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Dariusz Czaprowski, Łukasz Stoliński, Marcin Tyrakowski, Mateusz Kozinoga, Tomasz Kotwicki
Background: The physiological sagittal spinal curvature represents a typical feature of good body posture in the sagittal plane. The cervical and the lumbar spine are curved anteriorly (lordosis), while the thoracic segment is curved posteriorly (kyphosis). The pelvis is inclined anteriorly, and the lower limbs' joints remain in a neutral position. However, there are many deviations from the optimal body alignment.The aim of this paper is to present the most common types of non-structural misalignments of the body posture in the sagittal plane...
2018: Scoliosis and Spinal Disorders
Zhenjun Zhang, Guy R Fogel, Zhenhua Liao, Yitao Sun, Weiqiang Liu
Inappropriate lordotic angle of lumbar fusion cage could be associated with cage damage or subsidence. The biomechanical influence of cage lordotic angle on lumbar spine has not been fully investigated. Four surgical finite element models were constructed by inserting cages with various lordotic angles at L3-L4 disc space. The four motion modes were simulated. The range of motion (ROM) decreased with increased lordotic angle of cage in flexion, extension, and rotation, whereas it was not substantially changed in bending...
March 7, 2018: Computer Methods in Biomechanics and Biomedical Engineering
Yijian Zhang, Hao Liu, Huilin Yang, Bin Pi
PURPOSE: To compare the postoperative sagittal balance and occurrence of axial symptoms between anterior cervical corpectomy and fusion (ACCF) and anterior cervical discectomy and fusion (ACDF) for the treatment of two-level cervical spondylotic myelopathy (CSM). METHODS: A total of 71 consecutive patients who underwent ACCF or ACDF for two-level CSM in our institution from January 2014 to December 2016 were retrospectively reviewed. Of these patients, 30 (17 males, 13 females) were subjected to ACCF, and 41 (20 males, 21 females) were treated with ACDF...
February 24, 2018: International Orthopaedics
Chengzhen Jin, Milin S Jaiswal, Sin-Soo Jeun, Kyeong-Sik Ryu, Jung-Woo Hur, Jin-Sung Kim
BACKGROUND: Oblique lateral interbody fusion (OLIF) offers the solution to problems of anterior lumbar interbody fusion (ALIF) and lateral lumbar interbody fusion (LLIF). However, OLIF technique for degenerative spinal diseases of elderly patients has been rarely reported. The objective of this study was to determine the clinical and radiological results of OLIF technique for degenerative spinal diseases in patients under or over 65 years of age. METHODS: Sixty-three patients who underwent OLIF procedure were enrolled, including 29 patients who were less than 65 years of age and 34 patients who were over 65 years of age...
February 20, 2018: Journal of Orthopaedic Surgery and Research
B Lin, Z D Chen, T Y Cai, S S Wu, Z M Guo
Objective: To investigate the clinical curative effect of C(1)-C(2) pedicle screw fixation for pediatric atlantoaxial dislocation after a long-term follow-up. Methods: From March 2005 to April 2011, a total of 12 male and 9 female patients were included, with age from 3 to 9 years old (mean, 6.1 years old). Among them, 14 cases (67%) had typeⅠinstability atlantoaxial dislocation, 7 cases (33%) had type Ⅱ reducible atlantoaxial dislocation. All 21 pediatric patients with atlantoaxial dislocation underwent posterior pedicle screw fixations...
February 6, 2018: Zhonghua Yi Xue za Zhi [Chinese medical journal]
Yasser Kentar, Manuela Brunner, Thomas Bruckner, Andreas Hug, Patric Raiss, Felix Zeifang, Markus Loew, Haidara Almansour, Michael Akbar
BACKGROUND: We investigated the impact of poor seated posture on the prevalence of rotator cuff tears (RCTs) among wheelchair-dependent individuals with long-standing paraplegia. METHODS: The study included 319 patients. Lateral radiographs of the spine were collected from a database and analyzed to assess the global spinopelvic alignment (SPA). Magnetic resonance images of both shoulders were obtained to detect the presence of cuff tears. Patients were divided into 2 groups: Group RCT-I included all patients with cuff tears (right, left, or bilateral), whereas group RCT-II consisted exclusively of patients with bilateral cuff tears...
February 8, 2018: Journal of Shoulder and Elbow Surgery
F Lattig, E Stettin, S Weckbach
OBJECTIVE: Correction of a segmental or global lumbar hypolordosis to improve a sagittal imbalance. INDICATIONS: Lumbar segments fixed in kyphosis; degenerative or posttraumatic hypolordotic deformity of the lumbar spine with sagittal imbalance. CONTRAINDICATIONS: Bechterew disease; extended adhesions in the retroperitoneum. SURGICAL TECHNIQUE: Segmental correction of a kyphotic fixed segment using a unilateral transforaminal approach to release the annulus and anterior longitudinal ligament...
