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A retrospective case series.<br />The aim of this study was to introduce the prevention of total hip arthroplasty (THA) dislocation using an implant impingement simulation after spinal corrective fusion and to verify the outcomes.<br />A high dislocation rate was found among patients who underwent spinal deformity corrective fusion with previous THA. To avoid dislocation, an appropriate position of the stem and cup is important, but the pelvic inclination may change after corrective fusion for spinal deformity.<br />Twelve consecutive patients (two men, 10 women; average age, 72.1 [range, 55-81] years during spine surgery) with previous THA were included. Data were retrospectively retrieved from a single-center's prospectively collected database of adult spinal deformity operation. [https://www.selleckchem.com/products/anacetrapib-mk-0859.html this website] Before surgery, anterior implant impingement simulation in THA was performed using computed tomography-based software. The tolerable pelvic tilt (PT) in which the anterior implant impingement occurred in the hip at the 120° flexion positiidence 4.<br />Our simulation of anterior implant impingement and subsequent adjustment of the degree of spinal correction was useful to prevent dislocation. However, this method did not prevent dislocation in some patients.Level of Evidence 4.<br />Experimental animal study.<br />The aim of this study was to clarify chronological effects of mechanical stress on ligamentum flavum (LF) using a long-term fusion rabbit model.<br />LF hypertrophy is a major pathology of lumbar spinal stenosis (LSS), but its mechanism remains unclear. We previously demonstrated mechanical-stress-induced LF hypertrophy with a rabbit model. However, we only investigated LFs at a single time point in the short-term; the effects of long-term mechanical stress have not been elucidated.<br />Eighteen-week-old male New Zealand White rabbits were randomly divided into two groups the mechanical stress group underwent L2-3 and L4-5 posterolateral fusion and resection of the L3-4 supraspinal muscle, whereas the control group underwent only surgical exposure. Rabbits were sacrificed 16 and 52 weeks after the procedure. Axial specimens of LFs at L3-4 were evaluated histologically. Immunohistochemistry for alpha-smooth muscle actin (α-SMA) was performed to assess the numbers of vessels and myofibat long-term mechanical stress caused LF hypertrophy with progressive elastic fiber disruption and cartilage matrix production accompanied by enhanced myofibroblasts. In addition, the reported rabbit model could be extended to elucidate the mechanism of LF hypertrophy and to develop new therapeutic strategies for LSS by preventing LF hypertrophy.Level of Evidence SSSSS.<br />Observational, anatomical, radiological study.<br />The aim of this study was to explore the incidence and type of vertebral artery (VA) variation in patients with congenital cervical scoliosis and approach their clinical importance during surgery.<br />Congenital scoliosis of the cervical spine is usually sporadic and caused by a variety of bone structural anomalies. Most of the cases remain asymptomatic. Surgical intervention is the main management for patients with neurological compromise or with cosmetic demands. The operation involved more screw insertion and osteotomy than the regular degenerative cases. The incidence and pattern of VA variants in these patients have not been reported.<br />Patients with congenital cervical scoliosis treated in our department were reviewed. We measured Cobb angle of cervical spine. We observed bilateral VAs and recorded variants. We measured their diameter in each segment through CT angiography. The bilateral diameter in each patient was then compared respectively.<br />There is e, but patients with a dominance of VA have a larger Cobb angle. The incidence of variant in V2 and V3 segment is higher. A thorough evaluation of bilateral VAs is required before surgery. Extra cautions must be taken during surgery.Level of Evidence 5.<br />Retrospective cross-sectional cohort.<br />The aim of this sudy was to determine whether muscle health measurements are associated with health-related quality of life scores (HRQOLs) for patients with lumbar spine pathology.<br />Poor muscle health has been implicated as a source of pain/dysfunction for patients with lumbar spine pathology. Our aim was to quantify the relationship using muscle health measurements and HRQOLs.<br />Three hundred and eight patients were included (mean age 57.7 ± standard deviation 18.2 years' old). We randomly selected patients into a derivation cohort (200) and validation cohort (108) to create our muscle health grade. We measured muscle health by the lumbar indentation value (LIV), goutallier classification (GC), and ratio of paralumbar muscle cross-sectional area over body mass index (PL-CSA/BMI). A muscle health grade was derived based on whether a measurement showed a statistically significant impact on visual analog scale back and leg pain (VAS-leg and VAS-leg), Oswestry Disabiligy.Level of Evidence 3.<br />This study offers an objective measurement of muscle health that correlates with HRQOLs for patients with lumbar spine pathology.Level of Evidence 3.<br />Retrospective cohort.<br />The aim of this study was to analyze association between social determinants of health (SDH) disparity on postoperative complication rates, and 30-day and 90-day all-cause readmission in patients undergoing single-level lumbar fusions.<br />Decreasing postoperative complication rates is of great interest to surgeons and healthcare systems. Postoperative complications are associated with poor convalescence, inferior patient reported outcomes measures, and increased health care resource utilization. Better understanding of the association between Social Determinants of Health (SDH) on postoperative outcomes maybe helpful to decrease postoperative complication rates.<br />MARINER 2020, an all-payer claims database, was utilized to identify patients undergoing single-level lumbar fusions between 2010 and 2018. The primary outcomes were the rates of any postoperative complication, symptomatic pseudarthrosis, need for revision surgery, or 30-day and 90-day all-cause readmission.<br />The exact matched population analyzed in this study contained 16,560 patients (8280 [50.