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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Both increased sagittal vertical axis (SVA) and sarcopenia affect performance of daily activities and morbidity in the elderly; however, little is known regarding their relationship. The aim of this study was to analyze the association between sarcopenia and increased SVA. ⋯ Sarcopenia and fatty degeneration of paraspinal muscle are closely related to increased SVA in the elderly.
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The present consensus suggests urgent surgical decompression if clinical features of cauda equina syndrome (CES) are supported by MRI evidence of pressure on cauda equina. However, clinical diagnosis has a high false-positive rate and MRI is a poor indicator. Though urodynamic studies (UDS) provide objective information about the lower urinary tract symptoms experienced by patients including neurogenic bladder, its role in the diagnosis of CES is not established. ⋯ Multichannel UDS provides an objective diagnostic tool to definitively establish the neurovesical involvement in CES. Utilising multichannel UDS as an adjunct to clinical findings avoids the probability of false-positive diagnosis of CES. These slides can be retrieved under Electronic Supplementary Material.
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Predictors of long-term opioid usage in TLIF patients have not been previously explored in the literature. We examined the effect of pre-operative narcotic use in addition to other predictors of the pattern and duration of post-operative narcotic usage. ⋯ Pre-operative opioid usage is associated with higher total inpatient opioid use and a significantly higher risk of long-term opiate usage at 6 months. Approximately 40% of pre-operative narcotic users will continue to consume narcotics at 6-month follow-up, compared with 5% of narcotic-naïve patients. These slides can be retrieved under Electronic Supplementary Material.
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The purpose of this study was to determine the incidence of spinal deformities in ambulant adults with cerebral palsy (CP) and spastic diplegia, more than 15 years after orthopaedic interval surgery approach (ISA) treatment, and its relationship to contextual factors, level of pain and physical status. ⋯ Adults with spastic diplegic CP who received their first orthopaedic intervention more than 15 years ago (based on ISA) showed similar incidence of spinal deformities as reported in the younger CP population, suggesting stability of spinal curvature into adulthood. These slides can be retrieved under Electronic Supplementary Material.
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Authors assumed that the stability of iliac screw (IS) fixation could affect the development of proximal junctional kyphosis (PJK). The purpose of this study was to analyze the relationship between IS loosening and PJK after long fusion surgery for adult spinal deformity (ASD). ⋯ III. These slides can be retrieved under Electronic Supplementary Material.