February 2, 2018: Operative Orthopädie und Traumatologie
Koji Tamai, Joshua Romanu, Phillip Grisdela, Permsak Paholpak, Pengfei Zheng, Hiroaki Nakamura, Zorica Buser, Jeffrey C Wang
BACKGROUND CONTEXT: Cervical sagittal vertical axis (cSVA) of ≥40mm is recognized as the key factor of poor health-related quality of life, poor surgical outcomes, and correction loss after surgery for cervical deformity. However, little is known about the radiological characteristics of patients with cSVA≥40mm. PURPOSE: The purpose of this study was to identify the radiological characteristics of patients with cervical imbalance. DESIGN: Retrospective analysis of weight-bearing cervical magnetic resonance (MR) images PATIENT SAMPLE: Consecutive 1,500 MR images of symptomatic patients in weight-bearing position OUTCOME MEASURES: cSVA, cervical alignment, cervical balance parameters (T1 slope, Co-C2 angle, C2-C7 angle, C7-T1 angle, neck tilt and thoracic inlet angle), disc degeneration (Pfirmann and Suzuki classification), endplate degeneration (Modic change), Spondylolisthesis (antero- and retrolisthesis), antero-posterior (AP) diameter of dural sac, cross-sectional area (CSA) and fat infiltration ratio of the transversospinalis muscles at C4 and C7 levels METHODS: Patients were divided into two groups: cervical sagittal vertical axis (cSVA) ≥40mm and <40mm...
January 17, 2018: Spine Journal: Official Journal of the North American Spine Society
Andrew P Claus, Julie A Hides, G Lorimer Moseley, Paul W Hodges
BACKGROUND: Previous research explored muscle activity in four distinct sitting postures with fine-wire electromyography, and found that lumbar multifidus muscle activity increased incrementally between sitting with flat thoracolumbar and lumbar regions, long thoracolumbar lordosis, or short lordosis confined to the lumbar region. This study used similar methods to explore whether people with a history of low back pain provoked by prolonged sitting used different patterns of trunk muscle activity in specific postures...
January 10, 2018: Clinical Biomechanics
Chao Sun, Wei Ji Tian, Hui Xin Liu, Ping Guo Guan
PURPOSE: The aim of this study was to evaluate the clinical and radiologic results of multisegmental transforaminal enlarged decompression (TED) plus posterior pedicle screw fixation in the treatment of multilevel lumbar spinal canal stenosis (LSCS) with lumbar instability (MLSCSI). METHODS: 113 patients with MLSCSI underwent surgery were recruited in this study. All patients were suffering from symptoms typical of degenerative LSCS and treated with either TED plus fusion (TEDF group) or conventional laminectomy plus fusion (CLF group)...
January 9, 2018: International Journal of Surgery
Kittipong Sessumpun, Permsak Paholpak, Kevork N Hindoyan, Koji Tamai, Thananit Sangkomkamhang, Zorica Buser, Jeffrey C Wang
STUDY DESIGN: Retrospective study. OBJECTIVE: To evaluate how each type of sagittal cervical alignment affects the motion of the upper and subaxial cervical spine using kinematic magnetic resonance imaging. SUMMARY OF BACKGROUND DATA: The sagittal malalignment of the cervical spine from degeneration in the subaxial cervical spine reflects a disruption in the kinematic properties of the cervical spine and affects the motion of adjacent segments...
January 8, 2018: Clinical Spine Surgery
Fatih Dikici, Turgut Akgul, Kerim Sariyilmaz, Murat Korkmaz, Okan Ozkunt, Cuneyt Sar, Unsal Domanic
OBJECTIVE: The aim of this study was to investigate the effect of distal fusion level selection on the distal junctional kyphosis (DJK) in Scheuermann kyphosis (SK) patients who underwent posterior fusion. METHODS: Thirty-nine SK patients who underwent posterior fusion with a minimum follow-up of 3 years were retrospectively evaluated. According to the distal fusion level, patients were divided into 3 groups. Group S; lowest instrumented vertebra (LIV) was the sagittal stable vertebra (SSV), Group F; LIV was the first lordotic vertebra (FLV) and, Group L; LIV was the lower end vertebra (LEV)...
December 28, 2017: Acta Orthopaedica et Traumatologica Turcica
Lara W Massie, Hesham Mostafa Zakaria, Lonni R Schultz, Azam Basheer, Morenikeji Ayodele Buraimoh, Victor Chang
OBJECTIVE The inability to significantly improve sagittal parameters has been a limitation of minimally invasive surgery for transforaminal lumbar interbody fusion (MIS TLIF). Traditional cages have a limited capacity to restore lordosis. This study evaluates the use of a crescent-shaped articulating expandable cage (Altera) for MIS TLIF. METHODS This is a retrospective review of 1- and 2-level MIS TLIF. Radiographic outcomes included differences in segmental and lumbar lordosis, disc height, evidence of fusion, and any endplate violations...
