The Variability of the Cervicothoracic Inflection Point: A Cohort Analysis of the Multi-Ethnic Asymptomatic Normative Study (MEANS).

Study Design: Cross-sectional Cohort Study.

Objective: To determine the cervicothoracic inflection point in an asymptomatic, adult population.

Introduction: The cervicothoracic inflection point (CTIP) is an important sagittal marker to understand for patients with cervical deformities.

Rethinking Porosity-Based Diffusivity Estimates for Sorptive Gas Transport at Variable Temperatures.

The detection of noble gas radioisotopes following a suspected underground nuclear explosion is the surest indicator that nuclear detonation has occurred. However, the accurate interpretation and attribution of radioisotopic signatures is only possible with a complete understanding of transport processes occurring between the nuclear cavity and surface. In the far-field, diffusive forces contributing to gas transport are impacted by temperature gradients and subsurface lithology.

Characteristics of Spinal Morphology According to the "Current" and "Theoretical" Roussouly Classification Systems in a Diverse, Asymptomatic Cohort: Multi-Ethnic Alignment Normative Study (MEANS).

Study Design: Cross-sectional cohort study.

Objective: To classify spinal morphology using the "current" and "theoretical" Roussouly systems and assess sagittal alignment in an asymptomatic cohort.

Methods: 467 asymptomatic volunteers were recruited from 5 countries.

The Importance of Pelvic Obliquity in Assessing Spinal Coronal Alignment: Normative Values, Demographic, and Radiographic Correlations.

Study Design: Prospective, cross-sectional study.

Objective: In a geographically diverse population of asymptomatic volunteers, we sought to report the incidence of pelvic obliquity (PO), establish normative values of PO across patient factors, and assess the correlation of PO with radiographic parameters.

Summary Of Background Data: PO is defined as the misalignment of the pelvis and can be assessed through several anatomic landmarks.

The Posterior Cranial Vertical Line: A Novel Radiographic Marker for Classifying Global Sagittal Alignment.

Objective: To define a novel radiographic measurement, the posterior cranial vertical line (PCVL), in an asymptomatic adult population to better understand global sagittal alignment.

Methods: We performed a multicenter retrospective review of prospectively collected radiographic data on asymptomatic volunteers aged 20-79. The PCVL is a vertical plumb line drawn from the posterior-most aspect of the occiput.

Adult spinal deformity correction surgery using age-adjusted alignment thresholds: clinical outcomes and mechanical complication rates. A systematic review of the literature.

Purpose: Adult spinal deformity (ASD) surgery gives good clinical outcomes but has a high rate of mechanical complications (MC). In 2016, Lafage described the age-adjusted alignment thresholds (AAAT) to adapt the correction in relation to patient's age proposing less aggressive corrections for the elderly population. The aim of this review was to clarify the effectiveness of AAAT to achieve good health-related quality of life (HRQoL) and their relationship with post-operative MC.

The Thoracolumbar Inflection Point in a Population of Asymptomatic Volunteers: A Multi-Ethnic Alignment Normative Study Cohort Study.

Study Design: Prospective cohort study.

Objectives: To show population variance in the Inflection Point (IP) and its role in defining maximum Thoracic Kyphosis (TK) and Lumbar Lordosis (LL).

Methods: 468 asymptomatic adult volunteers were included in the Multi-Ethnic Normative Alignment Study (MEANS).

A novel device with pedicular anchorage provides better biomechanical properties than balloon kyphoplasty for the treatment of vertebral compression fractures.

Purpose: To compare the biomechanical behavior of vertebrae with vertebral compression fractures (VCF) treated by a novel system with pedicular anchorage (dowelplasty) versus balloon kyphoplasty.

Methods: Four cadaveric spines (T12-L5) were harvested, cleaned from soft tissues, and separated into vertebrae. Axial compressive loads were applied to each vertebra until a VCF was generated.

Morphological description of sagittal lumbar spinal alignment using curve magnitude, span, and apex-the multiethnic alignment normative study (MEANS).

Background Context: Current definition of lumbar lordosis uses the L1-S1 angle. Prevailing classification of sagittal spinal morphology, derived from a young adult population, classifies the spine into four subtypes defined by their sacral slope (SS) and curve morphology.

Purpose: To describe physiological sagittal alignment of the lumbar spine across age groups using three main parameters that dictate the lumbar curve: angular magnitude, span, and apex.

Sagittal spinal alignment varies with an individual's race: results of the multi-ethnic alignment normative study (MEANS).

Purpose: Assess normative values of sagittal spinal and lower extremity alignment in asymptomatic volunteers of three difference races.

