- Pelvic mobility before and after total hip arthroplasty. [Journal Article]Int Orthop. 2020 Jul 04 [Online ahead of print]IO
- CONCLUSIONS: The pre-operative and post-operative pelvic mobility is not equal and ranges widely among patients. In addition to assessment of pre-operative pelvic mobility, other pre-operative spinopelvic factors may also influence post-operative pelvic mobility, such as the SS while standing and sitting, the condition of the contralateral hip and the presence of scoliosis. Risk assessment for dislocation using these pre-operative factors may be useful before THA.
- Three-level lumbar Ponte osteotomies with less invasive pelvic fixation improve spinal balance, quality of life and decrease disability in adult and elderly women with moderate adult spinal deformity. [Journal Article]Eur Spine J. 2020 Jul 03 [Online ahead of print]ES
- CONCLUSIONS: Three-segment lumbar POs offered and maintained sufficient improvement of lumbar lordosis along with restoration of the sagittal and coronal spinal alignment, improvement of quality of life and disability of female adult and elderly population after primary and revision surgery for ASD.
- Estimation of the ideal correction of lumbar lordosis to prevent reoperation for symptomatic adjacent segment disease after lumbar fusion in older people. [Journal Article]BMC Musculoskelet Disord. 2020 Jul 03; 21(1):429.BM
- CONCLUSIONS: The significant predictors of the occurrence of ASDis were a smaller LL angle, △LL > 12°, and PI-LL > 10°. However, in patients older than 60 years, the incidence of ASDis after lumbar fusion was higher in those with a LL correction of ≥10° and PI-LL of > 20°. More attention should be paid to patient age and the angle of correction of LL before lumbar fusion.
- Is intrinsic lumbar spine shape associated with lumbar disc degeneration? An exploratory study. [Journal Article]BMC Musculoskelet Disord. 2020 Jul 03; 21(1):433.BM
- CONCLUSIONS: This exploratory study provides new evidence that intrinsic shape phenotypes are associated with LDD and quality of life in patients. Longitudinal studies are required to establish the potential role of these risk or prognostic shape phenotypes.
- Lack of interaction between prenatal stress and prenatal letrozole to induce same-sex preference in male rats. [Journal Article]Physiol Behav. 2020 Jun 30 [Online ahead of print]PB
- Same-sex partner preference between males has been observed in all species in which this behavior has been studied. Disruption of brain estradiol synthesis during development has been proposed as one of the biological causes underlying this behavior in some mammals. In support of this possibility, perinatal administration of aromatase inhibitors (such as letrozole) to male rat pups, induces aroun…
Same-sex partner preference between males has been observed in all species in which this behavior has been studied. Disruption of brain estradiol synthesis during development has been proposed as one of the biological causes underlying this behavior in some mammals. In support of this possibility, perinatal administration of aromatase inhibitors (such as letrozole) to male rat pups, induces around half of them to have same-sex preference and female sexual behavior in adulthood. Another putative factor that modifies sex preference is prenatal stress. Several stress protocols, applied to the pregnant dam, cause some of the adult male progeny to have an increased male preference, a decreased preference for the female, and lordosis behavior. Interestingly, these effects of stress might be mediated by its inhibitory action on brain aromatase. The aim of the present study was to analyze a possible interaction between these two factors in male rats. Pregnant dams were exposed to one of the four treatments across gestation days 10-22 (G10-G22): 1) vehicle-treated non-stressed controls; 2) letrozole (0.56µg/kg); 3) 30 min immobilization stress); 4) both letrozole and stress combined. The male offspring were tested in adulthood for partner preference in a three-chambered arena, where we also recorded the masculine and feminine sexual behaviors. One week later males were tested for masculine and feminine sexual behavior in cylindrical arenas where they interacted for 30 min with a receptive female and thereafter with a sexually active male for another 30 min. Letrozole, stress and their combination resulted in same-sex preference in 40, 31 and 50 % of males, respectively, compared to 5% in the control group. In the sexual behavior tests, prenatal stress reduced the percentage of males displaying intromissions and ejaculation (impaired masculinization), while letrozole mainly increased lordosis (impaired defeminization). The males prenatally submitted to stress and treated with letrozole presented these behavioral features but did not differ from both treatments given independently. The results indicate that the changes induced by stress or the aromatase inhibition produced by letrozole only accounts for a shift in partner preference in around half of the males and that there was no interaction between these two factors.
