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https://www.readbyqxmd.com/read/29424672/sacral-pedicle-subtraction-osteotomy-for-an-extreme-case-of-positive-sagittal-balance-case-report
#1
Ali K Ozturk, Patricia Zadnik Sullivan, Vincent Arlet
The importance of sagittal spinal balance and lumbopelvic parameters is now well understood. The popularization of various osteotomies, including Smith-Peterson, Ponte, and pedicle subtraction osteotomies (PSOs), as well as vertebral column resections, have greatly enhanced the spine surgeon's ability to recognize and effectively treat sagittal imbalance. Yet rare circumstances remain, most notably in distal kyphotic deformities and patients with extremely elevated pelvic incidences, where these techniques remain inadequate...
February 9, 2018: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/29417322/sagittal-imbalance-treated-with-l5-pedicle-subtraction-osteotomy-with-short-lumbar-fusion-from-l4-to-sacrum-using-four-screws-into-l4-for-enhanced-fixation-two-additional-vertebral-screws-a-technical-note
#2
Kuenzang Wangdi, Bungo Otsuki, Shunsuke Fujibayashi, Shimei Tanida, Kazutaka Masamoto, Shuichi Matsuda
PURPOSE: To report on suggested technique with four screws in a single vertebra (two pedicle screws and two direct vertebral body screws) for enhanced fixation with just one level cranially to a pedicle subtraction osteotomy (PSO). METHODS: A 60-year-old woman underwent L4/5 fusion surgery for degenerative spondylolisthesis. Two years later, she was unable to stand upright even for a short time because of lumbar kyphosis caused by subsidence of the fusion cage and of Baastrup syndrome in the upper lumbar spine [sagittal vertical axis (SVA) of 114 mm, pelvic incidence of 75°, and lumbar lordosis (LL) of 41°]...
February 7, 2018: European Spine Journal
https://www.readbyqxmd.com/read/29414927/diagnostic-value-of-t1-slope-in-degenerative-cervical-spondylotic-myelopathy
#3
Jin Sun, Hong-Wei Zhao, Jun-Jie Wang, Liang Xun, Na-Xin Fu, Hui Huang
BACKGROUND To explore the diagnostic value of sagittal measurement of thoracic inlet parameters for degenerative cervical spondylotic myelopathy (DCSM). MATERIAL AND METHODS Sixty patients with DCSM (study group) and the same number of normal subjects (control group) were initially enrolled in the study. All data from X-ray in the standing position and computed tomography (CT) in the supine position were collected and carefully analyzed. Cervical sagittal parameters, including C2-C7 angle, C2-C7 sagittal vertical axis (C2-C7 SVA), T1 slope, thoracic inlet angle (TIA), and neck tilt (NT), were measured at the lateral radiographs by using standard X-rays and CT...
February 7, 2018: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/29413731/the-berbeo-sardi-angle-bsa-an-innovative-method-to-effectively-estimate-pelvic-retroversion-in-anteroposterior-radiographs-a-correlation-with-traditional-parameters
#4
Juan P Sardi, Jorge E Camacho, Roberto C Diaz, Miguel E Berbeo
STUDY: Design: Diagnostic studies-concordance between diagnostic tests. OBJECTIVES: The purpose of this study was to develop a novel spinopelvic parameter (Berbeo-Sardi angle [BSA], the angle formed at the intersection of a line that connects the inferior margin of the sacroiliac joint to the midpoint of a horizontal line joining both femoral heads) measurable in anteroposterior radiographs that indirectly estimates pelvic retroversion and correlates with traditional measurements like pelvic tilt (PT)...
March 2018: Spine Deformity
https://www.readbyqxmd.com/read/29412187/how-does-sagittal-imbalance-affect-the-appropriateness-of-surgical-indications-and-selection-of-procedure-in-the-treatment-of-degenerative-scoliosis-findings-from-the-rand-auc-study
#5
Michael D Daubs, Harsimran S Brara, Laura B Raaen, Peggy Guey-Chi Chen, Ashaunta T Anderson, Steven M Asch, Teryl K Nuckols
BACKGROUND CONTEXT: Degenerative Lumbar Scoliosis (DLS) is often associated with sagittal imbalance, which may affect patients' health outcomes before and after surgery. The appropriateness of surgery and preferred operative approaches has not been examined in detail for patients with DLS and sagittal imbalance. PURPOSE: The goal of this paper is to describe what is currently known about the relationship between sagittal imbalance and health outcomes among patients with DLS, and to determine how indications for surgery in patients with DLS differ when sagittal imbalance is present...
