Spine
-
Systematic review of diagnostic studies. ⋯ There is a need for a consensus on criteria to define and classify lumbar spinal stenosis. At present, the most promising imaging test for lumbar spinal stenosis is magnetic resonance imaging, avoiding myelography because of its invasiveness and lack of superior accuracy. Electrodiagnostic studies showed no superior accuracy for conventional electrodiagnostic testing compared with magnetic resonance imaging. These tests should be considered in the context of those presenting symptoms with the highest diagnostic value, including radiating leg pain that is exacerbated while standing up, the absence of pain when seated, the improvement of symptoms when bending forward, and a wide-based gait.
-
Multicenter Study
Risk factors for complications associated with growing-rod surgery for early-onset scoliosis.
A retrospective multicenter study. ⋯ Increases in the upper thoracic scoliotic curve, thoracic kyphosis, and number of rod-lengthening procedures are positively associated with an increased risk of complications after GR surgery for EOS.
-
Comparative Study Clinical Trial
Comparison of teriparatide and bisphosphonate treatment to reduce pedicle screw loosening after lumbar spinal fusion surgery in postmenopausal women with osteoporosis from a bone quality perspective.
Prospective study. ⋯ Our findings suggest that administration of teriparatide increased the quality of the lumbar spine bone marrow and pedicle cortex.
-
Prospective cohort. ⋯ Repeated dual-energy x-ray absorptiometry was able to elucidate the biological process of bone graft remodeling in the intertransverse fusion mass. An active bone remodeling process was quantified with profound resorption or demineralization of the graft during the first 6 months, followed by subsequent bone apposition and restoration of BMD at the final follow-up. No difference in trend in BMD change between patients with and without fusion could be established; however, no firm conclusions can be drawn from small patient numbers.
-
Applied anatomical study and clinical application. ⋯ The intersection of the horizontal line through the midpoint of the transverse process root and the vertical line through the mediolateral third of the superior articular process represents a superior frame of reference for the entry point for C3-C5 pedicle screw fixation. Clinically, we recommend the transverse angles to be 90° for C3 and 80° for C4 and C5, and the vertical angles to be 70° for C3-C5. We found that screws with a diameter of 3.5 mm and length of 20 mm or 22 mm to be safe, objective, and reliable.