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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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-.
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Preoperative directionality of shoulder tilting seems to be independent of the radiographic features of proximal thoracic (PT) curve in adolescent idiopathic scoliosis (AIS) patients. To date, no study had investigated the mechanisms underlying the variety of preoperative directionalities of shoulder tilting in AIS patients. The purpose of this study was to evaluate the differences of radiographic features between Lenke type 2 (double thoracic curve) AIS patients with different preoperative directionalities of shoulder tilting. ⋯ The directionality of shoulder tilting is diverse in Lenke type 2 AIS patients. The preoperative directionality of shoulder mainly depends on the profile of MT curve rather than that of PT curve. The RSH should be carefully evaluated before making a surgical plan in these patients.
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To investigate coronal plane trunk asymmetry (TA) and its association with sagittal postural alignment in healthy subjects before pubertal peak growth. ⋯ In immature spines without known scoliosis, coronal plane TA is associated with whole-body sagittal alignment. It is more often seen in non-neutral than neutral sagittal posture types. Whether adolescent idiopathic scoliosis is related with postural characteristics before pubertal growth peak, should be addressed in future prospective studies.
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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.
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Case Reports
Tailor-made management of thoracic scoliosis with cervical hyperextension in muscular dystrophy.
We report the case of a 13-year-old boy managed for fixed cervical hyperextension due to congenital muscular dystrophy with partial merosin deficiency. He presented a right decompensated thoracic scoliosis (T6-L1 Cobb angle 72°) associated with cervical and lumbar lordosis. The spinal extension was accompanied by major flexion of the hip resulting in the trunk being bent forward. This posture caused daily severe back pain responsible for significant loss of quality of life. This led to the decision to perform surgery. ⋯ There is no gold standard treatment for cervical hyperextension, but approaches have to be tailor-made to the patient's needs and the team's experience.