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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To evaluate the effect of K-line on posterior single-door decompression with fusion fixation (PFF) and posterior single-door decompression with non-fusion fixation (PNF) for patients with ossification of posterior longitudinal ligament (OPLL). ⋯ In the K ( +) group, the improvement rate of JOA score was higher and the incidence of axial pain was lesser in the PNF group than in the PFF group. In the K (-) group, the improvement rate of JOA score was higher in the PFF group than in the PNF group, and there was significant loss of C2-C7 Cobb angle in the PNF group.
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Coronal malalignment (CM) causes pain, impairment of function and cosmetic problems for adult spinal deformity (ASD) patients in addition to sagittal malalignment. Certain types of CM are at risk of insufficient re-alignment after correction. However, CM has received minimal attention in the literature compared to sagittal malalignment. The purpose was to establish reliability for our recently published classification system of CM in ASD among spine surgeons. ⋯ Adequate intra- and inter-rater reliability was shown in the Obeid-CM classification with reference to full spine anteroposterior and lateral radiographs. While side bending radiographs did not improve the classification reliability, they contributed to a better understanding in certain cases. Surgeons should consider both the sagittal and coronal planes, and this system may allow better surgical decision making for CM.
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The purposes of this study were to analyse the correlations between the inflection point (IP) and spinal sagittal parameters and to establish the corresponding linear regressions in asymptomatic adults. ⋯ The IP was significantly related to spinal sagittal alignment in asymptomatic adults. Moreover, predictive formulae for sagittal parameters as a function of the IP were developed, which are helpful for surgeons in comprehending the regulatory mechanisms of spinal sagittal alignment and designing an ideal therapeutic plan. These slides can be retrieved under Electronic Supplementary Material.
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To raise the diagnostic criteria, classification and treatment strategy of dynamic sagittal imbalance (DSI). ⋯ Our study proposed a quantitative diagnostic criteria and novel classification of DSI. Nonoperative treatment is effective for most DSI patients with ΔSVA < 100 mm, while the majority of DSI patients with ΔSVA ≥ 100 mm need operative intervention.
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To investigate GAP scores in an asymptomatic cohort of adults, including older adults with age-expected changes in spinal alignment. ⋯ Most patients in this asymptomatic, nonoperative cohort were normally proportioned. However, a large percentage of asymptomatic volunteers were moderately or severely disproportioned. Older patients had higher scores, indicating some disproportion. There was also a small number of severely sagittally misaligned and poorly proportioned, yet asymptomatic, volunteers. Further refinement of individualized targets is needed to determine the effect on mechanical complications and quality of life given the divergent recommendations of age-adjusted targets and GAP targets.