Spine
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Prospective radiographic and clinical analysis of patients with idiopathic scoliosis who had complete implant removal following posterior spinal fusion (PSF) at least 2 years previously. ⋯ Implant removal after PSF for idiopathic scoliosis may be complicated by progression of deformity. Patients requiring implant removal should be appropriately counseled and monitored.
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A retrospective analysis, including prospectively collected patient outcomes data. ⋯ The overall complication rate was 37% and the major complication rate was 20%. Increasing age was a significant factor (P < 0.05) in predicting the presence of a complication. Patients older than 69 years had more complications. The presence of a comorbidity had no association with complication rates and neither had an effect on final patient reported outcomes, which showed significant improvement (ODI preoperative, 49; postoperative, 25) (P < 0.0001).
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Review Case Reports
Delayed presentation of pulmonary polymethylmethacrylate emboli after percutaneous vertebroplasty.
Literature review concerning pulmonary embolism of polymethylmethacrylate (PMMA) material following percutaneous vertebroplasty and a report on 2 new cases. ⋯ These 2 cases allow us to conclude that the risk of pulmonary embolism of PMMA might be underestimated. We propose routine chest radiograph following every vertebroplasty, in order to detect pulmonary PMMA embolism and thereby prevent serious delayed cardiopulmonary failures.
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Multicenter Study Comparative Study
Is the SRS-22 instrument responsive to change in adult scoliosis patients having primary spinal deformity surgery?
Multicenter study. ⋯ Based on these 3 outcome tools, the greatest responsiveness to change was demonstrated by the SRS self-image domain followed by SRS total, then SRS pain, then ODI. This suggests that the SRS tool is more responsive than ODI, which is more responsive than SF-12 to change brought on by primary surgical treatment of adult scoliosis patients. Surgical treatment in adult scoliosis significantly improved pain, self-image, and function based on the health-related quality of life measures used in this study.
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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.