The spine journal : official journal of the North American Spine Society
-
During quiet standing, the gravity line (GL) can be located according to the sum of the ground reaction forces (GRFs) measured with a force platform. C7 plumb line (C7PL) is an easy method to estimate sagittal trunk balance, but discordance between C7PL and the GL is widely recognized. However, the prevalence of occiput-trunk (O-T) discordance (GL-C7PL>3 cm) and the factors affecting this type of discordance have not yet been determined. ⋯ The prevalence of discordance between GL and C7PL in ASD patients was 24%, and thoracic kyphosis and global sagittal alignment were significantly correlated with this discordance. The concordance of GRF and GL and the discordance of GRF and C7PL highlight the importance and necessity of accounting for GL when considering surgical treatment.
-
Case Reports
Laminar screw fixation of the axis in the pediatric population: a series of eight patients.
Instability of the atlantoaxial spine is a recognized problem in children. Safe passage of pedicle screws at C2 poses challenges because of the proximity to the vertebral artery, size of the pedicles, and variations in the location of the foramen transversarium. ⋯ Children as young as 2 years can undergo safe and rigid fixation of the axis. The technique is especially valuable in patients with dysplastic bone and distorted anatomy where more traditional methods of C2 fixation cannot be safely used. To our knowledge, this is the largest reported series of C2 laminar screw fixation in a pediatric population.
-
Surgical treatment for lumbar degenerative disc disease (DDD) remains controversial. Options include anterior lumbar interbody fusion, posterior approach fusion procedures such as posterior lumbar interbody fusion (PLIF) and posterolateral lumbar fusion (PLF), anterior and posterior lumbar fusion (APLF), and total disc replacement (TDR). However, the trends during the last decade are uncertain. ⋯ During the last decade, surgical treatment for lumbar DDD has increased 2.4-fold in the United States. Although all fusion procedures significantly increased, TDR did not increase. Surgical treatment for lumbar DDD was more common in the Midwest and South regions. Trends in the procedures were different depending on the age group and hospital region.