- Adult spinal deformity and its relationship with height loss: a 34-year longitudinal cohort study. [Journal Article]BMC Musculoskelet Disord. 2020 Jul 01; 21(1):422.BM
- CONCLUSIONS: This longitudinal study revealed that height loss is more commonly observed in women and is associated with adult spinal deformity and degenerative lumbar scoliosis. Height loss is a normal physical change with aging, but excessive height loss is due to spinal kyphosis and scoliosis leading to spinal malalignment. Our findings suggest that height loss might be an early physical symptom for spinal malalignment.
- Analysis of the Factors Affecting Lumbar Segmental Lordosis After Lateral Lumbar Interbody Fusion. [Journal Article]Spine (Phila Pa 1976). 2020 Jul 15; 45(14):E839-E846.S
- CONCLUSIONS: To gain maximum segmental lordosis in LLIF, the cage should be located anteriorly. Furthermore, if the cage can be located anteriorly, a thicker cage with proper angle cage will gain segmental lordosis. If the cage is located posteriorly, a thin cage should be selected.
- The effect of minimally invasive dorsal cervical decompression for myelopathy on spinal alignment and range of motion. [Journal Article]Clin Neurol Neurosurg. 2020 May 28; 196:105967.CN
- CONCLUSIONS: miDCD can maintain cervical range of motion and alignment better than traditional laminectomy or laminoplasty techniques.
- Two different types of postoperative sagittal imbalance after long instrumented fusion to the sacrum for degenerative sagittal imbalance. [Journal Article]J Neurosurg Spine. 2020 Jun 26 [Online ahead of print]JN
- CONCLUSIONS: Optimal correction of sagittal alignment should be considered in long instrumented fusion for DSI, because insufficient correction might cause one of 2 different types of postoperative sagittal imbalance at different sites of decompression. Dynamic sagittal imbalance compared with proximal kyphosis was significantly associated with less correction of sagittal alignment, in conjunction with more fusion levels and degeneration of the paravertebral muscles.
- Spinopelvic sagittal balance: what does the radiologist need to know? [Journal Article]Radiol Bras. 2020 May-Jun; 53(3):175-184.RB
- Sagittal balance describes the optimal alignment of the spine in the sagittal plane, resulting from the interaction between the spine and lower limbs, via the pelvis. Understanding sagittal balance has gained importance, especially in the last decade, because sagittal imbalance correlates directly with disability and pain. Diseases that alter that balance cause sagittal malalignment and may trigg…
Sagittal balance describes the optimal alignment of the spine in the sagittal plane, resulting from the interaction between the spine and lower limbs, via the pelvis. Understanding sagittal balance has gained importance, especially in the last decade, because sagittal imbalance correlates directly with disability and pain. Diseases that alter that balance cause sagittal malalignment and may trigger compensatory mechanisms. Certain radiographic parameters have been shown to be clinically relevant and to correlate with clinical scores in the evaluation of spinopelvic alignment. This article aims to provide a comprehensive review of the literature on the spinopelvic parameters that are most relevant in clinical practice, as well as to describe compensatory mechanisms of the pelvis and lower limbs.
