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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Clinical Trial
Immediate postoperative coronal imbalance in Lenke 5 and Lenke 6 adolescent idiopathic scoliosis: Is it predictable?
Immediate postoperative coronal imbalance (IPCIB) is a common reason for worse postoperative appearance in adolescent idiopathic scoliosis (AIS) patients and rarely improves on its own at follow-up, thereby greatly influencing the patients' health-related quality of life. However, no studies have been performed to detect the primary risk factors for IPCIB and it remains unclear whether the condition can be predicted preoperatively. The purpose of this study is to detect the primary risk factors for IPCIB in Lenke 5 and Lenke 6 AIS patients and to explore whether IPCIB can be predicted preoperatively. ⋯ The preoperative bending L5 tilt, postoperative translation of the thoracic apex, and the postoperative lumbar Cobb angle were the primary risk factors for IPCIB in Lenke 5 and Lenke 6 AIS patients. The IPCIB index can be used to predict the occurrence of IPCIB with high accuracy. Our results indicate that the thoracic curve should be adequately corrected during surgery; however, moderate correction of the lumbar curve is recommended. These slides can be retrieved under Electronic Supplementary Material.
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Observational Study
Development of predictive models for all individual questions of SRS-22R after adult spinal deformity surgery: a step toward individualized medicine.
Health-related quality of life (HRQL) instruments are essential in value-driven health care, but patients often have more specific, personal priorities when seeking surgical care. The Scoliosis Research Society-22R (SRS-22R), an HRQL instrument for spinal deformity, provides summary scores spanning several health domains, but these may be difficult for patients to utilize in planning their specific care goals. Our objective was to create preoperative predictive models for responses to individual SRS-22R questions at 1 and 2 years after adult spinal deformity (ASD) surgery to facilitate precision surgical care. ⋯ To the best of our knowledge, this is the first study to explicitly model the prediction of individual answers to the SRS-22R questionnaire at 1 and 2 years after deformity surgery. The ability to predict individual question responses may prove useful in preoperative counseling in the age of individualized medicine. These slides can be retrieved under Electronic Supplementary Material.
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To clarify the relationship between sarcopenia and spinopelvic parameters. ⋯ Sarcopenia is related to spinal sagittal imbalance because of insufficient compensation by flattening thoracic kyphosis in patients with spinopelvic mismatch. These slides can be retrieved under Electronic Supplementary Material.
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To measure and compare the total and normalised tibial nerve movements during forward bending in patients with and without failed back surgery syndrome (FBSS) and persistent leg pain following anatomically successful lumbar decompression surgery and demonstrated no psychological stress. Nerve pathomechanics may contribute to FBSS with persistent leg pain following anatomically successful lumbar decompression surgery. ⋯ This was the first study to quantify the decreased total and normalised tibial nerve mobility in FBSS patients with persistent leg pain when compared with non-FBSS patients following anatomically successful lumbar decompression surgery. Further research could investigate the efficacy of intervention, such as nerve mobilisation in this particular group of patients with failed back surgery syndrome and limited nerve mobility. These slides can be retrieved under Electronic Supplementary Material.
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To test the hypothesis that the relationship between PI and L1-S1 lumbar lordosis (LL) is always positive, even in cases with different lumbar sagittal profiles. ⋯ Contrary to the hypothesis, the correlation coefficient between PI and LL was not significant in the cases with apex above L3, suggesting that the relationship between PI and LL is not always constant, and whole sagittal alignment should be taken into account. These slides can be retrieved under Electronic Supplementary Material.