Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association
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Patient satisfaction with posterior laminoplasty for cervical compression myelopathy is not yet established. Moreover, postoperative patient-reported outcomes (PROs) associated with patient satisfaction remain unclear. This study aimed to investigate patient satisfaction after double-door laminoplasty for cervical compression myelopathy, and to identify the postoperative patient-reported outcomes associated with patient satisfaction. ⋯ In conclusion, 71 % of the patients who underwent double-door laminoplasty for cervical compression myelopathy were satisfied. The findings of this study, which examines the association between patient satisfaction and PROs, suggest that improvement in lower extremity function following surgical intervention affects patient satisfaction in those with cervical compression myelopathy.
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Multicenter Study
Postoperative behavior of thoracolumbar/lumbar curve and coronal balance after posterior thoracic fusion for Lenke 1C and 2C adolescent idiopathic scoliosis.
Controversy still exists around surgical strategies for Lenke type 1C and 2C curves with primary thoracic and compensatory lumbar curves in adolescent idiopathic scoliosis (AIS). The benefit of selective thoracic fusion (STF) for these curve types is spontaneous lumbar curve correction while saving more mobile lumbar segments. However, a risk of postoperative coronal decompensation after STF has also been reported. This multicenter retrospective study was conducted to evaluate postoperative behavior of thoracolumbar/lumbar (TLL) curve and coronal balance after posterior thoracic fusion for Lenke 1C and 2C AIS. ⋯ Spontaneous correction of TLL curve occurred consistently by correcting the main thoracic curve and making the LIV more horizontal after posterior thoracic fusion for Lenke 1C and 2C AIS. The more distal fixation to stable vertebra resulted in coronal balance shifting more to the left postoperatively.
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Little evidence is available addressing biomechanical properties of posterior distraction forces and their effects on anterior spinal column in the growing rod technique. The question is often asked if posterior distraction forces may be kyphogenic. The goal of this study is to determine whether posterior distraction forces transmitted anteriorly through different foundation constructs (i.e., screws vs. hooks) affect intradiscal pressure. ⋯ Posterior distraction forces result in anterior disc separation (distraction) and are distributed across multiple levels rather than delivered to the disc immediately adjacent to a foundation. Constructs with upper foundation hooks had lower distraction forces possibly due to hook motion during distraction. The load distribution at multiple levels may assist with curve control and may affect vertebral growth. The distraction forces may not be kyphogenic as is commonly believed.
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Multicenter Study
Clinical and radiological results of locking plate fixation for periprosthetic femoral fractures around hip arthroplasties: a retrospective multi-center study.
Osteosynthesis of periprosthetic femoral fractures around hip arthroplasties is challenging, and locking plate fixation has been found to be a reasonable treatment. However, there is a paucity of evidence of the extent to which patients recover their activities of daily living (ADL). The purpose of this study was to study the clinical results, particularly recovery of ADL, radiological results, and potential complications arising from the use of locking plate fixation for periprosthetic femoral fractures around hip arthroplasties. ⋯ Our results reveal that locking plate fixation provided sufficient stability for satisfactory recovery of ADL for most elderly patients with periprosthetic femoral fractures around hip arthroplasties.