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spinal sagittal imbalance

F Völlner, J Grifka
BACKGROUND: Sagittal balance is dependent on a complex interplay of the spinal curves, shape and setting of the pelvis, but also the position of the joints of the lower limb. Degenerative processes such as stiffening of the spine, aging of musculature, or reduction of the range of motion of the joints lead to imbalance of the spine after all compensatory mechanisms have been exhausted. OBJECTIVES: Based on standardized imaging, compensation mechanisms must be identified within a biomechanical analysis of the spine, the original sagittal spine profile anticipated and included in the planning of the corrective intervention...
December 11, 2018: Der Orthopäde
Zoe B Cheung, Daniel H Chen, Samuel J W White, Jun S Kim, Samuel K Cho
OBJECTIVE: Anterior column realignment (ACR) is a new emerging minimally invasive surgical technique in adult spinal deformity (ASD) that has the potential to provide similar corrective ability to traditional posterior approaches. This paper reviews the current literature on the clinical efficacy and safety of ACR and illustrates an additional utilization of this technique in a case of sagittal imbalance following posterior spinal fusion with segmental instrumentation. METHODS: We performed a literature search of all published ACR reports using PubMed, including only clinical papers describing the ACR technique and reporting radiographic and/or clinical outcomes...
November 27, 2018: World Neurosurgery
(no author information available yet)
OBJECTIVEComplete radiographic and clinical evaluations are essential in the surgical treatment of cervical spondylotic myelopathy (CSM). Prior studies have correlated cervical sagittal imbalance and kyphosis with disability and worse health-related quality of life. However, little is known about C2-3 disc angle and its correlation with postoperative outcomes. The present study is the first to consider C2-3 disc angle as an additional radiographic predictor of postoperative adverse events.METHODSA retrospective chart review was performed to identify patients with CSM who underwent surgeries from 2010 to 2014...
October 1, 2018: Journal of Neurosurgery. Spine
Vicente Vanaclocha, Vicente Vanaclocha, Amparo Vanaclocha-Saiz, Marlon Rivera-Paz, Carlos Atienza-Vicente, José María Ortiz-Criado, Vicente Belloch, José Manuel Santabárbara-Gómez, Amelia Gómez, Leyre Vanaclocha
STUDY DESIGN: Cadaveric feasibility study. BACKGROUND: Osteotomies to correct fixed sagittal imbalance are usually performed at L3 / L4 . AIM: To investigate the feasibility of S1 pedicle subtraction osteotomy to correct spinal deformity and spinopelvic parameters, achieving better results with a more limited exposure. The data obtained will allow designing a fixation construct specific for this osteotomy. MATERIAL AND METHODS: S1 pedicle subtraction osteotomy was performed on twelve cadaveric specimens...
November 19, 2018: World Neurosurgery
Ibrahim Obeid, Pedro Berjano, Claudio Lamartina, Daniel Chopin, Louis Boissière, Anouar Bourghli
INTRODUCTION: In adult spinal deformity (ASD), sagittal imbalance and sagittal malalignment have been extensively described in the literature during the past decade, whereas coronal imbalance and coronal malalignment (CM) have been given little attention. CM can cause severe impairment in adult scoliosis and ASD patients, as compensatory mechanisms are limited. The aim of this paper is to develop a comprehensive classification of coronal spinopelvic malalignment and to suggest a treatment algorithm for this condition...
November 20, 2018: European Spine Journal
Stephen J Lewis, Sam G Keshen, So Kato, Taylor E Dear, Aaron M Gazendam
Study Design: A retrospective case-control study. Objectives: To determine factors influencing the ability to achieve coronal balance following spinal deformity surgery. Methods: Following institutional ethics approval, the radiographs of 47 patients treated for spinal deformity surgery with long fusions to the pelvis, were retrospectively reviewed. The postoperative measurements included coronal balance, L4 tilt, and L5 tilt, levels fused, apical vertebral translation and maximum Cobb angle...
October 2018: Global Spine Journal
Jack M Haglin, Jakub Godzik, Rohit Mauria, Tyler Cole, Corey T Walker, Udaya Kakarla, Juan S Uribe, Jay D Turner
BACKGROUND: Sagittal imbalance in adult spinal deformity (ASD) likely influences balance and ambulatory capacity due to muscular demand, pain, and disability. Disability measures for ASD rely heavily on ambulatory function, yet current metrics may fail to fully capture its contribution. We sought to determine (1) the utility of continuous remote step-count monitoring and activity tracking in ASD using a consumer-friendly accelerometer, and (2) investigate trends and patterns both before and after surgical intervention...
