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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To analyze the correlation between immediate postoperative coronal imbalance and the matching degree of the correction rates of the main curve and compensatory curves in the surgical treatment of severe adult idiopathic scoliosis. ⋯ Mismatch between the correction rates of the main curve and compensation curves is a critical cause of immediate postoperative CIB. The relatively equal correction of the main curve and compensatory curves is essential for type A patients to achieve postoperative coronal balance, while the correction rate of the main curve should be higher than the compensatory curves in type B patients and vice versa in type C patients. Three formulas for the three different types were developed to provide helpful guidance information for surgical planning.
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This study aims to introduce an innovative adjustable prone positioning frame (APPF) and explore its feasibility and safety for treatment of severe kyphosis secondary to ankylosing spondylitis (AS) with two-level osteotomy. ⋯ The innovative APPF provided great convenience to place patients with severe kyphosis secondary to AS in a prone position. Performing two-level osteotomy with the aid of APPF is safe, feasible and effective.
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Sedimentation sign was reported to have high sensitivity and specificity for diagnosis of lumbar spinal stenosis (LSS). We aimed to determine cerebrospinal fluid signal loss (CSFSL) at the intervertebral disc levels in the sagittal plane using a numerical scoring system and to evaluate the diagnostic value of this method in differential diagnosis of LSS and non-specific low back pain (LBP) and compare it with SS. ⋯ CSFSL sign might be used to distinguish LSS from LBP and unlike SS it is successful in moderate stenosis.
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Surgical indications for lumbar spinal stenosis are controversial, but most agree that leg dominant pain is a better predictor of success after decompression surgery. The objective of this study is to analyze the ability of the Nerve Root Sedimentation Sign (SedSign) on MRI to differentiate leg dominant symptoms from non-specific low back pain. ⋯ Patients with a positive SedSign were more likely to be offered surgery, in particular non-instrumented decompression. The SedSign has high specificity for leg dominant pain, but the sensitivity is poor. As such, its use in triaging appropriate surgical referrals is limited.
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Clinical evaluation of lumbar foraminal stenosis typically includes qualitative assessments of perineural epidural fat content around the spinal nerve root and evaluation of nerve root impingement. The present study investigates the use of several morphological MRI-derived metrics as quantitative predictors of foraminal stenosis grade. ⋯ The results of the study have demonstrated that segmented volumes of perineural fat predict the severity of clinically scored foraminal stenosis. This finding motivates further development of automated perineural fat segmentation methods, which could offer a quantitative imaging biometric that yields more reproducible diagnosis, assessment, and tracking of foraminal stenosis.