February 2, 2018: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/29397444/surgical-treatment-of-spinal-disorders-in-parkinson-s-disease
#6
REVIEW
Fabio Galbusera, Tito Bassani, Elena Stucovitz, Carlotta Martini, Maryem-Fama Ismael Aguirre, Pedro L Berjano, C Lamartina
PURPOSE: Most patients suffering from Parkinson's disease (PD) exhibit alterations in the posture, which can in several cases give rise to spine deformities, both in the sagittal and the coronal plane. In addition, degenerative disorders of the spine frequently associated to PD, such as spinal stenosis and sagittal instability, can further impact the quality of life of the patient. In recent years, spine surgery has been increasingly performed, with mixed results. The aim of this narrative review is to analyze the spinal disorders associated to PD, and the current evidence about their surgical treatment...
February 3, 2018: European Spine Journal
https://www.readbyqxmd.com/read/29396766/analysis-of-cervical-sagittal-alignment-variations-after-lumbar-pedicle-subtraction-osteotomy-for-severe-imbalance-study-of-59-cases
#7
W Thompson, A Cogniet, M Challali, R Saddiki, J Rigal, Jean Charles Le Huec
OBJECTIVE: To evaluate postoperative changes within the cervical alignment following surgical lumbar correction by pedicle subtraction osteotomy (PSO) in patients affected with sagittal global malalignment disease. METHODS: This was a monocentric, radiographic, and prospective study. 79 patients, who underwent sagittal correction by PSO, performed an EOS imaging pre- and postoperatively between January 2008 and December 2013 at the University Hospital of Bordeaux...
February 2, 2018: European Spine Journal
https://www.readbyqxmd.com/read/29396690/-correction-of-kyphotic-fixed-lumbar-segments-and-hypolordosis-with-the-transforaminal-lumbar-interbody-fusion-technique
#8
REVIEW
F Lattig, E Stettin, S Weckbach
OBJECTIVE: Correction of a segmental or global lumbar hypolordosis to improve a sagittal imbalance. INDICATIONS: Lumbar segments fixed in kyphosis; degenerative or posttraumatic hypolordotic deformity of the lumbar spine with sagittal imbalance. CONTRAINDICATIONS: Bechterew disease; extended adhesions in the retroperitoneum. SURGICAL TECHNIQUE: Segmental correction of a kyphotic fixed segment using a unilateral transforaminal approach to release the annulus and anterior longitudinal ligament...
February 2, 2018: Operative Orthopädie und Traumatologie
https://www.readbyqxmd.com/read/29360579/l5-incidence-an-important-parameter-for-spinopelvic-balance-evaluation-in-high-grade-spondylolisthesis
#9
Amer Sebaaly, Rami El Rachkidi, Pierre Grobost, Marion Burnier, Hubert Labelle, Pierre Roussouly
BACKGROUND: In high grade spondylolisthesis (HGSPL), the pelvic incidence (PI) is not a reliable measurement due to doming of the sacrum. Measurement of L5 incidence (L5I) was described as a tool to measure pelvic morphology in HGSPL and for surgical follow up. OBJECTIVE: evaluate L5I in HGSPL and its relationship to other spino-pelvic parameters. STUDY DESIGN: Retrospective study of a cohort of 184 with HGSPL. METHODS: Whole spine radiographs were analyzed for PI, pelvic tilt, sacral slope, lumbar lordosis, L5I, L5 tilt, L5 slope, lumbosacral kyphosis and slip percentage...
January 19, 2018: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/29358108/increased-pt-ss-may-play-an-important-role-in-the-pathogenesis-of-lumbar-spondylolisthesis-with-degenerative-lumbar-scoliosis
#10
Jinlei Zhang, Yong Hai, Jincai Yang, Aixing Pan, Yangpu Zhang
OBJECTIVE: To explore the clinical and spinopelvic features in patients with lumbar spondylolisthesis and degenerative lumbar scoliosis (LSDLS) and those with standalone lumbar spondylolisthesis (SALS). PATIENTS AND METHODS: We retrospectively analyzed 130 patients with lumbar spondylolisthesis seen between 05/2013 and 12/2016 in our hospital. Propensity score matching was used to reduce an age distribution imbalance between the two groups. Clinical and spinopelvic parameters were compared by independent samples t test and chi-square test...
