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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Analyze the modifications in the "safe zones" of T4-L4 vertebral bodies relative to aorta according to patient positioning, as well as in the relationship between the aorta and the vertebrae. ⋯ Patient positioning during spinal surgery significantly modifies T4-L4 vertebral safe zones relative to aorta. These variations should be taken into account when analyzing an MRI performed in supine if the patient is undergoing surgery in a different position, to avoid vascular-related injuries.
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To evaluate if there are differences in thoraco-lumbar disc characteristics between elite skiers and non-athletic controls as well as between different types of elite skiers, with diverse training histories, using a novel quantitative MRI method. ⋯ Differences in quantitative disc characteristics were found not only between elite skiers and non-athletic controls but also between subgroups of elite skiers with diverse training histories. The differences in the disc measures, reflecting tissue degradation, are likely related to type and intensity of the physical training. Future studies are encouraged to explore the relation between disc functionality, training history and pain to establish adequate prevention and rehabilitation programs.
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To assess the comparative accuracy of commonly utilised index radiological measurements in the prognosis of infantile idiopathic scoliosis (IIS) and build a parsimonious prognostic model utilising these measurements. ⋯ Of the three analysed index radiological parameters commonly used by surgeons in the prognosis of IIS, we found that the Cobb angle is the most accurate predictive measure. Further, neither addition of the RVAD nor convex RVA provided significant further prognostic value in a multivariate model of progression. However, not even the Cobb angle model was accurate in all cases; emphasising caution should be applied when relying on index radiological measurements to predict IIS outcomes.
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Review Meta Analysis
Surgical outcomes following hemivertebrectomy in congenital scoliosis: a systematic review and observational meta-analysis.
Hemivertebrectomy is widely used definitive correction surgery in congenital scoliosis due to hemivertebrae. It may be done either as combined anterior and posterior approach or a single-stage posterior approach only. The purpose of this meta-analysis was to compare two techniques with regards to blood loss, operative time, deformity correction and complications. ⋯ IV.
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Multicenter Study
The Impact of Corrective Surgery on Health-Related Quality of Life Subclasses in Adult Scoliosis: Will Degree of Correction Prognosticate Degree of Improvement?
Objectives in scoliosis corrective surgery include restoration of normal sagittal and coronal parameters to achieve patient satisfaction. HRQLs improvements remain limited after corrective surgery. The aim of this study was to evaluate the HRQL subclass variability specific to the sagittal and coronal correction in adult scoliosis surgery. ⋯ Adult scoliosis surgery improves overall HRQL, having a minimal effect on each variable. Importantly, greater coronal deformity correction affects only greater self-image scores, whereas with greater sagittal correction there are many greater HRQL sub-class impacts. Correction and restoration of coronal balance is one of the surgical goals in adult scoliosis but the degree to which Cobb angle is corrected, apart from self-image, does not correlate with gains in sub-classes of HRQL. These results need to be taken into account when planning surgery.