Spine
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A retrospective study. ⋯ A sagittal Cobb angle difference between lumbar lordosis and thoracic kyphosis of > 20 degrees (higher lumbar lordosis) is advisable in most circumstances to achieve optimal sagittal balance.
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Comparative Study
Anterior/posterior spinal instrumentation versus posterior instrumentation alone for the treatment of adolescent idiopathic scoliotic curves more than 90 degrees.
A retrospective review of patients with adolescent idiopathic scoliosis (AIS), with curves more than 90 degrees treated with either a combined anterior/posterior spinal fusion or a posterior spinal fusion alone. ⋯ In this patient population with often restrictive preoperative pulmonary function, a posterior-only approach with the use of an all-pedicle screw construct has the advantage of providing the same correction as an anterior/posterior spinal fusion, without the need for entering the thorax and more negatively impacting pulmonary function.
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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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Retrospective clinical cohort study. ⋯ Researchers and clinicians should be aware of the potential for non-injury-related factors to delay recovery, and be aware of the interaction between the initial intensity of a patient's pain and other covariates when confirming these results.