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Sagittal imbalance

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https://www.readbyqxmd.com/read/29672421/human-versus-robot-a-propensity-matched-analysis-of-the-accuracy-of-free-hand-versus-robotic-guidance-for-placement-of-s2-alar-iliac-s2ai-screws
#1
Jamal N Shillingford, Joseph L Laratta, Paul J Park, Joseph M Lombardi, Alexander Tuchman, Comron S Saifi, Ronald A Lehman, Lawrence G Lenke
STUDY DESIGN: Retrospective matched cohort analysis. OBJECTIVE: To compare the accuracy of S2 alar-iliac (S2AI) screw placement by robotic guidance versus free hand technique. SUMMARY OF BACKGROUND DATA: Spinopelvic fixation utilizing S2AI screws provides optimal fixation across the lumbosacral junction allowing for solid fusion, especially in long segment fusion constructs. Traditionally, S2AI screw placement has required fluoroscopic guidance for accurate screw placement...
April 18, 2018: Spine
https://www.readbyqxmd.com/read/29666897/-fixed-cervical-high-grade-kyphosis-chin-on-chest-deformity-treatment-plan
#2
REVIEW
H Koller, S Hartmann
BACKGROUND: Surgical correction of severe and rigid cervical kyphosis with chin-on-chest deformity poses significant challenges to both the patient and surgeon once surgery is considered as the treatment of choice. OBJECTIVES: This article presents the current concepts of corrective surgery for patients with severe and rigid cervical kyphosis. MATERIAL AND METHODS: Narrative review and report of clinical experience. RESULTS: The treatment of severe cervical kyphosis indicates a dedicated deformity assessment, the analysis of regional and global imbalance, the identification of spinal sagittal plane compensation mechanisms, detailed radiographic and clinical planning of corrective surgery, and the meticulous performance of surgical correction...
April 17, 2018: Der Orthopäde
https://www.readbyqxmd.com/read/29656629/differences-in-cervical-sagittal-alignment-changes-in-patients-undergoing-laminoplasty-and-anterior-cervical-discectomy-and-fusion
#3
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
https://www.readbyqxmd.com/read/29629580/current-concepts-in-the-surgical-management-of-adolescent-idiopathic-scoliosis
#4
A D Tambe, S J Panikkar, P A Millner, A I Tsirikos
Adolescent idiopathic scoliosis (AIS) is a complex 3D deformity of the spine. Its prevalence is between 2% and 3% in the general population, with almost 10% of patients requiring some form of treatment and up to 0.1% undergoing surgery. The cosmetic aspect of the deformity is the biggest concern to the patient and is often accompanied by psychosocial distress. In addition, severe curves can cause cardiopulmonary distress. With proven benefits from surgery, the aims of treatment are to improve the cosmetic and functional outcomes...
April 1, 2018: Bone & Joint Journal
https://www.readbyqxmd.com/read/29621202/thoracic-inlet-parameters-for-degenerative-cervical-spondylolisthesis-imaging-measurement
#5
Quanbing Wang, Xiao-Tao Wang, Lei Zhu, Yu-Xi Wei
BACKGROUND The aim of this study was to explore the diagnostic value of sagittal measurement of thoracic inlet parameters for degenerative cervical spondylolisthesis (DCS). MATERIAL AND METHODS We initially included 65 patients with DCS and the same number of health people as the control group by using cervical radiograph evaluations. We analyzed the x-ray and computer tomographic (CT) data in prone and standing position at the same time. Measurement of cervical sagittal parameters was carried out in a standardized supine position...
April 5, 2018: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/29609082/risk-factors-of-adjacent-segment-disease-after-anterior-cervical-arthrodesis-a-retrospective-study-of-sagittal-measurement-of-thoracic-inlet-parameters
#6
Jian Song, Yu-Xuan Zhang, Ke-Han Song, Hong-Li Wang, Fei Zou, Jian-Yuan Jiang
BACKGROUND: To explore the predictive parameters for adjacent segment disease (ASD) after anterior cervical arthrodesis at the sagittal measurement of thoracic inlet. METHODS: We included 212 subjects treated with anterior cervical fusion surgery to identify predictive parameters for ASD . We applied the multivariate logistic regression to find the revelant parameters. RESULTS: A total of 200 patients complete the final follow-up. The results of logistic regression analysis showed that preoperative T1 slope of less than 19...
