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Sagittal imbalance

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https://www.readbyqxmd.com/read/28331905/asymmetrical-pedicle-subtraction-osteotomy-for-progressive-kyphoscoliosis-caused-by-a-pediatric-chance-fracture-a-case-report
#1
Satoshi Suzuki, Nobuyuki Fujita, Tomohiro Hikata, Akio Iwanami, Ken Ishii, Masaya Nakamura, Morio Matsumoto, Kota Watanabe
BACKGROUND: Although most pediatric Chance fractures (PCFs) can be treated successfully with casting and bracing, some PCFs cause progressive spinal deformities requiring surgical treatment. There are only few reports of asymmetrical osteotomy for PCF-associated spinal deformities. CASE PRESENTATION: We here report a case of a 10-year-old girl who suffered an L2 Chance fracture from an asymmetrical flexion-distraction force, accompanied by abdominal injuries. She was treated conservatively with a soft brace...
2017: Scoliosis and Spinal Disorders
https://www.readbyqxmd.com/read/28330796/chronic-low-back-pain-after-lumbosacral-fracture-due-to-sagittal-and-frontal-vertebral-imbalance
#2
L Boyoud-Garnier, M Boudissa, S Ruatti, G Kerschbaumer, P Grobost, J Tonetti
PROBLEM AND HYPOTHESIS: Over time, some patients with unilateral or bilateral lumbosacral injuries experience chronic low back pain. We studied the sagittal and frontal balance in a population with these injuries to determine whether mismatch in the pelvic and lumbar angles are associated with chronic low back pain. PATIENTS AND METHODS: Patients with posterior pelvic ring fractures (Tile C1, C2, C3 and A3.3) that had healed were included. Foreign patients and those with an associated spinal or acetabular fracture or nonunion were excluded...
March 19, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/28303383/surgical-management-of-coronal-and-sagittal-imbalance-of-the-spine-without-pso-a-multicentric-cohort-study-on-compensated-adult-degenerative-deformities
#3
Alessandro Ramieri, Massimo Miscusi, Maurizio Domenicucci, Antonino Raco, Giuseppe Costanzo
PURPOSE: Sagittal imbalance of severe adult degenerative deformities requires surgical correction to improve pain, mobility and quality of life. Our aim was a harmonic and balanced spine, treating a series of adult degenerative thoracolumbar and lumbar kyphoscoliosis by a non posterior subtraction osteotomy technique. METHODS: We operated 22 painful thoracolumbar and lumbar compensated degenerative deformities by anterior (ALIF), extreme lateral (XLIF) and transforaminal (TLIF) interbody fusion and grade 2 osteotomy (SPO) to restore lumbar lordosis and mobilize the coronal curve...
March 16, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28284581/cognitive-function-surrounding-resection-of-nonfunctioning-pituitary-adenomas-with-suprasellar-extension-a-prospective-matched-control-study
#4
Philipp Hendrix, Christoph J Griessenauer, Elisa Hans, Andreas Simgen, Joachim Oertel, Julia Karbach
OBJECTIVE: Patients suffering from pituitary adenomas may experience cognitive dysfunctions due to hormonal imbalance or suprasellar tumor extension displacing neural structures. Progressively enlarging or symptomatic nonfunctioning pituitary adenomas with suprasellar extension are frequently resected. The literature on neurocognitive performance surrounding resection of these lesions is sparse. METHODS: A prospective matched-control study was conducted to investigate the impact of nonfunctioning pituitary adenomas with suprasellar extension on preoperative and postoperative cognitive performance...
March 8, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28266956/iatrogenic-flatback-and-flatback-syndrome-evaluation-management-and-prevention
#5
Barrett S Boody, Brett D Rosenthal, Tyler J Jenkins, Alpesh A Patel, Jason W Savage, Wellington K Hsu
Flatback syndrome can be a significant source of disability, affecting stance and gait, and resulting in significant pain. Although the historical instrumentation options for thoracolumbar fusion procedures have been commonly regarded as the etiology of iatrogenic flatback, inappropriate selection, or application of modern instrumentation can similarly produce flatback deformities. Patients initially compensate with increased lordosis at adjacent lumbar segments and reduction of thoracic kyphosis. As paraspinal musculature fatigues and discs degenerate, maintaining sagittal balance requires increasing pelvic retroversion and hip extension...
