14-Year RSA Follow-Up of Total Hip Arthroplasty.

    PubMed

    Otten, Volker T C; Crnalic, Sead; Röhrl, Stephan M; Nivbrant, Bo; Nilsson, Kjell G

    2016-01-01

    Screws, pegs and hydroxyapatite-coating are used to enhance the primary stability of uncemented cups. We present a 14-year follow-up of 48 hips randomized to four groups: press-fit only, press-fit plus screws, press-fit plus pegs and hydroxyapatite-coated cups. Radiostereometric migration measurements showed equally good stability regardless cup augmentation. The mean wear rate was high, 0.21 mm/year, with no differences between the groups. Seven hips had radiographical osteolysis but only in hips with augmented cups. Cups without screw-holes compared with cups with screw-holes resulted in better clinical outcome at the 14-year follow-up. Thus, augmentation of uncemented cups with screws, pegs, or hydroxyapatite did not appear to improve the long-term stability compared with press-fit only. PMID:26260783

  5. Strength comparison of allogenic bone screws, bioabsorbable screws, and stainless steel screw fixation.

    PubMed

    Rano, James A; Savoy-Moore, Ruth T; Fallat, Lawrence M

    2002-01-01

    Allogenic bone screws are new to the fixation market and have yet to be tested against current fixation materials. An in vitro comparison of the same sizes of stainless steel, bioabsorbable, and allogenic bone screws was undertaken to assess screw resistance to the forces of bending, pullout, and shear. Using aluminum plates to support the screws, forces up to 1000 Newtons were applied to six to eight samples of each type of screw. During each test, stainless steel screws withstood the maximum force that could be exerted by the testing apparatus without failing (bending, 113.9 +/- 11.8 N mean +/- SE; pullout 999.1 +/- 33.7 N; and shear, 997.5 +/- 108.8 N). In each test, compared to bioabsorbable screws, allogenic bone screws failed faster (pullout, allogenic: 12.4 +/- 1.1 seconds vs. bioabsorbable, 120.6 +/- 13.8 seconds; p = .001; bending, allogenic: 53.4 +/- 4.8 seconds vs. bioabsorbable, 201.9 +/- 11.1 seconds; p = .001; shear, allogenic 13.5 +/- 1.4 seconds vs. bioabsorbable, 43.8 +/- 0.9 seconds; p = .001) under equivalent (pullout: bioabsorbable, 385.0 +/- 18.4 N vs. allogenic, 401.0 +/- 35.9 N; p = .001) or lower (bending, allogenic: 4.7 +/- 0.2 N vs. bioabsorbable, 11.0 +/- 0.9 N; p = .675; shear, allogenic: 312.1 +/- 15.5 N vs. bioabsorbable 680.9 +/- 8.5 N; p = .001) loads, and in a highly variable fashion. Overall, the bioabsorbable screws withstood the forces of bending, pullout, and shear better than the allogenic screws, and stainless steel screws outperformed both bioabsorbable and allogenic screws. Despite these results, allogenic screws could still be useful in compliant patients who would benefit from their osteoconductive properties. PMID:11858609

  6. Parametric analysis of orthopedic screws in relation to bone density.

    PubMed

    Zanetti, Elisabetta M; Salaorno, Massimiliano; Grasso, Giovanni; Audenino, Alberto L

    2009-01-01

    A global study of geometry and material properties of orthopedic screws was performed, considering not only the effect of each single factor (screw pitch, number of threads, fillet angle, etc.) but also their interactions with respect to bone density.The stress patterns resulting from different screw geometries and bone densities were analyzed using finite element techniques, taking into account different levels of osseointegration between the screw and the bone. These numerical models where validated through experimental pull-out tests, where a pull out force of 120 N produced localized failure of the last thread (stresses above 0.42 MPa). The results of the numerical simulations were then summarised using a multi-factorial parametric analysis. This demonstrated the great relevance of the interaction between bone density and screw pitch, showing that the optimal screw pitch can vary by more than 25% for different densities (0.35 g/cm(3) and 0.47 g/cm(3), respectively).The parameters calculated by means of the multi-factorial analysis allow the pull out force to be estimated for different osseointegration levels, different screw geometries and material properties, and for different bone densities. The final objective is to determine the best choice of implant for each individual patient. PMID:19587807

  7. Pilot-optimal augmentation synthesis

    NASA Technical Reports Server (NTRS)

    Schmidt, D. K.

    1978-01-01

    An augmentation synthesis method usable in the absence of quantitative handling qualities specifications, and yet explicitly including design objectives based on pilot-rating concepts, is presented. The algorithm involves the unique approach of simultaneously solving for the stability augmentation system (SAS) gains, pilot equalization and pilot rating prediction via optimal control techniques. Simultaneous solution is required in this case since the pilot model (gains, etc.) depends upon the augmented plant dynamics, and the augmentation is obviously not a priori known. Another special feature is the use of the pilot's objective function (from which the pilot model evolves) to design the SAS.

  8. Low noise lead screw positioner

    NASA Technical Reports Server (NTRS)

    Perkins, Gerald S. (Inventor)

    1986-01-01

    A very precise and low noise lead screw positioner, for positioning a retroreflector in an interferometer is described. A gas source supplies inert pressurized gas, that flows through narrow holes into the clearance space between a nut and the lead screw. The pressurized gas keeps the nut out of contact with the screw. The gas flows axially along the clearance space, into the environment. The small amount of inert gas flowing into the environment minimizes pollution. By allowing such flow into the environment, no seals are required between the end of the nut and the screw.

  9. Access to Abutment Screw in Cement Retained Restorations: A Clinical Tip

    PubMed Central

    Harianawala, Husain; Kantharia, Nidhi; Sethi, Tania; Jambhekar, Shantanu

    2015-01-01

    Abutment screw loosening has been reported to be the most common prosthetic complications occurring in screw retained as well as cement retained implant restorations. Different methods to treat this issue have been reported in the literature so far; however these have their own short-comings. Retrievability of an implant restoration intact becomes a clinical challenge when the restoration is cement retained especially with an angulated abutment. This technique is aimed at accurately determining the position of the abutment screw in 3 dimensional relationships using a vacuum formed clear stent. This technique can be used as a viable protocol for management of screw loosening in cement retained implant restorations. PMID:25859535

  10. Accuracy of robot-assisted pedicle screw placement for adolescent idiopathic scoliosis in the pediatric population.

    PubMed

    Macke, Jeremy J; Woo, Raymund; Varich, Laura

    2016-06-01

    This is a retrospective review of pedicle screw placement in adolescent idiopathic scoliosis (AIS) patients under 18 years of age who underwent robot-assisted corrective surgery. Our primary objective was to characterize the accuracy of pedicle screw placement with evaluation by computed tomography (CT) after robot-assisted surgery in AIS patients. Screw malposition is the most frequent complication of pedicle screw placement and is more frequent in AIS. Given the potential for serious complications, the need for improved accuracy of screw placement has spurred multiple innovations including robot-assisted guidance devices. No studies to date have evaluated this robot-assisted technique using CT exclusively within the AIS population. Fifty patients were included in the study. All operative procedures were performed at a single institution by a single pediatric orthopedic surgeon. We evaluated the grade of screw breach, the direction of screw breach, and the positioning of the patient for preoperative scan (supine versus prone). Of 662 screws evaluated, 48 screws (7.2 %) demonstrated a breach of greater than 2 mm. With preoperative prone position CT scanning, only 2.4 % of screws were found to have this degree of breach. Medial malposition was found in 3 % of screws, a rate which decreased to 0 % with preoperative prone position scanning. Based on our results, we conclude that the proper use of image-guided robot-assisted surgery can improve the accuracy and safety of thoracic pedicle screw placement in patients with adolescent idiopathic scoliosis. This is the first study to evaluate the accuracy of pedicle screw placement using CT assessment in robot-assisted surgical correction of patients with AIS. In our study, the robot-assisted screw misplacement rate was lower than similarly constructed studies evaluating conventional (non-robot-assisted) procedures. If patients are preoperatively scanned in the prone position, the misplacement rate is further

  11. Biomechanical Evaluation of Plate Versus Lag Screw Only Fixation of Distal Fibula Fractures.

    PubMed

    Misaghi, Amirhossein; Doan, Josh; Bastrom, Tracey; Pennock, Andrew T

    2015-01-01

    Traditional fixation of unstable Orthopaedic Trauma Association type B/C ankle fractures consists of a lag screw and a lateral or posterolateral neutralization plate. Several studies have demonstrated the clinical success of lag screw only fixation; however, to date no biomechanical comparison of the different constructs has been performed. The purpose of the present study was to evaluate the biomechanical strength of these different constructs. Osteotomies were created in 40 Sawbones(®) distal fibulas and reduced using 1 bicortical 3.5-mm stainless steel lag screw, 2 bicortical 3.5-mm lag screws, 3 bicortical 3.5-mm lag screws, or a single 3.5-mm lag screw coupled with a stainless steel neutralization plate with 3 proximal cortical and 3 distal cancellous screws. The constructs were tested to determine the stiffness in lateral bending and rotation and failure torque. No significant differences in lateral bending or rotational stiffness were detected between the osteotomies fixed with 3 lag screws and a plate. Constructs fixed with 1 lag screw were weaker for both lateral bending and rotational stiffness. Osteotomies fixed with 2 lag screws were weaker in lateral bending only. No significant differences were found in the failure torque. Compared with lag screw only fixation, plate fixation requires larger incisions and increased costs and is more likely to require follow-up surgery. Despite the published clinical success of treating simple Orthopaedic Trauma Association B/C fractures with lag screw only fixation, many surgeons still have concerns about stability. For noncomminuted, long oblique distal fibula fractures, lag screw only fixation techniques offer construct stiffness similar to that of traditional plate and lag screw fixation. PMID:25990534

  12. Imaging screw dislocations at atomic resolution by aberration-corrected electron optical sectioning

    NASA Astrophysics Data System (ADS)

    Yang, H.; Lozano, J. G.; Pennycook, T. J.; Jones, L.; Hirsch, P. B.; Nellist, P. D.

    2015-06-01

    Screw dislocations play an important role in materials' mechanical, electrical and optical properties. However, imaging the atomic displacements in screw dislocations remains challenging. Although advanced electron microscopy techniques have allowed atomic-scale characterization of edge dislocations from the conventional end-on view, for screw dislocations, the atoms are predominantly displaced parallel to the dislocation line, and therefore the screw displacements are parallel to the electron beam and become invisible when viewed end-on. Here we show that screw displacements can be imaged directly with the dislocation lying in a plane transverse to the electron beam by optical sectioning using annular dark field imaging in a scanning transmission electron microscope. Applying this technique to a mixed [a+c] dislocation in GaN allows direct imaging of a screw dissociation with a 1.65-nm dissociation distance, thereby demonstrating a new method for characterizing dislocation core structures.

  13. Screw/stud removal tool

    NASA Technical Reports Server (NTRS)

    Daniels, K.; Herrick, D. E.; Rothermel, L.

    1980-01-01

    Tool removes stubborn panheaded screws or studs where conventional tools would be either too weak or inconvenient to use. Screws with damaged heads or slots can also be removed this way. Tool can be worked with one hand and easily fits limited-access and blind areas. It can be made in various sizes to fit different screwheads.

  14. Augmenting a Microbial Selective Plugging Technique with Polymer Flooding to Increase the Efficiency of Oil Recovery - A Search for Synergy

    SciTech Connect

    Brown, Lewis R.; Pittman Jr., Charles U.; Lynch, F. Leo; Vadie, A. Alex

    2003-02-10

    The overall objective of this project was to improve the effectiveness of a microbial selective plugging technique of improving oil recovery through the use of polymer floods. More specifically, the intent was to increase the total amount of oil recovered and to reduce the cost per barrel of incremental oil.

  15. The Use of Biofeedback to Augment the Acquisition of Skills in Performing Joint Mobilization Techniques among Physical Therapy Students

    ERIC Educational Resources Information Center

    Timmerberg, Jean Fitzpatrick

    2011-01-01

    Despite the frequent use of joint mobilizations and the available evidence of its effectiveness as a treatment for various musculoskeletal disorders, it is a technique that has been shown to have great variability within and between raters. This variability is believed to occur because of differences between therapists' ability to perceive…

  16. Polyaxial Screws in Locked Plating of Tibial Pilon Fractures.

    PubMed

    Yenna, Zachary C; Bhadra, Arup K; Ojike, Nwakile I; Burden, Robert L; Voor, Michael J; Roberts, Craig S

    2015-08-01

    This study examined the axial and torsional stiffness of polyaxial locked plating techniques compared with fixed-angle locked plating techniques in a distal tibia pilon fracture model. The effect of using a polyaxial screw to cross the fracture site was examined to determine its ability to control relative fracture site motion. A laboratory experiment was performed to investigate the biomechanical stiffness of distal tibia fracture models repaired with 3.5-mm anterior polyaxial distal tibial plates and locking screws. Sawbones Fourth Generation Composite Tibia models (Pacific Research Laboratories, Inc, Vashon, Washington) were used to model an Orthopaedic Trauma Association 43-A1.3 distal tibia pilon fracture. The polyaxial plates were inserted with 2 central locking screws at a position perpendicular to the cortical surface of the tibia and tested for load as a function of axial displacement and torque as a function of angular displacement. The 2 screws were withdrawn and inserted at an angle 15° from perpendicular, allowing them to span the fracture and insert into the opposing fracture surface. Each tibia was tested again for axial and torsional stiffness. In medial and posterior loading, no statistically significant difference was found between tibiae plated with the polyaxial plate and the central screws placed in the neutral position compared with the central screws placed at a 15° position. In torsional loading, a statistically significant difference was noted, showing greater stiffness in tibiae plated with the polyaxial plate and the central screws placed at a 15° position compared with tibiae plated with the central screws placed at a 0° (or perpendicular) position. This study showed that variable angle constructs show similar stiffness properties between perpendicular and 15° angle insertions in axial loading. The 15° angle construct shows greater stiffness in torsional loading. PMID:26270750

  17. An Innovative Universal Screw Removal Instrument

    PubMed Central

    Elmadağ, Mehmet; Uzer, Gökçer; Acar, Mehmet Ali

    2015-01-01

    Objective To present the clinical benefits of an instrument designed to facilitate removal of polyaxial screws during revision surgery. Methods All polyaxial screws can be removed without additional materials or a large amount of debridement using our newly designed instrument. Forty-two screws were removed from five patients without any complications using this instrument. Results We removed the cap screws and rods from the 42 polyaxial screws in five patients and made them monoaxial using the new screw removal apparatus. The screws and rods were removed quickly in a minimally invasive way with no complications. No damage to the pedicle or surrounding soft tissue occurred during screw removal. No neurogenic changes developed during revision surgery after changing the screws. Conclusion This newly designed screw removal instrument was used safely and effectively to remove all polyaxial and monoaxial pedicle screws. PMID:25883660

  18. Translational mini-screw implant research.

    PubMed

    Rossouw, Emile

    2014-09-01

    It is important to thoroughly test new materials as well as techniques when these innovations are to be utilized in the human clinical situation. Translational research fills this important niche. The purpose of translational research is to establish the continuity of evidence from the laboratory to the clinic and in so-doing, provide evidence that the material is functioning appropriately and that the process in the human will be successful. This concept applies to the mini-screw implant; which, has been very successfully introduced into the orthodontic armamentarium over the last decade for application as a temporary anchorage device. The examples of translational research that will be illustrated in this paper have paved the way to ensure that clinicians have evidence to confidently utilize mini-screw implants in orthodontic practice. Needless to say, more studies are needed to ensure a safe, effective and efficient manner to practice orthodontics. PMID:25138369

  19. Ridge augmentation with soft tissue procedures in aesthetic dentistry: first clinical results measured with a new kind of moire technique

    NASA Astrophysics Data System (ADS)

    Studer, Stephan P.; Bucher, Andreas; Mueller, Felix

    1993-09-01

    The oral health of the Swiss population was significantly improved by the successful prevention of dental caries and periodontitis. Along with the healthy dentition the demand for aesthetic dentistry is increasing. Removable partial dentures are becoming less accepted. Therefore, to substitute lost teeth by permanent fixed partial prosthesis (bridges), the often deformed alveolar ridge has to be operated, either to improve the aesthetic appearance or to make it possible to restore the missing teeth by a fixed cemented bridge. The aim of this paper is (1) to evaluate whether the moire technique is an appropriate and handy method, and (2) to validate the precision of the new method. The measuring system consisted of a moire projector with an integrated phase shift device and a moire viewer with a CCD video camera, connected to a frame grabber in a personal computer. a highly versatile software was allowed to control the system as well as to grab the moire images using the four-phase shift technique in order to compute the phase image of the actual object. The new technique was validated with one solid test object measured by a 3D coordination, high precision measuring machine.

  20. Mini-Open Suture Bridge Repair with Porcine Dermal Patch Augmentation for Massive Rotator Cuff Tear: Surgical Technique and Preliminary Results

    PubMed Central

    Lee, Sung-Moon; Lee, Young-Kuk; Shin, Hong-Kwan

    2014-01-01

    Background The aim of this study was to describe the mini-open suture bridge technique with porcine dermal patch augmentation for massive rotator cuff tear and to assess preliminary clinical and radiological results. Methods Five patients with massive rotator cuff tear for which it was not possible to restore the anatomical footprint underwent mini-open suture bridge repair using a porcine dermal patch. The patients' average age was 53.4 years (range, 45 to 57 years), and the average duration of follow-up was 20.6 months (range, 14 to 26 months). Patients were evaluated with preoperative and postoperative outcome measures, including a visual analog scale (VAS) for pain, the University of California Los Angeles (UCLA) score, and the American Shoulder and Elbow Surgeons (ASES) score. The structural integrity of repaired rotator cuffs was assessed by magnetic resonance imaging 6 months postoperatively. Results The average VAS pain score, UCLA score, and ASES score improved from 6.8, 15.4, and 39.4 preoperatively to 0.8, 31.2, and 86.4 postoperatively (p = 0.041, 0.042, and 0.043, respectively). Magnetic resonance images obtained at an average of 8 months after surgery showed that four patients had intact repair integrity with graft incorporation. One patient had a re-tear with partial healing but still had a satisfactory clinical outcome. There was no intraoperative or postoperative complication in any patient. Conclusions Mini-open suture bridge repair with porcine dermal patch augmentation can be an option in young patients with high physical demands and massive rotator cuff tears for which it is not possible to restore the anatomical footprint. PMID:25177460

  1. A novel approach to navigated implantation of S-2 alar iliac screws using inertial measurement units.

    PubMed

    Jost, Gregory F; Walti, Jonas; Mariani, Luigi; Cattin, Philippe

    2016-03-01

    OBJECT The authors report on a novel method of intraoperative navigation with inertial measurement units (IMUs) for implantation of S-2 alar iliac (S2AI) screws in sacropelvic fixation of the human spine and its application in cadaveric specimens. METHODS Screw trajectories were planned on a multiplanar reconstruction of the preoperative CT scan. The pedicle finder and screwdriver were equipped with IMUs to guide the axial and sagittal tilt angles of the planned trajectory, and navigation software was developed. The entry points were chosen according to anatomical landmarks on the exposed spine. After referencing, the sagittal and axial orientation of the pedicle finder and screwdriver were wirelessly monitored on a computer screen and aligned with the preoperatively planned tilt angles to implant the S2AI screws. The technique was performed without any intraoperative imaging. Screw positions were analyzed on postoperative CT scans. RESULTS Seventeen of 18 screws showed a good S2AI screw trajectory. Compared with the postoperatively measured tilt angles of the S2AI screws, the IMU readings on the screwdriver were within an axial plane deviation of 0° to 5° in 15 (83%) and 6° to 10° in 2 (11%) of the screws and within a sagittal plane deviation of 0° to 5° in 15 (83%) and 6° to 10° in 3 (17%) of the screws. CONCLUSIONS IMU-based intraoperative navigation may facilitate accurate placement of S2AI screws. PMID:26565762

  2. Decompressive cervical laminectomy and lateral mass screw-rod arthrodesis. Surgical analysis and outcome

    PubMed Central

    2011-01-01

    Background This study evaluates the outcome and complications of decompressive cervical Laminectomy and lateral mass screw fixation in 110 cases treated for variable cervical spine pathologies that included; degenerative disease, trauma, neoplasms, metabolic-inflammatory disorders and congenital anomalies. Methods A retrospective review of total 785 lateral mass screws were placed in patients ages 16-68 years (40 females and 70 males). All cases were performed with a polyaxial screw-rod construct and screws were placed by using Anderson-Sekhon trajectory. Most patients had 12-14-mm length and 3.5 mm diameter screws placed for subaxial and 28-30 for C1 lateral mass. Screw location was assessed by post operative plain x-ray and computed tomography can (CT), besides that; the facet joint, nerve root foramen and foramen transversarium violation were also appraised. Results No patients experienced neural or vascular injury as a result of screw position. Only one patient needed screw repositioning. Six patients experienced superficial wound infection. Fifteen patients had pain around the shoulder of C5 distribution that subsided over the time. No patients developed screw pullouts or symptomatic adjacent segment disease within the period of follow up. Conclusion decompressive cervical spine laminectomy and Lateral mass screw stabilization is a technique that can be used for a variety of cervical spine pathologies with safety and efficiency. PMID:21595968

  3. Percutaneous iliac screws for minimally invasive spinal deformity surgery.

    PubMed

    Wang, Michael Y

    2012-01-01

    Introduction. Adult spinal deformity (ASD) surgeries carry significant morbidity, and this has led many surgeons to apply minimally invasive surgery (MIS) techniques to reduce the blood loss, infections, and other peri-operative complications. A spectrum of techniques for MIS correction of ASD has thus evolved, most recently the application of percutaneous iliac screws. Methods. Over an 18 months 10 patients with thoracolumbar scoliosis underwent MIS surgery. The mean age was 73 years (70% females). Patients were treated with multi-level facet osteotomies and interbody fusion using expandable cages followed by percutaneous screw fixation. Percutaneous iliac screws were placed bilaterally using the obturator outlet view to target the ischial body. Results. All patients were successfully instrumented without conversion to an open technique. Mean operative time was 302 minutes and the mean blood loss was 480 cc, with no intraoperative complications. A total of 20 screws were placed successfully as judged by CT scanning to confirm no bony violations. Complications included: two asymptomatic medial breaches at T10 and L5, and one patient requiring delayed epidural hematoma evacuation. Conclusions. Percutaneous iliac screws can be placed safely in patients with ASD. This MIS technique allows for successful caudal anchoring to stress-shield the sacrum and L5-S1 fusion site in long-segment constructs. PMID:22900162

  4. Robot-assisted Anterior Odontoid Screw Fixation: A Case Report.

    PubMed

    Tian, Wei; Wang, Han; Liu, Ya-Jun

    2016-08-01

    Anterior odontoid screw fixation has been proved to be effective but technically challenging because the difficult approach is associated with high risks of screw malposition and damage to surrounding vital structures. Navigation techniques are therefore increasingly being used to improve safety and accuracy. However, no robot-assisted odontoid screw fixation has yet been reported. We here report a 61-year-old woman with a type II dens fracture on whom anterior odontoid screw fixation was performed under the guidance of a newly developed robotic system (TiRobot, co-designed by Beijing Jishuitan Hospital and TINAVI Medical Technologies). One odontoid screw was safely and accurately placed, the calculated deviation between the planned and actual positions being 0.9 mm. No intraoperative complications were identified and the patient was discharged on Day 5. Follow-up studies after 2 weeks showed good clinical and radiological results. We believe this is the first reported case of robot-assisted anterior odontoid screw fixation. We consider that complicated procedures can become feasible, safe and accurate using TiRobot systems. PMID:27627725

  5. Mersiline mesh in premaxillary augmentation.

    PubMed

    Foda, Hossam M T

    2005-01-01

    Premaxillary retrusion may distort the aesthetic appearance of the columella, lip, and nasal tip. This defect is characteristically seen in, but not limited to, patients with cleft lip nasal deformity. This study investigated 60 patients presenting with premaxillary deficiencies in which Mersiline mesh was used to augment the premaxilla. All the cases had surgery using the external rhinoplasty technique. Two methods of augmentation with Mersiline mesh were used: the Mersiline roll technique, for the cases with central symmetric deficiencies, and the Mersiline packing technique, for the cases with asymmetric deficiencies. Premaxillary augmentation with Mersiline mesh proved to be simple technically, easy to perform, and not associated with any complications. Periodic follow-up evaluation for a mean period of 32 months (range, 12-98 months) showed that an adequate degree of premaxillary augmentation was maintained with no clinically detectable resorption of the mesh implant. PMID:15959688

  6. Percutaneous pedicle screw placement into a spinal segment previously treated with vertebroplasty: technical note.

    PubMed

    Gernsback, Joanna E; Wang, Michael Y

    2016-05-01

    Vertebral augmentation with cement has become a common procedure for the treatment of compression fractures, leading to a growing population who have had this procedure and are now in need of another spinal surgery. This technical note reports an undescribed method for placing pedicle screws through a previously cemented level. PMID:26771370

  7. Fabrication of a screw-retained restoration avoiding the facial access hole: a clinical report.

    PubMed

    Garcia-Gazaui, Sabrina; Razzoog, Michael; Sierraalta, Marianella; Saglik, Berna

    2015-11-01

    Dental implant restorations may be either screw-retained or cemented onto an abutment. While each method has its advantages and disadvantages, cemented restorations are commonly used in the maxillary arch, usually because of esthetic concerns. Available bone in the anterior maxilla dictates the placement of the implant, which may result in a facially positioned screw-access opening. Still, a growing volume of literature states that periimplant soft tissues respond more favorably to screw-retained crowns than cement-retained crowns. This clinical report outlines a treatment with a new method of fabricating a custom abutment-crown combination for a screw-retained restoration. The technique allows the channel for the screw to be placed at an angle other than parallel to the implant body. In this case, the practitioner may choose either a screw-retained or cement-retained implant restoration, where previously only a cemented restoration was possible. PMID:26344192

  8. Two inhomogeneities of irregular shape with internal uniform stress fields interacting with a screw dislocation

    NASA Astrophysics Data System (ADS)

    Wang, Xu; Schiavone, Peter

    2016-07-01

    Using complex variable methods and conformal mapping techniques, we demonstrate rigorously that two inhomogeneities of irregular shape interacting with a screw dislocation can indeed maintain uniform internal stress distributions. Our analysis indicates that while the internal uniform stresses are independent of the existence of the screw dislocation, the shapes of the two inhomogeneities required to achieve this uniformity depend on the Burgers vector, the location of the screw dislocation, and the size of the inhomogeneities. In addition, we find that this uniformity of the internal stress field is achievable also when the two inhomogeneities interact with an arbitrary number of discrete screw dislocations in the matrix.

  9. Split spline screw

    NASA Technical Reports Server (NTRS)

    Vranish, John M. (Inventor)

    1993-01-01

    A split spline screw type payload fastener assembly, including three identical male and female type split spline sections, is discussed. The male spline sections are formed on the head of a male type spline driver. Each of the split male type spline sections has an outwardly projecting load baring segment including a convex upper surface which is adapted to engage a complementary concave surface of a female spline receptor in the form of a hollow bolt head. Additionally, the male spline section also includes a horizontal spline releasing segment and a spline tightening segment below each load bearing segment. The spline tightening segment consists of a vertical web of constant thickness. The web has at least one flat vertical wall surface which is designed to contact a generally flat vertically extending wall surface tab of the bolt head. Mutual interlocking and unlocking of the male and female splines results upon clockwise and counter clockwise turning of the driver element.

  10. A modified cementing technique using BoneSource to augment fixation of the acetabulum in a sheep model

    PubMed Central

    Timperley, A John

    2010-01-01

    Background and purpose Our aim was to assess in an animal model whether the use of HA paste at the cement-bone interface in the acetabulum improves fixation. We examined, in sheep, the effect of interposing a layer of hydroxyapatite cement around the periphery of a polyethylene socket prior to fixing it using polymethylmethacrylate (PMMA). Methods We performed a randomized study involving 22 sheep that had BoneSource hydroxyapatite material applied to the surface of the acetabulum before cementing a polyethylene cup at arthroplasty. We studied the gross radiographic appearance of the implant-bone interface and the histological appearance at the interface. Results There were more radiolucencies evident in the control group. Histologically, only sheep randomized into the BoneSource group exhibited a fully osseointegrated interface. Use of the hydroxyapatite material did not give any detrimental effects. In some cases, the material appeared to have been fully resorbed. When the material was evident in histological sections, it was incorporated into an osseointegrated interface. There was no giant cell reaction present. There was no evidence of migration of BoneSource to the articulation. Interpretation The application of HA material prior to cementation of a socket produced an improved interface. The technique may be useful in humans, to extend the longevity of the cemented implant by protecting the socket interface from the effect of hydrodynamic fluid flow and particulate debris. PMID:20586703

  11. Virtual estimates of fastening strength for pedicle screw implantation procedures

    NASA Astrophysics Data System (ADS)

    Linte, Cristian A.; Camp, Jon J.; Augustine, Kurt E.; Huddleston, Paul M.; Robb, Richard A.; Holmes, David R.

    2014-03-01

    Traditional 2D images provide limited use for accurate planning of spine interventions, mainly due to the complex 3D anatomy of the spine and close proximity of nerve bundles and vascular structures that must be avoided during the procedure. Our previously developed clinician-friendly platform for spine surgery planning takes advantage of 3D pre-operative images, to enable oblique reformatting and 3D rendering of individual or multiple vertebrae, interactive templating, and placement of virtual pedicle implants. Here we extend the capabilities of the planning platform and demonstrate how the virtual templating approach not only assists with the selection of the optimal implant size and trajectory, but can also be augmented to provide surrogate estimates of the fastening strength of the implanted pedicle screws based on implant dimension and bone mineral density of the displaced bone substrate. According to the failure theories, each screw withstands a maximum holding power that is directly proportional to the screw diameter (D), the length of the in-bone segm,ent of the screw (L), and the density (i.e., bone mineral density) of the pedicle body. In this application, voxel intensity is used as a surrogate measure of the bone mineral density (BMD) of the pedicle body segment displaced by the screw. We conducted an initial assessment of the developed platform using retrospective pre- and post-operative clinical 3D CT data from four patients who underwent spine surgery, consisting of a total of 26 pedicle screws implanted in the lumbar spine. The Fastening Strength of the planned implants was directly assessed by estimating the intensity - area product across the pedicle volume displaced by the virtually implanted screw. For post-operative assessment, each vertebra was registered to its homologous counterpart in the pre-operative image using an intensity-based rigid registration followed by manual adjustment. Following registration, the Fastening Strength was computed

  12. Removal torque of nail interlocking screws is related to screw proximity to the fracture and screw breakage.

    PubMed

    White, Alexander A; Kubacki, Meghan R; Samona, Jason; Telehowski, Paul; Atkinson, Patrick J

    2016-06-01

    Studies have shown that titanium implants can be challenging to explant due to the material's excellent biocompatibility and resulting osseointegration. Clinically, titanium alloy nail interlocking screws may require removal to dynamize a construct or revise the nail due to nonunion, infection, pain, or periprosthetic fracture. This study was designed to determine what variables influence the removal torque for titanium alloy interlocking screws. An intramedullary nail with four interlocking screws was used to stabilize a 1-cm segmental femoral defect in a canine model for 16 weeks. The animals were observed to be active following a several-day recovery after surgery. In six animals, the femora and implanted nail/screws were first tested to failure in torsion to simulate periprosthetic fracture of an implant after which the screws were then removed. In four additional animals, the screws were removed without mechanical testing. Both intraoperative insertional and extraction torques were recorded for all screws. Mechanical testing to failure broke 10/24 screws. On average, the intact screws required 70% of the insertional torque during removal while broken screws only required 16% of the insertional torque (p < 0.001). In addition, intact screws closer to the fracture required 2.8 times more removal torque than the outboard distal screw (p < 0.005). On average, the angle of rotation to peak torque was ∼80°. The peak axial load did not significantly correlate with the torque required to remove the screws. On average, the removal torque was lower than at the time of insertion, and less torque was required to remove broken screws and screws remote to the fracture. However, broken screws will require additional time to retrieve the remaining screw fragment. This study suggests that broken screws and screws in prematurely active patients will require less torque to remove. PMID:27129382

  13. Self-energized screw coupling

    NASA Technical Reports Server (NTRS)

    Lefever, A. E.; Totah, R. S.

    1980-01-01

    Threaded coupling carries its own store of rotational energy. Originally developed to ease task of astronauts assembling structures in space, coupling offers same advantages in other hazardous operations, such as underwater and in and around nuclear reactors. Coupling consists of two parts: crew portion and receptacle. When screw portion is inserted into receptacle and given slight push by operator, trigger pins release ratchet, allowing energy stored in springs to rotate screw into nut in receptacle.

  14. Augmented RIGS

    NASA Technical Reports Server (NTRS)

    Kaminskas, R. A.; Mcguire, D.

    1974-01-01

    The results of the Phase 2 Resonant Infrasonic Gauging System (RIGS) development program are presented. The program consisted of design, fabrication, and testing of an "augmented" RIGS concept. The RIGS is a gauging system capable of measuring propellant quantities in zero-g as well as under accelerated conditions. Except for hydrogen, it can be used to gauge virtually any propellant in liquid form, including cryogenics. The gage consists of a sensor unit which is attached to the propellant tank and an electronic control unit which may be positioned separately from the sensor. The control unit receives signals from the sensor as well as the propellant temperature measurement and the ullage gas pressure, and computes the propellant quantity in the tank.

  15. Anatomic Study of Anterior Transdiscal Axial Screw Fixation for Subaxial Cervical Spine Injuries

    PubMed Central

    Ji, Wei; Zheng, Minghui; Qu, Dongbin; Zou, Lin; Chen, Yongquan; Chen, Jianting; Zhu, Qingan

    2016-01-01

    Abstract Anterior transdiscal axial screw (ATAS) fixation is an alternative or supplement to the plate and screw constructs for the upper cervical spine injury. However, no existing literatures clarified the anatomic feasibility of this technique for subaxial cervical spine. Therefore, the objective of this study was to evaluate the anatomical feasibility and to establish guidelines for the use of the ATAS fixation for the subaxial cervical spine injury. Fifty normal cervical spines had radiographs to determine the proposed screw trajectory (the screw length and insertion angle) and the interbody graft-related parameters (the disc height and depth, and the distance between anterior vertebral margin and the screw) for all levels of the subaxial cervical spine. Following screw insertion in 8 preserved human cadaver specimens, surgical simulation and dissection verified the feasibility and safety of the ATAS fixation. Radiographic measurements showed the mean axial screw length and cephalic incline angle of all levels were 41.2 mm and 25.2°, respectively. The suitable depth of the interbody graft was >11.7 mm (the distance between anterior vertebral margin and the screw), but <17.1 mm (disc depth). Except the axial screw length, increase in all the measurements was seen with level up to C5–C6 segment. Simulated procedure in the preserved specimens demonstrated that ATAS fixation could be successfully performed at C2–C3, C3–C4, C4–C5, and C5–C6 levels, but impossible at C6–C7 due to the obstacle of the sternum. All screws were placed accurately. None of the screws penetrated into the spinal canal and caused fractures determined by dissecting the specimens. The anterior transdiscal axial screw fixation, as an alternative or supplementary instrumentation for subaxial cervical spine injuries, is feasible and safe with meticulous surgical planning. PMID:27495016

  16. Anatomic Study of Anterior Transdiscal Axial Screw Fixation for Subaxial Cervical Spine Injuries.

    PubMed

    Ji, Wei; Zheng, Minghui; Qu, Dongbin; Zou, Lin; Chen, Yongquan; Chen, Jianting; Zhu, Qingan

    2016-08-01

    Anterior transdiscal axial screw (ATAS) fixation is an alternative or supplement to the plate and screw constructs for the upper cervical spine injury. However, no existing literatures clarified the anatomic feasibility of this technique for subaxial cervical spine. Therefore, the objective of this study was to evaluate the anatomical feasibility and to establish guidelines for the use of the ATAS fixation for the subaxial cervical spine injury.Fifty normal cervical spines had radiographs to determine the proposed screw trajectory (the screw length and insertion angle) and the interbody graft-related parameters (the disc height and depth, and the distance between anterior vertebral margin and the screw) for all levels of the subaxial cervical spine. Following screw insertion in 8 preserved human cadaver specimens, surgical simulation and dissection verified the feasibility and safety of the ATAS fixation.Radiographic measurements showed the mean axial screw length and cephalic incline angle of all levels were 41.2 mm and 25.2°, respectively. The suitable depth of the interbody graft was >11.7 mm (the distance between anterior vertebral margin and the screw), but <17.1 mm (disc depth). Except the axial screw length, increase in all the measurements was seen with level up to C5-C6 segment. Simulated procedure in the preserved specimens demonstrated that ATAS fixation could be successfully performed at C2-C3, C3-C4, C4-C5, and C5-C6 levels, but impossible at C6-C7 due to the obstacle of the sternum. All screws were placed accurately. None of the screws penetrated into the spinal canal and caused fractures determined by dissecting the specimens.The anterior transdiscal axial screw fixation, as an alternative or supplementary instrumentation for subaxial cervical spine injuries, is feasible and safe with meticulous surgical planning. PMID:27495016

  17. Cement augmentation of implants--no general cure in osteoporotic fracture treatment. A biomechanical study on non-displaced femoral neck fractures.

    PubMed

    Hofmann-Fliri, Ladina; Nicolino, Tomas I; Barla, Jorge; Gueorguiev, Boyko; Richards, R Geoff; Blauth, Michael; Windolf, Markus

    2016-02-01

    Femoral neck fractures in the elderly are a common problem in orthopedics. Augmentation of screw fixation with bone cement can provide better stability of implants and lower the risk of secondary displacement. This study aimed to investigate whether cement augmentation of three cannulated screws in non-displaced femoral neck fractures could increase implant fixation. A femoral neck fracture was simulated in six paired human cadaveric femora and stabilized with three 7.3 mm cannulated screws. Pairs were divided into two groups: conventional instrumentation versus additional cement augmentation of screw tips with 2 ml TraumacemV+ each. Biomechanical testing was performed by applying cyclic axial load until failure. Failure cycles, axial head displacement, screw angle changes, telescoping and screw cut-out were evaluated. Failure (15 mm actuator displacement) occurred in the augmented group at 12,500 cycles (± 2,480) compared to 15,625 cycles (± 4,215) in the non-augmented group (p = 0.041). When comparing 3 mm vertical displacement of the head no significant difference (p = 0.72) was detected between the survival curves of the two groups. At 8,500 load-cycles (early onset failure) the augmented group demonstrated a change in screw angle of 2.85° (± 0.84) compared to 1.15° (± 0.93) in the non-augmented group (p = 0.013). The results showed no biomechanical advantage with respect to secondary displacement following augmentation of three cannulated screws in a non-displaced femoral neck fracture. Consequently, the indication for cement augmentation to enhance implant anchorage in osteoporotic bone has to be considered carefully taking into account fracture type, implant selection and biomechanical surrounding. PMID:26177609

  18. Simultaneous Use of Both Bilateral Intralaminar and Pedicle Screws for C2 Stabilization.

    PubMed

    Tarukado, Kiyoshi; Tono, Osamu; Doi, Toshio

    2015-10-01

    Four patients underwent stabilization surgery using both bilateral C2 pedicle screw (PS) and intralaminar screw (LS). Neural and vascular injury resulting from incorrect screw placement was assessed using computed tomography (CT). The evaluation of bone union was assessed by lateral flexion-extension X-ray films and CT. The symptoms were improved in all patients. There were no intraoperative complications. Furthermore, there were no cases of neurological worsening or vascular injury from incorrect screw placement. Failure of instrumentation or screw loosening during the follow-up period did not occur in any of the patients. All cases had accomplished bone union at the final follow-up. Theoretically, the stabilization technique using both bilateral C2 PS and LS at the same time can provide more stability than any other single technique. Simultaneous use of both bilateral C2 PS and LS is potentially a good choice for surgical repair. PMID:26435800

  19. Enhancement of pedicle screw stability using calcium phosphate cement in osteoporotic vertebrae: in vivo biomechanical study.

    PubMed

    Taniwaki, Yoshimichi; Takemasa, Ryuichi; Tani, Toshikazu; Mizobuchi, Hiroo; Yamamoto, Hiroshi

    2003-01-01

    We conducted an experimental study using female beagles with and without ovariectomy-induced osteoporosis to determine the effect of calcium phosphate cement (CPC) on the mechanical stability of inserted pedicle screws. A drill hole was created from the base of the transverse process to the vertebral body; CPC was injected into the hole, and then a screw was inserted into the same hole. In the presence of osteoporosis evidenced by dual X-ray absorptiometry, the stability of the inserted screw augmented by CPC against pull-out and cephalocaudal forces were significantly greater by 28% and 54% at 1 week after operation, 48% and 71% at 2 weeks, and 56% and 68% at 4 weeks compared with those without CPC. The pull-out strength increased progressively with time after surgery, probably reflecting new-bone growth from the surrounding cancellous bone, which was in direct contact with the CPC, as shown in the histologic study. At each time point the cephalocaudal rigidity was similar and the pull-out strength greater than that for the screws inserted without CPC in nonporotic dogs. These findings suggest that CPC augments the stability of the inserted pedicle screws and increases the stiffness of fixed osteoporotic motion segments using instrumentation. PMID:12768486

  20. Computer tomography assessment of pedicle screw insertion in percutaneous posterior transpedicular stabilization.

    PubMed

    Schizas, Constantin; Michel, Jacky; Kosmopoulos, Victor; Theumann, Nicolas

    2007-05-01

    Percutaneous insertion of cannulated pedicle screws has been recently developed as a minimally invasive alternative to the open technique during instrumented fusion procedures. Given the reported rate of screw misplacement using open techniques (up to 40%), we considered it important to analyze possible side effects of this new technique. Placement of 60 pedicle screws in 15 consecutive patients undergoing lumbar or lumbosacral fusion, mainly for spondylolisthesis, were analyzed. Axial, coronal, and sagittal reformatted computer tomography images were examined by three observers. Individual and consensus interpretation was obtained for each screw position. Along with frank penetration, we also looked at cortical encroachment of the pedicular wall by the screw. Thirteen percent of the patients (2/15) had severe frank penetration from the screws, while 80% of them (12/15) had some perforation. On axial images the incidence of severe frank pedicle penetration was 3.3% while the overall rate of screw perforation was 23%. In coronal images the overall screw perforation rate rose to 30% while the rate of severe frank pedicle penetration remained unchanged. One patient (6.6%) suffered S1 root symptoms due to a frankly medially misplaced screw, requiring re-operation. This study has shown that percutaneous insertion of cannulated pedicle screws in the lumbar spine is an acceptable procedure. The overall rate of perforation in axial images is below the higher rates reported in the literature but does remain important. Frank penetration of the pedicle was nevertheless low. It remains a demanding technique and has to be performed with extreme care to detail. PMID:16967297

  1. Cervical Pedicle Screw Fixation: Anatomic Feasibility of Pedicle Morphology and Radiologic Evaluation of the Anatomical Measurements

    PubMed Central

    2014-01-01

    Study Design All parameters were measured manually and with a computed tomography (CT) scanner. For the manual measurements, a Vernier scale instrument was used. Purpose This study evaluates quantitatively pedicles of middle and lower cervical spine (C3 to C7) and to evaluate the possibilities of using these structures as anchors in posterior cervical fusion. Overview of Literature Pedicle screws may be an alternative fixation technique for posterior cervical instrumentation. Methods Twenty-two bony sets of adult cervical spines were studied (110 vertebrae, 220 pedicles) from C3 down to C7. Results CT measurement of cervical pedicles appeared to be accurate and valuable for preoperative planning of cervical pedicle screw instrumentation. The study showed a high correlation between the values obtained by manual and CT measurements of pedicle dimensions. The technical challenge of insertion is the obvious theoretical drawback of the use of cervical pedicle screws. Many technical factors are important to consider, namely, the point of screw entry, the pedicle dimensions, the screw direction according to the pedicle angle and orientation, the screw diameter and length, and the method of screw introduction. Conclusions Transpedicular screw fixation of the cervical spine appears to be promising. Anatomic limitations should be clear to the surgeon. Further clinical and biomechanical studies are needed to settle this technique. PMID:24967041

  2. Minimally invasive dynamic hip screw for fixation of hip fractures

    PubMed Central

    Ho, Michael; Garau, Giorgio; Walley, Gayle; Oliva, Francesco; Panni, Alfredo Schiavone; Longo, Umile Giuseppe

    2008-01-01

    We compared a minimally invasive surgical technique to the conventional (open approach) surgical technique used in fixation of hip fractures with the dynamic hip screw (DHS) device. Using a case-control design (44 cases and 44 controls), we tested the null hypothesis that there is no difference between the two techniques in the following outcome measures: duration of surgery, time to mobilisation and weight bearing postoperatively, length of hospital stay, mean difference of pre- and postoperative haemoglobin levels, position of the lag screw of the DHS device in the femoral head, and the tip–apex distance. The minimally invasive DHS technique had significantly shorter duration of surgery and length of hospital stay. There was also less blood loss in the minimally invasive DHS technique. The minimally invasive DHS technique produces better outcome measures in the operating time, length of hospital stay, and blood loss compared to the conventional approach while maintaining equal fixation stability. PMID:18478227

  3. Expandable insert serves as screw anchor

    NASA Technical Reports Server (NTRS)

    1966-01-01

    Expandable self-locking adapter secures components to panels having one accessible side. Mounting holes in the panels may not be threaded to accommodate screws, therefore, the adapter contains a female thread that will mate a mounting screw.

  4. Postreduction Breast Augmentation

    PubMed Central

    Doft, Melissa A.