March 30, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29608699/development-of-proximal-junctional-kyphosis-after-minimally-invasive-lateral-anterior-column-realignment-for-adult-spinal-deformity
#7
Shashank V Gandhi, Jacob Januszewski, Konrad Bach, Randall Graham, Andrew C Vivas, Jason Paluzzi, Adam Kanter, David Okonkwo, Zachary J Tempel, Nitin Agarwal, Juan S Uribe
BACKGROUND: Development of proximal junctional kyphosis (PJK) after correction of adult spinal deformity (ASD) undermines sagittal alignment. Minimally invasive anterior column realignment (ACR) is a powerful tool for correction of ASD; however, long-term PJK rates are unknown. OBJECTIVE: To characterize PJK after utilization of ACR in ASD correction. METHODS: A retrospective multi-institution cohort analysis per STROBE criteria was conducted of all patients who underwent lateral lumbar interbody fusion (LLIF) or ACR for ASD from 2010 to 2015...
March 28, 2018: Neurosurgery
https://www.readbyqxmd.com/read/29570046/sagittal-radiographic-parameters-demonstrate-weak-correlations-with-pretreatment-patient-reported-health-related-quality-of-life-measures-in-symptomatic-de-novo-degenerative-lumbar-scoliosis-a-european-multicenter-analysis
#8
Sayf S A Faraj, Marinus De Kleuver, Alba Vila-Casademunt, Roderick M Holewijn, Ibrahim Obeid, Emre Acaroğlu, Ahmet Alanay, Frank Kleinstück, Francisco S Pérez-Grueso, Ferran Pellisé
OBJECTIVE Previous studies have demonstrated that among patients with adult spinal deformity (ASD), sagittal plane malalignment is poorly tolerated and correlates with suboptimal patient-reported health-related quality of life (HRQOL). These studies included a broad range of radiographic abnormalities and various types of ASD. However, the clinical and radiographic characteristics of de novo degenerative lumbar scoliosis (DNDLS), a subtype of ASD, may influence previously reported correlation strengths. The aim of this study was to correlate sagittal radiographic parameters with pretreatment HRQOL in patients with symptomatic DNDLS...
March 23, 2018: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/29530708/improvement-in-sagittal-balance-after-decompression-surgery-without-fusion-in-patients-with-degenerative-lumbar-stenosis-clinical-and-radiographic-results-at-1-year
#9
Rachid Madkouri, David Brauge, Anthony Vidon-Buthion, Elie Fahed, Klaus-Luc Mourier, Jacques Beaurain, Mickael Grelat
OBJECTIVE: The aim of this study was to evaluate modifications in static spinal status after posterior decompression surgery without fusion in patients with symptomatic central canal stenosis. MATERIAL & METHODS: From November 2014 to May 2016, 72 patients who underwent isolated decompression for lumbar spinal stenosis were prospectively enrolled in this monocentric study. All of the patients had lateral full-body x-rays using the EOS system (EOS Imaging, Paris, France) before surgery and after 12 months of follow-up...
March 9, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29526059/restoration-of-sagittal-balance-in-spinal-deformity-surgery
#10
REVIEW
Melvin C Makhni, Jamal N Shillingford, Joseph L Laratta, Seung-Jae Hyun, Yongjung J Kim
The prevalence of patients with adult spinal deformity (ASD) has been reported as high as 68%. ASD often leads to significant pain and disability. Recent emphasis has been placed on sagittal plane balance and restoring normal sagittal alignment with regards to the three dimensional deformity of ASD. Optimal sagittal alignment has been known to increase spinal biomechanical efficiency, reduce energy expenditure by maintaining a stable posture with improved load absorption, influence better bony union, and help to decelerate adjacent segment deterioration...
March 2018: Journal of Korean Neurosurgical Society
https://www.readbyqxmd.com/read/29462037/the-free-hand-technique-for-s2-alar-iliac-screw-placement-a-safe-and-effective-method-for-sacropelvic-fixation-in-adult-spinal-deformity
#11
Jamal N Shillingford, Joseph L Laratta, Lee A Tan, Nana O Sarpong, James D Lin, Charla R Fischer, Ronald A Lehman, Yongjung J Kim, Lawrence G Lenke
BACKGROUND: Spinopelvic fixation is an integral part of achieving solid fusion across the lumbosacral junction, especially in deformity procedures requiring substantial correction or long-segment constructs. Traditional S2-alar-iliac (S2AI) screw-placement techniques utilize fluoroscopy, increasing operative time and radiation exposure to the patient and surgeon. We describe a novel free-hand technique for S2AI screw placement in patients with adult spinal deformity. METHODS: We reviewed the records of 45 consecutive patients who underwent spinopelvic fixation performed with use of S2AI screws by the senior surgeon and various fellows or residents over a 12-month period (2015 to 2016)...
February 21, 2018: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/29424672/sacral-pedicle-subtraction-osteotomy-for-an-extreme-case-of-positive-sagittal-balance-case-report
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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 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
#18
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
#19
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
#20
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 because of 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: We aimed to evaluate L5I in HGSPL and its relationship to other spinopelvic parameters. STUDY DESIGN: A retrospective study of a cohort of 184 patients with HGSPL was carried out...
January 31, 2018: Spine Journal: Official Journal of the North American Spine Society
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