European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society
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Comparative Study
A comparative evaluation of the small leucine-rich proteoglycans of pathological human intervertebral discs.
Proteoglycans are important to the functioning of the intervertebral disc. In addition to aggrecan there are the small leucine-rich proteoglycans (SLRPs). These are less common but in other locations their functions include collagen organisation, sequestering growth factors and stimulating inflammation. We have performed a comparative analysis of the SLRP core protein species present in intervertebral discs with various pathologies. ⋯ In this cohort of pathological intervertebral discs, fragmentation of certain SLRP core proteins was common, indicating that some SLRPs are extensively processed during the pathological process. Identification of specific SLRP fragments which correlate with disc pathology may not only help understand their aetiopathogeneses, but also provide biomarkers which can be used to monitor disease progression or to identify particular disc disorders.
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Patients affected by cerebral palsy often develop progressive scoliosis that can results in trunk instability with an impairment of both coronal and sagittal balance. The aim of this retrospective study was to demonstrate the ability of UC to control the sagittal profile in a consecutive series of patients affected by neurological scoliosis. ⋯ The hybrid construct using UC appears effective in neurological scoliosis treatment, providing a good correction of the deformity in both coronal and sagittal planes. In the present series, physiological thoracic kyphosis has been restored in all patients, providing better sitting tolerance in wheelchair-bound patients, and retaining standing and walking abilities in ambulatory patients.
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Technical report on the surgical technique of asymmetric osteotomy of the spine for coronal imbalance. ⋯ Satisfactory correction of coronal deformity can be achieved with APSO from an isolated posterior approach. In contrast to sagittal osteotomies, blunt dissection along the anterior cortex is necessary to allow safe resection of anterior cortical bone for closure of the wedge.
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We present 120 patients (37 males, 83 females) affected by thoracic lumbar scoliosis, treated by posterior instrumented arthrodesis with the insertion of pedicle screws by "free hand technique", without any image guided system, radioscopy use during insertion or intraoperative neurophysiological monitoring. ⋯ In our experience pedicle screws is the method that leads to best correction and balance on vertebral bodies, with best results at distance concerning correction maintaining. Our experience shows that even at thoracic level, pedicle screws insertion by free-hand technique is safe and reliable.
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The aim of this study was to determine whether anterior column support is required in Smith-Petersen osteotomy procedure with correction angles of more than 10°, while examining the subsequent healing patterns in relation to the disrupted area. ⋯ In our study of subjects presenting with anterior opening angles from 10° to 32°, we obtained successful fusion without the need for additional anterior interbody fusion. Improved gap healing and increased correction angles were obtained when the opening was present in the upper or lower body endplates compared to those at the disc space level.