March 6, 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28264237/risk-factors-of-proximal-junctional-kyphosis-after-multilevel-fusion-surgery-more-than-2-years-follow-up-data
#6
Do Keun Kim, Ji Yong Kim, Do Yeon Kim, Seung Chul Rhim, Seung Hwan Yoon
OBJECTIVE: Proximal junctional kyphosis (PJK) is radiologic finding, and is defined as kyphosis of >10° at the proximal end of a construct. The aim of this study is to identify factors associated with PJK after segmental spinal instrumented fusion in adults with spinal deformity with a minimum follow-up of 2 years. METHODS: A total of 49 cases of adult spinal deformity treated by segmental spinal instrumented fusion at two university hospitals from 2004 to 2011 were enrolled in this study...
March 2017: Journal of Korean Neurosurgical Society
https://www.readbyqxmd.com/read/28264231/-lumbar-degenerative-kyphosis-is-not-byword-for-degenerative-sagittal-imbalance-time-to-replace-a-misconception
#7
REVIEW
Chang-Hyun Lee, Chun Kee Chung, Jee-Soo Jang, Sung-Min Kim, Dong-Kyu Chin, Jung-Kil Lee
Lumbar degenerative kyphosis (LDK) is a subgroup of the flat-back syndrome and is most commonly caused by unique life styles, such as a prolonged crouched posture during agricultural work and performing activities of daily living on the floor. Unfortunately, LDK has been used as a byword for degenerative sagittal imbalance, and this sometimes causes confusion. The aim of this review was to evaluate the exact territory of LDK, and to introduce another appropriate term for degenerative sagittal deformity. Unlike what its name suggests, LDK does not only include sagittal balance disorder of the lumbar spine and kyphosis, but also sagittal balance disorder of the whole spine and little lordosis of the lumbar spine...
March 2017: Journal of Korean Neurosurgical Society
https://www.readbyqxmd.com/read/28230573/global-sagittal-imbalance-due-to-change-in-pelvic-incidence-after-traumatic-spinopelvic-dissociation
#8
Han-Dong Lee, Chang-Hoon Jeon, Nam-Su Chung, Suk-Hyeong Won
OBJECTIVES: Traumatic spinopelvic dissociation separates the spinal column from the pelvis, which usually creates lumbosacral kyphosis. We aimed to examine how the spinopelvic profiles changes after traumatic spinopelvic dissociation, and which are the relevant factors for the sagittal imbalance of the spine. DESIGN: Retrospective analysis. SETTING: Level I trauma center PATIENTS:: Thirty-nine consecutive patients who were diagnosed with traumatic spinopelvic dissociation and had a minimum 2-year radiological follow-up were included...
February 20, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28204925/circumferential-fusion-for-degenerative-lumbar-spondylolisthesis-complicated-by-distal-junctional-grade-4-spondylolisthesis-in-the-sub-acute-post-operative-setting
#9
Alexander A Theologis, Deeptee Jain, Christopher P Ames, Murat Pekmezci
INTRODUCTION: Surgical management for lumbar stenosis is generally safe and provides significant improvements in pain, disability, and function. Successful lumbar decompression hinges on removing an appropriate amount of lamina and other compressive pathology in the lateral recess. Too little bony decompression can result in persistent pain and disability, while over resection of the pars and/or facets may jeopardize spinal stability. CASE REPORT: In this unique report, we present for the first time an acute iatrogenic grade 4 L5-S1 spondylolisthesis distal to a L3-5 laminectomy and circumferential instrumented fusion due to bilateral iatrogenic L5 pars fractures and its management and clinical outcomes after revision operation...
February 15, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28192267/posterior-only-vertebral-column-resection-for-the-treatment-of-severe-spinal-deformities-in-pediatric-patients-a-retrospective-case-series
#10
Malte Schroeder, Lennart Viezens, Philip Kunkel, Karsten Ridderbusch, Tim Nicolas Hissnauer, Oliver Dirk Jungesblut, Michael Hoffmann, Johannes Maria Rueger, Ralf Stuecker
OBJECTIVE: The treatment of severe spinal deformities in pediatric patients is very challenging. Posterior only vertebral column resection (PVCR) allows for correcting of severe deformities of the vertebral column via a posterior only procedure. We analyzed radiological outcome of PVCR performed on a series of pediatric patients with severe congenital and acquired spinal deformities. METHODS: A case series of eleven pediatric patients with severe spinal deformity who were treated by PVCR between 2009 and 2013 were retrospectively analyzed...
