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Sagittal imbalance

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https://www.readbyqxmd.com/read/28799837/effectiveness-of-deformity-correction-surgery-for-primary-degenerative-sagittal-imbalance-a-meta-analysis
#1
Chang-Hyun Lee, Chun Kee Chung, Jee-Soo Jang, Sung-Min Kim, Dong-Kyu Chin, Jung-Kil Lee, Seung Hwan Yoon, Jae Taek Hong, Yoon Ha, Chi Heon Kim, Seung-Jae Hyun
OBJECTIVE As life expectancy continues to increase, primary degenerative sagittal imbalance (PDSI) is diagnosed in an increasing number of elderly people. Although corrective surgery for this sagittal deformity is becoming more popular, the effectiveness of the procedure remains unclear. The authors aimed to collate the available evidence on the effectiveness and complications of deformity-correction surgery in patients with PDSI. METHODS The authors carried out a meta-analysis of clinical studies regarding deformity correction in patients with PDSI...
August 11, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28780621/an-international-consensus-on-the-appropriate-evaluation-and-treatment-for-adults-with-spinal-deformity
#2
Sigurd H Berven, Steven J Kamper, Niccole M Germscheid, Benny Dahl, Christopher I Shaffrey, Lawrence G Lenke, Stephen J Lewis, Kenneth M Cheung, Ahmet Alanay, Manabu Ito, David W Polly, Yong Qiu, Marinus de Kleuver
PURPOSE: Evaluation and surgical management for adult spinal deformity (ASD) patients varies between health care providers. The purpose of this study is to identify appropriateness of specific approaches and management strategies for the treatment of ASD. METHODS: From January to July 2015, the AOSpine Knowledge Deformity Forum performed a modified Delphi survey where 53 experienced deformity surgeons from 24 countries, rated the appropriateness of management strategies for multiple ASD clinical scenarios...
August 5, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28768786/posterior-spinal-fusion-for-adolescent-idiopathic-scoliosis-using-a-convex-pedicle-screw-technique-a-novel-concept-of-deformity-correction
#3
A I Tsirikos, G Mataliotakis, N Bounakis
AIMS: We present the results of correcting a double or triple curve adolescent idiopathic scoliosis using a convex segmental pedicle screw technique. PATIENTS AND METHODS: We reviewed 191 patients with a mean age at surgery of 15 years (11 to 23.3). Pedicle screws were placed at the convexity of each curve. Concave screws were inserted at one or two cephalad levels and two caudal levels. The mean operating time was 183 minutes (132 to 276) and the mean blood loss 0...
August 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28767630/predictive-findings-of-the-presence-of-stooping-in-patients-with-lumbar-degenerative-kyphosis-by-upright-whole-spine-lateral-radiography
#4
Seung Min Son, Jong Ki Shin, Tae Sik Goh, Kuen Tak Suh, Jung Sub Lee
STUDY DESIGN: Retrospective study. OBJECTIVE: To identify the relationships between radiological findings and the presence of stooping in lumbar degenerative kyphosis (LDK). SUMMARY OF BACKGROUND DATA: Many studies have addressed fixed sagittal imbalances and surgical treatments. However, information regarding the relationship between radiological findings and stooping in LDK is sparse. METHODS: The study included 73 patients with LDK and 44 with normal lumbar lordosis...
August 1, 2017: Spine
https://www.readbyqxmd.com/read/28765802/clinical-gait-analysis-on-a-patient-undergoing-surgical-correction-of-kyphosis-from-severe-ankylosing-spondylitis
#5
Ram Haddas, Theodore Belanger
BACKGROUND: Ankylosing spondylitis (AS) is a chronic inflammatory disease primarily affecting the axial skeleton, including the sacroiliac joints, costovertebral joints, and the spine. Patients with AS found to have an alter gait pattern. The purpose of this study was to investigate biomechanical alterations in gait after surgical correction in a patient with severe kyphosis from AS. METHODS: A case report in controlled laboratory study, a pretest-posttest design...
