Spine
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Description of surgical technique with case correlation. ⋯ In properly selected patients an anterior revision approach can provide a better outcome than posterior cervical fusion. This modified approach allows placement of an adequate fixation screw in a vertebra damaged by previous screw failure.
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Two cases of spondylolisthesis due to severe elongation of pedicles in osteogenesis imperfecta are reported. ⋯ High-grade spondylolisthesis due to elongation of pedicle in osteogenesis imperfecta is uncommon. Anterior interbody fusion of all the involved motion segments has produced good pain relief and arrested deformity progression at the 3-year follow-up.
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A retrospective review of 51 patients with adolescent idiopathic scoliosis (AIS) treated with a Boston brace for curves ranging from 36 degrees to 45 degrees. ⋯ Patients with a double curve pattern in which the thoracic curve is >35 degrees and the LPR angle is >12 degrees are significantly more likely to demonstrate curve progression. In-brace correction for double curves of at least 25% and a patient's ability to wear the orthosis >18 hours/day significantly increased the likelihood of success.
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A multisurgeon assessment of curve classification, selection of operative approach, and fusion levels via a case study presentation. ⋯ This case study assessment found a relatively high rate (84-90%) of agreement in curve classification of the individual components of a new classification system of AIS. This suggests the ability of a group of scoliosis surgeons to identify the specific criteria necessary for this new classification system of AIS. In addition, the high variability in selection of both operative approach and fusion levels confirms the current lack of standardized treatment paradigms. This further reinforces the need for a method to critically and objectively evaluate these variable treatments to determine the "best" radiographic and clinical results.