Spine
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Comparative Study Clinical Trial Controlled Clinical Trial
Recognition and treatment of the proximal thoracic curve in adolescent idiopathic scoliosis treated with Cotrel-Dubousset instrumentation.
A retrospective radiographic and clinical review of a consecutive series of patients with adolescent idiopathic scoliosis (AIS) instrumented/fused with Cotrel-Dubousset instrumentation (CDI) was undertaken. ⋯ When these aforementioned criteria are present and surgical correction with CDI is planned, we recommend extending the instrumentation up to T2 to produce level shoulders and maintain coronal balance.
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Comparative Study Clinical Trial Controlled Clinical Trial
Radiographic analysis of sagittal plane alignment and balance in standing volunteers and patients with low back pain matched for age, sex, and size. A prospective controlled clinical study.
A global and segmental study on standing lateral radiographs of 100 volunteers and 100 patients who had low back pain was undertaken to further define sagittal plane alignment and balance. The volunteer control group and the patient group were matched for age, sex, and size. ⋯ Definitions of sagittal balance are provided as well as additional sagittal plane data by which to compare corrections and fusions for different spinal disorders.
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Comparative Study
The Ste-Justine Adolescent Idiopathic Scoliosis Cohort Study. Part IV: Surgical correction and back pain.
This study determined whether the prevalence, nature, and consequences of back pain in adulthood among persons who underwent Harrington rod instrumentation was related to the number of vertebrae fused, distal level of hook insertion, and degree of correction. ⋯ Among the 723 AIS subjects who had surgery at Ste. Justine's Hospital, 555 completed the questionnaire on back pain. Overall, 73% of patients treated surgically reported back pain in the past year. Proportions varied little by presurgery characteristics or by degree of surgical correction. The distal level of fusion did not influence, in any consistent way, the occurrence of back pain in later life nor the degree of disability associated with back pain. This study does not provide any evidence that extending the level of fusion down even as far as L4 will increase the prevalence of back pain in adulthood.
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Clinical Trial
Sacroiliac joint: pain referral maps upon applying a new injection/arthrography technique. Part II: Clinical evaluation.
A pain referral map generated from Part I of this study was tested in 54 consecutive patients. Pain diagrams, completed by each patient, were compared to the map generated from sacroiliac injections in 10 volunteers (Part I). Two clinicians, blinded to the examination of each individual, selected the diagrams most consistent with the pain map. ⋯ Patients can be successfully screened for sacroiliac joint dysfunction based on comparison with a pain referral map. Further study on the false negative rates of sacroiliac pain maps is needed.
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The lumbar pedicles of 100 adult Chinese patients were studied with computed tomography to provide data on their dimensions and angular alignment. Data obtained were compared with published measurements of spines from white patients to determine similarities and differences between the lumbar spines. ⋯ There are differences between the lumbar pedicles of Asians and whites. Such differences need to be considered when posterior pedicle screw fixation of the spine is performed.