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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We intended to prospectively evaluate the clinical and radiological results of lumbo-sacral fusion achieved by a combined approach, anterior then posterior. ⋯ The combined procedure meets the requested criteria for a lumbar fusion in terms of clinical results, functional outcomes, fusion rates while restoring segmental lordosis and disc height. It cumulates the advantages of the anterior and posterior approach performed alone, especially for L5-S1.
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Adolescent idiopathic scoliosis (AIS) is a tridimensional deformity characterized by coronal and sagittal profiles changes. We present a series of 62 patients affected by AIS and treated by thoracic Universal Clamps and transpedicular lumbar screws hybrid system. ⋯ This case-series study showed the efficacy and safety of Universal Clamp hybrid system in correcting coronal deformity and restoring physiological thoracic kyphosis in patients affected by AIS.
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Computer-assisted navigation systems are largely used for pedicle screws positioning in degenerative and traumatic spine surgery. In oncologic spine surgery its use is still developing and could be extended for tumor identification and excision. Aim of this paper is to present our experience. ⋯ Navigation system can improve surgical accuracy in screws placement and tumor localization and excision. Learning curve and technical aspects must be considered to avoid potential serious mistakes.
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Observational Study
Failures and revisions in surgery for sagittal imbalance: analysis of factors influencing failure.
Sagittal imbalance is an important risk factor for spinal disability, pain and loss of health related quality of life. Its correction has a positive impact on these outcomes. Still, it is a very aggressive surgery, with a high revision rate. The aim of this study is to analyze the most important causes of failure of surgery for correction of sagittal imbalance. ⋯ Causes of failure were insufficient correction, junctional kyphosis, screw loosening and pseudoarthrosis with rod breakage. In every case, patients presented a new onset or a worsening of sagittal imbalance and pain.
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Due to their properties and characteristics human mesenchymal stem cells (MSCs) appear to have great therapeutic potential. Many different populations of MSCs have been described and to understand whether they have equivalent biological properties is a critical issue for their therapeutic application. ⋯ The ability of vertebrae-derived MSCs in terms of expansion and differentiation is very interesting at the light of a clinical application for bone fusion in spine surgery.