High-Yield Summary Degenerative lumbar scoliosis (DLS) in the elderly results from asymmetric disc degeneration and facet arthropathy, leading to coronal and sagittal imbalance with predominant back pain and neurogenic claudication. Surgical indications hinge on progressive deformity with neurological compromise or intractable pain refractory to optimized conservative management. Radiographic assessment must include full-length standing scoliosis films […]
High-Yield Summary Sagittal balance is critical for maintaining efficient posture and minimizing energy expenditure; disruption correlates strongly with pain and disability in spinal deformity and degenerative conditions. Key radiographic parameters include pelvic incidence (PI), pelvic tilt (PT), sacral slope (SS), lumbar lordosis (LL)and sagittal vertical axis (SVA); their interplay guides surgical planning. Mismatch between pelvic […]
High-Yield Summary Cervical laminoplasty decompresses the spinal cord by expanding the spinal canal while preserving posterior elements, minimizing post-laminectomy instability and kyphosis. Key anatomical considerations include the laminae, facet jointsand the vertebral artery course; preserving facet integrity is critical to maintain stability. Surgical approaches primarily include open-door and double-door laminoplasty, chosen based on pathology location […]
High-Yield Summary C1 (atlas) fractures primarily involve the anterior and posterior arches; stability hinges on the integrity of the transverse atlantal ligament (TAL). Non-displaced, stable fractures with intact TAL are managed conservatively with rigid cervical immobilization. Displaced fractures or those with TAL disruption require surgical stabilization to prevent atlantoaxial instability and neurologic compromise. Surgical options […]
High-Yield Summary Sacral fractures require precise classification to guide management; instability and neurological involvement are key determinants for surgery. The Denis classification remains the cornerstone for assessing fracture zone and neurological risk, while the AO Spine Sacral Classification refines surgical decision-making. Non-operative treatment is reserved for stable, non-displaced fractures without neurological deficit; operative intervention is […]
High-Yield Summary Basilar invagination (BI) and platybasia represent craniovertebral junction (CVJ) deformities causing brainstem and upper cervical spinal cord compression, often requiring precise radiographic assessment and tailored surgical intervention. Key surgical goals include decompression, stabilization, and realignment; choice of approach depends on reducibility and neurological status. Dynamic imaging and CT-based morphometrics guide classification and operative […]
High-Yield Summary Cauda Equina Syndrome (CES) is a surgical emergency characterized by compression of the lumbosacral nerve roots, requiring urgent decompression within 48 hours to optimize neurological recovery. Key clinical features include bilateral lower extremity weakness, saddle anesthesia, bladder/bowel dysfunction, and variable lower limb sensory loss. MRI is the diagnostic gold standard; clinical suspicion must […]
High-Yield Summary Ossification of the Posterior Longitudinal Ligament (OPLL) is a progressive hyperostotic condition causing spinal canal narrowing and myelopathy, predominantly affecting the cervical spine in East Asian populations but increasingly recognized worldwide. Surgical intervention is indicated for progressive myelopathy or significant canal compromise; approach selection hinges on OPLL morphology, spinal alignment, and extent of […]
High-Yield Summary Osteoporotic vertebral compression fractures (OVCFs) primarily affect the anterior column, leading to wedge deformities and sagittal imbalance; early recognition and management prevent chronic disability. Non-operative treatment is first-line for stable fractures without neurologic compromise, focusing on pain control, mobilization, and osteoporosis management. Indications for surgery include progressive deformity, intractable pain, neurologic deficit, or […]
High-Yield Summary Scheuermann’s kyphosis is a rigid, structural thoracic or thoracolumbar hyperkyphosis characterized by anterior vertebral wedging of ?5° in three consecutive vertebrae, typically presenting in adolescence. Clinical presentation includes progressive thoracic kyphosis, back pain, and postural deformity; neurological deficits are rare but warrant urgent evaluation. Diagnosis relies on standing lateral spine radiographs demonstrating wedging, […]
Last Updated on January 25, 2026 by Christian Veillette
