{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T19:36:36Z","timestamp":1740166596890,"version":"3.37.3"},"reference-count":40,"publisher":"Georg Thieme Verlag KG","issue":"01","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Neurol Surg A Cent Eur Neurosurg"],"published-print":{"date-parts":[[2023,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Background and Study Object\u2003Pedicle screw fixation has been widely used in surgical treatment for infective lumbar spondylodiskitis to prevent instability and deformity. The cortical bone trajectory pedicle screw (CBTPS) fixation is a minimally invasive posterior spinal fixation system that runs from the pedicle's entry point of the caudiomedial region toward the cephalad-divergent direction. Successful results with CBTPS fixation have been reported to treat degenerative and osteoporotic spinal diseases. This study aims to investigate the clinical feasibility of CBTPS in the surgical treatment of pyogenic lumbar spondylodiskitis.<\/jats:p><jats:p>\n          Patient and Methods\u2003We retrospectively retrieved 20 consecutive patients from two academic centers who were surgically treated for monosegmental lumbar pyogenic spondylodiskitis. The primary surgical treatment was the anterior lumbar interbody fusion with decompression, debridement, and reconstruction using an autogenous iliac strut bone graft. One to 2 weeks after the primary surgery, patients underwent a second surgery for posterior instrumentation using conventional pedicle screws (CPS; group I) and CBTPS (group II). Radiographic parameters of the deformity angle at the fusion segment and clinical parameter of visual analog scale (VAS) scores were assessed preoperatively, postoperatively, and at the last follow-up.<\/jats:p><jats:p>\n          Results\u2003There were 10 patients in each group. The mean follow-up periods of groups I and II were 51.10\u2009\u00b1\u20096.95 and 28.60\u2009\u00b1\u20099.31 months, respectively. Intergroup analysis indicated the two groups area age-matched (p\u2009=\u20090.38), but initial C-reactive protein (CRP; mg\/dL, p\u2009=\u20090.04), CRP normalization (months, p\u2009=\u20090.00), and follow-up duration (months, p\u2009=\u20090.00) were heterogeneous. Meanwhile, deformity angles (segmental lordosis) between the two groups were not significantly different preoperatively (p\u2009=\u20090.25), postoperatively (p\u2009=\u20090.13), and at last follow-up (p\u2009=\u20090.38). The intragroup analysis indicated a significant postoperative increase of lordosis in both group I and II (p\u2009=\u20090.00 and 0.04, respectively) with subsequent subsidence. Lordosis remained increased at the last follow-up with or without significance (group I, p\u2009=\u20090.02; group II, p\u2009=\u20090.62). Both groups showed significant improvement in VAS scores (group I, p\u2009=\u20090.00; group II, p\u2009=\u20090.00).<\/jats:p><jats:p>\n          Conclusion\u2003In monosegmental lumbar spondylodiskitis, posterior stabilization of the anterior strut bone graft by CBTPS and CPS was comparable via the radiographic parameter of segmental lordosis or deformity angle. Our observation suggests the clinical feasibility of CBTPS in the treatment of relatively mild monosegmental pyogenic lumbar spondylodiskitis.<\/jats:p>","DOI":"10.1055\/s-0041-1739211","type":"journal-article","created":{"date-parts":[[2021,12,12]],"date-time":"2021-12-12T23:33:30Z","timestamp":1639352010000},"page":"37-43","source":"Crossref","is-referenced-by-count":0,"title":["Cortical Bone Trajectory Pedicle Screw Fixation in Surgical Treatment of Monosegmental Pyogenic Lumbar Spondylodiskitis"],"prefix":"10.1055","volume":"84","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6344-0714","authenticated-orcid":false,"given":"Jae-Hyuk","family":"Shin","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sang-II","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jiyoung","family":"Jung","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kee-Won","family":"Rhyu","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2021,12,12]]},"reference":[{"issue":"02","key":"ref1","doi-asserted-by":"crossref","first-page":"265","DOI":"10.1093\/clinids\/9.2.265","article-title":"Update on spinal epidural abscess: 35 cases and review of the literature","volume":"9","author":"R L Danner","year":"1987","journal-title":"Rev Infect