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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Randomized Controlled Trial
Spine surgeon's kinematics during discectomy according to operating table height and the methods to visualize the surgical field.
The ergonomic problems for surgeons during spine surgery are an awkward body posture, repetitive movements, increased muscle activity, an overflexed spine, and a protracted time in a standing posture. The authors analyzed whole spine angles during discectomy. The objective of this study is to assess differences in surgeon whole spines angles according to operating table height and the methods used to visualize surgical field. ⋯ This study suggests that loupe use and a table height midpoint between the umbilicus and sternum are optimal for reducing surgeon musculoskeletal fatigue.
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Comparative Study
Validation of a novel spinal posture monitor: comparison with digital videofluoroscopy.
A novel, minimally invasive posture monitor which can monitor lumbar postures outside the laboratory has demonstrated excellent reliability, as well as concurrent validity compared to a surface marker-based motion analysis system. However, it is unclear if this device reflects underlying vertebral motion. ⋯ The BodyGuard™ appears to be a valid method for analysing vertebral motion in the sagittal plane and is a promising tool for long-term monitoring of spinal postures in laboratory and clinical settings in people with low back pain.
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We describe cases presenting with progressive thoracic myelopathy after lumbopelvic fusion attributed to proximal junctional vertebral compression fracture (PJF) followed by spinal calcium pyrophosphate dehydrate (CPPD) crystal deposition. ⋯ The combination of mechanical stress plus PJF and CPPD crystal deposition followed by a foreign body reaction to the deposited crystals caused myelopathy. Patients with radiographic evidence of PJF, especially UIV collapse, after lumbopelvic fusion should be followed carefully for the emergence of myelopathy.
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Pulsatile movements of the dura mater have been interpreted as a sign that the cord is free within the subarachnoid space, with no extrinsic compression. However, the association between restoration of pulsation and adequate decompression of the spinal cord has not been established. The present study investigated the relationship between the extent of spinal cord decompression and spinal cord and dural pulsations based on quantitative analysis of intraoperative ultrasonography (US). ⋯ The present results suggest that restoration of dural pulsation is not an adequate indicator of sufficient decompression of the spinal cord following a surgical procedure.
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To compare mid-term clinical outcomes of two revision strategies for patients with failed SB Charité III total disc replacements (TDRs). ⋯ Both procedures showed improvement clinically. There were no significant additional benefits of removing the TDR as compared to fusion alone at mid-term follow-up. The clinical decision to remove the TDR should be carefully weighed up against potential risks and complications of this procedure.