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Sagittal balance

Matteo Palmisani, Eugenio Dema, Stefano Cervellati, Rosa Palmisani
PURPOSE: To compare the 2-year minimum postoperative results of posterior correction and spinal arthrodesis using translational correction with hybrid (sublaminar bands on concave side and pedicle screw) constructs versus correction with intermediate density pedicle screw-only constructs in the treatment of AIS (Lenke 1). METHODS: A total of 37 patients with AIS at single institutions who underwent posterior spinal arthrodesis pedicle screw with sublaminar bands at the apex (19 patients) (Group A) or pedicle screw-only (18) constructs (Group B) were selected and matched according to similar age at surgery 13...
May 17, 2018: European Spine Journal
Qi Lai, Tian Gao, Xin Lv, Xuqiang Liu, Zongmiao Wan, Min Dai, Bin Zhang, Tao Nie
BACKGROUND: Pain and disability associated with degenerative lumbar spondylolisthesis (DLS) results in significant burden on both the patients' quality of life and healthcare costs. Currently, there is controversy regarding the specificity of spinopelvic measures of sagittal plane alignment with respect to DLS. Moreover, the correlation among spinopelvic parameters of sagittal plane alignment remains to be clarified. Our aim in this study was to compare these measurements between patients with single-segment DLS at L5 and a control group with no history of DLS...
May 16, 2018: BMC Musculoskeletal Disorders
Ioannis Siasios, Evan Winograd, Asham Khan, Kunal Vakharia, Vassilios G Dimopoulos, John Pollina
Background: Normal sagittal cervical alignment has been associated with improved outcome after anterior cervical discectomy and fusion (ACDF). Objective: The aim of this study is to identify alterations of cervical sagittal balance parameters after single-level ACDF and assess correlations with postoperative functionality. Methods: A retrospective chart review was performed between January 2010 and January 2014 to identify adult patients with no previous cervical spine surgery who underwent ACDF at any one level between C2 and C7 for the single-level degenerative disease...
January 2018: Journal of Craniovertebral Junction and Spine
Masashi Okamoto, Fouad Jabour, Kenichiro Sakai, Shun Hatsushikano, J C Le Huec, Kazuhiro Hasegawa
PURPOSE: An innovative low-dose X-ray biplanar imager (EOS®) allows measurement of the whole-body in standing-position which is necessary for the evaluation of spinal deformities. METHODS: A total of 60 asymptomatic subjects (ages 20-81 years) were evaluated using the 3D workflow called postural assessment and 2D measures. Subjects were measured twice each by two new observers following training, including: lordosis/kyphosis, pelvic parameters, sagittal-vertical axis, and spinal-sacral angle...
May 7, 2018: European Radiology
Pooria Hosseini, Behrooz A Akbarnia, Stacie Nguyen, Jeff Pawelek, John Emans, Peter F Sturm, Paul D Sponseller
INTRODUCTION: In addition to patient characteristics, consideration of length of construct to number of anchored levels ratio and rod diameter should be a part of preoperative planning to minimize implant-related complications (IRCs). IRCs including rod breakage, anchor dislodgement, and pullout are among the most common adverse events in traditional growing rods (TGRs). The current study hypothesized that anchor type and configuration are associated with IRC. METHODS: Patients with (1) age ≤10 years at surgery; (2) spine-based dual TGR; (3) minimum 2-year follow-up; and (4) available imaging...
May 2018: Spine Deformity
Javier Pizones, Mar Pérez Martín-Buitrago, José Miguel Sánchez Márquez, Nicomedes Fernández-Baíllo, Montserrat Baldan-Martin, Francisco Javier Sánchez Pérez-Grueso
STUDY DESIGN: Retrospective comparative analysis. OBJECTIVE: Study early-onset scoliosis (EOS) graduated patients to establish founded criteria for graduation decision making and determine the risks and benefits of definitive fusion. SUMMARY OF BACKGROUND DATA: EOS is treated by growth-friendly techniques until skeletal maturity. Afterwards, patients can be "graduated," either by definitive fusion (posterior spinal fusion [PSF]) or by retaining the previous implants (Observation) with no additional surgery...