    2015-01-01

    Background: Most breast reduction patients are highly satisfied after surgery. However, there is a subset of women who seek breast augmentation years later to restore lost volume chiefly associated with weight loss and postpartum changes. Breast shape and overall aesthetics are often revised at the same time. Methods: A retrospective review was performed of 2 surgeons’ experiences with post-reduction breast augmentation. Twenty patients were identified between 2002 and 2014. An in-depth chart review was conducted to determine patient motivation and to examine the operative techniques employed. Implant variables, a reduction specimen weight to implant volume comparison (where available), and complications are reported. Results: The average age was 37.1 years and average body mass index was 21.8 kg/m2. Most patients waited over a decade to have their breasts revised. Weight loss was the motivating factor in 8 patients and pregnancy changes in 11. Nineteen patients wished to stay with the same bra size or 1 cup size larger. Although all patients elected to have an implant placed, 19 patients wished to have an improved breast shape, not specifically a larger volume. The average breast implant was 203.5 cm3 (range, 120–340 cm3). Complications from implant placement included a seroma treated by aspiration and a Baker class III capsular contracture that required surgical correction. Conclusions: A small subset of reduction mammaplasty patients seek breast augmentation many years later primarily to improve breast contour, not to restore their prereduction breast volumes. Conservative augmentation combined with revision of breast shape and areolar aesthetics yields good results with minimal complications. PMID:26579333

  5. Gluteal augmentation with cryopreserved fat.

    PubMed

    Moscatiello, Fabrizio; Aznar-Benitah, Salvador; Grella, Roberto; Jover, Javier Herrero

    2010-03-01

    Gluteal augmentation with autologous fat is becoming a standard ancillary procedure for sculpting the buttock area. The high rate of resorption due to aggressive harvesting techniques or inadequate injection procedures often leads to repeated treatments. Currently, several techniques for storing fat by controlled freezing and thawing procedures can guarantee a high rate of cell viability, similar to that obtained with fresh tissue. This allows surgeons to compile fat tissue available for future repeat injections, decreasing additional costs and morbidity for patients. The authors describe a case of gluteal augmentation with cryopreserved fat in a 42-year-old man. PMID:20442098

  6. Neurally augmented sexual function.

    PubMed

    Meloy, S

    2007-01-01

    Neurally Augmented Sexual Function (NASF) is a technique utilizing epidural electrodes to restore and improve sexual function. Orgasmic dysfunction is common in adult women, affecting roughly one quarter of populations studied. Many male patients suffering from erectile dysfunction are not candidates for phosphdiesterase therapy due to concomitant nitrate therapy. Positioning the electrodes at roughly the level of the cauda equina allows for stimulation of somatic efferents and afferents as well as modifying sympathetic and parasympathetic activity. Our series of women treated by NASF is described. Our experience shows that the evaluation of potential candidates for both correctable causes and psychological screening are important considerations. PMID:17691397

  7. History of gluteal augmentation.

    PubMed

    de la Peña, J Abel; Rubio, Omar V; Cano, Jacobo P; Cedillo, Mariana C; Garcés, Miriam T

    2006-07-01

    The concept of female beauty has changed throughout time, but the form and size of the breasts and gluteal region have remained constant as symbols of maximum femininity. Sculptures and prints show us feminine figures that are voluminous and reflect human history's interest in fertility. The early years of gluteal augmentation saw few published reports that described the procedure technique, follow-up, or possible complications. But developments continued as surgeons began experimenting with different anatomical planes for implant placement. The most important goal in plastic surgery is meeting a patient's expectations. It is important for the surgeon to thoroughly explain to patients what can realistically be achieved with a procedure. PMID:16818090

  8. Augmentation phalloplasty.

    PubMed

    Alter, G J

    1995-11-01

    Aesthetic procedures can increase the girth and visual length of the penis. Dermal-fat grafts increase penile circumference without the complications that result from fat injections. Release of the suspensory ligaments with skin advancement may increase flaccid penile length. Suprapubic lipectomy and Z-plasty of a penoscrotal web enhance penile appearance. Accurate diagnosis and meticulous technique are mandatory. PMID:7483137

  9. The Surgical Management of Traumatic Lower Cervical Spondylolisthesis with Posterior Percutaneous Pedicle Screw Fixation

    PubMed Central

    Luo, Peng; Ni, Wen-Fei; Wu, Yao-Sen; Wu, Ai-Min; Wang, Xiang-Yang; Xu, Hua-Zi

    2015-01-01

    We reported a technical report of traumatic lower cervical spondylolisthesisca used by bilateral pedicle fracture, without neurological compression. The patient was treated with the minimally invasive technique of percutaneous pedicle screw fixation. Fracture healing and normal cervical motion were confirmed by plain films and physical examinations on the 18-monthpostoperatively. The technique of percutaneous pedicle screw fixation might be an alternative strategy for the treatment of traumatic lower cervical spondylolisthesis with pedicle fracture. PMID:25901240

  10. Augmentation cystoplasty in neurogenic bladder

    PubMed Central

    Kocjancic, Ervin; Demirdağ, Çetin

    2016-01-01

    The aim of this review is to update the indications, contraindications, technique, complications, and the tissue engineering approaches of augmentation cystoplasty (AC) in patients with neurogenic bladder. PubMed/MEDLINE was searched for the keywords "augmentation cystoplasty," "neurogenic bladder," and "bladder augmentation." Additional relevant literature was determined by examining the reference lists of articles identified through the search. The update review of of the indications, contraindications, technique, outcome, complications, and tissue engineering approaches of AC in patients with neurogenic bladder is presented. Although some important progress has been made in tissue engineering AC, conventional AC still has an important role in the surgical treatment of refractory neurogenic lower urinary tract dysfunction. PMID:27617312

  11. Augmentation cystoplasty in neurogenic bladder.

    PubMed

    Çetinel, Bülent; Kocjancic, Ervin; Demirdağ, Çetin

    2016-09-01

    The aim of this review is to update the indications, contraindications, technique, complications, and the tissue engineering approaches of augmentation cystoplasty (AC) in patients with neurogenic bladder. PubMed/MEDLINE was searched for the keywords "augmentation cystoplasty," "neurogenic bladder," and "bladder augmentation." Additional relevant literature was determined by examining the reference lists of articles identified through the search. The update review of of the indications, contraindications, technique, outcome, complications, and tissue engineering approaches of AC in patients with neurogenic bladder is presented. Although some important progress has been made in tissue engineering AC, conventional AC still has an important role in the surgical treatment of refractory neurogenic lower urinary tract dysfunction. PMID:27617312

  12. Air-Lubricated Lead Screw

    NASA Technical Reports Server (NTRS)

    Perkins, G. S.

    1983-01-01

    Air lubricated lead screw and nut carefully machined to have closely matched closely fitting threads. Compressed air injected into two plenums encircle nut and flow through orifices to lubricate mating threads. Originally developed to position precisely interferometer retroreflector for airborne measurement of solar infrared radiation, device now has positioning accuracy of 0.25 micron.

  13. The surgical learning curve and accuracy of minimally invasive lumbar pedicle screw placement using CT based computer-assisted navigation plus continuous electromyography monitoring – a retrospective review of 627 screws in 150 patients

    PubMed Central

    McMillen, Jason

    2014-01-01

    Objective This study retrospectively assessed the accuracy of placement of lumbar pedicle screws placed by a single surgeon using a minimally-invasive, intra-operative CT-based computer navigated technique in combination with continuous electromyography (EMG) monitoring. The rates of incorrectly positioned screws were reviewed in the context of the surgeon's experience and learning curve. Methods Data was retrospectively reviewed from all consecutive minimally invasive lumbar fusions performed by the primary author over a period of over 4 years from April 2008 until October 2012. All cases that had utilized computer-assisted intra-operative CT-based image guidance and continuous EMG monitoring to guide percutaneous pedicle screw placement were analysed for the rates of malposition of the pedicle screws. Pedicle screw malposition was defined as having occurred if the screw trajectory was adjusted intraoperatively due to positive EMG responses, or due to breach of the pedicle cortex by more than 2mm on intraoperative CT imaging performed at the end of the instrumentation procedure. Further analysis of the data was undertaken to determine if the rates of malposition changed with the surgeon's experience with the technique. Results Six hundred and twenty-seven pedicle screws were placed in one hundred and fifty patients. The overall rate of intraoperative malposition and subsequent adjustment of pedicle screw placement was 3.8% (24 of 627 screws). Screw malposition was detected by intraoperative CT imaging. Warning of potential screw misplacement was provided by use of the EMG monitoring. With increased experience with the technique, rates of intraoperative pedicle screw malposition were found to decrease from 5.1% of screws in the first fifty patients, to 2.0% in the last 50 patients. Only one screw was suboptimally placed at the end of surgery, which did not result in a neurological deficit. Conclusion The use of CT-based computer-assisted navigation in combination

  14. Metallurgical examination of gun barrel screws

    SciTech Connect

    Bird, E.L.; Clift, T.L.

    1996-06-01

    The examination was conducted to determine the extent of degradation that had occurred after a series of firings; these screws prevent live rounds of ammunition from being loaded into the firing chamber. One concern is that if the screw tip fails and a live round is accidentally loaded into the chamber, a live round could be fired. Another concern is that if the blunt end of the screw begins to degrade by cracking, pieces could become small projectiles during firing. All screws used in firing 100 rounds or more exhibited some degree degradation, which progressively worsened as the number of rounds fired increased. (SEM, metallography, x-ray analysis, and microhardness were used.) Presence of cracks in these screws after 100 fired rounds is a serious concern that warrants the discontinued use of these screws. The screw could be improved by selecting an alloy more resistant to thermal and chemical degradation.

  15. Treatment of proximal phalangeal fractures with an antegrade intramedullary screw: a cadaver study.

    PubMed

    Borbas, P; Dreu, M; Poggetti, A; Calcagni, M; Giesen, T

    2016-09-01

    The aim of this study was to quantify the articular cartilage defect created with two different antegrade techniques of intramedullary osteosynthesis with a headless compression screw inserted through the metacarpophalangeal joint. In 12 out of 24 fingers from six cadaveric hands, a trans-articular technique with cannulated headless compression screws (2.2 and 3.0 mm diameter) was used; whereas in the other 12 fingers, an intra-articular fixation technique was used. The areas of the articular surface and the defects created were measured with a digital image software program. All measurements were made twice by two observers. In the intra-articular technique, the average defect in the base of the articular surface of the proximal phalanx was 4.6% with the 2.2 mm headless compression screw and 8.5% with the 3.0 mm screw. In the trans-articular technique, the defect size was slightly smaller; 4.2% with the 2.2 mm screw and 8% with the 3.0 mm screw, but the differences were not statistically significant. The main advantage of the intra-articular technique was that it avoided damage to the articular surface of the metacarpal head. PMID:27056278

  16. Biomechanical and finite element analyses of bone cement-Injectable cannulated pedicle screw fixation in osteoporotic bone.

    PubMed

    Liu, Yaoyao; Xu, Jianzhong; Sun, Dong; Luo, Fei; Zhang, Zehua; Dai, Fei

    2016-07-01

    The objectives of this study were to investigate the safety and biomechanical stability of a polymethylmethacrylate (PMMA)-augmented bone cement-injectable cannulated pedicle screw (CICPS) in cancellous bone model, and to analyze the stress distribution at the screw-cement-bone interface. The OMEGA cannulated pedicle screw (OPS) and conventional pedicle screw (CPS) were used as control groups. Safety of the CICPS was evaluated by the static bending and bending fatigue tests. Biomechanical stability was analyzed by the maximum axial pullout strength and maximum torque tests. Stress distribution at the screw-cement-bone interface was analyzed by the finite element (FE) method. The CICPS and CPS produced statistically similar values for bending stiffness, bending structural stiffness, and bending yield moment. The maximum pullout force was 53.47 ± 8.65 N in CPS group, compared to 130.82 ± 7.32 N and 175.45 ± 43.01 N in the PMMA-augmented OPS and CICPS groups, respectively (p < 0.05). The CICPS had a significantly greater torque than the OPS and CPS. The FE model did not reveal excessive stress at the screw-cement-bone interface in the CICPS group. In conclusion, PMMA-augmentation with CICPS may be a potentially useful method to increase the stability of pedicle screws in patients with osteoporosis. © 2015 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 104B: 960-967, 2016. PMID:25976272

  17. Twin screw granulation - review of current progress.

    PubMed

    Thompson, M R

    2015-01-01

    Twin screw granulation (TSG) is a new process of interest to the pharmaceutical community that can continuously wet granulate powders, doing so at lower liquid concentrations and with better product consistency than found by a high shear batch mixer. A considerable body of research has evolved over the short time since this process was introduced but generally with little comparison of results. A certain degree of confidence has been developed through these studies related to how process variables and many attributes of machinery configuration will affect granulation but some major challenges still lay ahead related to scalability, variations in the processing regimes related to degree of channel fill and the impact of wetting and granulation of complex powder formulations. This review examines the current literature for wet granulation processes studied in twin screw extrusion machinery, summarizing the influences of operational and system parameters affecting granule properties as well as strives to provide some practical observations to newly interested users of the technique. PMID:25402966

  18. Screw dislocations in GaN

    SciTech Connect

    Liliental-Weber, Zuzanna; Jasinski, Jacek B.; Washburn, Jack; O'Keefe, Michael A.

    2002-02-15

    GaN has received much attention over the past few years because of several new applications, including light emitting diodes, blue laser diodes and high-power microwave transistors. One of the biggest problems is a high density of structural defects, mostly dislocations, due to a lack of a suitable lattice-matched substrate since bulk GaN is difficult to grow in large sizes. Transmission Electron Microscopy (TEM) has been applied to study defects in plan-view and cross-sections on samples prepared by conventional techniques such as mechanical thinning and precision ion milling. The density of dislocations close to the sample surface of a 1 mm-thick HVPE sample was in the range of 3x109 cm-2. All three types of dislocations were present in these samples, and almost 50 percent were screw dislocations. Our studies suggest that the core structure of screw dislocations in the same material might differ when the material is grown by different methods.

  19. Gluteus augmentation with fat grafting.

    PubMed

    Perén, P A; Gómez, J B; Guerrerosantos, J; Salazar, C A

    2000-01-01

    This study presents the authors' experience with gluteus augmentation with autologus fat grafts and liposuction methods, having recorded the evolution of gluteus reshaping with autologus intramuscular fat graft injections for the past 5 years. Preoperative shape is discussed and patient evaluations, operative techniques, postoperative management, and longterm results are emphasized. PMID:11246428

  20. Restoration of divergent implants with a 2-piece screw-retained fixed, complete dental implant prostheses.

    PubMed

    Pelekanos, Stavros; Pozidi, Georgia; Kourtis, Stefanos

    2016-04-01

    Restoring a severely resorbed maxilla is challenging because of poor bone quality and the resorptive pattern that follows tooth loss. When bone augmentation is not possible, implants are placed in suboptimal positions, making the prosthetic rehabilitation more complex. This report presents the steps used to rehabilitate a severely resorbed maxilla with divergent implants, using an implant-supported 2-piece screw-retained prosthesis. PMID:26597464

  1. Breast augmentation surgery

    MedlinePlus

    Breast augmentation; Breast implants; Implants - breast; Mammaplasty ... Breast augmentation is done by placing implants behind breast tissue or under the chest muscle. An implant is a sac filled with either sterile salt water (saline) or a ...

  2. Helical screw expander evaluation project

    NASA Technical Reports Server (NTRS)

    Mckay, R.

    1982-01-01

    A one MW helical rotary screw expander power system for electric power generation from geothermal brine was evaluated. The technology explored in the testing is simple, potentially very efficient, and ideally suited to wellhead installations in moderate to high enthalpy, liquid dominated field. A functional one MW geothermal electric power plant that featured a helical screw expander was produced and then tested with a demonstrated average performance of approximately 45% machine efficiency over a wide range of test conditions in noncondensing, operation on two-phase geothermal fluids. The Project also produced a computer equipped data system, an instrumentation and control van, and a 1000 kW variable load bank, all integrated into a test array designed for operation at a variety of remote test sites. Data are presented for the Utah testing and for the noncondensing phases of the testing in Mexico. Test time logged was 437 hours during the Utah tests and 1101 hours during the Mexico tests.

  3. Helical screw expander evaluation project

    NASA Astrophysics Data System (ADS)

    McKay, R.

    1982-03-01

    A one MW helical rotary screw expander power system for electric power generation from geothermal brine was evaluated. The technology explored in the testing is simple, potentially very efficient, and ideally suited to wellhead installations in moderate to high enthalpy, liquid dominated field. A functional one MW geothermal electric power plant that featured a helical screw expander was produced and then tested with a demonstrated average performance of approximately 45% machine efficiency over a wide range of test conditions in noncondensing, operation on two-phase geothermal fluids. The Project also produced a computer equipped data system, an instrumentation and control van, and a 1000 kW variable load bank, all integrated into a test array designed for operation at a variety of remote test sites. Data are presented for the Utah testing and for the noncondensing phases of the testing in Mexico. Test time logged was 437 hours during the Utah tests and 1101 hours during the Mexico tests.

  4. Screw-fed pump system

    SciTech Connect

    Sprouse, Kenneth M

    2014-11-25

    A pump system includes a pump that includes a first belt and a second belt that are spaced apart from each other to provide generally straight sides of a passage there between. There is an inlet at one end of the passage and an outlet at an opposite end of the passage, with a passage length that extends between the inlet and the outlet. The passage defines a gap distance in a width direction between the straight sides at the passage inlet. A hopper includes an interior space that terminates at a mouth at the passage inlet. At least one screw is located within the interior space of the hopper and includes a screw diameter in the width direction that is less than or equal to the gap distance.

  5. Screw dislocation in a two-phase isotropic thin film

    NASA Astrophysics Data System (ADS)

    Chu, S. N. G.

    1982-04-01

    By using the complex potential and conformal mapping techniques, the stress field of a straight screw dislocation lying parallel to the surface of a two-phase isotropic thin film of equal thickness in each phase and a welded interface is analyzed. The solution, when reduced to a single-phase thin film, is in agreement with that derived by Liebfried and Dietze using an infinite array of image dislocations. The presence of a second phase is found to increase the magnitude of the stress components for the screw dislocation except for τxz near the interface where the effect is the reverse. The image force on the dislocation near the interface can be attractive or repulsive depending upon whether the dislocation is situated in the hard or soft phase. In the case where the dislocation is situated in the soft phase, the total image force tends to drive the screw dislocation to the surface. Furthermore, the screw dislocation is found to be unstable at the interface. The elastic solution for an interfacial dislocation becomes a special case.

  6. Screw-retained crown restorations of single implants: A step-by-step clinical guide

    PubMed Central

    Assaf, Mohammad; Gharbyeh, Alaa’ Z. Abu

    2014-01-01

    This paper shows the clinical steps for preparing a screw-retained crown for the restoration of a single implant. Impression-taking using open-tray technique and delivery of the crown is presented in a step-by-step manner elucidated by detailed photographs. Furthermore, the advantages and disadvantages of screw-retained crowns are discussed in comparison with the cemented restorations. PMID:25512742

  7. Translaminar screw fixation of a kyphosis of the cervical and thoracic spine in neurofibromatosis.

    PubMed

    Gardner, A; Millner, P; Liddington, M; Towns, G

    2009-09-01

    The spinal manifestations of neurofibromatosis include cervicothoracic kyphosis, in which scalloping of the vertebral body and erosion of the pedicles may render conventional techniques of fixation impossible. We describe a case of cervicothoracic kyphosis managed operatively with a vascularised fibular graft anteriorly across the apex of the kyphus, followed by a long posterior construct using translaminar screws, which allow segmental fixation in vertebral bodies where placement of the pedicle screws was impracticable. PMID:19721057

  8. Shock-Absorbent Ball-Screw Mechanism

    NASA Technical Reports Server (NTRS)

    Hirr, Otto A., Jr.; Meneely, R. W.

    1986-01-01

    Actuator containing two ball screws in series employs Belleville springs to reduce impact loads, thereby increasing life expectancy. New application of springs increases reliability of equipment in which ball screws commonly used. Set of three springs within lower screw of ball-screw mechanism absorbs impacts that result when parts reach their upper and lower limits of movement. Mechanism designed with Belleville springs as shock-absorbing elements because springs have good energy-to-volume ratio and easily stacked to attain any stiffness and travel.

  9. Minimally Invasive Lumbar Pedicle Screw Fixation Using Cortical Bone Trajectory – A Prospective Cohort Study on Postoperative Pain Outcomes

    PubMed Central

    Deb, Sayantan; Pham, Lan; Singh, Harminder

    2016-01-01

    Objective: Our study aims to evaluate the clinical outcomes of cortical screws in regards to postoperative pain. Background: Pedicle screw fixation is the current mainstay technique for posterior spinal fusion. Over the past decade, a new technique called cortical screw fixation has been developed, which allows for medialized screw placement through stronger cortical bone. There have been several studies that showed either biomechanical equivalence or superiority of cortical screws. However, there is currently only a single study in the literature looking at clinical outcomes of cortical screw fixation in patients who have had no prior spine surgery. Methods: We prospectively looked at the senior author’s patients who underwent cortical versus pedicle lumbar screw fixation surgeries between 2013 and 2015 for lumbar degenerative disease. Eighteen patients underwent cortical screw fixation, and 15 patients underwent traditional pedicle screw fixation. We looked at immediate postoperative pain, changes in short-term pain (six to 12 weeks post-surgery), and changes in long-term pain (six to eight months). All pain outcomes were measured using a visual analog scale ranging from 1 to 10. Mann-Whitney or Kruskal-Wallis tests were used to measure continuous data, and the Fisher Exact test was used to measure categorical data as appropriate. Results: Our results showed that the cortical screw cohort showed a trend towards having less peak postoperative pain (p = 0.09). The average postoperative pain was similar between the two cohorts (p = 0.93). There was also no difference in pain six to 12 weeks after surgery (p = 0.8). However, at six to eight months, the cortical screw cohort had worse pain compared to the pedicle screw cohort (p = 0.02). Conclusions: The cortical screw patients showed a trend towards less peak pain in the short-term (one to three days post-surgery) and more pain in the long-term (six to eight months post-surgery) compared to pedicle screw patients

  10. Augmented Reality in astrophysics

    NASA Astrophysics Data System (ADS)

    Vogt, Frédéric P. A.; Shingles, Luke J.

    2013-09-01

    Augmented Reality consists of merging live images with virtual layers of information. The rapid growth in the popularity of smartphones and tablets over recent years has provided a large base of potential users of Augmented Reality technology, and virtual layers of information can now be attached to a wide variety of physical objects. In this article, we explore the potential of Augmented Reality for astrophysical research with two distinct experiments: (1) Augmented Posters and (2) Augmented Articles. We demonstrate that the emerging technology of Augmented Reality can already be used and implemented without expert knowledge using currently available apps. Our experiments highlight the potential of Augmented Reality to improve the communication of scientific results in the field of astrophysics. We also present feedback gathered from the Australian astrophysics community that reveals evidence of some interest in this technology by astronomers who experimented with Augmented Posters. In addition, we discuss possible future trends for Augmented Reality applications in astrophysics, and explore the current limitations associated with the technology. This Augmented Article, the first of its kind, is designed to allow the reader to directly experiment with this technology.

  11. Dorsal multiple plating without routine transarticular screws for fixation of Lisfranc injury.

    PubMed

    Stern, Richard E; Assal, Mathieu

    2014-12-01

    Following a Lisfranc joint injury, stable fixation of the tarsometatarsal joints is crucial to avoid deformity and posttraumatic osteoarthritis, but the ideal method of fixation remains controversial. Kirschner wire (K-wire) fixation of all involved joints with cast immobilization resulted in loss of position, and was replaced by open reduction with improved fixation using transarticular screws. However, it seems intuitive that transarticular screws will result in further damage to already traumatized joints, and this has led to plate-spanning techniques. The objective of this study was to describe the method of dorsal multiple plating without the routine use of transarticular screws, and to report on the ability of plate fixation to maintain alignment comparable to that of transarticular screw fixation in 15 patients. PMID:25437072

  12. Simultaneous implant placement with ridge augmentation using an autogenous bone ring transplant.

    PubMed

    Omara, M; Abdelwahed, N; Ahmed, M; Hindy, M

    2016-04-01

    The severely defective socket, in which implant placement within the remaining bone will result in a significantly off-axis implant position, precludes immediate implant placement and requires bone grafting as an initial surgical intervention. The aims of this study were to evaluate autogenous chin bone ring consolidation after the augmentation of severely defective sockets and the clinical application of these rings in the premolar-molar region with simultaneous implant placement in a one-stage procedure. Ten patients with 12 defective sockets were included. Sockets were prepared with a trephine bur. Bone rings with a tapped implant osteotomy were harvested from the chin with a larger trephine bur. Bone rings were fitted in the prepared sockets. An implant drill was used to prepare the bone apical to the ring through its central osteotomy. Implants were screwed through the rings and the apical bone. Patients were examined clinically and radiographically immediately and at 6 months postoperative. Crestal bone changes were measured and evaluated statistically. All grafted sockets showed bone healing with no significant crestal bone resorption and no infection; only one ring showed dehiscence, which healed during the follow-up period. All implants showed radiographic evidence of osseointegration. The autogenous chin bone ring augmentation technique was found to be a reliable alternative method for the management of severely defective sockets. PMID:26644216

  13. Visualization and understanding of the granulation liquid mixing and distribution during continuous twin screw granulation using NIR chemical imaging.

    PubMed

    Vercruysse, Jurgen; Toiviainen, Maunu; Fonteyne, Margot; Helkimo, Niko; Ketolainen, Jarkko; Juuti, Mikko; Delaet, Urbain; Van Assche, Ivo; Remon, Jean Paul; Vervaet, Chris; De Beer, Thomas

    2014-04-01

    Over the last decade, there has been increased interest in the application of twin screw granulation as a continuous wet granulation technique for pharmaceutical drug formulations. However, the mixing of granulation liquid and powder material during the short residence time inside the screw chamber and the atypical particle size distribution (PSD) of granules produced by twin screw granulation is not yet fully understood. Therefore, this study aims at visualizing the granulation liquid mixing and distribution during continuous twin screw granulation using NIR chemical imaging. In first instance, the residence time of material inside the barrel was investigated as function of screw speed and moisture content followed by the visualization of the granulation liquid distribution as function of different formulation and process parameters (liquid feed rate, liquid addition method, screw configuration, moisture content and barrel filling degree). The link between moisture uniformity and granule size distributions was also studied. For residence time analysis, increased screw speed and lower moisture content resulted to a shorter mean residence time and narrower residence time distribution. Besides, the distribution of granulation liquid was more homogenous at higher moisture content and with more kneading zones on the granulator screws. After optimization of the screw configuration, a two-level full factorial experimental design was performed to evaluate the influence of moisture content, screw speed and powder feed rate on the mixing efficiency of the powder and liquid phase. From these results, it was concluded that only increasing the moisture content significantly improved the granulation liquid distribution. This study demonstrates that NIR chemical imaging is a fast and adequate measurement tool for allowing process visualization and hence for providing better process understanding of a continuous twin screw granulation system. PMID:24211658

  14. Optimization of volar percutaneous screw fixation for scaphoid waist fractures using traction, positioning, imaging, and an angiocatheter guide.

    PubMed

    Zlotolow, Dan A; Knutsen, Elisa; Yao, Jeffrey

    2011-05-01

    Percutaneous screw fixation of nondisplaced or reducible scaphoid fractures has become more popular as techniques and implants have improved. Many authors have advocated for the dorsal approach, citing difficulties with adequate screw placement from the volar approach. We have developed a straightforward and reproducible technique for volar percutaneous scaphoid screw fixation that mitigates most of the drawbacks of the approach. The wrist is held in extension and ulnar deviation with traction through the thumb. A 14-gauge angiocatheter needle is then used to localize the starting point and as a cannula for the guide wire. Specific fluoroscopic views help to confirm optimal guide wire placement. PMID:21527146

  15. Optical screw-wrench for interlocking 2PP-microstructures

    NASA Astrophysics Data System (ADS)

    Köhler, J.; Zyla, G.; Ksouri, S. I.; Esen, C.; Ostendorf, A.

    2016-03-01

    Two-photon polymerization (2PP) has emerged as a powerful platform for processing three-dimensional microstructures with high resolution. Furthermore, by adding nanoparticles of different materials to the photopolymer the microstructures can be functionalized, e.g. magnetic or electric properties can be adjusted. However, to combine different functions within one microstructure or to manufacture complex microsystems, assembling techniques for multiple 2PP written building blocks are required. In this paper a qualitative approach for assembling microstructures utilizing optical forces is presented. Therefore, screw and nut shaped microstructures are produced by 2PP-technique and screwed together using a holographic optical tweezer (HOT). The interlocking structures are trapped and rotated into each other to cause connection. In this paper the used parameters and possible designs of the interlocking connection are discussed. These findings provide not only the assembling of building blocks to complex microstructures, rather different functionalized 2PP-microstructures can be combined by simply screwing them together with the use of optical forces.

  16. Screw insertion in trabecular bone causes peri-implant bone damage.

    PubMed

    Steiner, Juri A; Ferguson, Stephen J; van Lenthe, G Harry

    2016-04-01

    Secure fracture fixation is still a major challenge in orthopedic surgery, especially in osteoporotic bone. While numerous studies have investigated the effect of implant loading on the peri-implant bone after screw insertion, less focus has been put on bone damage that may occur due to the screw insertion process itself. Therefore, the aim of this study was to localize and quantify peri-implant bone damage caused by screw insertion. We used non-invasive three-dimensional micro-computed tomography to scan twenty human femoral bone cores before and after screw insertion. After image registration of the pre- and post-insertion scans, changes in the bone micro-architecture were identified and quantified. This procedure was performed for screws with a small thread size of 0.3mm (STS, N=10) and large thread size of 0.6mm (LTS, N=10). Most bone damage occurred within a 0.3mm radial distance of the screws. Further bone damage was observed up to 0.6mm and 0.9mm radial distance from the screw, for the STS and LTS groups, respectively. While a similar amount of bone damage was found within a 0.3mm radial distance for the two screw groups, there was significantly more bone damage for the LTS group than the STS group in volumes of interest between 0.3-0.6mm and 0.6-0.9mm. In conclusion, this is the first study to localize and quantify peri-implant bone damage caused by screw insertion based on a non-invasive, three-dimensional, micro-CT imaging technique. We demonstrated that peri-implant bone damage already occurs during screw insertion. This should be taken into consideration to further improve primary implant stability, especially in low quality osteoporotic bone. We believe that this technique could be a promising method to assess more systematically the effect of peri-implant bone damage on primary implant stability. Furthermore, including peri-implant bone damage due to screw insertion into patient-specific in silico models of implant-bone systems could improve the

  17. S-1 and S-2-alar-iliac screw fixation via intraoperative navigation.

    PubMed

    Pham, Martin H; Jakoi, Andre M; Hsieh, Patrick C

    2016-07-01

    Adult deformity patients often require fixation to the sacrum and pelvis for construct stability and improved fusion rates. Although certain sacropelvic fixation techniques can be challenging, the availability of intraoperative navigation has made many of these techniques more feasible. In this video case presentation, the authors demonstrate the techniques of S-1 bicortical screw and S-2-alar-iliac screw fixation under intraoperative navigation in a 67-year-old female. This instrumentation placement was part of an overall T-10-pelvis construct for the correction of adult spinal deformity. The video can be found here: https://youtu.be/3HZo-80jQr8 . PMID:27364427

  18. Navigation of Pedicle Screws in the Thoracic Spine with a New Electromagnetic Navigation System: A Human Cadaver Study

    PubMed Central

    Hahn, Patrick; Oezdemir, Semih; Komp, Martin; Giannakopoulos, Athanasios; Kasch, Richard; Merk, Harry; Liermann, Dieter; Godolias, Georgios; Ruetten, Sebastian

    2015-01-01

    Introduction. Posterior stabilization of the spine is a standard procedure in spinal surgery. In addition to the standard techniques, several new techniques have been developed. The objective of this cadaveric study was to examine the accuracy of a new electromagnetic navigation system for instrumentation of pedicle screws in the spine. Material and Method. Forty-eight pedicle screws were inserted in the thoracic spine of human cadavers using EMF navigation and instruments developed especially for electromagnetic navigation. The screw position was assessed postoperatively by a CT scan. Results. The screws were classified into 3 groups: grade 1 = ideal position; grade 2 = cortical penetration <2 mm; grade 3 = cortical penetration ≥2 mm. The initial evaluation of the system showed satisfied positioning for the thoracic spine; 37 of 48 screws (77.1%, 95% confidence interval [62.7%, 88%]) were classified as group 1 or 2. Discussion. The screw placement was satisfactory. The initial results show that there is room for improvement with some changes needed. The ease of use and short setup times should be pointed out. Instrumentation is achieved without restricting the operator's mobility during navigation. Conclusion. The results indicate a good placement technique for pedicle screws. Big advantages are the easy handling of the system. PMID:25759814

  19. Confronting an Augmented Reality

    ERIC Educational Resources Information Center

    Munnerley, Danny; Bacon, Matt; Wilson, Anna; Steele, James; Hedberg, John; Fitzgerald, Robert

    2012-01-01

    How can educators make use of augmented reality technologies and practices to enhance learning and why would we want to embrace such technologies anyway? How can an augmented reality help a learner confront, interpret and ultimately comprehend reality itself ? In this article, we seek to initiate a discussion that focuses on these questions, and…

  20. Equating of Augmented Subscores

    ERIC Educational Resources Information Center

    Sinharay, Sandip; Haberman, Shelby J.

    2011-01-01

    Recently, there has been an increasing level of interest in subscores for their potential diagnostic value. Haberman (2008b) suggested reporting an augmented subscore that is a linear combination of a subscore and the total score. Sinharay and Haberman (2008) and Sinharay (2010) showed that augmented subscores often lead to more accurate…

  1. Implicit modeling of screw threads for efficient finite element analysis of complex bone-implant systems.

    PubMed

    Inzana, Jason A; Varga, Peter; Windolf, Markus

    2016-06-14

    Finite element analysis is commonly used to assist in the development and evaluation of orthopedic devices. The physics of these models are simplified through approximations that enable more efficient simulations, without compromising the accuracy of the relative comparisons between implant designs or configurations. This study developed and evaluated a technique to approximate the behavior of a finely threaded screw using a smooth cylinder with the threads implicitly represented through interfacial contact conditions. This pseudo-threaded model was calibrated by comparing to simulations that explicitly modeled the thread geometry with frictional contact. A parametric analysis was performed with a single screw-in-bone system, five loading directions, and three Young׳s moduli that span the range of cancellous bone (200, 600, and 1,000MPa). Considering that screw cut-out from cancellous bone is a critical clinical issue in the osteoporotic proximal humerus, the pseudo-threaded model was compared with a bonded interface to examine three different screw configurations in a 3-part proximal humerus fracture across 10 patients. In the single screw-in-bone system, the pseudo-threaded model predicted the screw displacement of the explicitly threaded model with 1-5% difference and estimated the strain distributions and magnitudes more accurately than a bonded interface. Yet, the relative comparisons of implant stability across the three different screw configurations in the proximal humerus were not affected by the modeling choice for the bone-screw interface. Therefore, the bonded interface could serve as a more efficient methodology for making relative comparisons between implants that utilize the same thread profile. PMID:27157243

  2. Muzzle shunt augmentation of conventional railguns

    SciTech Connect

    Parker, J.V.

    1990-01-01

    Augmentation is a well-known technique for reducing the armature current and hence the armature power dissipation in a plasma armature railgun. In spite of the advantages, no large augmented railguns have been built, primarily due to the mechanical and electrical complexity introduce by the extra conductors required. It is possible to achieve some of the benefits of augmentation in conventional railgun by diverting a fraction {phi} of the input current through a shunt path at the muzzle of the railgun. In particular, the relation between force and armature current is the same as that obtained in an n-turn, series connected augmented railgun with n = 1/(1-{phi}). The price of this simplification is a reduction in electrical efficiency and some additional complexity in the external electrical system. Additions to the electrical system are required to establish the shunt current and to control its magnitude during projectile acceleration. The relationship between muzzle shunt augmentation and conventional series augmentation is developed and various techniques is developed and various techniques for establishing and controlling the shunt current are illustrated with a practical example. 5 refs., 8 figs., 2 tabs.

  3. Scaphoid Fracture Fixation with an Acutrak(®) Screw.

    PubMed

    Loving, Vilert A; Richardson, Michael L

    2006-01-01

    We report a case of fixation of a scaphoid fracture using an Acutrak(®) screw. This screw is cannulated and headless, which allows it to be implanted below the surface of the bone. It uses the same concept of variable thread pitch as the Herbert screw, but unlike the Herbert screw, is fully threaded, with continuously varying pitch along its length. This variable pitch creates constant compression across a fracture as the screw is advanced, and gives the screw its unique appearance. This feature may improve internal holding power, as well as allow a fracture or osteotomy site to lie anywhere along the length of the screw. PMID:27298683

  4. Bio-Augmentation of Cupriavidus sp. CY-1 into 2,4-D Contaminated Soil: Microbial Community Analysis by Culture Dependent and Independent Techniques

    PubMed Central

    Chang, Young-Cheol; Reddy, M. Venkateswar; Umemoto, Honoka; Sato, Yuki; Kang, Mi-Hye; Yajima, Yuka; Kikuchi, Shintaro

    2015-01-01

    In the present study, a 2,4-dichlorophenoxyacetic acid (2,4-D) degrading bacterial strain CY-1 was isolated from the forest soil. Based on physiological, biochemical and 16S rRNA gene sequence analysis it was identified as Cupriavidus sp. CY-1. Further 2,4-D degradation experiments at different concentrations (200 to 800 mg l-1) were carried out using CY-1. Effect of NaCl and KNO3 on 2,4-D degradation was also evaluated. Degradation of 2,4-D and the metabolites produced during degradation process were analyzed using high pressure liquid chromatography (HPLC) and GC-MS respectively. The amount of chloride ions produced during the 2,4-D degradation were analyzed by Ion chromatography (IC) and it is stoichiometric with 2,4-D dechlorination. Furthermore two different types of soils collected from two different sources were used for 2,4-D degradation studies. The isolated strain CY-1 was bio-augmented into 2,4-D contaminated soils to analyze its degradation ability. Culture independent methods like denaturing gradient gel electrophoresis (DGGE) and terminal restriction fragment length polymorphism (T-RFLP), and culture dependent methods like colony forming units (CFU) and most probable number (MPN) were used to analyze the survivability of strain CY-1 in contaminated soil. Results of T-RFLP were coincident with the DGGE analysis. From the DGGE, T-RFLP, MPN and HPLC results it was concluded that strain CY-1 effectively degraded 2,4-D without disturbing the ecosystem of soil indigenous microorganisms. PMID:26710231

  5. Screw-released roller brake

    NASA Technical Reports Server (NTRS)

    Vranish, John M. (Inventor)

    1999-01-01

    A screw-released roller brake including an input drive assembly, an output drive assembly, a plurality of locking sprags, a mechanical tripper nut for unlocking the sprags, and a casing therefor. The sprags consist of three dimensional (3-D) sprag members having pairs of contact surface regions which engage respective pairs of contact surface regions included in angular grooves or slots formed in the casing and the output drive assembly. The sprags operate to lock the output drive assembly to the casing to prevent rotation thereof in an idle mode of operation. In a drive mode of operation, the tripper is either self actuated or motor driven and is translated linearly up and down against a spline and at the limit of its travel rotates the sprags which unlock while coupling the input drive assembly to the output drive assembly so as to impart a turning motion thereto in either a clockwise or counterclockwise direction.

  6. Fluoroscopy-guided pedicle screw accuracy with a mini-open approach: a tomographic evaluation of 470 screws in 125 patients

    PubMed Central

    Soriano-Sánchez, José Antonio; Gutiérrez-Partida, Carlos Francisco; Ramírez-Barrios, Luis Rodolfo; Ortíz-Leyva, Ramses Uriel; Rodríguez-García, Manuel; Sánchez-Escandón, Oscar

    2015-01-01

    Background Transpedicular screws are currently placed with open free hand and minimally invasive techniques assisted with either fluoroscopy or navigation. Screw placement accuracy had been investigated with several methods reaching accuracy rates from 71.9% to 98.8%. The objective of this study was to assess the accuracy and safety for 2-D fluoroscopy-guided screw placement assisted with electrophysiological monitoring and the inter-observer agreement for the breach classification. Methods A retrospective review was performed on 125 consecutive patients who underwent minimally invasive transforaminal lumbar interbody fusion and transpedicular screws placement between the levels of T-12 and S-1. Screw accuracy was evaluated using a postoperative computed tomography by three independent observers. Pedicle breach was documented when there was a violation in any direction of the pedicle. Inter-observer agreement was assessed with the Kappa coefficient. Results A total of 470 transpedicular screws were evaluated between the levels of T-12 and S-1. In 57 patients the instrumentation was bilateral and in 68 unilateral. A substantial degree of agreement was found between the observers AB (κ=0.769) and A-C (κ=0.784) and almost perfect agreement between observers B-C (κ=0.928). There were a total of 427.33 (90.92%) screws without breach, 39.33 (8.37%) minor breach pedicles and 3.33 (0.71%) major breach pedicles. The pedicle breach rate was 9.08% Trajectory pedicle breach percentages were as follows: minor medial pedicle breach 4.68%, minor lateral pedicle breach 3.47%, minor inferior pedicle breach 0.22%, and major medial breach 0.70%. No intraoperative instrumentation-related or postoperative clinical complications were encountered and no surgical revision was needed. Conclusions Our study demonstrated a high accuracy (90.2%) for 2-D fluoroscopy-guided pedicle screw using electromonitoring. Only 0.71% of the 470 screws had a major breach. Knowing the radiological spine

  7. Reinforcement of osteosynthesis screws with brushite cement.

    PubMed

    Van Landuyt, P; Peter, B; Beluze, L; Lemaître, J

    1999-08-01

    The fixation of osteosynthesis screws remains a severe problem for fracture repair among osteoporotic patients. Polymethyl-methacrylate (PMMA) is routinely used to improve screw fixation, but this material has well-known drawbacks such as monomer toxicity, exothermic polymerization, and nonresorbability. Calcium phosphate cements have been developed for several years. Among these new bone substitution materials, brushite cements have the advantage of being injectable and resorbable. The aim of this study is to assess the reinforcement of osteosynthesis screws with brushite cement. Polyurethane foams, whose density is close to that of cancellous bone, were used as bone model. A hole was tapped in a foam sample, then brushite cement was injected. Trabecular osteosynthesis screws were inserted. After 24 h of aging in water, the stripping force was measured by a pull-out test. Screws (4.0 and 6.5 mm diameter) and two foam densities (0.14 and 0.28 g/cm3) were compared. Cements with varying solid/liquid ratios and xanthan contents were used in order to obtain the best screw reinforcement. During the pull-out test, the stripping force first increases to a maximum, then drops to a steady-state value until complete screw extraction. Both maximum force and plateau value increase drastically in the presence of cement. The highest stripping force is observed for 6.5-mm screws reinforced with cement in low-density foams. In this case, the stripping force is multiplied by 3.3 in the presence of cement. In a second experiment, cements with solid/liquid ratio ranging from 2.0 to 3.5 g/mL were used with 6.5-mm diameter screws. In some compositions, xanthan was added to improve injectability. The best results were obtained with 2.5 g/mL cement containing xanthan and with 3.0 g/mL cements without xanthan. A 0.9-kN maximal stripping force was observed with nonreinforced screws, while 1.9 kN was reached with reinforced screws. These first results are very promising regarding screw

  8. Vertical-Screw-Auger Conveyer Feeder

    NASA Technical Reports Server (NTRS)

    Walton, Otis (Inventor); Vollmer, Hubert J. (Inventor)

    2016-01-01

    A conical feeder is attached to a vertically conveying screw auger. The feeder is equipped with scoops and rotated from the surface to force-feed regolith the auger. Additional scoops are possible by adding a cylindrical section above the conical funnel section. Such then allows the unit to collect material from swaths larger in diameter than the enclosing casing pipe of the screw auger. A third element includes a flexible screw auger. All three can be used in combination in microgravity and zero atmosphere environments to drill and recover a wide area of subsurface regolith and entrained volatiles through a single access point on the surface.

  9. The Effects of Screw Length on Stability of Simulated Osteoporotic Distal Radius Fractures Fixed with Volar Locking Plates

    PubMed Central

    Wall, Lindley B.; Brodt, Michael D.; Silva, Matthew J.; Boyer, Martin I.; Calfee, Ryan P.

    2013-01-01

    Purpose Volar plating for distal radius fractures has caused extensor tendon ruptures secondary to dorsal screw prominence. This study was designed to determine the biomechanical impact of placing unicortical distal locking screws and pegs in an extra-articular fracture model. Methods Volar-locking distal radius plates were applied to 30 osteoporotic distal radius models. Radii were divided into 5 groups based on distal locking fixation: bicortical locked screws, 3 lengths of unicortical locked screws (abutting the dorsal cortex [full length], 75% length, and 50% length to dorsal cortex), and unicortical locked pegs. Distal radius osteotomy simulated a dorsally comminuted, extra-articular, fracture. Each constructs stiffness was determined under physiologic loads (axial compression, dorsal bending volar bending) before and after 1000 cycles of axial conditioning and prior to axial loading to failure (2mm of displacement) and subsequent catastrophic failure. Results Cyclic conditioning did not alter constructs stiffness. Stiffness to volar bending and dorsal bending forces were similar between groups. Final stiffness(N/mm) under axial load was statistically equivalent for all groups: bicortical screws(230), full-length unicortical screws(227), 75% length unicortical screws(226), 50% length unicortical screws(187), unicortical pegs(226). Force(N) at 2 mm displacement was significantly less for 50% length unicortical screws(311) compared to bicortical screws(460), full-length unicortical screws(464), 75% length unicortical screws(400), and unicortical pegs(356). Force(N) to catastrophic fracture was statistically equivalent between groups but mean values for pegs(749) and 50% length unicortical(702) screws were 16-21% less than means for bicortical(892), full-length unicortical(860), and 75% length(894) unicortical constructs. Discussion Locked unicortical distal screws of at least 75% length produce construct stiffness similar to bicortical fixation. Unicortical

  10. Hemispheric titanium porous coated acetabular component without screw fixation.

    PubMed

    Dorr, L D; Wan, Z; Cohen, J

    1998-06-01

    One hundred fifteen hips in 108 patients with primary total hip arthroplasty using the anatomic porous replacement hemispheric acetabular component implanted without adjunctive screw fixation had a mean postoperative followup time of 6 years (range, 5-7.4 years). Clinical evaluation was performed using the Harris hip score and patient self assessment using a modified Short Form-36 questionnaire. Radiographs were measured for radiolucent lines, polyethylene wear, osteolysis, migration, and fractures. No acetabular metal shell had been revised for loosening or was radiographically loose with or without migration (more than 3 mm) at final followup. Reoperation was done in nine (8%) hips because of polyethylene insert wear or disassembly. No fracture of the acetabular bone occurred at the time of surgery or was observed on radiograph. Fixation of the metal shell was stable, with progressive radiolucent lines observed at final followup in 2% of the hips. Osteolysis was recorded in one patient with two acetabular components. The fixation of noncemented hemispheric porous coated acetabular components is more related to the technique of acetabular bone preparation and press fit implantation than to whether additional screws or peg fixation are used. Fixation of this acetabular component without screws at an average of 6 years after surgery is reproducible and predictable in primary hip arthroplasty. The design of modular polyethylene inserts has been improved and should reduce the wear rate of reoperations of the polyethylene insert. PMID:9646758

  11. A novel radiographic targeting guide for percutaneous placement of transfacet screws in the cervical spine with limited fluoroscopy: A cadaveric feasibility study

    PubMed Central

    Jackson, David M.; Karp, Jacqueline E.; O'Brien, Joseph R.; Anderson, D. Greg; Gelb, Daniel E.; Ludwig, Steven C.

