Brain & spine最新文献

{"title":"Evaluating the impact of a hand-crafted 3D-Printed head Model and virtual reality in skull base surgery training","authors":"A. Mellal ,&nbsp;P. González-López ,&nbsp;L. Giammattei ,&nbsp;M. George ,&nbsp;D. Starnoni ,&nbsp;G. Cossu ,&nbsp;J.F. Cornelius ,&nbsp;M. Berhouma ,&nbsp;M. Messerer ,&nbsp;R.T. Daniel","doi":"10.1016/j.bas.2024.104163","DOIUrl":"10.1016/j.bas.2024.104163","url":null,"abstract":"<div><h3>Introduction</h3><div>While cadaveric dissections remain the cornerstone of education in skull base surgery, they are associated with high costs, difficulty acquiring specimens, and a lack of pathology in anatomical samples. This study evaluated the impact of a hand-crafted three-dimensional (3D)-printed head model and virtual reality (VR) in enhancing skull base surgery training.</div></div><div><h3>Research question</h3><div>How effective are 3D-printed models and VR in enhancing training in skull base surgery?</div></div><div><h3>Materials and methods</h3><div>A two-day skull base training course was conducted with 12 neurosurgical trainees and 11 faculty members. The course used a 3D-printed head model, VR simulations, and cadaveric dissections. The 3D model included four tumors and was manually assembled to replicate tumor-modified neuroanatomy. Trainees performed surgical approaches, with pre- and post-course self-assessments to evaluate their knowledge and skills. Faculty provided feedback on the model's educational value and accuracy. All items were rated on a 5-point scale.</div></div><div><h3>Results</h3><div>Trainees showed significant improvement in understanding spatial relationships and surgical steps, with scores increasing from 3.40 ± 0.70 to 4.50 ± 0.53 for both items. Faculty rated the educational value of the model with a score of 4.33 ± 0.82, and a score of 5.00 ± 0.00 for recommending the 3D-printed model to other residents. However, realism in soft tissue simulations received lower ratings.</div></div><div><h3>Discussion and conclusion</h3><div>Virtual reality and 3D-printed models enhance anatomical understanding and surgical training in skull base surgery. These tools offer a cost-effective, realistic, and accessible alternative to cadaveric training, though further refinement in soft tissue realism is needed.</div></div>","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":"5 ","pages":"Article 104163"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11718289/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142973666","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From knife to needle – the trend of vascular neurosurgery in Belgium","authors":"Jorn Van Der Veken ,&nbsp;Vera Van Velthoven ,&nbsp;Gilles Reuter ,&nbsp;Steven De Vleeschouwer ,&nbsp;Tomas Menovsky ,&nbsp;Johnny Duerinck ,&nbsp;Michaël Bruneau","doi":"10.1016/j.bas.2024.104158","DOIUrl":"10.1016/j.bas.2024.104158","url":null,"abstract":"<div><h3>Introduction</h3><div>The management of neurovascular pathologies has changed globally over the last few decades. Endovascular treatments are increasing, and fewer surgical procedures are performed.</div></div><div><h3>Research question</h3><div>Evaluate the evolution of vascular neurosurgery in Belgium over the last 30 years and compare with other countries.</div></div><div><h3>Material and methods</h3><div>Belgian nationwide data was obtained from 1991 to 2021 via the National Institute for Health and Disability Insurance (INAMI-RIZIV). Cost of surgical and endovascular implants used in 2022 was obtained.</div></div><div><h3>Results</h3><div>Over a 30-year period a total of 37,504 procedures were performed in Belgium, consisting of 13,767 (36.7%) surgeries and 23,737 (63.3%) endovascular treatments (EVT).Adjusted to population per 100000, surgical management peaked at 6.02 in 1996 and gradually dropped below 3.0 in 2019. EVT increased from 1.06 in 1991 to 10.5 in 2021.Important regional differences are seen in terms of total number of procedures as well as ratio of surgery to endovascular surgery.The total cost of surgical implants in 2022 was the equivalent of 1% of the total cost of endovascular implants.</div></div><div><h3>Discussion and conclusions</h3><div>This data confirms a similar trend to other regions in the world: a reduction in surgical management and increase in endovascular management for CNS vascular pathologies.Important regional differences are noted in terms of volume and ratio of endovascular to surgery.A nationwide registry based on patient data and outcomes can help decide whether there should be centralization to manage vascular pathologies.