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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Outcome after lumbar disc herniation (LDH) surgery in middle-aged patient is usually reported to fulfill the criteria for successful outcome. It is also known that women in these years have an inferior outcome compared to men. This study evaluates whether the same gender differences exist in elderly. ⋯ Elderly women with LDH surgery report inferior outcome compared to males, mainly as a result of being referred to surgery with an inferior status but are despite this as satisfied with outcome as the men.
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Our study aims to describe the postural alignment of young asymptomatic subjects from head to feet from bi-planar standing full-body X-rays, providing database to compare to aging adults. Novelty resides in the inclusion of the head and lower limbs in the erected posture's analysis. ⋯ This study on 3D postural alignment reports the geometry of the spine, pelvis and lower limbs, of the young asymptomatic adult. The less variable angle is the one of the line OD-HA with the vertical, highlighting the vertical alignment of the head above the pelvis. This study provides a basis for future comparisons when investigating aging populations.
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Sagittal balance analysis has gained importance and the measure of the radiographic spinopelvic parameters is now a routine part of many interventions of spine surgery. Indeed, surgical correction of lumbar lordosis must be proportional to the pelvic incidence (PI). The compensatory mechanisms [pelvic retroversion with increased pelvic tilt (PT) and decreased thoracic kyphosis] spontaneously reverse after successful surgery. ⋯ We showed that the key spinopelvic parameters obtained from a large database of healthy subjects were comparable for Causasian and Japanese populations. The normative values provided in this study and the equations obtained after linear regression modeling could help to estimate pre-operatively the lumbar lordosis restoration and could be also used as guidelines for spinopelvic sagittal balance.
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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.
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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.