Prevalence of degenerative vertebral disc changes in elite female Crossfit athletes - a cross-sectional study.

BACKGROUND: Crossfit athletes consistently recruit or transfer high levels of repetitive forces through the spine, and MRI has documented a higher rate of intervertebral disc degeneration in athletes compared with matched controls. The aim of this study was to evaluate early degenerative spinal disc changes in elite female CrossFit athletes quantified by 3.0 Tesla magnetic resonance imaging (MRI) matched with female none-athletes. METHODS: In a cross-sectional single-center study 19 asymptomatic adult participants, nine German female elite Crossfit athletes and ten female participants underwent spinal MRI (3.0T). Demographic data, spinal clinical examination results and sport-specific performance parameters were collected prior to the MRI. The primary outcome was the prevalence of degenerative spinal disc changes. The secondary outcome was the grade of degeneration using Pfirrmann grading. RESULTS: A total of 437 discs underwent spinal MRI (3.0T). The prevalence of early degenerative disc disease was not increased. Pfirrmann degenerative grade did not show significant differences among groups. CONCLUSION: Asymptomatic female elite Crossfit athletes do not show an increased prevalence of degenerative disc disease. Compared to a sex-matched control group, high training volume in Crossfit does not correlate to a higher incidence of degenerative disc changes in young females.

[Camera-based navigation in the hybrid operating room]. / Kamerabasierte Navigation im Hybridoperationssaal.

Camera-based navigation in the hybrid operating room represents a possibility for precise, low-complication and efficient pedicle screw insertion in spinal surgery. In addition to increasing patient safety, the use of camera-based navigation as an orientation aid for the surgeon reduces radiation exposure. Camera-based navigation focuses on the surgeon's anatomical knowledge of landmarks, preoperative image acquisition, and subsequent information integration by the navigation software. The information provided from volume tomography (cone beam computed tomography, CBCT) and surface referencing through the video input from four optical cameras and the associated surface markers is collected, processed, optimized and customized by the software used. The result is the creation of a trajectory that allows the surgeon to analyze and evaluate complex anatomical structures more easily and facilitates the performance of the planned procedure. Minimally invasive insertion of pedicle screws using surface-reference navigation (augmented reality surgical navigation; ARSN) provides comparable accuracy to conventional fluoroscopic insertion of pedicle screws while reducing radiation by eliminating the need for postoperative computed tomographic imaging.

Continuous Wear of Night and Day Orthosis Is a Key Factor for Improvement of Fixed Equinus Deformity after the Transverse Vulpius Procedure.

Background: Equinus foot deformity is secondary to either spasticity or contracture of the gastrocnemius-soleus complex. The plantar flexion is basically treated conservatively; several different surgical methods have been discussed. This paper focuses on the improvement of passive ankle dorsiflexion after a transverse Vulpius procedure in equinus foot deformity. Additionally, the influence of consequent postoperative wear of orthosis on the improvement of ankle range of motion was investigated. Methods: In total, 41 patients with neuromuscular impairment and 59 equinus feet deformities were surgically treated by using a transverse Vulpius procedure. A total of 19 female patients and 22 male patients with a mean age at surgery of 10.18 years (2 to 31) were included. Mean follow-up took place 12.26 ± 7.95 months after surgery. Passive ankle dorsiflexion was measured and subjective patients' satisfaction was assessed. Results: Range of motion, measured as the maximum of passive ankle joint dorsiflexion, improved significantly from -8° ± 5.9° to 11.1° ± 6.7° directly after surgery to 16.2° ± 10.7° at follow-up. The improvement of passive ankle dorsiflexion was significantly associated with the continuous wearing of night and day orthosis (p = 0.0045). Patient subjective satisfaction was very high. Conclusion: A transverse Vulpius procedure for aponeurotic gastrocnemius and soleus muscle lengthening of equinus foot deformity resulted in a significant improvement of passive ankle dorsiflexion. Positive surgical results correlated to a continuous use of orthotic devices.