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 narrow correlation between sagittal alignment parameters and clinical outcomes has been widely established, demonstrating that improper sagittal alignment is a clinical condition that is associated with increased pain and limitations in patients' functional ability. ⋯ PSO is a valuable surgical procedure in correction of severe hypolordosis (=relative kyphosis) in the lumbar spine. It is a demanding procedure for the surgeon, the anesthesiologist and the intensive care team. Although its complication rate is high, it has a substantial positive impact in the quality of life of patients, including the elderly.
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Sagittal imbalance is a spine deformity with multifactorial etiology, associated with severe low back pain and gait disturbance that worsen deeply patients' quality of life. The amount of correction achievable through PSO is limited by the height of the resection of the posterior wall, causing a ceiling of segmental correction of 30-35°. The aim of this study is to describe and preliminarily evaluate the results of an alternative technique, corner osteotomy (CO), that can increase the amount of correction. ⋯ Corner osteotomy technique was more effective than the PSO in increasing segmental and lumbar lordosis with modest increase in blood loss and similar complication rate. The CO technique, in addition, proved a good reproducibility. Further studies with larger populations should confirm these preliminary results.
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Metastatic spinal cord compression (MSCC) incidences are increasing. Our objective was to identify predictive factors involved in long-term survival after use of a surgical approach. ⋯ Long-term metastatic cancer survivor patients are an increasing population with specific characteristics.
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Evaluation of effectiveness of internal rigid fixation for occipito-cervical fusion with occipital hooks and cervical screws and/or hooks to improve fusion in young or small children with various bone dysplasia or congenital abnormality. ⋯ Instrumentation was technically feasible even in a very young child. Rigid internal fixation in the little children did not increase surgical complications and significantly increased the union rate of occipito-cervical arthrodesis.