</div></div>","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":"5 ","pages":"Article 104158"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11719377/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142973670","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bio-ethical considerations in the application of artificial intelligence in spinal surgery","authors":"B. Bhavani Sowndharya,&nbsp;C.M. Mathan Muthu,&nbsp;A.S. Vickram,&nbsp;A. Saravanan","doi":"10.1016/j.bas.2024.104161","DOIUrl":"10.1016/j.bas.2024.104161","url":null,"abstract":"","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":"5 ","pages":"Article 104161"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11731293/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142985655","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to Editor for “Subgaleal drainage with one burr-hole for chronic subdural hematomas: Our Two-Years’ Experience”","authors":"Yad Ram Yadav ,&nbsp;Jitin Bajaj ,&nbsp;Shailendra Ratre","doi":"10.1016/j.bas.2025.104194","DOIUrl":"10.1016/j.bas.2025.104194","url":null,"abstract":"","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":"5 ","pages":"Article 104194"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143102292","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spinal metastases at the thoracolumbar junction – Influencing factors for surgical decision-making according to a multicentric registry","authors":"Vanessa Hubertus ,&nbsp;Arthur Wagner ,&nbsp;Arian Karbe ,&nbsp;Leon-Gordian Leonhardt ,&nbsp;Beate Kunze ,&nbsp;Susanne Borchert ,&nbsp;Fatma Kilinc ,&nbsp;Michelle Mariño ,&nbsp;Nitzan Nissimov ,&nbsp;Charlotte Buhre ,&nbsp;Marcus Czabanka ,&nbsp;Marc Dreimann ,&nbsp;Sven O. Eicker ,&nbsp;Lennart Viezens ,&nbsp;Hanno S. Meyer ,&nbsp;Peter Vajkoczy ,&nbsp;Bernhard Meyer ,&nbsp;Julia S. Onken","doi":"10.1016/j.bas.2025.104198","DOIUrl":"10.1016/j.bas.2025.104198","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Introduction&lt;/h3&gt;&lt;div&gt;Spinal metastases at the thoracolumbar junction (TLJ) pose a significant risk for spinal instability and necessitate special considerations regarding surgical management. Longer patient survival due to improved oncologic therapies may justify extensive instrumented surgery.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Research question&lt;/h3&gt;&lt;div&gt;The aim of this study was to analyze the standard of care in a large multicentric cohort of patients with TLJ metastases regarding surgical decision-making, management, and associated morbidity.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Material and methods&lt;/h3&gt;&lt;div&gt;Patients with surgically treated spinal metastases at the TLJ between 2010 and 2022 were enrolled at five academic tertiary spine centers. Epidemiological, surgical, clinical, and outcome data was assessed retrospectively. Surgical management was sorted according to three groups: decompression (&lt;strong&gt;&lt;em&gt;i&lt;/em&gt;&lt;/strong&gt;), decompression and posterior instrumentation (&lt;strong&gt;&lt;em&gt;ii&lt;/em&gt;&lt;/strong&gt;), and decompression and 360° instrumentation with vertebral body replacement (&lt;strong&gt;&lt;em&gt;iii&lt;/em&gt;&lt;/strong&gt;). Sole biopsies or kypho-/vertebroplasties were excluded.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;The inclusion criteria was met by 396 patients, of which 59 (15%) were treated with decompression (&lt;strong&gt;&lt;em&gt;i&lt;/em&gt;&lt;/strong&gt;), 235 (59%) with posterior instrumentation (&lt;strong&gt;&lt;em&gt;ii&lt;/em&gt;&lt;/strong&gt;), and 102 (26%) with additional vertebral body replacement (&lt;strong&gt;&lt;em&gt;iii&lt;/em&gt;&lt;/strong&gt;). The main factor for selection towards instrumentation was a higher SINS score (SINS 9 in &lt;strong&gt;&lt;em&gt;ii&lt;/em&gt;&lt;/strong&gt;, 10 in &lt;strong&gt;&lt;em&gt;iii&lt;/em&gt;&lt;/strong&gt; vs. 7 in &lt;strong&gt;&lt;em&gt;i&lt;/em&gt;&lt;/strong&gt;, p &lt; 0.0001). Surgical complications occurred in 55 cases (14%), slightly more frequent following instrumentations (15% &lt;strong&gt;&lt;em&gt;ii, iii&lt;/em&gt;&lt;/strong&gt; vs. 8% &lt;strong&gt;&lt;em&gt;i&lt;/em&gt;&lt;/strong&gt;, p = 0.427). Reoperations were necessary in 65 cases (16%), mostly due to SSI (n = 19, 29%), local recurrence (n = 15, 23%), and hardware failure (HWF) during follow-up (n = 9, 18%, &lt;strong&gt;&lt;em&gt;i-iii&lt;/em&gt;&lt;/strong&gt;, p = 0.7853). HWF occurred significantly more frequent in cases with multisegmental metastases at the TLJ (p = 0.0002) which were treated with longer constructs (p = 0.0092). Median postoperative survival was 10 months. The occurrence of complications reduced postoperative survival drastically in all groups (p = 0.0023).