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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To evaluate the effect of spectral CT for metal artifact reduction in patients with pedicle screw. ⋯ Virtual monochromatic images at high-energy levels have a well-concordant effect of removing metal artifacts, and 120 keV monochromatic images provided an accurate CT number and good subjective score.
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To compare outcomes between transdiscal and conventional pedicle fixation for high-grade L5-S1 spondylolisthesis. ⋯ L5-S1 transdiscal screw fixation provided better functional and radiographic outcomes at medium-term than conventional pedicle fixation for high-grade spondylolisthesis, although transdiscal sacral screws are difficult to place in correct position.
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To directly compare the safety of fluoroscopic guided percutaneous thoracic pedicle screw placement between Caucasians and Asians. ⋯ There were no statistical significant differences in the overall perforation rates, grades of perforations, direction of perforations for implantation of percutaneous thoracic pedicle screws insertion using fluoroscopic guidance between Europeans and Asians. The safety profile for this technique was comparable to the current reported perforation rates for conventional open pedicle screw technique.
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Ossification of the ligamentum flavum (OLF) is a common cause of progressive thoracic myelopathy in East Asia. Good surgical results are expected for patients who already show myelopathy. Surgical decompression using a posterior approach is commonly used to treat OLF. This study investigated the use of microendoscopic posterior decompression for the treatment of thoracic OLF. ⋯ Microendoscopic posterior decompression combined with MEP monitoring can be used to treat patients with thoracic OLF. The optimal surgical indication is OLF at a single vertebral level and of a unilateral or bilateral nature, without comma and tram track signs, and a round morphology.
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Spinal cord function classification systems are not useful for guiding surgery in patients with severe spinal deformities. The aim of this study is to propose a classification system for determining a surgical strategy that minimizes the risk of neurological dysfunction in patients with severe spinal deformities. ⋯ The classification system may be useful for guiding surgical decisions in patients with severe spinal deformities to minimize the risk of neurological complications.