    2012-01-01

    Background We describe a technique for percutaneous transfacet screw placement in the cervical spine without the need for lateral-view fluoroscopy. Methods Previously established articular pillar morphometry was used to define the ideal trajectory for transfacet screw placement in the subaxial cervical spine. A unique targeting guide was developed to allow placement of Kirschner wires across the facet joint at 90° without the guidance of lateral-view fluoroscopy. Kirschner wires and cannulated screws were placed percutaneously in 7 cadaveric specimens. Placement of instrumentation was performed entirely under modified anteroposterior-view fluoroscopy. All specimens were assessed for acceptable screw placement by 2 fellowship-trained orthopaedic spine surgeons using computed tomography. Open dissection was used to confirm radiographic interpretation. Acceptable placement was defined as a screw crossing the facet joint, achieving purchase in the inferior and superior articular processes, and not violating critical structures. Malposition was defined as a violation of the transverse foramen, spinal canal, or nerve root or inadequate fixation. Results A total of 48 screws were placed. Placement of 45 screws was acceptable. The 3 instances of screw malposition included a facet fracture, a facet distraction, and a C6-7 screw contacting the C7 nerve root in a specimen with a small C7 superior articular process. Conclusions Our data show that with the appropriate radiographic technique and a targeting guide, percutaneous transfacet screws can be safely placed at C3-7 without the need for lateral-view fluoroscopy during the targeting phase. Because of the variable morphometry of the C7 lateral mass, however, care must be taken when placing a transfacet screw at C6-7. Clinical Relevance This study describes a technique that has the potential to provide a less invasive strategy for posterior instrumentation of the cervical spine. Further investigation is needed before this

  12. Ridge augmentation with soft tissue procedures in aesthetic dentistry: pre- and postoperative volume measurements with a new kind of moire technique

    NASA Astrophysics Data System (ADS)

    Studer, Stephan P.; Mueller, Ernst; Bucher, Alfred

    1993-09-01

    The aim of this paper was to measure the volume differences of operated alveolar ridge defects before and until 3 months post-surgically. Ten patients with ten localized alveolar ridge defects were operated on. Five alveolar ridge defects were corrected by using the full thickness onlay graft technique and the other five defects were operated by the subepithelial connective tissue graft technique. A strict standardized operation protocol was followed and all alveolar ridge defects were operated on by the same dental surgeon. Before as well as 1, 2, and 3 months after surgery the corrected defect was photographed and an impression was made by using an A-silicon material to produce a gypsum-cast model. The form of all these cast models was then measured using the moire technique. The three months result of ten cases shows that the form of the operated alveolar ridge defects, which were corrected by the subepithelial connective tissue graft technique are more stable compared to those which were operated on by the full thickness onlay graft technique. Localized alveolar ridge defects using the latter method does not show a form stability after 3 months post-surgically.

  13. Magnetohydrodynamic Augmented Propulsion Experiment

    NASA Technical Reports Server (NTRS)

    Litchford, Ron J.; Cole, John; Lineberry, John; Chapman, Jim; Schmidt, Harold; Cook, Stephen (Technical Monitor)

    2002-01-01

    A fundamental obstacle to routine space access is the specific energy limitations associated with chemical fuels. In the case of vertical take-off, the high thrust needed for vertical liftoff and acceleration to orbit translates into power levels in the 10 GW range. Furthermore, useful payload mass fractions are possible only if the exhaust particle energy (i.e., exhaust velocity) is much greater than that available with traditional chemical propulsion. The electronic binding energy released by the best chemical reactions (e.g., LOX/LH2 for example, is less than 2 eV per product molecule (approx. 1.8 eV per H2O molecule), which translates into particle velocities less than 5 km/s. Useful payload fractions, however, will require exhaust velocities exceeding 15 km/s (i.e., particle energies greater than 20 eV). As an added challenge, the envisioned hypothetical RLV (reusable launch vehicle) should accomplish these amazing performance feats while providing relatively low acceleration levels to orbit (2-3g maximum). From such fundamental considerations, it is painfully obvious that planned and current RLV solutions based on chemical fuels alone represent only a temporary solution and can only result in minor gains, at best. What is truly needed is a revolutionary approach that will dramatically reduce the amount of fuel and size of the launch vehicle. This implies the need for new compact high-power energy sources as well as advanced accelerator technologies for increasing engine exhaust velocity. Electromagnetic acceleration techniques are of immense interest since they can be used to circumvent the thermal limits associated with conventional propulsion systems. This paper describes the Magnetohydrodynamic Augmented Propulsion Experiment (MAPX) being undertaken at NASA Marshall Space Flight Center (MSFC). In this experiment, a 1-MW arc heater is being used as a feeder for a 1-MW magnetohydrodynamic (MHD) accelerator. The purpose of the experiment is to demonstrate

  14. Augmented reality: a review.

    PubMed

    Berryman, Donna R

    2012-01-01

    Augmented reality is a technology that overlays digital information on objects or places in the real world for the purpose of enhancing the user experience. It is not virtual reality, that is, the technology that creates a totally digital or computer created environment. Augmented reality, with its ability to combine reality and digital information, is being studied and implemented in medicine, marketing, museums, fashion, and numerous other areas. This article presents an overview of augmented reality, discussing what it is, how it works, its current implementations, and its potential impact on libraries. PMID:22559183

  15. Tool Preloads Screw and Applies Locknut

    NASA Technical Reports Server (NTRS)

    Wood, K. E.

    1982-01-01

    Special tool reaches through structural members inside Space Shuttle fasten nut on preloaded screw that holds thermal protection tile against outside skin of vehicle. Tool attaches tiles with accuratelycontrolled tensile loading.

  16. Minimally invasive transforaminal lumbar interbody fusion with percutaneous navigated guidewireless lumbosacral pedicle screw fixation.

    PubMed

    Chen, Kevin S; Park, Paul

    2016-07-01

    This video details the minimally invasive approach for treatment of a symptomatic Grade II lytic spondylolisthesis with high-grade foraminal stenosis. In this procedure, the use of a navigated, guidewireless technique for percutaneous pedicle screw placement at the lumbosacral junction is highlighted following initial decompression and transforaminal interbody fusion. Key steps of the procedure are delineated that include positioning, exposure, technique for interbody fusion, intraoperative image acquisition, and use of a concise 2-step process for navigated screw placement without using guidewires. The video can be found here: https://youtu.be/2u6H4Pc_8To . PMID:27364422

  17. Titanium integration with bone, welding, and screw head destruction complicating hardware removal of the distal radius: report of 2 cases.

    PubMed

    Van Nortwick, Sara S; Yao, Jeffrey; Ladd, Amy L

    2012-07-01

    Increasingly, surgeons treat distal radius fractures with locking plate systems. Recent case reports have focused on technical insertion errors resulting in removal difficulties: poor drilling orientation or cross-threading, destruction of the screw head, and filling of the screw recess with tissue. We report 2 complications of titanium locked plate removal secondary to in vivo reactions including titanium integration with bone and mechanical binding between the titanium screw and plate. We clarify and discuss terminology relevant to implant removal, including cold-welding, galling, fretting, and anodization. Even with optimal technique, in situ reactions can complicate titanium implant removal. PMID:22652178

  18. Additional Drive Circuitry for Piezoelectric Screw Motors

    NASA Technical Reports Server (NTRS)

    Smythe, Robert; Palmer, Dean; Gursel, Yekta; Reder, Leonard; Savedra, Raymond

    2004-01-01

    Modules of additional drive circuitry have been developed to enhance the functionality of a family of commercially available positioning motors (Picomotor . or equivalent) that provide linear motion controllable, in principle, to within increments .30 nm. A motor of this type includes a piezoelectric actuator that turns a screw. Unlike traditional piezoelectrically actuated mechanisms, a motor of this type does not rely on the piezoelectric transducer to hold position: the screw does not turn except when the drive signal is applied to the actuator.

  19. Helical rotary screw expander power system

    NASA Technical Reports Server (NTRS)

    Mckay, R. A.; Sprankle, R. S.

    1974-01-01

    An energy converter for the development of wet steam geothermal fields is described. A project to evaluate and characterize a helical rotary screw expander for geothermal applications is discussed. The helical screw expander is a positive displacement machine which can accept untreated corrosive mineralized water of any quality from a geothermal well. The subjects of corrosion, mineral deposition, the expansion process, and experience with prototype devices are reported.

  20. Muzzle shunt augmentation of conventional railguns

    SciTech Connect

    Parker, J.V. . Physics Div.)

    1991-01-01

    This paper reports on augmentation which is a technique for reducing the armature current and hence the armature power dissipation in a plasma armature railgun. In spite of the advantages, no large augmented railguns have been built, primarily due to the mechanical and electrical complexity introduced by the extra conductors required. it is possible to achieve some of the benefits of augmentation in a conventional railgun by diverting a fraction {phi} of the input current through a shunt path at the muzzle of the railgun. In particular, the relation between force and armature current is the same as that obtained in an n-turn, series-connected augmented railgun with n = 1/(1 {minus} {phi}). The price of this simplification is a reduction in electrical efficiency and some additional complexity in the external electrical system.

  1. Implant Augmentation: Adding Bone Cement to Improve the Treatment of Osteoporotic Distal Femur Fractures

    PubMed Central

    Wähnert, Dirk; Hofmann-Fliri, Ladina; Richards, R. Geoff; Gueorguiev, Boyko; Raschke, Michael J.; Windolf, Markus

    2014-01-01

    Abstract The increasing problems in the field of osteoporotic fracture fixation results in specialized implants as well as new operation methods, for example, implant augmentation with bone cement. The aim of this study was to determine the biomechanical impact of augmentation in the treatment of osteoporotic distal femur fractures. Seven pairs of osteoporotic fresh frozen distal femora were randomly assigned to either an augmented or nonaugmented group. In both groups, an Orthopaedic Trauma Association 33 A3 fractures was fixed using the locking compression plate distal femur and cannulated and perforated screws. In the augmented group, additionally, 1 mL of polymethylmethacrylate cement was injected through the screw. Prior to mechanical testing, bone mineral density (BMD) and local bone strength were determined. Mechanical testing was performed by cyclic axial loading (100 N to 750 N + 0.05N/cycle) using a servo-hydraulic testing machine. As a result, the BMD as well as the axial stiffness did not significantly differ between the groups. The number of cycles to failure was significantly higher in the augmented group with the BMD as a significant covariate. In conclusion, cement augmentation can significantly improve implant anchorage in plating of osteoporotic distal femur fractures. PMID:25415673

  2. Breast augmentation surgery

    MedlinePlus

    ... the shape of your breasts. Talk with a plastic surgeon if you are considering breast augmentation. Discuss ... mammograms or breast x-rays before surgery. The plastic surgeon will do a routine breast exam. Several ...

  3. The effect of hydroxyapatite coated screw in the lateral fragility fractures of the femur. A prospective randomized clinical study.

    PubMed

    Pesce, V; Maccagnano, G; Vicenti, G; Notarnicola, A; Moretti, L; Tafuri, S; Vanni, D; Salini, V; Moretti, B

    2014-01-01

    Due to a growing numbers of lateral fragility fractures of the femur and their high social costs the need to work out an effective strategy in order to find a better solution for these patients is warranted. From January 2010 to July 2011, we carried out a prospective randomized clinical study comparing the results of patients with femoral lateral fractures treated by nail and cephalic hydroxyapatite coated screws (study group including 27 patients) compared to the patients with the same fractures treated with nail and head standard screws (control group including 27 patients). We defined the two parts of the femoral neck as ROI 1 (under the head screw) and ROI 2 (above the femoral screw) on the AP view. The bone density of the two areas was calculated using DEXA at T0 (1st day post-surgery), at T1 (40th day post-surgery), at T2 (3 months later), at T3 (1 year later). The clinical-radiography evaluations were based on the Harris Hip Score (HHS), ADL test and x-ray views of the hip. As far as the bone mineral density average of ROI 1 and ROI 2 is concerned, we found a significant statistical increase at T1 and T3 in the study group, while it was not significant in the control group. We could account for this data through the higher mechanical stability of hydroxyapatite coated screws than standard screws. In fact, this material was responsible for improved implant osteointegration. Thanks to a 1 year follow-up we were able to demonstrate the implant utility associated with augmentation and the importance of densitometry exams such as easily repeatable and low cost diagnostics to prevent the onset of complications linked to screw loosening. PMID:24750798

  4. RMS active damping augmentation

    NASA Technical Reports Server (NTRS)

    Gilbert, Michael G.; Scott, Michael A.; Demeo, Martha E.

    1992-01-01

    The topics are presented in viewgraph form and include: RMS active damping augmentation; potential space station assembly benefits to CSI; LaRC/JSC bridge program; control law design process; draper RMS simulator; MIMO acceleration control laws improve damping; potential load reduction benefit; DRS modified to model distributed accelerations; accelerometer location; Space Shuttle aft cockpit simulator; simulated shuttle video displays; SES test goals and objectives; and SES modifications to support RMS active damping augmentation.

  5. Percutaneous screw placement in acetabular posterior column surgery: gender differences in implant positioning.

    PubMed

    Dienstknecht, Thomas; Müller, Michael; Sellei, Richard; Nerlich, Michael; Pfeifer, Christian; Krutsch, Werner; Fuechtmeier, Bernd; Berner, Arne

    2014-04-01

    Percutaneous reduction and periarticular screw implantation techniques have been successfully introduced in acetabular surgery. Image guided navigation techniques might be beneficial in increasing accuracy. However, a thorough understanding of standard values is needed to oversee pitfalls. This cadaver study was designed to identify reliable angulation values for screw implantation in the posterior acetabular column and to provide knowledge of the bony thickness for the periarticular corridor. Gender differences were specifically addressed. 27 embalmed cadaveric hemipelvic specimens (13 male, 14 female) were used. After soft-tissue removal posterior column acetabular screw placement was conducted by one experienced orthopaedic trauma surgeon under visibility. Radiographic verification of ideal screw placement was followed by radiographic assessment in three standard views and angulation values were assessed. Through bony dissection the maximal periarticular canal width was assessed. Various angulation values with regard to anatomical landmarks could be determined in the anteroposterior radiograph, as well as in the iliac oblique and the obturator oblique view. Gender differences were significant for all reference points with the pubic rami involved. The minimal canal width was 1.1cm in female and 1.6 cm in male specimen. The findings provide standard values for safe passages in percutaneous posterior column acetabular surgery. Gender differences have to be taken in consideration when planning the drill corridor. By adherence to standard values, screw placement can be performed safely. PMID:24182644

  6. Serum albumin and fixation failure with cannulated hip screws in undisplaced intracapsular femoral neck fracture.

    PubMed

    Riaz, O; Arshad, R; Nisar, S; Vanker, R

    2016-07-01

    Introduction Internal fixation of undisplaced intracapsular femoral neck fractures with cannulated hip screws is a widely accepted surgical technique, despite reported failure rates of 12%-19%. This study determined whether preoperative serum albumin levels are linked to fixation failure. Methods We retrospectively reviewed 251 consecutive undisplaced intracapsular femoral neck fracture patients treated with cannulated hip screws in a district general hospital. Preoperative albumin levels were measured, and the fixation technique, classification and posterior tilt on radiography assessed. Fixation failure was defined as a screw cut, avascular necrosis (AVN) or non-union. Results Of the patients, 185 were female and 66 male. The mean age was 77 years (range 60-101 years). Thirty seven (15%) patients had fixation failure: 10 (4%) due to AVN; 12 (5%) due to non-union; and 15 (6%) due to fixation collapse. Low serum albumin levels were significantly associated with failure (p=0.01), whereas gender (p=0.56), operated side (p=0.62), age (p=0.34) and screw configuration (p=0.42) were not. A posterior tilt angle greater than 20° on lateral radiography significantly predicted failure (p=0.002). Conclusions Preoperative serum albumin is an independent predictor of cannulated hip screw fixation failure in undisplaced femoral neck fractures. Nutritional status should therefore be considered when deciding between surgical fixation and arthroplasty to avoid the possibility of revision surgery, along with an increased risk of morbidity and mortality. PMID:27055409

  7. Interference Screw vs. Suture Anchor Fixation for Open Subpectoral Biceps Tenodesis: Does it Matter?

    PubMed Central

    Millett, Peter J; Sanders, Brett; Gobezie, Reuben; Braun, Sepp; Warner, Jon JP

    2008-01-01

    Background Bioabsorbable interference screw fixation has superior biomechanical properties compared to suture anchor fixation for biceps tenodesis. However, it is unknown whether fixation technique influences clinical results. Hypothesis We hypothesize that subpectoral interference screw fixation offers relevant clinical advantages over suture anchor fixation for biceps tenodesis. Study Design Case Series. Methods We performed a retrospective review of a consecutive series of 88 patients receiving open subpectoral biceps tenodesis with either interference screw fixation (34 patients) or suture anchor fixation (54 patients). Average follow up was 13 months. Outcomes included Visual Analogue Pain Scale (0–10), ASES score, modified Constant score, pain at the tenodesis site, failure of fixation, cosmesis, deformity (popeye) and complications. Results There were no failures of fixation in this study. All patients showed significant improvement between their preoperative and postoperative status with regard to pain, ASES score, and abbreviated modified Constant scores. When comparing IF screw versus anchor outcomes, there was no statistical significance difference for VAS (p = 0.4), ASES score (p = 0.2), and modified Constant score (P = 0.09). One patient (3%) treated with IF screw complained of persistent bicipital groove tenderness, versus four patients (7%) in the SA group (nonsignificant). Conclusion Subpectoral biceps tenodesis reliably relieves pain and improves function. There was no statistically significant difference in the outcomes studied between the two fixation techniques. Residual pain at the site of tenodesis may be an issue when suture anchors are used in the subpectoral location. PMID:18793424

  8. Design and testing of external fixator bone screws.

    PubMed

    Evans, M; Spencer, M; Wang, Q; White, S H; Cunningham, J L

    1990-11-01

    In external fixation, bone screw loosening still presents a major clinical problem. For this study, the design factors influencing the mechanics of the bone-screw interface were analysed and various experimental screws designed with the intention of maximizing the strength and stiffness of the inserted screw. Push-in, pull-out and bending tests were then carried out on the three experimental screws, and on two commercially available screws in both a synthetic material and in cadaveric bone; photoelastic tests on different screw threadforms were also performed. The results of the push-in and pull-out tests indicate that both the screw threadform and cutting head have a significant effect on the holding strength of the screw. The photoelastic tests show that most of the applied load is distributed over the first few threads closest to the load, and that the area between the thread crests is subjected to high shear stresses. PMID:2266740

  9. Ball Screw Actuator Including a Stop with an Integral Guide

    NASA Technical Reports Server (NTRS)

    Wingett, Paul T. (Inventor); Perek, John (Inventor); Geck, Kellan (Inventor)

    2015-01-01

    An actuator includes a housing assembly, a ball nut, a ball screw, and a ball screw stop. The ball nut is rotationally mounted in the housing assembly, is adapted to receive an input torque, and is configured, upon receipt thereof, to rotate and supply a drive force. The ball screw is mounted within the housing assembly and extends through the ball nut. The ball screw has a first end and a second end, and is coupled to receive the drive force from the ball nut. The ball screw is configured, upon receipt of the drive force, to selectively translate between a stow position and a deploy position. The ball screw stop is mounted on the ball screw to translate therewith and is configured to at selectively engage the housing assembly while the ball screw is translating, and engage the ball nut when the ball screw is in the deploy position.

  10. Insertion Profiles of 4 Headless Compression Screws

    PubMed Central

    Hart, Adam; Harvey, Edward J.; Lefebvre, Louis-Philippe; Barthelat, Francois; Rabiei, Reza; Martineau, Paul A.

    2013-01-01

    Purpose In practice, the surgeon must rely on screw position (insertion depth) and tactile feedback from the screwdriver (insertion torque) to gauge compression. In this study, we identified the relationship between interfragmentary compression and these 2 factors. Methods The Acutrak Standard, Acutrak Mini, Synthes 3.0, and Herbert-Whipple implants were tested using a polyurethane foam scaphoid model. A specialized testing jig simultaneously measured compression force, insertion torque, and insertion depth at half-screw-turn intervals until failure occurred. Results The peak compression occurs at an insertion depth of −3.1 mm, −2.8 mm, 0.9 mm, and 1.5 mm for the Acutrak Mini, Acutrak Standard, Herbert-Whipple, and Synthes screws respectively (insertion depth is positive when the screw is proud above the bone and negative when buried). The compression and insertion torque at a depth of −2 mm were found to be 113 ± 18 N and 0.348 ± 0.052 Nm for the Acutrak Standard, 104 ± 15 N and 0.175 ± 0.008 Nm for the Acutrak Mini, 78 ± 9 N and 0.245 ± 0.006 Nm for the Herbert-Whipple, and 67 ± 2N, 0.233 ± 0.010 Nm for the Synthes headless compression screws. Conclusions All 4 screws generated a sizable amount of compression (> 60 N) over a wide range of insertion depths. The compression at the commonly recommended insertion depth of −2 mm was not significantly different between screws; thus, implant selection should not be based on compression profile alone. Conically shaped screws (Acutrak) generated their peak compression when they were fully buried in the foam whereas the shanked screws (Synthes and Herbert-Whipple) reached peak compression before they were fully inserted. Because insertion torque correlated poorly with compression, surgeons should avoid using tactile judgment of torque as a proxy for compression. Clinical relevance Knowledge of the insertion profile may improve our understanding of the implants, provide a better basis for comparing screws

  11. Linking granulation performance with residence time and granulation liquid distributions in twin-screw granulation: An experimental investigation.

    PubMed

    Kumar, Ashish; Alakarjula, Maija; Vanhoorne, Valérie; Toiviainen, Maunu; De Leersnyder, Fien; Vercruysse, Jurgen; Juuti, Mikko; Ketolainen, Jarkko; Vervaet, Chris; Remon, Jean Paul; Gernaey, Krist V; De Beer, Thomas; Nopens, Ingmar

    2016-07-30

    Twin-screw granulation is a promising wet granulation technique for the continuous manufacturing of pharmaceutical solid dosage forms. A twin screw granulator displays a short residence time. Thus, the solid-liquid mixing must be achieved quickly by appropriate arrangement of transport and kneading elements in the granulator screw allowing the production of granules with a size distribution appropriate for tableting. The distribution of residence time and granulation liquid is governed by the field conditions (such as location and length of mixing zones) in the twin-screw granulator, thus contain interesting information on granulation time, mixing and resulting sub-processes such as wetting, aggregation and breakage. In this study, the impact of process (feed rate, screw speed and liquid-to-solid ratio) and equipment parameters (number of kneading discs and stagger angle) on the residence time (distribution), the granulation liquid-powder mixing and the resulting granule size distributions during twin-screw granulation were investigated. Residence time and axial mixing data was extracted from tracer maps and the solid-liquid mixing was quantified from moisture maps, obtained by monitoring the granules at the granulator outlet using near infra-red chemical imaging (NIR-CI). The granule size distribution was measured using the sieving method. An increasing screw speed dominantly reduced the mean residence time. Interaction of material throughput with the screw speed and with the number of kneading discs led to most variation in the studied responses including residence time and mixing capacity. At a high screw speed, granulation yield improved due to high axial mixing. However, increasing material throughput quickly lowers the yield due to insufficient mixing of liquid and powder. Moreover, increasing liquid-to-solid ratio resulted in more oversized granules, and the fraction of oversized granules further increased at higher throughput. Although an increasing number

  12. Minimal inframammary incision for breast augmentation

    PubMed Central

    Fanous, Nabil; Tawilé, Caroline; Brousseau, Valérie J

    2008-01-01

    The inframammary approach in breast augmentation, still the most popular technique among plastic surgeons, has always been hampered by the undesirable appearance of its scar. The present paper describes a modified approach to inframammary augmentation with saline-filled prostheses. This approach uses a very short incision, thus resulting in a much less noticeable scar. The surgical technique is easy to learn, simple to execute, does not necessitate any special equipment and gives consistent results. Decreasing the scar length to an absolute minimum ensures higher patient and surgeon satisfaction. PMID:19554159

  13. Clival Screw Placement in Patient with atlas assimilation: A CT-based feasibility study

    PubMed Central

    Ji, Wei; Liu, Xiang; Huang, Wenhan; Huang, Zucheng; Chen, Jianting; Zhu, Qingan; Wu, Zenghui

    2016-01-01

    Clival screw and plate fixation technique is an alternative or supplement to the occipitocervical instrumentation. However, no report has clarified the applied anatomy of clivus in patients with atlas assimilation (C1A), especially for clival screw fixation. Therefore, we measured the parameters of clival lengths, widths, putative screw lengths, clival-cervical angel and foramen magnum diameters on CT images in a cohort of 81 C1A patients and patients without C1A. The clivus showed a rectangular shape in 96.3% (78/81) of C1A patients, and a normal-like triangle shape in 3.7% (3/81) of C1A patients. The intracranial clival length decreased 13% (37 mm) in C1A patients, the extracranial clival length 14.8% (24.1 mm), the clival-cervical angle 6.2% (122.3°) and the superior screw length 11.3% (14.1 mm), the sagittal diameter of foramen magnum 16% (28.0 mm), respectively. There was no significant difference in the widest or narrowest clival width, or the middle screw length, or the transverse diameter of foramen magnum between groups. The inferior clivus was feasible for an average 9.7-mm-length screw placement in C1A patients, while not in patients without C1A. The present study characterizes clivus of C1A patients with an unnormal-like rectangular shape, and confirmes a screw placement at the inferior clivus. PMID:27539005

  14. Primary Breast Augmentation with Fat Grafting.

    PubMed

    Coleman, Sydney R; Saboeiro, Alesia P

    2015-07-01

    The controversy over fat grafting to the breasts has now been settled. In 2009, the American Society of Plastic Surgeons Fat Graft Task Force stated that "Fat grafting may be considered for breast augmentation and correction of defects associated with medical conditions and previous breast surgeries; however, results are dependent on technique and surgeon expertise." This article discusses the history, indications, planning, complications, and present technique of fat grafting to the breast using the Coleman technique. PMID:26116935

  15. Ureteral bladder augmentation.

    PubMed

    Churchill, B M; Aliabadi, H; Landau, E H; McLorie, G A; Steckler, R E; McKenna, P H; Khoury, A E

    1993-08-01

    Virtually all segments of the gastrointestinal tract have been used successfully in augmentation cystoplasty. The complications inherent in enterocystoplasty are well described. Megaureters subtending effete kidneys (poorly or nonfunctioning) provide a novel and excellent source of augmentation material with urothelium and muscular backing, free of the electrolyte and acid base disturbances, and mucus production that plague enterocystoplasty. Augmentation cystoplasty using detubularized, reconfigured, otherwise disposable megaureter, with or without ipsilateral total or partial nephrectomy, was performed in 16 patients (mean age 8.8 years, range 1 to 25) with inadequate and dysfunctional bladders. Postoperative followup varied between 8 and 38 months (mean 22). The overall renal function and radiographic appearance of the remaining upper tracts have remained stable or improved in all patients. Of the 16 patients 15 require intermittent catheterization and 1 voids spontaneously. Ten patients are continent day and night, 5 have improved continence (4 damp at night and 1 stress incontinence) and 1 has failed to gain continence despite good capacity and compliance. Complete postoperative urodynamic evaluations in 12 of 13 patients show good capacity, low pressure bladders with no instability. Complications occurred in 5 patients, including transient urine extravasation in 2, contralateral ureterovesical obstruction in 2 and Mitrofanoff stomal stenosis in 1. Augmentation ureterocystoplasty combines the benefits common to all enterocystoplasties without adding any of the untoward complications or risks associated with nonurothelial augmentations. PMID:8326632

  16. Augmenting computer networks

    NASA Technical Reports Server (NTRS)

    Bokhari, S. H.; Raza, A. D.

    1984-01-01

    Three methods of augmenting computer networks by adding at most one link per processor are discussed: (1) A tree of N nodes may be augmented such that the resulting graph has diameter no greater than 4log sub 2((N+2)/3)-2. Thi O(N(3)) algorithm can be applied to any spanning tree of a connected graph to reduce the diameter of that graph to O(log N); (2) Given a binary tree T and a chain C of N nodes each, C may be augmented to produce C so that T is a subgraph of C. This algorithm is O(N) and may be used to produce augmented chains or rings that have diameter no greater than 2log sub 2((N+2)/3) and are planar; (3) Any rectangular two-dimensional 4 (8) nearest neighbor array of size N = 2(k) may be augmented so that it can emulate a single step shuffle-exchange network of size N/2 in 3(t) time steps.

  17. Apparatus to test insertion and removal torque of bone screws.

    PubMed

    Koistinen, A; Santavirta, S; Lappalainen, R

    2003-01-01

    This paper describes affordable equipment for testing bone screw torque, corresponding to ASTM standard F543-00 for testing metallic medical bone screws. Correct testing of thin and long bone screws is essential due to screw failures during insertion and removal of the screws. Furthermore, insertion torque is an important factor in predicting fixation strength, screw pull-out force and effects of surface treatment of screws. The capability of the custom-built tester was determined using polytetrafluoroethylene and wood disc samples and bone screws. Bovine cortical bones allowed testing to the failure limit, i.e. the torque increased in long screws to the fracture limit. For 2.7 and 3.5 mm thick self-tapping cortical bone screws, the failure torques were 30-50 per cent higher than the minimum values required by the standard (1.0 and 2.3 N m respectively). The equipment provided reproducible results and fulfilled the ASTM standard very well. Preliminary testing with amorphous diamond coated bone screws showed good durability of the coating and on average 10-15 per cent lower torque values compared with uncoated screws. The equipment can be used to measure insertion and removal torques as described in the standard. Furthermore, it also allows testing of normal screws and bolts. PMID:14702987

  18. Freehand Thoracic Pedicle Screw Placement: Review of Existing Strategies and a Step-by-Step Guide Using Uniform Landmarks for All Levels

    PubMed Central

    Baaj, Ali A

    2016-01-01

    Pedicle screw fixation in the thoracic spine presents certain challenges due to the critical regional neurovascular anatomy as well as the narrow pedicular corridor that typically exists. With increased awareness of the dangers of intraoperative radiation, the ability to place pedicle screws with anatomic landmarks alone is paramount. In this study, we reviewed the literature from 1990 to 2015 for studies that included freehand pedicle screw placement in the thoracic spine with special emphasis on entry points and the trajectories of the screws. We excluded studies that used fluoroscopy guidance, navigation techniques, cadaveric and biomechanical articles, case reports, and experimental studies on animals. The search retrieved 40 articles, and after careful selection, seven articles were analyzed. Over 8,000 screws were placed in the different studies. The mean accuracy for placement of the thoracic screws was 93.3%. However, there is little consensus between studies in entry points, sagittal, and axial trajectories of the screws. We complete this review by presenting our step-by-step technique for the placement of freehand pedicle screws in the thoracic spine. PMID:27014535

  19. Freehand Thoracic Pedicle Screw Placement: Review of Existing Strategies and a Step-by-Step Guide Using Uniform Landmarks for All Levels.

    PubMed

    Avila, Mauricio J; Baaj, Ali A

    2016-01-01

    Pedicle screw fixation in the thoracic spine presents certain challenges due to the critical regional neurovascular anatomy as well as the narrow pedicular corridor that typically exists. With increased awareness of the dangers of intraoperative radiation, the ability to place pedicle screws with anatomic landmarks alone is paramount. In this study, we reviewed the literature from 1990 to 2015 for studies that included freehand pedicle screw placement in the thoracic spine with special emphasis on entry points and the trajectories of the screws. We excluded studies that used fluoroscopy guidance, navigation techniques, cadaveric and biomechanical articles, case reports, and experimental studies on animals. The search retrieved 40 articles, and after careful selection, seven articles were analyzed. Over 8,000 screws were placed in the different studies. The mean accuracy for placement of the thoracic screws was 93.3%. However, there is little consensus between studies in entry points, sagittal, and axial trajectories of the screws. We complete this review by presenting our step-by-step technique for the placement of freehand pedicle screws in the thoracic spine. PMID:27014535

  20. Management of a Fractured Multiunit Maxillary Implant-Supported Fixed Prosthesis with Stripped Abutment Screws Using a Hybrid Cement-Retained and Screw-Retained Design: A 5-Year Follow-Up Clinical Report.

    PubMed

    Al Amri, Mohammad D

    2016-06-01

    Fracture and loosening of implant-supported prostheses (ISPs) are complications encountered in routine dental practice. In the present report, management of a fractured maxillary full-arch cement-retained (CR) fixed dental prosthesis supported by six implants is presented. Due to stripped screws, complications were encountered that prevented the retrieval of two of the six abutment screws, which was managed by using a hybrid retention approach, whereby a single full-arch CR and screw-retained (SR) ISP was used. The techniques used to successfully retrieve four of the abutment screws are described. The final retention design involved a combination of three CR and three SR restorations, which offers the advantages of both retention designs. PMID:26713868

  1. C2 nerve dysfunction associated with C1 lateral mass screw fixation.

    PubMed

    Huang, Da-geng; Hao, Ding-jun; Li, Guang-lin; Guo, Hao; Zhang, Yu-chen; He, Bao-rong

    2014-11-01

    The C1 lateral mass screw technique is widely used for atlantoaxial fixation. However, C2 nerve dysfunction may occur as a complication of this procedure, compromising the quality of life of affected patients. This is a review of the topic of C2 nerve dysfunction associated with C1 lateral mass screw fixation and related research developments. The C2 nerve root is located in the space bordered superiorly by the posterior arch of C1 , inferiorly by the C2 lamina, anteriorly by the lateral atlantoaxial joint capsule, and posteriorly by the anterior edge of the ligamentum flavum. Some surgeons suggest cutting the C2 nerve root during C1 lateral mass screw placement, whereas others prefer to preserve it. The incidence, clinical manifestations, causes, management, and prevention of C2 nerve dysfunction associated with C(1) lateral mass screw fixation are reviewed. Sacrifice of the C2 nerve root carries a high risk of postoperative numbness, whereas postoperative nerve dysfunction can occur when it has been preserved. Many surgeons have been working hard on minimizing the risk of postoperative C2 nerve dysfunction associated with C1 lateral mass screw fixation. PMID:25430709

  2. Tibial Tunnel Cyst Formation after Anterior Cruciate Ligament Reconstruction Using a Non-Bioabsorbable Interference Screw

    PubMed Central

    Joshi, Yogesh V.; Phaltankar, Padmanabh M.; Charalambous, Charalambos P.

    2015-01-01

    Tibial cyst formation following the use of bioabsorbable interference screws in anterior cruciate ligament (ACL) reconstruction is well-described; however, cyst formation after the use of metallic interference screws is not well-documented. We describe a case of osteolytic lesion of the proximal tibia presenting to us 20 years after ACL reconstruction using an autologous bone-tendon-bone graft. The original graft fixation technique was interference fixation with a metal screw in the tibial and femoral tunnels. A two-stage revision reconstruction of the ACL was undertaken with curettage and bone grafting of the tibial lesion in the first stage and reconstruction using a four-strand hamstring tendon in the second stage. The patient recovered satisfactorily with complete healing of the cyst and returned to pre-injury level of activities. We have reviewed case reports and case series that describe the aetiology of intra-osseous cyst formation following ACL reconstruction. PMID:26673117

  3. A novel modeling approach to the mixing process in twin-screw extruders

    NASA Astrophysics Data System (ADS)

    Kennedy, Amedu Osaighe; Penlington, Roger; Busawon, Krishna; Morgan, Andy

    2014-05-01

    In this paper, a theoretical model for the mixing process in a self-wiping co-rotating twin screw extruder by combination of statistical techniques and mechanistic modelling has been proposed. The approach was to examine the mixing process in the local zones via residence time distribution and the flow dynamics, from which predictive models of the mean residence time and mean time delay were determined. Increase in feed rate at constant screw speed was found to narrow the shape of the residence time distribution curve, reduction in the mean residence time and time delay and increase in the degree of fill. Increase in screw speed at constant feed rate was found to narrow the shape of the residence time distribution curve, decrease in the degree of fill in the extruder and thus an increase in the time delay. Experimental investigation was also done to validate the modeling approach.

  4. Tibial Tunnel Cyst Formation after Anterior Cruciate Ligament Reconstruction Using a Non-Bioabsorbable Interference Screw.

    PubMed

    Joshi, Yogesh V; Bhaskar, Deepu; Phaltankar, Padmanabh M; Charalambous, Charalambos P

    2015-12-01

    Tibial cyst formation following the use of bioabsorbable interference screws in anterior cruciate ligament (ACL) reconstruction is well-described; however, cyst formation after the use of metallic interference screws is not well-documented. We describe a case of osteolytic lesion of the proximal tibia presenting to us 20 years after ACL reconstruction using an autologous bone-tendon-bone graft. The original graft fixation technique was interference fixation with a metal screw in the tibial and femoral tunnels. A two-stage revision reconstruction of the ACL was undertaken with curettage and bone grafting of the tibial lesion in the first stage and reconstruction using a four-strand hamstring tendon in the second stage. The patient recovered satisfactorily with complete healing of the cyst and returned to pre-injury level of activities. We have reviewed case reports and case series that describe the aetiology of intra-osseous cyst formation following ACL reconstruction. PMID:26673117

  5. AB027. Penile augmentation: informed text briefing

    PubMed Central

    Park, Nam Cheol

    2016-01-01

    The men’s desire to have larger and longer penis have created endless medical demands throughout human history. Until up to date, various medical skills for penile augmentation have developed in aspect of experimental and clinical outcome. Recently with throwing away socially unacceptable ideas, the need for penile augmentation is considered as equivalent level with mammoplasty for breast augmentation in women for cosmetic and psychological reason. Concurrently advanced technologies in medical material and tissue engineering provide a variety of options to features functional plastic surgery as well as defected tissue compensation procedures. This creative description works accordingly presents state of art knowledge on the penile augmentation with more than 100 full-colored helpful illustrations clarifying penile surgical anatomy, operative procedures by experienced surgeon from the traditional fat transfer to the penile disassembly technique, the newest tissue engineering techniques by researchers with valuable data of world top level, auxiliary medical devices, and how to reconstruct for damaged penis by a quack or accident. Obviously this text book will be a great guidebook in clinical practice for all who are involved or interested in the penile augmentation procedure.

  6. The reaction of cortical bone to compression by screw threads.

    PubMed

    Schatzker, J; Horne, J G; Sumner-Smith, G

    1975-09-01

    Cortical bone subjected to compression by screw threads retains its integrity and is not resorbed. Screws which generate compression at the interface of their threads with bone can be expected to provide adequate fixation until bone union occurs. PMID:1157421

  7. Screw expander for light duty diesel engines

    NASA Technical Reports Server (NTRS)

    1983-01-01

    Preliminary selection and sizing of a positive displacement screw compressor-expander subsystem for a light-duty adiabatic diesel engine; development of a mathematical model to describe overall efficiencies for the screw compressor and expander; simulation of operation to establish overall efficiency for a range of design parameters and at given engine operating points; simulation to establish potential net power output at light-duty diesel operating points; analytical determination of mass moments of inertia for the rotors and inertia of the compressor-expander subsystem; and preparation of engineering layout drawings of the compressor and expander are discussed. As a result of this work, it was concluded that the screw compressor and expander designed for light-duty diesel engine applications are viable alternatives to turbo-compound systems, with acceptable efficiencies for both units, and only a moderate effect on the transient response.

  8. Low energy high pressure miniature screw valve

    DOEpatents

    Fischer, Gary J.; Spletzer, Barry L.

    2006-12-12

    A low energy high pressure screw valve having a valve body having an upper portion and a lower portion, said lower portion of said valve body defining an inlet flow passage and an outlet flow passage traversing said valve body to a valve seat, said upper portion of said valve body defining a cavity at said valve seat, a diaphragm restricting flow between said upper portion of said valve body and said lower portion, said diaphragm capable of engaging said valve seat to restrict fluid communication between said inlet passage and said outlet passage, a plunger within said cavity supporting said diaphragm, said plunger being capable of engaging said diaphragm with said valve seat at said inlet and outlet fluid passages, said plunger being in point contact with a drive screw having threads engaged with opposing threads within said upper portion of said valve body such engagement allowing motion of said drive screw within said valve body.

  9. Effect of augmented cup fixation on stability, wear, and osteolysis: a 5-year follow-up of total hip arthroplasty with RSA.

    PubMed

    Röhrl, Stephan M; Nivbrant, Bosse; Ström, Håkan; Nilsson, Kjell G

    2004-12-01

    To evaluate different modes of cementless fixation of hemispherical cups, we operated on 87 hips in 81 patients using 4 different means of cup fixation. The hips were randomly assigned to fixation with press-fit technique only (PF), or with augmentation with screws (S), pegs (P), or hydroxyapatite (HA) coating. The patients were evaluated with radiostereometric analysis (RSA) for cup migration and wear, conventional radiography for osteolysis, and Harris Hip Score for clinical outcome over 5 years. The fixation of the cups did not differ between the groups, but HA showed a tendency to decrease proximal migration. HA-coated cups displayed the best interface with hardly any signs of radiolucent lines, indicating a superior sealing effect of the HA coating. Cups with screws or pegs had more radiolucent lines and osteolytic lesions than the other groups. Radiolucent lines were correlated to higher proximal migration, young age, and female gender (r2=.2). The wear rate of the ethylene oxide-sterilized polyethylene liner was high (0.2 mm/y) but did not differ between the groups. Two cups with a perioperative fracture of the acetabular rim showed large initial migration but stabilized thereafter. PMID:15586331

  10. SCREW MIGRATION IN TOTAL KNEE ARTHROPLASTY: CLINICAL REPORT

    PubMed Central

    Fonseca, Fernando; Tomé, José; Barreto, Manuel

    2015-01-01

    Complications from total knee arthroplasty caused by the implanted material are rare, with the exception of polyethylene wear. Descriptions of screw migration into the knee joint cavity are very rare. The authors report intra-articular migration of a polyethylene safety screw in a case of total knee arthroplasty, with sacrifice of the posterior cruciate ligament (TKA Performance; Biomet, Warsaw, IN, USA), which necessitated new surgery to remove the screw, replace the polyethylene insert and emplace a new fixation screw. PMID:27022526

  11. Effect of bone material properties on effective region in screw-bone model: an experimental and finite element study

    PubMed Central

    2014-01-01

    Background There have been numerous studies conducted to investigate the pullout force of pedicle screws in bone with different material properties. However, fewer studies have investigated the region of effect (RoE), stress distribution and contour pattern of the cancellous bone surrounding the pedicle screw. Methods Screw pullout experiments were performed from two different foams and the corresponding reaction force was documented for the validation of a computational pedicle screw-foam model based on finite element (FE) methods. After validation, pullout simulations were performed on screw-bone models, with different bone material properties to model three different age groups (<50, 50–75 and >75 years old). At maximum pullout force, the stress distribution and average magnitude of Von Mises stress were documented in the cancellous bone along the distance beyond the outer perimeter pedicle screw. The radius and volume of the RoE were predicted based on the stress distribution. Results The screw pullout strengths and the load–displacement curves were comparable between the numerical simulation and experimental tests. The stress distribution of the simulated screw-bone vertebral unit showed that the radius and volume of the RoE varied with the bone material properties. The radii were 4.73 mm, 5.06 mm and 5.4 mm for bone properties of ages >75, 75 > ages >50 and ages <50 years old, respectively, and the corresponding volumes of the RoE were 6.67 mm3, 7.35 mm3 and 8.07 mm3, respectively. Conclusions This study demonstrated that there existed a circular effective region surrounding the pedicle screw for stabilization and that this region was sensitive to the bone material characteristics of cancellous bone. The proper amount of injection cement for augmentation could be estimated based on the RoE in the treatment of osteoporosis patients to avoid leakage in spine surgery. PMID:24952724

  12. Spline-Screw Multiple-Rotation Mechanism

    NASA Technical Reports Server (NTRS)

    Vranish, John M.

    1994-01-01

    Mechanism functions like combined robotic gripper and nut runner. Spline-screw multiple-rotation mechanism related to spline-screw payload-fastening system described in (GSC-13454). Incorporated as subsystem in alternative version of system. Mechanism functions like combination of robotic gripper and nut runner; provides both secure grip and rotary actuation of other parts of system. Used in system in which no need to make or break electrical connections to payload during robotic installation or removal of payload. More complicated version needed to make and break electrical connections. Mechanism mounted in payload.

  13. Reversed-field pinch and screw pinch

    SciTech Connect

    Kito, M.; Yoshimura, H.

    1983-12-01

    The Electrotechnical Laboratory and the College of Science and Technology at Nihon University discuss the results, device parameters, and objectives of reversed-field pinch TPE-1R(M). This device is illustrated and tables are given of machine parameters, as well as plasma parameters and temperature and density scalings. Other reversed-field pinch (RFP) machines are discussed, and tables show the RFP devices of Japan and design parameters of TPE-2, a screw-pinch device with a noncircular cross section. The STP-3 screw-pinch device is also discussed.