- Comparison of anterior and posterior approaches for treatment of traumatic cervical dislocation combined with spinal cord injury: Minimum 10-year follow-up. [Journal Article]Sci Rep. 2020 Jun 25; 10(1):10346.SR
- Anterior reduction and interbody fusion fixation has not been compared directly with posterior reduction and short-segmental pedicle screw fixation for lower cervical dislocation, and so consensus is lacking as to which is the optimal method. The purpose of this paper is to compare long-term outcomes of the anterior versus posterior approach for traumatic cervical dislocation with spinal cord inj…
Anterior reduction and interbody fusion fixation has not been compared directly with posterior reduction and short-segmental pedicle screw fixation for lower cervical dislocation, and so consensus is lacking as to which is the optimal method. The purpose of this paper is to compare long-term outcomes of the anterior versus posterior approach for traumatic cervical dislocation with spinal cord injury. One hundred and fifty-nine patients could be followed for more than 10 years (follow-up rate 84.1%). Ninety-two patients underwent anterior reduction and interbody fusion and fixation, and 67 patients underwent posterior reduction and short-segmental pedicle screw fixation. Japanese Orthopaedic Association (JOA) scores, the Neck Disability Index (NDI), the American Spinal Injury Association grading (ASIA), Odom's criteria, cervical kyphosis, operative parameters, and surgical or post-operative complications were evaluated. Patients were followed for 10 to 17 years. There was no significant difference in main JOA scores, NDI scores or ASIA scores between the two groups at follow-up. The posterior approach was associated with greater loss of alignment by two years (P = 0.012) and at final follow-up (P < 0.001). The posterior approach group had more blood loss (P < 0.001), longer operation times (P < 0.001), longer hospital stays (P < 0.001) and fewer complications than the anterior approach group. The anterior approach is better than the posterior approach for preserving cervical lordosis, which is associated with a better long-term effect.
- Effectiveness of cervical zero profile integrated cage with and without supplemental posterior Interfacet stabilization. [Journal Article]Clin Biomech (Bristol, Avon). 2020 Jun 10; 78:105078.CB
- CONCLUSIONS: Anterior integrated cages provides less stability than traditional cage-plate constructs while supplemental interfacet cages improve stabilization. Integrated cages provide more lordosis at caudal levels and increase neuroforaminal height more at cranial levels. After interfacet cages, posterior disc height and neuroforaminal height increased more at the caudal segments.
- Effect of sagittal shape on proximal junctional kyphosis following thoracopelvic corrective fusion for adult spinal deformity: postoperative inflection vertebra cranial to T12 is a significant risk factor. [Journal Article]Spine Deform. 2020 Jun 23 [Online ahead of print]SD
- CONCLUSIONS: Geometrical spinal shape should be taken into account to reduce the rate of postoperative mechanical complications.
- Crossing the Cervicothoracic Junction During Posterior Cervical Fusion for Myelopathy Is Associated With Superior Radiographic Parameters But Similar Clinical Outcomes. [Journal Article]Neurosurgery. 2020 Jun 23 [Online ahead of print]N
- CONCLUSIONS: Subaxial LPSF for CSM that crossed the CTJ were associated with superior radiographic outcomes for cSVA, CL, and CL minus T1-slope, but longer operative times. There were no differences in neck pain or reoperation rate.
- The Prevalence of Abnormal Spinopelvic Relationships in Patients Presenting for Primary Total Hip Arthroplasty. [Journal Article]Arthroplast Today. 2020 Sep; 6(3):381-385.AT
- CONCLUSIONS: In a cohort of 228 patients presenting for primary THA, the prevalence of spinopelvic imbalance was 62.3%, the prevalence of decreased spinopelvic motion was 34.2%, and the prevalence of both spinopelvic imbalance and decreased spinopelvic motion was 22%. Hip surgeons are likely to encounter patients with abnormal spinopelvic relationships.
- Comparison of Clinical and Radiographic Outcomes of Laminoplasty, Anterior Decompression with Fusion, and Posterior Decompression with Fusion for Degenerative Cervical Myelopathy: A Prospective Multicenter Study. [Journal Article]Spine (Phila Pa 1976). 2020 Jun 18 [Online ahead of print]S
- CONCLUSIONS: Although groups showed no significant differences in clinical outcomes, cervical alignment worsened after surgery in the LAMP and PDF groups. Within the PDF group, lower CL was an independent risk factor for poor recovery. Therefore, the indications for PDF in DCM patients with preoperative kyphotic alignment should be carefully considered.
- [Meta-analysis of calcium chemotherapeutic effect of anterior cervical subtotal vertebroplasty and posterior laminoplasty]. [Journal Article]Zhongguo Gu Shang. 2020 Jun 25; 33(6):576-84.ZG
- CONCLUSIONS: The recovery of functionof ACCF group was better, but operation time, complications and reoperations of LAMP group were all better than ACCF group. There was no difference in postoperative lordosis and intraoperative blood loss between two groups. However, there are some limitations in this study. Therefore, higher quality and larger sample size clinical studies are needed to further verify.