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Discussion and conclusion&lt;/h3&gt;&lt;div&gt;In this large multicentric patient cohort with TLJ metastases, the majority of patients (85%) were treated with instrumented spine surgery. The main factor for patient selection towards instrumented surgery was a higher SINS score. Long instrumentations for multisegmental disease at the TLJ were identified with higher risk for hardware-failure during follow-up. In those patients, frequent follow-up imaging is warranted. As postoperative survival is drastically reduced by the occurrence of postoperative complications, it is im","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":"5 ","pages":"Article 104198"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143430136","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stem cell therapies for spinal cord injury in humans: A review of recent clinical research","authors":"Keiko Sugai ,&nbsp;Masaya Nakamura ,&nbsp;Hideyuki Okano ,&nbsp;Narihito Nagoshi","doi":"10.1016/j.bas.2025.104207","DOIUrl":"10.1016/j.bas.2025.104207","url":null,"abstract":"<div><div>Recently, cell transplantation has emerged as a promising treatment for spinal cord injury (SCI). Over the past decade, numerous clinical studies of SCI have been conducted using various types of cells, including fetal neural stem/progenitor cells (NS/PCs), pluripotent stem cell-derived NS/PCs, mesenchymal stem/stromal cells (MSCs), olfactory ensheathing cells, and Schwann cells. Promising results have been reported for patients with subacute SCI, especially in studies involving MSCs, such as those conducted with Stemirac, although no universally recognized breakthroughs have been achieved. Allogenic NS/PCs may offer advantages over autologous MSCs because they have the potential for cell engraftment within the spinal cord and can be prepared in advance, facilitating their administration during the hyperacute phase. Recent advances achieved with induced pluripotent stem cells indicate their promise potential to be used in future therapies. This review provides an overview of recent clinical studies and discusses potential advancements anticipated in the future.</div></div>","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":"5 ","pages":"Article 104207"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143387279","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The management of odontoid fractures through the lens of evolution in classification schemes: A systematic review with illustrative case examples","authors":"Fernando Luiz Rolemberg Dantas ,&nbsp;François Dantas ,&nbsp;Karlo M. Pedro ,&nbsp;Victor Kelles Tupy da Fonseca ,&nbsp;Michael G. Fehlings","doi":"10.1016/j.bas.2025.104205","DOIUrl":"10.1016/j.bas.2025.104205","url":null,"abstract":"<div><h3>Introduction</h3><div>Odontoid fractures account for approximately 15% of all cervical spine fractures. Despite numerous classification systems, controversy persists regarding the ideal treatment of these fractures, especially in elderly and medically frail patients.</div></div><div><h3>Research question</h3><div>This article aims to provide a systematic review of odontoid fracture classifications and assess their clinical applicability.</div></div><div><h3>Material and methods</h3><div>A systematic literature review was conducted in PubMed, Embase, and Cochrane databases using the terms “odontoid”, “fracture”, and “classification”. Articles published between 1974 and 2024 were analyzed and those containing odontoid fracture classifications were included.</div></div><div><h3>Results</h3><div>Four hundred and fifty-seven articles were identified, and 32 were selected for detailed investigation. Seven articles were selected after reviewing the full text, and four additional articles cited in the references were included, from which two were published before 1974. A total of eleven classification systems were found in the literature. The classifications were based on the position and direction of the fracture line, displacement, angulation, embryology, and odontoid anatomy. The AO Spine Classification System was among the more recent frameworks reviewed and analyzes the presence of ligamentous injury or translation.</div></div><div><h3>Discussion and conclusions</h3><div>Anderson and D'Alonzo, Roy-Camille, Grauer, and the AO Spine Classification System are the most commonly applied in clinical practice. However, existing systems lack specific considerations for osteoporosis and the medical frailty of elderly patients, who constitute a substantial portion of cases. Future classification systems should address these factors to better guide treatment for this population.</div></div>","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":"5 ","pages":"Article 104205"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143387280","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of spinal deformity and its progression in pyogenic spondylodiscitis: A retrospective MRI study of 59 cases","authors":"Andreas Kramer ,&nbsp;Jonathan Neuhoff ,&nbsp;Santhosh G. Thavarajasingam ,&nbsp;Rebecca Sutherland ,&nbsp;Hugh McCaughan ,&nbsp;Benjamin Davies ,&nbsp;Ehab Shiban ,&nbsp;Florian Ringel ,&nbsp;Andreas K. Demetriades","doi":"10.1016/j.bas.2025.104204","DOIUrl":"10.1016/j.bas.2025.104204","url":null,"abstract":"<div><h3>Introduction</h3><div>Pyogenic spondylodiscitis management often remains conservative without surgical intervention, yet the risk of spinal deformity under such therapy is unclear.</div></div><div><h3>Research question</h3><div>This study explores spinal deformity progression in conservatively treated patients and identifies predictive factors for deformity advancement.