The Natural Course of Compensatory Lumbar Curves in Nonoperated Patients With Thoracic Adolescent Idiopathic Scoliosis.

Study Design: A retrospective, long-term follow-up study.

Objective: We investigated the natural course of compensatory lumbar curves in patients with primary thoracic adolescent idiopathic scoliosis (AIS).

Summary Of Background Data: The natural course of compensatory lumbar curves in primary thoracic AIS remains unknown.

Lumbar lordosis does not correlate with pelvic incidence in the cases with the lordosis apex located at L3 or above.

Purpose: To test the hypothesis that the relationship between PI and L1-S1 lumbar lordosis (LL) is always positive, even in cases with different lumbar sagittal profiles.

Methods: Standing whole-spine sagittal alignment was measured with EOS system in 100 healthy adults (46 men, 54 women, mean age 40.9 years).

Biomechanical Analysis of a Long-Segment Fusion in a Lumbar Spine-A Finite Element Model Study.

Examine the biomechanical effect of material properties, geometric variables, and anchoring arrangements in a segmental pedicle screw with connecting rods spanning the entire lumbar spine using finite element models (FEMs). The objectives of this study are (1) to understand how different variables associated with posterior instrumentation affect the lumbar spine kinematics and stresses in instrumentation, (2) to compare the multidirectional stability of the spinal instrumentation, and (3) to determine how these variables contribute to the rigidity of the long-segment fusion in a lumbar spine. A lumbar spine FEM was used to analyze the biomechanical effects of different materials used for spinal rods (TNTZ or Ti or CoCr), varying diameters of the screws and rods (5 mm and 6 mm), and different fixation techniques (multilevel or intermittent).

Sagittal balance measures are more reproducible when measured in 3D vs in 2D using full-body EOS® images.

Purpose: An innovative low-dose X-ray biplanar imager (EOS®) allows measurement of the whole-body in standing-position which is necessary for the evaluation of spinal deformities.

Methods: A total of 60 asymptomatic subjects (ages 20-81 years) were evaluated using the 3D workflow called postural assessment and 2D measures. Subjects were measured twice each by two new observers following training, including: lordosis/kyphosis, pelvic parameters, sagittal-vertical axis, and spinal-sacral angle.

The best cited articles of the European Journal of Orthopaedic Surgery and Traumatology (EJOST): a bibliometric analysis.

European Journal of Orthopaedic Surgery and Traumatology (EJOST) was founded in 1991. It was initially named as Orthopédie-Traumatologie, and since then it is dedicated in sharing knowledge and new evidence in the field of orthopaedics. Within 28 volumes and 157 issues, it has published 3218 scientific articles.

Radiographic Outcomes of Upper Cervical Fusion for Pediatric Patients Younger Than 10 Years.

Purpose: This study aimed to investigate radiographic outcomes after posterior spinal fusion (PSF) for pediatric patients younger than 10 years with upper cervical disorders.

Methods: Thirteen patients (mean age at surgery, 5.9 years; range, 1 to 9 years) who underwent PSF with a minimum of 2 years of follow-up (mean, 5.

The Clinical Features, Risk Factors, and Surgical Treatment of Cervicogenic Headache in Patients With Cervical Spine Disorders Requiring Surgery.

Objective: To clarify the clinical features and risk factors of cervicogenic headache (CEH; as diagnosed according to the International Classification of Headache Disorders-Third Edition beta) in patients with cervical spine disorders requiring surgery.

Background: CEH is caused by cervical spine disorders. The pathogenic mechanism of CEH is hypothesized to involve a convergence of the upper cervical afferents from the C1, C2, and C3 spinal nerves and the trigeminal afferents in the trigeminocervical nucleus of the upper cervical cord.

Surgical Outcomes of Posterior Spinal Fusion Alone Using Cervical Pedicle Screw Constructs for Cervical Disorders Associated With Athetoid Cerebral Palsy.

Study Design: Retrospective case series.

Objective: The aim of this study was to investigate clinical outcomes after posterior spinal fusion (PSF) using cervical pedicle screw (CPS) constructs for cervical disorders associated with athetoid cerebral palsy (CP).

Summary Of Background Data: Traditionally, most patients with cervical myelopathy associated with CP have required combined anterior and posterior fusion to achieve solid stability against severe involuntary movement.

National Trends and In-Hospital Outcomes of Patients With Solid Organ Transplant Undergoing Spinal Fusion.

Study Design: A retrospective analysis of population-based national hospital discharge data collected for the Nationwide Inpatient Sample.

Objective: To examine the demographics and in-hospital outcomes of patients with solid organ transplant (SOT) undergoing spinal fusion on a national level.

Summary Of Background Data: Solid organ transplantation has become more common in recent years and some of these patients undergo spinal fusion surgery.

How Did the Pelvis and Vertebral Column Become a Functional Unit during the Transition from Occasional to Permanent Bipedalism?

The functional linkage between pelvis and spine remained long hidden to science. Here, we recount the history of research that led in 1992 to the discovery of the "angle of sacral incidence" by the team of G. Duval-Beaupère.

Standing sagittal alignment of the whole axial skeleton with reference to the gravity line in humans.

Human beings stand upright with the chain of balance beginning at the feet, progressing to the lower limbs (ankles, knees, hip joints, pelvis), each of the spinal segments, and then ending at the cranium to achieve horizontal gaze and balance using minimum muscle activity. The details of the alignment and balance of the chain, however, are not clearly understood, due to the lack of information regarding the three-dimensional (3D) orientation of all bony elements in relation to the gravity line (GL). We performed a clinical study to clarify the standing sagittal alignment of whole axial skeletons in reference to the GL using the EOS slot-scanning 3D X-ray imaging system with simultaneous force plate measurement in a healthy human population.

