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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Severe scoliosis is primarily managed with surgery. This cohort study describes the incidence of surgically treated scoliosis among Swedish youth and young adults, stratified by age, sex, scoliosis type, and surgical approach and identifies changes in incidence rate and hospital length of stay (LOS), infections requiring re-surgery and mortality within 90 days. ⋯ Surgical management of scoliosis is increasing with a concurrent decrease in hospital LOS. Surgical management of neuromuscular scoliosis is associated with high 90-day post-operative infections and mortality rate.
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Correction of rigid cervical deformities often requires osteotomies to realign the spine. Cervical pedicle subtraction osteotomy can be technically challenging due to the presence of cervical nerve roots and usually can only be performed at C7 or T1 due to the presence of vertebral arteries. In contrast, anterior cervical osteotomy can be performed throughout the cervical spine and is a safe and effective method for correction of both sagittal and coronal cervical deformities. We describe the anterior cervical osteotomy technique with a review of the pertinent literature. ⋯ Anterior cervical osteotomy is a safe and effective technique for correction of rigid cervical deformities. Spine surgeons should be familiar with this technique to optimize clinical outcome in patients undergoing cervical deformity correction.
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In this article, we summarize our work on understanding the influence of cervical sagittal malalignment on the mechanics of the cervical spine. ⋯ The results of our biomechanical studies have improved our understanding of the impact of cervical sagittal malalignment on pathomechanics of the cervical spine. We believe this improved understanding will assist in clinical decision-making.
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The cartilage oligomeric matrix protein (COMP) was reported to be down-regulated in adolescent idiopathic scoliosis (AIS). The purposes of the study were to evaluate the roles of COMP promoter methylation on the abnormal gene expression and the epigenetic phenotype in AIS. ⋯ AIS patients had significantly high COMP promoter methylation and low gene expression. Positive and high COMP promoter methylation was correlated with young age and high Cobb angle of main curve. Therefore, COMP gene promoter methylation may provide significant prognostic information in predicting the susceptibility and curve progression of AIS.
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Lumbosacral stress and age may contribute to increased pelvic incidence: an analysis of 1625 adults.
While there is a consensus that pelvic incidence (PI) remains constant after skeletal maturity, recent reports argue that PI increases after 60 years. This study aims to investigate whether PI increases with age and to determine potential associated factors. ⋯ PI is higher in female patients and in older patients, especially those over 45 years old. Spinal malalignment also may have a role in increased PI due to increased L5-S1 bending moment.