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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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.
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A multi-detector computed tomography (CT) imaging system with a mobile scanner gantry in the operating room can provide intraoperative reconstructed images with a high resolution. We devised a technique for cervical pedicle screw (CPS) placement using the mobile CT system and evaluated the accuracy of this technique. ⋯ The technique of CPS placement using mobile CT was shown to be safe and effective in preventing catastrophic complications associated with CPS insertion.
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The Majeed scoring system is a disease-specific outcome measure that was originally designed to assess pelvic injuries. The aim of this study was to determine the psychometric properties of the Majeed scoring system for chronic sacroiliac joint pain. ⋯ Overall the Majeed scoring system demonstrated acceptable psychometric properties for outcome assessment in chronic sacroiliac joint pain. Thus, its use in this condition is adequate. However, some domains demonstrated suboptimal performance indicating that improvement might be achieved with the development of an outcome measure specific for sacroiliac joint dysfunction and degeneration.
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The aim of this study was to assess the accuracy of rapid prototyping drill template technique for placing pedicle screws in the mid-upper thoracic vertebrae in clinics. ⋯ Use of a rapid prototyping drill template to assist in the placement of mid and upper thoracic pedicle screws may lead to increased accuracy. This patient specific technology must be combined with an understanding of the patients' anatomy and carefully secured to the posterior elements intraoperatively to avoid nerve or vascular complications.
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The changed relative anatomic position of trachea with increased potential risk of injury from thoracic pedicle screw (TPS) has been reported in Lenke 1 type adolescent idiopathic scoliosis (AIS) patients. However, such change of main-stem bronchus has not been investigated. The purposes of this study were to evaluate the altered positions of both left and right main-stem bronchus in Lenke 1 type patients and to assess the potential risks of main-stem bronchus injuries from TPS screw insertion in these patients. ⋯ Both the right and left main-stem bronchus were located much closer to the vertebrae in Lenke 1 type AIS patients when compared with normal teenagers. However, the potential risk of injury of main-stem bronchus from TPS placement was higher on the right side than that on the left side.