Distal Hamstring Muscle Injuries.

¼: Distal hamstring muscle injuries, although relatively uncommon, can potentially lead to substantial morbidity in athletes; prolonged rehabilitation times and high rates of reoccurrence have been documented. ¼: Overall, magnetic resonance imaging is considered the "gold standard" for evaluation of hamstring injuries because it allows assessment for concomitant pathology and can clarify return-to-sport timelines. ¼: Complete tears of the distal biceps femoris and semimembranosus muscles respond well to surgical repair, whereas complete tears of the distal semitendinosus can be successfully treated nonoperatively or with surgical resection. ¼: Future research may be necessary to further optimize treatment of these injuries and to determine the efficacy of biologic adjuvant therapy.

Sagittal alignment differences on the operating room table compared to preoperative and postoperative imaging in anterior cervical discectomy and fusion.

Study Design: The study design used was a retrospective cohort. Objective: The objective of this study is to determine if intraoperative improvements in sagittal alignment on the operating table persisted on postoperative standing radiographs. Summary of Background Data: Cervical sagittal alignment may be correlated to postoperative outcomes. Since anterior cervical discectomy and fusions (ACDFs) can restore some cervical lordosis through intervertebral grafts/cages, it is important to understand if intraoperative radiographic measurements correlate with persistent postoperative radiographic changes. Materials and Methods: Patients undergoing elective primary ACDF were screened for the presence of lateral cervical radiographs preoperatively, intraoperatively, and postoperatively. Patients were excluded if their first postoperative radiograph was more than 3 months following the procedure or if cervical lordosis was not able to be measured at each time point. Paired t-tests were utilized to compare differences in measurements between time points. Statistical significance was set at P < 0.05. Results: Of 46 included patients, 26 (56.5%) were female, and the mean age was 55.2 ± 11.6 years. C0-C2 lordosis significantly increased from the preoperative to intraoperative time point (delta [Δ] = 4.49, P = 0.029) and significantly decreased from the intraoperative to postoperative time period (Δ = -6.57, P < 0.001), but this resulted in no significant preoperative to postoperative change (Δ = -2.08, P = 0.096). C2 slope decreased from the preoperative to the intraoperative time point (Δ = -3.84, P = 0.043) and significantly increased from the intraoperative to the postoperative time point (Δ = 3.68, P = 0.047), which also resulted in no net change in alignment between the preoperative and postoperative periods (Δ = -0.16, P = 0.848). There was no significant difference in the C2-C7 SVA from the preoperative to intraoperative (Δ = 0.85, P = 0.724) or intraoperative to postoperative periods (Δ = 2.04, P = 0.401); however, the C2-C7 SVA significantly increased from the preoperative to postoperative period (Δ = 2.88, P = 0.006). Conclusions: Intraoperative positioning predominantly affects the mobile upper cervical spine, particularly C0-C2 lordosis and C2 slope, but these changes do not persist postoperatively.