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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Transforaminal lumbar interbody fusion (TLIF) is a widely accepted surgical procedure for degenerative disk disease. While numerous studies have analyzed complication rates and risk factors this study investigates the extent to which complications after TLIF spondylodesis alter the clinical outcome regarding pain and physical function. ⋯ Our results suggest that major complications with need of revision surgery after TLIF spondylodesis lead to a significantly worse clinical outcome (VAS-B, VAS-L, and ODI) compared to no or minor complications. It is therefore vitally important to raise the surgeon´s awareness of consequences of major complications, and the topic should be given high priority in clinical work.
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This study aimed to validate the usefulness of the global alignment proportion (GAP) score to predict postoperative mechanical failure in the elderly (mean age, 70.5 years) individuals with severe sagittal imbalance. ⋯ This study showed promising results regarding the GAP score's predictive power for MC, mMC, and PJF in the elderly population with degenerative kyphoscoliosis. Using the GAP score, we can determine the patient's specific correction goal preoperatively to prevent mechanical failure based on individual patient's characteristics such as pelvic incidence.
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The mean potential of lordosis restoration by transforaminal lumbar interbody fusion (TLIF) is supposed to be low in general. In contrast, clinical experience shows a wide range of segmental lordosis correction. In this study, the predictability of lordosis correction should be investigated. ⋯ Significant segmental relordosation can be performed by TLIF L4/5. The potential of correction strongly correlates with preoperative lordosis. Therefore, TLIF technique should be considered carefully in cases with a preoperative segmental lordosis of more than 15° and additional need of lordosation.
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Observational Study
Revisiting thoracic kyphosis: a normative description of the thoracic sagittal curve in an asymptomatic population.
Thoracic kyphosis (TK) remained in the shadow of lumbar lordosis. Based on Berthonnaud and Roussouly segmentation, TK is divided into two arches: upper TK (UTK) and lower TK (LTK). The purpose of this study is to propose a normative description of the TK arches in an asymptomatic adults' population and their correlation with spinal and pelvic parameters. ⋯ In asymptomatic young adults, thoracic kyphosis is composed by two unequal arches, a stable UTK and a variable LTK, with an apex around T8 and T9 vertebra, depending on the spinal morphotype according to Roussouly classification. This should be taken into consideration when analyzing spine sagittal compensation and preparing corrections to minimize risk of mechanical complications.
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To assess feasibility of a three-dimensional ultrashort echo time (3D-UTE)-sequence to evaluate normal and pathological disco-vertebral complex (DVC), with assessment of its different portions in a rat model of degenerative disk disease (DDD) with histological correlation. To assess whether this sequence, in comparison with long echo time T2-weighted sequence, is able to monitor DDD with differentiation of early from chronic DVC changes in pathological mechanical conditions. ⋯ Diagnostic: individual cross-sectional studies with the consistently applied reference standard and blinding.