2017: International Journal of Spine Surgery
https://www.readbyqxmd.com/read/28760028/correction-of-severe-spinopelvic-mismatch-decreased-blood-loss-with-lateral-hyperlordotic-interbody-grafts-as-compared-with-pedicle-subtraction-osteotomy
#6
Jean-Christophe Leveque, Vijay Yanamadala, Quinlan D Buchlak, Rajiv K Sethi
OBJECTIVE Pedicle subtraction osteotomy (PSO) provides extensive correction in patients with fixed sagittal plane imbalance but is associated with high estimated blood loss (EBL). Anterior column realignment (ACR) with lateral graft placement and sectioning of the anterior longitudinal ligament allows restoration of lumbar lordosis (LL). The authors compare peri- and postoperative measures in 2 groups of patients undergoing correction of a sagittal plane imbalance, either through PSO or the use of lateral lumbar fusion and ACR with hyperlordotic (20°-30°) interbody cages, with stabilization through standard posterior instrumentation in all cases...
August 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/28746131/assessment-of-the-cross-sectional-areas-of-the-psoas-major-and-multifidus-muscles-in-patients-with-adult-spinal-deformity-a-case-control-study
#7
Tomohiro Banno, Yu Yamato, Tomohiko Hasegawa, Sho Kobayashi, Daisuke Togawa, Shin Oe, Yuki Mihara, Kenta Kurosu, Naoto Yamamoto, Yukihiro Matsuyama
STUDY DESIGN: This is a case-control study. OBJECTIVE: The present study aimed to compare the cross-sectional areas of the psoas major and multifidus muscles between elderly patients with adult spinal deformity (ASD) and age-matched and body weight-matched controls, and to evaluate the associations between the cross-sectional areas of these muscles and the severity of spinal deformity. SUMMARY OF BACKGROUND DATA: The study included 49 female kyphosis patients with mild scoliosis (Cobb angle <20 degrees; mean age, 70...
August 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28741218/asymmetric-pedicle-subtractionosteotomy-apso-guided-by-a-3d-printed-model-to-correct-a-combined-fixed-sagittal-and-coronal-imbalance
#8
Pierre-Pascal Girod, S Hartmann, P Kavakebi, J Obernauer, M Verius, C Thomé
Surgical correction of fixed thoracolumbar deformity is usually achieved by estimating the preoperatively planned correction angles during surgery and is therefore prone to inaccuracy. This is particularly problematic in biplanar deformities. To overcome these difficulties, 3D model for planning, preparation, and simulation of an asymmetric pedicle subtraction osteotomy (aPSO) was printed and used to realign coronal and sagittal balance in case of rigid degenerative kyphoscoliosis. A 59-year-old woman presented with severe back pain and spinal claudication and was diagnosed with a rigid kyphoscoliosis with multilevel spinal stenosis...
July 24, 2017: Neurosurgical Review
https://www.readbyqxmd.com/read/28731559/association-between-anthropometric-measures-of-regional-fat-mass-and-heart-rate-variability-in-obese-women
#9
Marina Rastović, Biljana Srdić-Galić, Oto Barak, Edita Stokić
AIM: Impaired autonomic function could be the mechanism for the development of cardiometabolic diseases in obesity. Hence, simple anthropometric measures of overall and central obesity could be screening markers for autonomic imbalance. We analysed the relationship between heart rate variability (HRV) parameters and obesity indicators. METHODS: Sixty-three obese women underwent blood pressure, lipids and anthropometric measurements, body composition assessment, HOMA (homeostasis model assessment) index calculation and short-term HRV analysis...
February 2017: Nutrition & Dietetics: the Journal of the Dietitians Association of Australia
https://www.readbyqxmd.com/read/28713528/the-double-transforaminal-lumbar-interbody-fusion-an-innovative-one-stage-surgical-technique-for-posterior-kyphosis-correction
#10
Marcus Jäger, Tjark Tassemeier
Posttraumatic deformities after vertebral fractures are challenging for orthopedic surgeons in the non-operative and operative field. Especially osteoporotic fractures may cause a hyperkyphosis resulting in segmental or global sagittal imbalance and chronic back pain. Different vertebral osteotomies are potent to restore sagittal profile but show a very high perioperative risk including neurological and soft tissue complications. In addition, some of these extensive operations require a two-step procedure including posterior and anterior approaches...
