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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Hounsfield unit (HU) measurements and vertebral bone quality (VBQ) scores are opportunistic screening methods for evaluating bone quality. Since studies comparing the efficacies of the two methods are rare, this retrospective study aimed to examine the efficacy of VBQ scores compared with that of HU measurements for diagnosing osteoporosis in lumbar spine surgery patients. ⋯ The calculation of VBQ scores is a novel opportunistic screening method for diagnosing osteoporosis; however, CT-based HU measurements outperform MRI-based VBQ scores. HU measurements can be used as a screening method when pre-operative CT scans are available.
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Proximal junctional kyphosis (PJK) is one of the most common complications after thoracic AIS surgery. Previous studies reported that the etiology of PJK was associated with osteopenia and meanwhile the AIS patients were found osteopenia which could persist into adulthood. Recently, an MRI-based vertebral bone quality score (VBQ) was reported to be a promising tool which can assess preoperative bone quality. ⋯ Higher VBQ scores were independently associated with PJK occurrence after corrective surgery for thoracic AIS. Preoperative measurement of VBQ score on MRI may serve as a valuable tool in planning thoracic AIS surgery.
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Spinal augmentation procedures (SAP) are standard procedures for vertebral compression fractures. Often, SAPs are carried out in a minimally invasive, percutaneous way. Certain anatomic conditions such as small pedicles or kyphotic deformities resulting from a significant collapse of the vertebral body might render the operation more difficult and increase the risk of complications. Thus, robot assistance might be useful to optimize the trajectory and to reduce procedure-associated complications. In this study robot-assisted percutaneous SAPs are compared with conventional fluoroscopy-guided percutaneous SAP. ⋯ The use of robot assistance in SAP seems not to be superior with regard to accuracy, radiation exposure and the rate of complications when compared to fluoroscopy-guided SAP.
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The aim of this study is to identify risk factors for vertebral compression fracture (VCF) progression in patients treated conservatively with a brace. Then, a case-control study was designed. ⋯ Male gender, type A3 fracture of the AOSpine classification, thoracolumbar junction location, and incorrect use of the brace were identified as independent risk factors for VCF progression, which resulted in worse pain control, when treated with brace. Thus, other treatments such as percutaneous vertebral augmentation could be considered to avoid progression in selected cases, since collapse rate has been demonstrated lower with these procedures.
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The purpose of this study was to establish the best prediction model for postoperative nosocomial pulmonary infection through machine learning (ML) and assist physicians to make accurate diagnosis and treatment decisions. ⋯ Age, ASIA scale and tracheotomy were the independent risk factors of postoperative nosocomial pulmonary infection in SCI. The prediction model based on RF algorithm had the best performance.