The spine journal : official journal of the North American Spine Society
-
Little is known about the effect of rod stiffness as a risk factor of proximal junctional kyphosis (PJK) after adult spinal deformity (ASD) surgery. ⋯ Increasing the rod stiffness by the use of cobalt chrome rod and can prevent rod breakage but adversely affects the occurrence and the time of PJK.
-
Comparative Study
Optimum pelvic incidence minus lumbar lordosis value after operation for patients with adult degenerative scoliosis.
Schwab classification for adult degenerative scoliosis (ADS) concluded that health-related quality of life was closely related to curve type and three sagittal modifiers. It was suggested that pelvic incidence minus lumbar lordosis value (PI-LL) should be corrected within -10°~+10°. However, recent studies also indicated that ideal clinical outcomes could also be achieved in patients without the ideal PI-LL mentioned above. ⋯ Optimal PI-LL value may be achieved between 10° and 20° in Chinese patients with ADS after long posterior instrumentation and fusion surgery with excellent clinical outcomes and a lower PJK occurrence.
-
Osteoporosis adversely affects disc degeneration cascades, and prophylactic alendronate (ALN) helps delay intervertebral disc degeneration (IDD) in ovariectomized (OVX) rats. However, there remains no information regarding whether ALN affects IDD with bone loss. ⋯ ALN has favorable effects on disc degeneration with bone loss and helps to alleviate IDD while enhancing the biological and mechanical properties of vertebrae and end plates.
-
General questionnaires are often used to assess quality of life in patients with spine metastases, although a disease-specific survey did not exist until recently. The Spine Oncology Study Group has developed an outcomes questionnaire (SOSG-OQ) to measure quality of life in these patients. However, a scoring system was not developed, and the questionnaire was not validated in a group of patients, nor was it compared with other general quality of life questionnaires such as the EuroQol 5 Dimensions (EQ-5D) questionnaire. ⋯ In conclusion, our study proposes a scoring methodology-after reversing four inversely scored items-for the SOSG-OQ and shows that the questionnaire is a valid tool for the assessment of quality of life in patients with metastatic spine disease. The SOSG-OQ is superior to the EQ-5D in terms of coverage and internal consistency but consists of more questions.
-
Cement-augmented pedicle screw instrumentation (CAPSI) of the thoracolumbar spine is indicated in osteoporosis or osteopenia to improve pullout strength and biomechanical stability of pedicle screws (PS). Only a few studies report on the incidence of pulmonary cement embolism or other complications associated with CAPSI. ⋯ CAPSI bears a high risk of asymptomatic cement leakage. The risk for associated severe complications was also relatively high and probably underestimated considering the retrospective nature of the present study. A strict indication for cement augmentation, especially in patients with cardiac predisposition, should be the consequence. We doubt that technical aspects of cement application and/or different types of cement are capable of reducing the risk of these complications substantially.