The midline and lateral parascapular extrapleural exposuresAlexander Bardis
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This document discusses the cervicothoracic junction (CTJ) region of the spine, which spans from C7 to T3. It covers various pathologies that can affect the CTJ including trauma, tumors, metastases, and iatrogenic instability. Surgical treatment approaches for the CTJ are also summarized, including both posterior approaches like laminectomy and instrumented fusion as well as combined anterior-posterior procedures.
1. Interspinous process spacers are implants placed between adjacent lumbar spinous processes as a less invasive alternative to spinal fusion surgery. They are designed to preserve motion while reducing pain by decreasing pressure on spinal discs and facets.
2. Biomechanical studies show that spacers reduce intradiscal pressure and facet joint contact area at implanted levels without affecting adjacent segments. Clinical reports also suggest spacers provide short-term symptom improvement for appropriately selected patients.
3. However, concerns exist that the spacers may cause local pain over time and weaken spinal stability by disrupting ligaments and maintaining facet joints in distraction. Further research is still needed to establish the long-term efficacy and safety of interspin
123. Scoliosis should be considered as an independent
disease; only in the case of scoliosis curve progression
over time, associated scoliosis must be treated,
according to therapeutic principles of the care of any socalled
idiopathic scoliosis of similar magnitude, and a
similar approach must be applied in the case of spondylolisthesis
progression or painful spondylolisthesis.
124. Relevant parameters of sagittal imbalance
have been identified and correlated with clinical outcomes.
Methods for calculation of surgical correction of imbalance
have been proposed, but not validated in patients with midterm
follow-up.