RESUMEN
Cervical plates are in use since the 1990ies for anterior cervical discectomy and fusion (ACDF). The latest step in development was a dynamic plate that allows sliding of the screws facilitating the natural settling of the bone after surgery. We investigated the clinical and radiological results of such a dynamic plate in a patient cohort that underwent single or multi-level ACDF for various cervical degenerative indications, including revision cases, from 2014 to 2019. Clinical and radiological outcome were assessed in 60 eligible patients after a mean of 2.9 years. The assessed neck disability index (NDI), and the visual analogue scale (VAS) of neck and arm pain show comparable results to the literature of ACDF, and specifically other plate designs. Forty-eight Adverse and Serious Adverse Events do not show a link to the product used. Clinical and radiological outcomes of ACDF with dynamic, third generation cervical plates show comparable results to the literature. Careful reporting of all Adverse Events revealed a variety of concomitant diseases, but could not be correlated to the implant used.
RESUMEN
Background: In healthy, nonelderly populations, prevalence of 3 modifiers of global spinal malalignment (GS-MalAlign) (PT â§20°, PI-LLâ§10°, SVAâ§40 mm) remains unknown. The clinical significance has not been determined. The purposes are to disclose the prevalence of the 3 modifiers of GS-MalAlign, and evaluate the influence on LBP, and HR-QOL related to bone mineral density (BMD), skeletal muscle mass index (SMI), and back muscle extensors strength (BMES) in a healthy, nonelderly population. Methods: A mono-centric, cross-sectional survey. Three hundred and 2 participants (18< age <65 years) without ADL disturbance were consecutively enrolled. Sagittal parameters of the spine and the pelvis were measure on whole spine radiograms. BMD and SMI were determined using DEXA. BMES was defined as a maximum extension force at the T4 to T7 level and measured by a strain-gauge dynamotor. LBP was checked through interview. HR-QOL was ascertained by score of Medical Outcome Study Short-Form 36-Health Survey (SF-36v2). Results: The final analysis could be done in 84 females and 179 males. PTâ§20°, PI-LLâ§10°, and SVAâ§40 mm were found in 12% (31/263), 11% (31/263), and 6% (16/263), and each mean value was 25.0 ± 4.0°, 15.3 ± 5.9°, and 52.7 ± 12.2 mm (Mean ± S.D.). Prevalence of LBP was significantly higher in the participants with PI-LLâ§10° than with PI-LL<10°; 43% (12/28) versus 21% (49/235) (p<.05). PI-LLâ§10° only had an association with LBP (OR: 3.0435, 95% CI, 1.1378-8.141, p<.05). Four 2% of participants (4/263) associated with all 3 modifiers had LBP and a significantly lower mental component summary score of SF-36v2 (p<.05). Conclusions: Some of individuals are associated with GS-MalAlign even in healthy, nonelderly populations. There is a possibility that PI-LL â§10° results in LBP within a degree of no ADL disturbance, and it is speculated that coexistence of all 3 modifiers of GS-MalAlign would lead to a poor mental HR-QOL.
RESUMEN
We propose a visualization application, designed for the exploration of human spine simulation data. Our goal is to support research in biomechanical spine simulation and advance efforts to implement simulation-backed analysis in surgical applications. Biomechanical simulation is a state-of-the-art technique for analyzing load distributions of spinal structures. Through the inclusion of patient-specific data, such simulations may facilitate personalized treatment and customized surgical interventions. Difficulties in spine modelling and simulation can be partly attributed to poor result representation, which may also be a hindrance when introducing such techniques into a clinical environment. Comparisons of measurements across multiple similar anatomical structures and the integration of temporal data make commonly available diagrams and charts insufficient for an intuitive and systematic display of results. Therefore, we facilitate methods such as multiple coordinated views, abstraction and focus and context to display simulation outcomes in a dedicated tool. By linking the result data with patient-specific anatomy, we make relevant parameters tangible for clinicians. Furthermore, we introduce new concepts to show the directions of impact force vectors, which were not accessible before. We integrated our toolset into a spine segmentation and simulation pipeline and evaluated our methods with both surgeons and biomechanical researchers. When comparing our methods against standard representations that are currently in use, we found increases in accuracy and speed in data exploration tasks. in a qualitative review, domain experts deemed the tool highly useful when dealing with simulation result data, which typically combines time-dependent patient movement and the resulting force distributions on spinal structures.