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 construct a nomogram model based on magnetic resonance imaging (MRI) radiomics combined with clinical characteristics and evaluate its role and value in predicting the prognosis of patients with cervical spinal cord injury (cSCI). ⋯ We constructed a combined model that can be used to help predict the prognosis of cSCI patients with radiomics and clinical characteristics, and further provided guidance for clinical decision-making by generating a nomogram.
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This study investigates the relationship between surgical levels and coronal deformity to identify risk factors for failing to achieve a minimal clinically important difference (MCID) in the Oswestry Disability Index (ODI) following short-segment isolated decompression or fusion surgery in patients with degenerative scoliosis (DS) and concurrent lumbar canal stenosis (LCS), without severe sagittal deformity malalignment. ⋯ In patients with mild to moderate coronal deformity and minimal sagittal deformity, decompression alone at or across end vertebrae significantly lowers the likelihood of achieving the MCID in ODI compared to fusion surgery, with an 84% reduction in odds. No significant difference in MCID achievement was observed between decompression and fusion surgeries outside the Cobb angle.
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To perform a large-scale assessment of reoperation risk among spine deformity patients undergoing thoracic to pelvis surgery. ⋯ This study, representing a real-world cohort of over six times the largest current prospective data set, found a 2-year reoperation rate of 17%, similar to previous studies, suggesting study group findings are applicable to a broader population. Preoperative kyphosis and ≥ 13 levels of posterior instrumentation was associated with higher reoperation risk, while the use of interbody cages was protective. Age, medical comorbidities, and osteotomies did not predict reoperations.
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With the increasing prevalence of adult spinal deformity (ASD) in the aging population, the need for corrective surgery has surged, highlighting the importance of preventing mechanical complications (MC) such as junctional kyphosis/failure and rod breakage. The Roussouly classification, which categorizes natural variations in spinal posture, may hold predictive value in assessing the risk of these complications, as it guides the restoration of sagittal alignment based on a patient's preoperative spinal shape. ⋯ III.
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The purpose of this systematic review and meta-analysis was to examine the clinical outcomes and complication rates for fusion procedures of adult spinal deformity (ASD) performed via an anterior-posterior approach as compared to a posterior-only approach to guide surgical decision-making. Numerous surgical techniques exist for operative management of ASD; however, no systematic review and meta-analysis exists comparing combined anterior-posterior approaches to posterior-only approach, despite significant interest in the current literature. ⋯ Surgical management for ASD may provide comparable results in terms of surgical parameters, radiographic outcomes, functional outcomes, and complication rates, irrespective of surgical approach.