  14. 21 CFR 888.3070 - Pedicle screw spinal system.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Pedicle screw spinal system. 888.3070 Section 888.3070 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES ORTHOPEDIC DEVICES Prosthetic Devices § 888.3070 Pedicle screw spinal system. (a) Identification. Pedicle screw spinal systems...

  15. Biomechanical evaluation of a new composite bioresorbable screw.

    PubMed

    Bailey, C A; Kuiper, J H; Kelly, C P

    2006-04-01

    A new bioresorbable composite cannulated screw has been developed for small bone fracture fixation. The LG ("Little Grafter") screw is manufactured from Biosteon, which is a composite of poly L-lactic acid and hydroxyapatite. This study aimed to compare interfragmentary compression generated by this new screw with conventional metal screws commonly used in scaphoid fracture fixation. Four small metallic screws were compared with the LG screw, using a bone model produced from rigid polyurethane foam. The screws included the Acutrak, Asnis III, Herbert and Herbert-Whipple screws. The mean maximum compression forces for the LG screw, the Asnis and the Acutrak were comparable (LG 32.3 N, Asnis 32.8 N, Acutrak 38.3 N), whereas those using the Herbert and the Herbert-Whipple screw were significantly lower (Herbert 21.8 N, Herbert-Whipple 19.9 N). The bioresorbable LG screw has been shown to have good compressive properties compared to commonly used small bone fragment compression screws. PMID:16361004

  16. Augmented Thermal Bus

    NASA Technical Reports Server (NTRS)

    Schrage, Dean S. (Inventor)

    1996-01-01

    The present invention is directed to an augmented thermal bus. In the present design a plurality of thermo-electric heat pumps are used to couple a source plate to a sink plate. Each heat pump is individually controlled by a model based controller. The controller coordinates the heat pumps to maintain isothermality in the source.

  17. Augmented thermal bus

    NASA Technical Reports Server (NTRS)

    Schrage, Dean S. (Inventor)

    1993-01-01

    The present invention is directed to an augmented thermal bus. In the present design a plurity of thermo-electric heat pumps are used to couple a source plate to a sink plate. Each heat pump is individually controlled by a model based controller. The controller coordinates the heat pump to maintain isothermality in the source.

  18. Computer Augmented Lectures

    ERIC Educational Resources Information Center

    Seitz, W. A.; Matsen, F. A.

    1974-01-01

    Discusses the use of a central computer linked to a CRT console, with display projected onto a large screen, to operate computer augmentation of lectures in large group instruction. Indicates that both introductory tutorial and computer modes are feasible in subject matter presentation. (CC)

  19. Augmentative & Alternative Communication

    ERIC Educational Resources Information Center

    Murphy, Patti

    2007-01-01

    There is no definitive recipe for augmentative and alternative communication (AAC) success, but its universal ingredients can be found at home. The main ones are: (1) Understanding that all children need to express themselves, however outgoing or shy they may be; (2) Willingness to embrace the technology that may help your child regardless of your…

  20. Augmented Reality Binoculars.

    PubMed

    Oskiper, Taragay; Sizintsev, Mikhail; Branzoi, Vlad; Samarasekera, Supun; Kumar, Rakesh

    2015-05-01

    In this paper we present an augmented reality binocular system to allow long range high precision augmentation of live telescopic imagery with aerial and terrain based synthetic objects, vehicles, people and effects. The inserted objects must appear stable in the display and must not jitter and drift as the user pans around and examines the scene with the binoculars. The design of the system is based on using two different cameras with wide field of view and narrow field of view lenses enclosed in a binocular shaped shell. Using the wide field of view gives us context and enables us to recover the 3D location and orientation of the binoculars much more robustly, whereas the narrow field of view is used for the actual augmentation as well as to increase precision in tracking. We present our navigation algorithm that uses the two cameras in combination with an inertial measurement unit and global positioning system in an extended Kalman filter and provides jitter free, robust and real-time pose estimation for precise augmentation. We have demonstrated successful use of our system as part of information sharing example as well as a live simulated training system for observer training, in which fixed and rotary wing aircrafts, ground vehicles, and weapon effects are combined with real world scenes. PMID:26357208

  1. Technique for code augmentation. Memorandum report

    SciTech Connect

    Fickie, K.D.; Grosh, J.

    1987-10-01

    A simple method for calling pre-existing computer codes from inside another program is described. Three applications drawn from the field of interior ballistics are included as examples. Two of the cases are optimization problems and the other is a simple search for a constraint condition. More elaborate applications in the area of computer-aided design are discussed.

  2. Augmentation Mammaplasty Using Implants: A Review

    PubMed Central

    2012-01-01

    One of the techniques for augmentation mammaplasty is the procedure using implants. Even though this technique has been used for many years, there are still several controversial issues to be discussed and overcome for patient safety. In this review article, capsular contracture, leak or rupture of the implants, possible systemic disease, relation with breast cancer, and recent problems with Poly Implant Prothese implants are described and discussed. PMID:23094237

  3. Analysis of screw pullout strength: a function of screw orientation in subtalar joint arthrodesis.

    PubMed

    McGlamry, Michael C; Robitaille, Melissa F

    2004-01-01

    The purpose of this cadaveric study was to compare the pullout strength and failure load of 2 different screw orientations for subtalar arthrodesis. Twenty-six specimens from 13 cadaver donors (1 left and 1 right each) were used. A 7.3- x 65-mm long-thread profile (32-mm length) cannulated screw inserted into the calcaneus from dorsal to plantar (calcaneal specimens) was compared with a 7.3- x 65-mm short-thread profile (16-mm length) cannulated screw inserted into the talus from plantar to dorsal (talar specimens). A torque screwdriver with a calibrated electronic vernier scale measured the torque of screw insertion. Screw pullout strength and load failure were measured by using a servohydraulic materials testing machine. Distraction was applied along the axis of the screw at a displacement rate of 25 mm/min. The peak torque of insertion in all calcaneal specimens was reached on initial insertion through the dorsal subchondral bone plate of the calcaneus; in talar specimens, it was reached as the screw threads were completely buried into the talus. A significant difference (P = .00647) was found between the mean torque of insertion for the calcaneal (1.50 Nm) and talar specimens (1.30 Nm). A comparison of pullout forces showed a significantly stronger mean failure load for calcaneal specimens (P = .000085). The mean failure load for paired calcaneal specimens was 1782 N compared with a mean 1245 N for talar specimens. Although the pullout force was clearly greater in the dorsal-to-plantar screw application, the pullout force in the plantar-to-dorsal orientation was also considerable. PMID:15480401

  4. Fatigue strength of common tibial intramedullary nail distal locking screws

    PubMed Central

    Griffin, Lanny V; Harris, Robert M; Zubak, Joseph J

    2009-01-01

    Background Premature failure of either the nail and/or locking screws with unstable fracture patterns may lead to angulation, shortening, malunion, and IM nail migration. Up to thirty percent of all unreamed nail locking screws can break after initial weight bearing is allowed at 8–10 weeks if union has not occurred. The primary problem this presents is hardware removal during revision surgery. The purposes of our study was to evaluate the relative fatigue resistance of distal locking screws and bolts from representative manufacturers of tibial IM nail systems, and develop a relative risk assessment of screws and materials used. Evaluations included quantitative and qualitative measures of the relative performance of these screws. Methods Fatigue tests were conducted to simulate a comminuted fracture that was treated by IM nailing assuming that all load was carried by the screws. Each screw type was tested ten times in a single screw configuration. One screw type was tested an additional ten times in a two-screw parallel configuration. Fatigue tests were performed using a servohydraulic materials testing system and custom fixturing that simulated screws placed in the distal region of an appropriately sized tibial IM nail. Fatigue loads were estimated based on a seventy-five kilogram individual at full weight bearing. The test duration was one million cycles (roughly one year), or screw fracture, whichever occurred first. Failure analysis of a representative sample of titanium alloy and stainless steel screws included scanning electron microscopy (SEM) and quantitative metallography. Results The average fatigue life of a single screw with a diameter of 4.0 mm was 1200 cycles, which would correspond roughly to half a day of full weight bearing. Single screws with a diameter of 4.5 mm or larger have approximately a 50 percent probability of withstanding a week of weight bearing, whereas a single 5.0 mm diameter screw has greater than 90 percent probability of

  5. Improvements In Ball-Screw Linear Actuators

    NASA Technical Reports Server (NTRS)

    Iskenderian, Theodore; Joffe, Benjamin; Summers, Robert

    1996-01-01

    Report describes modifications of design of type of ball-screw linear actuator driven by dc motor, with linear-displacement feedback via linear variable-differential transformer (LVDT). Actuators used to position spacecraft engines to direct thrust. Modifications directed toward ensuring reliable and predictable operation during planned 12-year cruise and interval of hard use at end of cruise.

  6. Computation of Flow in Screw Compressors

    NASA Astrophysics Data System (ADS)

    Kalitzin, Georgi; Cai, Xiaodan; Reba, Ramons; Medic, Gorazd

    2015-08-01

    A CFD model enabling accurate and computationally affordable simulation of unsteady flow in screw compressors has been developed. This paper focuses on computational aspects, including real-gas CFD using hybrid structured/unstructured moving grids, and specifics of grid generation for moving rotors and their communication with the discharge plenum.

  7. Improvements to the single screw extruder

    NASA Technical Reports Server (NTRS)

    Hiemenz, C.; Ziegmann, G.; Franzkoch, B.; Hoffmanns, W.; Michaeli, W.

    1977-01-01

    The extrusion on a single screw extruder is examined. The process is divided into several steps: the dosage of the materials to be conveyed; the modification of the shape of the feeding opening which influences the feeding process and consequently the throughput of the extruder; optimizing the shape of the feeding zone to meet the specific material requirements; and plasticizing and homogenizing.

  8. The transareolar incision for breast augmentation revisited.

    PubMed

    Kompatscher, Peter; Schuler, Christine; Beer, Gertrude M

    2004-01-01

    Of the various possible incisions for breast augmentation, the transareolar access has gained only limited popularity. The potential side effects of this incision are said to be altered nipple sensation, impaired lactation, an increased rate of infections with capsular fibrosis, well visible scar formation with hypopigmentation, and the need for an additional access in case a breast ptosis correction should prove necessary at a later date. The purpose of this retrospective study was to judge advantages and limitations of transareolar breast augmentation, and to verify whether the reluctant attitude toward this surgical approach is justified. A sample of 18 patients with a transareolar, retropectoral breast augmentation was selected for a retrospective evaluation. The suitability of the technique in general was examined together with early postoperative complications, sensory changes, and late complications on the basis of an evaluation system for cosmetic surgical results. The study showed that only women with an areolar diameter of 3.5 cm or more without pronounced breast ptosis were suitable for the transareolar access. No early infections were noted. The rate of capsular fibrosis was 11%. Two years after breast augmentation, 16 women (89%) judged their breast sensation to be normal, but objective assessment showed that mean pressure and vibration sensation were moderately compromised in all parts of the breast. The scars were of good quality, with very little hypopigmentation. With appropriate patient selection, respecting the advantages and limitations, the transareolar incision has its definite place among the different incisions for breast augmentation. PMID:15164231

  9. Combined silicone implant and cartilage grafts for augmentation rhinoplasty.

    PubMed

    Wang, Huan; Fan, Fei; You, Jianjun; Wang, Sheng

    2013-03-01

    Silicone implants are widely used in Asia for nasal dorsal augmentation. Meanwhile, autologous cartilage grafts are the most preferred materials for tip surgery. In order to minimize the drawbacks of silicone implants, combined silicone implant and cartilage grafts were introduced for augmentation rhinoplasty. In this work, augmentation rhinoplasty technique using combined silicone implant and cartilage grafts are reported. Forty-six patients underwent dorsal and tip augmentation using this technique. The outcomes were satisfactory in 45 patients. Bilateral marginal incisions were used without transcolumellar incision. By suturing the silicone nasal implant with a shield cartilage graft, a new complex was achieved. Assisted with a columellar strut either sutured to the complex or not, the new complex could provide improved dorsal height and tip projection with low complication rate in augmentation rhinoplasty. PMID:23524723

  10. Mini posterior lumbar interbody fusion with presacral screw stabilization in early lumbosacral instability

    PubMed Central

    Shetty, Arjun; Kini, Abhishek R; Chacko, A; Sunil, Upadhyaya; Vinod, K; Geover, Lobo

    2015-01-01

    Background: Surgical options for the management of early lumbosacral spondylolisthesis and degenerative disc disease with instability vary from open lumbar interbody fusion with transpedicular fixation to a variety of minimal access fusion and fixation procedures. We have used a combination of micro discectomy and axial lumbosacral interbody fusion with presacral screw fixation to treat symptomatic patients with lumbosacral spondylolisthesis or lumbosacral degenerative disc disease, which needed surgical stabilization. This study describes the above technique along with analysis of results. Materials and Methods: Twelve patients with symptomatic lumbosacral (L5-S1) instability and degenerative lumbosacral disc disease were treated by micro discectomy and interbody fusion using presacral screw stabilization. Patients with history of bowel, bladder dysfunction and local anorectal diseases were excluded from this study. Postoperatively all patients were evaluated neurologically and radiologically for screw position, fusion and stability. Oswestry disability index was used to evaluate results. Results: We had nine females and three males with a mean age of 47.33 years (range 26–68 years). Postoperative assessment revealed three patients to have screw placed in anterior 1/4th of the 1st sacral body, in rest nine the screws were placed in the posterior 3/4th of sacral body. At 2 years followup, eight patients (67%) showed evidence of bridging trabeculae at bone graft site and none of the patients showed evidence of instability or implant failure. Conclusion: Presacral screw fixation along with micro discectomy is an effective procedure to manage early symptomatic lumbosacral spondylolisthesis and degenerative disc disease with instability. PMID:26015626

  11. Biomechanical testing of a new design for Schanz pedicle screws.

    PubMed

    Willett, K; Hearn, T C; Cuncins, A V

    1993-01-01

    Standard 5-mm AO Schanz pedicle screws were biomechanically compared with a new design, featuring 6-mm threads with a 5-mm core diameter continuous with the shaft. One each of the two screw designs was surgically inserted into the matching pedicles of 32 cadaveric vertebrae. The pull-out strengths of the screws were then determined by recording the peak force values during extraction under servohydraulic displacement control. The screws were also tested in three-point bending, varying the inner load point with respect to the shaft thread junction, within a clinically anticipated range. The mean pull-out strength for the 6-mm screw was 597 N, which was significantly greater than the mean strength of 405 N for the 5 mm screw (p = 0.002). The 6-mm screw was also stronger in three-point bending, and failed at the point of inner load application, with no evidence of a stress-raising effect at the shaft/thread junction. In contrast, the 5-mm screw withstood lower loads, and failed at the shaft/thread junction, regardless of the point of loading. Pedicle screw breakage and pull-out are the recognized modes of failure of spinal implants, which are dependent on pedicle screw fixation. The results suggest distinct biomechanical advantages for the 6-mm screw, which should be used whenever clinically feasible. PMID:8377050

  12. Surgical screw segmentation for mobile C-arm CT devices

    NASA Astrophysics Data System (ADS)

    Görres, Joseph; Brehler, Michael; Franke, Jochen; Wolf, Ivo; Vetter, Sven Y.; Grützner, Paul A.; Meinzer, Hans-Peter; Nabers, Diana

    2014-03-01

    Calcaneal fractures are commonly treated by open reduction and internal fixation. An anatomical reconstruction of involved joints is mandatory to prevent cartilage damage and premature arthritis. In order to avoid intraarticular screw placements, the use of mobile C-arm CT devices is required. However, for analyzing the screw placement in detail, a time-consuming human-computer interaction is necessary to navigate through 3D images and therefore to view a single screw in detail. Established interaction procedures of repeatedly positioning and rotating sectional planes are inconvenient and impede the intraoperative assessment of the screw positioning. To simplify the interaction with 3D images, we propose an automatic screw segmentation that allows for an immediate selection of relevant sectional planes. Our algorithm consists of three major steps. At first, cylindrical characteristics are determined from local gradient structures with the help of RANSAC. In a second step, a DBScan clustering algorithm is applied to group similar cylinder characteristics. Each detected cluster represents a screw, whose determined location is then refined by a cylinder-to-image registration in a third step. Our evaluation with 309 screws in 50 images shows robust and precise results. The algorithm detected 98% (303) of the screws correctly. Thirteen clusters led to falsely identified screws. The mean distance error for the screw tip was 0.8 +/- 0.8 mm and for the screw head 1.2 +/- 1 mm. The mean orientation error was 1.4 +/- 1.2 degrees.

  13. Pull-out strength of screws from polymethylmethacrylate cement.

    PubMed

    Motzkin, N E; Chao, E Y; An, K N; Wikenheiser, M A; Lewallen, D G

    1994-03-01

    We aimed to determine the optimal method of inserting a screw into polymethylmethacrylate (PMMA) cement to enhance fixation. We performed six groups of ten axial pull-out tests with two sizes of screw (3.5 and 4.5 mm AO cortical) and three methods of insertion. Screws were placed into 'fluid' PMMA, into 'solid' PMMA by drilling and tapping, or into 'curing' PMMA with quarter-revolution turns every 30 seconds until the PMMA had hardened. After full hardening, we measured the maximum load to failure for each screw-PMMA construct. We found no significant difference in the pull-out strengths between screw sizes or between screws placed in fluid or solid PMMA. Screws placed in curing PMMA were significantly weaker: the relative strengths of solid, fluid and curing groups were 100%, 97% and 71%, respectively. We recommend the use of either solid or fluid insertion according to the circumstances and the preference of the surgeon. PMID:8113302

  14. Combination of luque instrumentation with polyaxial screws in the treatment of myelomeningocele kyphosis.

    PubMed

    Kocaoğlu, Bariş; Erol, Bülent; Akgülle, Hamdi; Gasimov, Elviz; Yalçin, Selim

    2008-05-01

    Rigid congenital kyphosis in myelomeningocele is associated with an important morbidity with skin breakdown, recurrent infection, and decreased function. Kyphectomy is the classic treatment to restore spinal alignment; however, surgery is associated with morbidity and long-term complications. The purpose of this retrospective study was to examine the authors' experience using combination of Luque instrumentation with posterolaterally placed polyaxial screws in the treatment of myelomeningocele kyphosis. From June 1999 to June 2003, 7 patients were treated and followed up for an average of 68.6 months. The average age at the time of the operation was 7 year and 1 month. All patients underwent vertebral excision from just above the apex of vertebral deformity to realign the sagittal deformity. Posterolaterally placed polyaxial screws were used in combination with segmental Luque instrumentation. Kyphotic deformity averaged 104 degrees before surgery, 15.2 degrees after surgery, and 18.5 degrees at the latest follow-up. The average loss of correction was 3.3 degrees. The average blood loss was 611 mL. Complications occurred in 2 of 7 patients were superficial wound breakdown and deep wound infection that required rotational flap closure. Kyphectomy with posterior instrumentation by using Luque technique in the combination with polyaxial screws is reliable method for correcting rigid kyphotic deformity in patients with myelomeningocele. Rigidity of the construct, greater correction capacity, and low profile instrumentation by the help of posterolateral insertion of the polyaxial screws and wiring were the distinct advantages of this technique. PMID:18458590

  15. Foam granulation: new developments in pharmaceutical solid oral dosage forms using twin screw extrusion machinery.

    PubMed

    Thompson, M R; Weatherley, S; Pukadyil, R N; Sheskey, P J

    2012-07-01

    This paper investigates foam granulation in a twin screw extruder as a new continuous wet granulation technique for pharmaceutical powder drug formulations. Foamed aqueous binder has a reportedly lower soak-to-spread ratio than drop or spray liquid addition in batch granulation. This work demonstrates a twin screw extruder configuration for foam granulation and subsequently compares the new approach against liquid injection in the granulation of α-lactose monohydrate with a methylcellulose binder. Trials were conducted at high powder output rates (20-40 kg/h) and high screw speeds (220-320 RPM) with two screw configurations. Process stability improved with the new technique allowing granulation with less binder. The extruded mass maintained a low exit temperature, being insensitive to operating conditions unlike the liquid injection approach, where temperatures rose significantly as flow rate increased. The particle size distribution by foam granulation reflected a more uniformly wetted mass with larger granule growth noted even for conditions where dry powder exited by liquid injection. Other factors were found similar between the two binder delivery methods such as consumed mechanical energy, as well as fracture strength and compressibility of produced granules. PMID:22085462

  16. Batten augmented triangular beam

    NASA Technical Reports Server (NTRS)

    Adams, Louis R.; Hedgepeth, John M.

    1986-01-01

    The BAT (Batten-Augmented Triangular) BEAM is characterized by battens which are buckled in the deployed state, thus preloading the truss. The preload distribution is determined, and the effects of various external loading conditions are investigated. The conceptual design of a deployer is described and loads are predicted. The influence of joint imperfections on effective member stiffness is investigated. The beam is assessed structurally.

  17. Molecular dynamics studies of the dissociated screw dislocation in silicon.

    PubMed

    Choudhury, R; Gattinoni, C; Makov, G; De Vita, A

    2010-02-24

    Characterizing the motion of dislocations through covalent, high Peierls barrier materials is a key problem in materials science, while despite the progress in experimental studies the actual observation of the atomistic behaviour involved in core migration remains limited. We have applied a hybrid embedding scheme to investigate the dissociated screw dislocation in silicon, consisting of two 30° partials separated by a stacking fault ribbon, under the influence of a constant external strain. Our 'learn on the fly' hybrid technique allows us to calculate the forces on atoms in the vicinity of the core region using the tight binding Kwon potential, whilst the remainder of the bulk matrix is treated within a classical approximation. Applying a 5% strain to the dissociated screw dislocation, for a simulation time of 100 ps at a temperature of 600 K, we observe movement of the partials through two different mechanisms: double kink formation and square ring diffusion at the core. Our results suggest that in these conditions, the role of solitons or anti-phase defects in seeding kink formation and subsequent migration is an important one, which should be taken into account in future studies. PMID:21386388

  18. Augmentation of tendon-to-bone healing.

    PubMed

    Atesok, Kivanc; Fu, Freddie H; Wolf, Megan R; Ochi, Mitsuo; Jazrawi, Laith M; Doral, M Nedim; Lubowitz, James H; Rodeo, Scott A

    2014-03-19

    Tendon-to-bone healing is vital to the ultimate success of the various surgical procedures performed to repair injured tendons. Achieving tendon-to-bone healing that is functionally and biologically similar to native anatomy can be challenging because of the limited regeneration capacity of the tendon-bone interface. Orthopaedic basic-science research strategies aiming to augment tendon-to-bone healing include the use of osteoinductive growth factors, platelet-rich plasma, gene therapy, enveloping the grafts with periosteum, osteoconductive materials, cell-based therapies, biodegradable scaffolds, and biomimetic patches. Low-intensity pulsed ultrasound and extracorporeal shockwave treatment may affect tendon-to-bone healing by means of mechanical forces that stimulate biological cascades at the insertion site. Application of various loading methods and immobilization times influence the stress forces acting on the recently repaired tendon-to-bone attachment, which eventually may change the biological dynamics of the interface. Other approaches, such as the use of coated sutures and interference screws, aim to deliver biological factors while achieving mechanical stability by means of various fixators. Controlled Level-I human trials are required to confirm the promising results from in vitro or animal research studies elucidating the mechanisms underlying tendon-to-bone healing and to translate these results into clinical practice. PMID:24647509

  19. Addition of an anti-rotation screw to the dynamic hip screw for femoral neck fractures.

    PubMed

    Makki, Daoud; Mohamed, Ahmed M; Gadiyar, Rajeev; Patterson, Marc

    2013-07-01

    The authors investigated the use of an anti-rotation screw with the dynamic hip screw (DHS) during internal fixation of Garden I and II femoral neck fractures. Sixty-five patients with Garden I and II femoral neck fractures (mean age, 70 years) were treated with internal fixation at the authors' institution. In 31 patients, a 2-hole DHS was used alone (group 1), and in 34 patients, the DHS was combined with an anti-rotation screw placed in the cranial part of femoral head and neck (group 2). Patients' preinjury function and mental level were assessed using the Barthel index and the Abbreviated Mental test, respectively. The outcome measures included cost implications, operative time, and intraoperative radiation dose. The modified Harris Hip Score and a radiological assessment were performed at a mean of 11 months (range, 8-24 months) postoperatively. The use of the anti-rotation screw was associated with a longer operative time (mean, 44.54 minutes in group 1 vs 51.52 minutes in group 2; P<.0001) and more fluoroscopy screening (mean dose area product, 28.39 cGy/cm(2) in group 1 vs 44.33 cGy/cm(2) in group 2; P=.03). The additional cost of using an anti-rotation screw was £106 ($170) per case. No difference existed between the 2 groups with regard to radiological union, onset of avascular necrosis, and rate of revision surgeries. An anti-rotation screw, used with the dynamic hip screw, involves extra costs, prolongs operative time, and requires more intraoperative fluoroscopy screening but offers no advantages with regard to fracture union. PMID:23823042

  20. The applicability of PEEK-based abutment screws.

    PubMed

    Schwitalla, Andreas Dominik; Abou-Emara, Mohamed; Zimmermann, Tycho; Spintig, Tobias; Beuer, Florian; Lackmann, Justus; Müller, Wolf-Dieter

    2016-10-01

    The high-performance polymer PEEK (poly-ether-ether-ketone) is more and more being used in the field of dentistry, mainly for removable and fixed prostheses. In cases of screw-retained implant-supported reconstructions of PEEK, an abutment screw made of PEEK might be advantageous over a conventional metal screw due to its similar elasticity. Also in case of abutment screw fracture, a screw of PEEK could be removed more easily. M1.6-abutment screws of four different PEEK compounds were subjected to tensile tests to set their maximum tensile strengths in relation to an equivalent stress of 186MPa, which is aused by a tightening torque of 15Ncm. Two screw types were manufactured via injection molding and contained 15% short carbon fibers (sCF-15) and 40% (sCF-40), respectively. Two screw types were manufactured via milling and contained 20% TiO2 powder (TiO2-20) and >50% parallel orientated, continuous carbon fibers (cCF-50). A conventional abutments screw of Ti6Al4V (Ti; CAMLOG(®) abutment screw, CAMLOG, Wimsheim, Germany) served as control. The maximum tensile strength was 76.08±5.50MPa for TiO2-20, 152.67±15.83MPa for sCF-15, 157.29±20.11MPa for sCF-40 and 191.69±36.33MPa for cCF-50. The maximum tensile strength of the Ti-screws amounted 1196.29±21.4MPa. The results of the TiO2-20 and the Ti screws were significantly different from the results of the other samples, respectively. For the manufacturing of PEEK abutment screws, PEEK reinforced by >50% continuous carbon fibers would be the material of choice. PMID:27434650

  1. Augmentation of the cheeks, chin and pre-jowl sulcus, and nasolabial folds.

    PubMed

    Romo, T; Baskin, J Z; Sclafani, A P

    2001-02-01

    The demand for augmentation of central and lower facial features continues to increase. There are several safe and effective materials available for this purpose, and techniques have become highly refined. The relative strengths and weaknesses of silicone, expanded polytetrafluoroethylene (ePTFE), high-density polyethylene (HDPE), and merseline mesh are discussed for augmentation of the chin/pre-jowl sulcus and cheek. Materials for augmentation of the nasolabial folds (NLF) are also discussed. There are various forms of solid ePTFE that have been developed for soft tissue augmentation. These are particularly well suited for the NLF. Techniques for facial skeletal and soft tissue augmentation are presented. PMID:11518979

  2. Comparison of the retro screw and standard interference screw for ACL reconstruction.

    PubMed

    Wang, Robert Y; Arciero, Robert A; Obopilwe, Elifho; Mazzocca, Augustus D

    2012-07-01

    The objective of the study was to compare the load to failure between a retro screw (RS) and a standard interference screw (IS) for tibial-sided anterior cruciate ligament (ACL) fixation. We used 20 bovine tibia and extensor tendons for the study. A group of 10 specimens underwent IS fixation while the other 10 underwent RS fixation. Within each group, five specimens had graft suture in contact (interdigitating) with the screw threads. All specimens were tested on the MTS 858 Mini Bionix II (MTS Systems, Shakopee, MN). There was no statistically significant difference between the RS and IS with respect to peak load to failure. IS with suture interdigitation failed at an average of 520 N (range: 358 to 793 N), while the RS with suture interdigitation failed at 613 N (range: 438 to 1089 N). The IS without suture interdigitation failed at 654 N and the RS without suture interdigitation at 531 N. Specimens with a whipstitch in contact with the screw did not demonstrate higher pull out strength. The RS fixation strength appears to equal the IS. Graft suture contact with screw threads does not increase fixation strength. Based on this study, using a RS for tibial ACL soft tissue graft fixation is feasible and provides equal fixation strength compared with the standard IS. PMID:23057142

  3. Analysis of Modeling Parameters on Threaded Screws.

    SciTech Connect

    Vigil, Miquela S.; Brake, Matthew Robert; Vangoethem, Douglas

    2015-06-01

    Assembled mechanical systems often contain a large number of bolted connections. These bolted connections (joints) are integral aspects of the load path for structural dynamics, and, consequently, are paramount for calculating a structure's stiffness and energy dissipation prop- erties. However, analysts have not found the optimal method to model appropriately these bolted joints. The complexity of the screw geometry cause issues when generating a mesh of the model. This paper will explore different approaches to model a screw-substrate connec- tion. Model parameters such as mesh continuity, node alignment, wedge angles, and thread to body element size ratios are examined. The results of this study will give analysts a better understanding of the influences of these parameters and will aide in finding the optimal method to model bolted connections.

  4. Mutually Augmented Cognition

    NASA Astrophysics Data System (ADS)

    Friesdorf, Florian; Pangercic, Dejan; Bubb, Heiner; Beetz, Michael

    In mac, an ergonomic dialog-system and algorithms will be developed that enable human experts and companions to be integrated into knowledge gathering and decision making processes of highly complex cognitive systems (e.g. Assistive Household as manifested further in the paper). In this event we propose to join algorithms and methodologies coming from Ergonomics and Artificial Intelligence that: a) make cognitive systems more congenial for non-expert humans, b) facilitate their comprehension by utilizing a high-level expandable control code for human experts and c) augment representation of such cognitive system into “deep representation” obtained through an interaction with human companions.

  5. Considerations in breast augmentation in the adolescent patient.

    PubMed

    Jordan, Sumanas W; Corcoran, Julia

    2013-02-01

    Nearly 320,000 breast augmentations were performed in 2011, with adolescents under 18 years of age accounting for 4,830 procedures (1.5%). Breast development typically starts at 11 years (range, 8-13 years) and is complete at 15 years (range, 11-18 years). This wide age range for physical maturity matches the equally wide range of emotional maturity in this patient population. Developmental, psychological, and regulatory aspects unique to adolescent breast augmentation are reviewed. Self-image and societal influences must be considered, including both internal and external motivations for seeking breast augmentation. Preoperative assessment and counseling of these patients are discussed. Both parental consent and adolescent assent must be considered. Ideal conditions for adolescent assent are described. Breast augmentation for purely aesthetic purposes should be undertaken with extreme caution as ideal conditions for complete assent are rare. Augmentation as a technique for breast balancing in cases of significant asymmetry can be helpful. PMID:24872743

  6. [Scaphoid percutaneous osteosynthesis by screw using computer assisted surgery: an experimental study].

    PubMed

    Liverneaux, P

    2005-01-01

    need for calibration of the navigation tools one by one. The solid immobilization device, although having the potential for micromovement, did not lead to any misdirection of the guide wire or screw. Our technique cannot be employed at the moment in live human surgery. Its limits are of a geometrical nature "two images available in two planes", data processing "non-specific software dedicated", instrumental "instrument calibration, micromobility of the immobilisation device" and live surgery "no current validation on a fractured scaphoid". Meantime, the development of a percutaneous scaphoid osteosynthesis procedure by CAS can only bring advantages: reduction in the learning curve, widening of the indications, comfort in the technique, reduction in the errors of ostesynthesis and, reduction in the exposure to x-rays. In the current state of knowledge, the method would only be applicable to undisplaced fractures. PMID:16121623

  7. Biomechanical analysis of expansion screws and cortical screws used for ventral plate fixation on the cervical spine

    PubMed Central

    Ullrich, Bernhard; Huber, Gerd; Morlock, Michael M.

    2009-01-01

    Compared to bicortical screws, the surgical risk of injuring intraspinal structures can be minimized with the use of monocortical screws. However, this reduction should not be achieved at the expense of the stability of the fixation. With monocortical stabilization, the expansion screws have the potential of absorbing high loads. Therefore, they are expected to be a suitable alternative to bicortical screws for revision surgeries and in osteoporotic bone. The purpose of this in vitro study was to investigate the stiffness of the two screw-plate systems used for ventral stabilization of the cervical spine, by focusing on the suitability of expansion screws as tools for revision treatments. The study was conducted in ten functional units of human cervical spines. The device sample stiffness was determined for four conditions using a turning moment of 2.25 N m each around one of the three principle axes. The conditions were native, destabilized, primarily stabilized with one of the screw-plate systems, followed by secondary stabilization using the expansion screw implant. The stabilized samples achieved a comparable, in most cases higher stiffness than the native samples. The samples undergoing secondary stabilization using expansion screws tend to display greater stiffness for all three axes compared to the primarily stabilized samples. The achieved tightening moment of the screws was higher than the one achieved with primary fixation. Both plates revealed similar primary stability. Revision surgeries with secondary instrumentation achieve a high stiffness of the screwed up segments. Monocortical expansion screws combined with a trapezoidal plate allow ventral stabilization of the cervical spine that is comparable to the plate fixation using bicortical screws. PMID:19588171

  8. Sliding screw implants for extracapsular hip fractures.

    PubMed

    Mavrogenis, Andreas F; Kouvidis, George; Stavropoulos, Nikolaos A; Stavrakakis, Loannis; Katonis, Pavlos; Papagelopoulos, Panayiotis J

    2012-01-01

    Hip fractures are associated with significant mortality and morbidity for the patients, more dependent residual status, and increased socio-economic cost. Many hip-fracture patients experience severe functional impairment, and most never recover their pre-fracture level of function. Current research has sought to identify the most effective treatments to reduce the incidence of hip fractures, improve survival and quality of life, and minimize complications and disability. The treatment of these fractures in the elderly aims to return these people to their pre-fracture mobility and functional level. This article reviews the surgical treatment options for extracapsular hip fractures and discusses their associated advantages, disadvantages, and complications. Two types of implants are currently available: the dynamic hip screw (DHS), and the intramedullary hip nail with one or two sliding screws. In this review, no clear advantage of one implant over another for the treatment of extracapsular hip fractures was evident. Both the DHS and hip nails can be used successfully for the treatment of stable hip fractures; for unstable fractures and low subtrochanteric fractures, hip nails are preferred. Although hip nails are associated with limited exposure, lower blood loss and transfusion requirements, and shorter operative time, complications are more common with hip nails. Long-term survival and function are similar in the two approaches. Hip nails with two sliding screws do not seem to make the difference in clinical practice that is reported in biomechanical studies. PMID:23016784

  9. Dual load path ball screw with rod end swivel

    NASA Technical Reports Server (NTRS)

    Wngett, Paul (Inventor)

    2002-01-01

    A dual drive ball has a ball screw shaft coupled at one end to a gear train and coupled at the other end to a ball screw nut. The ball screw shaft and ball screw nut are connected through complementary helical grooves filled with ball bearing balls. The outer surface of the ball screw nut is plined and can be driven by a second gear train. An output tube is coupled at one end to the ball screw nut and at its opposite end has a connector portion with a groove on its inner surface. A rod end has a coupling member for coupling to a surface to be actuated and a shaft portion with a groobe on its outer surface. This shaft portion is received with in the outputtube portion and the corresponding grooves are coupled through the use of a plurality of ball bearing balls.

  10. Percutaneous Vertebral Body Augmentation: An Updated Review

    PubMed Central

    Omidi-Kashani, Farzad

    2014-01-01

    There are many medical conditions like osteoporosis, tumor, or osteonecrosis that weaken the structural strength of the vertebral body and prone it to fracture. Percutaneous vertebral augmentation that is usually applied by polymethylmethacrylate is a relatively safe, effective, and long lasting procedure commonly performed in these situations. In this paper, we updated a review of biomechanics, indications, contraindications, surgical techniques, complications, and overall prognosis of these minimally invasive spinal procedures. PMID:25379561

  11. Fracture fixation with two locking screws versus three non-locking screws

    PubMed Central

    Grawe, B.; Le, T.; Williamson, S.; Archdeacon, A.; Zardiackas, L.

    2012-01-01

    Objectives We aimed to further evaluate the biomechanical characteristics of two locking screws versus three standard bicortical screws in synthetic models of normal and osteoporotic bone. Methods Synthetic tubular bone models representing normal bone density and osteoporotic bone density were used. Artificial fracture gaps of 1 cm were created in each specimen before fixation with one of two constructs: 1) two locking screws using a five-hole locking compression plate (LCP) plate; or 2) three non-locking screws with a seven-hole LCP plate across each side of the fracture gap. The stiffness, maximum displacement, mode of failure and number of cycles to failure were recorded under progressive cyclic torsional and eccentric axial loading. Results Locking plates in normal bone survived 10% fewer cycles to failure during cyclic axial loading, but there was no significant difference in maximum displacement or failure load. Locking plates in osteoporotic bone showed less displacement (p = 0.02), but no significant difference in number of cycles to failure or failure load during cyclic axial loading (p = 0.46 and p = 0.25, respectively). Locking plates in normal bone had lower stiffness and torque during torsion testing (both p = 0.03), but there was no significant difference in rotation (angular displacement) (p = 0.84). Locking plates in osteoporotic bone showed lower torque and rotation (p = 0.008), but there was no significant difference in stiffness during torsion testing (p = 0.69). Conclusions The mechanical performance of locking plate constructs, using only two screws, is comparable to three non-locking screw constructs in osteoporotic bone. Normal bone loaded with either an axial or torsional moment showed slightly better performance with the non-locking construct. PMID:23610681

  12. 21 CFR 888.3070 - Pedicle screw spinal system.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ...; spinal tumor; and failed previous fusion (pseudarthrosis). These pedicle screw spinal systems must comply... tumor, and failed previous fusion (pseudarthrosis). The safety and effectiveness of these devices...

  13. Screws, Propellers and Fans Based on a Mobius Strip

    NASA Technical Reports Server (NTRS)

    Seiner, John M.; Backley, Floyd D.; Gilinsky, Mikhail

    1998-01-01

    A Mobius strip concept is intended for improving the working efficiency of propellers and screws. Applications involve cooling, boat propellers, mixing in appliance, blenders, and helicopters. Several Mobius shaped screws for the average size kitchen mixers have been made and tested. The tests have shown that the mixer with the Mobius shaped screw pair is most efficient, and saves more than 30% of the electric power by comparison with the standard. The created video film about these tests illustrates efficiency of Mobius shaped screws.

  14. Use of polymethylmethacrylate to enhance screw fixation in bone.

    PubMed

    Cameron, H U; Jacob, R; Macnab, I; Pilliar, R M

    1975-07-01

    Pull-out testing of screws inserted into cement and bone under various conditions showed that the cement-screw complex was significantly stronger when the screw was placed in soft cement and the cement was allowed to polymerize without further manipulation. When screw fixation in osteoporotic bone was reinforced with cement, the bone was the weakest component in the system. Fixation under these conditions should be enhanced by increasing the area of contact between the cement and bone. By cooling the cement to prolong its working time, it could be injected with a syringe in such a way that maximum endosteal and periosteal contact was provided. PMID:1150708

  15. A Finite Element Model of Electrode Placement During Stimulus Evoked Electromyographic Monitoring of Iliosacral Screw Insertion

    PubMed Central

    Kopec, M.A; Moed, B.R; Barnett, D.W

    2008-01-01

    Pelvic ring fractures that occur as a result of substantial orthopedic trauma are frequently repaired using iliosacral screws to stabilize the fracture. Stimulus evoked electromyography, using pulsed current stimuli provided through the drill bit cathode, has been advocated to prevent nerve root injury during iliosacral screw insertion. Our objective was to examine the effects of anode location, drill bit position, and anatomical structure on the nerve monitoring technique. A three-dimensional finite element model was constructed from computed tomography data to evaluate the effectiveness of five anode locations at four stations of drill bit insertion. Results indicate that the anode location should be at the midline or on the side contralateral to drill bit insertion. Locating the anode at other positions, such that the nerve root is outside of the primary electromagnetic field, leads to an attenuated electromyographic response that will ultimately lead to the failure of the monitoring technique. PMID:19587797

  16. Vertebroplasty plus short segment pedicle screw fixation in a burst fracture model in cadaveric spines.

    PubMed

    Grossbach, Andrew J; Viljoen, Stephanus V; Hitchon, Patrick W; DeVries Watson, Nicole A; Grosland, Nicole M; Torner, James

    2015-05-01

    The current project investigates the role of vertebroplasty in supplementing short segment (SS) posterior instrumentation, only one level above and below a fracture. In the treatment of thoracolumbar burst fractures, long segment (LS) posterior instrumentation two levels above and below the fracture level has been used. In our study, burst fractures were produced at L1 in eight fresh frozen human cadaveric spines. The spines were then tested in three conditions: 1) intact, 2) after LS (T11-L3), 3) SS (T12-L2) instrumentation with pedicle screws and rods, and 4) short segment instrumentation plus cement augmentation of the fracture level (SSC). LS instrumentation was found to significantly reduce the motion at the instrumented level (T12-L2) as well as the levels immediately adjacent in flexion, extension and lateral bending. Similarly, SSC augmentation was found to significantly reduce the motion compared to intact at T12-L2 but still maintained the adjacent level motion. However, SS instrumentation alone did not significantly reduce the motion at T12-L2 except for left lateral bending. While LS instrumentation remains the most stable construct, SS instrumentation augmented with vertebroplasty at the fracture level increases rigidity in flexion, extension and right lateral bending beyond SS instrumentation alone. PMID:25769251

  17. Serious complication of cement augmentation for damaged pilot hole.

    PubMed

    Jung, Moon Young; Shin, Dong Ah; Hahn, In Bo; Kim, Tae Gon; Huh, Ryoong; Chung, Sang Sup

    2010-05-01

    Polymethl methacrylate (PMMA) screw reinforcement is frequently used in osteoporotic bone as well as in damaged pilot holes. However, PMMA use can be dangerous, since the amount of applied cement is uncontrolled. A 47-year-old male with traumatic cervical spondylolisthesis at C6-7 underwent anterior cervical plate fixation. During repeated drilling and tapping for false trajectory correction, a pilot hole was damaged. Although it was an unconventional method, PMMA augmentation was tried. However, PMMA was accidentally injected to the cervical spinal cord owing to lack of fluoroscopic guidance. The PMMA was surgically removed after corpectomy and durotomy. The patient had left side hemiparesis (Grade 2/5) immediately post operation. The patient improved spontaneously (Grade 4/5) except for 4th and 5th digit extension. Here, we report a rare complication of PMMA extrusion in the spinal cord during a damaged pilot hole injection, which has not previously been described. PMID:20376906

  18. Pyriform Aperture Augmentation as An Adjunct to Rhinoplasty.

    PubMed

    Yaremchuk, Michael J; Vibhakar, Dev

    2016-01-01

    Skeletal deficiency in the central midface impacts nasal aesthetics. This lack of lower face projection can be corrected by alloplastic augmentation of the pyriform aperture. Creating convexity in the deficient midface will make the nose seem less prominent. Augmentation of the pyriform aperture is, therefore, often a useful adjunct during the rhinoplasty procedure. Augmenting the skeleton in this area can alter the projection of the nasal base, the nasolabial angle, and the vertical plane of the lip. The implant design and surgical techniques described here are extensions of others' previous efforts to improve paranasal aesthetics. PMID:26616706

  19. Finite Element Analysis of a New Pedicle Screw-Plate System for Minimally Invasive Transforaminal Lumbar Interbody Fusion

    PubMed Central

    Zhou, Yue; Li, Changqing; Liu, Huan

    2015-01-01

    Purpose Minimally invasive transforaminal lumbar interbody fusion (MI-TLIF) is increasingly popular for the surgical treatment of degenerative lumbar disc diseases. The constructs intended for segmental stability are varied in MI-TLIF. We adopted finite element (FE) analysis to compare the stability after different construct fixations using interbody cage with posterior pedicle screw-rod or pedicle screw-plate instrumentation system. Methods A L3–S1 FE model was modified to simulate decompression and fusion at L4–L5 segment. Fixation modes included unilateral plate (UP), unilateral rod (UR), bilateral plate (BP), bilateral rod (BR) and UP+UR fixation. The inferior surface of the S1 vertebra remained immobilized throughout the load simulation, and a bending moment of 7.5 Nm with 400N pre-load was applied on the L3 vertebra to recreate flexion, extension, lateral bending, and axial rotation. Range of motion (ROM) and Von Mises stress were evaluated for intact and instrumentation models in all loading planes. Results All reconstructive conditions displayed decreased motion at L4–L5. The pedicle screw-plate system offered equal ROM to pedicle screw-rod system in unilateral or bilateral fixation modes respectively. Pedicle screw stresses for plate system were 2.2 times greater than those for rod system in left lateral bending under unilateral fixation. Stresses for plate were 3.1 times greater than those for rod in right axial rotation under bilateral fixation. Stresses on intervertebral graft for plate system were similar to rod system in unilateral and bilateral fixation modes respectively. Increased ROM and posterior instrumentation stresses were observed in all loading modes with unilateral fixation compared with bilateral fixation in both systems. Conclusions Transforaminal lumbar interbody fusion augmentation with pedicle screw-plate system fixation increases fusion construct stability equally to the pedicle screw-rod system. Increased posterior

  20. NASA Communications Augmentation network

    NASA Astrophysics Data System (ADS)

    Omidyar, Guy C.; Butler, Thomas E.; Laios, Straton C.