Dis"},{"issue":"01","key":"ref2","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1016\/S0033-8389(05)70266-9","article-title":"Imaging of spinal infection","volume":"39","author":"A St\u00e4bler","year":"2001","journal-title":"Radiol Clin North Am"},{"issue":"06","key":"ref3","doi-asserted-by":"crossref","first-page":"1066","DOI":"10.1007\/s003300050793","article-title":"Spinal infection","volume":"9","author":"P N Tyrrell","year":"1999","journal-title":"Eur Radiol"},{"issue":"17","key":"ref4","doi-asserted-by":"crossref","first-page":"1856","DOI":"10.1097\/BRS.0b013e318108b804","article-title":"The fate of anterior autogenous bone graft after anterior radical surgery with or without posterior instrumentation in the treatment of pyogenic lumbar spondylodiscitis","volume":"32","author":"K Y Ha","year":"2007","journal-title":"Spine"},{"issue":"05","key":"ref5","doi-asserted-by":"crossref","first-page":"366","DOI":"10.1016\/j.spinee.2008.07.008","article-title":"Cortical bone trajectory for lumbar pedicle screws","volume":"9","author":"B G Santoni","year":"2009","journal-title":"Spine J"},{"issue":"22","key":"ref6","doi-asserted-by":"crossref","first-page":"E1297","DOI":"10.1097\/BRS.0000000000000553","article-title":"Effect of physiological loads on cortical and traditional pedicle screw fixation","volume":"39","author":"D A Baluch","year":"2014","journal-title":"Spine"},{"key":"ref7","doi-asserted-by":"crossref","first-page":"46","DOI":"10.14444\/2046","article-title":"Cortical and standard trajectory pedicle screw fixation techniques in stabilizing multisegment lumbar spine with low grade spondylolisthesis","volume":"9","author":"W K Cheng","year":"2015","journal-title":"Int J Spine Surg"},{"issue":"05","key":"ref8","doi-asserted-by":"crossref","first-page":"817","DOI":"10.4184\/asj.2017.11.5.817","article-title":"Review of cortical bone trajectory: evidence of a new technique","volume":"11","author":"J Delgado-Fernandez","year":"2017","journal-title":"Asian Spine J"},{"issue":"33","key":"ref9","doi-asserted-by":"crossref","first-page":"e16751","DOI":"10.1097\/MD.0000000000016751","article-title":"Comparison of cortical bone trajectory versus pedicle screw techniques in lumbar fusion surgery: a meta-analysis","volume":"98","author":"J N Hu","year":"2019","journal-title":"Medicine (Baltimore)"},{"issue":"04","key":"ref10","doi-asserted-by":"crossref","first-page":"273","DOI":"10.1055\/s-0038-1639333","article-title":"Fixation strength of pedicle and cortical lumbar vertebral screws after laminectomy: a cadaver study","volume":"79","author":"D S Kwak","year":"2018","journal-title":"J Neurol Surg A Cent Eur Neurosurg"},{"key":"ref11","doi-asserted-by":"crossref","first-page":"e717","DOI":"10.1016\/j.wneu.2018.07.253","article-title":"Biomechanical fixation properties of the cortical bone trajectory in the osteoporotic lumbar spine","volume":"119","author":"H M Li","year":"2018","journal-title":"World Neurosurg"},{"issue":"15","key":"ref12","doi-asserted-by":"crossref","first-page":"E873","DOI":"10.1097\/BRS.0000000000000983","article-title":"Evaluation of the fixation strength of pedicle screws using cortical bone trajectory: what is the ideal trajectory for optimal fixation?","volume":"40","author":"K Matsukawa","year":"2015","journal-title":"Spine"},{"issue":"04","key":"ref13","doi-asserted-by":"crossref","first-page":"164","DOI":"10.22603\/ssrr.1.2017-0006","article-title":"Lumbar pedicle screw fixation with cortical bone trajectory: a review from anatomical and biomechanical standpoints","volume":"1","author":"K Matsukawa","year":"2017","journal-title":"Spine Surg Relat Res"},{"issue":"06","key":"ref14","doi-asserted-by":"crossref","first-page":"910","DOI":"10.3171\/2015.11.SPINE15926","article-title":"Biomechanical evaluation of lumbar pedicle screws in spondylolytic vertebrae: comparison of fixation strength between the traditional trajectory and a cortical bone trajectory","volume":"24","author":"K Matsukawa","year":"2016","journal-title":"J Neurosurg Spine"},{"issue":"04","key":"ref15","doi-asserted-by":"crossref","first-page":"E240","DOI":"10.1097\/BRS.0000000000000116","article-title":"In vivo analysis of insertional torque during pedicle screwing using cortical bone trajectory technique","volume":"39","author":"K Matsukawa","year":"2014","journal-title":"Spine"},{"issue":"02","key":"ref16","doi-asserted-by":"crossref","first-page":"251","DOI":"10.4184\/asj.2016.10.2.251","article-title":"Radiological