Study Design Retrospective cohort study. Purpose The objective of this study was to compare three widely used interbody fusion approaches in regard to their ability to correct sagittal balance, including pelvic parameters. Overview of Literature Restoration of sagittal balance in lumbar spine surgery is associated with better postoperative outcomes. Various interbody fusion techniques can help to correct sagittal balance, with no clear consensus on which technique offers the best correction. Methods The charts and imaging of patients who have undergone surgery through either open transforaminal lumbar interbody fusion (TLIF), minimally invasive TLIF (MIS TLIF), or oblique lumbar interbody fusion (OLIF) were retrospectively reviewed. The following sagittal balance parameters were measured pre- and postoperatively: segmental lordosis, lumbar lordosis, disk height, pelvic tilt, and pelvic incidence. Data on postoperative complications were gathered. Results Only OLIF managed to significantly improve segmental lordosis (4.4°, p <0.001) and lumbar lordosis (4.8°, p =0.049). All approaches significantly augmented disk height, with OLIF having the greatest effect (3.7°, p <0.001). No approaches were shown to significantly correct pelvic tilt. Pelvic incidence remained unchanged in all approaches. Open TLIF was the only approach with a higher rate of postoperative complications (33%, p =0.009). Conclusions The OLIF approach might offer greater correction of sagittal balance over open and MIS TLIF, mainly in regard to segmental lordosis, lumbar lordosis, and disk height. MIS TLIF, although offering more limited access than open TLIF, was not inferior to open TLIF in regard to sagittal balance correction. A higher rate of complications was shown for open TLIF than the other approaches, possibly due to its more invasive nature.
This article argues that well before the taxpayer revolts of the 1970s, taxpayer identity was a consciously privileged claim that both obscured class divisions among whites and elevated those racialized groups presumed to have higher taxable income to a higher position in claiming citizenship rights. The paper examines hundreds of letters to the Supreme Court defending racial segregation in the wake of the Brown decision from 1954 to 1970, a third of which deployed the purportedly ‘neutral’ language of taxpayer status to argue for the maintenance of the structure of white supremacy and inequality in educational access and resources. In this ‘marketplace of citizenship,’ whiteness was automatically presumed to imply ‘taxpayer,’ a category which was then deployed to claim educational entitlement for white children. Meanwhile, ‘nontaxpayer’ was consistently racialized – regardless of actually taxpaying levels – and treated as a justification for inequality. This article argues that the very question of who can claim an identity as a ‘taxpayer’ (and why they may choose to) is deeply historically racialized and serves to construct people of color as outside the burdens and benefits of citizenship as well as ensuring that the poor more broadly are perpetually insecure in their access to rights claims.
In the United States, it is quite common to lay claim to the benefits of society by appealing to “taxpayer citizenship”--the idea that, as taxpayers, we deserve access to certain social services like a public education. Tracing the genealogy of this concept, this book shows how tax policy and taxpayer identity were built on the foundations of white supremacy and intertwined with ideas of whiteness in civil rights law and constitutional law. From the origins of unequal public school funding after the Civil War and the history of African American families resisting segregated taxation through school desegregation cases from Brown v. Board of Education to San Antonio v. Rodriguez in the 1970s, this study spans over a century of racial injustice, dramatic courtroom clashes, and white supremacist backlash to collective justice claims. Incorporating letters from everyday individuals as well as the private notes of Supreme Court justices as they deliberated, this legal history reveals how the idea of a “taxpayer” identity contributed to the contemporary crises of public education, racial disparity, and income inequality.
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