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Variations of transverse foramina in cervical vertebrae: what happens to the vertebral artery?
ConclusionsVertebral artery injury is not common but may be a disastrous complication during cervical spine surgery. Proper preoperative planning is essential for any surgeon and exact knowledge of the anatomy in each patient is essential. This study strongly recommends the preoperative use of a CTa when suspicion of a variation is present and implied by a foramen variation.Graphical abstractThese slides can be retrieved under Electronic Supplementary Material. (Source: European Spine Journal)
Source: European Spine Journal - February 17, 2018 Category: Orthopaedics Source Type: research

Reviewer ’s comment concerning “Classification of normal sagittal spine alignment: refounding the Roussouly classification” by F. Laouissat et al. (2017). doi:10.1007/s00586-017-5111-x (Epub ahead of print)
(Source: European Spine Journal)
Source: European Spine Journal - February 16, 2018 Category: Orthopaedics Source Type: research

Risk factors of non-specific spinal pain in childhood
AbstractPurposeNon-specific spinal pain can occur at all ages and current evidence suggests that pediatric non-specific spinal pain is predictive for adult spinal conditions. A 5-year long, prospective cohort study was conducted to identify the lifestyle and environmental factors leading to non-specific spinal pain in childhood.Materials and methodsData were collected from school children aged 7 –16 years, who were randomly selected from three different geographic regions in Hungary. The risk factors were measured with a newly developed patient-reported questionnaire (PRQ). The quality of the instrument was asse...
Source: European Spine Journal - February 15, 2018 Category: Orthopaedics Source Type: research

Bone graft materials for posterolateral fusion made simple: a systematic review
ConclusionsWhile our results find that LAG+BMA provided highest fusion rate, most material options analyzed in this study provide comparable fusion outcomes. The ideal graft option must incorporate a combination of materials with osteoconductive, osteoinductive, and osteogenic properties. Our results represent the robust and dynamic nature of the current state of lumbar graft technology.Graphical abstract These slides can be retrieved under Electronic Supplementary Material. (Source: European Spine Journal)
Source: European Spine Journal - February 14, 2018 Category: Orthopaedics Source Type: research

Paravertebral tumours of the cervicothoracic junction extending into the mediastinum: surgical strategies in a no man ’s land
ConclusionsClassification of cervicothoracic paravertebral neoplasms with mediastinal extension according to the relationship with the subclavicular fossa and dual speciality involvement allows for a structured surgical approach and provides minimal morbidity/maximum resection and satisfactory oncological outcomes.Graphical abstractThese slides can be retrieved under Electronic Supplementary Material. (Source: European Spine Journal)
Source: European Spine Journal - February 14, 2018 Category: Orthopaedics Source Type: research

Postoperative K-line conversion from negative to positive is independently associated with a better surgical outcome after posterior decompression with instrumented fusion for K-line negative cervical ossification of the posterior ligament
ConclusionPostoperative K-line conversion from ( −) to (+) is a factor independently associated with a better surgical outcome.Graphical abstractThese slides can be retrieved under Electronic Supplementary material. (Source: European Spine Journal)
Source: European Spine Journal - February 14, 2018 Category: Orthopaedics Source Type: research

Full endoscopic lumbar interbody fusion (FELIF): technical note
ConclusionsFELIF is a safe and effective interbody fusion option to decompress the lumbar exiting nerve root and ventral side of dura directly with minimal invasive situation.Graphical abstractThese slides can be retrieved under Electronic Supplementary Material. (Source: European Spine Journal)
Source: European Spine Journal - February 14, 2018 Category: Orthopaedics Source Type: research

The importance of proximal femoral angle on sagittal balance and quality of life in children and adolescents with high-grade lumbosacral spondylolisthesis
ConclusionA PFA ≥ 10° is proposed as a criterion to define abnormal PFA. PFA was increased in HGS and increased along with deteriorating sagittal balance and QOL. PFA is a clinically relevant parameter of sagittal balance, and can be useful in the evaluation and management of patients with HGS. (Source: European Spine Journal)
Source: European Spine Journal - February 14, 2018 Category: Orthopaedics Source Type: research

