Asymmetric pedicle subtractionosteotomy (aPSO) guided by a 3D-printed model to correct a combined fixed sagittal and coronal imbalance

AbstractSurgical correction of fixed thoracolumbar deformity is usually achieved by estimating the preoperatively planned correction angles during surgery and is therefore prone to inaccuracy. This is particularly problematic in biplanar deformities. To overcome these difficulties, 3D model for planning, preparation, and simulation of an asymmetric pedicle subtraction osteotomy (aPSO) was printed and used to realign coronal and sagittal balance in case of rigid degenerative kyphoscoliosis. A 59-year-old woman presented with severe back pain and spinal claudication and was diagnosed with a rigid kyphoscoliosis with multilevel spinal stenosis. Spino-pelvic parameters were measured preoperatively (pelvic incidence 47 ° [PI], lumbar lordosis 18° [LL]; pelvic tilt 42° [PT], T1 pelvic angle 40° [TPA], Cobb angle 33°, sagittal vertical axis 10.5 cm [SVA]). To aid the complex deformity in the sagittal and coronal plane, a 1:1 3D model of the spine was printed according to the preoperative computed tomography (C T). With the use of a rebalancing software, the spine was prepared in vitro as a model for intraoperative realignment and the correction was preoperatively simulated. Surgery was accomplished according to the preoperative software-guided plan. Asymmetric pedicle subtraction osteotomy (aPSO) of L3 id entical to the 3D model was performed. Additionally, a Smith-Peterson osteotomy of L4/5 with transforaminal lumbar interbody fusion (TLIF) and laminectomy ...
Source: Neurosurgical Review - Category: Neurosurgery Source Type: research

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ConclusionWhile these practices were implemented because of sound biologic plausibility or encouraging observational data, well-done RCTs have failed to show evidence of effectiveness. These examples raise caution in introducing new clinical interventions into widespread clinical practice without sufficient high quality evidence demonstrating efficacy.
Source: Current Therapeutic Research - Category: Drugs & Pharmacology Source Type: research
Publication date: Available online 22 February 2020Source: Neuroscience LettersAuthor(s): Yan Liu, Zhiwei Zhang, Xiaofen Lu, Jian Meng, Xuying Qin, Jie JiangAbstractEndometriosis of sciatic nerve is a common gynecological disease. Here we aimed to study the anti-inflammatory and anti-nociceptive role of sulforaphane on sciatic nerve endometriosis. The sciatic nerve endometriosis rat model was constructed by autologous implantation of uterine tissue. Sulforaphane was administered intraperitoneally at the dose of 5, 15, 30 and 60 mg/kg/day for 28 days. Behavioral testing was performed at day 7, 14, 21 and 28. At day 2...
Source: Neuroscience Letters - Category: Neuroscience Source Type: research
In this study, olfactory ensheathing cells (OECs) were cultured, chitosan (CS) was prepared, and the compatibility of CS and OECs was detected by MTT method. Animal model of chronic constrictive sciatic nerve injury (CCI) was made, OECs and OECs+CS were transplanted to the region surrounding the chronic sciatic nerve injury, and the difference between the two groups in the treatment of NPP was compared. The mechanical withdrawal threshold (MWT) and thermal withdrawal latency (TWL) were measured by using behavioral method. In situ hybridization and Western-blotting were used to detect the expression of P2X4R mRNA and protei...
Source: Neuroscience Letters - Category: Neuroscience Source Type: research
Study Design. Retrospective cohort study. Objective. The aim of this study was to compare clinical and radiographic outcomes of patients who underwent stand-alone lateral lumbar interbody fusion (LLIF) to those who underwent posterolateral fusion (PLF) for symptomatic adjacent segment disease (ASD). Summary of Background Data. Recent studies have suggested that LLIF can successfully treat ASD; however, there are no studies to date that compare LLIF with the traditional open PLF in this cohort. Methods. A total of 47 consecutive patients who underwent LLIF or PLF for symptomatic ASD between January 2007 and Augus...
Source: Spine - Category: Orthopaedics Tags: SURGERY Source Type: research
ConclusionLSS is frequent in lumbar scoliosis. Relationships exist between curve characteristics and symptomatic LSS in lumbar scoliosis; especially, concavity of the lumbosacral contra-curve and the junctional level between the lumbar curve and the lumbosacral contra-curve. Therefore, accurate analysis of stenosis in ASD seems mandatory, to at least perform decompression because perfect planned treatment for stenosis and scoliosis correction might not always be possible because of the patient's general health status.Level of EvidenceLevel 4.
Source: Spine Deformity - Category: Orthopaedics Source Type: research
Study Design. Prospective, cohort study. Objective. Demonstrate validity of Patient reported outcomes measurement information system (PROMIS) physical function, pain interference, and pain behavior computer adaptive tests (CATs) in surgically treated lumbar stenosis patients. Summary of Background Data. There has been increasing attention given to patient reported outcomes associated with spinal interventions. Historical patient outcome measures have inadequate validation, demonstrate floor/ceiling effects, and infrequently used due to time constraints. PROMIS is an adaptive, responsive National Institutes of Healt...
Source: Spine - Category: Orthopaedics Tags: SURGERY Source Type: research
Discussion: Five participants met criteria for having SLSS. Differences are reported in medians and interquartile ranges. Participants with SLSS reported more global pain, a greater number of comorbid conditions [SLSS: 7.0 (2.0) vs no-SLSS: 4.0 (2.0), P
Source: Journal of Geriatric Physical Therapy - Category: Physiotherapy Tags: Research Reports Source Type: research
This study aimed to investigate whether the restoration of disc dimensions would relieve symptoms of radiculopathy, claudication and back pain. In this retrospective study, patients undergoing XLIF surgery for relief of radicular symptoms or degenerative disc disease were included. Radiologically proven changes were used to assess the modes of degeneration. Objective measures such as the Visual Analogue Scale (VAS) for back and legs and the Oswestry Disability Index (ODI) were used. Complications were collated post-operatively from clinical notes and outpatient appointments. Twenty-three consecutive patients were included,...
Source: Journal of Clinical Neuroscience - Category: Neuroscience Source Type: research
Conclusions: Patients with smaller PI tended to be restored higher, and those patients with a larger PI were more likely to be restored lower. For patients with normal sagittal balance, the surgical outcomes in the treatment of low-grade lumbar degenerative spondylolisthesis with spinal fusion are not correlated with restoration of the LL.
Source: Journal of Spinal Disorders and Techniques - Category: Surgery Tags: Primary Research Source Type: research
Publication date: Available online 23 May 2015 Source:Formosan Journal of Surgery Author(s): Hsien-Ta Hsu , Ming-Hsueh Lee , Kuo-Feng Huang A 56-year-old female patient experienced mild back pain, which radiated to her legs, as well as intermittent claudication for 5 years. The symptoms became more pronounced on sitting and walking, and conservative therapy was ineffective in relieving pain. Preoperative whole-spine X-ray scans revealed degenerative lumbar kyphoscoliosis. Asymmetrical pedicle subtraction osteotomy was performed and a convex-sided posterolateral wedge osteotomy was applied to correct the scoliosis and res...
Source: Formosan Journal of Surgery - Category: Surgery Source Type: research
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