Spine
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Retrospective study. ⋯ Risk factors for sagittal thoracic decompensation developing were sagittal imbalance at 8 weeks postoperatively (> or = 5 cm), smaller lumbar lordosis compared with thoracic kyphosis (< 10 degrees) at 8 weeks postoperatively, preoperative sagittal imbalance (> or = 5 cm), age at surgery (older than 55 years), and associated comorbidities. Sagittal thoracic decompensation adversely affected Scoliosis Research Society 24 outcomes scores.
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Comparative Study
Selective posterior thoracic fusions for adolescent idiopathic scoliosis: comparison of hooks versus pedicle screws.
A retrospective review of adolescent idiopathic scoliosis (AIS) patients with major thoracic-compensatory lumbar C modifier curves treated with a selective posterior fusion using an all-hook construct versus pedicle screw construct. ⋯ Selective thoracic fusion of main thoracic-compensatory lumbar C modifier AIS curves with pedicle screws allowed for better thoracic correction and less postoperative coronal decompensation than seen with hooks.
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A radiographic review of 78 consecutive patients with degenerative rotatory lumbar scoliosis. ⋯ In degenerative scoliotic curves, lateral translation is associated with rotation. Increased rotary olisthesis does not lead to decreased dural sac area. Anteroposterior olisthesis is inversely correlated to the dural sac anteroposterior diameter and cross-sectional area. With increased segmental Cobb angle, foraminal cross-sectional area enlarges in the convexity and does not decrease in the concavity. Presence of intervertebral rotation alone does not appear to be associated with reduced neural canal dimensions. Ligamentum flavum hypertrophy, posterior disc bulging, and bony overgrowth are more likely to contribute to stenosis irrespective of scoliosis.
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Comparative Study Clinical Trial
Analysis of patients with nonambulatory neuromuscular scoliosis surgically treated to the pelvis with intraoperative halo-femoral traction.
Retrospective case-control study. ⋯ Intraoperative use of halo-femoral traction during the surgical treatment of patients with nonambulatory neuromuscular scoliosis provided significantly improved lumbar curve and pelvic obliquity correction. Intraoperative halo-femoral traction had no associated perioperative complications.