Computed tomography analysis of sacropelvic parameters in relation to anterior access to the lumbosacral disc.

Anecdotally a higher pelvic incidence (PI) confers a 'deeper' pelvis with the potential for challenging access, yet this is ill-defined in the existing literature. The aim of this study was to assess the relationship of sacropelvic sagittal parameters and their relationship with the projection angle (PA), an indicator of access to and orientation of the lumbosacral disc with respect to the pelvis and identify a threshold PI value beyond which more difficult surgical access may be anticipated. Computed tomography (CT) scans taken for trauma were studied.

Pelvic Incidence: Computed Tomography Study Evaluating Correlation with Sagittal Sacropelvic Parameters.

Normal values for spinal alignment are often based on the pelvic incidence (PI), defined as the angle subtended by a line from the bicoxofemoral axis to the midpoint of the sacral endplate and a line perpendicular to the midpoint. Despite widespread use, determinants of its values remain obscure. The aim of this study was to determine correlation of sacropelvic parameters with the PI on computed tomography (CT).

Do position and size matter? An analysis of cage and placement variables for optimum lordosis in PLIF reconstruction.

Purpose: To examine monosegmental lordosis after posterior lumbar interbody fusion (PLIF) surgery and relate lordosis to cage size, shape, and placement.

Methods: Eighty-three consecutive patients underwent single-level PLIF with paired identical lordotic cages involving a wide decompression and bilateral facetectomies. Cage parameters relating to size (height, lordosis, and length) and placement (expressed as a ratio relative to the length of the inferior vertebral endplate) were recorded.

Universal No-fault Compensation is Associated With Improved Return to Work Rates in Spine Fusion.

Study Design: Retrospective cohort study and systematic literature review.

Objective: To examine the influence of "universal no-fault compensation" upon return-to-work rates in patients undergoing lumbar spinal fusion, and then to make comparison with workers' compensation (WC) and non-workers' compensation (non-WC) claimants.

Summary Of Background Data: Compensation has an adverse influence upon outcomes and return to work in lumbar spinal fusion.

2009 ISSLS Prize Winner: Does discography cause accelerated progression of degeneration changes in the lumbar disc: a ten-year matched cohort study.

Study Design: Prospective, match-cohort study of disc degeneration progression over 10 years with and without baseline discography. Objectives. To compare progression of common degenerative findings between lumbar discs injected 10 years earlier with those same disc levels in matched subjects not exposed to discography.

Anatomic determination of optimal entry point and direction for C1 lateral mass screw placement.

Study Design: Anatomic study of C1 osteology using computerized tomography.

Objectives: To define the anatomy of the C1 lateral mass and make recommendations for optimal entry point and screw placement at C1.

Summary Of Background Data: C1 lateral mass screw fixation is a reliable biomechanical technique that gives equivalent stability to that of Magerl transarticular screw fixation combined with posterior wiring for C1-C2 fusion.

Is the self-reported history accurate in patients with persistent axial pain after a motor vehicle accident?

Background Context: A patient's self-reported history has, in general, assumed to be accurate. Clinical management of individuals with persistent axial pain after a motor vehicle accident (MVA) and measures to prevent future MVA, spinal cord injury, and traffic deaths often depend on a presumed accurate report of preexisting axial pain, drug, alcohol, and psychological problems to initiate intervention. In addition, research efforts to determine the effects of MVA on subsequent health are often predicated on a presumed accurate history from the patient of past medical and psychosocial problems.

Selection of fusion levels in adolescent idiopathic scoliosis using fulcrum bending prediction: a prospective study.

Study Design: A prospective study of 50 consecutive patients undergoing selective thoracic fusion for idiopathic scoliosis with minimum 2 year follow-up.

Objective: We aim to establish the validity and safety of a new strategy using fulcrum bending (FB) radiographs and the inherent flexibility of the curve to select fusion levels for King type 2 and 3 curves (Lenke 1a, 1b, and 1c). The purpose of this new strategy is to preserve motion segments compared to the traditional method of selecting fusion levels.

Facet joint orientation in spondylolysis and isthmic spondylolisthesis.

Study Design: The orientation of facet joints (FJs) in a normal population and isthmic spondylolisthesis (IS) population was assessed using magnetic resonance imaging in the lumbar spine.

Objective: To document the difference in FJ orientation (FJO) between a normal population and a population with spondylolysis of L5 and IS. SUMMARY OF BACKGROUND [corrected]

Data: Spondylolysis and IS have both a familial and mechanical etiology, yet the phenotypic expression of the familial etiology is unknown except for the observation of spinal bifida occulta.

A brief overview of evidence-informed management of chronic low back pain with surgery.

The management of chronic low back pain (CLBP) has proven to be very challenging in North America, as evidenced by its mounting socioeconomic burden. Choosing among available nonsurgical therapies can be overwhelming for many stakeholders, including patients, health providers, policy makers, and third-party payers. Although all parties share a common goal and wish to use limited health-care resources to support interventions most likely to result in clinically meaningful improvements, there is often uncertainty about the most appropriate intervention for a particular patient.

Painful lumbosacral melorheostosis treated by fusion.

Study Design: A case report of low back pain associated with a diagnosis of melorheostosis of the lumbosacral spine.

Objective: To describe a rare presentation of melorheostosis and subsequent successful surgical treatment.

Summary Of Background Data: Melorheostosis is a rare condition and spinal pain has not been described in association with the condition.