June 23, 2017: Orthopedic Reviews
https://www.readbyqxmd.com/read/28700454/posterior-only-hemivertebra-resection-for-congenital-cervicothoracic-scoliosis-correcting-neck-tilt-and-balancing-the-shoulders
#11
Zhonghui Chen, Yong Qiu, Zezhang Zhu, Song Li, Xi Chen, Liang Xu, Xu Sun
STUDY DESIGN: A retrospective study. OBJECTIVE: To evaluate radiographic and cosmetic outcomes following posterior-only cervicothoracic hemivertebra resection and instrumentation. SUMMARY OF BACKGROUND DATA: Cervicothoracic hemivertebra is a rare congenital deformity. It locates between the mobile cervical spine and the fixed thoracic spine, leading to rapid curve progression, shoulder imbalance, fixed torticollis and facial asymmetry. METHODS: This study reviewed a consecutive series of 18 patients with cervicothoracic hemivertebra...
July 11, 2017: Spine
https://www.readbyqxmd.com/read/28688061/new-method-for-correction-of-lumbo-sacral-kyphosis-deformity-in-patient-with-high-pelvic-incidence
#12
Marcin Czyz, Stephen Forster, James Holton, Babak Shariati, David J Clarkson, Bronek M Boszczyk
STUDY DESIGN: Technical note. OBJECTIVE: We describe a novel technique of bilateral longitudinal sacral osteotomy allowing direct reduction of high pelvic incidence (PI) and correction of sagittal imbalance. METHODS: A 25-year-old female patient presented with a disabling lumbo-sacral kyphosis fused in situ through previous operations with residual low-grade wound infection and grade IV L5/S1 spondylolisthesis with severity index (SI) of 65%...
August 2017: European Spine Journal
https://www.readbyqxmd.com/read/28658036/short-limited-fusion-versus-long-fusion-with-deformity-correction-for-spinal-stenosis-with-balanced-de-novo-degenerative-lumbar-scoliosis-a-meta-analysis-of-direct-comparative-studies
#13
Chang-Hyun Lee, Chun Kee Chung, Moon Jun Sohn, Chi Heon Kim
STUDY DESIGN: A systematic review and meta-analysis. OBJECTIVE: To identify advantages and disadvantages of long versus short fusion for patients with SBSS, and to determine whether short fusions and long fusions have different curve progression after surgeries and differences in operative characteristics. SUMMARY OF BACKGROUND DATA: Patients with Spinal stenosis with Balanced de novo degenerative lumbar Scoliosis without substantial Sagittal imbalance (SBSS) usually undergo short limited fusion or long fusion with curve correction...
June 27, 2017: Spine
https://www.readbyqxmd.com/read/28645673/supra-acetabular-line-is-better-than-supra-iliac-line-for-coronal-balance-referencing-a-study-of-perioperative-whole-spine-x-rays-in-degenerative-lumbar-scoliosis-and-ankylosing-spondylitis-patients
#14
Hwee Weng Dennis Hey, Cheung-Kue Kim, Won-Gyu Lee, Hyung-Suk Juh, Ki-Tack Kim
BACKGROUND CONTEXT: The aim of spinal deformity correction is to restore the spine's functional alignment by balancing it in both the sagittal and coronal planes. Regardless of posture, the ideal coronal profile is straight, and therefore readily assessable. PURPOSE: This study compares two radiological methods to determine which better predicts postoperative standing coronal balance. STUDY DESIGN/SETTING: We conducted a single-centre, radiographic comparative study between 2011 and 2015...
June 20, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28638492/importance-of-radiological-evaluation-of-global-spinal-balance-together-with-lower-limb-alignment-in-planning-lumbar-spine-deformity-surgery-illustrative-case-presentation
#15
Mariusz Głowacki, Jerzy Walecki, Przemysław Kołakowski, Danuta Kolońska
BACKGROUND: The presented case illustrates the critical role of a detailed preoperative radiological evaluation in complex spine surgery. CASE REPORT: A 49-year-old patient was admitted for a revision surgery after L3-L5 fusion. Preoperative assessment showed preserved sagittal balance, coronal imbalance and valgus knee deformity. The patient reported pain of 8-10 in VAS (Visual Analogue Scale) and had an ODI (Oswestry Disability Index) of 60%. The first step of the surgery was L2-S1 fusion with decompression and spine deformity correction...
