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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Magnetic resonance imaging (MRI) is increasingly used to estimate the geometric dimensions of lower lumbar vertebrae. While MRI-based measurements have demonstrated good reliability with interclass correlation coefficients (ICCs) of 0.80 or higher, many evaluations focus solely on the comparison of identical MRI images. This approach primarily reflects analyst dexterity and does not assess the reliability of the entire process, including imaging and image selection. ⋯ The process of using MRI to derive biomechanical measures, particularly for bony structures, demonstrates robust reliability. Variability in measurements is minimal even under challenging conditions, supporting the use of MRI for biomechanical assessments.
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Disruptions in global sagittal spinal alignment can lead to changes in global sagittal spinal alignment, often manifesting as sagittal malalignment, where the trunk shifts forward. We proposed that these alignment changes are linked to degenerative lumbar spondylolisthesis (DS). The objective was to assess global spinal alignment in low-grade DS using sagittal vertical axis (SVA) classification. ⋯ A high PI is a key risk factor for worsening SVA in DS, and it may contribute to the initiation and progression of the condition.
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Giant sacral and presacral schwannomas are very rare conditions and their prevalence is estimated to account for only 0.3 to 3.3% of overall schwannomas. Current published literature about these tumors is limited to case reports and small case series. In this paper we systematically reviewed and analyzed the available literature on giant sacral schwannomas focusing on identifying the presenting symptoms, Klimo type, surgical approach, recurrence rate and postoperative complications. ⋯ The management approach of giant sacral and presacral schwannomas are mainly tailored according to the tumor size and location. Due to the benign nature and the overall recurrence rate of the tumor, frequent imaging follow-up is required after safe resection with adequate clean margins.
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To describe a novel alternative technique for C2 fixation under the concept of atlantoaxial joint distraction and fusion with intra-articular Cages, and to report its preliminary clinical outcomes. ⋯ This novel technique can provide reliable fixation of the axis while eliminating VA injury. When placement of a C2 pedicle screw is not possible due to anatomical constraints, C2APS can be considered as a safe and efficient alternative when the technique of atlantoaxial joint distraction and fusion with intra-articular Cages was used.
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Posterior laminectomy is a standard treatment for thoracic ossification of the ligamentum flavum (TOLF), but it often leads to neurological deterioration during surgery. This study aimed to reduce iatrogenic neurological deterioration by using an S8 navigation system combined with an ultrasonic osteotome for three-dimensional real-time dynamic visualization decompression. ⋯ The S8 navigation system combined with an ultrasonic osteotome for three-dimensional real-time dynamic visualization decompression significantly reduces the incidence of intraoperative neurological deterioration, improves postoperative motor function recovery, and reduces decompression time per vertebral segment, intraoperative bleeding, and complications such as cerebrospinal fluid leakage. This technology is safe and reliable and offers a promising option for spinal surgeons in treating thoracic ossification of the ligamentum flavum.