February 9, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28116458/correlation-analysis-of-osteoporotic-vertebral-compression-fractures-and-spinal-sagittal-imbalance
#11
Yi-Long Zhang, Li-Tao Shi, Pei-Fu Tang, Zhi-Jie Sun, Ya-Hui Wang
PURPOSE: To evaluate the correlation between osteoporotic vertebral compression fractures and spinal sagittal imbalance, in order to provide a reference for clinical treatment. METHODS: From September 2013 to March 2015, 60 elderly patients with old osteoporotic vertebral compression factures (observation group) and 60 healthy elderly people (control group) were studied. Whole-spine anteroposterior and lateral view X‑ray photographs were taken from all participants, the number and location of fractured vertebrae were recorded, and sagittal parameters in both groups were compared...
January 23, 2017: Der Orthopäde
https://www.readbyqxmd.com/read/28059683/spinopelvic-sagittal-imbalance-as-a-risk-factor-for-adjacent-segment-disease-after-single-segment-posterior-lumbar-interbody-fusion
#12
Tomiya Matsumoto, Shinya Okuda, Takafumi Maeno, Tomoya Yamashita, Ryoji Yamasaki, Tsuyoshi Sugiura, Motoki Iwasaki
OBJECTIVE The importance of spinopelvic balance and its implications for clinical outcomes after spinal arthrodesis has been reported in recent studies. However, little is known about the relationship between adjacent-segment disease (ASD) after lumbar arthrodesis and spinopelvic alignment. The purpose of this study was to clarify the relationship between spinopelvic radiographic parameters and symptomatic ASD after L4-5 single-level posterior lumbar interbody fusion (PLIF). METHODS This was a retrospective 1:5 matched case-control study...
January 6, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28042117/spinopelvic-mobility-and-acetabular-component-position-for-total-hip-arthroplasty
#13
M Stefl, W Lundergan, N Heckmann, B McKnight, H Ike, R Murgai, L D Dorr
AIMS: Posterior tilt of the pelvis with sitting provides biological acetabular opening. Our goal was to study the post-operative interaction of skeletal mobility and sagittal acetabular component position. MATERIALS AND METHODS: This was a radiographic study of 160 hips (151 patients) who prospectively had lateral spinopelvic hip radiographs for skeletal and implant measurements. Intra-operative acetabular component position was determined according to the pre-operative spinal mobility...
January 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28033151/spinal-realignment-for-adult-deformity-three-column-osteotomies-alter-total-hip-acetabular-component-positioning
#14
Jeffrey J Barry, Altug Yucekul, Alexander A Theologis, Erik N Hansen, Christopher Ames, Vedat Deviren
INTRODUCTION: A goal of adult spinal deformity surgery is correction of sagittal imbalance by increasing lumbar lordosis (LL), allowing a previously retroverted pelvis to normalize as evidenced by decreases in pelvic tilt (PT). Realignment of pelvic orientation may alter the position of preexisting total hip arthroplasties (THAs). METHODS: Twenty-seven patients with unilateral THA who underwent thoracolumbar fusions for adult spinal deformity from the pelvis to L1 or above were retrospectively reviewed (levels fused, 10...
February 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/28032224/asymmetric-c7-pedicle-subtraction-osteotomy-for-correction-of-rigid-cervical-coronal-imbalance-secondary-to-post-traumatic-heterotopic-ossification-a-case-report-description-of-a-novel-surgical-technique-and-literature-review
#15
Alexander A Theologis, Kate D Bellevue, Erion Qamirani, Christopher P Ames, Vedat Deviren
PURPOSE: Deformities of the cervical spine are uncommon in the coronal plane. In this report, a unique case of a 31-year-old male with a fixed, 30° left coronal deformity due to heterotopic ossification 3 years status post poly-trauma was treated with an asymmetric C7 pedicle subtraction osteotomy (PSO). METHODS: Case report. RESULTS: Pre-operatively, the patient had a fixed 45-degree left tilt of his neck and radiographs demonstrated a rigid 30° scoliosis, 7 cm coronal imbalance, and 4 cm negative sagittal balance, diffuse bridging bone between the spinous processes and the facet joints of C5 to T1 bilaterally...
