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 aim of this study was to quantify the stabilizing effect of the passive structures in thoracic spinal motion segments by stepwise resections. These data can be used to calibrate finite element models of the thoracic spine, which are needed to explore novel surgical treatments of spinal deformities, fractures, and tumours. ⋯ The anulus fibrosus defines the motion characteristics qualitatively, while the ligaments and the presence of the nucleus pulposus restrict the mobility of a thoracic spinal motion segment solely in a quantitative manner. The posterior ligaments do not predominantly serve for primary stability but for the prevention of hyperflexion. These slides can be retrieved under Electronic Supplementary Material.
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To update evidence of diagnostic potential for identification of lumbar spinal stenosis (LSS) based on demographic and patient history, clinical findings, and physical tests, and report posttest probabilities associated with test findings. ⋯ Outside of one study that was able to completely rule out LSS with no functional neurological changes none of the stand-alone findings were strong enough to rule in or rule out LSS. These slides can be retrieved under Electronic Supplementary Material.
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To validate the reliability of Berjano and Lamartina classification system of surgical planning in cases of de novo degenerative lumbar scoliosis (DNDLS) combined with degenerative segment disease and identify factors contributing to curve progression. ⋯ Selective decompression and short-segment fusion were effective for treating type I and II cases DNDLS. The Cobb angle increased relative to preoperative sagittal spine alignment. These slides can be retrieved under Electronic Supplementary Material.
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Multicenter Study
Opioids and analgesics use after adult spinal deformity surgery correlates with sagittal alignment and preoperative analgesic pattern.
To assess pain, health-related quality of life (HRQOL) scores and sagittal parameters of adult spinal deformity (ASD)-operated patients in the context of their analgesic consumption especially opioids (narcotics) over the first year postoperative period. ⋯ This study evaluated the analgesics use after ASD surgery in relation to the clinical and radiological outcomes. Despite important postoperative opioids consumption in the narcotics group, clinical outcome yet improved. Malalignment parameters demonstrated a predictive value in regard to NSAIDs' usage. These slides can be retrieved under Electronic Supplementary Material.
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There are still no data proving whether restoring the ideal sagittal profile (according to Roussouly classification) in adult scoliosis (AS) patients leads to any additional benefit, especially regarding mechanical complications. ⋯ Adult scoliosis surgery should restore the ideal Roussouly sagittal profile to decrease the rate of mechanical complications, especially in patients older than 65, instrumented to the pelvis. These slides can be retrieved under Electronic Supplementary Material.