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
-
Transitional lumbosacral vertebrae (TLSV) are a congenital anomaly of the lumbosacral region that is characterized by the presence of a vertebra with morphological properties of both the lumbar and sacral vertebrae, with a prevalence of up to 36% in asymptomatic patients and 20% in adolescent idiopathic scoliosis patients. In patients with TLSV, because of these morphological changes and the different numbers of lumbar vertebrae, there are two optional reference sacral endplates that can be selected intently or inadvertently to measure the spinopelvic parameters: upper and lower endplates. The spinopelvic parameters measured using the upper and lower endplates are significantly different from each other as well as from the normative values. Therefore, the selection of a reference endplate changes the spinopelvic parameters, lumbar lordosis (LL), and surgical goals, which can result in surgical over- or under-correction. Because there is no consensus on the selection of sacral endplate among these patients, it is unclear as to which of these parameters should be used in diagnosis or surgical planning. The present study describes a standardization method for measuring the spinopelvic parameters and LL in patients with TLSV. ⋯ Because PI is unique for every individual, the endplate whose PI value is closer to the normative value should be selected as the reference sacral endplate in patients with TLSV.
-
This research was to unravel the impact of the lncRNA differentiation antagonizing non-protein coding RNA (DANCR)/microRNA (miR)-146a-5p/mitogen-activated protein kinase 6 (MAPK6) axis on spinal cord injury (SCI). ⋯ DANCR affects spinal cord neuron apoptosis and inflammation of SCI by mediating the miR-146a-5p/MAPK6 axis.
-
Hybrid cervical spine surgery (HS) is a novel surgical strategy wherein an artificial disc replacement is done with a cervical fusion nearby with a stand-alone titanium cage to combine the advantages in both procedures. The aim of this study was to evaluate interactions of these devices within the same patient, and to analyze, if the different goal of each implant is accomplished. ⋯ HS results in preservation of the segmental motion in the cTDR and fast and solid fusion in the cage cohort simultaneously. Patient safety was proven. In carefully selected cases, HS is a safe and viable treatment option by choosing the right "philosophy" level per level.
-
To assess whether the intention to intraoperatively reposition pedicle screws differs when spine surgeons evaluate the same screws with 2D imaging or 3D imaging. ⋯ When provided with 3D imaging, spine surgeons not only intend to intraoperatively reposition pedicle screws at risk of causing postoperative complications more often but also screws with acceptable positions. This study highlights the potential of intraoperative 3D imaging as well as the need for consensus on how to act on intraoperative 3D information.
-
Symptomatic Tarlov cysts in children with a possible underlying one-way check-valve mechanism are very rare. We aim to introduce a new variation of the surgical technique to overcome a check-valve mechanism. ⋯ One-way check-valve mechanism might contribute to the symptomatology of large sacral Tarlov cysts in children. Our new variation of a surgical technique enables elimination of the check-valve mechanism without the necessity to open and close the typically very thin and fragile cyst surface and is therefore an efficacious and simple option in this situation.