Lieven Moke

• Universitair Ziekenhuis Leuven

Introduction Integrated care pathways may help to bridge evidence-practice gaps. To overcome the limitations of traditional researcher-centred and linear pathway development frameworks, a more user-centred approach is needed. In this study, we propose design thinking as a framework for developing integrated care pathways, specifically targeting reh...

Background: Musculoskeletal models (MSKM) can non-invasively evaluate the effect of altered muscle geometry and physiology on locomotor function. Nevertheless, this requires anatomically accurate muscle paths throughout functional ranges of motion. However, reference data to evaluate such muscle paths is rarely available, including in adult spinal...

Purpose To evaluate the effectiveness of an evidence-based pre-, peri- and postoperative rehabilitation pathway (i.e. the REACT rehabilitation pathway) on disability in patients undergoing lumbar fusion surgery (LFS), compared to usual care. Methods A prospective, nonrandomized controlled trial included 72 patients scheduled for one- or two-level...

Introduction The REACT trial demonstrated that a pre-, peri- and postoperative rehabilitation pathway (i.e. REACT rehabilitation) was associated with greater improvements in disability, back pain, and return-to-work rate, compared with usual care, after lumbar fusion surgery (LFS). Research question To assess the potential cost-utility of the REAC...

The insertion of ilio-sacral (IS) screws for distal anchoring in the instrumentation of pediatric neuromuscular scoliosis (NS) presents a significant challenge, often leading to elevated rates of complications. Utilizing computed tomography (CT) navigation and preoperative planning technology is proposed as a potential solution to mitigate these ch...

Objectives To explore the views of patients and healthcare providers on current rehabilitation after lumbar fusion surgery (LFS) to fuel the development of a novel rehabilitation care pathway. Design A cross-sectional, qualitative study with an interpretive descriptive design. Setting Academic and non-academic hospital setting in Belgium. Partic...

Purpose: Treatment of AIS, a three-dimensional spinal (3D) deformity, is guided by a two-dimensional (2D) evaluation. Novel 3D approaches that address the 2D limitations have not been adopted in AIS care due to their lengthy and complex 3D reconstruction procedures. This study aims to introduce a simple 3D method that translates the 2D key paramet...

Background: There is limited evidence to guide the rehabilitation of patients following single or double-level lumbar fusion surgery (LFS). This is reflected in extensive variability in current rehabilitation regimes and subsequent low clinical success rates, which urges a call for a consensus rehabilitation pathway. Aim: To establish consensus...

We present the case of a 56-year-old male unable to sit because of an ankylosed right hip. This ankylosis originated from combined neurogenic heterotopic ossifications (NHO) and traumatic heterotopic ossifications (THO) as a result of a road traffic accident. Because of multiple ossifications, the proximity of neurovascular structures, and chronic...

Background Diagnostic imaging for low back pain (LBP) without any indication of a serious underlying cause does not improve patient outcomes. However, there is still overuse of imaging, especially at emergency departments (EDs). Although evidence-based guidelines for LBP and radicular pain management exist, a protocol for use at the ED in the Belgi...

Purpose: To investigate the participation restriction of adult spinal deformity (ASD) patients, and its relation with the impairments in body structure and function, and activity limitation, as this important information regarding the individual's perspective on the social impact of the disease on their life is presently not captured. Methods: F...

Purpose: To evaluate the effectiveness of rehabilitation strategies on disability, pain, pain-related fear, and return-to-work in patients undergoing lumbar fusion surgery for degenerative conditions or adult isthmic spondylolisthesis. Methods: Six electronic databases were systematically searched for randomized controlled trials (RCTs) evaluating...

Objectives Studies on variability drivers of treatment costs in hospitals can provide the necessary information for policymakers and healthcare providers seeking to redesign reimbursement schemes and improve the outcomes-over-cost ratio, respectively. This systematic literature review, focusing on the hospital perspective, provides an overview of s...

Background Research interest on the impact of adult spinal deformity (ASD) on spinopelvic and whole body motion has increased over the past years. Studies focusing on overground walking, showed that patients with ASD indeed present with functional impairments. Functional tasks challenging the spinopelvic complex, such as sit-to-stand-to-sit, might...

Study design: Cross-sectional study. Objective: To develop and validate the Function Assessment scale for Spinal Deformity (FASD). Summary of background data: Spinal malalignment impacts daily functioning. Standard evaluation of adult spinal deformity (ASD) is based on static radiography and patient-reported scores, which fail to assess functi...

Image-based subject-specific models and simulations are recently being introduced to complement current state-of-the-art mostly static insights of the adult spinal deformity (ASD) pathology and improve the often poor surgical outcomes. Although the accuracy of a recently developed subject-specific modeling and simulation framework has already been...

Spinal alignment measurement in spinal deformity research has recently shifted from using mainly two-dimensional static radiography toward skin marker-based motion capture approaches, allowing three-dimensional (3D) assessments during dynamic conditions. The validity and accuracy of such skin marker-based methods is highly depending on correct mark...

A correction to this paper has been published: https://doi.org/10.1007/s10439-021-02791-2

This study aims to propose a new optimization framework for solving spine kinematics based on skin-mounted markers and estimate subject-specific mechanical properties of the intervertebral joints. The approach enforces dynamic consistency in the entire skeletal system over the entire time-trajectory while personalizing spinal stiffness. 3D reflecti...

