The spine journal : official journal of the North American Spine Society
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Characteristic changes of the facet joints, including synovial cysts, facet joint hypertrophy, and facet joint effusions, on magnetic resonance imaging (MRI) and computed tomography have been associated with lumbar degenerative spondylolisthesis. The cervical facets have not been examined for associations with cervical degenerative spondylolisthesis similar to those seen in the lumbar spine. ⋯ Supine MRIs underestimate sagittal displacement compared with upright lateral radiographs. Asymmetric facet hypertrophy at C3-C4 and C4-C5 is associated with degenerative spondylolisthesis on upright lateral films even in the absence of anterolisthesis on supine MRIs.
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Knowledge of sagittal spinopelvic parameters is important for the treatment of cerebral palsy (CP) because they differ in the normal population and can induce symptoms. ⋯ A significant difference was observed in the sagittal spinopelvic parameters in the CP and normal control groups and was possibly related to the symptoms. The study shows that the evaluations of sagittal spinopelvic parameters could be useful during the treatment of disorders associated with CP.
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Fazal A, Yoo A, Bendo JA. Does the presence of the nerve root sedimentation sign on MRI correlate with the operative level in patients undergoing posterior lumbar decompression for lumbar stenosis? Spine J 2013;13:837-42 (in this issue).
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There is currently no reliable technique for intraoperative assessment of pedicle screw fixation strength and optimal screw size. Several studies have evaluated pedicle screw insertional torque (IT) and its direct correlation with pullout strength. However, there is limited clinical application with pedicle screw IT as it must be measured during screw placement and rarely causes the spine surgeon to change screw size. To date, no study has evaluated tapping IT, which precedes screw insertion, and its ability to predict pedicle screw pullout strength. ⋯ Our findings suggest that tapping IT directly correlates with pedicle screw IT, pedicle screw pullout strength, and optimal pedicle screw size. Therefore, tapping IT may be used during thoracic pedicle screw instrumentation as an adjunct to preoperative imaging and clinical experience to maximize fixation strength and optimize pedicle "fit and fill" with the largest screw possible. However, further prospective, in vivo studies are necessary to evaluate the intraoperative use of tapping IT to predict screw loosening/complications.
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Posttibial nerve somatosensory evoked potential (PTN-SSEP) often fails to detect individual nerve root dysfunction, whereas dermatomal somatosensory evoked potential (DSSEP) can be difficult to obtain in anesthetized patients. ⋯ SPN-SSEP was a more sensitive measure for intraoperative L4-5 nerve root dysfunction in comparison with PTN-SSEP and SN-SSEP.