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Sagittal balance

Enrico Tessitore, Granit Molliqaj, Karl Schaller, Oliver Pascal Gautschi
Extreme lateral interbody fusion (XLIF) is an alternative to standard posterior approaches for achieving fusion in the lumbar spine. It allows exposure of the lateral aspect of the lumbar disc through a lateral approach with the possibility to insert a wide footprint interbody cage as a stand-alone procedure or associated with a uni- or bilateral percutaneous fixation. This is a retrospective series of 20 consecutive patients operated with a XLIF procedure from 2014 to 2015. N=10 women and N=10 men with a mean age of 67...
October 17, 2016: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Shaishav Bhagat, Alexander Z E Durst, Am S Rai
With an increasingly aging population, adult spinal deformity is becoming more common. This can be associated with increased morbidity. Results from multicentre studies of deformity surgery correction confirm complication rates as high as 40 percent. Most often a bad result is associated with inadequate restoration of the sagittal balance. Posterior vertebral body resection has been described as a method to correct significant deformity, but this is a complicated procedure. It is possible to do this in the thoracic spine where nerve roots can be sacrificed, but it is difficult in the lumbar spine due to the significant role of the lumbar nerve roots...
September 2016: J Spine Surg
Junlin Yang, Zifang Huang, Michael Grevitt, Jun Li, Fobao Li, Jingfan Yang
STUDY DESIGN: To report a new technique. OBJECTIVE: To introduce a new method of precise correction controlling for ankylosing spondylitis kyphosis. SUMMARY OF BACKGROUND DATA: The exact angle method is excellent for calculating the pedicle subtraction osteotomy angle but is difficult to perform during surgery. In this study, the precise rod bending technique was proposed as a new method for precise correction controlling for ankylosing spondylitis kyphosis through illustrative cases...
November 2016: Clinical Spine Surgery
Hsuan-Lun Lu, Tung-Wu Lu, Hsiu-Chen Lin, Hong-Jung Hsieh, Wing P Chan
Treadmills are often used in clinical settings to improve walking balance control in patients with gait impairments. However, knowledge of the effects of belt speed on balance control remains incomplete. The current study determined such effects in terms of inclination angles (IA) and the rate of change (RCIA) of the center of mass (COM) motion relative to the center of pressure (COP) in twelve healthy adults at five belt speeds, including the subjects' preferred walking speed (PWS), as measured using a motion capture system and an instrumented treadmill...
September 29, 2016: Gait & Posture
Wenhao Hu, Bin Wang, Hongyu Run, Xuesong Zhang, Yan Wang
BACKGROUND: It is estimated that upwards of 50,000 individuals suffer traumatic fracture of the spine each year, and the instability of the fractured vertebra and/or the local deformity results in pain and, if kyphosis increases, neurological impairment can occur. There is a significant controversy over the ideal management. The purpose of the study is to present clinical and radiographic results of pedicle subtraction osteotomy and disc resection with cage placement in correcting post-traumatic thoracolumbar kyphosis...
October 12, 2016: Journal of Orthopaedic Surgery and Research
Emily I McIntosh, John L Zettel, Lori Ann Vallis
The objective of this work was to investigate the influence perturbation direction has on postural responses during overground gait, and whether these responses are age related. Differences in stepping patterns following perturbations of the support surface were examined in the frontal and sagittal planes during forward walking. Eleven young and 10 older adults completed Mini BESTest, hip strength tests, and 45 perturbed walking trials, triggered on heel contact. Lateral perturbations were more challenging to postural stability for both groups...
October 10, 2016: Journal of Motor Behavior
Mojdeh Pajoutan, Xu Xu, Lora A Cavuoto
The objective of this study was to assess the effect of obesity on postural stability during a standardized lifting task. Twelve young males, six obese and six non-obese, completed three replications of repeated six lifts (at a rate of six lifts per minutes) at two levels of loads (10% and 25% of capacity) crossed with two levels of orientation (0° and 45° from sagittal plane). Postural stability measures showed that center of pressure sway path and sway area were ∼21% and ∼53% lower with obesity, respectively...