    1990-09-01

    The NASA Communications (Nascom) Division of the Mission Operations and Data Systems Directorate (MO&DSD) is to undertake a major initiative to develop the Nascom Augmentation (NAUG) network to achieve its long-range service objectives for operational data transport to support the Space Station Freedom Program, the Earth Observing System (EOS), and other projects. The NAUG is the Nascom ground communications network being developed to accommodate the operational traffic of the mid-1990s and beyond. The NAUG network development will be based on the Open Systems Interconnection Reference Model (OSI-RM). This paper describes the NAUG network architecture, subsystems, topology, and services; addresses issues of internetworking the Nascom network with other elements of the Space Station Information System (SSIS); discusses the operations environment. This paper also notes the areas of related research and presents the current conception of how the network will provide broadband services in 1998.

  1. Augmented Virtual Reality Laboratory

    NASA Technical Reports Server (NTRS)

    Tully-Hanson, Benjamin

    2015-01-01

    Real time motion tracking hardware has for the most part been cost prohibitive for research to regularly take place until recently. With the release of the Microsoft Kinect in November 2010, researchers now have access to a device that for a few hundred dollars is capable of providing redgreenblue (RGB), depth, and skeleton data. It is also capable of tracking multiple people in real time. For its original intended purposes, i.e. gaming, being used with the Xbox 360 and eventually Xbox One, it performs quite well. However, researchers soon found that although the sensor is versatile, it has limitations in real world applications. I was brought aboard this summer by William Little in the Augmented Virtual Reality (AVR) Lab at Kennedy Space Center to find solutions to these limitations.

  2. NASA Communications Augmentation network

    NASA Technical Reports Server (NTRS)

    Omidyar, Guy C.; Butler, Thomas E.; Laios, Straton C.

    1990-01-01

    The NASA Communications (Nascom) Division of the Mission Operations and Data Systems Directorate (MO&DSD) is to undertake a major initiative to develop the Nascom Augmentation (NAUG) network to achieve its long-range service objectives for operational data transport to support the Space Station Freedom Program, the Earth Observing System (EOS), and other projects. The NAUG is the Nascom ground communications network being developed to accommodate the operational traffic of the mid-1990s and beyond. The NAUG network development will be based on the Open Systems Interconnection Reference Model (OSI-RM). This paper describes the NAUG network architecture, subsystems, topology, and services; addresses issues of internetworking the Nascom network with other elements of the Space Station Information System (SSIS); discusses the operations environment. This paper also notes the areas of related research and presents the current conception of how the network will provide broadband services in 1998.

  3. NAESA Augmentation Pilot Project

    NASA Technical Reports Server (NTRS)

    Hoover, John J.

    1998-01-01

    This project was one project within the Native American Earth and Space Academy (NAESA). NAESA is a national initiative comprised of several organizations that support programs which focus on 1) enhancing the technological, scientific and pedagogical skills of K-14 teachers who instruct Native Americans, 2) enhancing the understanding and applications of science, technology, and engineering of college-bound Native Americans and teaching them general college "survival skills" (e.g., test taking, time management, study habits), 3) enhancing the scientific and pedagogical skills of the faculty of tribally-controllcd colleges and community colleges with large Native American enrollments, and 4) strengthening the critical relationships between students, their parents, tribal elders, and their communities. This Augmentation Pilot Project focused on the areas of community-school alliances and intemet technology use in teaching and learning and daily living addressing five major objectives.

  4. Augmented reality system

    NASA Astrophysics Data System (ADS)

    Lin, Chien-Liang; Su, Yu-Zheng; Hung, Min-Wei; Huang, Kuo-Cheng

    2010-08-01

    In recent years, Augmented Reality (AR)[1][2][3] is very popular in universities and research organizations. The AR technology has been widely used in Virtual Reality (VR) fields, such as sophisticated weapons, flight vehicle development, data model visualization, virtual training, entertainment and arts. AR has characteristics to enhance the display output as a real environment with specific user interactive functions or specific object recognitions. It can be use in medical treatment, anatomy training, precision instrument casting, warplane guidance, engineering and distance robot control. AR has a lot of vantages than VR. This system developed combines sensors, software and imaging algorithms to make users feel real, actual and existing. Imaging algorithms include gray level method, image binarization method, and white balance method in order to make accurate image recognition and overcome the effects of light.

  5. Magnetohydrodynamic Augmented Propulsion Experiment

    NASA Technical Reports Server (NTRS)

    Litchford, Ron J.

    2008-01-01

    Over the past several years, efforts have been under way to design and develop an operationally flexible research facility for investigating the use of cross-field MHD accelerators as a potential thrust augmentation device for thermal propulsion systems. The baseline configuration for this high-power experimental facility utilizes a 1.5-MWe multi-gas arc-heater as a thermal driver for a 2-MWe MHD accelerator, which resides in a large-bore 2-tesla electromagnet. A preliminary design study using NaK seeded nitrogen as the working fluid led to an externally diagonalized segmented MHD channel configuration based on an expendable heat-sink design concept. The current status report includes a review of engineering/design work and performance optimization analyses and summarizes component hardware fabrication and development efforts, preliminary testing results, and recent progress toward full-up assembly and testing

  6. Estimation of mean glandular dose for mammography of augmented breasts

    NASA Astrophysics Data System (ADS)

    Beckett, J. R.; Kotre, C. J.

    2000-11-01

    The standard quantity used to relate breast surface exposure to radiation risk is the mean dose received by the radiation sensitive tissue contained within the female breast, the mean glandular dose (MGD). At present, little is known about the MGD received by women with breast implants as there is no technique available to facilitate its calculation. The present work has involved modification of the conventional method for MGD estimation to make it applicable to women with augmented breasts. The technique was used to calculate MGDs for a cohort of 80 women with breast implants, which were compared with similar data calculated for a total of 1258 non-augmented women. Little difference was found in median MGD at low compressed breast thickness. At high breast thickness, however, the MGDs received by women with augmented breasts were found to be considerably lower than those relating to their non-augmented counterparts.

  7. The biomechanical aspects of reconstruction for segmental defects of the mandible: a finite element study to assess the optimisation of plate and screw factors.

    PubMed

    Bujtár, Péter; Simonovics, János; Váradi, Károly; Sándor, George K B; Avery, C M E

    2014-09-01

    A bone plate is required to restore the load-bearing capacity of the mandible following a segmental resection. A good understanding of the underlying principles is crucial for developing a reliable reconstruction. A finite element analysis (FEA) technique has been developed to study the biomechanics of the clinical scenarios managed after surgical resection of a tumour or severe trauma to assist in choosing the optimal hardware elements. A computer aided design (CAD) model of an edentulous human mandible was created. Then 4 common segmental defects were simulated. A single reconstruction plate was designed to span the defects. The hardware variations studied were: monocortical or bicortical screw fixation and non-locking or locking plate design. A standardized load was applied to mimic the human bite. The von Mises stress and strain, spatial changes at the screw-bone interfaces were analysed. In general, the locking plate and monocortical screw fixation systems were most effective. Non-locking plating systems produced larger screw "pull-out" displacements, especially at the hemimandible (up to 5% strain). Three screws on either side of the defect were adequate for all scenarios except extensive unilateral defects when additional screws and an increased screw diameter are recommended. The simplification of screw geometry may underestimate stress levels and factors such as poor adaptation of the plate or reduced bone quality are likely to be indications for bicortical locking screw fixation. The current model provides a good basis for understanding the complex biomechanics and developing future refinements in plate or scaffold design. PMID:24467871

  8. A biomechanical comparison of internal fixation techniques for ankle arthrodesis.

    PubMed

    Clifford, Craig; Berg, Scott; McCann, Kevin; Hutchinson, Byron

    2015-01-01

    The purpose of the present study was to compare the primary bending stiffness characteristics of 5 different ankle arthrodesis fixation techniques: 3 compression screws, an anterior locking plate, a lateral locking plate, an anterior locking plate with a compression screw, and a lateral locking plate with a compression screw. A total of 25 full-scale anatomic models consisting of fourth-generation composite tibiae and tali were tested using an Instron 4505 Universal Testing System. We hypothesized that the use of a compression screw with a locking plate would add considerable stiffness to the fixation construct compared with the use of a locking plate alone. The data have shown that an anterior or lateral plate with a compression screw provides significantly greater stiffness than both a plate and 3 compression screws used individually. No significant difference was seen between the anterior plate with a compression screw and the lateral plate with a compression screw. No significant differences were found among the use of an anterior plate, a lateral plate, or 3 compression screws. We have concluded that when using a locking plate in an anterior or lateral configuration, the addition of a compression screw will considerably increase the primary bending stiffness of ankle arthrodesis. PMID:25116232

  9. Modeling bicortical screws under a cantilever bending load.

    PubMed

    James, Thomas P; Andrade, Brendan A

    2013-12-01

    Cyclic loading of surgical plating constructs can precipitate bone screw failure. As the frictional contact between the plate and the bone is lost, cantilever bending loads are transferred from the plate to the head of the screw, which over time causes fatigue fracture from cyclic bending. In this research, analytical models using beam mechanics theory were developed to describe the elastic deflection of a bicortical screw under a statically applied load. Four analytical models were developed to simulate the various restraint conditions applicable to bicortical support of the screw. In three of the models, the cortical bone near the tip of the screw was simulated by classical beam constraints (1) simply supported, (2) cantilever, and (3) split distributed load. In the final analytical model, the cortices were treated as an elastic foundation, whereby the response of the constraint was proportional to screw deflection. To test the predictive ability of the new analytical models, 3.5 mm cortical bone screws were tested in a synthetic bone substitute. A novel instrument was developed to measure the bending deflection of screws under radial loads (225 N, 445 N, and 670 N) applied by a surrogate surgical plate at the head of the screw. Of the four cases considered, the analytical model utilizing an elastic foundation most accurately predicted deflection at the screw head, with an average difference of 19% between the measured and predicted results. Determination of the bending moments from the elastic foundation model revealed that a maximum moment of 2.3 N m occurred near the middle of the cortical wall closest to the plate. The location of the maximum bending moment along the screw axis was consistent with the fracture location commonly observed in clinical practice. PMID:24105350

  10. Magnesium Alloys as a Biomaterial for Degradable Craniofacial Screws

    PubMed Central

    Henderson, Sarah E.; Verdelis, Konstantinos; Maiti, Spandan; Pal, Siladitya; Chung, William L.; Chou, Da-Tren; Kumta, Prashant N.; Almarza, Alejandro J.

    2014-01-01

    Recently, magnesium (Mg) alloys have received significant attention as a potential biomaterial for degradable implants, and this study was directed at evaluating the suitability of Mg for craniofacial bone screws. The objective was to implant screws fabricated from commercially available Mg-alloys (pure Mg and AZ31) in-vivo in a rabbit mandible. First, Mg-alloy screws were compared to stainless steel screws in an in-vitro pull-out test and determined to have a similar holding strength (~40N). A finite element model of the screw was created using the pull-out test data, and the model can be used for future Mg-alloy screw design. Then, Mg-alloy screws were implanted for 4, 8, and 12 weeks, with two controls of an osteotomy site (hole) with no implant and a stainless steel screw implanted for 12 weeks. MicroCT (computed tomography) was used to assess bone remodeling and Mg-alloy degradation, both visually and qualitatively through volume fraction measurements for all time points. Histologic analysis was also completed for the Mg-alloys at 12 weeks. The results showed that craniofacial bone remodeling occurred around both Mg-alloy screw types. Pure Mg had a different degradation profile than AZ31, however bone growth occurred around both screw types. The degradation rate of both Mg-alloy screw types in the bone marrow space and the muscle were faster than in the cortical bone space at 12 weeks. Furthermore, it was shown that by alloying Mg, the degradation profile could be changed. These results indicate the promise of using Mg-alloys for craniofacial applications. PMID:24384125

  11. Augmented Reality Comes to Physics

    ERIC Educational Resources Information Center

    Buesing, Mark; Cook, Michael

    2013-01-01

    Augmented reality (AR) is a technology used on computing devices where processor-generated graphics are rendered over real objects to enhance the sensory experience in real time. In other words, what you are really seeing is augmented by the computer. Many AR games already exist for systems such as Kinect and Nintendo 3DS and mobile apps, such as…

  12. Dynamic Abutment: A method of redirecting screw access for implant-supported restorations: Technical details and a clinical report.

    PubMed

    Berroeta, Eva; Zabalegui, Ion; Donovan, Terrence; Chee, Winston

    2015-06-01

    The esthetic outcome of implant-supported restorations is affected by the implant position. A well-placed implant will allow appropriate contours of the restoration and together with an adequate volume of soft tissue will result in a functional and esthetic restoration. When a screw-retained restoration is anticipated, an implant that is angled too far facially would be esthetically unacceptable. In 2004, an abutment called the Dynamic Abutment (Talladium International Implantology) became commercially available. This abutment can allow a deviation of the restoration screw access angle to the implant angle of up to 28 degrees while allowing a screw-retained restoration to be connected directly to the platform of the implant. The purpose of this article was to describe the components, technique, and clinical use of this abutment. PMID:25794919

  13. Transsacral transdiscal L5-S1 screws for the management of high-grade spondylolisthesis in an adolescent.

    PubMed

    Palejwala, Ali; Fridley, Jared; Jea, Andrew

    2016-06-01

    The surgical management of high-grade spondylolisthesis in adolescents remains a controversial issue. Because the basic procedure, posterolateral fusion, is associated with a significant rate of pseudarthrosis and listhesis progression, there is a pressing need for alternative surgical techniques. In the present report, the authors describe the case of an adolescent patient with significant low-back pain who was found to have Grade IV spondylolisthesis at L5-S1 that was treated with transsacral transdiscal screw fixation. Bilateral pedicle screws were placed starting from the top of the S-1 pedicle, across the L5-S1 intervertebral disc space, and into the L-5 body. At 14 months after surgery, the patient had considerable improvement in his pain and radiographic fusion across L5-S1. The authors conclude that transsacral transdiscal pedicle screws may serve as an efficacious and safe option for the correction of high-grade spondylolisthesis in adolescent patients. PMID:26894520

  14. Does Abutment Collar Length Affect Abutment Screw Loosening After Cyclic Loading?

    PubMed

    Siadat, Hakimeh; Pirmoazen, Salma; Beyabanaki, Elaheh; Alikhasi, Marzieh

    2015-07-01

    A significant vertical space that is corrected with vertical ridge augmentation may necessitate selection of longer abutments, which would lead to an increased vertical cantilever. This study investigated the influence of different abutment collar heights on single-unit dental implant screw-loosening after cyclic loading. Fifteen implant-abutment assemblies each consisted of an internal hexagonal implant were randomly assigned to 3 groups: Group1, consisting of 5 abutments with 1.5 mm gingival height (GH); Group2, 5 abutments with 3.5 mm GH; and Group3, 5 abutments with 5.5 mm GH. Each specimen was mounted in transparent auto-polymerizing acrylic resin block, and the abutment screw was tightened to 35 Ncm with an electric torque wrench. After 5 minutes, initial torque loss (ITL) was recorded for all specimens. Metal crowns were fabricated with 45° occlusal surface and were placed on the abutments. A cyclic load of 75 N and frequency of 1 Hz were applied perpendicular to the long axis of each specimen. After 500 000 cycles, secondary torque loss (STL) was recorded. One-way ANOVA analysis was used to evaluate the effects of abutment collar height before and after cyclic loading. One-way ANOVA showed that ITL among the groups was not significantly different (P = .52), while STL was significantly different among the groups (P = .008). Post-hoc Tukey HSD tests showed that STL values were significantly different between the abutments with 1.5 mm GH (Group1) and with 5.5 mm GH (Group3) (P = .007). A paired comparison t-test showed that cyclic loading significantly influenced the STL in comparison with the ITL in each group. Within the limitations of this study, it can be concluded that increase in height of the abutment collar could adversely affect the torque loss of the abutment screw. PMID:26237093

  15. Single screw interrupted thread positive displacement mechanism

    NASA Astrophysics Data System (ADS)

    Boblitt, Wayne W.

    1992-07-01

    A single screw positive displacement compressor mechanism employing shallow gate rotor tooth penetration of the main rotor for purposes of reducing internal leakage and consequent compressor inefficiencies is presented. The invention is provided with an interrupted main rotor thread for purposes of insuring multiple gate rotor teeth meshing with the drive portion of the main rotor thread, thereby reducing gate rotor tooth flank loads in the compressor section of the device. Provision is also made for main rotor thread baffling between the main rotor chamber section and the mechanism inlet.

  16. Injection of coal by screw feed

    NASA Technical Reports Server (NTRS)

    Fisher, R.

    1977-01-01

    The use of the screw feeder for injecting solids through a 20 to 30 psi barrier is common practice in the cement making industry. An analytical extrapolation of that design, accounting for pressure holding characteristics of a column of solids, shows that coal can be fed to zones at several hundred psi with minimal or no loss of gas. A series of curves showing the calculated pressure gradient through a moving column of solids is presented. Mean particle size, solids velocity, and column length are parameters. Further study of this system to evaluate practicality is recommended.

  17. A histological study of non-ceramic hydroxyapatite as a bone graft substitute material in the vertical bone augmentation of the posterior mandible using an interpositional inlay technique: A split mouth evaluation.

    PubMed

    Bechara, Karen; Dottore, Alexandre M; Kawakami, Paulo Y; Gehrke, Sergio A; Coelho, Paulo G; Piattelli, Adriano; Iezzi, Giovanna; Shibli, Jamil Awad

    2015-11-01

    The aim of this study was to compare the influence of graft material (non-ceramic hydroxyapatite versus autologous bone) on bone behaviour and perform a resonance frequency analysis of implants placed in augmented sites to evaluate stability. For this study, 11 patients with bilateral edentulous areas in the mandibular posterior region were selected. Alveolar augmentation osteotomies were bilaterally (split mouth design) performed. In one hemiarch, the space generated by the osteotomy was grafted with an interpositional intra-oral autologous bone graft (control group). In the other hemiarch, the space generated by the osteotomy was grafted with an interpositional non-ceramic hydroxyapatite (ncHA) (test group). The groups were randomized. After 6 months of healing, a bone sample was retrieved from each side for histological evaluation using a trephine drill that was 2-mm in internal diameter. The implant stability quotient (ISQ) was measured by the resonance frequency immediately following implant placement at baseline and after 6 months of follow-up. Good incorporation of the graft was observed in both groups; however, in the test group, a residual-grafted material was observed. Bone density and marrow spaces were similar between groups. Correlations between the ISQ values and the histometric variables were not observed (p>0.05). The results of this trial suggest that both intra-oral autologous bone and ncHA may be elected as interpositional grafting materials to vertically augment posterior atrophic mandibles. PMID:26325427

  18. Arthroscopic Treatment for Shoulder Instability with Glenoid Bone Loss Using Distal Tibia Allograft Augmentation - Short Term Results

    PubMed Central

    Wong, Ivan; Amar, Eyal; Coady, Catherine M.; Dilman, Daryl B.; Smith, Ben

    2016-01-01

    Objectives: Background: The results of arthroscopic anterior labral (Bankart) repair have been shown to have high failure rate in patients with significant glenoid bone loss. Several reconstruction procedures using bone graft have been described to overcome the bone loss, including autogenous coracoid transfer to the anterior glenoid (Latarjet procedure) as well as iliac crest autograft and tibial allografts. In recent years, trends toward minimally invasive shoulder surgery along with improvements in technology and technique have led surgeons to expand the application of arthroscopic treatment. Purpose: This study aims to perform a retrospective analysis of prospectively collected data to evaluate the clinical and radiological follow up of patient who underwent anatomic glenoid reconstruction using distal tibia allograft for the treatment of shoulder instability with glenoid bone loss at 1-year post operation time point. Methods: Between December 2011 and January 2015, 55 patients underwent arthroscopic stabilization of the shoulder by means of capsule-labral reattachment to glenoid ream and bony augmentation of glenoid bone loss with distal tibial allograft for recurrent instability of the shoulder. Preoperative and postoperative evaluation included general assessment by the western Ontario shoulder instability index (WOSI) questionnaire, preoperative and postoperative radiographs and CT scans. Results: Fifty-five patients have been evaluated with mean age of 29.73 years at time of the index operation. There were 40 males (mean age of 29.66) and 15 female (mean age of 29.93). Minimum follow up time was 12 months. The following adverse effects were recorded: none suffered from recurrent dislocation, 2 patients suffered from bone resorption but without overt instability, 1 patient had malunion due to screw fracture, none of the patients had nonunion. The mean pre-operative WOSI score was 36.54 and the mean postoperative WOSI score was 61.0. Conclusion: Arthroscopic

  19. Accuracy of free-hand placement of thoracic pedicle screws in adolescent idiopathic scoliosis: how much of a difference does surgeon experience make?

    PubMed

    Samdani, Amer F; Ranade, Ashish; Sciubba, Daniel M; Cahill, Patrick J; Antonacci, M Darryl; Clements, David H; Betz, Randal R

    2010-01-01

    breaches (3.5 vs. 7.4% and 8.4% for groups A and B, respectively, P < 0.01). The breach rate for the concave periapical screws was not statistically different from the overall breach rate (13.0% vs. 12.1%, P = 0.93). In conclusion, the overall accuracy of placement of pedicle screws in the deformed spine was 87.9%, with no neurologic, vascular, or visceral complications. Meticulous technique allows spine surgeons with a range of surgical experience to accurately and safely place thoracic pedicle screws in the deformed spine. The most experienced surgeons demonstrated the lowest rate of medial breaches. PMID:19882179

  20. Application studies of CFRTP hexagon socket head cap screws

    NASA Astrophysics Data System (ADS)

    Sano, Akihiko; Matsumoto, Masaru

    PPS thermoplastic CFRP is used to fabricate screws via injection molding; these samples were tested for tensile strength and torque vs axial tension. Attention was given to the effects of various lubricants. When MoS2 was applied to the screw's threading, its axial tension increased from 10 to 16 kN.

  1. [Loosening of a Calcaneo-Stop Screw after Trampolining].

    PubMed

    Trieb, K; Fingernagel, T; Petershofer, A; Hofstaetter, S G

    2015-06-01

    Flexible flatfoot is a common malalignment in the paediatric population. Arthroereisis with a calcaneo-stop screw is an effective surgical procedure for treating juvenile flexible flatfoot after conservative measures have been fully exploited. In the present report, we describe the case of a loosening of a calcaneo-stop screw in a 12-year-old youth after excessive trampolining. PMID:25710392

  2. Periodic Stresses in Gyroscopic Bodies, with Applications to Air Screws

    NASA Technical Reports Server (NTRS)

    Zahm, A F

    1918-01-01

    Report discusses periodic stresses in gyroscopic bodies with applications to air screws caused by particle mass. Report concludes that all modern air screws obey the laws found for plane groups of particles. In particular the two-bladers exert on the shaft a rhythmic gyroscopic torque; the multibladers a steady one; both easily calculable for any given conditions of motion and mass distribution.

  3. Power-Tool Adapter For T-Handle Screws

    NASA Technical Reports Server (NTRS)

    Deloach, Stephen R.

    1992-01-01

    Proposed adapter enables use of pneumatic drill, electric drill, electric screwdriver, or similar power tool to tighten or loosen T-handled screws. Notched tube with perpendicular rod welded to it inserted in chuck of tool. Notched end of tube slipped over screw handle.

  4. 21 CFR 872.4880 - Intraosseous fixation screw or wire.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Intraosseous fixation screw or wire. 872.4880 Section 872.4880 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES.... (a) Identification. An intraosseous fixation screw or wire is a metal device intended to be...

  5. Use of small cannulated screws for fixation in foot surgery.

    PubMed

    Burns, A E

    2000-05-01

    Use of cannulated bone screws, as compared with use of traditional bone screws, has been reported to decrease surgical time, allow for more precise screw placement, and reduce sources of error. Cannulation of the smaller-size screws that are routinely used in foot surgery has not been available until the last few years. This article reports on the use of the small cannulated screws manufactured by Alphatec Manufacturing, Inc (Palm Desert, California). The screw sizes available in the Mini Lag Screw System are 2.7, 3.5, and 4.0 mm. A long-term clinical and radiographic prospective evaluation of 70 procedures performed on 49 patients was conducted. The follow-up time for all patients was 2 years. None of the 70 implants fractured, and seven procedures (in seven patients) resulted in some type of implant-fixation failure. All of the fixation failures, however, appeared to be related to an untoward event or patient noncompliance. These smaller cannulated screws proved to be a reliable and effective means of fixation in foot surgery. PMID:10833872

  6. Role of Cranial and Spinal Virtual and Augmented Reality Simulation Using Immersive Touch Modules in Neurosurgical Training

    PubMed Central

    Alaraj, Ali; Charbel, Fady T.; Birk, Daniel; Tobin, Mathew; Luciano, Cristian; Banerjee, Pat P.; Rizzi, Silvio; Sorenson, Jeff; Foley, Kevin; Slavin, Konstantin; Roitberg, Ben

    2013-01-01

    Recent studies have shown that mental script-based rehearsal and simulation-based training improves the transfer of surgical skills in various medical disciplines. Despite significant advances in technology and intraoperative techniques over the last several decades, surgical skills training on neurosurgical operations still carries significant risk of serious morbidity or mortality. Potentially avoidable technical errors are well recognized as contributing to poor surgical outcome. Surgical education is undergoing overwhelming change, with reduction of working hours and current trends to focus on patient’s safety and linking reimbursement with clinical outcomes, and there is a need for adjunctive means for neurosurgical training;this has been recent advancement in simulation technology. ImmersiveTouch (IT) is an augmented reality (AR) system that integrates a haptic device and a high-resolution stereoscopic display. This simulation platform utilizes multiple sensory modalities, recreating many of the environmental cues experienced during an actual procedure. Modules available include ventriculostomy, bone drilling, percutaneous trigeminal rhizotomy, in addition to simulated spinal modules such as pedicle screw placement, vertebroplasty, and lumbar puncture. We present our experience with development of such AR neurosurgical modules and the feedback from neurosurgical residents. PMID:23254799

  7. Complications of buttocks augmentation: diagnosis, management, and prevention.

    PubMed

    Bruner, Terrence W; Roberts, Thomas L; Nguyen, Karl

    2006-07-01

    Over the past several years, there has been a tremendous growth and interest in buttocks augmentation in the United States. Surgical techniques have evolved over time to correct anatomical deficiencies and fulfill patient requests, including silicone implant placement (subcutaneous, intramuscular, submuscular, and subfascial) and autologous micro fat grafting. Unfortunately, these techniques have presented great challenges with regard to the incidence, diagnosis, management, and prevention of various postsurgical complications. Extensive collaboration and transparency in discussing complications has resulted in refinement of both surgical technique and medical management,resulting in improved outcomes for patients undergoing buttocks augmentation. PMID:16818100

  8. The Analysis of Soil Resistance During Screw Displacement Pile Installation

    NASA Astrophysics Data System (ADS)

    Krasinski, Adam

    2015-02-01

    The application of screw displacement piles (SDP) is still increasing due to their high efficiency and many advantages. However, one technological problem is a serious disadvantage of those piles. It relates to the generation of very high soil resistance during screw auger penetration, especially when piles are installed in non-cohesive soils. In many situations this problem causes difficulties in creating piles of designed length and diameter. It is necessary to find a proper method for prediction of soil resistance during screw pile installation. The analysis of screw resistances based on model and field tests is presented in the paper. The investigations were carried out as part of research project, financed by the Polish Ministry of Science and Higher Education. As a result of tests and analyses the empirical method for prediction of rotation resistance (torque) during screw auger penetration in non-cohesive subsoil based on CPT is proposed.

  9. Ball Screw Actuator Including an Axial Soft Stop

    NASA Technical Reports Server (NTRS)

    Wingett, Paul T. (Inventor); Forrest, Steven Talbert (Inventor); Abel, Steve (Inventor); Woessner, George (Inventor); Hanlon, Casey (Inventor)

    2016-01-01

    An actuator includes an actuator housing, a ball screw, and an axial soft stop assembly. The ball screw extends through the actuator housing and has a first end and a second end. The ball screw is coupled to receive a drive force and is configured, upon receipt of the drive force, to selectively move in a retract direction and an extend direction. The axial soft stop assembly is disposed within the actuator housing. The axial soft stop assembly is configured to be selectively engaged by the ball screw and, upon being engaged thereby, to translate, with compliance, a predetermined distance in the extend direction, and to prevent further movement of the ball screw upon translating the predetermined distance.

  10. Control Augmented Structural Synthesis

    NASA Technical Reports Server (NTRS)

    Lust, Robert V.; Schmit, Lucien A.

    1988-01-01

    A methodology for control augmented structural synthesis is proposed for a class of structures which can be modeled as an assemblage of frame and/or truss elements. It is assumed that both the plant (structure) and the active control system dynamics can be adequately represented with a linear model. The structural sizing variables, active control system feedback gains and nonstructural lumped masses are treated simultaneously as independent design variables. Design constraints are imposed on static and dynamic displacements, static stresses, actuator forces and natural frequencies to ensure acceptable system behavior. Multiple static and dynamic loading conditions are considered. Side constraints imposed on the design variables protect against the generation of unrealizable designs. While the proposed approach is fundamentally more general, here the methodology is developed and demonstrated for the case where: (1) the dynamic loading is harmonic and thus the steady state response is of primary interest; (2) direct output feedback is used for the control system model; and (3) the actuators and sensors are collocated.

  11. Augmented Likelihood Image Reconstruction.

    PubMed

    Stille, Maik; Kleine, Matthias; Hägele, Julian; Barkhausen, Jörg; Buzug, Thorsten M

    2016-01-01

    The presence of high-density objects remains an open problem in medical CT imaging. Data of projections passing through objects of high density, such as metal implants, are dominated by noise and are highly affected by beam hardening and scatter. Reconstructed images become less diagnostically conclusive because of pronounced artifacts that manifest as dark and bright streaks. A new reconstruction algorithm is proposed with the aim to reduce these artifacts by incorporating information about shape and known attenuation coefficients of a metal implant. Image reconstruction is considered as a variational optimization problem. The afore-mentioned prior knowledge is introduced in terms of equality constraints. An augmented Lagrangian approach is adapted in order to minimize the associated log-likelihood function for transmission CT. During iterations, temporally appearing artifacts are reduced with a bilateral filter and new projection values are calculated, which are used later on for the reconstruction. A detailed evaluation in cooperation with radiologists is performed on software and hardware phantoms, as well as on clinically relevant patient data of subjects with various metal implants. Results show that the proposed reconstruction algorithm is able to outperform contemporary metal artifact reduction methods such as normalized metal artifact reduction. PMID:26208310

  12. Perceptually Augmented Simulator Design.

    PubMed

    Edmunds, T; Pai, D K

    2012-01-01

    Training simulators have proven their worth in a variety of fields, from piloting to air-traffic control to nuclear power station monitoring. Designing surgical simulators, however, poses the challenge of creating trainers that effectively instill not only high-level understanding of the steps to be taken in a given situation, but also the low-level "muscle-memory" needed to perform delicate surgical procedures. It is often impossible to build an ideal simulator that perfectly mimics the haptic experience of a surgical procedure, but by focussing on the aspects of the experience that are perceptually salient we can build simulators that effectively instill learning. We propose a general method for the design of surgical simulators that augment the perceptually salient aspects of an interaction. Using this method, we can increase skill-transfer rates without requiring expensive improvements in the capability of the rendering hardware or the computational complexity of the simulation. In this paper, we present our decomposition-based method for surgical simulator design, and describe a user-study comparing the training effectiveness of a haptic-search-task simulator designed using our method versus an unaugmented simulator. The results show that perception-based task decomposition can be used to improve the design of surgical simulators that effectively impart skill by targeting perceptually significant aspects of the interaction. PMID:26963831

  13. Structural consequences of railgun augmentation

    SciTech Connect

    Wellman, G.W.; Schuler, K.W. . Applied Mechanics Div. III)

    1989-01-01

    An augmented railgun can provide the same driving force on a projectile at a lower plasma arc current and thus less potential erosion and barrel damage as an unaugmented railgun. However, there are structural consequences to railgun augmentation which must be overcome before the advantages of lower plasma arc currents can be realized. To investigate these consequences, a bolted V-block supporting structure is considered with two cores; unaugmented (a single pair of conducting rails), and augmented (conducting rails augmented by a second tandem set of conductors). The mechanical load on the cores consist of the static bolt preload, the plasma pressure behind the projectile, and the magnetic pressure induced by currents flowing in the rails or augmenting conductors. Assuming no current diffusion into the conductors, the magnetic pressure distribution on the conductors is determined by solving the two dimensional magnetostatic field equations using an analogy with heat transfer. These loads are then used in a dynamic finite element structural model. The maximum rail current is found at which the unaugmented railgun can be repetitively fired without detrimental gaps forming at the bore. For the augmented railgun, at the same projectile acceleration, large permanent deformations can occur. Thus successful implementation of rail gun augmentation will require improvement of the supporting structure.

  14. Structural consequences of railgun augmentation

    SciTech Connect

    Wellman, G.W.; Schuler, K.W.

    1988-01-01

    An augmented railgun can provide the same driving force on a projectile at a lower plasma arc current and thus less potential erosion and barrel damage as an unaugmented railgun. However, there are structural consequences to railgun augmentation which must be overcome before the advantages of lower plasma arc currents can be realized. To investigate these consequences, a bolted V-block supporting structure is considered with two cores; unaugmented (a single pair of conducting rails), and augmented (conducting rails augmented by a second tandem set of conductors). The mechanical load on the cores consist of the static bolt preload, the plasma pressure behind the projectile, and the magnetic pressure induced by currents flowing in the rails or augmenting conductors. Assuming no current diffusion into the conductors, the magnetic pressure distribution on the conductors is determined by solving the two-dimensional magnetostatic field equations using an analogy with heat transfer. These loads are then used in a dynamic finite element structural model. The maximum rail current is found at which the unaugmented railgun can be repetitively fired without detrimental gaps forming at the bore. For the augmented railgun, at the same projectile acceleration, large permanent deformations can occur. Thus successful implementation of rail gun augmentation will require improvement of the supporting structure.

  15. Asymmetric distribution in twin screw granulation.

    PubMed

    Chan Seem, Tim; Rowson, Neil A; Gabbott, Ian; de Matas, Marcel; Reynolds, Gavin K; Ingram, Andy

    2016-09-01

    Positron Emission Particle Tracking (PEPT) was successfully employed to validate measured transverse asymmetry in material distribution in the conveying zones of a Twin Screw Granulator (TSG). Flow asymmetry was established to be a property of the granulator geometry and dependent on fill level. The liquid distribution of granules as a function of fill level was determined. High flow asymmetry at low fill level negatively affects granule nucleation leading to high variance in final uniformity. Wetting of material during nucleation was identified as a critical parameter in determining final granule uniformity and fill level is highlighted as a crucial control factor in achieving this. Flow asymmetry of dry material in conveying zones upstream of binder fluid injection leads to poor non-uniform wetting at nucleation and results in heterogeneous final product. The granule formation mechanism of 60°F kneading blocks is suggested to be primarily breakage of agglomerates formed during nucleation. Optimisation of screw configuration would be required to provide secondary growth. This work shows how fill dependent flow regimes affect granulation mechanisms. PMID:26820919

  16. Axial cyclic behavior of the bone-screw interface.

    PubMed

    Inceoğlu, Serkan; Ehlert, Mike; Akbay, Atilla; McLain, Robert F

    2006-11-01

    Screw fixation strength is investigated by using a pullout test. Despite many screw pullout studies, the effects of loading rate on the pullout behavior of pedicle screws are not known. The objective of this study was to assess the effects of loading rate on the pullout stiffness and strength of pedicle screws. Sixty pedicle screws were inserted in foam blocks and pulled out at four different rates: 0.1, 1, 5 and 50 mm/min. Twenty of these 60 screws were cycled non-destructively at four different rates sequentially, i.e., 0.1, 1, 5 and 50 mm/min prior to pullout. Ten additional pedicle screws were inserted in five calf lumbar vertebrae, cycled as in foam group, and pulled out at a rate of either 0.1 or 50 mm/min. The results showed that the stiffness was higher at all rates compared to 0.1 mm/min in foam model but in bone model only 1 and 5 mm/min groups were higher compared to 0.1 mm/min. The pullout strength in 50 mm/min group was higher than that in 0.1 mm/min group in both foam and bone model. The results suggested that loading rate influenced the mechanics of the bone-screw interface. Therefore, a fair comparison between the pullout studies can be achieved under same loading rate conditions. Moreover, the cycling of the pedicle screws in axial direction within a pre-yield region showed an unusual hysteresis curve. Further studies are needed for a better understanding of the mechanics of the screw-bone interface. PMID:16458568

  17. A Surgical Method for Determining Proper Screw Length in ACDF

    PubMed Central

    Park, Hae-Gi; Kang, Moo-Sung; Kim, Kyung-Hyun; Park, Jeong-Yoon; Kim, Keun-Su

    2014-01-01

    Objective We describe a surgical tool that uses the distractor pin as a reference for determining proper screw length in ACDF. It is critical that screw purchase depth be as deep as possible without violating or penetrating the posterior cortical wall, which ensures strong pull out strength. Methods We enrolled 81 adult patients who underwent ACDF using an anterior cervical plate from 2010 to 2012. Patients were categorized into Groups A (42 patients: retractor pin used as a reference for screw length) and B (39 patients: control group). Intraoperative lateral x-rays were taken after screwing the retractor pin to confirm the approaching vertebral level. The ratio of retractor pin length to body anteroposterior (A-P) diameter was measured as a reference. Proper screw length was determined by comparison to the reference. Results The average distance from screw tip to posterior wall was 3.0±1.4mm in Group A and 4.1±2.3mm in Group B. The ratio of screw length to body sagittal diameter was 86.2±5.7% in Group A and 80.8±9.0% in Group B. Screw length to body sagittal diameter ratios higher than 4/5 occurred in 33 patients (90%) in Group A and 23 patients (59%) in Group B. No cases violated the posterior cortical wall. Conclusion We introduce a useful surgical method for determining proper screw length in ACDF using the ratio of retractor pin length to body A-P diameter as a reference. This method allows for deeper screw purchase depth without violation of the posterior cortical wall. PMID:25346756

  18. Lateral Movement of Screw Dislocations During Homoepitaxial Growth and Devices Yielded Therefrom Free of the Detrimental Effects of Screw Dislocations

    NASA Technical Reports Server (NTRS)

    Neudeck, Philip G. (Inventor); Powell, J. Anthony (Inventor)

    2004-01-01

    The present invention is related to a method that enables and improves wide bandgap homoepitaxial layers to be grown on axis single crystal substrates, particularly SiC. The lateral positions of the screw dislocations in epitaxial layers are predetermined instead of random, which allows devices to be reproducibly patterned to avoid performance degrading crystal defects normally created by screw dislocations.

  19. Scaphoid excision and 4-corner fusion using retrograde headless compression screws.

    PubMed

    Ball, Brandon; Bergman, Joseph W

    2012-12-01

    Scapholunate advanced collapse is a predictable form of wrist arthritis resulting from longstanding scapholunate instability. Four-corner fusion and scaphoid excision is a reliable procedure used to treat scapholunate advanced collapse wrist that improves pain and preserves range of motion. Multiple methods of achieving fixation have been described for the procedure including K-wires, staples, and headless compression screws. In previously described techniques, the compression screws are inserted in an antegrade manner, breaching the articular surface of the lunate. Even small areas of chondral damage may undermine the long-term durability of the radiocarpal joint. Given the 4-corner fusion relies on the integrity of the radiolunate articulation for success, it would seem advantageous to preserve the articular cartilage of the lunate. The technique described here involves retrograde insertion of headless compression screws to achieve a 4-corner fusion. Although it is still early, we anticipate that this procedure will result in similar fusion rates to other forms of fixation. PMID:23160552

  20. Augmented Reality Comes to Physics

    NASA Astrophysics Data System (ADS)

    Buesing, Mark; Cook, Michael

    2013-04-01

    Augmented reality (AR) is a technology used on computing devices where processor-generated graphics are rendered over real objects to enhance the sensory experience in real time. In other words, what you are really seeing is augmented by the computer. Many AR games already exist for systems such as Kinect and Nintendo 3DS and mobile apps, such as Tagwhat and Star Chart (a must for astronomy class). The yellow line marking first downs in a televised football game2 and the enhanced puck that makes televised hockey easier to follow3 both use augmented reality to do the job.

  1. Augmented reality aiding collimator exchange at the LHC

    NASA Astrophysics Data System (ADS)

    Martínez, Héctor; Fabry, Thomas; Laukkanen, Seppo; Mattila, Jouni; Tabourot, Laurent

    2014-11-01

    Novel Augmented Reality techniques have the potential to have a large positive impact on the way remote maintenance operations are carried out in hazardous areas, e.g. areas where radiation doses that imply careful planning and optimization of maintenance operations are present. This paper describes an Augmented Reality strategy, system and implementation for aiding the remote collimator exchange in the LHC, currently the world's largest and highest-energy particle accelerator. The proposed system relies on marker detection and multi-modal augmentation in real-time. A database system has been used to ensure flexibility. The system has been tested in a mock-up facility, showing real time performance and great potential for future use in the LHC. The technical-scientific difficulties identified during the development of the system and the proposed solutions described in this paper may help the development of future Augmented Reality systems for remote handling in scientific facilities.

  2. Measurement of Optimal Insertion Angle for Iliosacral Screw Fixation Using Three-Dimensional Computed Tomography Scans

    PubMed Central

    Kim, Jung-Jae; Jung, Chul-Young; Eastman, Jonathan G.

    2016-01-01

    Background Percutaneous iliosacral screw fixation can provide stable fixation with a minimally invasive surgical technique for unstable posterior pelvic ring injuries. This surgical technique is not limited by cases of difficult fracture patterns, sacral dysplasia, and small sacral pedicles that can occur in Asians. The purpose of this study was to investigate the incidence of the sacral dysplasia in the Korean population and determine the optimal direction of iliosacral screws by analyzing pelvic three-dimensional computed tomography (3D-CT) scans. Methods One hundred adult patients who had pelvic 3D-CT scans were evaluated. The upper sacral morphology was classified into three groups, i.e., normal, transitional, and dysplastic groups; the cross-sectional area of the safe zone was measured in each group. S1 pedicle with a short width of more than 11 mm was defined as safe pedicle. The incidences of safe pedicles at different angles ranging from 0° to 15° were investigated in order to determine optimal angle for screw direction. Results The incidence of normal, transitional, and dysplastic group was 46%, 32%, and 22%, respectively. There were significant increases of the cross-sectional area of the safe zones by increasing the angles from 0° to 15° in all groups. The incidence of safe pedicles increased similar to the changes in cross-sectional area. The overall incidence of safe pedicles was highest at the 10° tilt angle. Conclusions The incidence of sacral dysplasia in Koreans was 54%, which is higher than previous studies for Western populations. The cross-sectional area of the safe zone can be increased by anteromedial direction of the iliosacral screw. Considering the diversity of sacral morphology present in the Korean population, a tilt angle of 10° may be the safest angle. PMID:27247736

  3. Technique of Open Reduction and Internal Fixation of Comminuted Proximal Humerus Fractures With Allograft Femoral Head Metaphyseal Reconstruction.

    PubMed

    Parada, Stephen A; Makani, Amun; Stadecker, Monica J; Warner, Jon J P

    2015-10-01

    Proximal humerus fractures are common injuries that can require operative treatment. Different operative techniques are available, but the hallmark of fixation for 3- and 4-part fractures is a locking-plate-and-screw construct. Despite advances in this technology, obtaining anatomical reduction and fracture union can be difficult, and complications (eg, need for revision) are not uncommon. These issues can be addressed by augmenting the fixation with an endosteally placed fibular allograft. Although biomechanical and clinical results have been good, the technique can lead to difficulties in future revision to arthroplasty, a common consequence of failed open reduction and internal fixation. The technique described, an alternative to placing a long endosteal bone graft, uses a trapezoidal, individually sized pedestal of allograft femoral head to facilitate the reduction and healing of the humeral head and tuberosity fragments in a displaced 3- or 4-part fracture of the proximal humerus. It can be easily incorporated with any plate-and-screw construct and does not necessitate placing more than 1 cm of bone into the humeral intramedullary canal, limiting the negative effects on any future revision to arthroplasty. PMID:26447409

  4. In vitro study of accuracy of cervical pedicle screw insertion using an electronic conductivity device (ATPS part III)

    PubMed Central

    Hitzl, Wolfgang; Acosta, Frank; Tauber, Mark; Zenner, Juliane; Resch, Herbert; Yukawa, Yasutsugu; Meier, Oliver; Schmidt, Rene; Mayer, Michael

    2009-01-01

    Reconstruction of the highly unstable, anteriorly decompressed cervical spine poses biomechanical challenges to current stabilization strategies, including circumferential instrumented fusion, to prevent failure. To avoid secondary posterior surgery, particularly in the elderly population, while increasing primary construct rigidity of anterior-only reconstructions, the authors introduced the concept of anterior transpedicular screw (ATPS) fixation and plating. We demonstrated its morphological feasibility, its superior biomechanical pull-out characteristics compared with vertebral body screws and the accuracy of inserting ATPS using a manual fluoroscopically assisted technique. Although accuracy was high, showing non-critical breaches in the axial and sagittal plane in 78 and 96%, further research was indicated refining technique and increasing accuracy. In light of first clinical case series, the authors analyzed the impact of using an electronic conductivity device (ECD, PediGuard) on the accuracy of ATPS insertion. As there exist only experiences in thoracolumbar surgery the versatility of the ECD was also assessed for posterior cervical pedicle screw fixation (pCPS). 30 ATPS and 30 pCPS were inserted alternately into the C3–T1 vertebra of five fresh-frozen specimen. Fluoroscopic assistance was only used for the entry point selection, pedicle tract preparation was done using the ECD. Preoperative CT scans were assessed for sclerosis at the pedicle entrance or core, and vertebrae with dense pedicles were excluded. Pre- and postoperative reconstructed CT scans were analyzed for pedicle screw positions according to a previously established grading system. Statistical analysis revealed an astonishingly high accuracy for the ATPS group with no critical screw position (0%) in axial or sagittal plane. In the pCPS group, 88.9% of screws inserted showed non-critical screw position, while 11.1% showed critical pedicle perforations. The usage of an ECD for posterior and

  5. Implant augmentation: adding bone cement to improve the treatment of osteoporotic distal femur fractures: a biomechanical study using human cadaver bones.