- Comparison of surgical correction rates between titanium and cobalt-chrome-alloy as rod materials in adolescent idiopathic scoliosis. [Journal Article]Sci Rep. 2020 Jun 22; 10(1):10053.SR
- Numerous biomechanical studies comparing titanium (Ti) and cobalt-chrome-alloy (CCM) rods are described in the literature. However, there is a dearth of literature comparing the two rod materials in adolescent idiopathic scoliosis (AIS). Therefore, the purpose of this study is to compare the correction rates of Ti and CCM rods in the treatment of AIS with double major curves. We enrolled 45 patie…
Numerous biomechanical studies comparing titanium (Ti) and cobalt-chrome-alloy (CCM) rods are described in the literature. However, there is a dearth of literature comparing the two rod materials in adolescent idiopathic scoliosis (AIS). Therefore, the purpose of this study is to compare the correction rates of Ti and CCM rods in the treatment of AIS with double major curves. We enrolled 45 patients with AIS who underwent surgery between 2009 and 2012. We divided patients into two groups, Group A (n = 29) treated with six-millimeter Ti rods and Group B (n = 16) treated with six-millimeter CCM rods. The rod-derotation maneuver was used for correction. We measured pre- and postoperative indices of coronal alignment (Cobb's angle, coronal balance, T1-tilt, clavicle angle) and sagittal alignment (sagittal vertical axis, thoracic kyphosis, lumbar lordosis). In our study, there were no significant differences between the two groups with respect to demographics or curve characteristics (P > 0.05). In Group A, thoracic and lumbar curvature correction rates were 71.2% and 66.8% respectively, and in Group B they were 71.2% and 73.3%, respectively (P = 0.664 and 0.09). There were no significant differences between the two groups in coronal or sagittal factors (P > 0.05) except for greater postoperative lumbar lordosis in the CCM group (P < 0.001). In conclusion, Ti and CCM rods showed similar correction rates in the sagittal and coronal planes for the surgical correction of AIS with double major curves. Biomechanical studies of Ti and CCM rods in vitro is different in biological condition.
- G protein-coupled estrogen receptor immunoreactivity in the rat hypothalamus is widely distributed in neurons, astrocytes and oligodendrocytes, fluctuates during the estrous cycle and is sexually dimorphic. [Journal Article]Neuroendocrinology. 2020 Jun 22 [Online ahead of print]N
- Introduction The membrane-associated G protein-coupled estrogen receptor 1 (GPER) mediates the regulation by estradiol on arginine-vasopressin immunoreactivity in the supraoptic and paraventricular hypothalamic nuclei of female rats and is involved in the estrogenic control of hypothalamic regulated functions, such as food intake, sexual receptivity and lordosis behavior. Objective To assess GPER…
Introduction The membrane-associated G protein-coupled estrogen receptor 1 (GPER) mediates the regulation by estradiol on arginine-vasopressin immunoreactivity in the supraoptic and paraventricular hypothalamic nuclei of female rats and is involved in the estrogenic control of hypothalamic regulated functions, such as food intake, sexual receptivity and lordosis behavior. Objective To assess GPER distribution in the rat hypothalamus. Methods GPER immunoreactivity was assessed in different anatomical subdivisions of five selected hypothalamic regions of young adult male and cycling female rats: the arcuate nucleus, the lateral hypothalamus, the paraventricular nucleus, the supraoptic nucleus and the ventromedial hypothalamic nucleus. GPER immunoreactivity was colocalized with NeuN as a marker of mature neurons, GFAP as a marker of astrocytes and CC1 as a marker of mature oligodendrocytes. Results GPER immunoreactivity was detected in hypothalamic neurons, astrocytes and oligodendrocytes. Sex and regional differences and changes during the estrous cycle were detected in the total number of GPER immunoreactive cells and in the proportion of neurons, astrocytes and oligodendrocytes that were GPER immunoreactive. Conclusions These findings suggest that estrogenic regulation of hypothalamic function through GPER may be different in males and in females and may fluctuate during the estrous cycle in females.