Methods: Asymptomatic volunteers between the ages of 18-80 years were enrolled prospectively and then analyzed retrospectively from six different centers. Volunteers included reported no significant neck or back pain, nor any known spinal disorder(s).

Cervical Inclination Angle: Normative Values in an Adult Multiethnic Asymptomatic Population.

Objective: The role of the craniocervical complex in spinal sagittal alignment has rarely been analyzed but it may play a fundamental role in postoperative mechanical complications. The aim of the study is to analyze the normative value of the cervical inclination angle (CIA) in an adult asymptomatic multiethnic population.

Methods: Standing full-spine EOS of adult asymptomatic volunteers from 5 different countries were analyzed.

High dispersal rates in hybrids drive expansion of maladaptive hybridization.

Hybridization between native and invasive species, a major cause of biodiversity loss, can spread rapidly even when hybrids have reduced fitness. This paradox suggests that hybrids have greater dispersal rates than non-hybridized individuals, yet this mechanism has not been empirically tested in animal populations. Here, we test if non-native genetic introgression increases reproductive dispersal using a human-mediated hybrid zone between native cutthroat trout (<i>Oncorhynchus clarkii</i>) and invasive rainbow trout (<i>Oncorhynchus mykiss</i>) in a large and connected river system.

Can Lumbopelvic Parameters Be Used to Predict Thoracic Kyphosis at all Ages? A National Cross-Sectional Study.

Study Design: National cross-sectional study.

Objective: Thoracic kyphosis (TK) is related to sagittal parameters as pelvic tilt (PT), lumbar lordosis (LL) and pelvic incidence (PI). The equation TK = 2 (PT+LL-PI) was validated for adolescents.

Team management in complex posterior spinal surgery allows blood loss limitation.

Purpose: The objective is to analyse peri-operative blood loss (BL) and hidden blood loss (HBL) rates in spinal deformity complex cases surgery, with a focus on the strategies to prevent major bleeding.

Methods: We retrospectively analysed surgical and anaesthesiologic data of patients who had been operated for adolescent idiopathic scoliosis (AIS) or adult spinal deformities (ASD) with a minimum of five levels fused. A statistical comparison among AIS, ASD without a pedicle subtraction osteotomy (PSO) (ASD-PSO( -)) and ASD with PSO (ASD-PSO( +)) procedures was performed with a view to identifying patient- and/or surgical-related factors affecting peri-operative BL and HBL.

GAP score potential in predicting post-operative spinal mechanical complications: a systematic review of the literature.

Purpose: In 2017, the GAP score was proposed as a tool to reduce mechanical complications (MC) in adult spinal deformity (ASD) surgery: the reported MC rate for the GAP proportioned category was only 6%, which is clearly lower to the MC rate reported in the literature. The aim of this study is to analyse if the most recent literature confirms the promising results of the original article.

Materials And Methods: Using the PRISMA flow chart, we reviewed the literature to analyse GAP score capacity in predicting MC occurrence.

Computed Tomography Intraoperative Navigation in Spinal Surgery: Assessment of Patient Radiation Exposure in Current Practices.

Background: Patient radiation exposure associated with the use of computed tomography (CT) navigation during spinal surgeries was widely compared with other intraoperative imaging techniques. The aim of this study is to explore the use of navigation with regard to current spinal surgery practices and the technical limitations of such imaging systems.

Methods: Dosimetric data from 101 patients who underwent intraoperative, CT-navigated spine surgery were retrospectively collected.

Age- and Gender-based Global Sagittal Spinal Alignment in Asymptomatic Adult Volunteers: Results of the Multiethnic Alignment Normative Study (MEANS).

Study Design: Multicenter Cohort.

Objective: Assess normative values of sagittal spinal and lower extremity alignment in asymptomatic volunteers stratified by age and gender.

Summary Of Background Data: Our understanding of ideal sagittal alignment is still evolving.

Age and Gender Based Spinopelvic and Regional Spinal Alignment in Asymptomatic Adult Volunteers: Results of the Multi-Ethnic Alignment Normative Study (MEANS).

Background: Spinal alignment can have a significant impact on a patient's overall quality of life. Predicting the ideal sagittal spinal alignment of a specific individual is still a difficult task. The Multi-Ethnic Alignment Normative Study (MEANS) investigated skeletal alignment, including the spine and lower extremities, of the largest multi-ethnic cohort of asymptomatic adult volunteers.

Original Surgical Treatment and Long-term Follow-up for Chronic Inflammatory Demyelinating Polyradiculoneuropathy Causing a Compressive Cervical Myelopathy: Review of the Literature.

Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) is a chronic relapsing disease of unknown aetiology. The diagnosis of this disease is still very complicated. The treatment is medical but, in some cases, a surgical decompression might be required.