Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UNIPROT:Q9NRP7 (fused)
 58,367 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Forty-two consecutive patients with scoliosis who between 1981 and 1988 underwent posterior Harrington distraction rod and interspinous process or sublaminar wiring were retrospectively reviewed. No difference was found between the techniques with respect to age, sex, curve pattern, curve magnitude, levels fused, operative time, blood loss, correction, and loss of correction at the 1-year and 2-year follow-up. The interspinous process wiring was superior to the sublaminar wiring as regards ease of technique, early ambulation, few complications, and a more effective means for maintaining the correction without postoperative immobilization.
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PMID:Fusion of scoliosis by Harrington distraction rod. Interspinous process and sublaminar wiring compared in 42 cases. 176 38

We compared the lateral profile of the lumbar spine after lumbosacral dorsal fusion in two groups of each 32 patients with comparable age, sex distribution and indication; one group had been fused with the use of two short Harrington rods, the other with the Universal Spinal Instrumentation System (USIS) according to Zielke/Harms. The sparing of motion segments using a transpedicular system is demonstrated by the average number of 1.7 fused motion segments compared to 2.2 with the Harrington rods. The average increase of cyphosis of the fused area could be reduced with USIS from 7.3 to 3.0 degrees in spite distraction. The greatest difference could be seen in cases of spondylolisthesis (2.0 degrees compared to 8.2) and in fusions including three segments (2.0 versus 7.0). No significant difference in total lordosis of the lumbar spine could be evaluated and there was no influence of preoperative mobility on the grade of postoperative cyphosis. The early results of lumbar fusion using USIS are clinically satisfying in spite of a relative high rate of rod fracture. measures to achieve a higher stability and diminish the rate of implant failure are discussed.
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PMID:[The lateral profile of the lumbar vertebrae following lumbosacral spondylodesis--comparison between Harrington rods and a transpedicular fixation system (Zielke's USIS method)]. 182 85

An animal model of anterior and posterior column instability was developed to allow in vivo observation of bone remodeling and arthrodesis following spinal instrumentation. After an initial anterior and posterior destabilizing lesion was created at the L5-L6 vertebral levels in 63 adult beagles, various spinal reconstructive surgical procedures were performed--with or without bilateral posterolateral bone grafting, with or without bilateral oophorectomies, and with or without spinal instrumentation (Harrington distraction, Luque rectangular, Cotrel-Dubousset pedicular, or Steffee pedicular implants). Observation 6 months after surgery revealed a significantly improved probability of achieving a spinal fusion if spinal instrumentation had been used (X2 = 5.84, P = .016). Nondestructive mechanical testing after removal of all metal instrumentation in torsion, axial compression, and flexion revealed that the fusions performed in conjunction with spinal instrumentation were more rigid (P less than .05). Quantitative histomorphometry showed that the volumetric density of bone was significantly lower (ie, device-related osteoporosis occurred) for fused versus unfused spines. In addition, a linear correlation occurred between decreasing volumetric density of bone and increasing rigidity of the spinal implant (r = .778); ie, device-related osteoporosis occurred secondary to Harrington, Cotrel-Dubousset, and Steffee pedicular instrumentation. Oophorectomized dogs became more osteoporotic than their surgically matched controls (posterolateral bone grafting alone, Cotrel-Dubousset pedicular instrumentation, and Steffee pedicular instrumentation); device-related osteoporosis added to the degree of hormonally induced osteoporosis (t = 5.0, P less than .0001). This is the first study to date documenting the occurrence of stress shielding in the spine secondary to spinal instrumentation.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:The effect of spinal implant rigidity on vertebral bone density. A canine model. 186 13

The authors examined the stability of combined distraction and compression rod instrumentation with posterolateral fusion in 40 consecutive patients with unstable degenerative spondylolisthesis. All operations were performed by floating fusion of L3-4 or L4-5 after decompression procedures. Mobility at the fused level was checked every 4 weeks after operation by the disc space angle on the functional radiographic films without brace. The average period of postoperative follow-up was 26 months. In 30 patients, no mobility was found at any time. In six patients, any mobility disappeared within 24 weeks, and in three patients, within 1 year. Pseudoarthrosis was found in one patient. The solid fusion rate was 97.5%. The values of percent slippage and slip angle were slightly improved. Lumbar lordosis was in the normal range at follow-up.
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PMID:Clinical study on stability of combined distraction and compression rod instrumentation with posterolateral fusion for unstable degenerative spondylolisthesis. 226 19

Reports in the literature have questioned the practice of using Harrington distraction rods spanning unfused spinal segments for internal fixation of the fractured thoracolumbar spine. However, the long-term incidence of facet joint osteoarthritis has not been reported. This is the report on a retrospective analysis of 20 of these patients with an average follow-up period of 8.0 years. Eighty-five percent of the patients received a classification of good to excellent regarding back pain and 90% returned to their preinjury occupation. Of significance, of 75 lumbar facets traversed by rods but not fused, only two were classified as "closed" or autofused. It remains to be seen if some pedicular systems are superior to this technique in trained hands. However, multisegmental instrumentation with unisegmental fusion is possible without obtaining the severe osteoarthritic changes that animal studies have demonstrated.
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PMID:Long-term lumbar facet joint changes in spinal fracture patients treated with Harrington rods. 240 87

