Spine
-
Comparative Study
Thoracic adolescent idiopathic scoliosis curves between 70 degrees and 100 degrees: is anterior release necessary?
A retrospective review of adolescents with main thoracic scoliotic curves surgically treated with either anterior release and posterior fusion or posterior fusion only. ⋯ APSF of large thoracic curves allows greater coronal correction of thoracic curves between 70 degrees and 100 degrees, when compared with PSF alone using thoracic hook constructs, but not with the use of thoracic pedicle screw constructs. Scoliosis surgeons not using pedicle screw constructs need to decide if the modest improvement in coronal correction with a combined approach justifies its routine use in this patient population.
-
Comparative Study
Evaluation of pedicle screw placement in the deformed spine using intraoperative plain radiographs: a comparison with computerized tomography.
A retrospective study. ⋯ Intraoperative plain radiographs alone using 3 radiographic criteria were very sensitive to detect lateral wall pedicle screw violations, specific for assessing for medial wall violations, and highly accurate for both. This result confirms the ability of careful intraoperative plain radiographic assessment after pedicle screw insertion to detect malpositioned screws, to allow for possible revision during the index operation.
-
Comparative Study
Monaxial versus multiaxial thoracic pedicle screws in the correction of adolescent idiopathic scoliosis.
Radiographic outcome analysis following thoracic fusion of Lenke Type I adolescent idiopathic scoliosis (AIS) curves with segmental pedicle screw fixation. ⋯ Both monaxial and multiaxial thoracic pedicle screws provide excellent coronal deformity correction for thoracic fusion of main thoracic AIS. Monaxial screws provide superior derotation and restoration of thoracic symmetry as noted by significantly greater correction of the AVB-R, RH, and ARSD.
-
Comparative Study
Long-term outcome in neuromuscular scoliosis fused only to lumbar 5.
Outcomes are retrospectively compared for patients with neuromuscular scoliosis after instrumented surgery and fusion to the pelvis versus lumbar 5 fusion alone. ⋯ Instrumentation and fusion to L5 is a less technically difficult procedure, requires less surgical time, has decreased blood loss, and less risk of infection compared to instrumented pelvic fusion. Postoperative and long-term follow-up indicates that L5 fusion can correct scoliosis and pelvic obliquity, comparable to results of sacrum fusion.
-
This study is a retrospective review of 752 patients with adult spinal deformity enrolled in a multicenter prospective database in 2002 and 2003. Patients with positive sagittal balance (N = 352) were further evaluated regarding radiographic parameters and health status measures, including the Scoliosis Research Society patient questionnaire, MOS short form-12, and Oswestry Disability Index. ⋯ This study shows that although even mildly positive sagittal balance is somewhat detrimental, severity of symptoms increases in a linear fashion with progressive sagittal imbalance. The results also show that kyphosis is more favorable in the upper thoracic region but very poorly tolerated in the lumbar spine.