tag:blogger.com,1999:blog-126852961571725269.post4357788044223003833..comments2024-02-24T06:25:59.743-08:00Comments on The Spine Blogger: 501 Pedicle Screws and CountingMusculoskeletal Manhttp://www.blogger.com/profile/14873819014357051373noreply@blogger.comBlogger15125tag:blogger.com,1999:blog-126852961571725269.post-12258531332521222802017-05-20T07:45:05.632-07:002017-05-20T07:45:05.632-07:00Just deposited $6000 to their account. Can I ask t...Just deposited $6000 to their account. Can I ask them for the refund of my money. They charged me $23500 as their standard surgery bill. Pls adviceAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-126852961571725269.post-10752409304183600492010-03-01T13:03:57.757-08:002010-03-01T13:03:57.757-08:00An expandable screw can allow for less inventory (...An expandable screw can allow for less inventory (one size fits all)-good for the company, distributor.<br /><br />To the patient, and his/her bone howeve, metal is still metal. Poor bone will react (resorb,break, fuse) and behave the same to a 5.5mm screw that is fixed as it will to a 5.5mm screw that was "expanded" to this "perfect size."<br /><br />The product is a screw and ends up being a screw---pedicle screws have not had much pull out issues, bones on the other hand have issues that will not change.<br /><br />Product is a Non-Event in the continuum of healthcare.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-126852961571725269.post-25819343559304795462010-02-23T22:30:18.064-08:002010-02-23T22:30:18.064-08:00just use better biologics, get a solid anterior co...just use better biologics, get a solid anterior column fusion (old osteoporotic patients arent getting big scoli surgeries anyways). harware fails (fracture, pullout, "windshield wipering") when the race between bony fusion and harware failure is lost. Many poor ped. screw placers use 5.0-5.5 screws. Use a modern dual minor design of a decent diameter and length and youre set. If the pts dexa score is that bad then instrumented fusion via ped. screws might not be the best option. Give them an XLIF with spinous process fixation, they'll fuse.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-126852961571725269.post-43353228018954355652010-02-12T14:53:19.912-08:002010-02-12T14:53:19.912-08:00Far be it from me to suggest, but depth, trajector...Far be it from me to suggest, but depth, trajectory and intimal bone conact are probably THE biggest determinants of screw pullout, regardless of bone quality or screw geometry.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-126852961571725269.post-11284576391589401532010-02-10T12:03:38.823-08:002010-02-10T12:03:38.823-08:00Most technology has a place. This will have a plac...Most technology has a place. This will have a place with Oseopenic and Oseoporotic patients. Also revision surgery will be assisted significantly by weak pedicles not bearing the brunt of larger width screws that have the potential to damage the integrity of the pedicle.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-126852961571725269.post-45228409869337199912010-02-08T17:50:25.240-08:002010-02-08T17:50:25.240-08:00Our spine practice saw them at NAS but did not hav...Our spine practice saw them at NAS but did not have time to view their preso. As someone else commented the booth was full of people waiting to get information and we had a plane to catch. They have a website www.baxano.com for doctors and administrators that wish to get info and have been responsive.uknowdocnoreply@blogger.comtag:blogger.com,1999:blog-126852961571725269.post-30144372767109894512010-02-03T16:40:03.007-08:002010-02-03T16:40:03.007-08:00Bad bone is bad bone. Metal wears through bone. Pu...Bad bone is bad bone. Metal wears through bone. Putting pressure on bad bone with an expandable screw is going to change the mode of failure, not so much the rate of failure. For bad bone a better solution is to strengthen the vertebra as a whole. That is what one tries to do with screw augmentation. PMMA or some other injectable self setting material, maybe even calcium phosphate cements, although these have some mechanical limitations.Unknownhttps://www.blogger.com/profile/00670352669210786388noreply@blogger.comtag:blogger.com,1999:blog-126852961571725269.post-6726380252714737382010-02-03T15:31:58.363-08:002010-02-03T15:31:58.363-08:00Pull-out is not a real problem in most cases. Whe...Pull-out is not a real problem in most cases. When dealing with fixation screws. Pull-out and loosening are often attributed to improper selection and implantation. <br /><br />There are limited factors that influence pull-out and loosening characteristics. However testing methods can influence results.<br /><br />The biggest issue with screws is still breaking at the necks of the heads and overall construct strength.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-126852961571725269.post-48719624190707614192010-02-03T08:56:44.652-08:002010-02-03T08:56:44.652-08:00Asking about the rate of screw loosening or pull-o...Asking about the rate of screw loosening or pull-out is a great question. Other good questions: What is the revision rate for pedicle screws? What percentage can be attributed to fixation failure of the screw? How many patients that would otherwise be candidates for fusion with pedicle screws are turned away because of poor bone quality? I don't have the answers - just asking. <br /><br />If newer screws have exeptional pull-out, what has changed in the design in recent years?Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-126852961571725269.post-48040535459142617052010-02-03T06:51:05.570-08:002010-02-03T06:51:05.570-08:00How often do we hear of screw loosening? In addit...How often do we hear of screw loosening? In addition, many of the newer screws have exceptional "pull-out" strength. Is this a real problem, or is this a solution to a problem that doesn't really exist?Musculoskeletal Manhttps://www.blogger.com/profile/14873819014357051373noreply@blogger.comtag:blogger.com,1999:blog-126852961571725269.post-63187425740343618012010-02-03T06:28:00.746-08:002010-02-03T06:28:00.746-08:00I am under the impression that improved fixation i...I am under the impression that improved fixation is needed for patients with osteoporosis. Screw loosening in bone is probably the bigger issue, as compared to pull-out. Pull-out tests are relatively simple and pull-out tests could be an indicator of overall better fixation.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-126852961571725269.post-85620995028613933182010-02-02T19:41:08.689-08:002010-02-02T19:41:08.689-08:00Take a field trip to your local Home Depot/Lowes a...Take a field trip to your local Home Depot/Lowes and glance at all the possible "INNOVATIONS" in the hardware/fastener section!!!!Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-126852961571725269.post-58834894887656697002010-02-02T17:39:04.065-08:002010-02-02T17:39:04.065-08:00...not to mention 173 spine startups and counting ......not to mention 173 spine startups and counting listed alphabetically on OrthoStreams.com.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-126852961571725269.post-35289398481924893822010-02-02T10:15:05.864-08:002010-02-02T10:15:05.864-08:00Pull-out strength is a highly subjective character...Pull-out strength is a highly subjective characteristic of a screw. In my years of development and testing, there are factors besides the geometry of the screw that can boost results in a screw pull-out testing. First it is sometimes common practice that test medium consideration can and will be adjusted to suit the needs of the product. This adjusting can be hidden by vague report writing. <br /><br />Comparing pull-out strength on screws is a delicate science only due to the fact each company has what is the best method for them, and sometimes stack the results against a competitors. <br /><br />The bigger questions we all need to be asking ourselves is when is testing and discussion going to be fair and balanced. Testing and reporting will never be fair and balanced only due to the fact each company says it has the best and want the results to stand by it.<br /><br />However the deeper question is do implant companies actually care about a patient or is it one big pissing contest at the end of the day.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-126852961571725269.post-21006702795863081412010-02-02T07:04:40.932-08:002010-02-02T07:04:40.932-08:00The question I have regarding these screws is how ...The question I have regarding these screws is how do you get them out during a revision case? Can you or do you just have a corpectomy system available, instead?Anonymousnoreply@blogger.com