European Spine Journal 

About: European Spine Journal is an academic journal published by Springer Science+Business Media. The journal publishes majorly in the area(s): Medicine & Lumbar. It has an ISSN identifier of 0940-6719. Over the lifetime, 8546 publications have been published receiving 286871 citations.

A comprehensive classification of thoracic and lumbar injuries

Abstract: In view of the current level of knowledge and the numerous treatment possibilities, none of the existing classification systems of thoracic and lumbar injuries is completely satisfactory As a result of more than a decade of consideration of the subject matter and a review of 1445 consecutive thoracolumbar injuries, a comprehensive classification of thoracic and lumbar injuries is proposed The classification is primarily based on pathomorphological criteria Categories are established according to the main mechanism of injury, pathomorphological uniformity, and in consideration of prognostic aspects regarding healing potential The classification reflects a progressive scale of morphological damage by which the degree of instability is determined The severity of the injury in terms of instability is expressed by its ranking within the classification system A simple grid, the 3-3-3 scheme of the AO fracture classification, was used in grouping the injuries This grid consists of three types: A, B, and C Every type has three groups, each of which contains three subgroups with specifications The types have a fundamental injury pattern which is determined by the three most important mechanisms acting on the spine: compression, distraction, and axial torque Type A (vertebral body compression) focuses on injury patterns of the vertebral body Type B injuries (anterior and posterior element injuries with distraction) are characterized by transverse disruption either anteriorly or posteriorly Type C lesions (anterior and posterior element injuries with rotation) describe injury patterns resulting from axial torque The latter are most often superimposed on either type A or type B lesions Morphological criteria are predominantly used for further subdivision of the injuries Severity progresses from type A through type C as well as within the types, groups, and further subdivisions The 1445 cases were analyzed with regard to the level of the main injury, the frequency of types and groups, and the incidence of neurological deficit Most injuries occurred around the thoracolumbar junction The upper and lower end of the thoracolumbar spine and the T 10 level were most infrequently injured Type A fractures were found in 661 %, type B in 145%, and type C in 194% of the cases Stable type Al fractures accounted for 347% of the total Some injury patterns are typical for certain sections of the thoracolumbar spine and others for age groups The neurological deficit, ranging from complete paraplegia to a single root lesion, was evaluated in 1212 cases The overall incidence was 22% and increased significantly from type to type: neurological deficit was present in 14% of type A, 32% of type B, and 55% of type C lesions Only 2% of the Al and 4% of the A2 fractures showed any neurological deficit The classification is comprehensive as almost any injury can be itemized according to easily recognizable and consistent radiographic and clinical findings Every injury can be defined alphanumerically or by a descriptive name The classification can, however, also be used in an abbreviated form without impairment of the information most important for clinical practice Identification of the fundamental nature of an injury is facilitated by a simple algorithm Recognizing the nature of the injury, its degree of instability, and prognostic aspects are decisive for the choice of the most appropriate treatment Experience has shown that the new classification is especially useful in this respect

Osteoinduction, osteoconduction and osseointegration.

Abstract: Osteoinduction is the process by which osteogenesis is induced. It is a phenomenon regularly seen in any type of bone healing process. Osteoinduction implies the recruitment of immature cells and the stimulation of these cells to develop into preosteoblasts. In a bone healing situation such as a fracture, the majority of bone healing is dependent on osteoinduction. Osteoconduction means that bone grows on a surface. This phenomenon is regularly seen in the case of bone implants. Implant materials of low biocompatibility such as copper, silver and bone cement shows little or no osteoconduction. Osseointegration is the stable anchorage of an implant achieved by direct bone-to-implant contact. In craniofacial implantology, this mode of anchorage is the only one for which high success rates have been reported. Osseointegration is possible in other parts of the body, but its importance for the anchorage of major arthroplasties is under debate. Ingrowth of bone in a porous-coated prosthesis may or may not represent osseointegration.

Pelvic incidence: a fundamental pelvic parameter for three-dimensional regulation of spinal sagittal curves

Abstract: This paper proposes an anatomical parameter, the pelvic incidence, as the key factor for managing the spinal balance. Pelvic and spinal sagittal parameters were investigated for normal and scoliotic adult subjects. The relation between pelvic orientation, and spinal sagittal balance was examined by statistical analysis. A close relationship was observed, for both normal and scoliotic subjects, between the anatomical parameter of pelvic incidence and the sacral slope, which strongly determines lumbar lordosis. Taking into account the Cobb angle and the apical vertebral rotation confers a three-dimensional aspect to this chain of relations between pelvis and spine. A predictive equation of lordosis is postulated. The pelvic incidence appears to be the main axis of the sagittal balance of the spine. It controls spinal curves in accordance with the adaptability of the other parameters.

Scaffolding in tissue engineering: general approaches and tissue-specific considerations.

Abstract: Scaffolds represent important components for tissue engineering. However, researchers often encounter an enormous variety of choices when selecting scaffolds for tissue engineering. This paper aims to review the functions of scaffolds and the major scaffolding approaches as important guidelines for selecting scaffolds and discuss the tissue-specific considerations for scaffolding, using intervertebral disc as an example.