We report the assessment of anatomical relationships between lumbar nerves and vertebral bodies using diffusion tensor imaging (DTI). The lumbar nerves at L3/4 and L4/5 were located posterior to the vertebral body center, those in the lateral decubitus position were displaced posteriorly, and those on the convex side exhibited a posterior shift in the adult spinal deformity. The lateral decubitus position or the supine position with hips flexed may be useful for avoiding nerve damage. In the direct lateral transpsoas approach, the approach from the convex side was safer than that from the concave side. Preoperative DTI appears to be useful in evaluating the lumbar nerve course because it anatomically relates to the vertebral body.
This study describes the involvement of low back pain and sarcopenia/osteoporosis associated with kyphosis in elderly women. The findings of our study suggest the involvement of decreases in trunk and limb skeletal muscle mass, which are pelvic-lumbar support structures, in spinal deformity progression and increased low back pain. Spinal deformity, osteoporosis, and sarcopenia may be associated with each other, and conservative treatments, such as exercise therapy, nutritional methods, and medications (e.g., vitamin D), that promote skeletal muscle enhancement are anticipated.
Introduction: Pedicles of the main thoracic curve in patients with adolescent idiopathic scoliosis (AIS) are often narrow on the concave side and within close proximity to risk structures, pedicle screw (PS) insertion can be challenging. Although sublaminar taping may be used as an anchor in such cases, the possibility of its insufficient corrective force remains a concern.
Methods: This study retrospectively investigated the differences in the surgical results of posterior spinal fusion with and without sublaminar taping for AIS Lenke type 1-4 curves. A total of 36 patients with AIS (mean age, 14.7 years) were enrolled.
Results: Corrective surgery with sublaminar taping achieved a Cobb angle correction rate of 63.3% and rotational correction rate of 48.8% at 1 year after surgery, which were comparable to the results of PS fixation (59% and 46%, respectively).
Conclusions: Thus, AIS deformity correction with sublaminar taping may be a suitable option in Lenke 1-4 cases with very narrow pedicles.
Introduction: It is unknown whether changes in CRP at an early stage correlate with conservative treatment period in spondylodiscitis.
Methods: In total, 41 cases of spondylodiscitis managed conservatively from 2012 to 2014 were retrospectively identified. Changes in CRP at 1 week were measured. According to the median of the change (54.9%), we divided the objects in two groups, namely, good or poor, and investigated the difference in the treatment period.
Results: The conservative treatment period was significantly longer in the poor group (69.7 days) than the good group (37.9 days). The risk ratio was 1.019 with a proportion hazard model assessing the correlation between the CRP level percent improvement in 1 week and the conservative treatment period.
Conclusions: Changes in CRP at an early stage correlate with the conservative treatment period in spondylodiscitis.