Spine
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Multicenter Study
Predictors of change in postoperative pulmonary function in adolescent idiopathic scoliosis: a prospective study of 254 patients.
A multicenter study of prospectively collected pulmonary function testing and radiographic measures in patients surgically treated for adolescent idiopathic scoliosis (AIS). ⋯ Aside from preoperative PFT values, open anterior approaches predict the largest percent of variance in 2-year PFT. Additionally, a clinically significant reduction in the predicted 2-year pulmonary function is more likely when performing a thoracoplasty. The magnitude of the effects for both these variables, however, is modest. This may facilitate the decision-making process as regards to operative intervention.
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Quantitative versus subjective evaluation of sacral doming in lumbosacral spondylolisthesis. ⋯ This study confirms the relevance of the SDSG index to assess sacral doming in lumbosacral spondylolisthesis. The authors propose a criterion of 25% to differentiate significant from nonsignificant sacral doming using the SDSG index. Such a criterion will allow more accurate assessment of sacral remodeling, especially for borderline cases, and facilitate comparisons between studies.
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Comparative Study
Psychiatric comorbidity in chronic disabling occupational spinal disorders has minimal impact on functional restoration socioeconomic outcomes.
A prospective study conducted at a tertiary functional restoration center for patients with chronic disabling occupational spinal disorders (CDOSDs), comparing treatment outcome status 1-year posttreatment of patients with specific diagnosed psychiatric disorders to those without. ⋯ Despite intensive management of psychiatric disorders during interdisciplinary functional restoration for CDOSD, several disorders were found to be associated with less successful outcomes. Poorer work outcomes were more common with specific (and comorbid) Axis I psychiatric disorders. Opioid dependence was the single disorder associated most often with less successful outcomes. Despite these findings, the large majority of patients demonstrated successful outcomes. Depression did not independently link to less successful outcomes.
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Comparative Study
Biomechanical comparison of a fully threaded, variable pitch screw and a partially threaded lag screw for internal fixation of Type II dens fractures.
Stiffness and load to failure were studied in a human cadaver model of Type II odontoid fractures stabilized with either a single partially threaded lag screw and washer or a headless fully threaded variable pitch screw. ⋯ A headless, fully threaded variable pitch screw was biomechanically favorable in comparison with a partially threaded lag screw and washer in this cadaver model of Type II dens fractures. The mode of failure at the C2 vertebral body may have important implications for further improvements in construct strength.
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A retrospective clinical study. ⋯ Reduction of intervertebral height and loss of sagittal profile occurred in both groups. Complications relating to the bone graft were more common in Group I than in Group II. Despite loss of correction, both groups had a high fusion rate without recurrence of infection. The reduction of intervertebral graft height appears to be the result of destruction of the endplate either due to surgical debridement or the infective process.