Intraspinal neural axis abnormalities in severe spinal deformity: a 10-year MRI review
ConclusionThe incidence of INAAs in SSDs was 42.6%. 65.1% of them present intact neurologic status. The most common neural anomaly was syrinx. Preoperative whole spine MRI must be beneficial for SSDs even in the absence of neurological findings.Graphical abstractThese slides can be retrieved under Electronic Supplementary Material. (Source: European Spine Journal)
Source: European Spine Journal - February 14, 2018 Category: Orthopaedics Source Type: research

The adolescent idiopathic scoliotic IVD displays advanced aggrecanolysis and a glycosaminoglycan composition similar to that of aged human and ovine IVDs
DiscussionSulphated KS and 3-B-3(+) CS were prominently associated with IVD maturation and AIS IVDs, while the 2-B-6(+) CS isomer was associated with immature IVD tissues. The polydispersity of aggrecan in AIS IVDs, which was similar to in old human and ovine IVDs, reflected altered processing in the AIS IVDs in response to the biomechanical microenvironments the disc cells were exposed to in AIS IVDs.Graphical abstractThese slides can be retrieved under Electronic Supplementary Material. (Source: European Spine Journal)
Source: European Spine Journal - February 13, 2018 Category: Orthopaedics Source Type: research

Editorial
(Source: European Spine Journal)
Source: European Spine Journal - February 13, 2018 Category: Orthopaedics Source Type: research

Epidemiological trends in spine surgery over 10  years in a multicenter database
AbstractPurposeThere are few epidemiological studies of spinal surgery in Asia and none in Japan. The goal of this study was to review spine surgeries performed in our group between 2004 and 2015 in a cross-sectional study, with a focus on the effects of the superaging society on the characteristics and trends of spinal surgeries.MethodsA retrospective review was performed for all 45,831 spinal surgeries conducted between 2004 and 2015 and recorded in our prospective multicenter database.ResultsDuring the study period, there was a significant increase in annual spine surgeries (p 
Source: European Spine Journal - February 12, 2018 Category: Orthopaedics Source Type: research

Feasibility and outcome of stand-alone trans-articular screw fixation in atlantoaxial instability in children less than 8  years of age
AbstractPurposeTo study the feasibility and outcome of stand-alone trans-articular screw (TAS) fixation for atlantoaxial instability (AAI) in children less than 8  years of age.MethodsThis prospective study was conducted between 2009 and 2014. Thirteen children suffering from AAI were operated for a TAS fixation. Feasibility of TAS fixation was assessed on CT scan and a screw diameter was chosen based on C2 isthmus diameter. Demographic data collected included the etiology for AAI, age, and sex. Intra-operative data recorded was the duration of surgery, blood loss, vertebral artery injury or any adverse event. Radiolo...
Source: European Spine Journal - February 12, 2018 Category: Orthopaedics Source Type: research

Long-term follow-up of whiplash injuries reported to insurance companies: a cohort study on patient-reported outcomes and impact of financial compensation
ConclusionsThe non-recovery rate among patients making insurance claims is high, especially among those receiving financial compensation even if causal relationship cannot be determined based on this study. However, lack of association between baseline level of pain and compensation supports the compensation hypothesis. (Source: European Spine Journal)
Source: European Spine Journal - February 10, 2018 Category: Orthopaedics Source Type: research

Posterolateral cervical transpedicular corpectomy for the surgical management of metastatic tumor
AbstractManagement of metastatic spinal disease in the upper cervical spine can be particularly challenging. Depending on the level of the lesion and the patient ’s anatomy, multiple anterior approaches have been described for resection of the cancer, followed by posterior fixation and instrumentation. Although a single-stage posterolateral approach is now well established for thoracic pathology, less is known about the applicability of these principles wh en applied as an approach to the cervical spine. The authors present here a case using a posterolateral transpedicular approach for corpectomy and graft placement ...
Source: European Spine Journal - February 9, 2018 Category: Orthopaedics Source Type: research

Self-learning computers for surgical planning and prediction of postoperative alignment
ConclusionIntegrating newer technology can change the current way of planning/simulating surgery. The use of powerful computer-assisted tools that are able to integrate several parameters and learn from experience can change the traditional way of selecting treatment pathways and counseling patients. However, there is still much work to be done to reach a desired level as noted in other orthopedic fields, such as hip surgery. Many of these tools already exist in non-medical fields and their adaptation to spine surgery is of considerable interest. (Source: European Spine Journal)
Source: European Spine Journal - February 9, 2018 Category: Orthopaedics Source Type: research

