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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The aim of this study was to describe the disease-related sagittal balance changes in relation to the sacropelvic morphology of PD patients with different durations of disease. ⋯ Sagittal balance evaluation provides new valuable insights for biomechanical understanding of PD patients. Specific spinal parameters (spinosacral, spinopelvic and spinal tilt angles), and their clinical correlation, as well as pelvic parameters like pelvic tilt and sacral slope, appear particularly interesting for their clinical implications in terms of spinal deformities correction in PD population.
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A comparative study of the spinopelvic sagittal alignment in patients with lumbar disc degeneration or herniation (LDD/LDH) in normal population was designed to analyse the role of sagittal anatomical parameter (pelvic incidence, PI) and positional parameters in the pathogenesis and development of the disease. Several comparative studies of these patients with asymptomatic controls have been done. However, in previous studies without lumbar MRI, a certain number of asymptomatic LDD patients should have been included in the control group and then impacted on the results. ⋯ PI may play a predisposing role in the pathogenesis of lumbar disc degenerative diseases. The secondary structural and compensatory factors would lead to a straighter spine after disc degenerative change.
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Measurement and classification of standing posture in the sagittal plane has important clinical implications for adolescent spinal disorders. Previous work using cluster analysis on three gross body segment orientation parameters (lower limbs, trunk, and entire body inclination) has identified three distinct postural groups of healthy subjects before pubertal peak growth: "neutral", "sway-back", and "leaning-forward". Although accurate postural subgrouping may be proposed to be crucial in understanding biomechanical challenges posed by usual standing, there is currently no objective method available for class assignment. Hence, this paper introduces a novel approach to subclassify new cases objectively according to their overall sagittal balance. ⋯ Based on three angular measures describing gross body segment orientation, our triage method is capable of reliably classifying pre-PHV subjects as either "neutral", "sway-back", or "leaning-forward". The discriminant prediction equations presented here enable a highly accurate posture class allocation of new cases with a prediction capability higher than 95.9%, thereby removing subjectivity from sagittal plane posture classification.
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To evaluate the natural course of end plate marrow (Modic) changes (MC) in the cervical spine on MRI scans of patients with neck pain. A few longitudinal studies have assessed the development of MC over time in the lumbar spine but only two recent studies evaluated MC in the cervical spine in asymptomatic volunteers and those with whiplash. Thus, this study now reports on the natural course of MC in the cervical spine in symptomatic patients. ⋯ MC in the cervical spine are a dynamic phenomenon similar to the lumbar spine.
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In the acute phase of spinal cord injury (SCI), ischemia and parenchymal hemorrhage are believed to worsen the primary lesions induced by mechanical trauma. To minimize ischemia, keeping the mean arterial blood pressure above 85 mmHg for at least 1 week is recommended, and norepinephrine is frequently administered to achieve this goal. However, no experimental study has assessed the effect of norepinephrine on spinal cord blood flow (SCBF) and parenchymal hemorrhage size. We have assessed the effect of norepinephrine on SCBF and parenchymal hemorrhage size within the first hour after experimental SCI. ⋯ In the rat, after a severe SCI at the Th10 level, injection of norepinephrine 15 min after SCI does not modify SCBF and increases the size of the parenchymal hemorrhage.