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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Foraminal stenosis is commonly investigated with radiological methods in patients with radiating pain in extremities. However, there is a lack of consensus regarding the methodology to assess compression of the nerve roots. This systematic review was performed to identify validated classification systems for foraminal stenosis in the lumbar and cervical spine based on magnetic resonance imaging (MRI). ⋯ The three classification systems demonstrated moderate to good reliability and have all been shown feasible in the clinical setting. There is however a need for further studies testing the validity of these classifications in relation to both clinical findings and to surgical outcome data.
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Clinical Trial
The impact of lumbar alignment targets on mechanical complications after adult lumbar scoliosis surgery.
The purpose of this study was to determine the discriminatory ability of age-adjusted alignment offset and the global alignment and proportion (GAP) score parameters to predict postoperative mechanical complications. ⋯ Radiographic alignment targets using either age-adjusted alignment target offset or GAP score parameters had minimal ability to predict mechanical complications in isolation. Mechanical complications following adult spinal deformity surgery are complex, and patient factors play a critical role. Clinical trial registeration This study was registered at ClinicalTrials.gov (number NCT00854828) in March 2009.
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The focus of SPINE20 is to develop evidence-based policy recommendations for the G20 countries to work with governments to reduce the burden of spine disease, and disability. ⋯ SPINE20's initiatives will make governments and decision makers aware of efforts to reduce needless suffering from disabling spine pain through education that can be instituted across the globe.
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To compare instrumentation configurations consisting of bilateral single or double rods and additional interbody cages (IBCs) at different levels in terms of Range of Motion (ROM) and distribution of von Mises stress in rods. ⋯ Double rods and IBCs reduced global and segmental ROM as well as von Mises stress in rods. The results suggest a possible benefit in using both strategies to minimize pseudarthrosis and instrumentation failure. However, increased ROM in adjacent levels and the shift of maximal von Mises stress to adjacent areas might cause complications elsewhere.
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To report on the phenomenon of body drift in neurofibromatosis scoliosis and discuss its implication on surgical safety. ⋯ The 'body drift' phenomenon was unique to neurofibromatosis scoliosis and was secondary to severe pedicle morphology changes. This was present even in curves less than 60° and could result in cord injury while instrumenting the concave pedicle. Therefore, a thorough preoperative assessment and planning by a 3D CT are mandatory.