Feasibility of anterior screw fixation in children: a tomographic study
ConclusionIn both groups, the minimal transverse diameter of the odontoid process allowed for the use of one 3.5 –4.5 mm screw for anterior internal fixation.Graphical abstractThese slides can be retrieved under Electronic Supplementary Material. (Source: European Spine Journal)
Source: European Spine Journal - February 9, 2018 Category: Orthopaedics Source Type: research

Reoperation within 2  years after lumbar interbody fusion: a multicenter study
ConclusionSurgical invasiveness, as reflected by number of fused levels, operation time, EBL and dural tear, was associated with reoperation. Fusion of two or more levels is a strong risk factor for reoperation within 2  years after initial PLIF/TLIF.Graphical abstractThese slides can be retrieved under Electronic Supplementary Material. (Source: European Spine Journal)
Source: European Spine Journal - February 8, 2018 Category: Orthopaedics Source Type: research

Intraosseous basivertebral nerve ablation for the treatment of chronic low back pain: a prospective randomized double-blind sham-controlled multi-center study
ConclusionPatients treated with RF ablation of the BVN for CLBP exhibited significantly greater improvement in ODI at 3  months and a higher responder rate than sham treated controls. BVN ablation represents a potential minimally invasive treatment for the relief of chronic low back pain.Graphical abstract These slides can be retrieved under Electronic Supplementary Material. (Source: European Spine Journal)
Source: European Spine Journal - February 8, 2018 Category: Orthopaedics Source Type: research

Paraplegic patients: how to measure balance and what is normal or functional?
Conclusion Current available literature data have not defined normal sagittal parameters for paraplegic patients. There are significant differences in postural sagittal parameters and muscle activations in paraplegic and non-spinal cord injury patients that can lead to differences in sagittal alignment and balance. Treatment goal in spine surgery for paraplegic patients should address their global function, sitting balance, and ability to perform self-care rather than the accepted radiographic parameters for adult spinal deformity in ambulatory patients. (Source: European Spine Journal)
Source: European Spine Journal - February 8, 2018 Category: Orthopaedics Source Type: research

Sagittal imbalance treated with L5 pedicle subtraction osteotomy with short lumbar fusion from L4 to sacrum using four screws into L4 for enhanced fixation two additional vertebral screws: a technical note
ConclusionPSO surgery for sagittal imbalance usually requires a long fusion at least two levels above and below the osteotomy site to achieve adequate stability and better global alignment. However, longer fixation may decrease the patients ’ quality of life and cause a proximal junctional failure. Our novel technique may shorten the fixation area after osteotomy surgery.Graphical abstractThese slides can be retrieved under Electronic Supplementary Material. (Source: European Spine Journal)
Source: European Spine Journal - February 7, 2018 Category: Orthopaedics Source Type: research

Radiological severity of hip osteoarthritis in patients with adult spinal deformity: the effect on spinopelvic and lower extremity compensatory mechanisms
This study examines the effect of hip osteoarthritis (OA) on compensatory mechanisms in SSD patients.MethodsPatients  ≥ 18 years with SSD were included for analysis. Spinopelvic, lower extremity, and cervical alignment were assessed on standing full-body stereoradiographs. Hip OA severity was graded by Kellgren–Lawrence scale (0–4). Patients were categorized as limited osteoarthritis (LOA: grade 0–2) an d severe osteoarthritis (SOA: grade 3–4). Patients were matched for age and T1-pelvic angle (TPA). Spinopelvic [sagittal vertical axis (SVA), T1-pelvic angle, thoracic kyphosis (TK)...
Source: European Spine Journal - February 7, 2018 Category: Orthopaedics Source Type: research

Georg Schmorl Prize of the German Spine Society (DWG) 2017: correction of spino-pelvic alignment with relordosing mono- and bisegmental TLIF spondylodesis
AbstractIntroductionA balanced ratio of the main parameters of lumbar lordosis (LL) and pelvic incidence (PI) has high clinical relevance. A postoperative mismatch of LL and PI has been described in the literature to be associated with an inferior clinical outcome and higher postoperative revision rates. The aim of this retrospective, radiological study is to evaluate the magnitude of relordosing in mono-/bisegmental TLIF spondylodesis affecting the spino-pelvic alignment and the main contributing factors.Materials and methods164 patients (pat.) underwent monosegmental (n = 115, G1) and bisegmental (n = ...
Source: European Spine Journal - February 7, 2018 Category: Orthopaedics Source Type: research

