Spine
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To analyze patient outcomes and risk factors associated with proximal junctional kyphosis (PJK) in adults undergoing long posterior spinal fusion. ⋯ Incidence of proximal junctional kyphosis was high, but SRS-24 scores were not significantly affected in patients with PJK. The sagittal C7 plumb was not significantly more positive in PJK patients. No patient, radiographic, or instrumentation variables were identified as risk factors for developing PJK.
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Retrospective study. ⋯ Selective thoracic fusion with segmental pedicle screw fixation in thoracic idiopathic scoliosis had satisfactory radiographic and clinical outcomes after surgery and has been well-maintained for minimum 5-year follow-up. It is a safe and effective method for preservation of lumbar motion segments as well as for restoration and maintenance of both coronal and sagittal alignment.
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Case Reports
Failure of standard imaging to detect a cervical fracture in a patient with ankylosing spondylitis.
Retrospective case study of 38-year-old male with ankylosing spondylitis who presented with a Brown-Séquard syndrome following a fall and an occult fracture on initial spinal imaging studies. ⋯ Occult fractures in ankylosing spondylitis may not be apparent on routine plain radiographic and MRI studies. In the setting of ankylosing spondylitis, a high index of suspicion must be maintained in all patients presenting with spinal pain following even minor trauma. High-resolution multidetector CT imaging appears to be more sensitive and accurate in the diagnosis of fractures in this patient subgroup than other contemporary imaging methods.
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A retrospective study was conducted to investigate the incidence and prognosis of postoperative lumbar nerve root palsy after surgical treatment for adult spinal deformity. ⋯ Patients with increasingly complex spinal deformities are at a higher risk for postoperative lumbar nerve root palsy. These injuries can be treated nonoperatively when there is no identifiable cause on postoperative imaging studies.
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Comparative Study
Spinopelvic alignment in patients with osteoarthrosis of the hip: a radiographic comparison to patients with low back pain.
A retrospective, age- and sex-matched radiographic study. ⋯ These findings suggest that higher PI in the younger individual may contribute to the development of HOA in later life without both lumbar kyphosis and acetabular dysplasia because of the anterior uncovering of the acetabulum. More investigation will be expected to analyze the spinopelvic alignment in patients with hip spine syndrome.