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 determine the association of the ultrasound reflection coefficient index and other clinical parameters to predict curve progression in children with AIS. ⋯ This pilot study showed that curve progression is associated with the Risser sign, KA, and RC index. Other parameters and a more extensive clinical study should be combined to develop a higher-accuracy prediction model.
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Both thoracic ossification of the posterior longitudinal ligament (T-OPLL) and thoracic disc herniation (TDH) may cause thoracic spinal stenosis (TSS) resulting in thoracic myelopathy. Surgical decompression is the only effective treatment for symptomatic TSS. 360° Circumferential decompression, also called the "cave-in" technique, can safely and effectively treat T-OPLL; however, this procedure has not yet been performed endoscopically. Herein, we report the first case of massive T-OPLL combined with TDH that was treated endoscopically using the "cave-in" technique, with 36 months of follow-up. Further, we review the literature on this subject. ⋯ The endoscopic "cave-in" technique can effectively treat T-OPLL with satisfactory clinical results, and is associated with less trauma and fewer complications than conventional posterior circumferential decompression. The endoscopic "cave-in" technique can be a good surgical option for patients with T-OPLL.
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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.
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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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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.