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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Clinical Trial
Importance of the spinopelvic factors on the pelvic inclination from standing to sitting before total hip arthroplasty.
Dislocation after total hip arthroplasty (THA) is a major postoperative complication. Even if the cup is in the safe zone, dislocation caused by implant impingement may occur during postural changes. The aim of the present study was to investigate the spinopelvic factors that influence pelvic inclination changes from standing to sitting in patients with hip diseases who were candidates for THA. ⋯ The change in pelvic inclination from standing to sitting is strongly related to the mobility of the lumbar spine in patients with hip diseases.
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This technical note presents, to the authors' knowledge, the first reported case of a hybrid pedicle-cortical screw system for instrumented fusion in a patient with congenital vertebral column deformity. ⋯ Cortical screw fixation may serve to be helpful in augmenting pedicle screw fixation and in circumstances in which the bone quality is suboptimal or the pedicles are compromised. Cortical screw fixation is a relatively new technology, but it may prove to be invaluable in providing an adjunct to pedicle screw constructs in anatomically distorted or osteoporotic spines.
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Pelvic incidence (PI), pelvic tilt (PT) and sacral slope (SS) are important parameters in sagittal spine alignment evaluation. The measurements are a projection of the three-dimensional pelvis onto a two-dimensional radiograph and they may be influenced by orientation of the pelvis. The aim of this study was to assess the influence of pelvic rotation in the coronal plane (CPR) on radiographic accuracy of PI, PT, and SS measurements. ⋯ Rotation of the pelvis in the coronal plane during acquisition of radiographs influences PI, PT and SS measurements. Substantial error of PI, PT and SS measurements occurs with CPR of more than 20° which is equivalent to a lower limb discrepancy of 5.2 cm. CPR may be calculated while acquiring the radiograph. Further evaluation of the influence of CPR on spinopelvic parameters with a larger sample would be valuable.
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To identify predictors of both intermediate and long-term unfavorable outcomes after first time, uncomplicated lumbar disc surgery. ⋯ Identified predictors suggest that particular emphasis should put on comprehensive post-operative care at large and encouragement to adapt a physically active lifestyle in particular in rehabilitation concepts after first time uncomplicated lumbar disc surgery.
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Previous investigations have recognized the critical role of pelvic parameters in the setting of a fixed sagittal deformity. Pelvic incidence (PI) is a constant, as everyone knows. However, PI might change reciprocally because of increased shear force on the sacroiliac joint, following surgical correction of fixed lumbar lordosis (LL). The disparity in PI after surgery according to the surgical method, and its impact on final follow-up, has not been reported. This study was undertaken to analyze the disparity of PI before and after surgery, and to evaluate its impact on final sagittal alignment in surgically corrected lordosis when there is immediate postoperative normal alignment following correction of adult sagittal deformity. ⋯ PI increased in all patients with surgically corrected, adult sagittal deformity, following surgical correction of fixed LL. The disparity of PI after surgery was significantly higher in non-sacropelvic fixation, and showed a significant correlation with follow-up period without influence on sagittal alignment at last follow-up.