2017: Polish Journal of Radiology
https://www.readbyqxmd.com/read/28633648/radiologic-comparison-of-posterior-release-internal-distraction-final-pso-and-spinal-fusion-with-one-stage-posterior-vertebral-column-resection-for-multi-level-severe-congenital-scoliosis
#16
Shichang Liu, Nannan Zhang, Yueming Song, Zongrang Song, Liping Zhang, Jijun Liu, En Xie, Qining Wu, Dingjun Hao
BACKGROUND: To compare radiologic results of posterior release, internal distraction, and final pedicle subtraction osteotomy (PSO) and spinal fusionwith one-stage posterior vertebral column resection (PVCR) in treating multi-level severe congenital scoliosis. METHODS: Forty-onesevere congenital scoliosis patients were used in the study. Group A comprised 24 patients who underwent one-stage PVCR. Group B comprised 17 patients who underwent posterior release with internal distraction, followed by final posterior fusion and instrumentation...
June 20, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28622902/a-critical-analysis-of-sagittal-plane-deformity-correction-with-minimally-invasive-adult-spinal-deformity-surgery-a-2-year-follow-up-study
#17
Gregory M Mundis, Jay D Turner, Vedat Deverin, Juan S Uribe, Pierce Nunley, Praveen Mummaneni, Neel Anand, Paul Park, David O Okonkwo, Michael Y Wang, Shay Bess, Adam S Kanter, Richard Fessler, Stacie Nguyen, Behrooz A Akbarnia
INTRODUCTION: Sagittal plane realignment is important to achieve desirable clinical outcomes after adult spinal deformity (ASD) surgery. This study evaluates the impact of minimally invasive (MIS) techniques on sagittal plane alignment and clinical outcomes in ASD patients. METHODS: A retrospective, multi-center review of ASD patients (age ≥18 years, and with one of the following: coronal Cobb ≥20°, sagittal vertical axis [SVA] >5 cm, and/or pelvic tilt >25°), MIS surgery, and four or more levels instrumented...
July 2017: Spine Deformity
https://www.readbyqxmd.com/read/28601994/radiologic-features-of-dropped-head-syndrome-in-the-overall-sagittal-alignment-of-the-spine
#18
Kazuki Hashimoto, Hiroshi Miyamoto, Terumasa Ikeda, Masao Akagi
PURPOSE: Dropped head syndrome (DHS) is a rare clinical entity which is defined as a chin-on-chest deformity in the standing or sitting position, resulting from sagittal imbalance of the cervical region. The purpose of the present study was to clarify the radiologic features of DHS in the overall sagittal alignment of the spine. We also investigated the changes in sagittal alignment after correction surgery for DHS. METHODS: Twenty DHS patients [1 male and 19 female, with an average age of 78...
June 10, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28600607/-osteotomies-around-the-knee-for-ligament-insufficiency
#19
REVIEW
M J Feucht, T Tischer
BACKGROUND: The osseous geometry of the lower limb has a significant impact on knee instability after ligament injuries, and osseous malalignment has been shown to be a significant risk factor for the failure of ligament reconstruction procedures. Therefore, osteotomies around the knee have gained importance as a combined or isolated treatment option in the ligament deficient and malaligned knee. In addition to unloading of an arthritic knee compartment, osteotomies are also performed to protect a reconstructed ligament and to stabilize the joint without ligament surgery...
June 9, 2017: Der Orthopäde
https://www.readbyqxmd.com/read/28598295/pelvic-retroversion-a-compensatory-mechanism-for-lumbar-stenosis
#20
Sina Pourtaheri, Akshay Sharma, Jason Savage, Iain Kalfas, Thomas E Mroz, Edward Benzel, Michael P Steinmetz
OBJECTIVE The flexed posture of the proximal (L1-3) or distal (L4-S1) lumbar spine increases the diameter of the spinal canal and neuroforamina and can relieve symptoms of neurogenic claudication. Distal lumbar flexion can result in pelvic retroversion; therefore, in cases of flexible sagittal imbalance, pelvic retroversion may be compensatory for lumbar stenosis and not solely compensatory for the sagittal imbalance as previously thought. The authors investigate underlying causes for pelvic retroversion in patients with flexible sagittal imbalance...
August 2017: Journal of Neurosurgery. Spine
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