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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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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Proximal junctional kyphosis (PJK) of the cervicothoracic spine is a deformity that can affect patients who have undergone long thoracolumbar instrumented fusion. Preoperative hyperkyphosis of the thoracic spine and changes of more than 30° in lumbar lordosis are independent risk factors for the onset of PJK. ⋯ The aim of corrective surgery is to restore the cervicothoracic alignment, obtaining an adequate postoperative sagittal balance and decreasing the risk of further complications and new revision surgeries.
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Restoring a physiological sagittal spine balance is one of the main goals in spine surgery. Several technics have been described previously, as pedicle subtraction osteotomy. In more complicated cases involving spino-pelvic disorders, three authors proposed sacral osteotomy to restore sagittal balance of the spine. The authors describe the use of pelvic osteotomies for the correction of lumbo-sacral kyphosis, for decreasing pelvic incidence and for achieving sagittal balance correction in cases of lumbo-sacral sagittal deformity as an alternative of pedicle subtraction osteotomies (PSO). ⋯ A study of a more substantial series would be considered.