November 12, 2018: World Neurosurgery
Yusuke Hori, Akira Matsumura, Takashi Namikawa, Minori Kato, Shinji Takahashi, Shoichiro Ohyama, Tomonori Ozaki, Akito Yabu, Hiroaki Nakamura
BACKGROUND: The degenerative lumbar scoliosis (DLS) patients who mainly complained about neurogenic claudication due to spinal canal stenosis are well-indicated for short segment fusion (SSF) at the affecting levels. However, it is unclear whether we should consider global sagittal balance or not. The aim of this study was to evaluate the impact of sagittal balance on the surgical outcomes of degenerative lumbar scoliosis (DLS) patients who underwent SSF. METHODS: We retrospectively reviewed 70 DLS patients who underwent SSF (less than 3 levels) and could be followed for at least 2 years...
October 31, 2018: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
Xiaobang Hu, Isador H Lieberman
PURPOSE: To study the effect of the number of previous operations on the outcome of revision adult spinal deformity (ASD) surgery. METHODS: One hundred and thirty-seven consecutive patients who underwent revision ASD surgery were classified as follows: those who had one previous operation (group 1), had two previous operations (group 2) and had three or more previous operations (group 3). Perioperative complications and additional surgeries were reviewed. Back pain, leg pain, ODI scores and radiographic measurements were obtained...
October 31, 2018: European Spine Journal
Zifang Zhang, Kai Song, Bing Wu, Pengfei Chi, Zhaohan Wang, Zheng Wang
STUDY DESIGN: A retrospective radiographic study. OBJECTIVE: To explore the radiological parameters which correlated to postoperative immediately coronal imbalance in adult spinal deformity (ASD) and to determine whether preoperative coronal imbalance affects postoperative coronal imbalance following posterior multi-level fusion with instruments and osteotomy operation. SUMMARY OF BACKGROUND DATA: There was paucity of literature paying attention to the postoperative immediately coronal imbalance after operation...
October 11, 2018: Spine
Kenji Fukaya, Mitsuhiro Hasegawa
OBJECTIVE: Minimally invasive surgery(MIS)for adult spinal deformity(ASD)is aimed at minimizing perioperative and postoperative complications. However, MIS techniques have been reported to result in suboptimal sagittal plane correction or pseudoarthrosis when used for severe deformities. The authors present their early experience with circumferential MIS(cMIS), which involves oblique lumbar interbody fusion(OLIF)with percutaneous pedicle screw(PPS)fixation using a rod cantilever technique to enhance lumbar lordosis(LL)for ASD...
September 2018: No Shinkei Geka. Neurological Surgery
Federico Solla, Cédric Y Barrey, Evalina Burger, Christopher J Kleck, Vincent Fière
STUDY DESIGN: This was an innovative concept and a preliminary prospective series. OBJECTIVE: The aim of this study was to present the concept and the technical aspects of patient-specific rods (PSR), and compare preoperative and postoperative sagittal parameters (after PSR implantation), with a special focus on the difference pelvic incidence (PI)-lumbar lordosis (LL). BACKGROUND: Despite established techniques for planning and proven correlations between quality of life and sagittal alignment, some patients do not achieve optimal radiologic outcomes after surgery and are still hypolordotic and imbalanced...
September 25, 2018: Clinical Spine Surgery
Brittany E Haws, Benjamin Khechen, Dil V Patel, Philip K Louie, Sravisht Iyer, Kaitlyn L Cardinal, Jordan A Guntin, Kern Singh
STUDY DESIGN: Retrospective Cohort. SUMMARY OF BACKGROUND DATA: Studies have shown that lumbar fusion procedures are associated with an increased risk of total hip arthroplasty (THA) dislocation. Some have speculated that the increased risk of dislocation is caused by mispositioning of the acetabular component because of spinal sagittal imbalance. Unfortunately, the exact relationship between spinal sagittal balance and cup orientation is unknown. OBJECTIVE: The objective of this study was to investigate the effect of spinal sagittal alignment on cup anteversion in THA dislocation...
September 21, 2018: Clinical Spine Surgery
Andrew K Chan, Alvin Y Chan, Darryl Lau, Beata Durcanova, Catherine A Miller, Paul S Larson, Philip A Starr, Praveen V Mummaneni
OBJECTIVE Camptocormia is a potentially debilitating condition in the progression of Parkinson's disease (PD). It is described as an abnormal forward flexion while standing that resolves when lying supine. Although the condition is relatively common, the underlying pathophysiology and optimal treatment strategy are unclear. In this study, the authors systematically reviewed the current surgical management strategies for camptocormia. METHODS PubMed was queried for primary studies involving surgical intervention for camptocormia in PD patients...
