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 evaluate effects of spinal and rib osteotomies on the resulting spinal flexibility for surgical correction of thoracic scoliosis and to explore effects of posterior fixation on thoracolumbar segmental range of motion and lumbar intervertebral disc loading. ⋯ Low effects of Schwab grade 1 and 2 osteotomies question the impact of isolated posterior spinal releases for surgical correction maneuvers in adolescent idiopathic scoliosis, in contrast to additional concave rib osteotomies. High effects of posterior fixation potentially explain frequently reported complications such as adjacent segment disease or proximal junctional kyphosis.
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To investigate the impact of the Global Alignment and Proportion (GAP) score components on patient outcomes in Adult Spine Deformity (ASD) surgery. ⋯ The spinopelvic component of the GAP score is the most significant independent predictor of clinical outcomes. Its interaction with the other components of the GAP score also aids assessment of the risk for mechanical complications.
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Limited nutrient transport is hypothesized to be involved in intervertebral disc (IVD) degeneration. It is widely recognized that the dominant mode of transport of small molecules such as glucose is via diffusion, rather than convection. However, recent findings suggest a role for convection-induced by fast (motion-related) and slow (diurnal) dynamic loading in molecular transport of even such small solutes. The aim of this study was to investigate whether fluid exchange induced by simulated physiological loading (composed of both fast cyclic or slower diurnal loading) can influence the molecular transport of a small molecule through the cartilage endplate (CEP) into the nucleus pulposus (NP) of IVDs. ⋯ Slower diurnal cyclic compression of the IVD might enhance the transport of small molecules into the IVD although it could not be discerned whether this was due to diffusion/convection or a combination.