January 19, 2018: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/29355790/small-c7-t1-lordotic-angle-and-muscle-degeneration-at-c7-level-were-independent-radiological-characteristics-of-patients-with-cervical-imbalance-a-propensity-score-matched-analysis
#11
Koji Tamai, Joshua Romanu, Phillip Grisdela, Permsak Paholpak, Pengfei Zheng, Hiroaki Nakamura, Zorica Buser, Jeffrey C Wang
BACKGROUND CONTEXT: Cervical sagittal vertical axis (cSVA) of ≥40mm is recognized as the key factor of poor health-related quality of life, poor surgical outcomes, and correction loss after surgery for cervical deformity. However, little is known about the radiological characteristics of patients with cSVA≥40mm. PURPOSE: The purpose of this study was to identify the radiological characteristics of patients with cervical imbalance. DESIGN: Retrospective analysis of weight-bearing cervical magnetic resonance (MR) images PATIENT SAMPLE: Consecutive 1,500 MR images of symptomatic patients in weight-bearing position OUTCOME MEASURES: cSVA, cervical alignment, cervical balance parameters (T1 slope, Co-C2 angle, C2-C7 angle, C7-T1 angle, neck tilt and thoracic inlet angle), disc degeneration (Pfirmann and Suzuki classification), endplate degeneration (Modic change), Spondylolisthesis (antero- and retrolisthesis), antero-posterior (AP) diameter of dural sac, cross-sectional area (CSA) and fat infiltration ratio of the transversospinalis muscles at C4 and C7 levels METHODS: Patients were divided into two groups: cervical sagittal vertical axis (cSVA) ≥40mm and <40mm...
January 17, 2018: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/29354757/obstructed-spinopelvic-fixation-in-the-setting-of-a-triangular-titanium-sacroiliac-fusion-implant-a-case-description
#12
Joseph L Laratta, James D Lin, Jamal N Shillingford, Nathan E Hardy, Hemant Reddy, Ronald A Lehman
Achieving lumbosacral fusion through spinopelvic fixation is an important and challenging aspect of spinal deformity surgery. Numerous instrumentation techniques are available, with iliac screws and S2-alar-iliac (SRAI) screws being most commonly used today. However, the increasing popularity of minimally invasive sacroiliac (SI) fusion as a common procedure performed for SI joint pain presents a distinct challenge in complex adult deformity cases requiring iliac screw fixation. We report a case of a 71-year-old female with a longstanding history of spinal deformity status-post T11-L5 fusion and a subsequent right-sided SI joint fusion who presented with sagittal imbalance...
December 2017: Journal of Spine Surgery (Hong Kong)
https://www.readbyqxmd.com/read/29352353/regarding-loads-after-spinal-fusion-every-level-should-be-seen-separately-a-musculoskeletal-analysis
#13
A Benditz, S Auer, J F Spörrer, S Wolkerstorfer, J Grifka, F Suess, S Dendorfer
INTRODUCTION: The number of spinal fusion surgeries is steadily increasing and biomechanical consequences are still in debate. The aim of this study is to provide biomechanical insights into the sagittal balance of the spine and to compare spinal load before and after spinal fusion. METHOD: The joint reaction forces of 52 patients were analyzed in proximo-distal and antero-posterior direction from the levels T12-L1 to L5-S1 using musculoskeletal simulations. RESULTS: In 104 simulations, pre-surgical forces were equal to post-surgical...
January 19, 2018: European Spine Journal
https://www.readbyqxmd.com/read/29335900/hypercomplex-pedicle-subtraction-osteotomies-definition-early-clinical-and-radiological-results-and-complications
#14
Pedro Berjano, Andrea Zanirato, Domenico Compagnone, Andrea Redaelli, Marco Damilano, Claudio Lamartina
PURPOSE: To describe hypercomplex pedicle subtraction osteotomies (HyC-PSO) for adult spine deformity with sagittal imbalance in terms of preoperative, intraoperative and postoperative outcomes and complications. METHODS: From a prospective single centre database, patients undergoing PSO between January 2016 and May 2017 were reviewed. HyC-PSO were defined as those in patients with one of the following conditions: sagittal correction > 45° needed at a single level or at 1-3 consecutive vertebrae, more than 60° of total sagittal correction needed and PSO on segments of the spine with congenital deformities...
