Spine surgery and related research
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Spine Surg Relat Res · Jan 2021
Localization of the Lumbar Plexus in the Psoas Muscle: Considerations for Avoiding Lumbar Plexus Injury during the Transpsoas Approach.
Transpsoas lumbar spine surgery is minimally invasive and has very good corrective effects. However, approach-side nerve complications delay post-operative rehabilitation. We anatomically investigated the localization of the lumbar plexus running in the psoas muscle. ⋯ The lumbar plexus was localized in the posterior one-third and medial one-third of the psoas muscle and moved to a posterolateral location at L4/5. To avoid neuropathy, consider the psoas muscle's position relative to that of the intervertebral disc. It is essential to understand lumbar plexus localization in the psoas muscle when looking directly at this muscle to enter the pricking point or route with a lower risk of nerve damage.
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Spine Surg Relat Res · Jan 2021
Posterior Spinal Correction and Fusion Surgery in Patients with Spinal Muscular Atrophy-Associated Scoliosis for Whom Treatment with Nusinersen Was Planned.
Spinal muscular atrophy (SMA) is defined as a neuromuscular disorder induced by progressive weakness of the skeletal muscle and is usually accompanied by progressive spinal deformity including scoliosis. The newly developed Nusinersen, which is the first approved drug worldwide for SMA, requires accurate intrathecal injection, which is sometimes difficult in patients with severe spinal deformity. ⋯ Our findings show that additional lumbar laminectomy during surgery for spinal scoliosis has effectively allowed for intrathecal injection of Nusinersen.
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Spine Surg Relat Res · Jan 2021
Incidence, Risk Factors, and Prevention Strategy for Proximal Junctional Kyphosis in Adult Spinal Deformity Surgery.
Proximal junctional kyphosis (PJK) is an acute complication of adult spinal deformity (ASD) surgery and may require re-operation because of proximal junctional failure (PJF). PJK causes and prevention strategies remain unknown. This study aimed to investigate the differences in the backgrounds of patients with PJK, compared to those without PJK, in ASD surgery. ⋯ One risk factor for PJK was lower postoperative PI-LL that was 0° or less. In ASD surgery, the most critical factor in a PJK prevention strategy is to obtain a postoperative LL adjusted by PI, which is >0°.