Spine
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Review Case Reports
Unilateral calf hypertrophy seen in lumbosacral stenosis: case report and review of the literature.
A case report of a patient with neurogenic unilateral calf hypertrophy and review of the literature are reported. ⋯ Although the patient had bilateral L5 radiculopathies, he only had hypertrophy in the distribution of his right S1 radiculopathy. This supports the hypothesis that dysfunction of the S1 nerve root or its distribution is a predisposing factor to develop neurogenic muscle hypertrophy. Furthermore, patients presenting with unilateral calf hypertrophy need a careful diagnostic evaluation for S1 radiculopathy as well as to exclude asymmetric presentation of systemic neuromuscular conditions.
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Multicenter Study
Radiographic markers in spondyloptosis: implications for spondylolisthesis progression.
Radiographic analysis of spinopelvic morphology and posterior element dysplasia in spondyloptosis. ⋯ Prognostic factors for spondylolisthesis progression, such as percent of slippage, do not identify lower-grade slips at risk for progression. Progression is linked to increased shear stress across the lumbosacral junction and inability to resist it. Increased stress is related to increased verticality of the lumbosacral joint, which is individually predetermined by pelvic incidence and sacral anatomy. Pelvic incidence is fundamental in determining sagittal spine curvature required for economic spinopelvic balance. Pelvic incidence is independent of adaptive changes in higher-grade spondylolisthesis. Pelvic incidence in our spondyloptosis series (76 degrees) is higher than in normal (48.2-53.2 degrees ) and low-grade spondylolisthesis (64.5 degrees). Posterior element dysplasia decreases mechanical resistance to lumbosacral shear stress. Incidence of dysplasia in our series (62%) is higher than that reported in low-grade spondylolisthesis. Analysis of pelvic incidence and posterior element dysplasia may aid in estimation of risk for progression of spondylolisthesis.
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This is a clinical study that examines the results of partial reduction and fibular dowel graft placement for high-grade isthmic spondylolisthesis. ⋯ Fibular strut grafting is a useful surgical adjunct in high-grade spondylolisthesis that is partially reduced. Clinical and radiographic outcomes were satisfactory. Our experience shows that there is no significant difference between allograft and autograft. All struts healed and remodeled by the ultimate follow-up, and there was only one instance of fibula fracture.
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Multicenter Study Comparative Study
Pelvic or lumbar fixation for the surgical management of scoliosis in duchenne muscular dystrophy.
This retrospective study evaluates two groups of patients with scoliosis and Duchenne muscular dystrophy, treated with two different surgical stabilization methods. ⋯ Lumbar fixation to L5 is adequate if the surgery is performed early, soon after becoming wheelchair bound, and with smaller curves and minimal pelvic obliquity. Use of pedicle screws in lumbar spine provides a solid foundation to maintain the correction over the period of relatively short life expectancy of these children. Pelvic fixation may be necessary in older children, who have larger curves and established pelvic obliquity. In the presence of deteriorating lung function, this is associated with a greater morbidity and higher complication rate.
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Multicenter Study Clinical Trial
A multicenter study analyzing the relationship of a standardized radiographic scoring system of adolescent idiopathic scoliosis and the Scoliosis Research Society outcomes instrument.
A multicenter study examining the association between radiographic and outcomes measures in adolescent idiopathic scoliosis. ⋯ The Cobb angle measure of the major deformity has a small, but statistically significant, correlation with the reported Total Pain, General Self-Image, and General Function as measured by the Scoliosis Research Society outcomes instrument. None of the radiographic measures in this population correlated with postoperative domain scores of the Scoliosis Research Society outcomes tool.