Expert ’s comment concerning Grand Rounds Case entitled “pancreatic fracture: a rare complication following scoliosis surgery” by Mélodie Juricic Jr. et al. (Eur Spine J; [2017]: doi: 10.1007/s00586-017-5318-x)
(Source: European Spine Journal)
Source: European Spine Journal - February 5, 2018 Category: Orthopaedics Source Type: research

Letter to the Editor concerning “Robot-assisted and conventional freehand pedicle screw placement: a systematic review and meta-analysis of randomized controlled trials” by Gao ST et al. (Eur Spine J; 2017. DOI 10.1007/s00586-017-5333-y)
(Source: European Spine Journal)
Source: European Spine Journal - February 5, 2018 Category: Orthopaedics Source Type: research

Decompression with or without concomitant fusion in lumbar stenosis due to degenerative spondylolisthesis: a systematic review
ConclusionCurrently there is not enough evidence that adding instrumented fusion to a decompression leads to superior outcomes compared to decompression only in patients with lumbar stenosis and degenerative spondylolisthesis. The most important clinical outcome measures, including the ODI, show comparable results. Therefore, the least invasive and least costly procedure, being decompression alone, is preferred in patients with low-grade spondylolisthesis with predominant leg pain.Graphical abstractThese slides can be retrieved under Electronic Supplementary Material. (Source: European Spine Journal)
Source: European Spine Journal - February 5, 2018 Category: Orthopaedics Source Type: research

Surgical treatment of spinal disorders in Parkinson ’s disease
ConclusionsDisorders of the posture and spinal alignment, both in the sagittal and in the coronal planes, are common in PD patients, and have a major impact on the quality of life. Outcomes of spine surgery are generally not satisfactory, likely mostly due to muscle dystonia and poor bone quality. Knowledge in this field needs to be consolidated by further clinical and basic science studies.Graphical abstractThese slides can be retrieved under Electronic Supplementary Material. (Source: European Spine Journal)
Source: European Spine Journal - February 3, 2018 Category: Orthopaedics Source Type: research

Announcements
(Source: European Spine Journal)
Source: European Spine Journal - February 3, 2018 Category: Orthopaedics Source Type: research

Correction to: A method to quantify the “cone of economy”
Unfortunately, in the abstract at the results section units have been published incorrectly. (Source: European Spine Journal)
Source: European Spine Journal - February 2, 2018 Category: Orthopaedics Source Type: research

The evaluation of lumbar paraspinal muscle quantity and quality using the Goutallier classification and lumbar indentation value
AbstractPurposeThe cross-sectional area and fat infiltration are accepted as standard parameters for quantitative and qualitative evaluation of muscle degeneration. However, they are time-consuming, which prevents them from being used in a clinical setting. The aim of this study was to analyze the relationship between lumbar muscle degeneration and spinal degenerative disorders, using lumbar indentation value (LIV) as quantitative and Goutallier classification as qualitative measures.MethodsThis is a retrospective analysis of kinematic magnetic resonance images (kMRI). Two-hundred and thirty patients with kMRIs taken in we...
Source: European Spine Journal - February 2, 2018 Category: Orthopaedics Source Type: research

Analysis of cervical sagittal alignment variations after lumbar pedicle subtraction osteotomy for severe imbalance: study of 59 cases
AbstractObjectiveTo evaluate postoperative changes within the cervical alignment following surgical lumbar correction by pedicle subtraction osteotomy (PSO) in patients affected with sagittal global malalignment disease.MethodsThis was a monocentric, radiographic, and prospective study. 79 patients, who underwent sagittal correction by PSO, performed an EOS imaging pre- and postoperatively between January 2008 and December 2013 at the University Hospital of Bordeaux. Inclusion criteria were a performed pre- and postoperative EOS imaging and a preoperative C7SVA>  5 cm. Were excluded patients who did not all...
Source: European Spine Journal - February 2, 2018 Category: Orthopaedics Source Type: research

