Spine
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Multicenter Study Comparative Study
Surgical revision rates of hooks versus hybrid versus screws versus combined anteroposterior spinal fusion for adolescent idiopathic scoliosis.
Multi-institution retrospective review. ⋯ All pedicle screw and anteroposterior constructs have a lower surgical revision rate when compared with hook and hybrid constructs. The hidden patient and financial costs of these findings should be considered when evaluating overall instrumentation efficacy.
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Multicenter Study
Diabetes and early postoperative outcomes following lumbar fusion.
Retrospective cohort study using data from the Nationwide Inpatient Sample administrative data from 1988 through 2003. ⋯ This nationally representative study of inpatients in the United States provides evidence that diabetes is associated with increased risk for postoperative complications, nonroutine discharge, increased total hospital charges, and length of stay following lumbar fusion. Prospective studies to determine causality as well as the potential impact of diabetes control on these variables have not yet been done.
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Multicenter Study
Classification of high-grade spondylolistheses based on pelvic version and spine balance: possible rationale for reduction.
Retrospective review of a radiographic database of high-grade spondylolisthesis patients in comparison with asymptomatic controls. ⋯ Analysis of sagittal alignment of high-grade spondylolisthesis patients revealed distinct groups termed "balanced" and "unbalanced" pelvis. The PT and SS were similar in controls and balanced pelvis patients. Unbalanced pelvis patients had a sagittal spinal alignment that differed from the balanced pelvis and control groups. Treatment strategies for high-grade spondylolisthesis should reflect the different mechanical strain on the spinopelvic junction in each group; reduction techniques might be considered in patients with an unbalanced pelvis high-grade spondylolisthesis.
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Multicenter Study
The relationship between thoracic hyperkyphosis and the Scoliosis Research Society outcomes instrument.
A retrospective chart review and radiographic analysis. ⋯ These findings indicate that higher kyphosis magnitudes were associated with increased pain, lower self-image, and decreased function and activity. Patients with thoracic hyperkyphosis were significantly more symptomatic than normal subjects in all domains. The r values for this analysis of kyphosis (0.40-0.66), in fact were substantially greater than those previously reported for scoliosis magnitude versus SRS Questionnaire scores (0.16-0.26), suggesting this instrument may be even better suited for the evaluation of hyperkyphosis patients.
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Comparative Study
Posterior lumbar interbody fusion versus posterolateral fusion in adult isthmic spondylolisthesis.
A prospective study with historical controls. ⋯ Type of fusion, PLIF or PLF, does not affect the 2-year outcome of surgical treatment of adult isthmic spondylolisthesis. Despite the theoretical advantages of PLIF, no improvement on patient outcome compared with posterolateral fusion could be demonstrated, questioning the need of anterior support in short lumbar fusions.