European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society
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Cement reinforcement for the treatment of osteoporotic vertebral fractures is efficient mean with high success in pain release and prevention of further sintering of the reinforced vertebrae; however, the technique does not allow to address the kyphotic deformity. Kyphoplasty was designed to address the kyphotic deformity and help to realign the spine. It involves the percutaneous placement of an inflatable bone tamp into a vertebral body. ⋯ The cavity formation, on one hand, and the different cementing technique leads to lower risk for cement extravasation. An alternative method for kyphosis correction represents the so-called lordoplasty where the adjacent vertebrae are reinforced first and with the cannulas in place acting as a lever the reduction of the collapsed vertebra can be performed. The results with respect to kyphosis correction are superior in comparison with a kyphoplasty procedure.
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Case Reports
Sacroiliac joint fusion for chronic pain: a simple technique avoiding the use of metalwork.
A previously undescribed method for posterior fusion of the sacroiliac joint (SIJ) utilizing the Cloward instrumentation is presented, suitable for cases with chronic pain and intact ligamental structures of the SIJ. The advantages of the method in comparison with other described options include minimal disturbance of the periarticular structures, avoidance of introduction of metalwork and preservation of the iliac crest contour. This technique has been used in five cases with follow-up longer than 2 years (mean 29 months, range 25-41 months). In all cases there was resolution of their painful symtomatology.
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A model of sacroiliac joint (SIJ) function postulates that SIJ shear is prevented by friction, dynamically influenced by muscle force and ligament tension. Thus, SIJ stability can be accommodated to specific loading situations. The purpose of this study was to examine, in vivo, whether muscles contribute to force closure of the SIJ. ⋯ The finding that SIJ stiffness increased even with slight muscle activity supports the notion that effectiveness of load transfer from spine to legs is improved when muscle forces actively compress the SIJ, preventing shear. When joints are manually tested, the influence of muscle activation patterns must be considered, since both inter- and intra-tester reliability of the test can be affected by muscle activity. In this respect, the relation between emotional states, muscle activity and joint stiffness deserves further exploration.