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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Variability of the human lower lumbar geometry is related to complications of disc arthroplasty surgery. Accurate morphometric descriptions are essential for the design of artificial intervertebral discs to ensure good prothesis-vertebra contact and better load distribution, and can improve spinal biomechanics. Unfortunately, current knowledge of the lower lumbar geometry is limited either in the representativeness of sample populations or the accuracy and comprehensiveness of measurements. The objective of this study was to establish an accurate and reliable measurement protocol, provide a comprehensive database of lower lumbar geometry, and compare and summarize geometric data as reported in the literature. ⋯ This study demonstrates the potential of using MRI data to establish a standard measurement protocol for morphometric quantification of the lower lumbar intervertebral discs and vertebral endplates. These results are invaluable in characterizing comprehensive lower lumbar morphometry, which may provide crucial information for planning spinal surgeries, designing artificial intervertebral discs, and for biomechanical modeling of the low lack.
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Comparative Study
Thoracic spine morphology of a pseudo-biped animal model (kangaroo) and comparisons with human and quadruped animals.
Based on the structural anatomy, loading condition and range of motion (ROM), no quadruped animal has been shown to accurately mimic the structure and biomechanical function of the human spine. The objective of this study is to quantify the thoracic vertebrae geometry of the kangaroo, and compare with adult human, pig, sheep, and deer. ⋯ Similarities in thoracic spine vertebral geometry, particularly of the vertebrae, pedicles and facets may render the kangaroo a more clinically relevant human surrogate for testing spinal implants. The pseudo-biped kangaroo may also be a more suitable model for the human thoracic spine for simulating spine deformities, based on previously published similarities in biomechanical loading, posture and ROM.
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Identify risk factors, enabling reduction of the rate of complications and improve outcome in en bloc resection surgeries. ⋯ The rate of complication is higher in multisegmental resections and when double combined approach is performed. Reoperations display greater morbidity owing to dissection through scar/fibrosis from previous operations and possibly from RT. Careful treatment planning and, in the event of uncertainty, referral to a specialty center must be stressed. The high risk of complications should not discourage surgeons from performing en bloc resection when needed. Most of the patients who sustain complications benefit from the better local control resulting from en bloc resection.