- Is the Cranial Sagittal Vertical Axis (Cr-SVA) a Better Midterm Predictor of Clinical Results Than C7-SVA in Adult Patients Operated on Spinal Deformity After a Minimum 2-Year Follow-Up? [Journal Article]Clin Spine Surg. 2020 Jun 19 [Online ahead of print]CS
- CONCLUSIONS: The Cr-SVA measured in full spine standing radiographs seems to be a better predictor of health-related quality of life outcomes than the C7-SVA for adults operated on spinal deformity >2 years after surgery.
- Pelvic Incidence Affects Age-adjusted Alignment Outcomes in a Population of Adult Spinal Deformity. [Journal Article]Clin Spine Surg. 2020 Jun 19 [Online ahead of print]CS
- CONCLUSIONS: Patients with high PI reached ideal postoperative age-adjusted PT alignment at a lower rate than patients with normative and low PI. Height had no impact on postoperative age-adjusted alignment outcomes. Current postoperative ideal alignment targets may warrant an adjustment to account for PI.
- Sagittal imbalance, muscle atrophy, and osteoporosis: risk factors for revision posterior lumbar fusion surgery in patients with Parkinson's disease. [Journal Article]Int Orthop. 2020 Jun 20 [Online ahead of print]IO
- CONCLUSIONS: PD patients with low pre-operative BMD, fatty infiltration, a smaller rCSA of the paraspinal muscle, and larger PI-LL and SVA had a higher rate of revision lumbar fusion. Maintaining sagittal balance, functional exercises, and anti-osteoporosis treatment were important in preventing complications in PD patients.
- Effect of 9-month Pilates program on sagittal spinal curvatures and hamstring extensibility in adolescents: randomised controlled trial. [Journal Article]Sci Rep. 2020 Jun 19; 10(1):9977.SR
- The percentage of spine misalignment increases during the childhood and adolescence stages. The Pilates method has been associated with an improvement in the sagittal spine disposition, but no studies have been conducted on adolescents. Therefore, the present study aimed to evaluate the effectiveness of a 9-month Pilates exercise program (PEP) on hamstring extensibility and sagittal spinal curvat…
The percentage of spine misalignment increases during the childhood and adolescence stages. The Pilates method has been associated with an improvement in the sagittal spine disposition, but no studies have been conducted on adolescents. Therefore, the present study aimed to evaluate the effectiveness of a 9-month Pilates exercise program (PEP) on hamstring extensibility and sagittal spinal curvatures on adolescents. This randomised controlled trial included 236 adolescents. The experimental group (EG) received a PEP (9 months, 2 sessions/week, 15 minutes/session). The control group (CG) did not receive any intervention. Hamstring extensibility was measured with the passive and active straight leg raise and toe-touch tests. Sagittal spinal curvatures and pelvic tilt was assessed in relaxed standing, active alignment and toe-touch test positions. The EG had significant changes in hamstring extensibility, lumbar curvature and pelvic tilt in standing sagittal curvature. The CG became significantly worse in thoracic kyphosis in standing. This study provides evidence of nine-months of a PEP increased the hamstring extensibility; averted the increase of the thoracic curvature, and decreased the curvature of the lumbar lordosis and pelvic tilt in standing position; avoided a greater increase of thoracic curvature in active alignment in standing position; and avoided the increase of thoracic curvature in trunk flexion.
- Complication profile associated with S1 pedicle subtraction osteotomy compared with 3-column osteotomies at other thoracolumbar levels for adult spinal deformity: series of 405 patients with 9 S1 osteotomies. [Journal Article]
- CONCLUSIONS: S1 PSO is a powerful technique for correction of rigid sagittal imbalance due to an artificially elevated PI in patients with rigid high-grade spondylolisthesis and chronic sacral fractures. However, the technique and intraoperative corrective maneuvers are challenging and associated with high surgical and neurological complications. Additional investigations into the learning curve associated with S1 PSO and complication prevention are needed.
- Prospective multicenter assessment of complication rates associated with adult cervical deformity surgery in 133 patients with minimum 1-year follow-up. [Journal Article]
- CONCLUSIONS: This report provides benchmark rates for ACSD surgery complications at a minimum 1-year (mean 1.8 years) follow-up. The marked health and functional impact of ACSD, the frail population it affects, and the high rates of surgical complications necessitate a careful risk-benefit assessment when contemplating surgery. Collectively, these findings provide benchmarks for complication rates and may prove useful for patient counseling and efforts to improve the safety of care.