October 7, 2016: Journal of Occupational and Environmental Hygiene
Ali Babashahi, Morteza Taheri
Spinal kyphotic deformity after spinal laminectomy or laminoplasty is more common in pediatric patients than adults. Laminectomy can lead to decreased cartilage growth, anterior wedging and posterior spinal muscle insufficiency which can result in kyphotic deformity. Herein we outline a case report of a child presenting with kyphotic deformity after receiving a spinal laminectomy to treat a penetrating spinal trauma. The 8-year-old male presented with penetrating spinal trauma following a gunshot wound and subsequently underwent L1 laminectomy and thecal sac decompression to remove the foreign body...
March 2016: J Spine Surg
Laure Mathevon, Nicolas Leroux, Céline Piscicelli, Emmanuelle Clarac, Shenhao Dai, Patrice Davoine, Paul Krack, Dominic Perennou
OBJECTIVE: To take care of postural disorders is a major issue in Parkinson's disease (PD). We present a documented observation suggesting the existence of a biased representation of verticality in PD, resulting in a severe retropulsion and recurrent falls. A rehabilitation program aimed to modulate verticality perception dramatically improved the postural perception of the vertical, trunk posture and balance abilities, and reduced retropulsion as well as lastingly fall frequency. OBSERVATIONS: A 68 year-old patient with Parkinson's disease fall backward 3 times a day...
September 2016: Annals of Physical and Rehabilitation Medicine
Nathaniel T Pickle, Jason M Wilken, Jennifer M Aldridge Whitehead, Anne K Silverman
Sloped walking requires altered strategies for maintaining dynamic balance relative to level-ground walking, as evidenced by changes in sagittal-plane whole-body angular momentum (H) in able-bodied individuals. The ankle plantarflexor muscles are critical for regulating H, and functional loss of these muscles from transtibial amputation affects this regulation. However, it is unclear if a powered prosthesis, which more closely emulates intact ankle function than a passive energy-storage-and-return prosthesis, affects H differently during sloped walking...
October 3, 2016: Journal of Biomechanics
Bartosz Polis, Jacek Krawczyk, Lech Polis, Emilia Nowosławska
PURPOSE: The aim of the article is to present the new extrapedicular percutaneous technique for posttraumatic vertebral column fracture. METHODS: A 15-year-old boy needed a surgical Th8 posttraumatic vertebral body (VB) compressive fracture reduction due to insufficient conservative treatment and consistent severe clinical symptoms. After 6 months of external Jevett long-roll brace stabilization, progressive sagittal balance disturbance of thoracic kyphosis was measured and persistent clinical symptoms were observed...
September 26, 2016: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
Mitsuru Yagi, Shinjiro Kaneko, Yoshiyuki Yato, Takashi Asazuma
STUDY DESIGN: Prospective case series. OBJECTIVE: To compare the standing balance and posture between patients with ASD and healthy volunteers (HV). SUMMARY OF BACKGROUND DATA: The effect of adult spinal deformity (ASD) on standing posture and balance has not been fully documented. METHODS: 40 consecutive female patients with ASD (65.4 ± 6.7 years, Cobb angle 48.6 ± 20.2°, C7PL 9.1 ± 6.4 cm, and PI-LL 41...
September 23, 2016: Spine
Vincent J Alentado, Stephanie Caldwell, Heath P Gould, Michael P Steinmetz, Edward C Benzel, Thomas E Mroz
BACKGROUND CONTEXT: Multiple studies have determined minimum clinically important difference (MCID) thresholds for EuroQOL-5 Dimensions (EQ-5D) scores in lumbar fusion patients. However, a comprehensive understanding of predictors for a CSI postoperatively does not exist. PURPOSE: To determine medical, radiographic and surgical predictors for obtaining a clinically significant improvement (CSI) following lumbar fusion surgery. STUDY DESIGN: Retrospective Review...
September 21, 2016: Spine Journal: Official Journal of the North American Spine Society
Daniel J Blizzard, Michael A Gallizzi, Charles Sheets, Benjamin T Smith, Robert E Isaacs, Megan Eure, Christopher R Brown
BACKGROUND: Sagittal balance restoration has been shown to be an important determinant of outcomes in corrective surgery for degenerative scoliosis. Lateral interbody fusion (LIF) is a less-invasive technique which permits the placement of a high lordosis interbody cage without risks associated with traditional anterior or transforaminal interbody techniques. Studies have shown improvement in lumbar lordosis following LIF, but only one other study has assessed sagittal balance in this population...
