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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Comparative Study
Use of a personalized hybrid biomechanical model to assess change in lumbar spine function with a TDR compared to an intact spine.
Total disc replacements (TDRs) have been employed with increasing frequency in recent years with the intention of restoring natural motion to the spine and reducing adjacent level trauma. Previous assessments of the TDRs have subjectively measured patient satisfaction, evaluated sagittal range of motion via static imaging, or examined biomechanical loading in vitro. This study examined the kinematics and biomechanical loading of the lumbar spine with an intact spine compared to a TDR inserted at L5/S1 in the same spine. ⋯ At levels above the TDR insertion, larger ROM was present during the lifting conditions. Sagittal motions were often greater at the higher lumbar levels, but there appeared to be less lateral and twisting motion. Collectively, this analysis indicates that the insertion of a TDR significantly alters the function of the spine.
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To report on a female patient diagnosed with Currarino's triad in adulthood. ⋯ In (young) patients with anorectal malformations, although having no other symptoms, further examination might be required to exclude Currarino's triad. Importance of early diagnosis and multidisciplinary assessment is recommended to establish adequate treatment if needed.
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Restitution of sagittal balance is important after lumbar fusion, because it improves fusion rate and may reduce the rate of adjacent segment disease. The purpose of the present study was to describe the impact of transforaminal lumbar interbody fusion (TLIF) procedures on pelvic and spinal parameters and sagittal balance. ⋯ Single-level circumferential fusion helps patients reducing their pelvic compensation, but the amount of correction does not allow for complete correction of sagittal imbalance.
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Brown-Sequard syndrome is an incomplete spinal cord lesion characterized by ipsilateral loss of motor function and contralateral loss of pain and temperature sensitivity, reflecting a hemi-compression or hemi-section of the spinal cord. Cervical disc herniation is an exceptional cause of this syndrome. ⋯ A prompt diagnosis, followed by spinal cord decompression should be warranted. Intraoperative neuromonitoring is a useful tool in preservation of neurologic function in these cases.
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To report a serious complication of the StaXx FX system used to stabilize an osteoporotic vertebral fracture. ⋯ New treatment modalities have their own pitfalls and possible complications, as demonstrated in this case report. Caution regarding implementation of new treatment modalities should be practiced.