C.V. Guy Rutledge Fogel M.D. as of 5/30/2008 RECENT PUBLICATIONS 2003-2008: 1. Coccygodynia Evaluation and Treatment G Fogel MD, S. Esses MD, JAAOS 2003 2. Hip Spine Syndrome G Fogel MD, S. Esses MD, The Spine Journal 2003 3. Cervical Plates Comparison of Physical Characteristics and In Vitro Push Out Strength G Fogel MD,C. Reitman MD, W. Liu Phd., S. Esses MD, The Spine Journal 2003 4. Physical Characteristics of Polyaxial-Headed Pedicle Screws and Biomechanical Comparison of Load With Their Failure, G Fogel MD,C. Reitman MD, W. Liu Phd., S. Esses MD, Spine March 03. 5. Management of Chronic Limb Pain with Spinal Cord Stimulation G Fogel MD,O. Calvillo MD Phd., S. Esses MD Pain Practice-03 6. Biomechanical Evaluation of Relationship of Pullout Strength, Insertional Torque and Bone Mineral Density in the Cervical Vertebral Body Journal of Spinal Disorders 2003, C. Reitman, G. Fogel MD, Lyndon Nguyen, MS 7. Spinal Epidural Lipomatosis 3 case reports and Literature Metanalysis, The Spine Journal 2005 Fogel, G. R., P. Y. Cunningham, 3rd, SI Esses 8. Meningeal Cyst Evaluation and Management, American Journal of Orthopedics 2004. Fogel, G. R., P. Y. Cunningham, 3rd, SI Esses 9. Anterior Hardware Removal Improves Dysphagia Following Anterior Cervical Discectomy and Fusion, The Spine Journal March 2005, G Fogel M.D., M McDonnell M.D. 10. Complications, Pitfalls, and their management in a clinical practice setting. Book Chapter in “Lumbar Interbody Fusion Cage” John W. Brantigan MD, Guy R. Fogel MD 2006 11. Outcomes Of L1-2 Posterior Lumbar Interbody Fusion With the Lumbar I/F Cage Reporting Unexpected Poor Fusion Results at L1-2, Guy R Fogel MD, John S. Toohey, Arvo Neidre, John Brantigan. Spine Journal July 2006 12. Is One Cage Enough in Lumbar Interbody Fusion: A Comparison of Unilateral Single Cage Interbody fusion to Bilateral Cages. Guy R. Fogel M.D., John S. Toohey M.D., Arvo Neidre M.D., John W. Brantigan M.D. Journal of Spinal Disorders and Techniques 2006 13. Repair of Pars Interarticularis Defect with a Modified Cable-Screw Construct- Case Reports Gordon R. Bozarth MD Guy R. Fogel MD John S. Toohey MD Arvo Neidre MD. Journal of Surgical Orthopedic Advances 2006 14. Fusion Assessment in Posterior Lumbar Interbody Fusion Using Radiolucent Cages: X-rays and Helical CT scan Compared with Surgical Exploration of Fusion. Guy R. Fogel M.D., John S. Toohey M.D., Arvo Neidre M.D., John W. Brantigan M.D. Accepted The Spine Journal 2007 15. Outcomes Of 9mm Width Posterior Lumbar Interbody Fusion With the Lumbar I/F Cage, Guy R Fogel MD, John S. Toohey, Arvo Neidre, John Brantigan. Accepted Journal of Surgical Orthopedic Advances 2007 SUBMITTED FOR PUBLICATION 2007 16. Improved Fusion Rates with Anterior and Posterior Fusion in Tobacco Abuse Patients Treated for Dominant Axial-Mechanical Cervical Spine Pain, G Fogel M.D., M McDonnell M.D., In Press 17. Biomechanical Comparison Of Translational and Constrained Anterior Cervical Plate With Two-level Corpectomy Of The Cervical Spine, Guy R Fogel MD, Weiqiang Liu PhD, In Press SUBMITTED FOR PUBLICATION 2008 18. Biomechanical comparison of Medicrea Cervical Staple and Cervical Plate fixation, Guy R Fogel MD, Weiqiang Liu PhD, In Press 19. Biomechanical Comparison Facetbolt to Pedicle Screw Fixation, Guy R Fogel MD, Weiqiang Liu PhD, In Press Current as of 5/30/2008 C.V. Guy Rutledge Fogel M.D. as of 5/30/2008 20. In Vivo Study of Lumbar Fusion with Bone Marrow and Adipose Stem Cells, Guy R Fogel MD, Daria Neidre MS, In Press 21. Biomechanical Study of Edge Erosion Wear in Vertebron Pedicle Screw Tulip and Rod, Guy R Fogel MD, Weiqiang Liu PhD, In Press 22. Biomechanical Evaluation of Vertebron Cervical Cage versus Cervical Plate Fixation, Guy R Fogel MD, Weiqiang Liu PhD, In Press RECENT PRESENTATIONS PAPERS/POSTERS 2005 1. Cervical Plates Comparison of Physical Characteristics and In Vitro Push Out Strength Texas Spine Society Austin Texas May 05 2. Anterior Hardware Removal Improves Dysphagia Following Anterior Cervical Discectomy and Fusion Cervical Spine Research Society Scottsdale Az 12/2004 3. Improved Fusion Rates with Anterior and Posterior Fusion in Tobacco Abuse Patients Treated for Dominant Axial-Mechanical Cervical Spine Pain Texas Orthopedic Association San Antonio 04 4. Total Disc Arthroplasty San Antonio Rheumatology Group January 2005 5. Stingers and Burners Spine and Sports Orthopedic Residents February 2005 6. Osteoporosis and Vertebroplasty Orthopedic Residents April 2005 2006 7. Spondylolisthesis Orthopedic Grand Rounds Methodist March 2006 8. Spinal Cord Injury Orthopedic Residents March 2006 9. Cervical Spine Trauma Orthopedic Residents April 2006 10. Spine Surgery overview for Physical Therapy Students April 2006 11. Is One Cage Enough in Lumbar Interbody Fusion: A Comparison of Unilateral Single Cage Interbody fusion to Bilateral Cages. Paper Mid American Orthopedic Association San Antonio April 2006 12. Outcomes Of L1-2 Posterior Lumbar Interbody