The spine journal : official journal of the North American Spine Society
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Adolescent idiopathic scoliosis (AIS) is a complex three-dimensional (3D) deformity of the spine involving deviations in the frontal plane, modifications of the sagittal profile, and rotations in the transverse plane. Although Lenke classification system is based on 2D radiographs and includes sagittal thoracic and coronal lumbar modifiers, Lenke et al. suggested inclusion of axial thoracic and lumbar modifiers in the analysis. ⋯ Addition of axial plane analysis to conventional coronal and sagittal evaluations in patients with Lenke 1A curves may reveal inherent structural differences that are not apparent in single planar radiographic assessments and may necessitate a different surgical strategy.
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Comparative Study Observational Study
Depressive burden is associated with a poorer surgical outcome among lumbar spinal stenosis patients: a 5-year follow-up study.
In lumbar spinal stenosis (LSS), conservative treatment is usually the first choice of treatment. If conservative treatment fails, surgery is indicated. Psychological factors such as depression and anxiety are known to affect the outcome of surgery. Previous studies on depression and surgery outcome using long follow-up times are scarce. ⋯ Even slightly elevated long-term depressive symptoms in LSS patients are associated with an increased risk of a poorer functional ability after decompressive surgery.
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The incidence and relevant risk of ischemic stroke after cervical spine trauma remain unknown. ⋯ This analysis revealed that ischemic stroke after cervical spine injury was not uncommon and was associated with increased mortality and morbidity. Occurrence of ischemic stroke was significantly associated with age, comorbidities such as diabetes, and consciousness level at admission, but not with the type of spine injury.
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Posterior cervical foraminotomy (PCF) with or without microdiscectomy (posterior cervical discectomy [PCD]) is a frequently used surgical technique for cervical radiculopathy secondary to foraminal stenosis or a laterally located herniated disc. Currently, these procedures are being performed with increasing frequency using advanced minimally invasive techniques. Although the safety and efficacy of minimally invasive PCF/PCD (MI-PCF/PCD) have been established, reports on long-term outcome and need for secondary surgical intervention at the index or adjacent level are lacking. ⋯ Minimally invasive PCF with or without MI-PCD is an excellent alternative for cervical radiculopathy secondary to foraminal stenosis or a laterally located herniated disc. There is a low rate (1.1% per index level per year) of future index site fusion and a very low rate (0.9% per adjacent level per year) of adjacent-level disease requiring surgery.
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Comment
Commentary: Spinal instrumentation for mechanical radiculopathy secondary to lumbar metastases.
Moliterno J, Veselis CA, Hershey MA, et al. Improvement in pain after lumbar surgery in cancer patients with mechanical radiculopathy. Spine J 2014;14:2434-9 (in this issue).