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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The purpose of this study was to evaluate total spinal alignment in asymptomatic individuals with 6 lumbar vertebrae (LVs). ⋯ Asymptomatic individuals with 6LVs presented with different spinopelvic alignment compared to those with 5LVs. We need to establish a treatment strategy for symptomatic 6LV cases.
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Normal spino-pelvic values for patients with lumbarization of S1 have not been described in the literature. Presented are the normal values for this population group, the prevalence of S1 lumbarization, and the correlation between pelvic incidence (PI) and lumbar lordosis (LL) in this group. ⋯ Incomplete imaging of the spine may lead to false estimation of the prevalence of lumbarization. Patients with lumbarization have higher lordosis values and lordosis can now be estimated during pre-operative planning for this group.
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Pelvic incidence is a position- and posture-independent parameter used to quantify sagittal balance of the spine, sacrum, pelvis and hips. Its functional consequences have been associated with a number of different pathologies of the spine. However, there exists considerable controversy over which demographic features contribute to the development of pelvic incidence. ⋯ This study represents the largest single cohort of pelvic incidence measurements reported in the literature. Our data suggest that pelvic incidence does not change with age or height, although racial differences do exist. As spine care providers increasingly rely on pelvic incidence as an important means to quantify sagittal balance, the normative data provided herein will provide an essential reference.
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Leakage is the most common complication of percutaneous cement augmentation of the spine. The viscosity of the polymethylmethacrylate (PMMA) cement is strongly correlated with the likelihood of cement leakage. We hypothesized that cement leakage can be reduced by sequential cement injection in a vertebroplasty model. ⋯ The sequential cement injection is a simple approach to minimize the risk for leakage. Taking advantage of the temperature gradient between body and room temperature, it is possible to increase the cement viscosity inside the vertebra while keeping it low in the syringe. Using sequential injection of small cement volumes, further leakage paths are blocked before further injection of the low-viscosity cement.