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
-
This is a prospective study of adolescent patients in whom idiopathic thoracic scoliosis was corrected by short anterior fusion through a mini-open thoracotomy approach. Clinical, radiological and pulmonary function results of minimal 2-year (2-6) follow-up are presented. ⋯ A good deformity correction without loss of correction or adding on, a good cosmetic result and good patient's satisfaction were achieved through shorter than end-to-end thoracic fusions. The radiological residual deformity is acceptable. Anterior correction of thoracic scoliosis with a short spinal fusion is recommended to keep the large part of the spine mobile. A very short fusion, small thoracotomy incision, low-profile implants and complete closure of parietal pleura are keys to prevent reduction in postoperative lung function.
-
In patients with cervical spondylotic myelopathy, ventral disease and loss of physiological cervical lordosis are indications for anterior approach. As bone graft and titanium cage present many drawbacks, expandable titanium cage has been recently introduced for this indication. The authors present the clinical and radiological outcomes in patients undergoing the placement of an expandable cage in the treatment of spondylotic myelopathy with straight or kyphotic cervical spine alignment. ⋯ Expandable titanium cage is an effective device, which achieves good clinical and radiological outcomes at a minimum 2-year follow-up.
-
To study the anatomic parameters related to clival screw and establish reference data concerning the craniovertebral fixation technique. ⋯ Clival screw placement is a viable option for craniovertebral fixation. There is a safe scope for the screw length and angle of the screw placement. And, these parameters obtained in the present study will be helpful for anyone contemplating the use of clival screw fixation.
-
Comparative Study
Comparative effectiveness research across two spine registries.
Comparative effectiveness research in spine surgery is still a rarity. In this study, pain alleviation and quality of life (QoL) improvement after lumbar total disc arthroplasty (TDA) and anterior lumbar interbody fusion (ALIF) were anonymously compared by surgeon and implant. ⋯ Pain alleviation after TDA and ALIF was similar. Differences in surgeon's patient selection based on pain and QoL were revealed. Some surgeons seem to miss the full therapeutic potential of TDA by selecting patients with lower symptom severity.
-
The SRS-24 questionnaire was originally validated using methods of classical test theory, but internal construct validity has never been shown. Internal construct validity, i.e. unidimensionality and linearity, is a fundamental arithmetic requirement and needs to be shown for a scale for summating any set of Likert-type items. Here, internal construct validity of the SRS-24 questionnaire in adolescent idiopathic scoliosis (AIS) patients is analyzed. ⋯ The SRS-24 score is a non-linear and multidimensional construct. Adding the items into a single value is therefore not supported and invalid in principle. Making profound changes to the questionnaire yields a score which fulfills the properties of internal construct validity and supports its use a change score for outcome measurement.