Journal of neurosurgery. Spine
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The incidence of postoperative shoulder imbalance following posterior spinal fusion (PSF) is still high in Lenke 1 curves despite following current treatment recommendations for upper instrumented vertebra (UIV) selection. The objective of this retrospective study was to identify differences in preoperative shoulder balance and to report the surgical outcome of two subtypes of Lenke 1 curves (flexible vs stiff) in patients with adolescent idiopathic scoliosis (AIS). ⋯ Lenke 1 (flexible) and Lenke 1 (stiff) curves had distinct preoperative T1 tilt and CA measurements. Following PSF, the authors noted +ve T1 tilt in 41% of patients with Lenke 1 (stiff) curves versus 2.0% in those with Lenke 1 (flexible) curves. The authors also noted a significant difference in postoperative RSH and Cla-A measurements.
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The optimal timing of operative stabilization of patients with traumatic spinal fractures without spinal cord injury (SCI) has not been established. The challenges of early operative intervention, which may require prone positioning in a patient with multisystem injuries, must be balanced with the disadvantages of prolonged immobilization. The authors set out to define the optimal timing of surgical repair of traumatic spinal fractures in patients without SCI and the effect of delayed repair on the incidence of major complications. ⋯ In the absence of clear contraindications, surgeons should strive to stabilize traumatic spinal fractures without SCI within 24 hours. Early fixation can be expected to reduce major complications by 25%-30%.
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The objective of this study was to determine the publication rate of abstracts presented at the annual meetings of the AANS/CNS Section on Disorders of the Spine and Peripheral Nerves (Spine Summit). ⋯ The publication rate of the Spine Summit is among the highest compared to other spine meetings. Many of the abstracts initially presented at the meeting are further published in high-IF journals and had a high citation count. Therefore, the Spine Summit maintains its high standards of scientific papers, which reflects the high quality of the research performed in the spine surgery field in North America.
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Scheuermann kyphosis (SK) could require surgical treatment in certain situations. A posterior reduction is the most widespread treatment so far, although the development of proximal junctional kyphosis (PJK) is one of the possible complications of this procedure. The contour of the proximal part of the rod could influence the occurrence of PJK in SK patients. The objective of this study was to analyze the impact of the proximal rod contour on the occurrence of a PJK complication in SK patients. ⋯ Under-contouring of the proximal part of the rods (lower than 10°) is a risk factor for PJK after posterior correction of SK.
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Rigid multiplanar thoracolumbar adult spinal deformity (ASD) cases are challenging and many require a 3-column osteotomy (3CO), specifically asymmetrical pedicle subtraction osteotomy (APSO). The outcomes and additional risks of performing APSO for the correction of concurrent sagittal-coronal deformity have yet to be adequately studied. ⋯ ASD patients with significant coronal imbalance often have severe concurrent sagittal deformity. APSO is a powerful and effective technique to achieve multiplanar correction without higher risk of morbidity and complications compared with PSO for sagittal imbalance. However, APSO is associated with slightly longer ICU and hospital stays.