Spine
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Comparative Study
Anterior-posterior surgery versus posterior closing wedge osteotomy in posttraumatic kyphosis with neurologic compromised osteoporotic fracture.
Retrospective study. ⋯ Although technically demanding, the posterior closing wedge osteotomy procedure demonstrated a better surgical result with significant less mean operative time and mean blood loss (P < 0.05). It may be a better alternative than a combined anterior-posterior procedure in patients with posttraumatic kyphosis and neurologic compromise secondary to osteoporotic fracture.
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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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Retrospective analysis with prospective outcomes. ⋯ Staged posterior surgery can be performed safely with few surgical complications and no major medical complications, as well as excellent outcomes in a population known to be at high risk. Such staging can be useful in performing complex posterior revision and osteotomy surgery while limiting hemodynamic stresses.
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Comparative Study
Treatment recommendations for idiopathic scoliosis: an assessment of the Lenke classification.
To determine the usefulness of the treatment recommendation criteria based on the Lenke classification for treatment of idiopathic scoliosis. DESIGN A retrospective radiographic review of 183 patients who underwent anterior and/or posterior fusion for the treatment of idiopathic scoliosis. ⋯ Better radiologic results were achieved through the use of the Lenke classification system for the selection of fusion levels by avoiding unnecessary fusion of the nonstructural lumbar or thoracic spine as well as avoiding undercorrection of the structural secondary curves.
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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.