2016: International Journal of Spine Surgery
W Z Morris, C A Fowers, R T Yuh, J J Gebhart, M J Salata, R W Liu
OBJECTIVES: The spinopelvic relationship (including pelvic incidence) has been shown to influence pelvic orientation, but its potential association with femoroacetabular impingement has not been thoroughly explored. The purpose of this study was to prove the hypothesis that decreasing pelvic incidence is associated with increased risk of cam morphology. METHODS: Two matching cohorts were created from a collection of cadaveric specimens with known pelvic incidences: 50 subjects with the highest pelvic incidence (all subjects > 60°) and 50 subjects with the lowest pelvic incidence (all subjects < 35°)...
September 2016: Bone & Joint Research
Nikita Zaborovskii, Dmitrii Ptashnikov, Dmitrii Mikhaylov, Oleg Smekalenkov, Sergei Masevnin, Olga Lapaeva, Zabioulah Mooraby
PURPOSE: This report compares the clinical, radiographic, and functional outcomes of fusion from thoracolumbar region terminating at L5 or at sacrum and pelvis in elderly patients with spinal deformity. METHODS: Ninety-four elderly patients who underwent spinal deformity surgery at our institution were evaluated. Patients were divided into two groups. The group L included 43 patients who underwent fusion of lumbar curve from thoracolumbar region to L5. The group P consisted of 51 patients who were treated using fusion from lower thoracic region to S1 extending to the pelvis...
September 19, 2016: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
Milad Vazirian, Iman Shojaei, Anuj Agarwal, Babak Bazrgari
Age-related differences in lumbar contribution to the trunk motion in the sagittal plane were investigated. Sixty individuals between 20-70 years old in five gender-balanced age groups performed forward bending and backward return with slow and fast paces. Individuals older than 50 years old, irrespective of the gender or pace, had smaller lumbar contribution than those younger than this age. The lumbar contribution to trunk motion was also smaller in female participants than male participants, and under fast pace than under the slow pace...
October 12, 2016: Ergonomics
Tim D Coleman, Haley J Lawrence, W Lee Childers
This research tested a reproducible uneven walkway designed to destabilize human gait. Ten participants walked thirty times over even and uneven (7.3x.08m, sequentially placed wooden blocks in a rotating pattern, 1 cm thick rubber mat) walkways.. A full-body marker set and eight-camera motion capture system recorded limb kinematics. Matlab 2013b was used to calculate measures of gait stability: angular momentum, margin of stability, step width variability, CoM height, toe clearance, lateral arm swing. The minimum number of strides necessary to minimize intra-participant variability was calculated via the interquartile range/median ratio (IMR) at 25 and 10% thresholds for each measure...
September 6, 2016: Journal of Applied Biomechanics
Junseok Bae, Alexander A Theologis, Jee-Soo Jang, Sang-Ho Lee, Vedat Deviren
STUDY DESIGN: Retrospective analysis of prospectively collected data. OBJECTIVE: To assess global and regional spinal sagittal radiographic parameters in adults with loss of lumbar lordosis ("flatback") before and after walking 10 minutes. SUMMARY OF BACKGROUND DATA: While routine activities of daily living may exacerbate functional disability of spinal sagittal-plane deformity, there is limited understanding of how sagittal parameters and compensatory mechanisms are affected by activity...
September 9, 2016: Spine
Olcay Guler, Turgut Akgul, Murat Korkmaz, Caner Gunerbuyuk, Kerim Sariyilmaz, Fatih Dikici, Ufuk Talu
PURPOSE: To comparatively evaluate the biomechanical alterations those occur in the sagittal plane of sacropelvic junction in angular kyphosis (AK) and Scheuermann kyphosis (SK) patients after surgery. METHODS: The spine radiographs of 52 patients operated for short-segment AK (n = 20) or SK (n = 32) were studied. Main outcome measures were sacral slope, pelvic incidence, pelvic tilt, lumbar lordosis, and thoracic kyphosis angles. RESULTS: In AK group, local and thoracic kyphosis angles, as well as lumbar lordosis angle, showed statistically significant reduction with surgery...
September 3, 2016: European Spine Journal
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