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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This is a prospective study to investigate the clinical and radiological results 10 years after percutaneous balloon kyphoplasty and cement augmentation with calcium phosphate cement (CPC) in traumatic vertebral fractures type A. ⋯ In our 10-year follow-up, we did not recognize any high loss of correction of the vertebral and segmental kyphosis angle. We also did not recognize a high diminution of the disc height without degeneration of the disc over the last 10 years. There was a partial resorption of the cement but not as much as we expected with variable bone formation. In summary, the long follow-up about 10 years of kyphoplasty show us very good clinical and radiological results and in our opinion we consider this to be a treatment option for traumatic selected vertebral type A fractures also in young patients.
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It has been shown previously that a history of low back pain often begins in childhood or adulthood. Indeed, the prevalence of severe back symptoms among schoolchildren is not insignificant. Possibilities for the primary prevention of intervertebral disc degeneration-related conditions are poorly reported in the literature despite the assumed socio-economical impact of the prevention of these conditions. ⋯ Considering the growing evidence about the importance of normal and bad posture, an exercise-based posture correction program is suggested as a school-based primary prevention of disc degeneration-related symptoms. Further, prospective randomized studies with more than 20 years follow-up, however, are strongly required to confirm it.
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Determining a surgical plan for the treatment of adolescent idiopathic scoliosis (AIS) can be challenging. Despite treatment recommendations and classification systems (such as the Lenke classification system) there is still no consensus on the optimal surgical plan for each curve type. The main objective of this study is to analyze the disagreements in surgical planning between spinal surgeons in AIS. ⋯ There was at least one difference in surgical planning in 31 of the 100 cases (31 %). This shows that despite treatment algorithms and the Lenke classification system, disagreements in surgical planning still exist between spinal surgeons.
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Review
Ageing and degenerative changes of the intervertebral disc and their impact on spinal flexibility.
Degeneration of the intervertebral disc is associated with various morphological changes of the disc itself and of the adjacent structures, such as reduction of the water content, collapse of the intervertebral space, disruption and tears, and osteophytes. These morphological changes of the disc are linked to alterations of the spine flexibility. This paper aims to review the literature about the ageing and degenerative changes of the intervertebral disc and their link with alterations in spinal biomechanics, with emphasis on flexibility. ⋯ The literature suggests that the degenerative changes of the intervertebral disc and surrounding structures lead to subtle alteration of the mechanical properties of the functional spinal unit. A trend toward spinal stiffening with the increasing degeneration has been observed in most studies.
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To be deemed effective in preventing curve progression, brace treatment should show alteration of the expected natural history. Most of the reported studies on the effect of bracing on the evolution of Chiari malformation-associated scoliosis (CMS) following posterior fossa decompression (PFD) were small series with inconclusive results. The goal of this study was to investigate whether post-PFD brace treatment for CMS produces better outcomes than observation alone. ⋯ Compared with observation alone, bracing treatment following PFD in patients with CMS was observed to reduce the rates of curve progression and scoliosis surgery. However, patients and their parents should be informed that almost a third of patients still go on to surgery.