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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Syringomyelia is a misleading disease since the problem always lies elsewhere. Arachnoiditis, because it is radiographically difficult to discern, is an especially insidious cause. To better guide selection from among surgical treatment options for syringomyelia, we reviewed our case series of patients without Chiari malformation or spinal injury. ⋯ To remove the cause of syringomyelia, surgical planning will rely on thorough clinical history and accurate imaging to determine the site of cerebrospinal fluid obstruction. Craniocervical decompression to dissect basal arachnoiditis in the posterior fossa can be recommended in hindbrain syringomyelia. Treatment of non-hindbrain arachnoiditis is more controversial, probably owing to uncertainties about the extent of adhesions.
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In the last few years several reports stressed the importance of sagittal alignment in adolescent idiopathic scoliosis (AIS) patients. It was recently reported that T1 slope, defined as the angle between the superior endplate of T1 and the horizontal, correlates strongly with overall sagittal parameters. The aim of this study was to assess the impact of T1 parameters (T1-slope and T1-tilt) on sagittal alignment of AIS hypokyphotic patients preoperatively and postoperatively. ⋯ According to these results, T1 seems to be of major interest in postoperative modifications of sagittal alignment. T1 slope and sagittal tilt are good indicators of postoperative changes for regional (cervical lordosis and thoracic kyphosis) and global parameters. We therefore consider these parameters as essential in the assessment of AIS patients. Further studies and correlation with clinical scores will, however, be necessary in order to confirm the present findings.
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To evaluate the benefits of minimally invasive balloon kyphoplasty (BKP) in patients with cancer and painful pathologic vertebral lesions. ⋯ Minimally invasive BKP provided excellent long-term palliation of pain and improved mobility in patients with cancer and painful osteolytic spinal lesions or vertebral fractures.
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The Metastatic spinal cord compression (MSCC) secondary to lung cancer (LC) has worse prognosis when compared to MSCC related to other solid tumors. The purpose of this study is to identify the survival time and the prognostic factors in the MSCC secondary to LC. ⋯ The prognosis of the MSCC secondary to LC was poor. Considering the small number of studies identified, further research is needed to identify prognostic factors that are independent of the MSCC secondary to LC.
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The medial branch of the posterior ramus of the lumbar spinal nerve is well known to be innervated independently and to end in the multifidus muscle without anastomosis. This prospective cohort study aimed to determine the diagnostic specificity and sensitivity of multifidus muscle denervation (MMD) by needle electromyography (N-EMG) for lumbar foraminal and lateral exit-zone stenosis (LF/LEZS). ⋯ Needle electromyography is a simple and available additional method for the diagnosis of LF/LEZS.