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 assess the benefits of using the touched vertebra (TV) rule in Lenke classification for thoracic curves of adolescent idiopathic scoliosis (AIS). ⋯ Selecting the TV as LIV minimizes the loss of the distal mobile segment and reduces the complications in the thoracic curves of AIS, which produces a more stable LIV on the CSVL. Therefore, TV is an ideal landmark for determining the distal fusion level using the Lenke classification or Suk classification.
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As the number of instrumented fusions increases, so does the utilization of bone substitutes. However, controversies persist regarding the effectiveness of ceramics in promoting solid fusion. Few histological studies have been conducted on patients to address this issue. To contribute insights into this topic, we assessed bony fusion both intraoperatively and histologically in patients who underwent posterolateral instrumented fusions enhanced with a biphasic ceramic compound. ⋯ The utilization of biphasic ceramics proved ineffective in attaining a proper fusion mass between the intertransverse space. Both surgical inspection and histological studies confirmed the absence of integration. Prudence should be exercised regarding the use of ceramics. While no clear instability was observed, neither was there any integration.
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This study determined the prevalence of cauda equina clumping among patients with Schizas grade C or higher central stenosis after decompression and compared the radiographic and clinical outcomes between patients with and without clumping. ⋯ Post-decompression cauda equina clumping is commonly observed in patients with severe lumbar stenosis and impacts intermediate-term clinical recovery. Although long-term outcomes at 1 year are similar, tailored postoperative care is essential for patients exhibiting clumping to effectively manage prolonged symptoms.
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The demand for SIJ fusion among obese patients has grown substantially. However, the clinical relevance of obesity in the context of SI joint fusion has not been well investigated specifically, whether there is a BMI cutoff above which the benefit-risk ratio is low. ⋯ This study demonstrates similar benefits across all BMI categories. This data suggests that obese patients do benefit from minimally invasive SIJ fusion, specifically the 35-40 BMI cohort of patients, and should not be denied this procedure based on arbitrary healthcare organizations BMI criteria.
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Observational Study
The change in lumbar lordosis from the standing to the lateral position: implications for lateral interbody fusion.
The purpose of this cross-sectional, observational study was to establish the relationship between standing lumbar lordosis (LL) and lateral decubitus LL. ⋯ Standing LL was strongly correlated to lateral decubitus LL, although subjects lost an average of 11.9° from the standing to the lateral decubitus position. This has important implications for fusion in the lateral position.