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 evaluate the accuracy of opportunistic measurements of volumetric bone mineral density (vBMD) in intraoperative multi-detector CT (MDCT) scans, using preoperative MDCT as the reference. ⋯ Opportunistic osteoporosis screening with the presented approach is feasible and demonstrates high accuracy in reference to preoperative MDCT scans. This could enable the identification of patients with low bone mass during surgery, allowing surgeons to take measures (e.g., adapted techniques) that prevent postoperative complications and improve patient outcomes.
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This study aimed to evaluate the applicability and technical feasibility of magnetic resonance imaging (MRI) and ultrasonography (US) fusion-guided transforaminal epidural steroid injection (TFESI) in patients with lumbar disc herniation (LDH) leading to radiculopathy, who are unresponsive to conservative treatment. ⋯ MRI-US fusion-guided TFESI is a feasible and safe technique with a high success rate and low radiation exposure in patients with LDH-induced radiculopathy. Younger age, lower BMI, shorter fluoroscopy duration, and lower radiation dose are significant predictors of procedural success. This technique may enhance spatial orientation during the procedure, potentially improving outcomes particularly in younger patients with lower BMI.
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During full flexion of the spine, the paraspinal muscles are largely inactive. This suggests that passive structures like the posterior osteoligamentous complex (POLC), consisting of interspinous and supraspinous ligaments and the spinous processes, play a key role in spinal stability and protection of the spinal column. The POLC, however, is often resected or damaged during spinal decompression surgeries, whereas the biomechanical implications of this resection or damage are not yet fully understood. ⋯ The experiment indicates that the POLC is the primary passive stabilizer of the fully flexed lumbar spine. Surgical resection of this structure can redistribute loads and increase stresses on remaining spinal tissues, potentially leading to spinal instability, accelerated degeneration, and poor clinical long-term outcomes.
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Cervical pedicle screw (CPS) instrumentation offers significant biomechanical advantages compared to lateral mass or transarticular fixation. Nonetheless, malpositioning complications constitute a relevant concern. Customized patient-specific 3D-printed templates have been developed to improve CPS placement accuracy and safety. The aim of this study is to present our experience with this surgical technique and its accuracy and safety in a clinical setting. ⋯ Cervical pedicle screw placement using patient-specific guides is safe and accurate, supporting the feasibility of this technique in posterior cervical spine fusion surgery.
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Although several studies have documented indirect decompression after oblique lateral interbody fusion (OLIF), limited research exists that directly quantifies the degree of decompression. This study seeks to quantify the degree of indirect decompression achieved by OLIF using magnetic resonance imaging (MRI). ⋯ OLIF provides a significant amount of indirect decompression from L2-L5 including increased anterior and posterior disc height, bilateral foraminal height, bilateral foraminal area, bilateral subarticular recess, and thecal sac area. The proximal adjacent level above an interbody level also shows increased foraminal height and area.