{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,31]],"date-time":"2026-01-31T08:16:57Z","timestamp":1769847417604,"version":"3.49.0"},"reference-count":19,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2015,8,26]],"date-time":"2015-08-26T00:00:00Z","timestamp":1440547200000},"content-version":"vor","delay-in-days":25,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Orthopaedic Surgery"],"published-print":{"date-parts":[[2015,8]]},"abstract":"Objective<\/jats:title>This study aimed to determine whether an isthmus\u2010guided cortical bone trajectory (CBT<\/jats:styled-content>) technique provides better clinical outcomes than the original cortical bone trajectory CBT<\/jats:styled-content> technique for screw fixation.<\/jats:p><\/jats:sec>Methods<\/jats:title>A consecutive series of 21 patients with lumbar spondylolisthesis who had undergone CBT<\/jats:styled-content> screw fixation using the original technique from J<\/jats:styled-content>une 2012 to F<\/jats:styled-content>ebruary 2013 and 33 who had undergone the isthmus\u2010guided technique from M<\/jats:styled-content>arch 2013 to A<\/jats:styled-content>ugust 2014 was retrospectively reviewed. The number of screws inserted, interbody fusion and screw misplacements, amount of blood loss, and creatinine phosphokinase (CPK<\/jats:styled-content>) ratios (postoperative day 1 CPK<\/jats:styled-content>\/preoperative CPK<\/jats:styled-content>) were reviewed to evaluate clinical outcomes and compared between the original and isthmus\u2010guided CBT<\/jats:styled-content> techniques.<\/jats:p><\/jats:sec>Results<\/jats:title>Postoperative serum CPK<\/jats:styled-content> concentrations were significantly lower with the isthmus\u2010guided than the original CBT<\/jats:styled-content> technique (P<\/jats:italic> < 0.05). There were no significant differences in age, blood loss, or number of screws, vertebral interbody fusions and patients with history of previous decompression surgery at the same level. There was a trend to higher incidence of screw misplacement with the original than the isthmus\u2010guided CBT<\/jats:styled-content> technique; this difference was not significant (P<\/jats:italic> = 0.53). There were no major intraoperative complications. In all the CBT<\/jats:styled-content> procedures performed in our institution, almost half (47%) the screw misplacements have occurred at the level of L<\/jats:styled-content>5<\/jats:sub>, and most on the right side.<\/jats:p><\/jats:sec>Conclusions<\/jats:title>Right\u2010handed operators should take care inserting screws on the right side. From the viewpoint of screw misplacement, isthmus\u2010guided CBT<\/jats:styled-content> provides superior or equivalent safety to the original CBT<\/jats:styled-content> technique.<\/jats:p><\/jats:sec>","DOI":"10.1111\/os.12189","type":"journal-article","created":{"date-parts":[[2015,8,27]],"date-time":"2015-08-27T03:59:40Z","timestamp":1440647980000},"page":"232-238","source":"Crossref","is-referenced-by-count":19,"title":["Isthmus\u2010guided Cortical Bone Trajectory Reduces Postoperative Increases in Serum Creatinine Phosphokinase Concentrations"],"prefix":"10.1111","volume":"7","author":[{"given":"Toshika","family":"Ohkawa","sequence":"first","affiliation":[{"name":"Department of Neurosurgery Osaka University Graduate School of Medicine Suita Osaka Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Koichi","family":"Iwatsuki","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery Osaka University Graduate School of Medicine Suita Osaka Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yu\u2010ichiro","family":"Ohnishi","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery Osaka University Graduate School of Medicine Suita Osaka Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Koshi","family":"Ninomiya","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery Osaka University Graduate School of Medicine Suita Osaka Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Toshiki","family":"Yoshimine","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery Osaka University Graduate School of Medicine Suita Osaka Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2015,8,26]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.spinee.2008.07.008"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/os.12027"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0b013e318279a95e"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.spinee.2010.09.024"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-199003000-00007"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.3171\/2013.7.SPINE13191"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.3171\/2014.10.SPINE14205"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-199309000-00016"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0000000000000116"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.3171\/2014.10.SPINE14371"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.3171\/2014.9.SPINE1484"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.92B8.24237"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.3171\/2010.11.SPINE09886"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/os.12122"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/BSD.0b013e318288ac39"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1757-7861.2010.00086.x"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-199411001-00017"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.101.5.1386"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1097\/BSD.0000000000000130"}],"container-title":["Orthopaedic Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fos.12189","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/os.12189","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,2]],"date-time":"2023-10-02T19:38:26Z","timestamp":1696275506000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/os.12189"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,8]]},"references-count":19,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2015,8]]}},"alternative-id":["10.1111\/os.12189"],"URL":"https:\/\/doi.org\/10.1111\/os.12189","archive":["Portico"],"relation":{},"ISSN":["1757-7853","1757-7861"],"issn-type":[{"value":"1757-7853","type":"print"},{"value":"1757-7861","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,8]]}}}