A Japanese nationwide multicenter survey on perioperative complications of corrective fusion for elderly patients with adult spinal deformity.

Background: Recently, corrective fusion surgery for patients with adult spinal deformity (ASD) has become common in Japan. This study aimed to clarify the status of surgeries for ASD in Japan, focusing on perioperative complications. A nationwide multicenter survey gathering information on surgically treated ASD patients was conducted by the committee for Adult Spinal Deformity of the Japanese Scoliosis Society.

Normative values of spino-pelvic sagittal alignment, balance, age, and health-related quality of life in a cohort of healthy adult subjects.

Purpose: To elucidate the normative values of whole body sagittal alignment and balance of a healthy population in the standing position; and to clarify the relationship among the alignment, balance, health-related quality of life (HRQOL), and age.

Methods: Healthy Japanese adult volunteers [n = 126, mean age 39.4 years (20-69), M/F = 30/96] with no history of spinal disease were enrolled in a cross-sectional cohort study.

Normative values for the spine shape parameters using 3D standing analysis from a database of 268 asymptomatic Caucasian and Japanese subjects.

Purpose: Sagittal balance analysis has gained importance and the measure of the radiographic spinopelvic parameters is now a routine part of many interventions of spine surgery. Indeed, surgical correction of lumbar lordosis must be proportional to the pelvic incidence (PI). The compensatory mechanisms [pelvic retroversion with increased pelvic tilt (PT) and decreased thoracic kyphosis] spontaneously reverse after successful surgery.

Lumbar degenerative spondylolisthesis is not always unstable: clinicobiomechanical evidence.

Study Design: A clinicobiomechanical study.

Objective: To clarify the clinicobiomechanical characteristics of a segment with lumbar degenerative spondylolisthesis (LDS) using an original intraoperative measurement system.

Summary Of Background Data: Although radiographical evaluation of LDS is extensively performed, the diagnosis of segmental instability remains controversial.

Can recumbent magnetic resonance imaging replace myelography or computed tomography myelography for detecting lumbar spinal stenosis?

Objective: To compare the diagnostic efficacy of recumbent magnetic resonance imaging (MRI), computed tomography myelography (CTM), and myelography, with regard to indications for surgery for lumbar stenosis.

Background Data: In patients with lumbar spinal stenosis-like disorders, small compressions are sometimes observed in magnetic resonance images acquired in the recumbent position, leading to potential misdiagnosis. Few prospective studies have compared the diagnostic accuracy of MRI, myelography, and CTM.

Biomechanical evaluation of destabilization following minimally invasive decompression for lumbar spinal canal stenosis.

Object: This study aimed to clarify changes in segmental instability following a unilateral approach for microendoscopic posterior decompression and muscle-preserving interlaminar decompression compared with traditional procedures and destabilized models.

Methods: An ex vivo experiment was performed using 30 fresh frozen porcine functional spinal units (FSUs). Each intact specimen was initially tested for flexion-extension, lateral bending, and torsion up to 1.

Facet joint opening in lumbar degenerative diseases indicating segmental instability.

Object: The objective of this study was, using a novel intraoperative measurement (IOM) system, to test the hypothesis that an increased facet joint volume is evidence of spinal instability.

Methods: In 29 patients (male/female ratio 13:16; mean age 67.5 years, range 43-80 years)-17 with degenerative spondylolisthesis (DS) of the lumbar spine (Group DS) and 12 with canal stenosis (CS) of the lumbar spine (Group CS)-DICOM (Digital Imaging and Communications in Medicine) data derived from CT scans were transferred to a workstation.

Biomechanical evaluation of segmental instability in degenerative lumbar spondylolisthesis.

Here we investigated the biomechanical properties of spinal segments in patients with degenerative lumbar spondylolisthesis (DLS) using a novel intraoperative measurement system. The measurement system comprised spinous process holders, a motion generator, a load cell, an optical displacement transducer, and a computer. Cyclic displacement of the holders produced flexion-extension of the segment with all ligamentous structures intact.

Indications for cervical pedicle screw instrumentation in nontraumatic lesions.

Study Design: Retrospective clinical study.

Objective: To evaluate clinical results of patients with nontraumatic cervical lesions treated by cervical pedicle screw (PS) fixation and to discuss the surgical indications.

Summary Of Background Data: PS fixation provides an outstanding stability for cervical lesions with instability.

Evaluation of lumbar segmental instability in degenerative diseases by using a new intraoperative measurement system.

Object: In vivo quantitative measurement of lumbar segmental stability has not been established. The authors developed a new measurement system to determine intraoperative lumbar stability. The objective of this study was to clarify the biomechanical properties of degenerative lumbar segments by using the new method.

Upper extremity palsy following cervical decompression surgery results from a transient spinal cord lesion.

Study Design: Retrospective analysis.

Objective: To test the hypothesis that spinal cord lesions cause postoperative upper extremity palsy.

Summary Of Background Data: Postoperative paresis, so-called C5 palsy, of the upper extremities is a common complication of cervical surgery.

Margin-free spondylectomy for extended malignant spine tumors: surgical technique and outcome of 13 cases.

Study Design: Description of surgical technique and retrospective review of 13 cases.

Objectives: To describe the surgical technique of margin-free spondylectomy and the outcome of 13 cases and to discuss the advantages and limitations of the procedure.

Summary Of Background Data: Recently, spondylectomy became a standard procedure by several pioneers.