Surgical Realignment After Anterior Multilevel Decompression Using Cages and Plate for 3-level to 5-level Degenerative Fusions: Lessons Learned From the Analysis of Geometric Changes, Reciprocal Coupling, and Prediction of Sagittal Cervical Balance.

Study Design: Retrospective, single-center case study.

Objective: Postoperative cervical imbalance with cervical sagittal vertical axis (cSVA) >4 cm can be predicted in 3-level to 5-level anterior-only cervical multilevel fusion surgery (ACMS).

Summary Of Background Data: Previous studies established correlations between cervical kyphosis (CK) correction and postoperative balance (cSVA ≤4 cm) with improved clinical outcomes.

Surgical outcomes with anatomic reduction of high-grade spondylolisthesis revisited: an analysis of 101 patients.

Objective: The ideal strategy for high-grade L5-S1 isthmic spondylolisthesis (HGS) remains controversial. Critical questions include the impact of reduction on clinical outcomes, rate of pseudarthrosis, and postoperative foot drop. The scope of this study was to delineate predictors of radiographic and clinical outcome factors after surgery for HGS and to identify risk factors of foot drop.

Temporary treatment with magnetically controlled growing rod for surgical correction of severe adolescent idiopathic thoracic scoliosis greater than 100°.

Introduction: Correction of severe idiopathic scoliosis poses surgical challenges. Treatment options entail anterior and/or posterior release, Halo-gravity traction (HGT) and three-column osteotomies (3CO). The authors report results with a novel technique of temporary short-term magnetically controlled growing rod (MCGR) as part of a posterior-only strategy to treat severe idiopathic major thoracic curves (MTC).

Diagnostic accuracy of CT scan-based criteria compared with surgical exploration for the analysis of cervical fusion and nonunion.

Objective: Computed tomography (CT) scans are accepted as the imaging standard of reference to define union after anterior cervical discectomy and fusion (ACDF). However, ideal CT criteria to diagnose union have not been identified or validated. The objective of this study was to analyze the diagnostic value of 9 CT-based criteria and identify the ideal criteria among them to assess cervical fusion after ACDF using surgical exploration as the standard of reference.

Morphological differences in adolescent idiopathic scoliosis: a histological and ultrastructural investigation.

Study Design: Histological and ultrastructural evaluation of cell morphologies at the concave and convex side of apical intervertebral discs (IVD) of adolescent idiopathic scoliosis (AIS).

Objective: To determine changes in cell morphology, viability, and cell death after asymmetric disc loading in AIS and to compare the findings with the tilt angles.

Summary Of Background Data: The reaction of cells to loading stimuli in the IVD seems to be specific.

The impact of halo-gravity traction on curve rigidity and pulmonary function in the treatment of severe and rigid scoliosis and kyphoscoliosis: a clinical study and narrative review of the literature.

Introduction: The treatment of rigid and severe scoliosis and kyphoscoliosis is a surgical challenge. Presurgical halo-gravity traction (HGT) achieves an increase in curve flexibility, a reduction in neurologic risks through gradual traction on a chronically tethered cord and an improvement in preoperative pulmonary function. However, little is known with respect to the ideal indications for HGT, its appropriate duration, or its efficacy in the treatment of rigid deformities.

The morbidity of open transthoracic approach for anterior scoliosis correction.

Study Design: Retrospective study.

Objective: To analyze the patient satisfaction and the patients' perceived approach-related morbidity (ArM) after open thoracotomy (OTC) for instrumented anterior scoliosis surgery.

Summary Of Background Data: There is no mid- to long-term data on the patients' perceived ArM concerning chest wall dissection for open anterior scoliosis correction.

The impact of cervical pedicle screws for primary stability in multilevel posterior cervical stabilizations.

Study Design: A total of 12 human cervical spines were tested in vitro in a biomechanical nondestructive set-up to compare the primary stability of different posterior cervical instrumentations after a bilevel corpectomy.

Objective: To evaluate the primary 3-dimensional stability with special focus on the impact of cervical pedicle screws.

Summary Of Background Data: Cervical pedicle screw fixation gains popularity due to supposed higher stability.

Spinal surgery in patients with Parkinson's disease: experiences with the challenges posed by sagittal imbalance and the Parkinson's spine.

Only a few reports exist concerning biomechanical challenges spine surgeons face when treating Parkinson's disease (PD) patients with spinal deformity. We recognized patients suffering from spinal deformity aggravated by the burden of PD to stress the principles of sagittal balance in surgical treatment. Treatment of sagittal imbalance in PD is difficult due to brittle bone and (the neuromuscular disorder) with postural dysfunction.

In vivo analysis of atlantoaxial motion in individuals immobilized with the halo thoracic vest or Philadelphia collar.

Study Design: In vivo biomechanical comparison of the halo thoracic vest (HTV) and the Philadelphia collar (PC).

Objective: To delineate the capacity of both orthoses for immobilization of the atlantoaxial complex (AAC), e.g.

4- and 5-level anterior fusions of the cervical spine: review of literature and clinical results.

In the future, there will be an increased number of cervical revision surgeries, including 4- and more-levels. But, there is a paucity of literature concerning the geometrical and clinical outcome in these challenging reconstructions. To contribute to current knowledge, we want to share our experience with 4- and 5-level anterior cervical fusions in 26 cases in sight of a critical review of literature.