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 describe hypercomplex pedicle subtraction osteotomies (HyC-PSO) for adult spine deformity with sagittal imbalance in terms of preoperative, intraoperative and postoperative outcomes and complications. ⋯ This is the first report on hypercomplex pedicle subtraction osteotomies. Hypercomplex PSO describes a subset of clinical scenarios with increased surgical effort that can be measured as longer surgical time and greater blood transfusion requirements. Successful correction of misalignment can be achieved in this specific group of patients, and clinical results and complications profile could be similar to standard PSO procedures.
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To evaluate postoperative changes within the cervical alignment following surgical lumbar correction by pedicle subtraction osteotomy (PSO) in patients affected with sagittal global malalignment disease. ⋯ Reciprocal changes in cervical spine after PSO are difficult to approach. Maintaining a horizontal gaze involves locoregional mechanisms of compensation adapting to the slope of C7. The cranial system by decreasing the cranial slope allows the gaze alignment and is the first compensation mechanism to get involved after a loss of lumbar lordosis. Restoring optimal C7SVA is necessary to prevent the development of secondary cervical painful symptomatology when the cranial compensation is outdated.
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To test the responsiveness of the EuroQoL 5-dimension (EQ-5D) utility scores for adolescent idiopathic scoliosis (AIS). ⋯ EQ-5D is found to be able to capture positive changes, and responsive in detecting important clinical changes in the improved group of this AIS population.
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Dropped head syndrome (DHS) is a rare clinical entity which is defined as a chin-on-chest deformity in the standing or sitting position, resulting from sagittal imbalance of the cervical region. The purpose of the present study was to clarify the radiologic features of DHS in the overall sagittal alignment of the spine. We also investigated the changes in sagittal alignment after correction surgery for DHS. ⋯ The present study has indicated that radiologic feature of DHS in the sagittal alignment of the overall spino-pelvis can be categorized into two types: SVA+ and SVA-.