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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To evaluate the relationship between height ratio of the iliac crest to L4 (HR), width ratio of the iliac crest to L4 (WR) and L5-S1 disc degeneration. ⋯ Low HR and (or) WR were the risk factors for L5-S1 disc degeneration. High HR could reduce the percentage of sROM of L5-S1 in L1-S1 segments and high HR and (or) WR could reduce the incidence of L5-S1 disc degeneration.
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To evaluate the entry zone of iliac screw fixation to maintain proper entry width and screw length. ⋯ The iliac screw fixation entry zone to maintain proper screw length and entry width is outlined from 20 mm superiorly to 10 mm inferiorly from the PSIS and is located more medially from the prominence of the posterior iliac spine.
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Medium- to long-term retrospective evaluation of clinical and radiographic outcome in the treatment of degenerative lumbar diseases with hybrid posterior fixation. ⋯ After 5-year follow-up, hybrid posterior lumbar fixation presented satisfying clinical outcomes in the treatment of degenerative disease.
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The purpose was to investigate the median sacral artery (MSA) anatomical pathway in terms of its relationship to the lumbosacral spine. ⋯ The MSA anatomy is important for prevention of intra-operative bleeding. For anterior lumbosacral surgery, the MSA should be identified and controlled before proceeding with the spinal surgery. For posterior bicortical sacral screw placement, the screw tip should be fluoroscopically checked to avoid inserting the screw tip into the mid sacral promontory. By first approaching the anterior sacral promontory, the surgeon will find the MSA within the middle one-third zone, and 2.47-2.99 cm cephalad to this, the iliac vessels. Knowledge of the MSA helps the surgeon to operate more safely.
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There have been few studies on revision surgery for clinically symptomatic adjacent segment degeneration (CASD). We aimed to find the incidence of revision surgery due to CASD and to analyze the factors that affected CASD at the L3-4 level after L4-5 or L4-5-S1 level fusion surgery over a long-term follow-up period. ⋯ We determined six significant factors affecting CASD development. Among these risk factors, facet degeneration, isthmic-type spondylolisthesis, and the type of fusion show higher hazard ratios and seem to be clinically more relevant than the other three factors (age, overall lordosis, and segmental lordosis).