Fusion With the Lumbar I/F Cage Reporting Unexpected Poor Fusion Results at L1-2 Paper Mid American Orthopedic Association San Antonio April 2006 13. Outcomes of Posterior Lumbar Interbody Fusion with the 9mm Width Lumbar I/F Cage and the Variable Screw Placement System. Poster Mid American Orthopedic Association San Antonio April 2006 14. Repair of Pars Interarticularis Defect with a Modified Cable-Screw Construct- Case Reports. Poster Mid American Orthopedic Association San Antonio April 2006 15. Is One Cage Enough in Lumbar Interbody Fusion: A Comparison of Unilateral Single Cage Interbody fusion to Bilateral Cages. Presented paper Mid American Orthopedic Association San Antonio April 2006 16. Biomechanical Comparison Of Translational and Constrained Anterior Cervical Plate With Two-level Corpectomy Of The Cervical Spine Paper Texas Orthopedic Association Houston May 2006 17. Fusion Assessment in Posterior Lumbar Interbody Fusion Using Radiolucent Cages: X-rays and Helical CT scan Compared with Surgical Exploration of Fusion. Paper Spine Across the Sea Maui Hi July 2006 18. Outcomes of Posterior Lumbar Interbody Fusion with the 9mm Width Lumbar I/F Cage and the Variable Screw Placement System. Poster Spine Across the Sea Maui Hi July 2006 19. Is One Cage Enough in Lumbar Interbody Fusion: A Comparison of Unilateral Single Cage Interbody fusion to Bilateral Cages. Poster Spine Across the Sea Maui Hi July 2006 2007 20. Orthopedic Spine Surgery Overview for Physical Therapists March 07 Current as of 5/30/2008 C.V. Guy Rutledge Fogel M.D. as of 5/30/2008 21. Metanalysis of Lumbar Fusion. Grand Rounds UTSA Orthopedic Department. April 2007 2008 22. Orthopedic Spine Surgery Overview for Physical Therapists March 08 23. Methodist Hospital Grand Rounds Stem Cell Therapy in Orthopedics. March 08 Current as of 5/30/2008 Coccygodynia: Evaluation and Management Guy R. Fogel, MD, Paul Y. Cunningham III, MD, and Stephen I. Esses, MD Abstract Coccygodynia is pain in the region of the coccyx. In most cases, abnormal mobility incidence of fusions between seg- is seen on dynamic standing and seated radiographs, although the cause of pain is ments.4 Symptomatic patients have a unknown in other patients. Bone scans and magnetic resonance imaging may show slightly higher incidence of sacral coc- inflammation and edema, but neither technique is as accurate as dynamic radiog- cygeal fusion and a more angular sag- raphy. Treatment for patients with severe pain should begin with injection of local ittal alignment of the coccyx than anesthetic and corticosteroid into the painful segment. Coccygeal massage and stretch- asymptomatic patients.4 No pathologic ing of the levator ani muscle can help. Coccygectomy is done only when nonsur- findings have been noted in the id- gical treatment fails, which is infrequent. Coccygectomy usually is successful in care- iopathic or hypermobile segments in fully selected patients, with the best results in those with radiographically demonstrated patients with coccygodynia. The ab- abnormalities of coccygeal mobility. normal subluxation and hypermobil- J Am Acad Orthop Surg 2004;12:49-54 ity appear to cause pain, but coccy- godynia can occur with an immobile coccyx. Only occasionally have post- traumatic nonunion, arthritis, or Coccygodynia, pain in the region of Anatomy malunion been found in surgical spec- the coccyx, typically is triggered by imens. or occurs while sitting. The intensity Five fused sacral and three or four of the pain varies and sometimes is fused coccygeal vertebrae form the ter- aggravated by arising from a seated minal end of the spinal column. Pri- Etiology position. Less severe symptoms may mary ossification centers are evident be managed by changing the sitting in the 9th to 10th week of gestation The clinical factors associated with position or injecting the painful area in the axial skeleton, but the coccyx coccygeal abnormalities are obesity, with local anesthetic and corticoste- does not begin to ossify until after birth. roids. Orthopaedic surgeons often In the sagittal plane, the sacrum is ky- see patients with more severe and photic and connects the lumbosacral Dr. Fogel is Spine Fellow, Department of Ortho- disabling symptoms, which in se- junction to the coccyx. The inferior sa- pedic Surgery, Baylor College of Medicine, Hous- lected cases can be managed suc- cral apex at S5, the sacral cornu, ar- ton, TX. Dr. Cunningham is Medical Research cessfully with surgery. ticulates with the coccygeal cornu, a Fellow, Department of Orthopedic Surgery, Bay- Coccygodynia is five times more facet-disk complex on the dorsal ar- lor College of Medicine. Dr. Esses is Professor of Orthopedics and Brodsky Chair of Spinal Surgery, prevalent in women than men. Al- ticulating surface of the coccyx. This Department of Orthopedic Surgery, Baylor Col- though it can occur over a wide age articulation can be a symphysis or a lege of Medicine. range, mean age of onset is 40 years.