- Factors affecting approach selection for minimally invasive versus open surgery in the treatment of adult spinal deformity: analysis of a prospective, nonrandomized multicenter study. [Journal Article]
- CONCLUSIONS: Increasing age was the primary driver for selecting MIS surgery. Conversely, increasingly severe deformities and the need for open decompression were the main factors influencing the selection of traditional open surgery. As experience with MIS surgery continues to accumulate, future longitudinal evaluation will reveal if more experience, use of specialized treatment algorithms, refinement of techniques, and technology will expand surgeon adoption of MIS techniques for adult spinal deformity.
- Magnetically controlled growing rods in early onset scoliosis: radiological results, outcome, and complications in a series of 22 patients. [Journal Article]Arch Orthop Trauma Surg. 2020 Jun 18 [Online ahead of print]AO
- CONCLUSIONS: MCGR treatment is able to control deformity progression. Complication rate was 54.5%. Sagittal balance was not altered and treatment does not seem to have a negative impact on the development of spino-pelvic parameters during growth. Optimal end of treatment for the individual patient still has to be defined.
- Dynamic Stabilization Adjacent to Fusion versus Posterior Lumbar Interbody Fusion for the Treatment of Lumbar Degenerative Disease: A Meta-Analysis. [Review]Biomed Res Int. 2020; 2020:9309134.BR
- This study evaluated differences in outcome variables between dynamic stabilization adjacent to fusion (DATF) and posterior lumbar interbody fusion (PLIF) for the treatment of lumbar degenerative disease. A systematic review of PubMed, EMBASE, and Cochrane was performed. The variables of interest included clinical adjacent segment pathologies (CASPs), radiological adjacent segment pathologies (RA…
This study evaluated differences in outcome variables between dynamic stabilization adjacent to fusion (DATF) and posterior lumbar interbody fusion (PLIF) for the treatment of lumbar degenerative disease. A systematic review of PubMed, EMBASE, and Cochrane was performed. The variables of interest included clinical adjacent segment pathologies (CASPs), radiological adjacent segment pathologies (RASPs), lumbar lordosis (LL), visual analogue scale (VAS) of back (VAS-B) and leg (VAS-L), Oswestry disability index (ODI), Japanese Orthopaedic Association (JOA) score, duration of surgery (DS), estimated blood loss (EBL), complications, and reoperation rate. Nine articles identified as meeting all of the inclusion criteria. DATF was better than PLIF in proximal RASP, CASP, and ODI during 3 months follow-up, VAS-L. However, no significant difference between DATF and PLIF was found in distal RASP, LL, JOA score, VAS-B, ODI after 3 months follow-up, complication rates, and reoperation rate. These further confirmed that DATF could decrease the proximal ASP both symptomatically and radiographically as compared to fusion group; however, the influence of DATF on functional outcome was similar with PLIF. The differences between hybrid surgery and topping-off technique were located in DS and EBL in comparison with PLIF. Our study confirmed that DATF could decrease the proximal ASP both symptomatically and radiographically as compared to the fusion group; however, the influence of DATF on functional outcome was similar with PLIF. The difference between hybrid surgery and topping-off technique was not significant in treatment outcomes.
- Incidence and risk factors of reoperation in patients with adjacent segment disease: A meta-analysis. [Review]J Craniovertebr Junction Spine. 2020 Jan-Mar; 11(1):9-16.JC
- CONCLUSIONS: We found that 8% of patients in our included studies required reoperation due to ASD. Our analysis also revealed that longer fusion constructs correlated with a higher rate of subsequent revision surgery. Therefore, the surgeon should limit the number of fusion levels if possible to reduce the risk of future reoperation due to ASD.
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- Effect of Schroth Rehabilitation Exercise Program on Scoliometer Readings, Lumbar Lordosis and Calcaneal Valgus Angle in Patients with Idiopathic Scoliosis. [Journal Article]Iran J Public Health. 2020 Apr; 49(4):808-809.IJ