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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Comparative Study
Comparison of clinical and radiographic outcomes in unilateral transforaminal lumbar interbody fusion: a retrospective analysis of three surgical approaches.
The primary objective of this study is to evaluate and compare the clinical and radiographic outcomes of the combined spinous process-splitting approach with a Wiltse (SPSW) approach, the combined conventional approach with a Wiltse (CW) approach, and the conventional open (CO) approach in unilateral transforaminal lumbar interbody fusion (TLIF). ⋯ All the SPSW, CW, and CO approach TLIF procedures achieved overall satisfactory effects of decompression and fusion for lumbar degenerative diseases. The SPSW approach procedure appears to be associated with the smallest surgical trauma and highest satisfaction because of reducing iatrogenic injury of the paraspinal muscles.
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This study aimed to explore associations between ABO blood type and postoperative adjacent segment degeneration/disease (ASD) following lumbar spine fusion, as well as evaluate differences in spinopelvic alignment, perioperative care, postoperative complications, and patient-reported outcome measures (PROMs). ⋯ This is the first large-scale study to address and demonstrate proof-of-principle that ABO blood type, a non-modifiable risk factor, is associated with ASD following lumbar spine fusion.
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CaO-SiO2-P2O5-B2O3 bioactive glass-ceramics7 (BGS-7) are known for their strong integration with bone and stability and are commonly used in spinal fusions. ⋯ In multilevel ACDF, BGS-7 demonstrated fusion rates comparable to those of the allograft spacer with IBG, experiencing fewer instances of subsidence and cage fracture. Therefore, BGS-7 spacer can be safely utilized in multilevel ACDF as a substitute for traditional allograft spacers, without the need for additional IBG.
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Clinicians monitor scoliosis progression using radiographs during growth. Three standing positions were assessed because the arms must be elevated to visualize all vertebrae on radiographs, possibly affecting sagittal parameters. 3D Ultrasound (3DUS) is safe to assess positions without radiation, but its test-retest reliability has not been established for common radiograph positions. The aim was to determine the test-retest reliability of frontal, sagittal, and transverse measurements obtained from three positions using 3DUS imaging. ⋯ 3DUS produces reliable frontal, sagittal, and transverse measurements for research use in three standing positions. Hands on wall produces reliable measurements for clinical practice.
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Appendicular skeleton markers are commonly used for maturity assessment for Adolescent Idiopathic Scoliosis (AIS) patients. Traditionally, Risser has been a standard skeletal maturity assessment method. More recently, Sanders classification (SSMS), as a more comprehensive system, became popular, especially in decision-making for Vertebral Body Tethering (VBT). Thumb-Ossification Composite Index (TOCI), using ossification of thumb epiphyses, has been claimed to more accurately stage patients around their peak height velocity. However, growth peaks may occur separately at lower limbs and trunk. Hence, Cervical Vertebral Maturity (CVM), using cervical spine morphology, possesses a potential to better estimate spinal growth as it uses axial skeleton markers instead of appendicular skeleton markers. The aim of the study was to compare various axial and appendicular skeletal maturity assessment methods for longitudinal growth and curve modulation after VBT. ⋯ Risser score provided considerably less information for all three outcome variables. TOCI and SSMS provided substantial information regarding remaining leg-length assessments, while in terms of assessment of total height gain and curve modulation after surgery, CVM and TOCI offered substantial information and SSMS offered strong information. Mutual use of axial and appendicular markers may provide valuable insight concerning timing of surgery and magnitude of surgical correction.