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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We aimed to determine the age- and sex-related changes in facet orientation and facet tropism in lower lumbar spine. ⋯ Predominant morphological changes in superior articular process are responsible for remodeling of facets that occur with increasing age, resulting in sagittalization. Even though the facet orientation changes over a period of time, differential changes within the facets at the same level might not be seen. These slides can be retrieved under Electronic Supplementary Material.
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Analysis of functional outcome of elderly patients with type II odontoid fractures treated conservatively in relation to their radiological outcome. ⋯ In geriatric type II odontoid fractures, pre-injury clinical status and comorbidities overcome imaging in determining post-treatment level of function. Hard collar immobilization led to a favourable functional outcome with mRS-post, NDI and SWPS values diffusely encouraging whatever a bony union or a fibrous non-union was obtained. These slides can be retrieved under Electronic Supplementary Material.
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A new variant ligament of the atlantooccipital joint: the lateral oblique atlantooccipital ligament.
During routine dissection of the anterior craniocervical junction (CCJ), a variant ligament just anterior to the articular capsule of the atlantooccipital joint was observed. To our knowledge, no literature has previously described this ligament. Therefore, the aim of this study was to clarify the anatomy, incidence, and biomechanics of this undescribed structure of the anterior atlantooccipital joint. ⋯ We propose that this ligament may be termed the lateral oblique atlantooccipital ligament. To date, this structure has not been described in any textbooks or reports in the extant medical literature. Although its function is not clear, based on its course and connections, it might function as a secondary stabilizer of the atlantooccipital joint. As the stability of the craniocervical junction is of paramount importance, knowledge of normal and variant anatomical structures in this region is important for the surgeon treating patients with pathology of this region. These slides can be retrieved under Electronic Supplementary Material.
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To investigate the normative value of distance between the spinous processes (inter-spinous process distance, ISPD), correlations between patients' demographics and ISPD, and determine cutoff ISPD values that result in segmental lordosis in posterior cervical-thoracic arthrodesis with instrumentation. ⋯ ISPD is a simple and useful parameter that correlates with the segmental Cobb angle. During posterior cervical deformity surgery, surgeons can intraoperatively predict adequate segmental lordosis by utilizing the vertebral level specific cutoff values of ISPD. These slides can be retrieved under Electronic Supplementary Material.
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To delineate the changes in functional outcomes of surgically treated U-shaped sacral fractures. ⋯ Neurological function in the lower extremities of patients with U-shaped sacral fractures improved after surgery; however, bowel and sexual functions did not change, and urinary function deteriorated over time. The majority of impairments appear to be permanent if still present at 1 year after surgery. These slides can be retrieved under Electronic Supplementary Material.