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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Early-stage spondylolysis (ESS) is a common cause of acute low back pain (LBP) in adolescents. When treating patients with ESS, early diagnosis is essential, yet difficult without magnetic resonance imaging. This study evaluates a self-reported questionnaire for detecting ESS. ⋯ Exercise frequency, training time, pain-provoking situations, and gender could be important factors to detect ESS within this questionnaire.
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To identify the clinical phenotypes associated with the rate of progression while waiting for surgery and propose a classification scheme for identifying subgroups of patients to prioritize for surgery when long surgical delays are expected. ⋯ We present an evidence-based surgical prioritization algorithm for pediatric idiopathic scoliosis that can easily be implemented in clinical practice when long surgical delays are expected.
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Cervical hemivertebrae (C3-6) causing significant osseous torticollis, head tilt and facial asymmetry are rare and complicated. Cervical hemivertebrectomy (CHVE) by a posterior-only approach was never reported because it is highly risky and its efficacy remains controversial. This study is to evaluate the feasibility and preliminary clinical outcomes of posterior-only approach for CHVE and torticollis correction in young children. ⋯ CHVE by a posterior-only approach was a feasible alternative option for the treatment of congenital cervical scoliosis. It could resect the CHV effectively and achieve satisfactory torticollis correction without additional anterior access surgery. Successful CPS placement in this child population was essentially important to enable reliable osteotomy closure and firm posterior instrumentation.
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In this study we aimed to identify whether paraspinal muscle morphology could play a role in surgical decision-making in patients with lumbar spondylolisthesis. ⋯ Each 1-point increment in fatty infiltration in the erector spinae at any lumbar level increased the likelihood of surgery by 8%. Lumbar spondylolisthesis patients with fatty infiltration score for erector spinae at or above 17 were more likely to have surgery. We recommend clinicians to focus on improving erector spinae muscles in patients with lumbar spondylolisthesis.
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In patients with traumatic, infectious, degenerative, and neoplastic surgical indications in the cervical spine, commonly the anterior approach is used. Often these patients require a tracheostomy necessary due to prolonged mechanical ventilation. The limited spinal mobility and proximity to the surgical site of anterior cervical spine fixation (ACSF) could pose an increased risk for complications of percutaneous dilational tracheostomy (PDT.) Importantly, PDT might raise wound infection rates of the cervical spine approach. The aim of this study is to prove safety of PDT after ACSF. ⋯ PDT is a feasible and safe procedure in patients after ACSF. Complication rates are comparable to patients without ACSF. Surgical site infections of ACSF are very rare.