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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The number of spinal fusion surgeries is steadily increasing and biomechanical consequences are still in debate. The aim of this study is to provide biomechanical insights into the sagittal balance of the spine and to compare spinal load before and after spinal fusion. ⋯ Imbalanced spines have a risk of increased compression forces at Th12-L1. L4-L5 always has increased spinal loads. These slides can be retrieved under Electronic Supplementary Material.
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Interbody fusion by open discectomy is the usual treatment for degenerative lumbar disease but requires a relatively long recovery period. Prevalent several interbody fusion methods have shown limitations by its own character. Full endoscopic lumbar interbody fusion (FELIF) has advantages in direct decompression of pathology with minimal invasive technique. We report novel technique of endoscopic fusion method through full guided with endoscopic view monitoring system. ⋯ FELIF is a safe and effective interbody fusion option to decompress the lumbar exiting nerve root and ventral side of dura directly with minimal invasive situation. These slides can be retrieved under Electronic Supplementary Material.
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Cervical laminectomy is an effective treatment for multilevel cervical compressive myelopathy. Symptomatic spinal cord compression (SSCC) by paraspinal musculature (PSM) following cervical laminectomy is rarely reported. The aim of this study was to evaluate the frequency and pathogenesis of this complication after cervical laminectomy. ⋯ SSCC by PSM is a rare but devastating complication following cervical laminectomy, especially in those patients with preoperative kyphosis, prior antiplatelet treatment, and decompression with prone position. MRI is an ideal tool to identify this complication. Rapid cervical cord decompression and avoidance of recurrent compressive events can achieve a good clinical outcome. These slides can be retrieved under Electronic Supplementary Material.
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Major concern during surgery for high-grade spondylolisthesis (HGS) is to reduce lumbosacral kyphosis and restore sagittal alignment. Despite the numerous methods described, lumbosacral fixation in HGS is a challenging technique associated with high complication rate. Few series have described outcomes and most of the results are limited to lumbosacral correction without global sagittal alignment analysis. This study aims at analyzing clinical and radiological outcomes of HGS patients treated with intrasacral rods on full spine radiographs. ⋯ Intrasacral rod fixation appears to be an effective technique to correct LSA kyphosis, compensatory hyperlordosis and restore global sagittal alignment with a postoperative T1SPi corresponding to the value of the asymptomatic subject and achieve fusion. However, it remains a demanding technique with high risk of transient neurologic complications.
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To determine if the mechanical properties of the annulus fibrosus (AF) are altered following end-plate fracture. Vertebral fractures, particularly those in the growth plate, are relatively common among adolescents. What is unclear is whether or not these fractures are also associated with concomitant damage to the intervertebral disc (IVD), in particular the AF. ⋯ This decrease in laminate adhesion strength suggests that growth plate fracture damage is not isolated to the vertebra and results in microdamage to the interlamellar matrix of the AF. This may increase in the risk of progressive delamination of the AF, which is associated with IVD herniation. These slides can be retrieved under Electronic Supplementary Material.