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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Nonspecific chronic low back pain (NCLBP) is one of the most common manifestations of degenerative spondylitis. It affects many patients of all ages and seriously interferes with quality of life. However, the associations between NCLBP, sagittal alignment and age remain unclear. We aimed to investigate the typical features of sagittal alignment in individuals with NCLBP and to discuss the relationships between age and these NCLBP-related changes in sagittal alignment. ⋯ Although decreased lumbar lordosis is the most typical sagittal feature in patients with NCLBP, there are still differences in sagittal alignment between different ages. Compared with young patients, elderly patients with NCLBP more commonly present with a decompensated pattern of the anterior inclination of the trunk as the main sagittal alignment abnormality. TPA is more predictive than LL for the diagnosis of geriatric NCLBP.
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Although many studies have reported clinical outcomes of spinal ependymoma (SE) patients after gross total resection (GTR), the data about the patient reported outcomes of the quality of life (PRO-QOL) was limited. ⋯ From the perspective of PRO-QOL, neurological rehabilitation should be continued for at least 6-12 months after GTR to the SE patients. For the preoperative patients with severe neurological damage, long-level intraspinal tumor and low VAS score, more cautious surgical considerations, more perioperative attention and earlier neurological intervention are necessary.
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Intraoperative traction can improve deformity correction during posterior spinal fusion (PSF). This is commonly done with invasive distal femoral or pelvic pins, or traction boots. The novel technique of intraoperative skin traction (ISkinT) avoids risks associated with intraoperative skeletal traction (ISkelT) or hyperlordosis with extended hip position. We aimed to describe ISkinT and assess its safety and efficacy in PSF in non-ambulatory scoliosis. ⋯ In non-ambulatory neuromuscular pediatric scoliosis patients, ISkinT during PSF to the pelvis is a safe and effective technique for deformity correction. There were no associated complications and no difference of corrective capacity for ISkinT compared to ISkelT. ISkinT can be considered for T2-pelvis PSF for pediatric scoliosis.
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To evaluate the complications and postoperative outcomes of implant removal after posterior fixation in adolescent idiopathic scoliosis. ⋯ The prevalence of complications after implant removal in adolescent idiopathic scoliosis was 12.1%. Spinal alignment is more variable in the sagittal plane than in the coronal plane, and patients with increased thoracic kyphosis after implant removal have greater preoperative PI and SS. Sufficient preoperative explanation is necessary if a patient wishes to undergo implant removal.