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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Multicenter Study Comparative Study
Comparison between pedicle subtraction osteotomy and anterior corpectomy and plating for correcting post-traumatic kyphosis: a multicenter study.
Kyphosis is a common sequel of inadequately managed thoracolumbar fractures. This study compares between pedicle subtraction osteotomy (PSO) and anterior corpectomy and plating (ACP) for correcting post-traumatic kyphosis. Forty-three patients with symptomatic post-traumatic kyphosis of the thoracolumbar spine were treated with PSO and prospectively followed for a minimum of 2 years. ⋯ Recorded complications in the ACP group included an aortic injury (1 patient) that was successfully repaired, pseudarthrosis (1 patient), persistent graft donor site morbidity (3 patients), and incisional hernia (1 patient). PSO and ACP are demanding procedures. PSO seems to be equally safe but more effective than ACP for correcting post-traumatic kyphosis.
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Randomized Controlled Trial
Do intramedullary spinal cord changes in signal intensity on MRI affect surgical opportunity and approach for cervical myelopathy due to ossification of the posterior longitudinal ligament?
Some controversy still exists over the optimal treatment time and the surgical approach for cervical myelopathy due to ossification of the posterior longitudinal ligament (OPLL). The aim of the current study was first to analyze the effect of intramedullary spinal cord changes in signal intensity (hyperintensity on T2-weighted imaging and hypointensity on T1-weighted imaging) on magnetic resonance imaging (MRI) on surgical opportunity and approach for cervical myelopathy due to OPLL. This was a prospective randomized controlled study. ⋯ In conclusion, regardless of hyperintensity on T2-weighted imaging or hypointensity on T1-weighted imaging in patients with OPLL, severe damage to the spinal cord is indicated. Surgical treatment should be provided before the advent of intramedullary spinal cord changes in signal intensity on MRI. The anterior approach is more effective than posterior approach for treating cervical myelopathy due to OPLL characterized by intramedullary spinal cord changes in signal intensity on MRI.
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The main objective of all the sagittal compensating mechanisms is to allow a subject to stand and keep an erect position. ⋯ Three questions to answer: What is the value of the pelvis incidence? Is the patient balanced? Are there compensatory mechanisms?
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Comparative Study
Correlation of clinical outcome and spinopelvic sagittal alignment after surgical treatment of low-grade isthmic spondylolisthesis.
The aim of this prospective study was to assess the sagittal alignment of the spine and pelvis before and after surgical treatment of isthmic spondylolisthesis with flat sacrum. At the same time, the functional outcome was analyzed and correlation examined. ⋯ Surgical management of low- and mid-grade isthmic spondylolisthesis showed good clinical outcome with restoration of correct values for the pelvic position-dependent parameters, i.e., pelvis tilt, sacral slope, C7 plumb line position and SSA.