Previous reports are inconclusive regarding changes in the lumbar region after Harrington rod distraction and posterior spinal fusion for idiopathic scoliosis. The purpose of this study was to evaluate the effects of spinal fusion on the lumbar region, particularly the overall lumbar lordosis, the lumbar lordosis in and below the fused segment, the sacro-horizontal angle, and the sagittal plane alignment of the spine. Sixty-six patients under 21 years of age with idiopathic scoliosis who had spine fusion extending to the lumbar vertebrae using only Harrington distraction instrumentation were evaluated. The total lordosis, sacro-horizontal angle, and sagittal plane alignment remained relatively constant. The lordosis within the fusion decreased, and lordosis caudal to the fusion, including the last fused vertebra, increased as the lower hook placement site moved caudally.
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PMID:Analysis of lumbar lordosis in posterior spine fusions for idiopathic scoliosis. 252 68

An animal model of anterior and posterior column instability was developed to allow in vivo observation of bone remodeling and arthrodesis after spinal instrumentation. After an initial anterior and posterior destabilizing lesion was created at the L5-L6 vertebral levels in 42 adult beagles, various spinal reconstructive surgical procedures were performed--with or without bilateral posterolateral bone grafting, and with or without spinal instrumentation (Harrington distraction; Luque rectangular, or Cotrel-Dubousset transpedicular methods). After 6 months' postoperative observation, there was a significantly improved probability of achieving a spinal fusion if spinal instrumentation had been used (P = 0.058). Nondestructive mechanical testing after removal of all metal instrumentation in torsion, axial compression, and flexion revealed that the fusions performed in conjunction with spinal instrumentation were more rigid (P less than 0.05). Quantitative histomorphometry showed that the volumetric density of bone was significantly lower (ie, device-related osteoporosis occurred) for fused versus unfused spines; and Harrington- and Cotrel-Dubousset-instrumented dogs became more osteoporotic than the other three groups. The rigidity of spinal instrumentation led to device-related osteoporosis (stress shielding) of the vertebra. However, as the rigidity of spinal instrumentation increased, there was an increased probability of achieving a successful spinal fusion. The improved mechanical properties of spinal instrumentation on spinal arthrodesis more than compensate for the occurrence of device-related osteoporosis in the spine.
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PMID:1989 Volvo Award in basic science. Device-related osteoporosis with spinal instrumentation. 278 9

The histology and mechanics of leg lengthening by callus distraction were studied in 27 growing rabbits. Tibial diaphyses were subjected to subperiosteal osteotomy, held in a neutral position for 10 days and then slowly distracted at 0.25 mm/12 hours, using a dynamic external fixator. Radiographs showed that the gap became filled with callus having three distinct zones. Elongation appeared to occur in a central radiolucent zone; this was bounded by two sclerotic zones. Histologically, the radiolucent zone consisted of longitudinally arranged cartilage and fibrous tissue while the sclerotic zones were formed by fine cancellous bone. New bone occasionally contained islands of cartilage, suggesting it had been formed by endochondral ossification. After completion of distraction, the two sclerotic zones fused, shrank and were eventually absorbed, leaving tubular bone with a new cortex. When the periosteum had been removed at the operation, callus formation was markedly disturbed and there was failure of bone lengthening. Scraping of endosteum, in contrast, did not have a pronounced effect. These results suggest that the preservation of periosteum is essential if bone lengthening by callus distraction is to succeed, and that preservation of the periosteum is more important than careful corticotomy.
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PMID:Bone lengthening in rabbits by callus distraction. The role of periosteum and endosteum. 340 95

Epiphyseal distraction of the left distal femur was accomplished in 10 goats (aged 3-4.5 months). A modified Hoffmann external fixation device was used as a unilateral distraction frame. A distraction rate of 1.5 mm/day was applied for 5.5 weeks. Epiphysiolysis occurred after 3-7 days of distraction. After the lengthening procedure, the growth plate had reduced in height in eight animals on radiographic examination. In two animals the growth plate was fused. Three animals were killed at 4 (Group 1) and 8 (Group 2) weeks and four animals at 16 (Group 3) weeks after the end of the distraction period. The gain in leg length obtained by distraction was reduced owing to growth retardation in the distal femur of the operated limb. The average final lengthening was 24.9, 19.4, and 13.4% in Groups 1, 2, and 3, respectively. Femur and tibia from both sides were tested mechanically in torsion. Only one femur fractured in the elongation area. All but one elongated femur fractured in the area of the diaphysis subjected to distractional force. The torsional strength of the elongated femur compared with control was reduced to approximately 50% in all groups. The corresponding torsional strength of the tibia on the elongated extremity compared with control was reduced to approximately 75% in all groups. The difference in relative strength of femur compared with that of tibia was statistically significant. This finding can be explained by a stress-protective effect on the femur in the distraction area caused by the external device.
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PMID:Limb lengthening by epiphyseal distraction. An experimental study in the caprine femur. 368 32

The use of Harrington distraction rods for stabilization of fracture dislocation of the thoracolumbar spine is well established. For better initial stabilization and later return of flexibility we routinely use a long rod but fuse over a short segment and then remove the rods at 1 year. A biplanar radiographic technique was used to assess vertebral motion both before and after removal of Harrington rods in five patients. The investigation showed the rod acted to restrict movement and relieved loads on the spine that they spanned. Although all the patients regained considerable spinal flexibility once the rods were removed, none of the intervertebral joints measured could be considered solidly fused. However, the pattern of movement remained abnormal 6 months after rod removal with many intervertebral joints exhibiting lateral flexion and axial rotation during voluntary flexion extension. Despite this, a long rod/short fuse stabilization with routine rod removal after 1 year combines the initial advantage of operative stabilization and is shown to allow a return of spinal flexibility subsequently.
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PMID:Vertebral motion measured using biplanar radiography before and after Harrington rod removal for unstable thoracolumbar fractures of the spine. 375 83


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