Spine
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A retrospective radiographical study. ⋯ This study demonstrated that the lower EV disc degeneration strongly correlated with sagittal imbalance in patients with DLS, implying that disc degeneration may be regarded as a potential risk factor for sagittal imbalance. This result strengthened the importance of not selecting the lower EV as the lower instrumented vertebra during the surgical decision making, which may lead to deterioration of sagittal balance. Disc degeneration was also strongly correlated with sagittal malalignment, as demonstrated by a more positive SVA, decreased TK and LL, providing insight into reasons for low quality of life in elderly patients with DLS.
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A retrospective radiographical analysis. ⋯ The reconstitution of coronal balance was mainly compensated by distal unfused segments after selective posterior fusion of TL/L idiopathic scoliosis. The effect of unfused thoracic segments in coronal balance reconstitution mainly depended on its flexibility.
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Multicenter Study Comparative Study
Results of selective thoracic versus nonselective fusion in Lenke type 3 curves.
A retrospective analysis of a prospectively collected multicenter database. ⋯ Despite preoperatively smaller lumbar curves with less apical translation and lumbar prominence, most patients with selective fusions were out of balance postoperatively and had inferior radiographical outcomes as compared with their nonselective comparison cohort with similar patient-reported outcomes. Long-term follow-up is required to determine whether the trade-off of sparing motion segments at the expense of somewhat lessened radiographical outcomes is worthwhile.
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Retrospective cohort analysis of prospectively collected data. ⋯ Obesity did not affect the amount of deformity correction and did not increase comorbidities and postoperative complication rates. Overweight patients had a greater lumbar lordosis before surgery than normal weight patients. Obese and overweight patients benefited from surgery just as much as normal weight patients at 2-year follow-up.