Great trochanter bursitis vs sciatica, a diagnostic –anatomic trap: differential diagnosis and brief review of the literature
ConclusionsThe GTB is a common clinical entity in middle-aged women, which can escape from the physician in cases of incomplete medical history and clinical examination, leading to unnecessary imaging tests and treatment approaches, burdening both the patient and the health system. Early diagnosis of GTB may dramatically reduce cost, prevent unwanted and inappropriate imaging exams and treatment, and make the patient free of symptoms immediately.Graphical abstractThese slides can be retrieved under Electronic Supplementary Material. (Source: European Spine Journal)
Source: European Spine Journal - February 1, 2018 Category: Orthopaedics Source Type: research

Shaping conservative spinal services with the Spine Tango Registry
ConclusionsThe secondary care spinal osteopathy service demonstrated high satisfaction, few therapeutic complications and positive outcomes on all PROMs. Registry participation has facilitated robust clinical governance and the data support the use of osteopaths to deliver a conservative spinal service in this setting. Registry data collection is a significant administrative and clinical task which should be structured to minimise burden on patients and resources.Graphical abstractThese slides can be retrieved under Electronic Supplementary Material. (Source: European Spine Journal)
Source: European Spine Journal - January 31, 2018 Category: Orthopaedics Source Type: research

Expert ’s comment concerning Grand Rounds case entitled “Posterolateral cervical transpedicular corpectomy for the surgical management of metastatic tumor” by M.H. Pham et al. (Eur Spine J; 2018: DOI 10.1007/s00586-018-5466-7)
(Source: European Spine Journal)
Source: European Spine Journal - January 31, 2018 Category: Orthopaedics Source Type: research

Expert ’s comment concerning Grand Rounds case entitled “Type V osteogenesis imperfecta undergoing surgical correction for scoliosis” by M. Jones et al. (Eur Spine J; 2018: doi 10.1007/s00586-018-5465-8)
(Source: European Spine Journal)
Source: European Spine Journal - January 31, 2018 Category: Orthopaedics Source Type: research

Intraosseous pseudomeningocele of the mobile spine: a case report and review of the literature
ConclusionsThis case illustrates a rare case of an intra-osseous pseudomeningocele and highlights the importance of CT myelogram for diagnosis. (Source: European Spine Journal)
Source: European Spine Journal - January 31, 2018 Category: Orthopaedics Source Type: research

102 lumbar pedicle subtraction osteotomies: one surgeon ’s learning curve
ConclusionPSO technique has a relatively long learning curve. This study showed that accumulating the experience over the years, while performing cases on a regular basis, is definitely the key in mastering this complex and risky technique, with significant improvements in the perioperative parameters that directly impact the recovery and global outcome.Graphical abstractThese slides can be retrieved under Electronic Supplementary Material. (Source: European Spine Journal)
Source: European Spine Journal - January 30, 2018 Category: Orthopaedics Source Type: research

Focal disorders of the spine with compensatory deformities: how to define them
ConclusionThe compensatory mechanisms involved in adaptive deformity represent an attempt to maintain a global alignment, to escape from pain or to control body posture.Graphical abstractThese slides can be retrieved under Electronic Supplementary material. (Source: European Spine Journal)
Source: European Spine Journal - January 30, 2018 Category: Orthopaedics Source Type: research

Answer to the Letter to the Editor of Qi Sun et al. concerning “Robot-assisted and conventional freehand pedicle screw placement: a systematic review and meta-analysis of randomized controlled trials” by Gao ST, et al. (Eur Spine J; 2017: DOI 10.1007/s00586-017-5333-y)
(Source: European Spine Journal)
Source: European Spine Journal - January 30, 2018 Category: Orthopaedics Source Type: research

Real-time ultrasound-MRI fusion image virtual navigation for locating intraspinal tumour in a pregnant woman
ConclusionWe presented the first case of using VNT based fusion imaging of real-time US/MRI to guide the surgical resection of an intraspinal tumour. Future study with larger patient number is needed to validate this technique as an alternative to fluoroscopy in patients who need to avoid radiation exposure. (Source: European Spine Journal)
Source: European Spine Journal - January 30, 2018 Category: Orthopaedics Source Type: research

Meet the Experts ™
(Source: European Spine Journal)
Source: European Spine Journal - January 30, 2018 Category: Orthopaedics Source Type: research

Pseudomalignant osteoblastoma of the odontoid process
ConclusionThis unique case of odontoid osteoblastoma illustrates that malignant behavior may not be predicted only by the presence of pseudomalignant features on histology. (Source: European Spine Journal)
Source: European Spine Journal - January 29, 2018 Category: Orthopaedics Source Type: research