January 15, 2018: European Spine Journal
https://www.readbyqxmd.com/read/29281107/outcomes-of-operative-treatment-for-adult-cervical-deformity-a-prospective-multicenter-assessment-with-1-year-follow-up
#15
Tamir Ailon, Justin S Smith, Christopher I Shaffrey, Han Jo Kim, Gregory Mundis, Munish Gupta, Eric Klineberg, Frank Schwab, Virginie Lafage, Renaud Lafage, Peter Passias, Themistocles Protopsaltis, Brian Neuman, Alan Daniels, Justin K Scheer, Alex Soroceanu, Robert Hart, Rick Hostin, Douglas Burton, Vedat Deviren, Todd J Albert, K Daniel Riew, Shay Bess, Christopher P Ames
BACKGROUND: Despite the potential for profound impact of adult cervical deformity (ACD) on function and health-related quality of life (HRQOL), there are few high-quality studies that assess outcomes of surgical treatment for these patients. OBJECTIVE: To determine the impact of surgical treatment for ACD on HRQOL. METHODS: We conducted a prospective cohort study of surgically treated ACD patients eligible for 1-yr follow-up. Baseline deformity characteristics, surgical parameters, and 1-yr HRQOL outcomes were assessed...
December 21, 2017: Neurosurgery
https://www.readbyqxmd.com/read/29258494/a-rare-case-of-osteoblastoma-combined-with-severe-scoliosis-deformity-coronal-and-sagittal-imbalance
#16
Lin-Nan Wang, Bo-Wen Hu, Lei Wang, Xi Yang, Li-Min Liu, Yue-Ming Song
BACKGROUND: Osteoblastoma is a rare and benign tumor which requires early diagnosis and surgical excision. Scoliosis is a common presentation following osteoblastoma. It is considered due to pain-provoked muscle spasm on the side of the lesion. Few researches about osteoblastoma combined with severe scoliosis have been reported. CASE PRESENTATION: A 14-year-old girl presents with progressive scoliosis deformity for 3 years, with gradually appeared low back pain and numbness of left leg...
December 19, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/29244695/recurrent-hip-dislocation-following-total-hip-arthroplasty-treatment-with-sagittal-spinal-deformity-correction-a-case-report
#17
Yoon-Je Cho, Jung-Hee Lee, Sung Joon Shin, Kyung-Chung Kang
CASE: A 63-year-old woman with lumbar degenerative kyphosis who had undergone total hip arthroplasty 34 months previously presented after having multiple episodes of anterior hip dislocation; evaluation also revealed progressive osteoarthritis in the contralateral hip joint. The patient was managed with sagittal correction with pedicle subtraction osteotomy, which resulted in optimal positioning of the acetabular component and an upright posture. The patient had had no additional dislocation events in the involved hip and had reduced pain in the contralateral hip at the time of the 2-year follow-up...
January 2017: JBJS Case Connector
https://www.readbyqxmd.com/read/29241108/the-efficacy-of-posterior-hemivertebra-resection-with-lumbosacral-fixation-and-fusion-in-the-treatment-of-congenital-scoliosis-a-more-than-2-year-follow-up-study
#18
Qiunan Lyu, Bowen Hu, Chunguang Zhou, Limin Liu, Yueming Song, Xi Yang, Liang Wang, Lei Wang
OBJECTIVE: Hemivertebrae (HV) located at the lower lumbar or lumbosacral region often produce early trunk imbalance and long compensatory curves. Because of the biomechanical characteristics of the lumbosacral junction, the rate of instrumentation failures at the region has always been high. Our study aimed to evaluate the results of posterior HV resection with lumbosacral fixation and fusion in the treatment of congenital scoliosis and to make a preliminary analysis of the possible risk factors for instrument failures...
December 9, 2017: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/29191468/malunion-of-post-traumatic-thoracolumbar-fractures
#19
REVIEW
C Mazel, L Ajavon
Thoracolumbar malunion is the result of loss of correction, insufficient correction, or even no correction (both in the frontal and sagittal planes) of a thoracolumbar fracture. The main causes are incorrect assessment of the fracture's complexity (burst fracture), its potential progression to kyphosis, and associated disc or ligament damage. It can also be the result of a poorly conducted initial treatment. The types of malunion have changed over the years because of the introduction of vertebroplasty and kyphoplasty...
November 27, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/29188373/l5-pedicle-subtraction-osteotomy-indication-surgical-technique-and-specificities
#20
Abdulmajeed Alzakri, Louis Boissière, Derek T Cawley, Anouar Bourghli, Vincent Pointillart, Olivier Gille, Jean-Marc Vital, Ibrahim Obeid
PURPOSE: To evaluate the radiographic, functional outcomes, complications and surgical specificities of L5 pedicle subtraction osteotomy for fixed sagittal and coronal malalignment. METHODS: A retrospective cohort of consecutive patients with prospectively collected data. Ten patients who underwent PSO at L5 were eligible for a 2-year minimum follow-up (average, 4.0 years). Patients were evaluated by standardized upright radiographs. Preoperative and postoperative radiographies, surgical data and complications were collected...
November 29, 2017: European Spine Journal
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