In addressing spinal sagittal imbalance through a posterior approach, the surgeon now may choose from among a variety of osteotomy techniques. Posterior column osteotomies such as the facetectomy or Ponte or Smith-Pet...In addressing spinal sagittal imbalance through a posterior approach, the surgeon now may choose from among a variety of osteotomy techniques. Posterior column osteotomies such as the facetectomy or Ponte or Smith-Petersen osteotomy provide the least correction, but can be used at multiple levels with minimal blood loss and a lower operative risk. Pedicle subtraction osteotomies provide nearly 3 times the per-level correction of Ponte/Smith-Petersen osteotomies; however, they carry increased technical demands, longer operative time, and greater blood loss and associated significant morbidity, including neurological injury. The literature focusing on pedicle subtraction osteotomy for fixed sagittal imbalance patients is reviewed. The longterm overall outcomes, surgical tips to reduce the complications and suggestions for their proper application are also provided.展开更多
Background: In order to detect possible abnormalities of the spine posture of an individual patient, it is mandatory to dispose of adequate reference values based on measurements in a normal, symptom-free population. ...Background: In order to detect possible abnormalities of the spine posture of an individual patient, it is mandatory to dispose of adequate reference values based on measurements in a normal, symptom-free population. The Diers formetric?system allows for non-invasive and accurate assessment of the vertebral column based on the registration of external aspect of the back surface using the Moiré principle. Objective: To create a qualitative spine profile based on the percentile ranking of measurements obtained by the Diers formetric system taking into account possible confounding factors. Materials and Methods: Statistical analysis of formetric recordings in 216 symptom-free volunteers. Results: Maximal kyphotic angle, maximal scoliotic angle, sagittal imbalance, flèche cervicale, and pelvic inclination are significantly influenced by gender and by body mass index (BMI). A synoptic chart was created presenting the percentile ranking taking into account gender and BMI. The percentile ranking was summarized in both a table with colour code and depicted in a histogram of the individual’s Qualitative Spine Profile (QSP). Clinical Significance: Percentile ranking and the Quantitative Spine Profile taking into account gender and BMI should permit a more precise and reliable assessment of possible posture deviations related to the patient’s complaints, and may assist the therapist in selecting the best mode of treatment.展开更多
文摘In addressing spinal sagittal imbalance through a posterior approach, the surgeon now may choose from among a variety of osteotomy techniques. Posterior column osteotomies such as the facetectomy or Ponte or Smith-Petersen osteotomy provide the least correction, but can be used at multiple levels with minimal blood loss and a lower operative risk. Pedicle subtraction osteotomies provide nearly 3 times the per-level correction of Ponte/Smith-Petersen osteotomies; however, they carry increased technical demands, longer operative time, and greater blood loss and associated significant morbidity, including neurological injury. The literature focusing on pedicle subtraction osteotomy for fixed sagittal imbalance patients is reviewed. The longterm overall outcomes, surgical tips to reduce the complications and suggestions for their proper application are also provided.
文摘Background: In order to detect possible abnormalities of the spine posture of an individual patient, it is mandatory to dispose of adequate reference values based on measurements in a normal, symptom-free population. The Diers formetric?system allows for non-invasive and accurate assessment of the vertebral column based on the registration of external aspect of the back surface using the Moiré principle. Objective: To create a qualitative spine profile based on the percentile ranking of measurements obtained by the Diers formetric system taking into account possible confounding factors. Materials and Methods: Statistical analysis of formetric recordings in 216 symptom-free volunteers. Results: Maximal kyphotic angle, maximal scoliotic angle, sagittal imbalance, flèche cervicale, and pelvic inclination are significantly influenced by gender and by body mass index (BMI). A synoptic chart was created presenting the percentile ranking taking into account gender and BMI. The percentile ranking was summarized in both a table with colour code and depicted in a histogram of the individual’s Qualitative Spine Profile (QSP). Clinical Significance: Percentile ranking and the Quantitative Spine Profile taking into account gender and BMI should permit a more precise and reliable assessment of possible posture deviations related to the patient’s complaints, and may assist the therapist in selecting the best mode of treatment.
