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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After posterior spinal fusion (PSF) for adolescent idiopathic scoliosis (AIS), there is alteration in trunk range of motion (ROM) in the coronal, sagittal and axial planes. Previous studies have shown that ROM decreases with increased number of levels fused, which may affect the ROM between patients who undergo non-selective thoracic fusion (NSF) and selective thoracic fusion (STF) patient groups. This study sought to longitudinally evaluate the ROM of the trunk in patients with AIS who underwent posterior spinal fusion, using surface topography, comparing STF and NSF patient motion at multiple time points postoperatively. ⋯ The coronal, sagittal, and axial ROM as measured by ST demonstrated significant decreases from preoperative to postoperative following PSF; however, this deficit trends towards improvement over time. Our data demonstrates that at two years, NSF has poorer motion than STF patients in all three planes.
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Orthogonal cage rotation is an essential technique in oblique lateral interbody fusion (OLIF). However, during OLIF at L4-5, this is often limited due to iliac crest. Angle-adjustable cages are designed to insert cages without interference from iliac crest, but there are few studies on whether they are useful. We aimed to compare the radiological outcomes between the conventional cage and angle-adjustable cage inOLIF at L4-5. ⋯ Our study demonstrated that using an angle-adjustable cage at L4-5 OLIF is more advantageous for orthogonal cage rotation and anterior cage positioning. In L4-5 OLIF, an angle-adjustable cage system is a particularly good option for patients with a high iliac crest.
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Basilar invagination (BI) represents a complex anomaly of the craniovertebral junction, characterized by the displacement of the odontoid process towards the foramen magnum. Current surgical interventions include anterior decompression and combined anterior-posterior decompression with posterior fusion. Traditional methods for odontoid resection encompass transoral, transnasal, and endonasal approaches. However, these techniques are fraught with significant risks. Furthermore, the restricted exposure provided by the endonasal corridor's anatomical limitations hampers surgical manipulation, prompting spine surgeons to seek alternative techniques. This report details a case of BI managed through an endoscopic posterolateral odontoidotomy, showcasing an innovative surgical approach. We aim to describe our experience in partially removing the odontoid via posterolateral approach with a novel endoscopic technique, preventing the need for additional approach and related complications. ⋯ Our findings demonstrate that partial or total resection of the odontoid process via a posterolateral approach is feasible using endoscopic techniques. The endoscopic posterolateral transmass odontoidotomy should be considered a viable alternative method and route for patients necessitating partial or total odontoidectomy.
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Thoracolumbar kyphosis (TLK) is frequently reported in children with achondroplasia. The combination of TLK and the narrow spinal canal in achondroplasia increases the risk of developing symptomatic spinal stenosis. However, there is no consensus on the optimal management of TLK. ⋯ TLK is highly prevalent in achondroplasia, necessitating careful monitoring. A wait-and-see policy with restrictions on unsupported sitting is recommended initially, but early bracing should be considered for more severe cases.
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The aim of this study is to assess inter-reader agreement of imaging findings and compare readers' assessment of image quality (IQ) and appearance of metal artifact (MA) in patients with spinal implants between 0.55T and 1.5T MRI. ⋯ Imaging patients with spinal hardware at 0.55T results in comparable inter-reader agreement for clinically-relevant imaging findings and equivalent or improved image quality compared to 1.5T.