</div></div><div><h3>Material and methods</h3><div>Retrospective cohort design with radiological data analysis from 59 patients with conservatively treated pyogenic spondylodiscitis. Deformities were categorized into four progression types reflecting severity: Type 1 (progressive vertebral body edema/endplate erosion), Type 2 (Type 1 plus disc space collapse), Type 3 (vertebral body destruction/mild translation), and Type 4 (significant segmental kyphosis &gt;20°/severe translation).</div></div><div><h3>Results</h3><div>Among 59 patients, 66% exhibited progressive deformity over a mean follow-up of 10.75 months. The distribution of deformity progression was: Type 1 in two cases (3%), Type 2 in seven cases (12%), Type 3 in 13 cases (22%), and Type 4 in 17 cases (29%). Progression of deformity included a 92% increase in cases with segmental kyphosis &gt;20°; and a 167% increase in cases with segmental translation. Risk factors for significant kyphosis included &gt;50% vertebral body erosive destruction (p &lt; 0.01) and the presence of an epidural abscess (p &lt; 0.05). Lumbar region involvement significantly reduced the likelihood of spinal fusion at follow-up (p &lt; 0.05). A paravertebral abscess was significantly associated with the presence of a fractured vertebrae at follow-up (p &lt; 0.05).</div></div><div><h3>Discussion and conclusion</h3><div>This study underscores the importance of closely monitoring patients with conservatively managed pyogenic spondylodiscitis for progressive spinal deformity, and suggests considering early surgical intervention in cases with a high risk of progression.</div></div>","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":"5 ","pages":"Article 104204"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143350173","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The onco-functional balance in diffuse gliomas: Evolution of the concept over the past decade – And the next steps","authors":"Hugues Duffau","doi":"10.1016/j.bas.2024.104170","DOIUrl":"10.1016/j.bas.2024.104170","url":null,"abstract":"","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":"5 ","pages":"Article 104170"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11753966/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143030362","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Kinematic limitations during stair ascent and descent in patients with adult spinal deformity","authors":"Marc Fakhoury ,&nbsp;Rami Rachkidi ,&nbsp;Karl Semaan ,&nbsp;Krystel Abi Karam ,&nbsp;Maria Saadé ,&nbsp;Elma Ayoub ,&nbsp;Celine Chaaya ,&nbsp;Ali Rteil ,&nbsp;Elena Jaber ,&nbsp;Elio Mekhael ,&nbsp;Nabil Nassim ,&nbsp;Mohamad Karam ,&nbsp;Julien Abinahed ,&nbsp;Ismat Ghanem ,&nbsp;Abir Massaad ,&nbsp;Ayman Assi","doi":"10.1016/j.bas.2024.104153","DOIUrl":"10.1016/j.bas.2024.104153","url":null,"abstract":"<div><h3>Background</h3><div>Adults with spinal deformity (ASD) are known to have spinal malalignment, which can impact their quality of life and their autonomy in daily life activities. Among these tasks, ascending and descending stairs is a common activity of daily life that might be affected.</div></div><div><h3>Research question</h3><div>What are the main kinematic alterations in ASD during stair ascent and descent?</div></div><div><h3>Methods</h3><div>112 primary ASD patients and 34 controls filled HRQoL questionnaires and underwent biplanar X-from which spino-pelvic radiographic parameters were calculated. Patients were divided into 3 groups: 44 with sagittal malalignment (ASD-Sag: PT &gt; 25°, SVA&gt;5 cm or PI-LL&gt;10°), 42 with isolated thoracic hyperkyphosis (ASD-HyperTK: TK &gt; 60°), 26 with isolated frontal spine deformity (ASD-Front: Cobb&gt;20°). All participants underwent 3D motion analysis of the whole body while ascending and descending a stair step from which kinematic waveforms were extracted.</div></div><div><h3>Results</h3><div>During stair ascent, ASD-Sag exhibited an increased thorax flexion (20 vs 5°), a decreased lumbar lordosis L1L3-L3L5 (7 vs 14°), and an increased ROM of lumbo-pelvic joint (15 vs 10°, all p &lt; 0.05), compared to controls. Similar compensations were shown while descending the stairstep. ASD-HyperTK had similar kinematic limitations as ASD-Sag but to a lesser extent. ASD-Front had normal kinematic patterns. PCS-SF36 correlated to thorax flexion (r = −0.45) and ODI was correlated to pelvic tilt ROM (r = 0.46).</div></div><div><h3>Discussion and conclusion</h3><div>ASD subjects with sagittal malalignment tend to ascend and descend stairs with increased thorax flexion, making them more prone to falls. Compensation mechanisms occur at the head and lumbo-pelvic levels to maintain balance and avoid falling forward.</div></div>","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":"5 ","pages":"Article 104153"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11699387/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142933954","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}