    PubMed

    Wähnert, Dirk; Hofmann-Fliri, Ladina; Richards, R Geoff; Gueorguiev, Boyko; Raschke, Michael J; Windolf, Markus

    2014-11-01

    The increasing problems in the field of osteoporotic fracture fixation results in specialized implants as well as new operation methods, for example, implant augmentation with bone cement. The aim of this study was to determine the biomechanical impact of augmentation in the treatment of osteoporotic distal femur fractures.Seven pairs of osteoporotic fresh frozen distal femora were randomly assigned to either an augmented or nonaugmented group. In both groups, an Orthopaedic Trauma Association 33 A3 fractures was fixed using the locking compression plate distal femur and cannulated and perforated screws. In the augmented group, additionally, 1 mL of polymethylmethacrylate cement was injected through the screw. Prior to mechanical testing, bone mineral density (BMD) and local bone strength were determined. Mechanical testing was performed by cyclic axial loading (100 N to 750 N + 0.05N/cycle) using a servo-hydraulic testing machine.As a result, the BMD as well as the axial stiffness did not significantly differ between the groups. The number of cycles to failure was significantly higher in the augmented group with the BMD as a significant covariate.In conclusion, cement augmentation can significantly improve implant anchorage in plating of osteoporotic distal femur fractures. PMID:25415673

  6. Effective Augmentation of Complex Networks.

    PubMed

    Wang, Jinjian; Yu, Xinghuo; Stone, Lewi

    2016-01-01

    Networks science plays an enormous role in many aspects of modern society from distributing electrical power across nations to spreading information and social networking amongst global populations. While modern networks constantly change in size, few studies have sought methods for the difficult task of optimising this growth. Here we study theoretical requirements for augmenting networks by adding source or sink nodes, without requiring additional driver-nodes to accommodate the change i.e., conserving structural controllability. Our "effective augmentation" algorithm takes advantage of clusters intrinsic to the network topology, and permits rapidly and efficient augmentation of a large number of nodes in one time-step. "Effective augmentation" is shown to work successfully on a wide range of model and real networks. The method has numerous applications (e.g. study of biological, social, power and technological networks) and potentially of significant practical and economic value. PMID:27165120

  7. Augmented classical least squares multivariate spectral analysis

    DOEpatents

    Haaland, David M.; Melgaard, David K.

    2004-02-03

    A method of multivariate spectral analysis, termed augmented classical least squares (ACLS), provides an improved CLS calibration model when unmodeled sources of spectral variation are contained in a calibration sample set. The ACLS methods use information derived from component or spectral residuals during the CLS calibration to provide an improved calibration-augmented CLS model. The ACLS methods are based on CLS so that they retain the qualitative benefits of CLS, yet they have the flexibility of PLS and other hybrid techniques in that they can define a prediction model even with unmodeled sources of spectral variation that are not explicitly included in the calibration model. The unmodeled sources of spectral variation may be unknown constituents, constituents with unknown concentrations, nonlinear responses, non-uniform and correlated errors, or other sources of spectral variation that are present in the calibration sample spectra. Also, since the various ACLS methods are based on CLS, they can incorporate the new prediction-augmented CLS (PACLS) method of updating the prediction model for new sources of spectral variation contained in the prediction sample set without having to return to the calibration process. The ACLS methods can also be applied to alternating least squares models. The ACLS methods can be applied to all types of multivariate data.

  8. Augmented Classical Least Squares Multivariate Spectral Analysis

    DOEpatents

    Haaland, David M.; Melgaard, David K.

    2005-01-11

    A method of multivariate spectral analysis, termed augmented classical least squares (ACLS), provides an improved CLS calibration model when unmodeled sources of spectral variation are contained in a calibration sample set. The ACLS methods use information derived from component or spectral residuals during the CLS calibration to provide an improved calibration-augmented CLS model. The ACLS methods are based on CLS so that they retain the qualitative benefits of CLS, yet they have the flexibility of PLS and other hybrid techniques in that they can define a prediction model even with unmodeled sources of spectral variation that are not explicitly included in the calibration model. The unmodeled sources of spectral variation may be unknown constituents, constituents with unknown concentrations, nonlinear responses, non-uniform and correlated errors, or other sources of spectral variation that are present in the calibration sample spectra. Also, since the various ACLS methods are based on CLS, they can incorporate the new prediction-augmented CLS (PACLS) method of updating the prediction model for new sources of spectral variation contained in the prediction sample set without having to return to the calibration process. The ACLS methods can also be applied to alternating least squares models. The ACLS methods can be applied to all types of multivariate data.

  9. Augmented Classical Least Squares Multivariate Spectral Analysis

    DOEpatents

    Haaland, David M.; Melgaard, David K.

    2005-07-26

    A method of multivariate spectral analysis, termed augmented classical least squares (ACLS), provides an improved CLS calibration model when unmodeled sources of spectral variation are contained in a calibration sample set. The ACLS methods use information derived from component or spectral residuals during the CLS calibration to provide an improved calibration-augmented CLS model. The ACLS methods are based on CLS so that they retain the qualitative benefits of CLS, yet they have the flexibility of PLS and other hybrid techniques in that they can define a prediction model even with unmodeled sources of spectral variation that are not explicitly included in the calibration model. The unmodeled sources of spectral variation may be unknown constituents, constituents with unknown concentrations, nonlinear responses, non-uniform and correlated errors, or other sources of spectral variation that are present in the calibration sample spectra. Also, since the various ACLS methods are based on CLS, they can incorporate the new prediction-augmented CLS (PACLS) method of updating the prediction model for new sources of spectral variation contained in the prediction sample set without having to return to the calibration process. The ACLS methods can also be applied to alternating least squares models. The ACLS methods can be applied to all types of multivariate data.

  10. Significantly lower femoral neck growth in screw fixation of the asymptomatic contralateral hip in unilateral slipped capital femoral epiphysis.

    PubMed

    Wölfle-Roos, Julia V; Urlaub, Stefanie; Reichel, Heiko; Taurman, Rita

    2016-05-01

    There is an ongoing debate on which fixation technique should be preferred for the prophylactic fixation of the asymptomatic contralateral hip in slipped capital femoral epiphysis (SCFE). In the case of Kirschner-wire (K-wire) fixation, there is a possibility of secondary loss of fixation because of longitudinal growth of the physis, whereas in screw fixation, physeal growth of the femoral neck might be impaired. The aim of this matched-pair study was to compare the longitudinal growth of the femoral neck in screw fixation versus K-wire fixation of the asymptomatic contralateral hip in SCFE. All 18 patients (female : male=3 : 15), who had undergone screw fixation of the asymptomatic contralateral hip between 9/2001 and 9/2011, were matched according to age, bone age, sex, and time to follow-up to another 18 patients with K-wire fixation. The length of the femoral neck of the contralateral hip was measured in parallel to either screw or K-wire from the apex of the femoral head to the opposite cortical bone. The ratio of the femoral neck length measured directly after surgery and on follow-up was defined as femoral neck growth. There was no significant difference between groups with respect to age, modified Oxford Bone age score, and time to follow-up. We found a significant difference in femoral neck growth between patients with screw fixation (5.5±4.3%) compared with K-wire fixation (8.9±5.7%, P=0.048 matched Wilcoxon test). The difference in femoral neck growth of patients with K-wire or screw fixation of the contralateral asymptomatic hip in SCFE was small, but statistically significant. Thus, despite high rates of secondary loss of fixation, K-wire fixation should still be considered, especially in very young patients. PMID:26919622

  11. The use of intraoperative triggered electromyography to detect misplaced pedicle screws: a systematic review and meta-analysis.

    PubMed

    Mikula, Anthony L; Williams, Seth K; Anderson, Paul A

    2016-04-01

    OBJECT Insertion of instruments or implants into the spine carries a risk for injury to neural tissue. Triggered electromyography (tEMG) is an intraoperative neuromonitoring technique that involves electrical stimulation of a tool or screw and subsequent measurement of muscle action potentials from myotomes innervated by nerve roots near the stimulated instrument. The authors of this study sought to determine the ability of tEMG to detect misplaced pedicle screws (PSs). METHODS The authors searched the US National Library of Medicine, the Web of Science Core Collection database, and the Cochrane Central Register of Controlled Trials for PS studies. A meta-analysis of these studies was performed on a per-screw basis to determine the ability of tEMG to detect misplaced PSs. Sensitivity, specificity, and receiver operating characteristic (ROC) area under the curve (AUC) were calculated overall and in subgroups. RESULTS Twenty-six studies were included in the systematic review. The authors analyzed 18 studies in which tEMG was used during PS placement in the meta-analysis, representing data from 2932 patients and 15,065 screws. The overall sensitivity of tEMG for detecting misplaced PSs was 0.78, and the specificity was 0.94. The overall ROC AUC was 0.96. A tEMG current threshold of 10-12 mA (ROC AUC 0.99) and a pulse duration of 300 µsec (ROC AUC 0.97) provided the most accurate testing parameters for detecting misplaced screws. Screws most accurately conducted EMG signals (ROC AUC 0.98). CONCLUSIONS Triggered electromyography has very high specificity but only fair sensitivity for detecting malpositioned PSs. PMID:26654343

  12. The effect of movement on the holding power of screws in bone.

    PubMed

    Schatzker, J; Horne, J G; Sumner-Smith, G

    1975-09-01

    Movement between screw threads and bone inhibits bone formation, revascularization and remodeling of dead bone. Movement causes the screw to become enveloped by fibrous tissue in response to necrosis and resorption of adjacent dead cortical bone. This results in a radiologically discernible radiolucent "halo" about the screw, a certain sign of screw loosening. PMID:1157420

  13. Cortical bone trajectory screws for the middle-upper thorax

    PubMed Central

    Sheng, Sun-Ren; Chen, Jiao-Xiang; Chen, Wei; Xue, En-Xing; Wang, Xiang-Yang; Zhu, Qing-An

    2016-01-01

    Abstract To quantify the reference data concerning the morphometrics of the middle-upper thorax to guide the placement of cortical bone trajectory (CBT) screws. Eighty patients were studied on computed tomography (CT) scans. The reference anatomical parameters were measured. Next, 20 cadaveric specimens were implanted with CBT screws based on CT measurements. These specimens were then judged directly from the cadaveric vertebrae and X-ray. The maximum length of the trajectory, the maximum diameter, and the cephaled angle exhibited a slight increase trend while the transverse and sagittal angles of the pedicle tended to decrease from T3 to T8. We recommend that the width of CBT screw for middle-upper thoracic spine is 5.0 mm, the length is 25 to 35 mm. The cadaveric anatomical study revealed that 5/240 screws penetrated in the medial or lateral areas, 5/240 screws penetrated in the superior or inferior pedicle wall, and 2/240 screws did not fit into the superior endplate of the pedicle. The CBT screws are safe for the middle-upper thorax. This study provides a theoretical basis for clinical surgery. PMID:27583893

  14. Economics of water injected air screw compressor systems

    NASA Astrophysics Data System (ADS)

    Venu Madhav, K.; Kovačević, A.

    2015-08-01

    There is a growing need for compressed air free of entrained oil to be used in industry. In many cases it can be supplied by oil flooded screw compressors with multi stage filtration systems, or by oil free screw compressors. However, if water injected screw compressors can be made to operate reliably, they could be more efficient and therefore cheaper to operate. Unfortunately, to date, such machines have proved to be insufficiently reliable and not cost effective. This paper describes an investigation carried out to determine the current limitations of water injected screw compressor systems and how these could be overcome in the 15-315 kW power range and delivery pressures of 6-10 bar. Modern rotor profiles and approach to sealing and cooling allow reasonably inexpensive air end design. The prototype of the water injected screw compressor air system was built and tested for performance and reliability. The water injected compressor system was compared with the oil injected and oil free compressor systems of the equivalent size including the economic analysis based on the lifecycle costs. Based on the obtained results, it was concluded that water injected screw compressor systems could be designed to deliver clean air free of oil contamination with a better user value proposition than the oil injected or oil free screw compressor systems over the considered range of operations.

  15. Management of a fractured implant abutment screw: a clinical report.

    PubMed

    Canpolat, Ceyhun; Ozkurt-Kayahan, Zeynep; Kazazoğlu, Ender

    2014-07-01

    In an abutment screw fracture, it is generally a challenge for the clinician to remove fractured fragments. In some cases, the screw cannot be removed, and alternative solutions should be considered. This clinical report describes the replacement of a ball attachment with a fractured screw, which was impossible to retrieve, with a cast dowel with ball attachment. The patient who presented to the Department of Prosthodontics, Yeditepe University, Faculty of Dentistry was a 65-year-old woman, wearing a mandibular complete denture supported by two implants for 4 years. She complained about the loss of retention of the denture because of the fractured abutment screw, and it was found that another dentist had previously tried to retrieve the fractured screw with no success. It was decided to construct a cast dowel with ball attachment to improve retention without sacrificing the implant. The interior of the implant and the fractured screw were machined with a rotating instrument. An impression was taken with a metal strip and silicone-based materials. In the laboratory, a stone die was generated from the impression, and a custom-made cast dowel with ball attachment was constructed. It was then cemented with glass ionomer cement and connected to the denture with the direct method. The alternative procedure described in this clinical report was successful for the removal of the fractured abutment screw and use of the existing denture. PMID:24393481

  16. Asian Breast Augmentation: A Systematic Review

    PubMed Central

    Zelken, Jonathan

    2015-01-01

    Background: Economic, cultural, and regulatory phenomena may explain recent popularization of implant-based augmentation in Asia; but the collective Eastern experience remains limited. Asian surgeons and their patients rely on evidence-based medicine that originates elsewhere and may not be entirely relevant. Distinct anatomic and cultural features of Asian women warrant a tailored approach to breast augmentation. We explore the Asian experience with a thorough exploration of the recent literature. Methods: A literature search was performed for articles written after 2000, of Asian women who underwent augmentation mammoplasty using MEDLINE, Embase, and Pubmed Databases. Technique and outcomes data were summarized. Results: Twelve articles reported outcomes of 2089 women. Korea contributed most series (English language, 7), followed by China (3), Taiwan (1), and Japan (1). Silicone implants were used in 82.1% of women studied, and almost exclusively after 2009. More round (68.9%) than anatomic implants (31.1%) were placed. Non-inframammary (axillary, areolar, and umbilical) incisions were used in 96.9% of cases. Nearly all implants were positioned below the muscle or fascia; subglandular placement accounted for 1.1% of cases. Implant/nipple malposition (1.3%), capsular contracture (1.9%), hematoma (0.6%), and infection (0.2%) rates were reported in most series. Undesirable scarring was the most frequent complication (7.3%), but was reported only in 4 of 12 series. Conclusions: Studies of Asian women undergoing augmentation mammoplasty are limited, often with ill-defined outcomes and inadequate follow-up. As experience accumulates, an expanding literature relevant to Asian women will provide evidence-based guidelines that improve outcomes and patient satisfaction, and foster innovation. PMID:26893980

  17. Posterior Interspinous Fusion Device for One-Level Fusion in Degenerative Lumbar Spine Disease : Comparison with Pedicle Screw Fixation - Preliminary Report of at Least One Year Follow Up

    PubMed Central

    Kim, Ho Jung; Chun, Hyoung Joon; Oh, Suck Jun; Kang, Tae Hoon; Yang, Moon Sool

    2012-01-01

    Objective Transpedicular screw fixation has some disadvantages such as postoperative back pain through wide muscle dissection, long operative time, and cephalad adjacent segmental degeneration (ASD). The purposes of this study are investigation and comparison of radiological and clinical results between interspinous fusion device (IFD) and pedicle screw. Methods From Jan. 2008 to Aug. 2009, 40 patients underwent spinal fusion with IFD combined with posterior lumbar interbody fusion (PLIF). In same study period, 36 patients underwent spinal fusion with pedicle screw fixation as control group. Dynamic lateral radiographs, visual analogue scale (VAS), and Korean version of the Oswestry disability index (K-ODI) scores were evaluated in both groups. Results The lumbar spine diseases in the IFD group were as followings; spinal stenosis in 26, degenerative spondylolisthesis in 12, and intervertebral disc herniation in 2. The mean follow up period was 14.24 months (range; 12 to 22 months) in the IFD group and 18.3 months (range; 12 to 28 months) in pedicle screw group. The mean VAS scores was preoperatively 7.16±2.1 and 8.03±2.3 in the IFD and pedicle screw groups, respectively, and improved postoperatively to 1.3±2.9 and 1.2±3.2 in 1-year follow ups (p<0.05). The K-ODI was decreased significantly in an equal amount in both groups one year postoperatively (p<0.05). The statistics revealed a higher incidence of ASD in pedicle screw group than the IFD group (p=0.029). Conclusion Posterior IFD has several advantages over the pedicle screw fixation in terms of skin incision, muscle dissection and short operative time and less intraoperative estimated blood loss. The IFD with PLIF may be a favorable technique to replace the pedicle screw fixation in selective case. PMID:23133725

  18. Biomechanical Analysis of Pedicle Screw Fixation for Thoracolumbar Burst Fractures.

    PubMed

    McDonnell, Matthew; Shah, Kalpit N; Paller, David J; Thakur, Nikhil A; Koruprolu, Sarath; Palumbo, Mark A; Daniels, Alan H

    2016-05-01

    Treatment of unstable thoracolumbar burst fractures remains controversial. Long-segment pedicle screw constructs may be stiffer and impart greater forces on adjacent segments compared with short-segment constructs, which may affect clinical performance and long-term out come. The purpose of this study was to biomechanically evaluate long-segment posterior pedicle screw fixation (LSPF) vs short-segment posterior pedicle screw fixation (SSPF) for unstable burst fractures. Six unembalmed human thoracolumbar spine specimens (T10-L4) were used. Following intact testing, a simulated L1 burst fracture was created and sequentially stabilized using 5.5-mm titanium polyaxial pedicle screws and rods for 4 different constructs: SSPF (1 level above and below), SSPF+L1 (pedicle screw at fractured level), LSPF (2 levels above and below), and LSPF+L1 (pedicle screw at fractured level). Each fixation construct was tested in flexion-extension, lateral bending, and axial rotation; range of motion was also recorded. Two-way repeated-measures analysis of variance was performed to identify differences between treatment groups and functional noninstrumented spine. Short-segment posterior pedicle screw fixation did not achieve stability seen in an intact spine (P<.01), whereas LSPF constructs were significantly stiffer than SSPF constructs and demonstrated more stiffness than an intact spine (P<.01). Pedicle screws at the fracture level did not improve either SSPF or LSPF construct stability (P>.1). Long-segment posterior pedicle screw fixation constructs were not associated with increased adjacent segment motion. Al though the sample size of 6 specimens was small, this study may help guide clinical decisions regarding burst fracture stabilization. [Orthopedics. 2016; 39(3):e514-e518.]. PMID:27135451

  19. Vibration analysis of three-screw pumps under pressure loads and rotor contact forces

    NASA Astrophysics Data System (ADS)

    Li, Wanyou; Lu, Hanfeng; Zhang, Yue; Zhu, Chuan; Lu, Xiqun; Shuai, Zhijun

    2016-01-01

    Two main vibration sources in three-screw pumps, the fluid exciting force and the screw contact force, are studied to provide the basis for vibration control in this paper. A fluid exciting force model and a screw contact model are proposed to calculate these forces. An experimental test is carried out to obtain the vibration response of a three-screw pump. A calibrated finite element model of the three-screw pump is used to verify the vibration response under the fluid exciting force and the screw contact force obtained from the proposed models. The results show that the screw contact force is more dominant than the fluid exciting force.

  20. Use of traction screw to aid in fracture reduction in bilateral parasymphysis fracture of mandible.

    PubMed

    Jaisani, Mehul R; Pradhan, Leeza; Dongol, Ashok; Acharaya, Pradeep; Sagtani, Alok

    2016-06-01

    Treatment of bilateral parasymphysis fracture often requires special attention due to airway considerations and difficulty in achieving precise anatomic reduction. The central fracture fragment is often displaced posteriorly and inferiorly due to muscle pull, and this adds to difficulty in reduction and stabilization of the central fracture fragment during plate fixation. With this article, we advocate a technique using stainless steel screw and self-holding screwdriver to manipulate the central fragment and achieve an anatomic reduction. We have used this technique in 12 patients with bilateral parasymphysis fracture without any complications and have found it very effective. PMID:26404945

  1. Spline-Screw Payload-Fastening System

    NASA Technical Reports Server (NTRS)

    Vranish, John M.

    1994-01-01

    Payload handed off securely between robot and vehicle or structure. Spline-screw payload-fastening system includes mating female and male connector mechanisms. Clockwise (or counter-clockwise) rotation of splined male driver on robotic end effector causes connection between robot and payload to tighten (or loosen) and simultaneously causes connection between payload and structure to loosen (or tighten). Includes mechanisms like those described in "Tool-Changing Mechanism for Robot" (GSC-13435) and "Self-Aligning Mechanical and Electrical Coupling" (GSC-13430). Designed for use in outer space, also useful on Earth in applications needed for secure handling and secure mounting of equipment modules during storage, transport, and/or operation. Particularly useful in machine or robotic applications.

  2. Spline-Locking Screw Fastening Strategy (SLSFS)

    NASA Technical Reports Server (NTRS)

    Vranish, John M.

    1991-01-01

    A fastener was developed by NASA Goddard for efficiently performing assembly, maintenance, and equipment replacement functions in space using either robotic or astronaut means. This fastener, the 'Spline Locking Screw' (SLS) would also have significant commercial value in advanced manufacturing. Commercial (or DoD) products could be manufactured in such a way that their prime subassemblies would be assembled using SLS fasteners. This would permit machines and robots to disconnect and replace these modules/parts with ease, greatly reducing life cycle costs of the products and greatly enhancing the quality, timeliness, and consistency of repairs, upgrades, and remanufacturing. The operation of the basic SLS fastener is detailed, including hardware and test results. Its extension into a comprehensive fastening strategy for NASA use in space is also outlined. Following this, the discussion turns toward potential commercial and government applications and the potential market significance of same.

  3. Spline-locking screw fastening strategy

    NASA Technical Reports Server (NTRS)

    Vranish, John M.

    1992-01-01

    A fastener was developed by NASA Goddard for efficiently performing assembly, maintenance, and equipment replacement functions in space using either robotics or astronaut means. This fastener, the 'Spline Locking Screw' (SLS) would also have significant commercial value in advanced space manufacturing. Commercial (or DoD) products could be manufactured in such a way that their prime subassemblies would be assembled using SLS fasteners. This would permit machines and robots to disconnect and replace these modules/parts with ease, greatly reducing life cycle costs of the products and greatly enhancing the quality, timeliness, and consistency of repairs, upgrades, and remanufacturing. The operation of the basic SLS fastener is detailed, including hardware and test results. Its extension into a comprehensive fastening strategy for NASA use in space is also outlined. Following this, the discussion turns toward potential commercial and government applications and the potential market significance of same.

  4. Screw Compressor Characteristics for Helium Refrigeration Systems

    NASA Astrophysics Data System (ADS)

    Ganni, V.; Knudsen, P.; Creel, J.; Arenius, D.; Casagrande, F.; Howell, M.

    2008-03-01

    The oil injected screw compressors have practically replaced all other types of compressors in modern helium refrigeration systems due to their large displacement capacity, minimal vibration, reliability and capability of handling helium's high heat of compression. At the present state of compressor system designs for helium systems, typically two-thirds of the lost input power is due to the compression system. Therefore it is important to understand the isothermal and volumetric efficiencies of these machines to help properly design these compression systems to match the refrigeration process. This presentation summarizes separate tests that have been conducted on Sullair compressors at the Superconducting Super-Collider Laboratory (SSCL) in 1993, Howden compressors at Jefferson Lab (JLab) in 2006 and Howden compressors at the Spallation Neutron Source (SNS) in 2006. This work is part of an ongoing study at JLab to understand the theoretical basis for these efficiencies and their loss mechanisms, as well as to implement practical solutions.

  5. Lean stability augmentation for premixing, prevaporizing combustors

    NASA Technical Reports Server (NTRS)

    Mcvey, J. B.; Kennedy, J. B.

    1979-01-01

    An experimental program was conducted to investigate techniques for improving the lean combustion limits of premixing, prevaporizing combustors applicable to gas turbine engine main burners. Augmented flameholders employing recessed perforated plates, catalyzed tube bundles, and configurations in which pilot fuel was injected into the wakes of V-gutters or perforated plates were designed and tested. Stable operation of the piloted designs was achieved at equivalence ratios as low as 0.25; NOx emissions of less than 1.0 g/kg at simulated turbine engine cruise conditions were obtained. A piloted perforated plate employing four percent pilot fuel flow produced the best performance while meeting severe NOx constraints.

  6. Screw- vs cement-implant-retained restorations: an experimental study in the Beagle. Part 1. Screw and abutment loosening.

    PubMed

    Assenza, Bartolomeo; Scarano, Antonio; Leghissa, Giulio; Carusi, Giorgio; Thams, Ulf; Roman, Fidel San; Piattelli, Adriano

    2005-01-01

    The causes of implant failures can be biological or mechanical. The mechanical causes include fracture of the implant, fracture of the abutment, and loosening of the abutment. Numerous studies show that abutment loosening constitutes one of the marked implant postsurgery complications requiring clinical intervention. The aim of the present study was to evaluate the incidence of the screw loosening in screwed or cemented abutments. Six adult male Beagles were used. In each dog, the first molars and 2 premolars were extracted. The sutures were removed after 7 days. After 3 months, 10 implants were placed in each dog, 5 in the right mandible and 5 in the left mandible. The abutments either were screwed in (n=30) by applying a total strength of 30 N/cm or were cemented (n=30). After 12 months, 8 (27%) loosened screws were present in screwed abutments, whereas no abutment loosening was observed in cemented abutments (P = .0001). Screwed abutments are often submitted to nonaxial loads that determine screw and abutment loosening. PMID:16265854

  7. Effects of Lateral Mass Screw Rod Fixation to the Stability of Cervical Spine after Laminectomy

    NASA Astrophysics Data System (ADS)

    Rosli, Ruwaida; Kashani, Jamal; Kadir, Mohammed Rafiq Abdul

    There are many cases of injury in the cervical spine due to degenerative disorder, trauma or instability. This condition may produce pressure on the spinal cord or on the nerve coming from the spine. The aim of this study was, to analyze the stabilization of the cervical spine after undergoing laminectomy via computational simulation. For that purpose, a three-dimensional finite element (FE) model for the multilevel cervical spine segment (C1-C7) was developed using computed tomography (CT) data. There are various decompression techniques that can be applied to overcome the injury. Usually, decompression procedures will create an unstable spine. Therefore, in these situations, the spine is often surgically restabilized by using fusion and instrumentation. In this study, a lateral mass screw-rod fixation was created to stabilize the cervical spine after laminectomy. Material properties of the titanium alloy were assigned on the implants. The requirements moments and boundary conditions were applied on simulated implanted bone. Result showed that the bone without implant has a higher flexion and extension angle in comparison to the bone with implant under applied 1Nm moment. The bone without implant has maximum stress distribution at the vertebrae and ligaments. However, the bone with implant has maximum stress distribution at the screws and rods. Overall, the lateral mass screw-rod fixation provides stability to the cervical spine after undergoing laminectomy.

  8. Efficacy of Pedicle Screw Fixation in Unstable Upper and Middle Thoracic Spine Fractures

    PubMed Central

    Ghasemi, Amir Abbas; Ashoori, Soudabeh

    2016-01-01

    Background: Treatment of unstable upper and middle thoracic spine fractures remains controversial. There is no consensus regarding optimal treatment. Objectives: In this study, we evaluated the efficacy of pedicular screw in the management of middle thoracic spine fractures to correct kyphosis and anterolisthesis and improve neurologic condition of patients. Patients and Methods: Twenty-five patients with unstable T1-T10 fractures treated with pedicle screw fixation technique were studied. Neurologic situation, preoperative and postoperative radiographs were evaluated. Radiographic measurements included kyphotic deformity and anterolisthesis. An American Spinal Injury Association (ASIA) scale was used for neurologic classification of the patients. Results: From a total of 25 patients, 21 cases were male and 4 were female. The mean age of the patients was 35.40 ± 14.39 years. The mean degree of kyphosis improved from 27.04 ± 7.33 degrees preoperatively to 15.96 ± 5.76 degrees at final follow-up. The mean of anterolisthesis improved from 6.44 ± 4.93 mm to 0.96 ± 0.36 mm at final follow-up. Kyphosis (P = 0.0001), anterolisthesis (P = 0.0001) and neurological state (P = 0.01) improved significantly after operation. No cases of hardware failure, neurological deterioration and loss of correction were reported. Conclusions: Application of pedicular screw in unstable upper and middle thoracic spine fractures is an effective method that can correct kyphotic deformity and anterolisthesis and improve neurologic deficit. PMID:27218058

  9. TREATMENT OF SCAPHOID NONUNION WITH OLECRANON BONE GRAFT AND COMPRESSION SCREW

    PubMed Central

    NEDER, ANTONIO TUFI; FRANCESCHINI, EDUARDO TRALDI; PARDINI, ARLINDO GOMES; RIBERTO, MARCELO; MAZZER, NILTON

    2016-01-01

    ABSTRACT Objective: To evaluate the outcome of olecranon bone graft and compression screw for the treatment of nonunion of the Lichtman type I scaphoid. Method: We evaluated 15 patients of 32 who underwent surgical treatment for nonunion of the Lichtman type I scaphoid with olecranon bone graft and screw compression. Results: We obtained 100% consolidation in our sample. The mean flexion of the wrist on the affected side was 68° and 75° on the non-affected side. The average extension was 63° and 72°, respectively. The average grip strength was 35 kgf. This corresponds to 98% of the handgrip strength of the non-affected side, which was 37 kgf. The DASH score averaged 5 points. Conclusion: We believe that the use of bone graft obtained from the olecranon and secured with cannulated screw is a resolute technique for cases of linear nonunion of the Lichtmann type I scaphoid. It has the advantages of a new anesthesia for removal of the graft and the access is easy, providing a good exposure for removal and good aesthetic results. Level of evidence IV. Case series. PMID:27217819

  10. Suture anchor versus screw fixation for greater tuberosity fractures of the humerus--a biomechanical study.

    PubMed

    Lin, Cheng-Li; Hong, Chih-Kai; Jou, I-Ming; Lin, Chii-Jeng; Su, Fong-Chin; Su, Wei-Ren

    2012-03-01

    Suture anchors and screws are commonly used for fixation of humeral greater tuberosity (GT) fractures in either arthroscopic or open surgeries, but no biomechanical studies have been performed to compare the strength of fixation constructs using these two implants. This cadaveric study aimed to compare the biomechanical strength of three different fixation constructs in the management of GT fractures: Double-Row Suture Anchor Fixation (DR); Suture-Bridge Technique using suture anchors and knotless suture anchors (SB); and Two-Screw Fixation (TS). The experimental procedure was designed to assess fracture displacement after cyclic loading, failure load, and failure mode of the fixation construct. Significant differences were found among the SB (321 N), DR (263 N), and TS (187 N) groups (SB > DR > TS, p < 0.05) in the mean force of cyclic loading to create 3 mm displacement. Regarding the mean force of cyclic loading to create 5 mm displacement and ultimate failure load, no significant difference was found between the DR (370 N, 480 N) and SB (399 N, 493 N) groups, but both groups achieved superior results compared with the TS group (249 N, 340 N) (p < 0.05). The results suggested that the suture anchor constructs would be stronger than the fixation construct using screws for the humeral GT fracture. PMID:21858857

  11. Screw-Home Movement of the Tibiofemoral Joint during Normal Gait: Three-Dimensional Analysis

    PubMed Central

    Kim, Ha Yong; Yang, Dae Suk; Jeung, Sang Wook; Choi, Han Gyeol; Choy, Won Sik

    2015-01-01

    Background The purpose of this study was to evaluate the screw-home movement at the tibiofemoral joint during normal gait by utilizing the 3-dimensional motion capture technique. Methods Fifteen young males and fifteen young females (total 60 knee joints) who had no history of musculoskeletal disease or a particular gait problem were included in this study. Two more markers were attached to the subject in addition to the Helen-Hayes marker set. Thus, two virtual planes, femoral coronal plane (Pf) and tibial coronal plane (Pt), were created by Skeletal Builder software. This study measured the 3-dimensional knee joint movement in the sagittal, coronal, and transverse planes of these two virtual planes (Pf and Pt) during normal gait. Results With respect to kinematics and kinetics, both males and females showed normal adult gait patterns, and the mean difference in the temporal gait parameters was not statistically significant (p > 0.05). In the transverse plane, the screw-home movement occurred as expected during the pre-swing phase and the late-swing phase at an angle of about 17°. However, the tibia rotated externally with respect to the femur, rather than internally, while the knee joint started to flex during the loading response (paradoxical screw-home movement), and the angle was 6°. Conclusions Paradoxical screw-home movement may be an important mechanism that provides stability to the knee joint during the remaining stance phase. Obtaining the kinematic values of the knee joint during gait can be useful in diagnosing and treating the pathological knee joints. PMID:26330951

  12. Twin Screw Extruders as Continuous Mixers for Thermal Processing: a Technical and Historical Perspective.

    PubMed

    Martin, Charlie

    2016-02-01

    Developed approximately 100 years ago for natural rubber/plastics applications, processes via twin screw extrusion (TSE) now generate some of the most cutting-edge drug delivery systems available. After 25 or so years of usage in pharmaceutical environments, it has become evident why TSE processing offers significant advantages as compared to other manufacturing techniques. The well-characterized nature of the TSE process lends itself to ease of scale-up and process optimization while also affording the benefits of continuous manufacturing. Interestingly, the evolution of twin screw extrusion for pharmaceutical products has followed a similar path as previously trodden by plastics processing pioneers. Almost every plastic has been processed at some stage in the manufacturing train on a twin screw extruder, which is utilized to mix materials together to impart desired properties into a final part. The evolution of processing via TSEs since the early/mid 1900s is recounted for plastics and also for pharmaceuticals from the late 1980s until today. The similarities are apparent. The basic theory and development of continuous mixing via corotating and counterrotating TSEs for plastics and drug is also described. The similarities between plastics and pharmaceutical applications are striking. The superior mixing characteristics inherent with a TSE have allowed this device to dominate other continuous mixers and spurred intensive development efforts and experimentation that spawned highly engineered formulations for the commodity and high-tech plastic products we use every day. Today, twin screw extrusion is a battle hardened, well-proven, manufacturing process that has been validated in 24-h/day industrial settings. The same thing is happening today with new extrusion technologies being applied to advanced drug delivery systems to facilitate commodity, targeted, and alternative delivery systems. It seems that the "extrusion evolution" will continue for wide

  13. Anatomical study of anterior column screw tunnels through virtual three-dimensional models of the pelvis.

    PubMed

    Chen, Hua; Tang, Peifu; Yao, Yimin; She, Fei; Wang, Yan

    2015-01-01

    We created 66 male and 74 female virtual three-dimensional models of the pelvis based on computed tomography data from 140 patients. Virtual cylindrical bolts (VCBs) were placed in the anterior column (AC), which was then resliced serially along the bolt's long axis. AC screw tunnel mainly comprises two long, narrow triangular prisms [zone III (acetabular fossa) and zone V (obturator foramen)]--forming the III/V angle--linked by a larger, shorter cylinder [zone IV (acetabular notch)]. VCBs' mean length and maximum diameter were 111.13 ± 7.33 and 7.37 ± 1.90 mm, respectively. The models' anatomical zone lengths were similar between the sexes. Zone V's narrowest diameters and the III/V angles were significantly different. VCBs >6.5 mm were accommodated in 65 of 66 male models and 31 of 74 female models. VCBs >5.0 and <6.5 mm were accommodated in one male and 30 female models. Eleven female models accommodated only VCBs >3.5 and <5.0 mm. However, to 13 female pelvic models with maximum VCB accommodation of <5 mm for the anterior column, the maximum diameter of the VCBs was 8.23 ± 1.22 mm in medial passage and 10.3 ± 1.91 mm in lateral passage, respectively. Percutaneous fixation of the AC with screws is a safe technique, even though in Chinese female patients. The narrowest diameters in zone V and the III/V angles are the key factors for application of AC screws. Female patients with a smaller interosseous space at zone V and a large III/V angle can accommodate segmental passage screws. PMID:24413847

  14. Posterior Fixation Techniques in the Subaxial Cervical Spine

    PubMed Central

    Ghori, Ahmer; Makanji, Heeren; Cha, Thomas

    2015-01-01

    This article reviews the historical context, indications, techniques, and complications of four posterior fixation techniques to stabilize the subaxial cervical spine. Specifically, posterior wiring, laminar screw fixation, lateral mass fixation, and pedicle screw fixation are among the common methods of operative fixation of the subaxial cervical spine. While wiring and laminar screw fixation are now rarely used, both lateral mass and pedicle screw fixation are technically challenging and present the risk of significant complications if performed incorrectly. With a sound understanding of anatomy and rigorous preoperative evaluation of bony structures, both lateral mass and pedicle screw fixation provide a safe and reliable method for subaxial cervical spine fixation. PMID:26594602

  15. Cervical anterior transpedicular screw fixation (ATPS)--Part II. Accuracy of manual insertion and pull-out strength of ATPS.

    PubMed

    Koller, Heiko; Acosta, Frank; Tauber, Mark; Fox, Michael; Martin, Hudelmaier; Forstner, Rosmarie; Augat, Peter; Penzkofer, Rainer; Pirich, Christian; Kässmann, H; Resch, Herbert; Hitzl, Wolfgang

    2008-04-01

    Reconstruction after multilevel decompression of the cervical spine, especially in the weakened osteoporotic, neoplastic or infectious spine often requires circumferential stabilization and fusion. To avoid the additional posterior surgery in these cases while increasing rigidity of anterior-only screw-plate constructs, the authors introduce the concept of anterior transpedicular screw (ATPS) fixation. We demonstrated its morphological feasibility as well as its indications in a previous study in Part I of our project. Consequently, the objectives of the current study were to assess the ex vivo accuracy of placing ATPS into the cervical vertebra as well as the biomechanical performance of ATPS in comparison to traditional vertebral body screws (VBS) in terms of pull-out strength (POS). Twenty-three ATPS were inserted alternately to two screws into the pedicles and vertebral bodies, respectively, of six cadaveric specimens from C3-T1. For insertion of ATPS, a manual fluoroscopically assisted technique was used. Pre- and post insertional CT-scans were used to assess accuracy of ATPS insertion in the axial and sagittal planes. A newly designed grading system and accuracy score were used to delineate accuracy of ATPS insertion. Following insertion of screws, 23 ATPS and 22 VBS were subjected to pull-out testing (POT). The bone mineral density (BMD) of each specimen was assessed prior to POT. Statistical analysis showed that the incidence of correctly placed screws and non-critical pedicles breaches in axial plane was 78.3%, and 95.7% in sagittal plane. Hence, according to our definition of "critical" pedicle breach that exposes neurovascular structures at risk, 21.7% (n = 5) of all ATPS inserted showed a critical pedicle breach in axial plane. Notably, no critical pedicle perforation occurred at the C6 to T1 levels. Pull-out testing of ATPS and VBS revealed that pull-out resistance of ATPS was 2.5-fold that of VBS. Mean POS of 23 ATPS with a mean BMD of 0.566 g/cm(2

  16. Screw-matrix method in dynamics of multibody systems

    NASA Astrophysics Data System (ADS)

    Yanzhu, Liu

    1988-05-01

    In the present paper the concept of screw in classical mechanics is expressed in matrix form, in order to formulate the dynamical equations of the multibody systems. The mentioned method can retain the advantages of the screw theory and avoid the shortcomings of the dual number notation. Combining the screw-matrix method with the tool of graph theory in Roberson/Wittenberg formalism. We can expand the application of the screw theory to the general case of multibody systems. For a tree system, the dynamical equations for each j-th subsystem, composed of all the outboard bodies connected by j-th joint can be formulated without the constraint reaction forces in the joints. For a nontree system, the dynamical equations of subsystems and the kinematical consistency conditions of the joints can be derived using the loop matrix. The whole process of calculation is unified in matrix form. A three-segment manipulator is discussed as an example.

  17. Adhesive-backed terminal board eliminates mounting screws

    NASA Technical Reports Server (NTRS)

    1965-01-01

    Low-profile terminal board is used in dense electronic circuits where mounting and working space is limited. The board has a thin layer of pressure-sensitive adhesive backing which eliminates the need for mounting screws.

  18. Percutaneous screw fixation of acetabular fractures: applicability of hip arthroscopy.

    PubMed

    Yang, Jae-Hyuk; Chouhan, Devendra Kumar; Oh, Kwang-Jun

    2010-11-01

    Percutaneous screw fixation of the anterior column of the acetabulum has been a challenging task because of its unique anatomy and a risk of intra-articular penetration. Evidence is lacking for any tools to provide visual scrutiny of fracture reduction and intra-articular screw penetration. We report 2 cases of fracture of the acetabulum that developed in young female athletes, in which the anterior column was fixed with a percutaneous screw by use of hip arthroscopy as an assisting tool for intra-articular observation. In our experience this method was found to be promising in terms of anatomic reduction of the fracture site, avoiding articular penetration during screw insertion, with additional advantages of joint debridement, lavage, and reduction in radiation exposure. PMID:20888169

  19. 21. NBS SUIT LAB. THREE GLOVES, HELMET, AND SCREW DRIVER ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    21. NBS SUIT LAB. THREE GLOVES, HELMET, AND SCREW DRIVER TORQUE WRENCH FOR ASSEMBLY AND REPAIR OF BOTH. - Marshall Space Flight Center, Neutral Buoyancy Simulator Facility, Rideout Road, Huntsville, Madison County, AL

  20. Usability engineering: domain analysis activities for augmented-reality systems

    NASA Astrophysics Data System (ADS)

    Gabbard, Joseph; Swan, J. E., II; Hix, Deborah; Lanzagorta, Marco O.; Livingston, Mark; Brown, Dennis B.; Julier, Simon J.

    2002-05-01

    This paper discusses our usability engineering process for the Battlefield Augmented Reality System (BARS). Usability engineering is a structured, iterative, stepwise development process. Like the related disciplines of software and systems engineering, usability engineering is a combination of management principals and techniques, formal and semi- formal evaluation techniques, and computerized tools. BARS is an outdoor augmented reality system that displays heads- up battlefield intelligence information to a dismounted warrior. The paper discusses our general usability engineering process. We originally developed the process in the context of virtual reality applications, but in this work we are adapting the procedures to an augmented reality system. The focus of this paper is our work on domain analysis, the first activity of the usability engineering process. We describe our plans for and our progress to date on our domain analysis for BARS. We give results in terms of a specific urban battlefield use case we have designed.

  1. Crystal geometry of screw dislocation glide in tungsten nanocrystals

    NASA Astrophysics Data System (ADS)

    Sadanov, E. V.

    2015-02-01

    A zigzag pattern of low-temperature dislocation glide occurring in tungsten nanocrystals in the intersecting planes {110} and {211}, which belong to the <111> crystallographic zone, has been revealed using field ion microscopy. It has been shown that cores of 1/2[111] screw dislocations are undissociated within the limits of the resolution of the field ion microscope. It has been found experimentally that surface atoms are displaced into metastable positions in the region of the trace of screw dislocation motion.

  2. Screw thread parameter measurement system based on image processing method

    NASA Astrophysics Data System (ADS)

    Rao, Zhimin; Huang, Kanggao; Mao, Jiandong; Zhang, Yaya; Zhang, Fan

    2013-08-01

    In the industrial production, as an important transmission part, the screw thread is applied extensively in many automation equipments. The traditional measurement methods of screw thread parameter, including integrated test methods of multiparameters and the single parameter measurement method, belong to contact measurement method. In practical the contact measurement exists some disadvantages, such as relatively high time cost, introducing easily human error and causing thread damage. In this paper, as a new kind of real-time and non-contact measurement method, a screw thread parameter measurement system based on image processing method is developed to accurately measure the outside diameter, inside diameter, pitch diameter, pitch, thread height and other parameters of screw thread. In the system the industrial camera is employed to acquire the image of screw thread, some image processing methods are used to obtain the image profile of screw thread and a mathematics model is established to compute the parameters. The C++Builder 6.0 is employed as the software development platform to realize the image process and computation of screw thread parameters. For verifying the feasibility of the measurement system, some experiments were carried out and the measurement errors were analyzed. The experiment results show the image measurement system satisfies the measurement requirements and suitable for real-time detection of screw thread parameters mentioned above. Comparing with the traditional methods the system based on image processing method has some advantages, such as, non-contact, easy operation, high measuring accuracy, no work piece damage, fast error analysis and so on. In the industrial production, this measurement system can provide an important reference value for development of similar parameter measurement system.