May 2018: Spine Deformity
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
Courtney O'Donnell, Nicole Michael, X Pan, John Emans, Sumeet Garg, Mark Erickson
STUDY DESIGN: Retrospective cohort study. OBJECTIVE: Retrospective comparison of radiographic and clinical outcomes between anterior spinal fusion (ASF) and posterior spinal fusion (PSF) in surgical treatment of Lenke 5 curves. SUMMARY OF BACKGROUND DATA: ASF and PSF are used for treatment of Lenke 5 curves in patients with adolescent idiopathic scoliosis (AIS). Currently, no consensus exists for optimal surgical treatment of Lenke 5 curves...
May 2018: Spine Deformity
Kousei Miura, Masao Koda, Hideki Kadone, Tetsuya Abe, Hiroshi Kumagai, Katsuya Nagashima, Kentaro Mataki, Kengo Fujii, Hiroshi Noguchi, Toru Funayama, Kenji Suzuki, Masashi Yamazaki
A 75-year-old Japanese woman with Parkinson's disease complained of lower back pain and gait disturbance because of iatrogenic flatback syndrome. The preoperative global spinal parameters were as follows: C7SVA, 168 mm; TK, 52°; LL, -0.8°; PI, 57°; PT, 55°; TPA, 60°. We performed 3D gait analysis using a VICON System and calculated the dynamic SVA. Preoperatively, her flexion deformity gradually progressed during walking. The dynamic parameters gradually increased as follows: thoracic SVA, 216-241 mm; lumbar SVA, 53-69 mm; spinal SVA, 270-311 mm...
May 3, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
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
Jun Mizutani, Russell Strom, Kuniyoshi Abumi, Kenji Endo, Ken Ishii, Mitsuru Yagi, Bobby Tay, Vedat Deviren, Christopher Ames
BACKGROUND: There have been no reports describing how cervical reconstruction surgery affects global spinal alignment (GSA). OBJECTIVE: To elucidate the effects of cervical reconstruction for GSA through a retrospective multicenter study. METHODS: Seventy-eight patients who underwent cervical reconstruction surgery for cervical kyphosis were divided into a Head-balanced group (n = 42) and a Trunk-balanced group (n = 36) according to the values of the C7 plumb line (PL)...
April 28, 2018: Neurosurgery
Koon-Man Sieh, Yue-Yan Chan, Po-Yan Ho, Kwai-Yau Fung
PURPOSE: To evaluate the influence of different arm postures from the physiological standing position using force plate analysis of the gravity line. METHODS: Forty healthy volunteered university students were enrolled. Each subject assumed different standing positions including standing with arms resting on the side (control), with fist over the clavicle (clavicular position), with active shoulder flexion in 30°, 60° and 90° with elbows extended (active flexion A), with hand rest on a bar with a static support (passive flexion P), and with hand rest on a bar with a drip stand (passive flexion D)...
May 2018: Journal of Orthopaedic Surgery
Sai Krishna M L V, Deep Sharma, Jagdish Menon
Study Design: This was a prospective, two-group comparative study. Purpose: The present study aimed to determine the importance of the spinopelvic parameters in the causation and progression of spondylolisthesis. Overview of Literature: Spondylolisthesis is slippage of one vertebra over the vertebra below. Since the discovery of pelvic incidence (PI) in 1998 in addition to documentation of other parameters in spinopelvic balance, slippage in spondylolisthesis has been attributed to these parameters...
April 2018: Asian Spine Journal
Mustafa Uysal, Metin Ozalay, Alihan Derincek, Alauddin Kochai, Mehmet Turker
OBJECTIVE: The aim of this study was to evaluate the effects of PLIF and TLIF on sagittal spinopelvic balance and to compare radiological results of two surgical procedures with regard to spinopelvic parameters. METHODS: Thirty-five patients (34 female and 1 male; mean age: 52.29 ± 13.08 (range: 35-75)) with degenerative spondylolisthesis cases were included in the study. Patients were divided into two groups according to surgical technique: PLIF and TLIF. The level and the severity of listhesis according to Meyerding classification were assessed and spinopelvic parameters including sacral slope, pelvic tilt, pelvic incidence (PI), lumbar lordosis, and segmental lumbar lordosis were measured on digital X-rays...
