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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To determine the postoperative temporal course of the forces acting on a vertebral body replacement (VBR) for two well reproducible activities. ⋯ The strong force reduction in the first 2 months is most likely caused by implant subsidence, and the force reduction over a period of more than 6 months is most likely caused by fusion of the vertebrae adjacent to the VBR. The short-term force increase could be attributed to bone atrophy at the index level, and the long-term force increase could be attributed to an increase in the thoracic spine kyphosis angle.
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To evaluate the clinical and radiological risk factors for exiting root injuries during transforaminal endoscopic discectomy. ⋯ We recommend measuring the distance from the exiting root to the facet at the lower disc level according to a preoperative MRI scan. If the distance is narrow, an alternative surgical method, such as microdiscectomy or conventional open discectomy, should be considered.
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We have evaluated the effect of bracing in scoliosis on coronal alignment in a cohort of patients. Current literature has not described the specific effect of bracing on the 3D shape of the scoliotic curves. The purpose of this study was to analyze the variability of the 3D effect of bracing on idiopathic scoliosis. ⋯ Global statistics of this study concur with the literature. The Cobb angle was significantly improved. It also showed a significant hypolordotic effect. However, the results showed a high variability of the brace treatment effect in almost every parameter. Analysis of this variability by means of 3D reconstructions instead of global statistics should help characterize the mechanisms of correction of brace treatment.
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Observational Study
The prognosis of self-reported paresthesia and weakness in disc-related sciatica.
To explore how patients with sciatica rate the 'bothersomeness' of paresthesia (tingling and numbness) and weakness as compared with leg pain during 2 years of follow-up. ⋯ During 2 years of follow-up, patients considered paresthesia more bothersome than weakness. At 2 years, the percentage of patients who reported bothersome paresthesia was similar to the percentage who reported bothersome leg pain. Based on patients' self-report, paresthesia and weakness are relevant aspects of disc-related sciatica.
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Although the occurrence and progression of AIS has been linked to low bone mineral density (BMD), the relationships between spinal curvature and bilateral differences in proximal femur BMD are controversial. Few correlation studies have stratified patients by curve type. The purpose of this study was to evaluate the relationships between spinal coronal profile and bilateral differences in proximal femur BMD in patients with adolescent idiopathic scoliosis (AIS). ⋯ The bilateral proximal femur BMD ratio was significantly correlated with the coronal balance in AIS patients. When the C7 plumb line was shifted toward one side, the BMD was greater in the contralateral proximal femur.