FELIF is a safe and effective interbody fusion option to decompress the lumbar exiting nerve root and ventral side of dura directly with minimal invasive situation. These slides can be retrieved under Electronic Supplementary Material.

4 J. Magn. Reson. Imaging 2017;45:94-102.

Changes in cervical sagittal parameters were significant after deformity correction in AIS patients. Correlation analysis revealed significant relationships between postoperative radiographic parameters and HRQOL. In particular, T1 slope and C2-C7 SVA were found to be significant predictors of HRQOL in AIS patient.

Purpose Little data are available on the relationship between sagittal spinopelvic parameters and health related quality of life (HRQOL) in ankylosing spondylitis (AS) patients. The aim of this study was to identify the relationships between spinopelvic parameters and HRQOL in AS. Methods The study and control groups comprised 107 AS patients and 40 controls. All underwent anteroposterior and lateral radiographs of the whole spine including hip joints and completed clinical questionnaires. The radiographic parameters examined were sacral slope, pelvic tilt, pelvic incidence, thoracic kyphosis, lumbar lordosis, and sagittal vertical axis. A Visual Analogue Scale (VAS: 0-10) score for back pain, the Oswestry disability index (ODI) questionnaire, Scoliosis Research Society (SRS-22) questionnaire and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) were administered to evaluate QOL. Statistical analysis was performed to identify significant differences between the study and control groups. In addition, correlations between radiological parameters and clinical questionnaires were sought. Results The AS patients and controls were found to be significantly different in terms of sagittal vertical axis, sacral slope, pelvic tilt, pelvic incidence, and lumbar lordosis. However, no significant intergroup difference was observed for thoracic kyphosis (P [ 0.05). Of the 107 AS patients, there were 18 women and 89 men. Correlation analysis revealed significant relationships between radiographic parameters and clinical outcomes. Multiple regression analysis was performed to identify predictors of clinical outcome, and the results obtained revealed that sagittal vertical axis and sacral slope significantly predicted VAS, ODI and BASDAI scores and that sagittal vertical axis and lumbar lordosis predicted SRS-22 scores. Conclusions AS patients and normal controls were found to be significantly different in terms of sagittal spinopelvic parameters. Correlation analysis revealed significant relationships between radiographic parameters and clinical outcomes. In particular, sagittal vertical axis, sacral slope and lumbar lordosis were found to be significant parameters in prediction of clinical outcomes in AS patient.

Purpose To retrospectively investigate the relationship between the kinetic features of breast cancer assessed with computer-aided diagnosis (CAD) at preoperative magnetic resonance (MR) imaging and disease-free survival in patients with primary operable invasive breast cancer. Materials and Methods This retrospective study was approved by the institutional review board. The requirement to obtain informed consent was waived. The authors identified 329 consecutive women (mean age, 52.9 years; age range, 32-88 years) with newly diagnosed invasive breast cancer who had undergone preoperative MR imaging and surgery between January 2012 and February 2013. All MR images were retrospectively reviewed by using a commercially available CAD system, and the following kinetic parameters were noted for each lesion: peak enhancement (highest pixel signal intensity in the first series obtained after administration of contrast material), angio-volume (total volume of the enhancing lesion), and delayed enhancement profiles (the proportions of washout, plateau, and persistently enhancing component within a tumor). Cox proportional hazards modeling was used to identify the relationship between CAD-generated kinetics and disease-free survival after adjusting for clinical-pathologic variables. Results A total of 36 recurrences developed at a median follow-up of 50 months (range, 15-55 months). CAD-measured peak enhancement at preoperative MR imaging enabled differentiation between patients with and patients without recurrence (area under the receiver operating characteristic curve = 0.728; 95% confidence interval [CI]: 0.676, 0.775; P < .001). Multivariate Cox analysis showed that a higher peak enhancement (hazard ratio [HR] = 1.001; 95% CI: 1.000, 1.002; P = .004), a higher washout component (HR = 1.029; 95% CI: 1.005, 1.054; P = .017), and lymphovascular invasion at histopathologic examination (HR = 3.011; 95% CI: 1.302, 6.962; P = .010) were associated with poorer disease-free survival. Conclusion Higher values of CAD-measured peak enhancement and washout component at preoperative MR imaging were significantly associated with poorer disease-free survival of patients with primary operable breast cancer. RSNA, 2017.

PurposeSpinopelvic fixations involving the S2-alar-iliac (S2AI) and iliac screws are commonly used in various spinal fusion surgeries. This study aimed to compare the biomechanical characteristics, specifically the risk of screw and adjacent bone failures of S2AI screw fixation with those of iliac screw fixation using a finite element analysis (FEA).MethodsA three-dimensional finite element (FE) model of a healthy spinopelvis was generated. The pedicle screws were placed on the L3-S1 with three different lengths of the S2AI and iliac screws (60 mm, 75 mm, and 90 mm). In particular, two types of the S2AI screw, 15°- and 30°-angled polyaxial screw, were adopted. Physiological loads, such as a combination of compression, torsion, and flexion/extension loads, were applied to the spinopelvic FE model, and the stress distribution as well as the maximum von Mises equivalent stress values were calculated.ResultsFor the iliac screw, the highest stress on the screw was observed with the 75-mm screw, rather than the 60-mm screw. The bones around the iliac screw indicated that the maximum equivalent stress decreased as the screw length increased. For the S2AI screw, the lowest stress was observed in the 90-mm screw length with a 30° head angle. The bones around the S2AI screw indicated that the lowest stress was observed in the 90-mm screw length and a 15° head angle.ConclusionsIt was found that the S2AI screw, rather than the iliac screw, reduced the risk of implant failure for the spinopelvic fixation technique, and the 90-mm screw length with a 15° head angle for the S2AI screw could be biomechanically advantageous.

Cervical sagittal parameters were found to be significantly different in AS patients and normal controls. Correlation analysis revealed significant relationships between radiographic parameters and QOL. In particular, C2-C7 SVA was found to be a significant predictor of QOL in AS patient.

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