April 25, 2018: Acta Orthopaedica et Traumatologica Turcica
Shahram Oliaei, Mohammed N Ashtiani, Kamran Azma, Sandra Saidi, Mahmood-Reza Azghani
Standing on an unstable platform requires continuous effort of the neuro‑musculoskeletal system. The aim of the present study is to evaluate the ability to remain standing on an unstable platform at different levels of postural and cognitive difficulty. Healthy young males stood in the sagittal plane on an unstable platform supported by a pair of springs with modifiable stiffness. The balance test also assessed different levels of vision and cognitive function. Linear and nonlinear metrics of standing, based on motion captured kinematic data, were assessed to analyze the stability of standing...
2018: Acta Neurobiologiae Experimentalis
Joshua M Pahys, Andrew C Vivas, Amer F Samdani, Gregory Cunn, Randal R Betz, Peter O Newton, Patrick J Cahill
STUDY DESIGN: A retrospective review of a prospectively collected multicenter database OBJECTIVE.: To assess the effect of proximal hooks vs. screws on proximal junctional kyphosis (PJK) as well as shoulder balance in otherwise all pedicle screw (>80%) posterior spinal fusion (PSF) constructs in adolescent idiopathic scoliosis (AIS). SUMMARY OF BACKGROUND DATA: Less rigid forms of fixation at the top of constructs in degenerative lumbar PSF have been postulated to decrease the risk of PJK...
April 23, 2018: Spine
Satoshi Nori, Tateru Shiraishi, Ryoma Aoyama, Ken Ninomiya, Junichi Yamane, Kazuya Kitamura, Seiji Ueda
PURPOSE: A high C7 slope induces C2-C7 lordosis to compensate for cervical sagittal balance adjustments. A muscle-preserving selective laminectomy (SL) can maintain this compensation postoperatively. This study evaluated the effect of an extremely high C7 slope on C2-C7 lordotic compensation following SL. METHODS: This study enrolled 151 cervical compressive myelopathy patients who underwent SL. Lateral cervical spine radiographs were taken before surgery and during final follow-up...
April 23, 2018: European Spine Journal
Vincent V G An, Corey J Scholes, Brett A Fritsch
PURPOSE: This study aimed to systematically review the literature and identify factors which would contribute to the intraoperative correction of FFD to frame a potential surgical algorithm or predictive model to guide intraoperative decision-making. METHODS: Electronic searches of six databases were undertaken in April 2016 according to the PRISMA guidelines, and the reference lists of studies searched. Quality of studies was assessed using the STROBE checklist, and the Downs and Black Scores...
April 19, 2018: Knee
Robert K Merrill, Jun S Kim, Ian T McNeill, Samuel C Overley, James E Dowdell, John M Caridi, Samuel K Cho
Study Design: Retrospective cohort study. Objective: Elucidate negative sagittal balance following adult spinal deformity surgery. Methods: We conducted a retrospective review of adult spinal deformity patients who underwent long fusion (>5 levels) to the sacrum by a single surgeon at a single institution between 2011 and 2015. Patients were divided into cohorts of postoperative sagittal vertical axis (SVA) <-10 mm, between -10 and +10 mm, or >+10 mm, denoted as groups 1, 2, and 3, respectively...
April 2018: Global Spine Journal
Su Hun Lee, Dong Wuk Son, Jun Seok Lee, Dong Ha Kim, Soon Ki Sung, Sang Weon Lee, Geun Sung Song
OBJECTIVE: Anterior cervical discectomy and fusion (ACDF) and laminoplasty (LP) are the most commonly performed procedures for degenerative cervical spondylosis. Cervical sagittal alignment (CSA) has recently been studied as an important predictor of clinical and radiological outcomes. The data from previous studies are insufficient for analysis using the recently designed CSA parameters, T1 slope (T1s), and T1s minus cervical angle (T1sCA). METHODS: We retrospectively collected data from patients who underwent ACDF and LP from January 2013 to May 2016...
March 2018: Neurospine
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