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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Some reported studies have evaluated the dural sac in patients with lumbar spinal stenosis (LSS) by computed tomography (CT) after conventional myelography or magnetic resonance imaging (MRI). But they have been only able to evaluate static factors. No reports have described detailed dynamic changes in the dural sac during flexion and extension observed by multidetector-row computed tomography (MDCT). The aim of this study was to elucidate or demonstrate, in detail, the influence of dynamic factors on the severity of stenosis. ⋯ MDCT clearly elucidated the dynamic changes in the lumbar dural sac. Before surgery, MDCT after myelography should be used to evaluate the dynamic change during flexion and extension, especially at L2-3, L3-4, and L4-5.
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The aim of this study is to determine the contribution of thrombospondin 2 (THBS2) polymorphisms to the development and progression of lumbar spinal stenosis (LSS) in the Korean population. ⋯ Although no SNPs in THBS2 were associated with LSS, haplotypes (HAP4 and HAP5) were significantly associated with progression of LSS in the Korean population, whereas another haplotype (HAP1) may play a protective role against LSS development.
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To investigate whether the sagittal morphology differs between the left and right thoracic curves in patients with Chiari malformation-associated scoliosis (CMS). ⋯ Significant differences in sagittal profiles indeed exist between CMS patients and healthy adolescents, as well as between CMS patients with different curve directions. In CMI patients with a left thoracic curve, compensatory alterations appear to occur in LL in response to the increased TK to maintain a balanced posture.
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We present the results of a prospective series of 60 patients treated for neuromuscular spinal deformities with an original spinopelvic construct using two sacral screws and two iliac screws. Clinical and radiological results obtained with this new surgical technique were studied and discussed according to the epidemiological data and relevant literature. ⋯ Despite a high rate of infectious complications, optimal correction of pelvic obliquity requires extension of spinal instrumentation to the pelvis. Spinopelvic fixation remains a difficult challenge in neurological patients with hypotrophy. We think that pelvic fixation with the "T construct" did provide effective and improved spinal stabilization in these patients, while reducing the need for a postoperative cast or brace. As a result, patients had a favourable postoperative course with early mobilization and return to a comfortable sitting position.
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There is sparse literature on how best to correct Scheuermann's kyphosis (SK). The efficacy of a combined strategy with anterior release and posterior fusion (AR/PSF) with regard to correction rate and outcome is yet to be determined. ⋯ The study highlighted that AR/PSF is an efficient strategy providing reliable results in a large single-center series. Results confirmed that flexibility was the decisive measure when comparing surgical outcomes with different treatment strategies. Findings indicated that changes at the proximal junctional level were impacted by individual spino-pelvic morphology and determined by the individually predetermined thoracolumbar curvature and sagittal balance. Results stressed that in SK correction, reconstruction of a physiologic alignment is decisive to achieving good clinical outcomes and avoiding complications.