September 14, 2018: Journal of Neurosurgery
Hassan Ghandhari, Maryam Ameri Mahabadi, Farshad Nikouei, Saeed Sabbaghan, Abouzar Azizi, Alireza Mirzaei, Behrooz Givehchian
Background: Sagittal imbalance is known as the main radiographic driver of disability in adult spinal deformity (ASD). In this study, the association of radiological spinopelvic parameters and clinical outcomes was evaluated following the corrective surgery of sagittal imbalance, in order to explore the predictive ability of each parameter. Methods: A total of 23 patients, who underwent corrective osteotomy for restoration of sagittal balance, were included in this study...
July 2018: Archives of Bone and Joint Surgery
Xudong J Li, Lawrence G Lenke, Earl Thuet, Lee A Tan, Alexander Tuchman
BACKGROUND: Transcranial motor evoked potential (TcMEP) is widely used intraoperatively to monitor spinal cord and nerve root function. To our knowledge, there is no report regarding TcMEP signal loss purely caused by patient positioning during the spinal procedure. PURPOSE: The objective of this article is to report an intraoperative TcMEP signal loss of a patient with fixed sagittal imbalance posture along with mild hip contractures. STUDY DESIGN: A retrospective case report...
September 2018: Spine Deformity
Yuji Matsuoka, Kenji Endo, Hidekazu Suzuki, Yasunobu Sawaji, Hirosuke Nishimura, Taichiro Takamatsu, Osamu Kojima, Kazuma Murata, Takeshi Seki, Shinji Horie, Takamitsu Konishi, Kengo Yamamoto
STUDY DESIGN: Retrospective study. PURPOSE: To investigate the relationship between preoperative total spinal sagittal alignment and the early onset of adjacent segment degeneration (ASD) after single-level posterior lumbar interbody fusion (PLIF) in patients with normal sagittal spinal alignment. OVERVIEW OF LITERATURE: Postoperative early-onset ASD is one of the complications after L4-L5 PLIF, a common surgical procedure for lumbar degenerative disease in patents without severe sagittal imbalance...
August 2018: Asian Spine Journal
Sho Dohzono, Hiromitsu Toyoda, Yusuke Hori, Shinji Takahashi, Akinobu Suzuki, Hidetomi Terai, Hiroaki Nakamura
BACKGROUND AND STUDY AIMS:  Spinopelvic sagittal balance is important in managing lumbar diseases. We evaluated the change in spinal sagittal alignment after microendoscopic laminotomy in patients with low-grade degenerative spondylolisthesis (DS). MATERIAL AND METHODS:  We retrospectively reviewed the records of 87 patients who underwent microendoscopic laminotomy. We enrolled 35 patients with DS and 52 patients without DS. Spinopelvic parameters were evaluated, including the sagittal vertical axis (SVA), lumbar lordosis (LL), sacral slope, pelvic tilt, and pelvic incidence (PI)...
November 2018: Journal of Neurological Surgery. Part A, Central European Neurosurgery
Yuji Matsuoka, Hidekazu Suzuki, Kenji Endo, Yasunobu Sawaji, Kazuma Murata, Hirosuke Nishimura, Hidetoshi Tanaka, Kengo Yamamoto
OBJECTIVE Preoperative positive cervical sagittal imbalance and global sagittal imbalance are risk factors for postoperative cervical kyphosis after expansive open-door cervical laminoplasty (ELAP). The purpose of this study was to investigate the relationship between the incidence of postoperative cervical kyphosis after ELAP and the preoperative global sagittal spinal alignment in patients with cervical spondylotic myelopathy (CSM) without spinal sagittal imbalance. METHODS Among 84 consecutive patients who underwent ELAP for CSM at the authors' hospital, 43 patients without preoperative cervical kyphosis (C2-7 angle ≥ 0°) and spinal sagittal imbalance (C2-7 sagittal vertical axis [SVA] ≤ 80 mm and C-7 SVA ≤ 95 mm) were included in the study...
August 2018: Journal of Neurosurgery. Spine
Weiwei Xia, Chenjun Liu, Shuo Duan, Shuai Xu, Kaifeng Wang, Zhenqi Zhu, Haiying Liu
BACKGROUND: The typical degeneration of the vertebral endplate shown in MRI imaging is Modic change. The aim of this study was to observe the distribution of the Modic changes of vertebral endplate in degenerative thoracolumbar/lumbar kyphosis (DTK/LK) patients and analyse the correlation between spinal-pelvic parameters and Modic changes. METHODS: The imaging data of 58 patients diagnosed with DTK/LK (coronal Cobb angle<10°with sagittal imbalance) in our hospital from March 2016 to May 2017 were reviewed retrospectively...
2018: PloS One
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