Background context Radiographic evaluation in adult spinal deformity (ASD) offers no information on spinopelvic alignment and compensation during dynamic conditions. Motion analysis offers the potential to bridge the gap between static radiographic and dynamic alignment measurement, increasing our understanding on how ASD impacts function. Purpose...

Objective: The aim of the study was to design an objective, transparent, pragmatic, and flexible workflow to assist with patient selection during the initial phase of return to elective orthopedic surgery during the COVID-19 pandemic with the main purpose of enhancing patient safety. Methods: A multidisciplinary working group was formed consisti...

Quantitative dynamic evaluation of spino-pelvic motion in subjects with spinal deformity using optical motion analysis is currently lacking. The aim of this study was to develop and validate subject-specific, thoracolumbar spine multi-body skeletal models for evaluating spino-pelvic kinematics in a spinal deformity population. A new workflow for cr...

Background The worldwide spread of a novel coronavirus disease (COVID-19) has led to a near total stop of non-urgent, elective surgeries across all specialties in most affected countries. In the field of aesthetic surgery, the self-imposed moratorium for all aesthetic surgery procedures recommended by most international scientific societies has bee...

Study design: Prospective cross-sectional case-control study design OBJECTIVE.: This study aims to analyze the relation between balance control as well as Health-related Quality of Life (HRQOL) in patients with Adult Spinal Deformity (ASD), with a novel Gravity Line (GL)-related 3D spinal alignment parameter, the Transverse Gravitational Deviation...

Objective To test the reliability of the Balance Evaluation Systems Test (BESTest) and Trunk Control Measurement Scale (TCMS) between sessions and raters in the adult spinal deformity (ASD) population. Summary of background data Up to now evaluation in ASD was mainly based on static radiographic parameters. Recently literature showed that dynamic...

An acute paraspinal compartment syndrome (CS) is a rare condition and is only described in a few case reports. In our spine surgery department, a 16-year-old boy with severe low back pain due to a lumbar paraspinal CS. was treated with a paraspinal fasciotomy. After this case, we performed a cadaver study to determinate the compartment. The objecti...

Purpose Bracing is frequently prescribed following lumbar surgery for degenerative conditions. However, previous studies failed to demonstrate the advantage of postoperative lumbar bracing in both short- and long-term outcome in terms of pain, quality of life and fusion rate. The purpose of this study was to assess the prescription patterns and rat...

Purpose: Management of patients with persisting pain after spine surgery (PPSS) shows significant variability, and there is limited evidence from clinical studies to support treatment choice in daily practice. This study aimed to develop patient-specific recommendations on the management of PPSS. Methods: Using the RAND/UCLA appropriateness meth...

The importance of subject-specificity in musculoskeletal modeling and simulations of movement is continuously increasing towards more realistic functional biomechanical characteristics, a fortiori in pathologic cases. The added value of using a subject-specific (SS) musculoskeletal model (MSM) created from CT or MRI, opposed to the use of generic m...

Study design: Prospective single-center study OBJECTIVE.: Study investigates how dynamic balance performance complements 2D static radiographic measurements and demographics in terms of understanding health-related quality of life in Adult Spinal Deformity (ASD) patients. Summary of background data: Recent insights suggest that demographic varia...

Background: Low back pain is extremely common and usually a minor self-limiting condition. Rarely, however, it is a harbinger of serious medical illness. Paraspinal compartment syndrome is a rare condition, but its timely recognition is important to allow adequate treatment. Case report: A 16-year-old boy presented to the Emergency Department (E...

Study Design: A case report on rotational vertebral artery syndrome (RVAS) and surgical treatment. Objective: To illustrate a safe treatment option of RVAS with diminished risk of iatrogenic damage to the vertebral artery. Summary of Background Data: RVAS is an uncommon cause of symptomatic transient vertebrobasilar insufficiency induced by physiol...

The authors conducted a retrospective study comparing the corrective effect of two sublaminar techniques on scoliosis: the classical one, based on metal wire, and a more recent one, based on polyester tape (thoracic Universal Clamp), known to be safer (less risk of neurological damage, less laminar breakthrough) and compatible with MRI. Lumbar scre...

STUDY DESIGN:: A case report of rotational vertebral artery syndrome (RVAS) and surgical treatment. OBJECTIVE:: To illustrate a safe treatment option of RVAS with diminished risk of iatrogenic damage to the vertebral artery. SUMMARY OF BACKGROUND DATA:: RVAS is an uncommon cause of symptomatic transient vertebrobasilar insufficiency induced by phys...

Parsonage-Turner syndrome (PTS) is a distinct clinical syndrome, characterized by acute and severe (mostly) unilateral shoulder pain, followed by paresis and atrophy of the shoulder girdle, while the pain decreases. Most authors consider it as an immune-mediated disorder. PTS is notoriously unrecognised and is usually diagnosed with delay. A PTS ma...

Report of a high dysplastic developmental spondylolisthesis in two identical twins of two unrelated families. To investigate the multifactorial etiology of developmental spondylolisthesis. Multiple studies have suggested an association between a high pelvic incidence and the presence of isthmic spondylolisthesis. Other studies suggest a genetic bac...

The most important factors for long-term survival of cementless prostheses are the initial fixation, the osteoconducting properties of the metal shell and the bony response. Porous tantalum, a new biomaterial with a geometric structure similar to trabecular bone, was reported in animal studies to allow for bone ingrowth even when 3-mm gaps exist be...