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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In adult spinal deformity (ASD), patients increase pelvic tilt (PT) to maintain standing alignment. Previously, ASD patients with low PT and high disability were described. This study investigates this unusual population in terms of demographic, radiographic, and clinical features after three-column osteotomy (3CO). ⋯ LowPT group had high levels of disability. After 3CO surgery, low PT patients experience only partial improvements in sagittal vertical axis (SVA) and 33 % of the group increased their PT. Further work is necessary to determine optimal realignment approaches for this unusual set of patients. It is unclear if neuromuscular pathology plays a role in the setting of high SVA without pelvic retroversion.
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Clinical Trial
Importance of the spinopelvic factors on the pelvic inclination from standing to sitting before total hip arthroplasty.
Dislocation after total hip arthroplasty (THA) is a major postoperative complication. Even if the cup is in the safe zone, dislocation caused by implant impingement may occur during postural changes. The aim of the present study was to investigate the spinopelvic factors that influence pelvic inclination changes from standing to sitting in patients with hip diseases who were candidates for THA. ⋯ The change in pelvic inclination from standing to sitting is strongly related to the mobility of the lumbar spine in patients with hip diseases.
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To determine whether the presence of intervertebral bridging ossifications is associated with intravertebral cleft (IVC) formation following a vertebral compression fracture (VCF). ⋯ A fresh VCF with bridging ossification at the second proximal intervertebral level is associated with increased risk of IVC formation. Careful observation and strict conservative treatment are recommended in such cases.
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Pelvic incidence (PI), pelvic tilt (PT) and sacral slope (SS) are important parameters in sagittal spine alignment evaluation. The measurements are a projection of the three-dimensional pelvis onto a two-dimensional radiograph and they may be influenced by orientation of the pelvis. The aim of this study was to assess the influence of pelvic rotation in the coronal plane (CPR) on radiographic accuracy of PI, PT, and SS measurements. ⋯ Rotation of the pelvis in the coronal plane during acquisition of radiographs influences PI, PT and SS measurements. Substantial error of PI, PT and SS measurements occurs with CPR of more than 20° which is equivalent to a lower limb discrepancy of 5.2 cm. CPR may be calculated while acquiring the radiograph. Further evaluation of the influence of CPR on spinopelvic parameters with a larger sample would be valuable.
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Clinical Trial
Influence of high-heeled shoes on the sagittal balance of the spine and the whole body.
Wearing high heels is associated with chronic pain of the neck, lower back and knees. The mechanisms behind this have not been fully understood. The purpose of this study was to investigate the influence of high-heeled shoes on the sagittal balance of the spine and the whole body in non-habitual wearers of high heels. ⋯ In all participants, wearing high heels led to increased flexion of the knees and to more ankle flexion. While some participants responded to high heels primarily through the lower extremities, others used increased cervical lordosis to adapt to the shift of the body's center of gravity. This could explain the different patterns of pain in the neck, lower back and knees seen in individuals wearing high heels frequently.