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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Comparative Study
Comparison of sacroiliac joint degeneration between patients with sagittal imbalance and lumbar spinal stenosis.
The purpose of this study was to compare the degeneration of sacroiliac joints (SIJs) between adult spinal deformity (ASD) patients with sagittal imbalance and an age- and sex-matched lumbar spinal stenosis (LSS) patients without sagittal imbalance. ⋯ ASD patients with sagittal imbalance demonstrated more severe SIJ degeneration compared to the age- and sex-matched LSS group. PI was significantly correlated with both SIJ degeneration and SVA only in the ASD group.
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Some atypical vertebral hemangiomas (VHs) may mimic metastases on routine MRI and can result in misdiagnosis and ultimately to additional imaging, biopsy and unnecessary costs. The purpose of this study is to assess the utility of intravoxel incoherent motion (IVIM) diffusion-weighted imaging (DWI) on account of field-of-view optimized and constrained undistorted single shot (FOCUS) in distinguishing atypical VHs and vertebral metastases. ⋯ The standard ADC value and D value may be used as an indicator to distinguish vertebral metastases from atypical VHs. FOCUS IVIM-derived parameters provide potential value in the quantitatively differentiating vertebral metastases from vertebral atypical hemangiomas.
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Review Case Reports
Isolated multiple lumbar transverse process fractures with spinal instability: an uncommon yet serious association.
Isolated vertebral transverse process fractures of thoracolumbar spine without other vertebral injuries and neurological deficit are generally considered as minor injuries with no concern for associated spinal instability. This report describes a case of multiple lumbar transverse fractures associated with an unexpected yet clinically significant spinal instability. ⋯ This is the first case description of association of multisegmental lumbar transverse process fractures with notoriously unstable injuries of the major soft-tissue stabilizers of the spine presenting subtle changes on CT images. When a seemingly benign spinal injury is caused by high-energy trauma, careful scrutiny for associated instability is needed. In this case, the standing in-brace X-ray was able to avoid a misdiagnosis and potentially unfavourable outcome.
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Review a series of 22 patients below the age of 16 affected by primary bone tumors of the spine who underwent en bloc resection, and describe the clinical presentation, tumor characteristics, results and complications associated with the surgical treatment, underlining the specific issues related to a younger age. ⋯ Young people with primary malignant or locally aggressive bone tumors of the spine should be treated in specialized centers, and wide surgery should be performed. The most frequent problems are related to reconstruction in a growing spine and subsequent hardware failure that make later surgeries necessary. These slides can be retrieved under Electronic Supplementary Material.
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To compare the surgical outcomes between ankylosing spondylitis (AS)-related thoracolumbar kyphosis patients with the lowest instrumented vertebra (LIV) at S1 or above following one-level pedicle subtraction osteotomy (PSO). ⋯ Selecting S1 as the LIV without pelvic fixation following one-level PSO in thoracolumbar kyphosis caused by AS could achieve satisfactory surgical outcomes and might not increase the complications. Patients with relatively severe sagittal imbalance, loss of LL, PI-LL mismatch, and small SS might be the potential candidates for distal fusion to S1 following one-level PSO.