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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This study exploits a novel musculoskeletal finite element (MS-FE) spine model to evaluate the post-fusion (L4-L5) alterations in adjacent segment kinetics. ⋯ Alterations in segmental rotations mainly affected adjacent disc shear forces, facet/ligament forces, and annulus/collagen fibers stresses/strains. An altered lumbopelvic rhythm (increased pelvis rotation) tends to mitigate some of these surgically induced changes.
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To develop a decision-making pathway for primary SA-LLIF. Furthermore, we analyzed the agreement of this pathway and compared outcomes of patients undergoing either SA-LLIF or 360-LLIF. ⋯ Diagnostic: individual cross-sectional studies with consistently applied reference standard and blinding.
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To assess spinal stability in different physiological positions whilst weight-bearing. ⋯ CBCT can be used to image the lumbar and cervical spine in physiological weight-bearing positions and at different extremes of spinal motion. This novel application of an existing technology can be used to aid surgical decision making to assess spinal stability and to investigate occult back and leg pain. Its use should be limited to specific clinical indications, given the relatively high radiation dose.
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Retrospective Cohort Study. ⋯ Frailty was associated with higher odds of all perioperative complications, LOS, and all-payer costs following multi-level lumbar fusion. Frail patients had significantly higher rates of 90 and 180-day readmission and higher rates of wound disruption at 90-days. On subgroup analysis, MIS was associated with significantly reduced rates of surgical complications specifically in frail patients. Our results suggest frailty status to be an important predictor of perioperative complications and long-term readmissions in geriatric patients receiving multi-level lumbar fusions. Frail patients should undergo surgery utilizing minimally invasive techniques to minimize risk of surgical complications. Future studies should explore the utility of implementing frailty in risk stratification assessments for patients undergoing spine surgery.
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Dural ossification (DO) is common in patients with ossification of the ligamentum flavum (OLF) and is the leading cause of dural tears. However, the methods used for DO diagnosis are limited. The purpose of this study was to propose a novel CT-based imaging sign, Banner cloud sign (BCs), and clarify its clinical characteristics and correlations with DO. ⋯ BCs can vividly and intuitively describe the imaging features of DO and has high diagnostic accuracy. It could be a promising and valuable method for the diagnosis of DO.