Spine
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A retrospective study. ⋯ We evaluated long-term outcomes regarding LBP following scoliosis surgery. Regardless of residual back deformity, LBP was found to be no more frequent than in the normal population in Japan. Positive sagittal balance at the latest follow-up was a factor significantly contributing to LBP following scoliosis surgery.
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Case series. ⋯ Notwithstanding high sensitivities, specificities, and negative predictive values for cervical spine imaging and "clearance" mechanisms, 4 cases that illustrate the potential for undetected unstable cervical spine injuries are presented. Tremendous advancements in medical imaging have been made. However, radiograph, CT, and MR imaging may still fail to accurately translate the anatomic and dynamic complexity of the cervical spine into digital images that accurately guide clinical practice. A full understanding of and keen appreciation for the fact that no imaging technique, classification method, or clearance protocol can produce 100% sensitivity at all times is essential. These case reports cumulatively demonstrate a 0.04% to 0.2% incidence of undetected cervical injury requiring surgical stabilization. Removing cervical collar immobilization as quickly as possible based on negative interpretation of imaging data may prove harmful in a measurable percentage of patients and must be undertaken with caution only after clinical correlation and strict follow-up is established.
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Retrospective case series. ⋯ This study documented a 3.9% overall reoperation rate at our medical center, a 3-fold lower reoperation rate than the previously reported 12.9%. The most common reoperations were for infections (34%), pseudarthroses (26%), and postoperative curve progression of the adjacent unfused spine (17%).
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Retrospective case review at a single center. ⋯ The incidence of PJK can be minimized by the appropriate selection of the upper end vertebra to be fused and avoiding disruption of the junctional ligamentum flavum. The development of DJK can be minimized by incorporation of the first lordotic disc into the fusion construct.