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 determine the postoperative temporal course of the forces acting on a vertebral body replacement (VBR) for two well reproducible activities. ⋯ The strong force reduction in the first 2 months is most likely caused by implant subsidence, and the force reduction over a period of more than 6 months is most likely caused by fusion of the vertebrae adjacent to the VBR. The short-term force increase could be attributed to bone atrophy at the index level, and the long-term force increase could be attributed to an increase in the thoracic spine kyphosis angle.
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This study investigated side-to-side gait asymmetry in subjects with adolescent idiopathic scoliosis. ⋯ These results indicated that the scoliosis group produced an asymmetrical rotation pattern of the segments bilaterally in the frontal and transverse planes, resulting in asymmetrical GRF patterns in the M/L direction. This asymmetrical gait may be produced by changes in global postural control during gait and not simply by changes in control of only one or two specific segments.
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Radiographic retrospective study of a consecutive series of 76 patients with adolescent idiopathic scoliosis (AIS) undergoing posterior only surgical correction and fusion. ⋯ In our series of 76 adolescent affected by AIS, we reported mean PI values of 48.9° with a mean pre-operative PT of 11.51°. After surgery we observed an increase in the PT mean value, about three degrees higher than the ideal value, meaning that there was some compensatory mechanism. Patients affected by AIS showed a slight posterior imbalance and the intervention of scoliosis correction seems to cause a slight further posterior imbalance, especially in Lenke 1 type curves and in patients with hypokyphosis. The clinical significance of this slight imbalance must be carefully evaluated. Further studies are necessary to better establish which could be the best surgical strategy to obtain an optimal spinal sagittal balance.
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To evaluate the clinical and radiological risk factors for exiting root injuries during transforaminal endoscopic discectomy. ⋯ We recommend measuring the distance from the exiting root to the facet at the lower disc level according to a preoperative MRI scan. If the distance is narrow, an alternative surgical method, such as microdiscectomy or conventional open discectomy, should be considered.
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Aging spine is characterized by facet joints arthritis, degenerative disc disease, bone remodeling and atrophy of extensor muscles resulting in a progressive kyphosis of the lumbar spine. ⋯ Finally, we propose a three-step algorithm to analyze the global balance status and take into consideration the presence of the compensatory mechanisms in the spinal, pelvic and lower limb areas.