By Florian Ringel MD, Jimmy Villard MD, Yu-Mi Ryang MD, Bernhard Meyer MD (auth.), Johannes Schramm (eds.)
This quantity of Advances and Technical criteria in Neurosurgery is dedicated completely to the backbone. Like different volumes within the sequence, it offers very important fresh growth within the box and provides targeted descriptions of ordinary approaches to help younger neurosurgeons. one of the advances thought of are techniques to spinal navigation, together with intraoperative imaging established navigation, and ideas of spinal robotics. the worth of sagittal stability as a parameter for the neurosurgeon is tested, and a singular surgical method of longitudinal pathologies in the spinal canal is gifted. advancements in surgical procedure for kyphosis also are mentioned, with a spotlight on pedicle subtraction osteotomy. The technical criteria part seriously studies the newest proof concerning cervical disc arthroplasty and pedicle-based non-fusion stabilization units. The publication concludes via discussing the therapy of craniovertebral junction instability due to juvenile power arthritis.
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Extra info for Advances and Technical Standards in Neurosurgery: Volume 41
Fig. 10 Typical cases of lumbosacral spondylolisthesis described in the Spinal Deformity Study Group classification. PI indicates pelvic incidence, PT pelvic tilt, SS sacral slope require greater than normal LL to achieve sagittal balance. Any loss of LL in the instrumentation will therefore be less well tolerated by high PI patients. Patients with high PI will most of the time have a low relative LL even in the presence of normal-appearing LL and are at risk for delayed complications, including implant failure or loosening and adjacent segment degeneration due to the increased solicitation of the mobile segments.
Balanced pelvis patients (low PT and high SS) are grouped in type 4 and unbalanced patients presenting a retroverted pelvis and a vertical sacrum (high PT and low SS) must further be divided in two groups, with a balanced spine (C7PL >3 cm) or unbalanced spine (C7PL ≥3 cm) (Fig. 9). The six types are depicted on Fig. 10. A recent study  proved substantial inter- and intraobserver reliability of this classification. 38 J. Villard et al. 100 90 80 Sacral slope (dergress) 70 Balanced 60 50 40 Unbalanced 30 20 10 0 0 10 20 30 Pelvic tilt (degress) 40 50 60 Fig.
The sacral slope (SS), defined as the angle between the superior plate of S1 and a horizontal line. A vertical sacrum is described by a low value, a horizontal sacrum by a high value. 3. Pelvic tilt (PT), defined as the angle between the line connecting the midpoint of the sacral plate to the femoral heads axis and the vertical. 4. The overhang of S1 with regard to the femoral heads commonly also called the sacrofemoral distance (SFD) defined as the distance between the bicoxofemoral axis and the projection to this level of the midpoint of the sacral plate.