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spinal sagittal imbalance

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
Chao Liu, Guoquan Zheng, Yue Guo, Kai Song, Xiangyu Tang, Xuesong Zhang, Zheng Wang, Yan Wang
OBJECTIVE: To report on the radiologic outcomes of different osteotomy position-selection strategies for a two-level osteotomy for correcting severe ankylosing spondylitis kyphosis. METHODS: From July 2009 to September 2016, a total of 46 patients in our department with severe ankylosing spondylitis kyphosis who underwent two-level pedicle subtraction osteotomy (PSO) were studied. Pre- and postoperative relevant parameters were recorded. The patients were divided into two types and further separated into four groups...
May 2018: Spine Deformity
Rami Alqroom
Introduction: Sagittal imbalance leads to muscular distress and results in low back pain. Objectives: This study scrutinize the segmental impact of short spinal fusion on spinopelvic parameters and the global patient's clinical outcome. Materials and Methods: A retrospective analysis evaluated 56-patients who underwent lumbar fusion surgery at Klinikum Dortmund, from July 2013 to February 2014. The population was allocated into two groups: (1-level group), (2-levels group)...
2018: Acta Informatica Medica: AIM
Jacob Januszewski, Andrew C Vivas, Juan S Uribe
Minimally invasive spine (MIS) surgery has rapidly progressed from simple short segment fusions to large adult deformity corrections, with radiographic and clinical outcomes as good as those of open surgery. Anterior longitudinal ligament release (ALLR) and anterior column realignment (ACR) have been key advancements in the ability to correct deformity using MIS techniques. However, patient selection and appropriate preoperative workup is critical to obtain good outcomes and for complication avoidance. Despite favorable outcomes in spinal deformity surgery, MIS techniques are limited in (I) pronounced cervical or thoracic deformity; (II) patients with prior fusion mass; and (III) severe sagittal imbalance necessitating Schwab 5 osteotomy or higher...
March 2018: Annals of Translational Medicine
H Koller, S Hartmann
BACKGROUND: Surgical correction of severe and rigid cervical kyphosis with chin-on-chest deformity poses significant challenges to both the patient and surgeon once surgery is considered as the treatment of choice. OBJECTIVES: This article presents the current concepts of corrective surgery for patients with severe and rigid cervical kyphosis. MATERIAL AND METHODS: Narrative review and report of clinical experience. RESULTS: The treatment of severe cervical kyphosis indicates a dedicated deformity assessment, the analysis of regional and global imbalance, the identification of spinal sagittal plane compensation mechanisms, detailed radiographic and clinical planning of corrective surgery, and the meticulous performance of surgical correction...
June 2018: Der Orthopäde
A D Tambe, S J Panikkar, P A Millner, A I Tsirikos
Adolescent idiopathic scoliosis (AIS) is a complex 3D deformity of the spine. Its prevalence is between 2% and 3% in the general population, with almost 10% of patients requiring some form of treatment and up to 0.1% undergoing surgery. The cosmetic aspect of the deformity is the biggest concern to the patient and is often accompanied by psychosocial distress. In addition, severe curves can cause cardiopulmonary distress. With proven benefits from surgery, the aims of treatment are to improve the cosmetic and functional outcomes...
April 1, 2018: Bone & Joint Journal
Shashank V Gandhi, Jacob Januszewski, Konrad Bach, Randall Graham, Andrew C Vivas, Jason Paluzzi, Adam Kanter, David Okonkwo, Zachary J Tempel, Nitin Agarwal, Juan S Uribe
BACKGROUND: Development of proximal junctional kyphosis (PJK) after correction of adult spinal deformity (ASD) undermines sagittal alignment. Minimally invasive anterior column realignment (ACR) is a powerful tool for correction of ASD; however, long-term PJK rates are unknown. OBJECTIVE: To characterize PJK after utilization of ACR in ASD correction. METHODS: A retrospective multi-institution cohort analysis per STROBE criteria was conducted of all patients who underwent lateral lumbar interbody fusion (LLIF) or ACR for ASD from 2010 to 2015...
March 28, 2018: Neurosurgery
Sayf S A Faraj, Marinus De Kleuver, Alba Vila-Casademunt, Roderick M Holewijn, Ibrahim Obeid, Emre Acaroğlu, Ahmet Alanay, Frank Kleinstück, Francisco S Pérez-Grueso, Ferran Pellisé
OBJECTIVE Previous studies have demonstrated that among patients with adult spinal deformity (ASD), sagittal plane malalignment is poorly tolerated and correlates with suboptimal patient-reported health-related quality of life (HRQOL). These studies included a broad range of radiographic abnormalities and various types of ASD. However, the clinical and radiographic characteristics of de novo degenerative lumbar scoliosis (DNDLS), a subtype of ASD, may influence previously reported correlation strengths. The aim of this study was to correlate sagittal radiographic parameters with pretreatment HRQOL in patients with symptomatic DNDLS...
June 2018: Journal of Neurosurgery. Spine
Rachid Madkouri, David Brauge, Anthony Vidon-Buthion, Elie Fahed, Klaus-Luc Mourier, Jacques Beaurain, Michael Grelat
OBJECTIVE: To evaluate modifications in static spinal status after posterior decompression surgery without fusion in patients with symptomatic central canal stenosis. METHODS: From November 2014 to May 2016, 72 patients who underwent isolated decompression for lumbar spinal stenosis were enrolled prospectively in this single-center study. All of the patients had lateral full-body x-ray scans with the EOS system (EOS Imaging, Paris, France) before surgery and after 12 months of follow-up...
June 2018: World Neurosurgery
Melvin C Makhni, Jamal N Shillingford, Joseph L Laratta, Seung-Jae Hyun, Yongjung J Kim
The prevalence of patients with adult spinal deformity (ASD) has been reported as high as 68%. ASD often leads to significant pain and disability. Recent emphasis has been placed on sagittal plane balance and restoring normal sagittal alignment with regards to the three dimensional deformity of ASD. Optimal sagittal alignment has been known to increase spinal biomechanical efficiency, reduce energy expenditure by maintaining a stable posture with improved load absorption, influence better bony union, and help to decelerate adjacent segment deterioration...
March 2018: Journal of Korean Neurosurgical Society
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