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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Sitting balance on an unstable surface requires coordinated out-of-phase lumbar spine and provides sufficient challenge to expose quality of spine control. We investigated whether the quality of spine coordination to maintain balance in acute low back pain (LBP) predicts recovery at 6 months. ⋯ These longitudinal data revealed that individuals with compromised contribution of the lumbar spine to the balance during unstable sitting during acute LBP are less likely to recover.
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Impact of osteosclerosis on cervical pedicle screw insertion using preoperative CT-based navigation.
Preoperative computed tomography (CT)-based navigation is used for cervical pedicle screw (CPS) insertion to mitigate the risk of spinal cord and vertebral artery injury. In vertebrae with osteosclerosis due to degeneration or other factors, however, probing may not proceed easily, with difficulty creating the CPS insertion hole. This study investigated the impact of osteosclerosis on the accuracy of CPS insertion. ⋯ The screw perforation rate of Grade 2 or higher in CPS insertion using preoperative CT-based navigation was 8.0%. Since osteosclerosis was an independent factor related to CPS deviation, additional care may be required during insertion into affected vertebrae.
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Postoperative cage subsidence after Anterior Cervical Discectomy and Fusion (ACDF) often has adverse clinical consequences and is closely related to Bone Mineral Density (BMD). Previous studies have shown that cage subsidence can be better predicted by measuring site-specific bone density. MRI-based Endplate Bone Quality (EBQ) scoring effectively predicts cage subsidence after lumbar interbody fusion. However, there is still a lack of studies on the practical application of EBQ scoring in the cervical spine. ⋯ Higher C-EBQ scores were significantly associated with postoperative cage subsidence after ACDF. There was a significant negative correlation between C-EBQ and endplate HU values. The C-EBQ score may be a promising tool for assessing preoperative bone quality and postoperative cage subsidence and is superior to the C-VBQ.
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The purpose of the study was to assess the changes in flexibility during night-time bracing in skeletally immature adolescent idiopathic scoliosis (AIS) with curves in the surgical range. ⋯ This is the first study to describe that curve flexibility decreases during bracing in severe AIS. However, this had only a modest impact on the surgical strategy. Bracing as a holding strategy can be applied, but the risk of losing flexibility in the lumbar spine should be outweighed against the risks of premature fusion surgery.
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To study the long-term outcome of revision microdiscectomy after classic microdiscectomy for lumbosacral radicular syndrome (LSRS). ⋯ The long-term results after revision microdiscectomy for LSRS show an unfavourable outcome in the majority of patients and a high risk of re-revision microdiscectomy, with similar results. Based on also the disappointing results of alternative treatments, revision microdiscectomy for recurrent LSRS seems to still be a valid treatment. The results of our study may be useful to counsel patients in making appropriate treatment choices.