The spine journal : official journal of the North American Spine Society
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Multicenter Study
The paravertebral muscle and psoas for the maintenance of global spinal alignment in patient with degenerative lumbar scoliosis.
Various factors are reported to affect the spinal alignment in degenerative lumbar scoliosis (DLS). Although trunk muscles also appear to affect spinal alignment, the role of the trunk muscles is not yet clear. ⋯ The CSAs of the MF and PS were significantly smaller in the DLS group. Whole-body DXA showed no significant difference in the lean composition between the groups. There were significant correlations in the DLS patients between the MF CSA and sagittal spinal alignment. These findings suggest the causal relationship between muscles and global spine alignment.
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Neuroforaminal stenosis is one of the key factors causing clinical symptoms in patients with cervical radiculopathy. Previous quantitative studies on the neuroforaminal dimensions have focused on measurements in a static position. Little is known about dimensional changes of the neuroforamina in the cervical spine during functional dynamic neck motion under physiological loading conditions. ⋯ The dimensional changes of the cervical neuroforamina showed segment-dependent characteristics during the dynamic flexion-extension. These data may have implications for diagnosis and treatment of patients with cervical radiculopathy.
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Anterior cervical discectomy and fusion with plating (ACDFP) is commonly used for the treatment of distractive-flexion cervical spine injuries. Despite the prevalence of ACDFP, there is little biomechanical evidence for graft height selection in the unstable trauma scenario. ⋯ This study found that graft size did affect the kinematic stability of ACDFP in a series of distractive-flexion injuries; the undersized graft resulted in both facet overlap and locking of the uncovertebral joints leading to decreased ROM in lateral bending and axial rotation, whereas an oversized graft provided larger ROM decreases in flexion-extension. As such, a graft that engages the uncovertebral joint may be more advantageous in providing a rigid environment for fusion with ACDFP.
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A new approach to the interpretation of treatment success comprises the reporting of the proportion of patients whose symptoms have reduced to an acceptable level, ie, who have reached a satisfactory state. ⋯ Most spine interventions decrease pain but rarely do they totally eliminate it. Reporting of the percent of patients achieving a pain score equivalent to the "acceptable symptom state" may represent a more stringent target for denoting surgical success in the treatment of painful spinal disorders. For DH, this is ≤2, and for other degenerative pathologies it is ≤3.
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Comparative Study
The impact of coronal alignment of device on radiographic degeneration in the case of total disc replacement.
Numerous studies have been conducted on the importance of radiographic parameters after a total disc replacement (TDR). Most of them have focused on sagittal alignment. There has been no research on what influence the coronal alignment or tilting of device has on radiographic parameters. ⋯ It is considered that maintaining appropriate coronal alignment of device is important in long-term success after a cervical TDR.