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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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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Management of C1-C2 instability is very challenging, especially when tumoral lesions are involved. ⋯ Literature is sparse on the treatment of major C1-C2 instability, especially when a secondary lesion is involved, the current case shows a successful treatment strategy with an original technique that was never described before in the literature. The patient was pain free at 1 year follow-up with a stable construct.
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Determine the effects of dynamic injurious axial compression applied at various lateral eccentricities (lateral distance to the centre of the spine) on mechanical flexibilities and structural injury patterns of the cervical spine. ⋯ Dynamic axial compression loading of the cervical spine with high lateral eccentricities produced primarily soft tissue injuries resulting in more post-injury spinal flexibility in lateral bending and axial rotation than that associated with the bony fractures resulting from low eccentricity impacts.
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Thoracic hyperkyphosis is a sagittal deformity that can cause back pain and neurological impairment, leading to difficulties in maintaining a straight gaze. Sagittal thoracic malalignment has different etiologies and different corrective strategies. ⋯ Ponte's is, together with Smith-Petersen osteotomy, a posterior column osteotomy. The magnitude of correction can reach 10° per level if intervertebral discs are still mobile.
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Pedicle screw instrumentation provides optimal stabilization of the cervical spine complex, but is associated with risk of neurovascular injury. Sex and ethnic disparities may compromise safe and accurate screw placement. Therefore, a comprehensive analysis of pedicle dimensions derived from computed tomography scans is pertinent for our multi-ethnic population. ⋯ Transpedicular screw fixation is generally feasible in our population except for 8 % with at least one PW < 4.00 mm. However, in view of significant sex and ethnic morphometric variability, pre-operative CT evaluation together with image-guided screw placement is highly advised to ensure safety and accuracy.