The Orthopedic clinics of North America
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Coralline porous ceramics are biocompatible and osteoconductive implants. They have proven to be effective as bone graft substitutes in large animal models and in humans. ⋯ Both the implant properties (chemistry and porosity) and the biologic environment modulate the rate of implant resorption. Composite technology with resorbable polymers can improve the mechanical properties of these ceramics.
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Neuromuscular scoliosis is classified as a neuropathic or myopathic type. Cerebral palsy is the most common form of neuropathic type, and Duchenne's muscular dystrophy best characterizes the principles and recommended treatment for the myopathic type. Nonoperative measures rarely fully control a progressive scoliosis. Careful preoperative planning and surgery can achieve a well-balanced spine over a level pelvis with a good functional result.
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Orthop. Clin. North Am. · Jul 1999
ReviewManagement of spondylolysis and spondylolisthesis in the pediatric and adolescent population.
Spondylolysis and low-grade spondylolisthesis are diagnoses that, for most patients, have a benign prognosis and can be managed nonoperatively. For most symptomatic patients for whom this management fails, fusion in situ yields satisfactory and lasting results and remains the gold standard against which other surgical treatment must be compared. ⋯ Reduction maneuvers are technically demanding and carry significant risk of neurologic injury. Surgical experience and in-depth understanding of the indications, the complications, and, especially, the limitations of each technique are required.
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Percutaneous interbody fusion procedures have evolved as a result of the need for precise and specific access corridors to facilitate the application of technology to perform these procedures. Endoscopic visualization has expanded minimally invasive capabilities, particularly in the thoracic and lumbar spine. Refinement of grafting concepts and structural composition continues. Based on the historical evolution of the described percutaneous interbody fusion procedures, the future of minimally invasive interbody arthrodesis shows promise through the ongoing definition of access corridors and the refinement of operative tools and techniques.
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Orthop. Clin. North Am. · Oct 1998
Thoracic and lumbar fusions for degenerative disorders: rationale for selecting the appropriate fusion techniques.
This article defines the indications for spinal fusion surgery based on the current literature as well as a rationale for selecting the appropriate spinal fusion techniques for the more common degenerative lumbar and thoracic conditions.