January 2018: Neurosurgical Focus
Zhen Zhang, Zhen Liu, Zezhang Zhu, Yong Qiu
This is a retrospective study. The aim of this study was to access sagittal compensatory mechanism of the cervical spine in thoracic adolescent idiopathic scoliosis (T-AIS) before and after posterior spinal fusion and to identify preoperative or immediate postoperative radiographic parameters that can predict the ultimate cervical sagittal alignment (CSA) after long-term follow-up.A retrospective study was performed on 44 T-AIS patients treated with posterior spinal fusion and with at least 5 years of follow-up...
December 2017: Medicine (Baltimore)
Jae Hwan Cho, Chang Ju Hwang, Young Hyun Choi, Dong-Ho Lee, Choon Sung Lee
OBJECTIVE Cervical sagittal alignment (CSA) is related to function and quality of life, but it has not been frequently studied in patients with adolescent idiopathic scoliosis. This study aimed to reveal the change in CSA following corrective surgery, compare the cervical sagittal parameters according to curve types, and assess related factors for postoperative aggravation of CSA. METHODS The authors studied 318 consecutive patients with adolescent idiopathic scoliosis who underwent corrective surgery at a single center...
December 15, 2017: Journal of Neurosurgery. Pediatrics
Manoj Dayalal Singrakhia, Nikhil Ramdas Malewar, Sonal Manoj Singrakhia, Shivaji Subhash Deshmukh
Background: Anterior cervical decompression and fusion is the standard procedure used for treating patients with cervical myelopathy. However, these procedures are associated with complications such as pseudarthrosis, construct failure, and neurological complications. Posterior cervical laminectomy and instrumentation is an alternative procedure to treat multilevel cervical myelopathy. In this study, we raised questions whether instrumentation is required at all levels and whether stabilizing the spine in neutral or lordotic contour with indirect decompression leads to neurological improvement with radiological evidence of anterior decompression...
November 2017: Indian Journal of Orthopaedics
Fahad H Abduljabbar, Alisson R Teles, Rakan Bokhari, Michael Weber, Carlo Santaguida
Stand-alone cervical laminectomy for degenerative cervical myelopathy (DCM) has become increasingly rare due to risk of postlaminectomy kyphosis. This article discusses the biomechanics of cervical degeneration and how laminectomy effects spine stability, and summarizes relevant clinical studies to help guide surgical decision-making for the posterior treatment of DCM. Laminectomy and fusion remains a safe and efficacious treatment. Stand-alone laminectomy should only be used for a highly selected patient population with relative stiff lordotic cervical spines, using care to not disrupt facets and C2 and C7 muscle attachments...
January 2018: Neurosurgery Clinics of North America
Simone Parrini, Benedetta Comba, Gabriele Rossini, Serena Ravera, Giovanni Cugliari, Ilaria De Giorgi, Andrea Deregibus, Tommaso Castroflorio
BACKGROUND: Correlation between malocclusions and body posture has been discussed in the last decades, but there is still a lack of consensus in existing literature. Rasterstereography allows tridimensional reconstruction of the spine, starting from the back surface analysis. So far studies which tested modifications of rasterstereographic parameters during orthodontic treatment, comparing with those obtained from untreated control group, are not available. Clear aligner treatment produces alteration of vertical height due to the occlusal coverage and, subsequently, a stimulation of periodontal receptors which causes an inhibition of the jaw closing muscles and, hypothetically, changes in mandibular posture...
February 2018: Journal of Electromyography and Kinesiology
Masashi Miyazaki, Toshinobu Ishihara, Naoki Notani, Shozo Kanezaki, Hiroshi Tsumura
OBJECTIVE: T1 slope (T1S) has emerged as a predictor of kyphotic alignment change after laminoplasty. Although it was reported that patients with cervical ossification of the posterior longitudinal ligament (OPLL) and higher T1S had more pronounced lordotic curvature before surgery and higher loss of cervical lordosis after surgery, few studies have attempted to correlate these findings with clinical outcomes. We aimed to investigate the relationship of T1S with loss of cervical lordosis and surgical outcomes after laminoplasty for cervical OPLL...
November 13, 2017: Clinical Neurology and Neurosurgery
Hao Li, Xiaopeng Zhou, Gang Chen, Fangcai Li, Junfeng Zhu, Qixin Chen
Combined upper cervical cord compression associated with cervical ossification of the posterior longitudinal ligament (OPLL) is a rare and under-recognized disorder. The aim of this study was to investigate the radiological manifestations and surgical outcome of this combined disease.Between May 2011 and July 2015, patients who underwent surgery for combined upper cervical cord compression and cervical OPLL in our institution were included in this study. After a minimum 2-year follow-up, radiological and clinical data were collected...
November 2017: Medicine (Baltimore)
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