evaluation of the initial fixation between cortical bone trajectory and conventional pedicle screw technique for lumbar degenerative spondylolisthesis","volume":"10","author":"K Ninomiya","year":"2016","journal-title":"Asian Spine J"},{"key":"ref17","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1186\/s13018-015-0270-0","article-title":"A biomechanical comparison between cortical bone trajectory fixation and pedicle screw fixation","volume":"10","author":"H Oshino","year":"2015","journal-title":"J Orthop Surg Res"},{"issue":"03","key":"ref18","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1111\/os.12185","article-title":"Cortical bone trajectory for lumbar pedicle screw placement: a review of published reports","volume":"7","author":"K Phan","year":"2015","journal-title":"Orthop Surg"},{"issue":"04","key":"ref19","doi-asserted-by":"crossref","first-page":"467","DOI":"10.3171\/2016.2.SPINE151046","article-title":"Biomechanical fixation properties of cortical versus transpedicular screws in the osteoporotic lumbar spine: an in vitro human cadaveric model","volume":"25","author":"C A Sansur","year":"2016","journal-title":"J Neurosurg Spine"},{"key":"ref20","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1016\/j.wneu.2015.12.065","article-title":"Lumbar spinal fixation with cortical bone trajectory pedicle screws in 79 patients with degenerative disease: perioperative outcomes and complications","volume":"88","author":"L A Snyder","year":"2016","journal-title":"World Neurosurg"},{"issue":"07","key":"ref21","doi-asserted-by":"crossref","first-page":"1678","DOI":"10.1007\/s00586-019-05999-y","article-title":"Comparative clinical efficacy and safety of cortical bone trajectory screw fixation and traditional pedicle screw fixation in posterior lumbar fusion: a systematic review and meta-analysis","volume":"28","author":"J Wang","year":"2019","journal-title":"European Spine J"},{"issue":"06","key":"ref22","doi-asserted-by":"crossref","first-page":"759","DOI":"10.3171\/2018.12.SPINE18970","article-title":"Cortical bone trajectory screws used to save failed traditional trajectory screws in the osteoporotic lumbar spine and vice versa: a human cadaveric biomechanical study","volume":"30","author":"R J Zhang","year":"2021","journal-title":"J Neurosurg Spine"},{"issue":"13","key":"ref23","doi-asserted-by":"crossref","first-page":"1668","DOI":"10.1097\/00007632-200007010-00010","article-title":"Hematogenous pyogenic spinal infections and their surgical management","volume":"25","author":"A G Hadjipavlou","year":"2000","journal-title":"Spine"},{"issue":"01","key":"ref24","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1016\/j.jiph.2010.01.001","article-title":"Pyogenic spondylodiscitis: an overview","volume":"3","author":"G S Skaf","year":"2010","journal-title":"J Infect Public Health"},{"issue":"03","key":"ref25","doi-asserted-by":"crossref","first-page":"326","DOI":"10.1097\/01.BRS.0000109410.46538.74","article-title":"Treatment of pyogenic vertebral osteomyelitis with anterior debridement and fusion followed by delayed posterior spinal fusion","volume":"29","author":"J R Dimar","year":"2004","journal-title":"Spine"},{"issue":"02","key":"ref26","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1097\/00024720-200204000-00010","article-title":"Better treatment of vertebral osteomyelitis using posterior stabilization and titanium mesh cages","volume":"15","author":"H T Hee","year":"2002","journal-title":"J Spinal Disord Tech"},{"issue":"09","key":"ref27","doi-asserted-by":"crossref","first-page":"1014","DOI":"10.1097\/01.brs.0000215049.08622.9d","article-title":"Anterior surgery with insertion of titanium mesh cage and posterior instrumented fusion performed sequentially on the same day under one anesthesia for septic spondylitis of thoracolumbar spine: is the use of titanium mesh cages safe?","volume":"31","author":"P Korovessis","year":"2006","journal-title":"Spine"},{"issue":"06","key":"ref28","doi-asserted-by":"crossref","first-page":"765","DOI":"10.1302\/0301-620X.88B6.17270","article-title":"Posterior lumbar interbody fusion with an autogenous iliac crest bone graft in the treatment of pyogenic spondylodiscitis","volume":"88","author":"J S Lee","year":"2006","journal-title":"J Bone Joint Surg Br"},{"issue":"05","key":"ref29","doi-asserted-by":"crossref","first-page":"405","DOI":"10.3171\/SPI\/2008\/8\/5\/405","article-title":"Anterior