The Global Spine Care Initiative: a narrative review of psychological and social issues in back pain in low- and middle-income communities
ConclusionPsychological and social factors are important components to addressing low back pain and health care providers play an important role in empowering patients to take control of their spinal health outcomes. Patients should be included in negotiating their spinal treatment and establishing treatment goals through careful listening, reassurance, and information providing by the health care provider. Instruments need to be developed for people with low literacy in medically underserved areas and low- and middle-income countries, especially where psychological and social factors may be difficult to detect and are poo...
Source: European Spine Journal - January 27, 2018 Category: Orthopaedics Source Type: research

Cryosurgery in the excision of a giant local recurrent sacral chordoma: a case report and literature review
ConclusionsGiven the gelatinous structure of the tumor and the possibility of contamination of operatory field, cryosurgery may be indicated when previous surgeries and the dimensions of tumor mass do not allow a resection with negative margins improving radiotherapy efficacy in the local control of tumor. (Source: European Spine Journal)
Source: European Spine Journal - January 25, 2018 Category: Orthopaedics Source Type: research

Sagittal balance and idiopathic scoliosis: does final sagittal alignment influence outcomes, degeneration rate or failure rate?
ConclusionIt is clear now that sagittal alignment plays a major role in clinical outcomes and should not be neglected in AIS. Seven key guidelines that should be considered for each patient before surgery are reported (Table  2). Personalized planning using 3D technology is gaining popularity and might help in the future reducing complications. (Source: European Spine Journal)
Source: European Spine Journal - January 24, 2018 Category: Orthopaedics Source Type: research

Bisphosphonate therapy for spinal aneurysmal bone cysts
ConclusionsBisphosphonate therapy can be used as the definitive treatment of spinal ABCs, except in patients with instability or progressive neurology, where surgical intervention is required. Clinicians should expect a patients symptoms to rapidly improve, their bone oedema to resolve by 3  months and their lesion to partially or completely ossify by 6–12 months. (Source: European Spine Journal)
Source: European Spine Journal - January 22, 2018 Category: Orthopaedics Source Type: research

Minimally invasive percutaneous endoscopic treatment for acute pyogenic spondylodiscitis following vertebroplasty
ConclusionWe report a case treated with endoscopic procedure without open surgery for acute pyogenic spondylodiscitis following vertebroplasty. (Source: European Spine Journal)
Source: European Spine Journal - January 22, 2018 Category: Orthopaedics Source Type: research

Neoadjuvant denosumab for the treatment of a sacral osteoblastoma
ConclusionsA short course of denosumab caused tumour regression, ossification and conversion of an aggressive OB into a sclerotic, well-defined lesion thus aiding surgical resection and preservation of neural structures. Neoadjuvant therapy reduced osteoclast numbers but PET showed that the lesion remained FDG avid post-therapy. (Source: European Spine Journal)
Source: European Spine Journal - January 22, 2018 Category: Orthopaedics Source Type: research

Radiological and functional outcomes of high-grade spondylolisthesis treated by intrasacral fixation, dome resection and circumferential fusion: a retrospective series of 20 consecutive cases with a minimum of 2  years follow-up
This study aims at analyzing clinical and radiological outcomes of HGS patients treated with intrasacral rods on full spine radiographs.MethodsHGS patients (Meyerding III or higher) operated between 2004 and 2014 were reviewed. All patients underwent full spine stereoradiographic images. After L5 and S1 decompression, reduction and circumferential fusion with intrasacral rod fixation and fusion up to L4 were performed under fluoroscopy. The entry points for S1 screws were located 3 –5 mm above and 5 mm lateral to the first sacral hole, toward the promontory. The two short distal fusion rods were then positi...
Source: European Spine Journal - January 20, 2018 Category: Orthopaedics Source Type: research

Transforaminal endoscopic decompression for thoracic spinal stenosis under local anesthesia
ConclusionTransforaminal endoscopic decompression is a safe and an effective surgical approach for the treatment of thoracic spinal stenosis. For patients with thoracic spinal stenosis, accurate diagnosis and elaborate surgical planning should be highlighted, and the surgical outcome can be favorable. (Source: European Spine Journal)
Source: European Spine Journal - January 20, 2018 Category: Orthopaedics Source Type: research