December 28, 2016: European Spine Journal
https://www.readbyqxmd.com/read/28025024/cervical-sagittal-alignment-in-adolescent-idiopathic-scoliosis-patients-lenke-type-1-6
#16
Lianlei Wang, Xinyu Liu
OBJECTIVE: We collected the radiographic and clinical data of 129 AIS patients (Lenke type 1-6) to analyze the characteristics of cervical sagittal alignment in adolescent idiopathic scoliosis patients and the correlations between cervical sagittal alignment and global sagittal alignment, and clinical symptoms. METHODS: 129 patients with AIS and 48 adolescent volunteers were included in this study. The angles of the main thoracic curve, proximal thoracic curve, thoracolumbar curve, lumbar curve, C2-7 Cobb angle, T5-12 Cobb angle, L1-5 Cobb angle, pelvic incidence, pelvic tilt, sacrum slop, C2-7 sagittal vertical axis, C7-S1 sagittal vertical axis, and T1 pelvic angle were included in radiographic measurements...
December 23, 2016: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
https://www.readbyqxmd.com/read/27977581/sagittal-spinopelvic-parameters-in-2-level-lumbar-degenerative-spondylolisthesis-a-retrospective-study
#17
COMPARATIVE STUDY
Tao Wang, Hui Wang, Huan Liu, Lei Ma, Feng-Yu Liu, Wen-Yuan Ding
The purpose of our study is to evaluate sagittal parameters in 2-level lumbar degenerative spondylolisthesis (DS) (TLDS).A total of 15 patients with TLDS, 40 patients with single-level DS (SLDS), and 30 normal volunteers as control were included in our study. All subjects performed on full spine X-ray. Two categorized data were analyzed: patient characteristics-age, sex, body mass index, radiographic parameters-pelvic incidence (PI), pelvic tilt (PT), lumbar lordosis (LL), sacral slope (SS), PI-LL, Cobb between the fifth thoracic vertebral and 12th thoracic vertebral (T5-T12), sagittal vertical axis (SVA) Cobb angle of spondylolisthesis level (CSL), ratio of PT to SS (PT/SS), CSL/LL, variation trend of SS over PI, and LL over PI...
December 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27935449/multiple-hook-fixation-in-revision-spinal-deformity-surgery-for-patients-with-a-previous-multilevel-fusion-mass-technical-note-and-preliminary-outcomes
#18
Ning Liu, Kirkham B Wood
OBJECTIVE A previous multilevel fusion mass encountered during revision spinal deformity surgery may obscure anatomical landmarks, making instrumentation unworkable or incurring substantial blood loss and operative time. This study introduced a surgical technique of multiple-hook fixation for fixating previous multilevel fusion masses in revision spinal deformity surgeries and then evaluated its outcomes. METHODS Patients with a previous multilevel fusion mass who underwent revision corrective surgery down to the lumbosacral junction were retrospectively studied...
March 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/27922572/comparative-study-between-pedicle-subtraction-osteotomy-pso-and-closing-opening-wedge-osteotomy-fish-mouth-pso-for-sagittal-plane-deformity-correction
#19
Jong-Hwa Park, Seung-Jae Hyun, Ki-Jeong Kim, Tae-Ahn Jahng
STUDY DESIGN: A retrospective study. OBJECTIVE: To evaluate the safety and efficacy of closing-opening wedge osteotomy (COWO: fish-mouth pedicle subtraction osteotomy [PSO]), for sagittal plane deformity correction and to compare the radiographical outcomes for patients undergoing conventional- and fish-mouth PSO. SUMMARY OF BACKGROUND DATA: The COWO has been developed to achieve a large magnitude of correction at a single level for patients with severe fixed sagittal imbalance...
December 2, 2016: Spine
https://www.readbyqxmd.com/read/27864681/are-sagittal-spinopelvic-radiographic-parameters-significantly-associated-with-quality-of-life-of-adult-spinal-deformity-patients-multivariate-linear-regression-analyses-for-pre-operative-and-short-term-post-operative-health-related-quality-of-life
#20
Mitsuru Takemoto, Louis Boissière, Jean-Marc Vital, Ferran Pellisé, Francisco Javier Sanchez Perez-Grueso, Frank Kleinstück, Emre R Acaroglu, Ahmet Alanay, Ibrahim Obeid
PURPOSE: To evaluate the association in ASD patients between spinopelvic sagittal parameters and health-related quality of life (HRQL), adjusted for demographic and surgical variables. METHODS: We constructed multiple linear regression models to investigate pre-operative (PreOp) and 6-month post-operative (PostOp) HRQL as assessed by the Oswestry Disability Index (ODI), with sagittal parameters as independent variables adjusted for potential confounders, such as age, sex, body mass index, past spine surgery, types of surgical treatment, and complications...
November 18, 2016: European Spine Journal
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