  3. Solid and hollow pedicle screws affect the electrical resistance: A potential source of error with stimulus-evoked electromyography

    PubMed Central

    Wang, Hongwei; Liao, Xinhua; Ma, Xianguang; Li, Changqing; Han, Jianda; Zhou, Yue

    2013-01-01

    Background: Although stimulus evoked electromyography (EMG) is commonly used to confirm the accuracy of pedicle screw placement. There are no studies to differentiate between solid screws and hollow screws to the electrical resistance of pedicle screws. We speculate that the electrical resistance of the solid and hollow pedicle screws may be different and then a potential source of error with stimulus-evoked EMG may happen. Materials and Methods: Resistance measurements were obtained from 12 pedicle screw varieties (6 screws of each manufacturer) across the screw shank based on known constant current and measured voltage. The voltage was measured 5 times at each site. Results: Resistance of all solid screws ranged from 0.084 Ω to 0.151 Ω (mean =0.118 ± 0.024 Ω) and hollow screws ranged from 0.148 Ω to 0.402 Ω (mean = 0.285 ± 0.081 Ω). There was a significant difference of resistance between the solid screws and hollow screws (P < 0.05). The screw with the largest diameter no matter solid screws or hollow screws had lower resistance than screws with other diameters. No matter in solid screws group or hollow screws group, there were significant differences (P < 0.05) between the 5.0 mm screws and 6.0 mm screws, 6.0 mm screws and 7.0 mm screws, 5.0 mm screws and 7.0 mm screws, 4.5 mm screws and 5.5 mm screws, 5.5 mm screws and 6.5 mm screws, 4.5 mm screws and 6.5 mm screws. The resistance of hollow screws was much larger than the solid screws in the same diameter group (P < 0.05). Conclusions: Hollow pedicle screws have the potential for high electrical resistance compared to the solid pedicle screws and therefore may affect the EMG response during stimulus-evoked EMG testing in pedicle screw fixation especially in minimally invasive percutaneous pedical screw fixation surgery. PMID:23960278

  4. Pullout strength of misplaced pedicle screws in the thoracic and lumbar vertebrae - A cadaveric study

    PubMed Central

    Saraf, Shyam K; Singh, Ravindra P; Singh, Vakil; Varma, Ashish

    2013-01-01

    Background: The objective of this cadaveric study was to analyze the effects of iatrogenic pedicle perforations from screw misplacement on the mean pullout strength of lower thoracic and lumbar pedicle screws. We also investigated the effect of bone mineral density (BMD), diameter of pedicle screws, and the region of spine on the pullout strength of pedicle screws. Materials and Methods: Sixty fresh human cadaveric vertebrae (D10–L2) were harvested. Dual-energy X-ray absorptiometry (DEXA) scan of vertebrae was done for BMD. Titanium pedicle screws of different diameters (5.2 and 6.2 mm) were inserted in the thoracic and lumbar segments after dividing the specimens into three groups: a) standard pedicle screw (no cortical perforation); b) screw with medial cortical perforation; and c) screw with lateral cortical perforation. Finally, pullout load of pedicle screws was recorded using INSTRON Universal Testing Machine. Results: Compared with standard placement, medially misplaced screws had 9.4% greater mean pullout strength and laterally misplaced screws had 47.3% lesser mean pullout strength. The pullout strength of the 6.2 mm pedicle screws was 33% greater than that of the 5.2 mm pedicle screws. The pullout load of pedicle screws in lumbar vertebra was 13.9% greater than that in the thoracic vertebra (P = 0.105), but it was not statistically significant. There was no significant difference between pullout loads of vertebra with different BMD (P = 0.901). Conclusion: The mean pullout strength was less with lateral misplaced pedicle screws while medial misplaced pedicle screw had more pullout strength. The pullout load of 6.2 mm screws was greater than that of 5.2 mm pedicle screws. No significant correlation was found between bone mineral densities and the pullout strength of vertebra. Similarly, the pullout load of screw placed in thoracic and lumbar vertebrae was not significantly different. PMID:23798753

  5. Transforming Polar Research with Google Glass Augmented Reality (Invited)

    NASA Astrophysics Data System (ADS)

    Ramachandran, R.; McEniry, M.; Maskey, M.

    2011-12-01

    Augmented reality is a new technology with the potential to accelerate the advancement of science, particularly in geophysical research. Augmented reality is defined as a live, direct or indirect, view of a physical, real-world environment whose elements are augmented (or supplemented) by computer-generated sensory input such as sound, video, graphics or GPS data. When paired with advanced computing techniques on cloud resources, augmented reality has the potential to improve data collection techniques, visualizations, as well as in-situ analysis for many areas of research. Google is currently a pioneer of augmented reality technology and has released beta versions of their wearable computing device, Google Glass, to a select number of developers and beta testers. This community of 'Glass Explorers' is the vehicle from which Google shapes the future of their augmented reality device. Example applications of Google Glass in geophysical research range from use as a data gathering interface in harsh climates to an on-site visualization and analysis tool. Early participation in the shaping of the Google Glass device is an opportunity for researchers to tailor this new technology to their specific needs. The purpose of this presentation is to provide geophysical researchers with a hands-on first look at Google Glass and its potential as a scientific tool. Attendees will be given an overview of the technical specifications as well as a live demonstration of the device. Potential applications to geophysical research in polar regions will be the primary focus. The presentation will conclude with an open call to participate, during which attendees may indicate interest in developing projects that integrate Google Glass into their research. Application Mockup: Penguin Counter Google Glass Augmented Reality Device

  6. Transforming Polar Research with Google Glass Augmented Reality (Invited)

    NASA Astrophysics Data System (ADS)

    Ruthkoski, T.

    2013-12-01

    Augmented reality is a new technology with the potential to accelerate the advancement of science, particularly in geophysical research. Augmented reality is defined as a live, direct or indirect, view of a physical, real-world environment whose elements are augmented (or supplemented) by computer-generated sensory input such as sound, video, graphics or GPS data. When paired with advanced computing techniques on cloud resources, augmented reality has the potential to improve data collection techniques, visualizations, as well as in-situ analysis for many areas of research. Google is currently a pioneer of augmented reality technology and has released beta versions of their wearable computing device, Google Glass, to a select number of developers and beta testers. This community of 'Glass Explorers' is the vehicle from which Google shapes the future of their augmented reality device. Example applications of Google Glass in geophysical research range from use as a data gathering interface in harsh climates to an on-site visualization and analysis tool. Early participation in the shaping of the Google Glass device is an opportunity for researchers to tailor this new technology to their specific needs. The purpose of this presentation is to provide geophysical researchers with a hands-on first look at Google Glass and its potential as a scientific tool. Attendees will be given an overview of the technical specifications as well as a live demonstration of the device. Potential applications to geophysical research in polar regions will be the primary focus. The presentation will conclude with an open call to participate, during which attendees may indicate interest in developing projects that integrate Google Glass into their research. Application Mockup: Penguin Counter Google Glass Augmented Reality Device

  7. Augmented Reality Tower Technology Assessment

    NASA Technical Reports Server (NTRS)

    Reisman, Ronald J.; Brown, David M.

    2009-01-01

    Augmented Reality technology may help improve Air Traffic Control Tower efficiency and safety during low-visibility conditions. This paper presents the assessments of five off-duty controllers who shadow-controlled' with an augmented reality prototype in their own facility. Initial studies indicated unanimous agreement that this technology is potentially beneficial, though the prototype used in the study was not adequate for operational use. Some controllers agreed that augmented reality technology improved situational awareness, had potential to benefit clearance, control, and coordination tasks and duties and could be very useful for acquiring aircraft and weather information, particularly aircraft location, heading, and identification. The strongest objections to the prototype used in this study were directed at aircraft registration errors, unacceptable optical transparency, insufficient display performance in sunlight, inadequate representation of the static environment and insufficient symbology.

  8. Augmentation mentoplasty using Mersilene mesh.

    PubMed

    McCollough, E G; Hom, D B; Weigel, M T; Anderson, J R

    1990-10-01

    Many different materials are available for augmentation mentoplasty. However, the optimal implant material for chin implantation has yet to be found. During the past several years, a number of experienced surgeons have turned to the use of Mersilene mesh. Mersilene mesh is a non-absorbable Dacron polyester fiber that can be conformed easily into layers to achieve tailored dimensions and shape. At the McCollough Plastic Surgery Clinic PA, Birmingham, Ala, 277 patients over a 10-year period underwent chin augmentation with Mersilene mesh implants. The material provides excellent tensile strength, durability, and surgical adaptability. The overall complication rate was 3.2% (nine patients); infection rate, 2.5% (seven patients); and removal secondary to infection, 1.7% (five patients). Based on this 10-year experience, Mersilene mesh remains our material of choice for chin augmentation. PMID:2206500

  9. Screw dislocation-driven growth of one-dimensional nanomaterials

    NASA Astrophysics Data System (ADS)

    Meng, Fei

    Nanoscience and nanotechnology are impacting our lives in many ways, from electronic and photonic devices to biosensors. They also hold the promise of tackling the renewable energy challenges facing us. However, one limiting scientific challenge is the effective and efficient bottom-up synthesis of nanomaterials. In this thesis, we discuss the fundamental theories of screw dislocation-driven growth of various nanostructures including one-dimensional nanowires and nanotubes, two-dimensional nanoplates, and three-dimensional hierarchical tree-like nanostructures. We then introduce the transmission electron microscopy (TEM) techniques to structurally characterize the dislocation-driven nanomaterials for future searching and identifying purposes. We summarize the guidelines for rationally designing the dislocation-driven growth and discuss specific examples to illustrate how to implement the guidelines. We also show that dislocation growth is a general and versatile mechanism that can be used to grow a variety of nanomaterials via distinct reaction chemistry and synthetic methods. The fundamental investigation and development of dislocation-driven growth of nanomaterials will create a new dimension to the rational design and synthesis of increasingly complex nanomaterials.

  10. Interacting with augmented holograms

    NASA Astrophysics Data System (ADS)

    Bimber, Oliver; Zeidler, Thomas; Grundhoefer, Anselm; Wetzstein, Gordon; Moehring, Mathias; Knoedel, Sebastian; Hahne, Uwe

    2005-04-01

    Holography and computer graphics are being used as tools to solve individual research, engineering, and presentation problems within several domains. Up until today, however, these tools have been applied separately. Our intention is to combine both technologies to create a powerful tool for science, industry and education. We are currently investigating the possibility of integrating computer generated graphics and holograms. This paper gives an overview over our latest results. It presents several applications of interaction techniques to graphically enhanced holograms and gives a first glance on a novel method that reconstructs depth from optical holograms.

  11. Biomechanical Evaluation of Supplemental Percutaneous Lumbo-Sacro-iliac Screws For Spino-pelvic Fixation Following Total Sacrectomy

    PubMed Central

    Le, Vu H.; Heckmann, Nathanael; Jain, Nickul; Wang, Lawrence; Turner, Alexander W. L.; Lee, Thay Q.; Bederman, S. Samuel

    2015-01-01

    Study Design This is a cadaveric biomechanical study evaluating the biomechanical properties of a novel spino-pelvic fixation technique with percutaneous lumbo-sacro-iliac (LSI) screws in an unstable total sacrectomy model. Objective To compare standard posterior dual rod spino-pelvic fixation alone with dual rod fixation supplemented with LSI screw fixation. Summary of Background Data Primary or metastatic tumors of the sacrum requiring a total sacrectomy can result in spino-pelvic instability if inadequate fixation is achieved. Many fixation techniques have been proposed to address this instability. However, to date, an optimal fixation technique has not been established. Methods Ten fresh-frozen cadaveric spino-pelvic specimens were randomized according to bone mineral density (BMD) to either posterior rod fixation (control group) or posterior rod fixation with supplemental LSI screws (LSI group). Following fixation, a total sacrectomy of each specimen was performed. Specimens where then potted and axially loaded in a caudal direction. Stiffness, yield load, energy absorbed at yield load, ultimate load, and energy absorbed at ultimate load were computed. A students t-test was used for statistical analysis with significance set at p<0.05. Results The average age and BMD were not significantly different between the control and LSI groups (age, p=0.255; BMD, p=0.810). After normalizing for BMD, there were no significant differences detected for any of the biomechanical parameters measured between the two fixation techniques: stiffness (p=0.857), yield load (p=0.219), energy at yield load (p=0.293), ultimate load (p=0.407), and energy at ultimate load (p=0.773). However, both fixation techniques were able to withstand physiological loads. Conclusions Our study did not demonstrate any biomechanical advantage for supplemental LSI screw fixation in our axial loading model. However, given the theoretical advantage of this percutaneous technique, further studies are

  12. Augmentation-related brain plasticity.

    PubMed

    Di Pino, Giovanni; Maravita, Angelo; Zollo, Loredana; Guglielmelli, Eugenio; Di Lazzaro, Vincenzo

    2014-01-01

    Today, the anthropomorphism of the tools and the development of neural interfaces require reconsidering the concept of human-tools interaction in the framework of human augmentation. This review analyses the plastic process that the brain undergoes when it comes into contact with augmenting artificial sensors and effectors and, on the other hand, the changes that the use of external augmenting devices produces in the brain. Hitherto, few studies investigated the neural correlates of augmentation, but clues on it can be borrowed from logically-related paradigms: sensorimotor training, cognitive enhancement, cross-modal plasticity, sensorimotor functional substitution, use and embodiment of tools. Augmentation modifies function and structure of a number of areas, i.e., primary sensory cortices shape their receptive fields to become sensitive to novel inputs. Motor areas adapt the neuroprosthesis representation firing-rate to refine kinematics. As for normal motor outputs, the learning process recruits motor and premotor cortices and the acquisition of proficiency decreases attentional recruitment, focuses the activity on sensorimotor areas and increases the basal ganglia drive on the cortex. Augmentation deeply relies on the frontoparietal network. In particular, premotor cortex is involved in learning the control of an external effector and owns the tool motor representation, while the intraparietal sulcus extracts its visual features. In these areas, multisensory integration neurons enlarge their receptive fields to embody supernumerary limbs. For operating an anthropomorphic neuroprosthesis, the mirror system is required to understand the meaning of the action, the cerebellum for the formation of its internal model and the insula for its interoception. In conclusion, anthropomorphic sensorized devices can provide the critical sensory afferences to evolve the exploitation of tools through their embodiment, reshaping the body representation and the sense of the self

  13. Augmentation-related brain plasticity

    PubMed Central

    Di Pino, Giovanni; Maravita, Angelo; Zollo, Loredana; Guglielmelli, Eugenio; Di Lazzaro, Vincenzo

    2014-01-01

    Today, the anthropomorphism of the tools and the development of neural interfaces require reconsidering the concept of human-tools interaction in the framework of human augmentation. This review analyses the plastic process that the brain undergoes when it comes into contact with augmenting artificial sensors and effectors and, on the other hand, the changes that the use of external augmenting devices produces in the brain. Hitherto, few studies investigated the neural correlates of augmentation, but clues on it can be borrowed from logically-related paradigms: sensorimotor training, cognitive enhancement, cross-modal plasticity, sensorimotor functional substitution, use and embodiment of tools. Augmentation modifies function and structure of a number of areas, i.e., primary sensory cortices shape their receptive fields to become sensitive to novel inputs. Motor areas adapt the neuroprosthesis representation firing-rate to refine kinematics. As for normal motor outputs, the learning process recruits motor and premotor cortices and the acquisition of proficiency decreases attentional recruitment, focuses the activity on sensorimotor areas and increases the basal ganglia drive on the cortex. Augmentation deeply relies on the frontoparietal network. In particular, premotor cortex is involved in learning the control of an external effector and owns the tool motor representation, while the intraparietal sulcus extracts its visual features. In these areas, multisensory integration neurons enlarge their receptive fields to embody supernumerary limbs. For operating an anthropomorphic neuroprosthesis, the mirror system is required to understand the meaning of the action, the cerebellum for the formation of its internal model and the insula for its interoception. In conclusion, anthropomorphic sensorized devices can provide the critical sensory afferences to evolve the exploitation of tools through their embodiment, reshaping the body representation and the sense of the self

  14. Increasing pedicle screw anchoring in the osteoporotic spine by cement injection through the implant. Technical note and report of three cases.

    PubMed

    Fransen, Patrick

    2007-09-01

    Instrumented spinal fusion in patients with osteoporosis is challenging because of the poor bone quality and is complicated by an elevated risk of delayed hardware failure. The author treated two patients presenting with severe osteoporosis, spinal stenosis, and degenerative spondylolisthesis. He performed decompressive laminectomy, posterolateral fusion, and pedicle screw (PS) fixation involving screws with side openings that allow cement to be injected through the implant. The cement injection was conducted under fluoroscopic control without complications. Although this technique needs validation in a larger population of patients, the author believes that the injection of cement through these PSs can be performed safely in carefully selected patients. This technique creates not only a vertebroplasty-like effect that strengthens the vertebral body but also provides the additional stability afforded by the immediate anchoring of the screw, which may allow a shorter-length construct, save mobile segments, and finally reduce the risk of hardware failure. PMID:17877276

  15. The pedicle screw-rod system is an acceptable method of reconstructive surgery after resection of sacroiliac joint tumours

    PubMed Central

    Zhou, Yi-Jun; Yunus, Akbar; Tian, Zheng; Chen, Jiang-Tao; Wang, Chong; Xu, Lei-Lei

    2016-01-01

    Hemipelvic resections for primary bone tumours require reconstruction to restore weight bearing along anatomic axes. However, reconstruction of the pelvic arch remains a major surgical challenge because of the high rate of associated complications. We used the pedicle screw-rod system to reconstruct the pelvis, and the purpose of this investigation was to assess the oncology, functional outcome and complication rate following this procedure. The purpose of this study was to investigate the operative indications and technique of the pedicle screw-rod system in reconstruction of the stability of the sacroiliac joint after resection of sacroiliac joint tumours. The average MSTS (Musculoskeletal Tumour Society) score was 26.5 at either three months after surgery or at the latest follow-up. Seven patients had surgery-related complications, including wound dehiscence in one, infection in two, local necrosis in four (including infection in two), sciatic nerve palsy in one and pubic symphysis subluxation in one. There was no screw loosening or deep vein thrombosis occurring in this series. Using a pedicle screw-rod after resection of a sacroiliac joint tumour is an acceptable method of pelvic reconstruction because of its reduced risk of complications and satisfactory functional outcome, as well as its feasibility of reconstruction for type IV pelvis tumour resection without elaborate preoperative customisation. Level of evidence: Level IV, therapeutic study. PMID:27095944

  16. Tangential View and Intraoperative Three-Dimensional Fluoroscopy for the Detection of Screw-Misplacements in Volar Plating of Distal Radius Fractures

    PubMed Central

    Rausch, Sascha; Marintschev, Ivan; Graul, Isabel; Wilharm, Arne; Klos, Kajetan; Hofmann, Gunther O.; Florian Gras, Marc

    2015-01-01

    Background: Volar locking plate fixation has become the gold standard in the treatment of unstable distal radius fractures. Juxta-articular screws should be placed as close as possible to the subchondral zone, in an optimized length to buttress the articular surface and address the contralateral cortical bone. On the other hand, intra-articular screw misplacements will promote osteoarthritis, while the penetration of the contralateral bone surface may result in tendon irritations and ruptures. The intraoperative control of fracture reduction and implant positioning is limited in the common postero-anterior and true lateral two-dimensional (2D)-fluoroscopic views. Therefore, additional 2D-fluoroscopic views in different projections and intraoperative three-dimensional (3D) fluoroscopy were recently reported. Nevertheless, their utility has issued controversies. Objectives: The following questions should be answered in this study; 1) Are the additional tangential view and the intraoperative 3D fluoroscopy useful in the clinical routine to detect persistent fracture dislocations and screw misplacements, to prevent revision surgery? 2) Which is the most dangerous plate hole for screw misplacement? Patients and Methods: A total of 48 patients (36 females and 13 males) with 49 unstable distal radius fractures (22 x 23 A; 2 x 23 B, and 25 x 23 C) were treated with a 2.4 mm variable angle LCP Two-Column volar distal radius plate (Synthes GmbH, Oberdorf, Switzerland) during a 10-month period. After final fixation, according to the manufactures' technique guide and control of implant placement in the two common perpendicular 2D-fluoroscopic images (postero-anterior and true lateral), an additional tangential view and intraoperative 3D fluoroscopic scan were performed to control the anatomic fracture reduction and screw placements. Intraoperative revision rates due to screw misplacements (intra-articular or overlength) were evaluated. Additionally, the number of surgeons

  17. Prediction of Deformity Correction by Pedicle Screw Instrumentation in Thoracolumbar Scoliosis Surgery

    NASA Astrophysics Data System (ADS)

    Kiriyama, Yoshimori; Yamazaki, Nobutoshi; Nagura, Takeo; Matsumoto, Morio; Chiba, Kazuhiro; Toyama, Yoshiaki

    In segmental pedicle screw instrumentation, the relationship between the combinations of pedicle screw placements and the degree of deformity correction was investigated with a three-dimensional rigid body and spring model. The virtual thoracolumbar scoliosis (Cobb’s angle of 47 deg.) was corrected using six different combinations of pedicle-screw placements. As a result, better correction in the axial rotation was obtained with the pedicle screws placed at or close to the apical vertebra than with the screws placed close to the end vertebrae, while the correction in the frontal plane was better with the screws close to the end vertebrae than with those close to the apical vertebra. Additionally, two screws placed in the convex side above and below the apical vertebra provided better correction than two screws placed in the concave side. Effective deformity corrections of scoliosis were obtained with the proper combinations of pedicle screw placements.

  18. Long-term success of sinus augmentation using various surgical approaches and grafting materials.

    PubMed

    Fugazzotto, P A; Vlassis, J

    1998-01-01

    Two hundred twenty-two sinus augmentation procedures were performed using one of three techniques: crestal approach; lateral approach; or lateral approach with simultaneous implant placement. Forty-one of these sinus augmentation procedures were performed in conjunction with buccolingual ridge augmentation. Of the 222 procedures, 217 (97.7%) were successful. Of 510 implants placed in augmented sinus areas, 495 (97.0%) were deemed successful by the criteria of Albrektsson et al for up to 73 months in function. Clinical considerations in the execution of such therapy are discussed. PMID:9509780

  19. Bibliography of US patents on augmentation of convective heat and mass transfer-II

    SciTech Connect

    Webb, R.L.; Bergles, A.E.; Junkhan, G.H.

    1983-12-01

    Patents are an important source of information on the potential commercialization of augmented heat transfer technology. This report presents a bibliography of US patents pertinent to that technology. The total number of patents cited is 454. They are presented in three separate lists: by patent number, alphabetically by first inventor, and by augmentation technique (with secondary arrangement according to mode of heat transfer).

  20. Bibliography of US patents on augmentation of convective heat and mass transfer

    SciTech Connect

    Webb, R.L.; Junkhan, G.H.; Bergles, A.E.

    1980-09-01

    Granted patents are an important source of information on the potential commercialization of augmented heat transfer technology. This report presents a bibliography of US patents pertinent to that technology. The total number of patents cited is 321. They are presented in three separate lists: by patent number, alphabetically by first inventor, and by augmentation techniques (with secondary arrangement according to mode of heat transfer).

  1. (PACT) Partners in Augmentative Communication Training: A Resource Guide for Interaction Facilitation Training for Children.

    ERIC Educational Resources Information Center

    Culp, Delva M.; Carlisle, Margaret

    "Partners in Augmentative Communication Training" (PACT) is a communication interaction facilitation program for child augmentative technique users and their communication partners. The program offers guidelines for use in developing individualized plans for improving conversational interaction. This resource guide addresses priority communication…

  2. Investigation of an 11mm diameter twin screw granulator: Screw element performance and in-line monitoring via image analysis.

    PubMed

    Sayin, Ridade; Martinez-Marcos, Laura; Osorio, Juan G; Cruise, Paul; Jones, Ian; Halbert, Gavin W; Lamprou, Dimitrios A; Litster, James D

    2015-12-30

    As twin screw granulation (TSG) provides one with many screw element options, characterization of each screw element is crucial in optimizing the screw configuration in order to obtain desired granule attributes. In this study, the performance of two different screw elements - distributive feed screws and kneading elements - was studied in an 11 mm TSG at different liquid-to-solid (L/S) ratios. The kneading element configuration was found to break large granules more efficiently, leading to narrower granule size distributions. While pharmaceutical industry shifts toward continuous manufacturing, inline monitoring and process control are gaining importance. Granules from an 11 mm TSG were analysed using the Eyecon™, a real-time high speed direct imaging system, which has been used to capture accurate particle size distribution and particle count. The size parameters and particle count were then assessed in terms of their ability to be a suitable control measure using the Shewhart control charts. d10 and particle count were found to be good indicators of the change in L/S ratio. However, d50 and d90 did not reflect the change, due to their inherent variability even when the process is at steady state. PMID:26385406

  3. Metal artifacts from titanium and steel screws in CT, 1.5T and 3T MR images of the tibial Pilon: a quantitative assessment in 3D

    PubMed Central

    Radzi, Shairah; Cowin, Gary; Robinson, Mark; Pratap, Jit; Volp, Andrew; Schuetz, Michael A.

    2014-01-01

    Radiographs are commonly used to assess articular reduction of the distal tibia (pilon) fractures postoperatively, but may reveal malreductions inaccurately. While magnetic resonance imaging (MRI) and computed tomography (CT) are potential three-dimensional (3D) alternatives they generate metal-related artifacts. This study aims to quantify the artifact size from orthopaedic screws using CT, 1.5T and 3T MRI data. Three screws were inserted into one intact human cadaver ankle specimen proximal to and along the distal articular surface, then CT, 1.5T and 3T MRI scanned. Four types of screws were investigated: titanium alloy (TA), stainless steel (SS) (Ø =3.5 mm), cannulated TA (CTA) and cannulated SS (CSS) (Ø =4.0 mm, Ø empty core =2.6 mm). 3D artifact models were reconstructed using adaptive thresholding. The artifact size was measured by calculating the perpendicular distance from the central screw axis to the boundary of the artifact in four anatomical directions with respect to the distal tibia. The artifact sizes (in the order of TA, SS, CTA and CSS) from CT were 2.0, 2.6, 1.6 and 2.0 mm; from 1.5T MRI they were 3.7, 10.9, 2.9, and 9 mm; and 3T MRI they were 4.4, 15.3, 3.8, and 11.6 mm respectively. Therefore, CT can be used as long as the screws are at a safe distance of about 2 mm from the articular surface. MRI can be used if the screws are at least 3 mm away from the articular surface except for SS and CSS. Artifacts from steel screws were too large thus obstructed the pilon from being visualised in MRI. Significant differences (P<0.05) were found in the size of artifacts between all imaging modalities, screw types and material types, except 1.5T versus 3T MRI for the SS screws (P=0.063). CTA screws near the joint surface can improve postoperative assessment in CT and MRI. MRI presents a favourable non-ionising alternative when using titanium hardware. Since these factors may influence the quality of postoperative assessment, potential improvements in

  4. Metal artifacts from titanium and steel screws in CT, 1.5T and 3T MR images of the tibial Pilon: a quantitative assessment in 3D.

    PubMed

    Radzi, Shairah; Cowin, Gary; Robinson, Mark; Pratap, Jit; Volp, Andrew; Schuetz, Michael A; Schmutz, Beat

    2014-06-01

    Radiographs are commonly used to assess articular reduction of the distal tibia (pilon) fractures postoperatively, but may reveal malreductions inaccurately. While magnetic resonance imaging (MRI) and computed tomography (CT) are potential three-dimensional (3D) alternatives they generate metal-related artifacts. This study aims to quantify the artifact size from orthopaedic screws using CT, 1.5T and 3T MRI data. Three screws were inserted into one intact human cadaver ankle specimen proximal to and along the distal articular surface, then CT, 1.5T and 3T MRI scanned. Four types of screws were investigated: titanium alloy (TA), stainless steel (SS) (Ø =3.5 mm), cannulated TA (CTA) and cannulated SS (CSS) (Ø =4.0 mm, Ø empty core =2.6 mm). 3D artifact models were reconstructed using adaptive thresholding. The artifact size was measured by calculating the perpendicular distance from the central screw axis to the boundary of the artifact in four anatomical directions with respect to the distal tibia. The artifact sizes (in the order of TA, SS, CTA and CSS) from CT were 2.0, 2.6, 1.6 and 2.0 mm; from 1.5T MRI they were 3.7, 10.9, 2.9, and 9 mm; and 3T MRI they were 4.4, 15.3, 3.8, and 11.6 mm respectively. Therefore, CT can be used as long as the screws are at a safe distance of about 2 mm from the articular surface. MRI can be used if the screws are at least 3 mm away from the articular surface except for SS and CSS. Artifacts from steel screws were too large thus obstructed the pilon from being visualised in MRI. Significant differences (P<0.05) were found in the size of artifacts between all imaging modalities, screw types and material types, except 1.5T versus 3T MRI for the SS screws (P=0.063). CTA screws near the joint surface can improve postoperative assessment in CT and MRI. MRI presents a favourable non-ionising alternative when using titanium hardware. Since these factors may influence the quality of postoperative assessment, potential improvements in

  5. Augmentative rhinoplasty with an "auricular gibbus".

    PubMed

    Rodríguez-Camps, S

    1998-01-01

    The philosophy of this work is to revise an interesting way to compensate a lack of nasal volume. Autologous auricular cartilage is used to augment a hollow dorsum. In this way, we treat depressed, asymmetrical, and irregular dorsa. We have 10 years' experience with this technique, in a total of nearly 350 cases. Among these cases are traumatic, secondary, and congenital noses. Prior to using this technique, we employed nasal septum, iliac crest bone or calotte, rib, dermis, fascia, etc. But actually, the "neogibbus" provided by the upper fossette of the concha of the auricle is enough, except for cases of exceptional volume needs. The ear does not suffer any damage when it is treated appropriately, and a uni- or bilateral graft can be taken, if necessary, to create a strong gibbus in the manner of a "sarcophagus" or of "Russian dolls." PMID:9618186

  6. Helical Screw Expander Evaluation Project. Final report

    SciTech Connect

    McKay, R.

    1982-03-01

    A functional 1-MW geothermal electric power plant that featured a helical screw expander was produced and then tested in Utah in 1978 to 1979 with a demonstrated average performance of approximately 45% machine efficiency over a wide range of test conditions in noncondensing operation on two-phase geothermal fluids. The Project also produced a computer-equipped data system, an instrumentation and control van, and a 1000-kW variable load bank, all integrated into a test array designed for operation at a variety of remote test sites. Additional testing was performed in Mexico in 1980 under a cooperative test program using the same test array, and machine efficiency was measured at 62% maximum with the rotors partially coated with scale, compared with approximately 54% maximum in Utah with uncoated rotors, confirming the importance of scale deposits within the machine on performance. Data are presented for the Utah testing and for the noncondensing phases of the testing in Mexico. Test time logged was 437 hours during the Utah tests and 1101 hours during the Mexico tests.

  7. Computer Augmented Learning; A Survey.

    ERIC Educational Resources Information Center

    Kindred, J.

    The report contains a description and summary of computer augmented learning devices and systems. The devices are of two general types programed instruction systems based on the teaching machines pioneered by Pressey and developed by Skinner, and the so-called "docile" systems that permit greater user-direction with the computer under student…

  8. Augmenting a Classical Electrochemical Demonstration.

    ERIC Educational Resources Information Center

    Yochum, Susan M.; Luoma, John R.

    1995-01-01

    Presents an augmentation of a classical electrochemical demonstration that addresses the learning styles of the students and teaches electrochemistry in a concrete manner. Enables each student to see each event clearly, repeatedly, or in stop-action mode and enables students to improve their own mental models by providing them with a visually…

  9. A New Orthodontic Appliance with a Mini Screw for Upper Molar Distalization

    PubMed Central

    2016-01-01

    The aim of this study is to present a new upper molar distalization appliance called Cise distalizer designed as intraoral device supported with orthodontic mini screw for upper permanent molar distalization. The new appliance consists of eight main components. In order to understand the optimum force level, the appliance under static loading is tested by using strain gage measurement techniques. Results show that one of the open coils produces approximately 300 gr distalization force. Cise distalizer can provide totally 600 gr distalization force. This range of force level is enough for distalization of upper first and second molar teeth. PMID:27528796

  10. A New Electromagnetic Navigation System for Pedicle Screws Placement: A Human Cadaver Study at the Lumbar Spine

    PubMed Central

    Hahn, Patrick; Oezdemir, Semih; Komp, Martin; Giannakopoulos, Athanasios; Heikenfeld, Roderich; Kasch, Richard; Merk, Harry; Godolias, Georgios; Ruetten, Sebastian

    2015-01-01

    Introduction Technical developments for improving the safety and accuracy of pedicle screw placement play an increasingly important role in spine surgery. In addition to the standard techniques of free-hand placement and fluoroscopic navigation, the rate of complications is reduced by 3D fluoroscopy, cone-beam CT, intraoperative CT/MRI, and various other navigation techniques. Another important aspect that should be emphasized is the reduction of intraoperative radiation exposure for personnel and patient. The aim of this study was to investigate the accuracy of a new navigation system for the spine based on an electromagnetic field. Material and Method Twenty pedicle screws were placed in the lumbar spine of human cadavers using EMF navigation. Navigation was based on data from a preoperative thin-slice CT scan. The cadavers were positioned on a special field generator and the system was matched using a patient tracker on the spinous process. Navigation was conducted using especially developed instruments that can be tracked in the electromagnetic field. Another thin-slice CT scan was made postoperatively to assess the result. The evaluation included the position of the screws in the direction of trajectory and any injury to the surrounding cortical bone. The results were classified in 5 groups: grade 1: ideal screw position in the center of the pedicle with no cortical bone injury; grade 2: acceptable screw position, cortical bone injury with cortical penetration ≤ 2 mm; grade 3: cortical bone injury with cortical penetration 2,1-4 mm, grad 4: cortical bone injury with cortical penetration 4,1-6 mm, grade 5: cortical bone injury with cortical penetration >6 mm. Results The initial evaluation of the system showed good accuracy for the lumbar spine (65% grade 1, 20% grade 2, 15% grade 3, 0% grade 4, 0% grade 5). A comparison of the initial results with other navigation techniques in literature (CT navigation, 2D fluoroscopic navigation) shows that the accuracy of

  11. Results of cement augmentation and curettage in aneurysmal bone cyst of spine

    PubMed Central

    Basu, Saumyajit; Patel, Dharmesh R; Dhakal, Gaurav; Sarangi, T

    2016-01-01

    Aneurysmal bone cyst (ABC) is a vascular tumor of the spine. Management of spinal ABC still remains controversial because of its location, vascular nature and incidence of recurrence. In this manuscript, we hereby describe two cases of ABC spine treated by curettage, vertebral cement augmentation for control of bleeding and internal stabilization with two years followup. To the best of our knowledge, this is the first case report in the literature describing the role of cement augmentation in spinal ABC in controlling vascular bleeding in curettage of ABC of spine. Case 1: A 22 year old male patient presented with chronic back pain. On radiological investigation, there were multiple, osteolytic septite lesions at L3 vertebral body without neural compression or instability. Percutaneous transpedicular biopsy of L3 from involved pedicle was done. This was followed by cement augmentation through the uninvolved pedicle. Next, transpedicular complete curettage was done through involved pedicle. Case 2: A 15-year-old female presented with nonradiating back pain and progressive myelopathy. On radiological investigation, there was an osteolytic lesion at D9. At surgery, decompression, pedicle screw-rod fixation and posterolateral fusion from D7 to D11 was done. At D9 level, through normal pedicle cement augmentation was added to provide anterior column support and to control the expected bleeding following curettage. Transpedicular complete curettage was done through the involved pedicle with controlled bleeding at the surgical field. Cement augmentation was providing controlled bleeding at surgical field during curettage, internal stabilization and control of pain. On 2 years followup, pain was relieved and there was a stable spinal segment with well filled cement without any sign of recurrence in computed tomography scan. In selected cases of spinal ABC with single vertebral, single pedicle involvement; cement augmentation of vertebra through normal pedicle has an

  12. Results of cement augmentation and curettage in aneurysmal bone cyst of spine.

    PubMed

    Basu, Saumyajit; Patel, Dharmesh R; Dhakal, Gaurav; Sarangi, T

    2016-01-01

    Aneurysmal bone cyst (ABC) is a vascular tumor of the spine. Management of spinal ABC still remains controversial because of its location, vascular nature and incidence of recurrence. In this manuscript, we hereby describe two cases of ABC spine treated by curettage, vertebral cement augmentation for control of bleeding and internal stabilization with two years followup. To the best of our knowledge, this is the first case report in the literature describing the role of cement augmentation in spinal ABC in controlling vascular bleeding in curettage of ABC of spine. Case 1: A 22 year old male patient presented with chronic back pain. On radiological investigation, there were multiple, osteolytic septite lesions at L3 vertebral body without neural compression or instability. Percutaneous transpedicular biopsy of L3 from involved pedicle was done. This was followed by cement augmentation through the uninvolved pedicle. Next, transpedicular complete curettage was done through involved pedicle. Case 2: A 15-year-old female presented with nonradiating back pain and progressive myelopathy. On radiological investigation, there was an osteolytic lesion at D9. At surgery, decompression, pedicle screw-rod fixation and posterolateral fusion from D7 to D11 was done. At D9 level, through normal pedicle cement augmentation was added to provide anterior column support and to control the expected bleeding following curettage. Transpedicular complete curettage was done through the involved pedicle with controlled bleeding at the surgical field. Cement augmentation was providing controlled bleeding at surgical field during curettage, internal stabilization and control of pain. On 2 years followup, pain was relieved and there was a stable spinal segment with well filled cement without any sign of recurrence in computed tomography scan. In selected cases of spinal ABC with single vertebral, single pedicle involvement; cement augmentation of vertebra through normal pedicle has an

  13. Image-guided transorbital procedures with endoscopic video augmentation

    PubMed Central

    DeLisi, Michael P.; Mawn, Louise A.; Galloway, Robert L.

    2014-01-01

    Purpose: Surgical interventions to the orbital space behind the eyeball are limited to highly invasive procedures due to the confined nature of the region along with the presence of several intricate soft tissue structures. A minimally invasive approach to orbital surgery would enable several therapeutic options, particularly new treatment protocols for optic neuropathies such as glaucoma. The authors have developed an image-guided system for the purpose of navigating a thin flexible endoscope to a specified target region behind the eyeball. Navigation within the orbit is particularly challenging despite its small volume, as the presence of fat tissue occludes the endoscopic visual field while the surgeon must constantly be aware of optic nerve position. This research investigates the impact of endoscopic video augmentation to targeted image-guided navigation in a series of anthropomorphic phantom experiments. Methods: A group of 16 surgeons performed a target identification task within the orbits of four skull phantoms. The task consisted of identifying the correct target, indicated by the augmented video and the preoperative imaging frames, out of four possibilities. For each skull, one orbital intervention was performed with video augmentation, while the other was done with the standard image guidance technique, in random order. Results: The authors measured a target identification accuracy of 95.3% and 85.9% for the augmented and standard cases, respectively, with statistically significant improvement in procedure time (Z = −2.044, p = 0.041) and intraoperator mean procedure time (Z = 2.456, p = 0.014) when augmentation was used. Conclusions: Improvements in both target identification accuracy and interventional procedure time suggest that endoscopic video augmentation provides valuable additional orientation and trajectory information in an image-guided procedure. Utilization of video augmentation in transorbital interventions could further minimize

  14. Evaluation of the Effect of Fixation Angle between Polyaxial Pedicle Screw Head and Rod on the Failure of Screw-Rod Connection.

    PubMed

    Çetin, Engin; Özkaya, Mustafa; Güler, Ümit Özgür; Acaroğlu, Emre; Demir, Teyfik

    2015-01-01

    Introduction. Polyaxial screws had been only tested according to the ASTM standards (when they were perpendicularly positioned to the rod). In this study, effects of the pedicle screws angled fixation to the rod on the mechanical properties of fixation were investigated. Materials and Method. 30 vertically fixed screws and 30 screws fixed with angle were used in the study. Screws were used in three different diameters which were 6.5 mm, 7.0 mm, and 7.5 mm, in equal numbers. Axial pull-out and flexion moment tests were performed. Test results compared with each other using appropriate statistical methods. Results. In pull-out test, vertically fixed screws, in 6.5 mm and 7.0 mm diameter, had significantly higher maximum load values than angled fixed screws with the same diameters (P < 0.01). Additionally, vertically fixed screws, in all diameters, had significantly greater stiffness according to corresponding size fixed with angle (P < 0.005). Conclusion. Fixing the pedicle screw to the rod with angle significantly decreased the pull-out stiffness in all diameters. Similarly, pedicle screw instrumentation fixed with angle decreased the minimum sagittal angle between the rod and the screw in all diameters for flexion moment test but the differences were not significant. PMID:27019578

  15. Early tissue responses to zoledronate, locally delivered by bone screw, into a compromised cancellous bone site: a pilot study

    PubMed Central

    2014-01-01

    Background In fracture treatment, adequate fixation of implants is crucial to long-term clinical performance. Bisphosphonates (BP), potent inhibitors of osteoclastic bone resorption, are known to increase peri-implant bone mass and accelerate primary fixation. However, adverse effects are associated with systemic use of BPs. Thus, Zoledronic acid (ZOL) a potent BP was loaded on bone screws and evaluated in a local delivery model. Whilst mid- to long-term effects are already reported, early cellular events occurring at the implant/bone interface are not well described. The present study investigated early tissue responses to ZOL locally delivered, by bone screw, into a compromised cancellous bone site. Methods ZOL was immobilized on fibrinogen coated titanium screws. Using a bilateral approach, ZOL loaded test and non-loaded control screws were implanted into femoral condyle bone defects, created by an overdrilling technique. Histological analyses of the local tissue effects such as new bone formation and osteointegration were performed at days 1, 5 and 10. Results Histological evaluation of the five day ZOL group, demonstrated a higher osseous differentiation trend. At ten days an early influx of mesenchymal and osteoprogenitor cells was seen and a higher level of cellular proliferation and differentiation (p < 5%). In the ZOL group bone-to-screw contact and bone volume values within the defect tended to increase. Local drug release did not induce any adverse cellular effects. Conclusion This study indicates that local ZOL delivery into a compromised cancellous bone site actively supports peri-implant osteogenesis, positively affecting mesenchymal cells, at earlier time points than previously reported in the literature. PMID:24656151

  16. Intermaxillary fixation screws versus Erich arch bars in mandibular fractures: A comparative study and review of literature

    PubMed Central

    Qureshi, Ahtesham Ahmad; Reddy, Umesh K.; Warad, N. M.; Badal, Sheeraz; Jamadar, Amjad Ali; Qurishi, Nilofar

    2016-01-01

    Objective: Various techniques have been employed from time to time to achieve maxillomamdibular fixation. Although arch bars provide an effective and versatile means of maxillomandibular fixation, their use is not without shortcomings. However the introduction of intermaxillary fixation screws (IMF) has eliminated many of these issues of arch bars. The aim of the present study was to compare the advantages and disadvantages of intermaxillary fixation screws over the Erich arch bars in mandibular fractures. Materials and Methods: Sixty dentulous patients who reported to Department of Oral and Maxillofacial Surgery, Al-Ameen Dental College and Hospital, Bijapur with mandibular fractures and required intermaxillary fixation as a part of treatment plan followd by open reduction and internal fixation under GA were selected and randomly divided into 2 groups of 30 patients each that is Group A and Group B. Group A included patients who received intermaxillary fixation with Erich arch bars. Group B includes patients who received intermaxillary fixation with IMF Screws. The parameters compared in both the groups included, surgical time taken, gloves perforation, post-operative occlusion, IMF stability, oral hygiene, patient acceptance and comfort and non-vitality characteristics. Results: The average surgical time taken and gloves perforations were more in Group A,the patient acceptance and oral hygiene was better in Group B, there was not much statistically significant difference in postoperative occlusion and IMF stability in both groups. Accidental root perforation was the only limitation of IMF screws. Conclusion: Intermaxillary fixation with IMF screws is more efficacious compared to Erich arch bars in the treatment of mandibular fractures.

  17. Treatment of Displaced Sacroiliac Fracture Using the Lateral Window for Short Plate Buttress Reduction and Percutaneous Sacroiliac Screw Fixation.

    PubMed

    Murphy, Colin G; Gill, James R; Carrothers, Andrew D; Hull, Peter D

    2016-04-01

    Fractures through the sacroiliac joint are very challenging to treat, technically difficult to reduce through closed methods on account of the multiaxial displacement of fractures fragments, frequently occur in very unwell patients, and have poor outcomes if malreduction is present. We describe a technique utilising the lateral window and a short buttress plate to reduce and stabilize the fragments prior to percutaneous fixation with sacroiliac screws. PMID:27200398

  18. Treatment of Displaced Sacroiliac Fracture Using the Lateral Window for Short Plate Buttress Reduction and Percutaneous Sacroiliac Screw Fixation

    PubMed Central

    Murphy, Colin G.; Gill, James R.; Carrothers, Andrew D.; Hull, Peter D.

    2016-01-01

    Fractures through the sacroiliac joint are very challenging to treat, technically difficult to reduce through closed methods on account of the multiaxial displacement of fractures fragments, frequently occur in very unwell patients, and have poor outcomes if malreduction is present. We describe a technique utilising the lateral window and a short buttress plate to reduce and stabilize the fragments prior to percutaneous fixation with sacroiliac screws. PMID:27200398

  19. Distalization controlled with the use of lip-bumper and mini-screw as anchorage: a new approach.

    PubMed

    Mendes Júnior, Tadeu Evandro; Lima, Anderson Barbosa; Mendes, Tadeu Evandro; Mendes, Camila Vas Tostes; Rosário, Henrique Damian; Paranhos, Luiz Renato

    2015-01-01

    An increasingly number of patients with Angle Class II has been seeking orthodontic clinics to have their malocclusion treated. Herein, it is presented a new method of promote distal movements in maxillary molars with a combination of limp-bumper (LB) and mini screw. This technique was proven to be fast, practical and with low-cost, thus favoring both the professional and the patient. PMID:25881381

  20. Free biceps tendon autograft to augment arthroscopic rotator cuff repair.

    PubMed

    Obma, Padraic R

    2013-01-01

    Arthroscopic rotator cuff repairs have become the standard of treatment for all sizes of tears over the past several years. Current healing rates reported in the literature are quite good, but improving the healing potential of rotator cuff repairs remains a challenging problem. There has been an increase recently in the use of augmentation of rotator cuff repairs with xenografts or synthetics for large and massive tears. Biceps tenodesis is often indicated as part of the treatment plan while one is performing rotator cuff surgery. A subpectoral biceps tenodesis provides a source of autograft to augment rotator cuff repairs of all sizes. Two techniques are presented to augment rotator cuff repairs with a free biceps tendon autograft. This is a novel idea in an attempt to improve healing rates and long-term results of rotator cuff repairs of all sizes. PMID:24400197

  1. The augmented Lagrangian method for parameter estimation in elliptic systems

    NASA Technical Reports Server (NTRS)

    Ito, Kazufumi; Kunisch, Karl

    1990-01-01

    In this paper a new technique for the estimation of parameters in elliptic partial differential equations is developed. It is a hybrid method combining the output-least-squares and the equation error method. The new method is realized by an augmented Lagrangian formulation, and convergence as well as rate of convergence proofs are provided. Technically the critical step is the verification of a coercivity estimate of an appropriately defined Lagrangian functional. To obtain this coercivity estimate a seminorm regularization technique is used.

