Spine
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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.
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Technical note. ⋯ We present a technique for controlled extension osteotomy correction of chin-on-chest deformity in a prone position. Use of the operating table mechanism in conjunction with a closing-wedge osteotomy diminishes the risk of translation, decreases risk of air embolus associated with a sitting position, and promotes greater opportunity for fusion through the osteotomy, and the stability allows for placement of modern instrumentation.
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Retrospective radiographic review of consecutive patients with universally applied standard. ⋯ Large (> 1.5 mm) facet effusions are highly predictive of degenerative spondylolisthesis at L4-L5 in the absence of measurable anterolisthesis on supine MRI. A clinically measurable facet effusion (> or = 1 mm) suggests the need for SLFE films to diagnose degenerative spondylolisthesis that can be missed with supine positioning on MRI.
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Multicenter Study Comparative Study
A pedicle screw construct gives an enhanced posterior correction of adolescent idiopathic scoliosis when compared with other constructs: myth or reality.
Tricenter retrospective cohort study of 72 patients who underwent posterior correction of Lenke 1 adolescent idiopathic scoliosis (AIS). Each center represented a single surgeon using only one type of construct. ⋯ The Group 3 (pedicle screw only) construct did not give an enhanced correction of Lenke 1 AIS, when the preoperative flexibility of the curve was considered. Also, contrary to popular belief, the pedicle screw construct has a lordosing effect on the thoracic spine. Therefore, we think that there is no significant advantage in using a relatively expensive pedicle screw construct in the correction of Lenke 1 AIS.
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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.