debridement and fusion followed by posterior pedicle screw fixation in pyogenic spondylodiscitis: autologous iliac bone strut versus cage","volume":"8","author":"Y H Pee","year":"2008","journal-title":"J Neurosurg Spine"},{"issue":"14","key":"ref30","doi-asserted-by":"crossref","first-page":"E851","DOI":"10.1097\/BRS.0000000000001459","article-title":"Incidence and risk factors of adjacent cranial facet joint violation following pedicle screw insertion using cortical bone trajectory technique","volume":"41","author":"K Matsukawa","year":"2016","journal-title":"Spine"},{"issue":"06","key":"ref31","doi-asserted-by":"crossref","first-page":"E335","DOI":"10.1097\/BRS.0000000000001233","article-title":"Fatigue performance of cortical bone trajectory screw compared with standard trajectory pedicle screw","volume":"41","author":"Y T Akpolat","year":"2016","journal-title":"Spine"},{"issue":"10","key":"ref32","doi-asserted-by":"crossref","first-page":"1036","DOI":"10.1097\/01.BRS.0000061991.11489.7F","article-title":"Sagittal alignment after anterior debridement and fusion with or without additional posterior instrumentation in the treatment of pyogenic and tuberculous spondylodiscitis","volume":"28","author":"C Kl\u00f6ckner","year":"2003","journal-title":"Spine"},{"key":"ref33","doi-asserted-by":"crossref","first-page":"983","DOI":"10.1007\/s00586-015-4318-y","article-title":"Outcome of conservative and surgical treatment of pyogenic spondylodiscitis: a systematic literature review","volume":"25","author":"J P Rutges","year":"2016","journal-title":"European Spine J"},{"issue":"02","key":"ref34","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1016\/j.jbspin.2006.11.002","article-title":"Suggestions for managing pyogenic (non-tuberculous) discitis in adults","volume":"74","author":"F Grados","year":"2007","journal-title":"Joint Bone Spine"},{"issue":"02","key":"ref35","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1016\/S0090-3019(01)00681-4","article-title":"Spontaneous disc space infections in adults","volume":"57","author":"J A Friedman","year":"2002","journal-title":"Surg Neurol"},{"issue":"05","key":"ref36","doi-asserted-by":"crossref","first-page":"509","DOI":"10.1001\/archinte.158.5.509","article-title":"Bacteremic Staphylococcus aureus spondylitis","volume":"158","author":"A G Jensen","year":"1998","journal-title":"Arch Intern Med"},{"issue":"10","key":"ref37","doi-asserted-by":"crossref","first-page":"1342","DOI":"10.1086\/340102","article-title":"Vertebral osteomyelitis: long-term outcome for 253 patients from 7 Cleveland-area hospitals","volume":"34","author":"M C McHenry","year":"2002","journal-title":"Clin Infect Dis"},{"issue":"08","key":"ref38","doi-asserted-by":"crossref","first-page":"876","DOI":"10.1097\/00007632-198908000-00019","article-title":"Comparison of disc space heights after anterior lumbar interbody fusion","volume":"14","author":"S Dennis","year":"1989","journal-title":"Spine"},{"issue":"398","key":"ref39","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1097\/00003086-200205000-00007","article-title":"Conservative treatment of tuberculosis of the lumbar and lumbosacral spine","author":"M S Moon","year":"2002","journal-title":"Clin Orthop Relat Res"},{"issue":"07","key":"ref40","doi-asserted-by":"crossref","first-page":"1173","DOI":"10.1007\/s00701-015-2432-6","article-title":"Cortical bone trajectory and traditional trajectory: a radiological evaluation of screw-bone contact","volume":"157","author":"K Kojima","year":"2015","journal-title":"Acta Neurochir (Wien)"}],"container-title":["Journal of Neurological Surgery Part A: Central European Neurosurgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/s-0041-1739211.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,1,6]],"date-time":"2023-01-06T00:27:49Z","timestamp":1672964869000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/s-0041-1739211"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,12,12]]},"references-count":40,"journal-issue":{"issue":"01","published-online":{"date-parts":[[2023,1,5]]},"published-print":{"date-parts":[[2023,1]]}},"URL":"https:\/\/doi.org\/10.1055\/s-0041-1739211","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["2193-6315","2193-6323"],"issn-type":[{"type":"print","value":"2193-6315"},{"type":"electronic","value":"2193-6323"}],"subject":[],"published":{"date-parts":[[2021,12,12]]}}}