  2. The best location for proximal locking screw for femur interlocking nailing: A biomechanical study

    PubMed Central

    Karaarslan, Ahmet A; Karakaşli, Ahmet; Aycan, Hakan; Çeçen, Berivan; Yildiz, Didem Venüs; Sesli, Erhan

    2016-01-01

    Background: Proximal locking screw deformation and screw fracture is a frequently seen problem for femur interlocking nailing that affects fracture healing. We realized that there is lack of literature for the right level for the proximal locking screw. We investigated the difference of locking screw bending resistance between the application of screws on different proximal femoral levels. Materials and Methods: We used a total of 80 proximal locking screws for eight groups, 10 screws for each group. Three-point bending tests were performed on four types of screws in two different trochanteric levels (the lesser trochanter and 20 mm proximal). We determined the yield points at three-point bending tests that a permanent deformation started in the locking screws using an axial compression testing machine. Results: The mean yield point value of 5 mm threaded locking screws applied 20 mm proximal of lesser trochanter was 1022 ± 49 (range 986–1057) (mean ± standard deviation, 95% confidence interval). On the other hand, the mean yield point value of the same type of locking screws applied on the lesser trochanteric level was 2089 ± 249 (range 1911–2268). Which means 103% increase of screw resistance between two levels (P = 0.000). In all screw groups, on the lesser trochanter line we determined 98–174% higher than the yield point values of the same type of locking screws in comparison with 20 mm proximal to the lesser trochanter (P = 0.000). Conclusion: According to our findings, there is twice as much difference in locking screw bending resistance between these two application levels. To avoid proximal locking screw deformation, locking screws should be placed in the level of the lesser trochanter in nailing of 1/3 middle and distal femur fractures. PMID:26955183

  3. Vertical Alveolar Ridge Augmentation by Distraction Osteogenesis

    PubMed Central

    Kumar, N. Nanda; Ravindran, C.

    2015-01-01

    Introduction Compromised alveolar ridge in vertical and horizontal dimension is a common finding in patients visiting practitioners for dental prosthesis. Various treatment modalities are available for correction of deficient ridges among which alveolar distraction osteogenesis is one. Aim To study the efficacy of alveolar distraction osteogenesis in augmentation of alveolar ridges deficient in vertical dimension. Materials and Methods Ten patients aged 16 to 46 years with deficient alveolar ridge underwent ridge augmentation in 11 alveolar segments using the distraction osteogenesis method. For each patient a custom made distraction device was fabricated. The device was indigenously manufactured with SS-316 (ISO 3506). Results The vertical bone gain reached more than 10mm without the use of bone transplantation. Certain complications like incorrect vector of distraction, paresthesia, pain and loss of transport segment were encountered during the course of the study. Conclusion Alveolar vertical distraction osteogenesis is a reliable and predictable technique for both hard and soft tissue genesis. Implant placement is feasible with primary stability in neogenerated bone at the level of the distracted areas. PMID:26816991

  4. Prospects for Optogenetic Augmentation of Brain Function

    PubMed Central

    Jarvis, Sarah; Schultz, Simon R.

    2015-01-01

    The ability to optically control neural activity opens up possibilities for the restoration of normal function following neurological disorders. The temporal precision, spatial resolution, and neuronal specificity that optogenetics offers is unequalled by other available methods, so will it be suitable for not only restoring but also extending brain function? As the first demonstrations of optically “implanted” novel memories emerge, we examine the suitability of optogenetics as a technique for extending neural function. While optogenetics is an effective tool for altering neural activity, the largest impediment for optogenetics in neural augmentation is our systems level understanding of brain function. Furthermore, a number of clinical limitations currently remain as substantial hurdles for the applications proposed. While neurotechnologies for treating brain disorders and interfacing with prosthetics have advanced rapidly in the past few years, partially addressing some of these critical problems, optogenetics is not yet suitable for use in humans. Instead we conclude that for the immediate future, optogenetics is the neurological equivalent of the 3D printer: its flexibility providing an ideal tool for testing and prototyping solutions for treating brain disorders and augmenting brain function. PMID:26635547

  5. Distal Locking Screws for Intramedullary Nailing of Tibial Fractures.

    PubMed

    Agathangelidis, Filon; Petsatodis, Georgios; Kirkos, John; Papadopoulos, Pericles; Karataglis, Dimitrios; Christodoulou, Anastasios

    2016-01-01

    Recently introduced tibial intramedullary nails allow a number of distal screws to be used to reduce the incidence of malalignment and loss of fixation of distal metaphyseal fractures. However, the number of screws and the type of screw configuration to be used remains obscure. This biomechanical study was performed to address this question. Thirty-six Expert tibial nails (Synthes, Oberdorf, Switzerland) were introduced in composite bone models. The models were divided into 4 groups with different distal locking configurations ranging from 2 to 4 screws. A 7-mm gap osteotomy was performed 72 mm from the tibial plafond to simulate a 42-C3 unstable distal tibial fracture. Each group was divided in 3 subgroups and underwent nondestructive biomechanical testing in axial compression, coronal bending, and axial torsion. The passive construct stiffness was measured and statistically analyzed with one-way analysis of variance. Although some differences were noted between the stiffness of each group, these were not statistically significant in compression (P=.105), bending (P=.801), external rotation (P=.246), and internal rotation (P=.370). This in vitro study showed that, when using the Expert tibial nail for unstable distal tibial fractures, the classic configuration of 2 parallel distal screws could provide the necessary stability under partial weight-bearing conditions. PMID:26840700

  6. Screw dislocations in GaN grown by different methods

    SciTech Connect

    Liliental-Weber, Z.; Zakharov, D.; Jasinski, J.; O'Keefe, M.A.; Morkoc, H.

    2003-05-27

    A study of screw dislocations in Hydride-Vapor-Phase-Epitaxy (HVPE) template and Molecular-Beam-Epitaxy (MBE) over-layers was performed using Transmission Electron Microscopy (TEM) in plan-view and in cross-section. It was observed that screw dislocations in the HVPE layers were decorated by small voids arranged along the screw axis. However, no voids were observed along screw dislocations in MBE overlayers. This was true both for MBE samples grown under Ga-lean and Ga-rich conditions. Dislocation core structures have been studied in these samples in the plan-view configuration. These experiments were supported by image simulation using the most recent models. A direct reconstruction of the phase and amplitude of the scattered electron wave from a focal series of high-resolution images was applied. It was shown that the core structures of screw dislocations in the studied materials were filled. The filed dislocation cores in an MBE samples were stoichiometric. However, in HVPE materials, single atomic columns show substantial differences in intensities and might indicate the possibility of higher Ga concentration in the core than in the matrix. A much lower intensity of the atomic column at the tip of the void was observed. This might suggest presence of lighter elements, such as oxygen, responsible for their formation.

  7. Numerical simulation of a twin screw expander for performance prediction

    NASA Astrophysics Data System (ADS)

    Papes, Iva; Degroote, Joris; Vierendeels, Jan

    2015-08-01

    With the increasing use of twin screw expanders in waste heat recovery applications, the performance prediction of these machines plays an important role. This paper presents a mathematical model for calculating the performance of a twin screw expander. From the mass and energy conservation laws, differential equations are derived which are then solved together with the appropriate Equation of State in the instantaneous control volumes. Different flow processes that occur inside the screw expander such as filling (accompanied by a substantial pressure loss) and leakage flows through the clearances are accounted for in the model. The mathematical model employs all geometrical parameters such as chamber volume, suction and leakage areas. With R245fa as working fluid, the Aungier Redlich-Kwong Equation of State has been used in order to include real gas effects. To calculate the mass flow rates through the leakage paths formed inside the screw expander, flow coefficients are considered as constant and they are derived from 3D Computational Fluid Dynamic calculations at given working conditions and applied to all other working conditions. The outcome of the mathematical model is the P-V indicator diagram which is compared to CFD results of the same twin screw expander. Since CFD calculations require significant computational time, developed mathematical model can be used for the faster performance prediction.

  8. Treatment of scaphoid waist fractures with the HCS screw

    PubMed Central

    Gehrmann, Sebastian V.; Grassmann, Jan-Peter; Wild, Michael; Jungbluth, Pascal; Kaufmann, Robert A.; Windolf, Joachim; Hakimi, Mohssen

    2014-01-01

    The aim of the study was to evaluate the clinical results of the Headless Compression Screw (HCS, Synthes) when used for treatment of acute scaphoid waist fractures. The new screw design generates interfragmentary compression with use of a compression sleeve. Twenty-one patients were treated for acute scaphoid waist fractures type B2 with HCS screws. The average time to the final follow-up examination was 12.8 months. All 21 fractures united after a mean time of 7.2 weeks. The mean DASH score was 7.1. The average motion of the wrist in extension was 61°, flexion was 46°, radial abduction reached 25° and the ulnar abduction was 31°. The maximally achieved grip strength was 86% compared to the uninjured side. Treatment of type B2 scaphoid fractures with the Headless Compression Screw showed good functional and radiographic results. The results are similar to those identified using other screw fixation systems. PMID:26504721

  9. Endovascular aortic injury repair after thoracic pedicle screw placement.

    PubMed

    Pesenti, S; Bartoli, M A; Blondel, B; Peltier, E; Adetchessi, T; Fuentes, S

    2014-09-01

    Our objective was to describe the management and prevention of thoracic aortic injuries caused by a malposition of pedicle screws in corrective surgery of major spine deformities. Positioning pedicle screws in thoracic vertebras by posterior approach exposes to the risk of injury of the elements placed ahead of the thoracic spine, as the descending thoracic aorta. This complication can result in a cataclysmic bleeding, needing urgent vascular care, but it can also be totally asymptomatic, resulting in the long run in a pseudoaneurysm, justifying the systematic removal of the hardware. We report the case of a 76-year-old woman who underwent spinal correction surgery for thoraco-lumbar degenerative kypho-scoliosis. Immediately after the surgery, a thoracic aortic injury caused by the left T7 pedicle screw was diagnosed. The patient underwent a two-step surgery. The first step was realized by vascular surgeons and aimed to secure the aortic wall by short endovascular aortic grafting. During the second step, spine surgeons removed the responsible screw by posterior approach. The patient was discharged in a rehabilitation center 7 days after the second surgery. When such a complication occurs, a co-management by vascular and spine surgeons is necessary to avoid major complications. Endovascular management of this kind of vascular injuries permits to avoid an open surgery that have a great rate of morbi-mortality in frail patients. Nowadays, technologies exist to prevent this kind of event and may improve the security when positioning pedicle screws. PMID:25023930

  10. Placement of C1 Pedicle Screws Using Minimal Exposure: Radiographic, Clinical, and Literature Validation

    PubMed Central

    Storey, Christopher M.; Nixon, Menarvia K.C.; Haydel, Justin; Nanda, Anil; Sin, Anthony

    2015-01-01

    Background Traditional C1-2 fixation involves placement of C1 lateral mass screws. Evolving techniques have led to the placement of C1 pedicle screws to avoid exposure of the C1-C2 joint capsule. Our minimal dissection technique utilizes anatomical landmarks with isolated exposure of C2 and the inferior posterior arch of C1. We evaluate this procedure clinically and radiographically through a technical report. Methods Consecutive cases of cranial-vertebral junction surgery were reviewed for one fellowship trained spinal surgeon from 2008-2014. Information regarding sex, age, indication for surgery, private or public hospital, intra-operative complications, post-operative neurological deterioration, death, and failure of fusion was extracted. Measurement of pre-operative axial and sagittal CT scans were performed for C1 pedicle width and C1 posterior arch height respectively. Results 64 patients underwent posterior cranio-vertebral junction fixation surgery. 40 of these patients underwent occipital-cervical fusion procedures. 7/9 (77.8%) C1 instrumentation cases were from trauma with the remaining two (22.2%) from oncologic lesions. The average blood loss among isolated C1-C2 fixation was 160cc. 1/9 patients (11.1%) suffered pedicle breech requiring sub-laminar wiring at the C1 level. On radiographic measurement, the average height of the C1 posterior arch was noted at 4.3mm (range 3.8mm to 5.7mm). The average width of the C1 pedicle measured at 5.3mm (range 2.8 to 8.7mm). The patient with C1 pedicle screw failure had a pedicle width of 2.78mm on pre-operative axial CT imaging. Conclusion Our study directly adds to the literature with level four evidence supporting a minimal dissection of C1 arch in the placement of C1 pedicle screws with both radiographic and clinical validation. Clinical Relevance Justification of this technique avoids C2 nerve root manipulation or sacrifice, reduces bleeding associated with the venous plexus, and leaves the third segment of the

  11. A Biomechanical Comparison of Intralaminar C7 Screw Constructs with and without Offset Connector Used for C6-7 Cervical Spine Immobilization : A Finite Element Study

    PubMed Central

    Qasim, Muhammad; Natarajan, Raghu N.; An, Howard S.

    2013-01-01

    Objective The offset connector can allow medial and lateral variability and facilitate intralaminar screw incorporation into the construct. The aim of this study was to compare the biomechanical characteristics of C7 intralaminar screw constructs with and without offset connector using a three dimensional finite element model of a C6-7 cervical spine segment. Methods Finite element models representing C7 intralaminar screw constructs with and without the offset connector were developed. Range of motion (ROM) and maximum von Mises stresses in the vertebra for the two techniques were compared under pure moments in flexion, extension, lateral bending and axial rotation. Results ROM for intralaminar screw construct with offset connector was less than the construct without the offset connector in the three principal directions. The maximum von Misses stress was observed in the C7 vertebra around the pedicle in both constructs. Maximum von Mises stress in the construct without offset connector was found to be 12-30% higher than the corresponding stresses in the construct with offset connector in the three principal directions. Conclusion This study demonstrated that the intralaminar screw fixation with offset connector is better than the construct without offset connector in terms of biomechanical stability. Construct with the offset connector reduces the ROM of C6-7 segment more significantly compared to the construct without the offset connector and causes lower stresses around the C7 pedicle-vertebral body complex. PMID:24003366

  12. Using a guide template with a handpiece sleeve to locate the abutment screw position of a cement-retained implant restoration.

    PubMed

    Kang, Hye-Won; Lee, Du-Hyeong

    2015-09-01

    The existing techniques for drilling a screw access hole in cement-retained restorations are limited by inaccurate drill guidance and ineffective cooling of the drilling area. An approach for fabricating a guide template to provide screw retrievability using computer-aided design and computer-aided manufacturing (CAD/CAM) is described. A handpiece sleeve was made by 3-dimensional printing and incorporating it into a vacuum-formed template. The handpiece sleeve not only guides the head of the handpiece accurately but also enables the cooling water to reach the area of drilling directly. PMID:26013071

  13. Transaxillary dual-plane augmentation mammaplasty: experience with 98 breasts.

    PubMed

    Luan, Jie; Mu, Dali; Mu, Lanhua

    2009-11-01

    The dual plane technique is a popular procedure for breast augmentation. However, traditional dual-plane augmentation mammaplasty usually requires incisions through the areola or inframammary crease, which produces a scar on the breast. Therefore, women may not favour this technique, especially Chinese women who are genetically susceptible to hyperplastic scars. In our institution, endoscopic transaxillary dual-plane augmentation mammaplasty was performed in patients under general anaesthesia. Incisions (4 cm long) were designed to overlap the natural creases of the skin bilaterally behind the mid-transaxillary frontline. The space behind the pectoralis major muscle was separated conventionally. Assisted by a 10mm/30 degrees endoscope, part of the ectopectoralis was excised. Through the transaxillary incision, the rough-surfaced silicone gel breast prosthesis was implanted. The volume varied from 185 to 315 g, and a routine indwelling drainage tube was inserted. From March 2006 to May 2007, we performed 49 cases of augmentation mammaplasty applying endoscopic-assisted dual-plane technique. At 6- to 12-month follow up, the surgical outcomes were satisfactory. There were no complications, such as capsular contracture, bleeding, scar hyperplasia, or infection. We believe that the dual-plane augmentation mammaplasty can be performed via transaxillary incision using an endoscope. Since the surgical incision is far from the front of the breast with this method, no scarring of the breast develops. Furthermore, the adoption of the dual-plane technique provides superior form to the anatomical prosthesis in the breast, alleviates postoperative pain, and improves suppleness of the postoperative breast. PMID:18838324

  14. Augmented reality building operations tool

    DOEpatents

    Brackney, Larry J.

    2014-09-09

    A method (700) for providing an augmented reality operations tool to a mobile client (642) positioned in a building (604). The method (700) includes, with a server (660), receiving (720) from the client (642) an augmented reality request for building system equipment (612) managed by an energy management system (EMS) (620). The method (700) includes transmitting (740) a data request for the equipment (612) to the EMS (620) and receiving (750) building management data (634) for the equipment (612). The method (700) includes generating (760) an overlay (656) with an object created based on the building management data (634), which may be sensor data, diagnostic procedures, or the like. The overlay (656) is configured for concurrent display on a display screen (652) of the client (642) with a real-time image of the building equipment (612). The method (700) includes transmitting (770) the overlay (656) to the client (642).

  15. Effective Augmentation of Complex Networks

    NASA Astrophysics Data System (ADS)

    Wang, Jinjian; Yu, Xinghuo; Stone, Lewi

    2016-05-01

    Networks science plays an enormous role in many aspects of modern society from distributing electrical power across nations to spreading information and social networking amongst global populations. While modern networks constantly change in size, few studies have sought methods for the difficult task of optimising this growth. Here we study theoretical requirements for augmenting networks by adding source or sink nodes, without requiring additional driver-nodes to accommodate the change i.e., conserving structural controllability. Our “effective augmentation” algorithm takes advantage of clusters intrinsic to the network topology, and permits rapidly and efficient augmentation of a large number of nodes in one time-step. “Effective augmentation” is shown to work successfully on a wide range of model and real networks. The method has numerous applications (e.g. study of biological, social, power and technological networks) and potentially of significant practical and economic value.

  16. Effective Augmentation of Complex Networks

    PubMed Central

    Wang, Jinjian; Yu, Xinghuo; Stone, Lewi

    2016-01-01

    Networks science plays an enormous role in many aspects of modern society from distributing electrical power across nations to spreading information and social networking amongst global populations. While modern networks constantly change in size, few studies have sought methods for the difficult task of optimising this growth. Here we study theoretical requirements for augmenting networks by adding source or sink nodes, without requiring additional driver-nodes to accommodate the change i.e., conserving structural controllability. Our “effective augmentation” algorithm takes advantage of clusters intrinsic to the network topology, and permits rapidly and efficient augmentation of a large number of nodes in one time-step. “Effective augmentation” is shown to work successfully on a wide range of model and real networks. The method has numerous applications (e.g. study of biological, social, power and technological networks) and potentially of significant practical and economic value. PMID:27165120

  17. Media-Augmented Exercise Machines

    NASA Astrophysics Data System (ADS)

    Krueger, T.

    2002-01-01

    Cardio-vascular exercise has been used to mitigate the muscle and cardiac atrophy associated with adaptation to micro-gravity environments. Several hours per day may be required. In confined spaces and long duration missions this kind of exercise is inevitably repetitive and rapidly becomes uninteresting. At the same time, there are pressures to accomplish as much as possible given the cost- per-hour for humans occupying orbiting or interplanetary. Media augmentation provides a the means to overlap activities in time by supplementing the exercise with social, recreational, training or collaborative activities and thereby reducing time pressures. In addition, the machine functions as an interface to a wide range of digital environments allowing for spatial variety in an otherwise confined environment. We hypothesize that the adoption of media augmented exercise machines will have a positive effect on psycho-social well-being on long duration missions. By organizing and supplementing exercise machines, data acquisition hardware, computers and displays into an interacting system this proposal increases functionality with limited additional mass. This paper reviews preliminary work on a project to augment exercise equipment in a manner that addresses these issues and at the same time opens possibilities for additional benefits. A testbed augmented exercise machine uses a specialty built cycle trainer as both input to a virtual environment and as an output device from it using spatialized sound, and visual displays, vibration transducers and variable resistance. The resulting interactivity increases a sense of engagement in the exercise, provides a rich experience of the digital environments. Activities in the virtual environment and accompanying physiological and psychological indicators may be correlated to track and evaluate the health of the crew.

  18. TDRSS Augmentation System for Satellites

    NASA Technical Reports Server (NTRS)

    Heckler, Gregory W.; Gramling, Cheryl; Valdez, Jennifer; Baldwin, Philip

    2016-01-01

    In 2015, NASA Goddard Space Flight Center (GSFC) reinvigorated the development of the TDRSS Augmentation Service for Satellites (TASS). TASS is a global, space-based, communications and navigation service for users of Global Navigation Satellite Systems(GNSS) and the Tracking and Data Relay Satellite System (TDRSS). TASS leverages the existing TDRSS to provide an S-band beacon radio navigation and messaging source to users at orbital altitudes 1400 km and below.

  19. Optically driven Archimedes micro-screws for micropump application.

    PubMed

    Lin, Chih-Lang; Vitrant, Guy; Bouriau, Michel; Casalegno, Roger; Baldeck, Patrice L

    2011-04-25

    Archimedes micro-screws have been fabricated by three-dimensional two-photon polymerization using a Nd:YAG Q-switched microchip laser at 532nm. Due to their small sizes they can be easily manipulated, and made to rotate using low power optical tweezers. Rotation rates up to 40 Hz are obtained with a laser power of 200 mW, i.e. 0.2 Hz/mW. A photo-driven micropump action in a microfluidic channel is demonstrated with a non-optimized flow rate of 6 pL/min. The optofluidic properties of such type of Archimedes micro-screws are quantitatively described by the conservation of momentum that occurs when the laser photons are reflected on the helical micro-screw surface. PMID:21643076

  20. C2 Pedicle Screw Placement: A Novel Teaching Aid

    PubMed Central

    Moisi, Marc; Chapman, Jens; Oskouian, Rod J; Tubbs, R. Shane

    2016-01-01

    The C2 pedicle screw is more biomechanically stable and provides patients with increased postoperative range of motion in comparison to other methods of C2 fixation. However, as a result of the proximity of the C2 pedicle to the transverse foramen, there is a considerable risk of intraoperative morbidity due to vertebral artery injury laterally or vertebral canal breach medially. Other than the use of cadavers for the demonstration and practice of C2 pedicle screw placement, there are currently few other readily available teaching aids for the training of residents and fellows. Herein, we describe a simple and cost effective modality for the demonstration, evaluation, and practice of C2 pedicle screw placement in a laboratory setting. PMID:27433409

  1. Experimental determination of bone cortex holding power of orthopedic screw.

    PubMed

    Bolliger Neto, R; Rossi, J D; Leivas, T P

    1999-01-01

    Cylindrical specimens of bone measuring 15 mm in diameter were obtained from the lateral cortical layer of 10 pairs of femurs and tibias. A central hole 3.2 mm in diameter was drilled in each specimen. The hole was tapped, and a 4.5 mm cortical bone screw was inserted from the outer surface. The montage was submitted to push-out testing up to a complete strip of the bone threads. The cortical thickness and rupture load were measured, and the shear stress was calculated. The results were grouped according to the bone segment from which the specimen was obtained. The results showed that bone cortex screw holding power is dependent on the bone site. Additionally, the diaphyseal cortical bone tissue is both quantitatively and qualitatively more resistant to screw extraction than the metaphyseal tissue. PMID:10881065

  2. Efficiency study of oil cooling of a screw compressor

    SciTech Connect

    Tree, D.R.; McKellar, M.G.

    1989-04-01

    One of the major goals of all compressor manufacturers is to build as efficient a compressor as possible. Over the last several years improvements to the design of screw compressors has made them efficiently competitive with other types of compressors, especially at large loads. The primary purpose of this research is to investigate four different methods of cooling a 250 horsepower compressor and determine their effects on the efficiency of the compressor. Two conventional methods, liquid injection and thermosyphon cooling, and two new methods, V-PLUS and Fresco oil injection, are investigated. The screw compressor used in the tests was a VRS-500 screw compressor made by the Vilter Manufacturing Corporation. 6 figs.

  3. Aesthetic occiput augmentation using methylmethacrylate.

    PubMed

    Song, Yong Tai

    2015-01-01

    Cranioplasty for only aesthetic reasons has not been commonly performed to date. However, recently there has been a new focus by the public on a more aesthetically pleasing head shape with frequent patient requests for purely aesthetic contouring of the occiput, an important definer of cosmetic head shape. For example, in Asia, where the normal cranial shape is mesocephalic or brachycephalic and often with a planar occiput, requests for its aesthetic correction are increasingly common. Accordingly, the author developed a minimally invasive occiput augmentation using methylmethacrylate. In this study, the indications for aesthetic occiput contouring were planar occiput, left-right asymmetric occiput, and grooved occiput. Under local anesthesia, soft methylmethacrylate is subperiosteally inserted through a small incision (about 5-cm length), manually and precisely contoured in situ through the scalp to the desired occipital shape. All is performed as an outpatient procedure, and a quick recovery is the case. Between March 2007 and October 2013, 959 patients received such aesthetic occiput augmentation. The mean follow-up period was 49 months (range, 3-84 months). Nearly all patients were satisfied with the outcome, and complications were very rare. Only 5 patients (0.5%) needed additional corrective procedures. The author has concluded that aesthetic occiput augmentation using methylmethacrylate yields consistent, predictable, and satisfactory results. Additional long-term follow-up is required for a final conclusion, however. PMID:25569386

  4. Accuracy of Percutaneous Lumbosacral Pedicle Screw Placement Using the Oblique Fluoroscopic View Based on Computed Tomography Evaluations

    PubMed Central

    Sato, Koji; Kanemura, Tokumi; Iwase, Toshiki; Togawa, Daisuke; Matsuyama, Yukihiro

    2016-01-01

    Study Design Retrospective. Purpose This study aims to investigate the accuracy of the oblique fluoroscopic view, based on preoperative computed tomography (CT) images for accurate placement of lumbosacral percutaneous pedicle screws (PPS). Overview of Literature Although PPS misplacement has been reported as one of the main complications in minimally invasive spine surgery, there is no comparative data on the misplacement rate among different fluoroscopic techniques, or comparing such techniques with open procedures. Methods We retrospectively selected 230 consecutive patients who underwent posterior spinal fusion with a pedicle screw construct for degenerative lumbar disease, and divided them into 3 groups, those who had undergone: minimally invasive percutaneous procedure using biplane (lateral and anterior-posterior views using a single C-arm) fluoroscope views (group M-1), minimally invasive percutaneous procedure using the oblique fluoroscopic view based on preoperative CT (group M-2), and conventional open procedure using a lateral fluoroscopic view (group O: controls). The relative position of the screw to the pedicle was graded for the pedicle breach as no breach, <2 mm, 2–4 mm, or >4 mm. Inaccuracy was calculated and assessed according to the spinal level, direction and neurological deficit. Inter-group radiation exposure was estimated using fluoroscopy time. Results Inaccuracy involved an incline toward L5, causing medial or lateral perforation of pedicles in group M-1, but it was distributed relatively equally throughout multiple levels in groups M-2 and controls. The mean fluoroscopy time/case ranged from 1.6 to 3.9 minutes. Conclusions Minimally invasive lumbosacral PPS placement using the conventional fluoroscopic technique carries an increased risk of inaccurate screw placement and resultant neurological deficits, compared with that of the open procedure. Inaccuracy tended to be distributed between medial and lateral perforations of the L5 pedicle

  5. Biomechanical and Histological Evaluation of Roughened Surface Titanium Screws Fabricated by Electron Beam Melting

    PubMed Central

    Yang, Jun; Cai, Hong; Lv, Jia; Zhang, Ke; Leng, Huijie; Wang, Zhiguo; Liu, Zhongjun

    2014-01-01

    Background Various fabrication methods are used to improve the stability and osseointegration of screws within the host bone. The aim of this study was to investigate whether roughened surface titanium screws fabricated by electron beam melting can provide better stability and osseointegration as compared with smooth titanium screws in sheep cervical vertebrae. Methods Roughened surface titanium screws, fabricated by electron beam melting, and conventional smooth surface titanium screws were implanted into sheep for 6 or 12 weeks (groups A and B, respectively). Bone ingrowth and implant stability were assessed with three-dimensional imaging and reconstruction, as well as histological and biomechanical tests. Results No screws in either group showed signs of loosening. Fibrous tissue formation could be seen around the screws at 6 weeks, which was replaced with bone at 12 weeks. Bone volume/total volume, bone surface area/bone volume, and the trabecular number were significantly higher for a define region of interest surrounding the roughened screws than that surrounding the smooth screws at 12 weeks. Indeed, for roughened screws, trabecular number was significantly higher at 12 weeks than at 6 weeks. On mechanical testing, the maximum pullout strength was significantly higher at 12 weeks than at 6 weeks, as expected; however, no significant differences were found between smooth and roughened screws at either time point. The maximum torque to extract the roughened screws was higher than that required for the smooth screws. Conclusions Electron beam melting is a simple and effective method for producing a roughened surface on titanium screws. After 12 weeks, roughened titanium screws demonstrated a high degree of osseointegration and increased torsional resistance to extraction over smooth titanium screws. PMID:24788866

  6. Bending strength and holding power of tibial locking screws.

    PubMed

    Lin, J; Lin, S J; Chiang, H; Hou, S M

    2001-04-01

    The bending strength and holding power of two types of specially designed tibial locking devices, a both-ends-threaded screw and an unthreaded bolt, were studied and compared with four types of commercially available tibial interlocking screws: Synthes, Howmedica, Richards, and Osteo AG. To test bending strength, the devices were inserted into a high molecular weight polyethylene tube and loaded at their midpoint by a materials testing machine to simulate a three point bending test. Single loading yielding strength and cyclic loading fatigue life were measured. To test holding power, the devices were inserted into tubes made of polyurethane foam, and their tips were loaded axially to measure pushout strength. The devices were tested with two different densities of foam materials and two different sizes of pilot holes. Insertion torque and stripping torque of the screws were measured first. Pushout tests were performed with each screw inserted with a tightness equal to 60% of its stripping torque. Test results showed that the yielding strength and the fatigue life were related closely to the inner diameter of the screws. The stripping torque predicted the pushout strength more reliably than did the insertion torque. All tested devices showed greater holding power in the foam with the higher density and with the smaller pilot holes. The both-ends-threaded screw had the highest pushout strength and a satisfactory fatigue strength. The unthreaded bolt had the highest fatigue strength but only fair holding power. Clinical studies of the use of these two types of locking devices are worthwhile. PMID:11302315

  7. Temporal Coherence Strategies for Augmented Reality Labeling.

    PubMed

    Madsen, Jacob Boesen; Tatzqern, Markus; Madsen, Claus B; Schmalstieg, Dieter; Kalkofen, Denis

    2016-04-01

    Temporal coherence of annotations is an important factor in augmented reality user interfaces and for information visualization. In this paper, we empirically evaluate four different techniques for annotation. Based on these findings, we follow up with subjective evaluations in a second experiment. Results show that presenting annotations in object space or image space leads to a significant difference in task performance. Furthermore, there is a significant interaction between rendering space and update frequency of annotations. Participants improve significantly in locating annotations, when annotations are presented in object space, and view management update rate is limited. In a follow-up experiment, participants appear to be more satisfied with limited update rate in comparison to a continuous update rate of the view management system. PMID:26780810

  8. Augmented Shock Wave Severance of Materials

    NASA Technical Reports Server (NTRS)

    Bement, Laurence J.; Schimmel, Morry L.

    1995-01-01

    This paper describes a new approach for severing or weakening a variety of materials. The technique employs embedding explosive cords into parallel grooves that are cut into a surface of a material. The cords are initiated simultaneously to produce shock waves that progress toward the centerline between the cords and the lower surface of the material. Intersecting incident and reflected waves augment at the centerline to fail or weaken the material in tension. No harmful debris is produced on the opposite side of the material from the explosive cords. The primary focus of the effort described in this paper was to fracture the F-16 aircraft trilaminate canopy. Also, complete severance was achieved in 2024-T4 aluminum plate stock. Possible applications are through canopy egress and crew module severance from military aircraft and separation of rocket vehicle stages and payloads. This approach offers important advantages over explosive methods currently in use.

  9. Effect of cement washout on loosening of abutment screws and vice versa in screw- and cement- retained implant-supported dental prosthesis

    PubMed Central

    Kim, Seok-Gyu; Son, Mee-Kyoung

    2015-01-01

    PURPOSE The purpose of this study was to examine the abutment screw stability of screw- and cement-retained implant-supported dental prosthesis (SCP) after simulated cement washout as well as the stability of SCP cements after complete loosening of abutment screws. MATERIALS AND METHODS Thirty-six titanium CAD/CAM-made implant prostheses were fabricated on two implants placed in the resin models. Each prosthesis is a two-unit SCP: one screw-retained and the other cemented. After evaluating the passive fit of each prosthesis, all implant prostheses were randomly divided into 3 groups: screwed and cemented SCP (Control), screwed and noncemented SCP (Group 1), unscrewed and cemented SCP (Group 2). Each prosthesis in Control and Group 1 was screwed and/or cemented, and the preloading reverse torque value (RTV) was evaluated. SCP in Group 2 was screwed and cemented, and then unscrewed (RTV=0) after the cement was set. After cyclic loading was applied, the postloading RTV was measured. RTV loss and decementation ratios were calculated for statistical analysis. RESULTS There was no significant difference in RTV loss ratio between Control and Group 1 (P=.16). No decemented prosthesis was found among Control and Group 2. CONCLUSION Within the limits of this in vitro study, the stabilities of SCP abutment screws and cement were not significantly changed after simulated cement washout or screw loosening. PMID:26140172

  10. CT-Guided Transfacet Pedicle Screw Fixation in Facet Joint Syndrome: A Novel Approach

    PubMed Central

    Manfré, Luigi

    2014-01-01

    Summary Axial microinstability secondary to disc degeneration and consequent chronic facet joint syndrome (CFJS) is a well-known pathological entity, usually responsible for low back pain (LBP). Although posterior lumbar fixation (PIF) has been widely used for lumbar spine instability and LBP, complications related to wrong screw introduction, perineural scars and extensive muscle dissection leading to muscle dysfunction have been described. Radiofrequency ablation (RFA) of facet joints zygapophyseal nerves conventionally used for pain treatment fails in approximately 21% of patients. We investigated a “covert-surgery” minimal invasive technique to treat local spinal instability and LBP, using a novel fully CT-guided approach in patients with axial instability complicated by CFJS resistant to radioablation, by introducing direct fully or partially threaded transfacet screws (transfacet fixation - TFF), to acquire solid arthrodesis, reducing instability and LBP. The CT-guided procedure was well tolerated by all patients in simple analogue sedation, and mean operative time was approximately 45 minutes. All eight patients treated underwent clinical and CT study follow-up at two months, revealing LBP disappearance in six patients, and a significant reduction of lumbar pain in two. In conclusion, CT-guided TFF is a fast and safe technique when facet posterior fixation is needed. PMID:25363265

  11. New Screw Design for Securing Buried Distractors Usefulness and Ease of Removal.

    PubMed

    Fariña, Rodrigo; Hinojosa, Andrés; Sánchez, Martín; Olate, Sergio

    2015-07-01

    There are 2 types of distraction devices for mandibular distraction: buried and external. The advantage of buried devices is the stability, but the difficulty in removing the screws is the greatest disadvantage. To resolve this problem, an osteosynthesis screw (Fariña Screw) has been designed, which greatly facilitates its removal when buried distractors are used. PMID:26102540

  12. Acrylic resin guide for locating the abutment screw access channel of cement-retained implant prostheses.

    PubMed

    Ahmed, Ayman; Maroulakos, Georgios; Garaicoa, Jorge

    2016-05-01

    Abutment screw loosening represents a common and challenging technical complication of cement-retained implant prostheses. This article describes the fabrication of a simple and accurate poly(methyl methacrylate) guide for identifying the location and angulation of the abutment screw access channel of a cement-retained implant prosthesis with a loosened abutment screw. PMID:26794698

  13. Angled Screw Channel: An Alternative to Cemented Single-Implant Restorations--Three Clinical Examples.

    PubMed

    Gjelvold, Björn; Sohrabi, Majid Melvin; Chrcanovic, Bruno Ramos

    2016-01-01

    This article presents three cases of single labially tilted implants restored with screw-retained single crowns. Individualized abutments with an angled screw channel were used to avoid an unesthetic vestibular access channel. This individualized abutment allows the dentist and dental technician to use the screw-retained restorations where a cemented reconstruction would otherwise have been needed. PMID:26757334

  14. Fracture resistance of abutment screws made of titanium, polyetheretherketone, and carbon fiber-reinforced polyetheretherketone.

    PubMed

    Neumann, Eduardo Aloisio Fleck; Villar, Cristina Cunha; França, Fabiana Mantovani Gomes

    2014-01-01

    Fractured abutment screws may be replaced; however, sometimes, the screw cannot be removed and the entire implant must be surgically removed and replaced. The aim of this study was to compare the fracture resistance of abutment retention screws made of titanium, polyetheretherketone (PEEK) and 30% carbon fiber-reinforced PEEK, using an external hexagonal implant/UCLA-type abutment interface assembly. UCLA-type abutments were fixed to implants using titanium screws (Group 1), polyetheretherketone (PEEK) screws (Group 2), and 30% carbon fiber-reinforced PEEK screws (Group 3). The assemblies were placed on a stainless steel holding apparatus to allow for loading at 45o off-axis, in a universal testing machine. A 200 N load (static load) was applied at the central point of the abutment extremity, at a crosshead speed of 5 mm/minute, until failure. Data was analyzed by ANOVA and Tukey's range test. The titanium screws had higher fracture resistance, compared with PEEK and 30% carbon fiber-reinforced PEEK screws (p < 0.05). In contrast, no statistically significant difference was observed between the fracture resistance of the PEEK and the 30% carbon fiber-reinforced PEEK screws (p> 0.05). Finally, visual analysis of the fractions revealed that 100% of them occurred at the neck of the abutment screw, suggesting that this is the weakest point of this unit. PEEK abutment screws have lower fracture resistance, in comparison with titanium abutment screws. PMID:25098826

  15. Posterior cervical spine arthrodesis with laminar screws: a report of two cases.

    PubMed

    Nakanishi, Kazuo; Tanaka, Masato; Sugimoto, Yoshihisa; Ozaki, Toshifumi

    2007-04-01

    We performed fixation using laminar screws in 2 patients in whom lateral mass screws, pedicle screws or transarticular screws could not be inserted. One was a 56-year-old woman who had anterior atlantoaxial subluxation (AAS). When a guide wire was inserted using an imaging guide, the hole bled massively. We thought the re-insertion of a guide wire or screw would thus increase the risk of vascular injury, so we used laminar screws. The other case was an 18-year-old man who had a hangman fracture. Preoperative magnetic resonance angiography showed occlusion of the left vertebral artery. A laminar screw was inserted into the patent side (i.e., the right side of C2). Cervical pedicle screws are the most biomechanically stable screws. However, their use carries a high risk of neurovascular complications during screw insertion, because the cervical pedicle is small and is adjacent laterally to the vertebral artery, medially to the spinal cord, and vertically to the nerve roots. Lateral mass screws are also reported to involve a risk of neurovascular injuries. The laminar screw method was thus thought to be useful, since arterial injuries could thus be avoided and it could also be used as a salvage modality for the previous misinsertion. PMID:17471313

  16. The Use of Percutaneous Lumbar Fixation Screws for Bilateral Pedicle Fractures with an Associated Dislocation of a Lumbar Disc Prosthesis

    PubMed Central

    Harrison, William D.; Harrison, David J.

    2013-01-01

    Study Design. Case report. Objective. To identify a safe technique for salvage surgery following complications of total disc replacement. Summary of Background Data. Lumbar total disc replacement (TDR) is considered by some as the gold standard for discogenic back pain. Revision techniques for TDR and their complications are in their infancy. This case describes a successful method of fixation for this complex presentation. Methods and Results. A 48-year-old male with lumbar degenerative disc disease and no comorbidities. Approximately two weeks postoperatively for a TDR, the patient represented with acute severe back pain and the TDR polyethylene inlay was identified as dislocated anteriorly. Subsequent revision surgery failed immediately as the polyethylene inlay redislocated intraoperatively. Further radiology identified bilateral pedicle fractures, previously unseen on the plain films. The salvage fusion of L5/S1 reutilized the anterior approach with an interbody fusion cage and bone graft. The patient was then turned intraoperatively and redraped. The percutaneous pedicle screws were used to fix L5 to the sacral body via the paracoccygeal corridor. Conclusion. The robust locking screw in the percutaneous screw allowed a complete fixation of the pedicle fractures. At 3-year followup, the patient has an excellent result and has returned to playing golf. PMID:24294533

  17. Rotational Stability of Scaphoid Osteosyntheses: An In Vitro Comparison of Small Fragment Cannulated Screws to Novel Bone Screw Sets

    PubMed Central

    Erhart, Jochen; Unger, Ewald; Schefzig, Philip; Varga, Peter; Trulson, Inga; Gormasz, Anna; Trulson, Alexander; Reschl, Martin; Hagmann, Michael; Vecsei, Vilmos; Mayr, Winfried

    2016-01-01

    Background The current standard of care for operative repair of scaphoid fractures involves reduction and internal fixation with a single headless compression screw. However, a compression screw in isolation does not necessarily control rotational stability at a fracture or nonunion site. The single screw provides rotational control through friction and bone interdigitation from compression at the fracture site. We hypothesize that osteosyntheses with novel bone screw sets (BSS) equipped with anti-rotational elements provide improved rotational stability. Methods Stability of osteosynthesis under increasing cyclic torsional loading was investigated on osteotomized cadaveric scaphoids. Two novel prototype BSS, oblique type (BSS-obl.) and longitudinal type (BSS-long.) were compared to three conventional screws: Acutrak2®mini, HCS®3.0 and Twinfix®. Biomechanical tests were performed on scaphoids from single donors in paired comparison and analyzed by balanced incomplete random block design. Loading was increased by 50 mNm increments with 1,000 cycles per torque level and repeated until a rotational clearance of 10°. Primary outcome measure was the number of cycles to 10° clearance, secondary outcome measure was the maximum rotational clearance for each torque level. Findings BSS-obl. performed significantly better than Acutrak2®mini and HCS® (p = 0.015, p<0.0001). BSS-long. performed significantly better than HCS® (p = 0.010). No significant difference in performance between BSS-obl. and BSS-long. (p = 0.361), between BSS obl. and Twinfix® (p = 0.50) and BSS long. and Twinfix® (p = 0.667) was detected. Within the torque range up to 200 mNm, four of 21 (19%) BSS-long. and four of 21 (19%) BSS-obl. preparations showed early failure. The same loading led to early failure in four (29%) Twinfix®, seven (50%) Acutrak2®mini and 10 (71%) HCS® of 14 screw samples, respectively. Conclusions For both BSS and to a lesser extent for Twinfix® (as dual-component screw

  18. Screw fixation of medial malleolar fractures: a cadaveric biomechanical study challenging the current AO philosophy.

    PubMed

    Parker, L; Garlick, N; McCarthy, I; Grechenig, S; Grechenig, W; Smitham, P

    2013-12-01

    The AO Foundation advocates the use of partially threaded lag screws in the fixation of fractures of the medial malleolus. However, their threads often bypass the radiodense physeal scar of the distal tibia, possibly failing to obtain more secure purchase and better compression of the fracture. We therefore hypothesised that the partially threaded screws commonly used to fix a medial malleolar fracture often provide suboptimal compression as a result of bypassing the physeal scar, and proposed that better compression of the fracture may be achieved with shorter partially threaded screws or fully threaded screws whose threads engage the physeal scar. We analysed compression at the fracture site in human cadaver medial malleoli treated with either 30 mm or 45 mm long partially threaded screws or 45 mm fully threaded screws. The median compression at the fracture site achieved with 30 mm partially threaded screws (0.95 kg/cm(2) (interquartile range (IQR) 0.8 to 1.2) and 45 mm fully threaded screws (1.0 kg/cm(2) (IQR 0.7 to 2.8)) was significantly higher than that achieved with 45 mm partially threaded screws (0.6 kg/cm(2) (IQR 0.2 to 0.9)) (p = 0.04 and p < 0.001, respectively). The fully threaded screws and the 30mm partially threaded screws were seen to engage the physeal scar under an image intensifier in each case. The results support the use of 30 mm partially threaded or 45 mm fully threaded screws that engage the physeal scar rather than longer partially threaded screws that do not. A 45 mm fully threaded screw may in practice offer additional benefit over 30 mm partially threaded screws in increasing the thread count in the denser paraphyseal region. PMID:24293597

  19. Webizing mobile augmented reality content

    NASA Astrophysics Data System (ADS)

    Ahn, Sangchul; Ko, Heedong; Yoo, Byounghyun

    2014-01-01

    This paper presents a content structure for building mobile augmented reality (AR) applications in HTML5 to achieve a clean separation of the mobile AR content and the application logic for scaling as on the Web. We propose that the content structure contains the physical world as well as virtual assets for mobile AR applications as document object model (DOM) elements and that their behaviour and user interactions are controlled through DOM events by representing objects and places with a uniform resource identifier. Our content structure enables mobile AR applications to be seamlessly developed as normal HTML documents under the current Web eco-system.

  20. Damage detection in nonlinear systems using multiple system augmentations and matrix updating

    NASA Astrophysics Data System (ADS)

    D'Souza, Kiran; Epureanu, Bogdan I.

    2006-03-01

    Recently, a damage detection method for nonlinear systems using model updating has been developed by the authors. The method uses an augmented linear model of the system, which is determined from the functional form of the nonlinearities and a nonlinear discrete model of the system. The modal properties of the augmented system after the onset of damage are extracted from the system using a modal analysis technique that uses known but not prescribed forcing. Minimum Rank Perturbation Theory was generalized so that damage location and extent could be determined using the augmented modal properties. The method was demonstrated previously for cubic springs and Coulomb friction nonlinearities. In this work, the methodology is extended to handle large systems where only the first few of the augmented eigenvectors are known. The methodology capitalizes on the ability to create multiple augmentations for a single nonlinear system. Cubic spring nonlinearities are explored within a nonlinear 3-bay truss structure for various damage scenarios simulated numerically.