The spine journal : official journal of the North American Spine Society
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It is known that positioning patients on the Jackson and Andrews operative tables causes changes in lumbar lordosis and pelvic rotation. However, it is unknown if the relationship between the iliac crest and underlying lumbar levels, in particular the L4-L5 interspace, changes from standing to prone on these tables. ⋯ Approximately 30% of patients demonstrated changes in the relationship between the iliac crest and lumbar levels between standing and positioning prone. The intraoperative position of the iliac crest aligned more accurately with the L4/L4-L5 spine level on the Jackson and Andrews frame compared with preoperative standing radiographs respectively. Further biomechanical studies should investigate the implication for lumbopelvic fixation.
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Although thoracic disc herniations are rare, misdiagnosis is an undesirable situation, as it results not only in unnecessary diagnostic studies and surgical procedures, but also in progressive myelopathy and paralysis. Therefore, it is important to be aware of patients with thoracic disc herniations presenting with unusual or atypical symptoms mimicking other non-spinal disorders. ⋯ Thoracic disc herniation should be considered in the differential diagnosis of patients with pain likely caused by nonspinal disorders, especially if basic diagnostic studies do not reveal the cause.