Spine
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Radiographic analysis, outcomes analysis (pain scale, Oswestry, SRS-24), and accumulation of complications. Outcomes and complications collected prospectively. Radiographic analysis performed retrospectively. ⋯ The clinical result with pedicle subtraction osteotomy is reduced with pseudarthrosis in the thoracic or lumbar spine and subsequent breakdown adjacent to the fusion. For patients with a degenerative sagittal imbalance etiology the results were worse and the complications were higher. Central canal enlargement is critical.
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A retrospective radiographic review was performed on 41 patients with scoliosis associated with a Chiari I malformation and/or syringomyelia. ⋯ Although the decision to obtain magnetic resonance imaging in a patient with scoliosis should be based on both clinical and radiographic criteria, we suggest that a heightened index of suspicion is warranted with certain curve patterns (left thoracic, double thoracic, triple, and a long right thoracic curve with end vertebra caudal to T12), and with a high or low apex and/or end vertebra, especially in males and patients with a normal to hyperkyphotic thoracic spine.
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Retrospective study with clinical evaluation of posterior hemivertebra resection with transpedicular instrumentation in very young children. ⋯ Correction surgery of congenital scoliosis should be performed early, before the development of severe local deformities and secondary structural changes, especially in patients with expected deterioration. Posterior resection of the hemivertebra with transpedicular instrumentation allows for early intervention in very young children. Excellent correction in the frontal and sagittal planes, and a short segment of fusion allows for normal growth in the unaffected parts of the spine.
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A cross-sectional study of anthropometric parameters in adolescent idiopathic scoliosis (AIS). ⋯ Various body segmental lengths were initially significantly shorter in AIS before puberty. However, after the onset of puberty, significantly longer corrected height, arm span, and various body segments were found. And there were significant correlations between anthropometric parameters and the scoliotic curve severity. Results of this large-scale study revealed the presence of abnormal growth in AIS patients during peripubertal development.
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A retrospective clinical and radiographic analysis of long adult deformity fusions terminating at L5. ⋯ Subsequent L5-S1 DDD developed in 61% of patients after long adult fusions to L5 and was associated with a significant loss of sagittal alignment and an increased likelihood for or definite need for another operation. Loss of L5 implant fixation is not uncommon, especially in patients with a deep-seated L5 vertebra.