Spine
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Multicenter Study Comparative Study
A prospective study of brace treatment versus observation alone in adolescent idiopathic scoliosis: a follow-up mean of 16 years after maturity.
The Swedish patients included in the previous SRS brace study were invited to take part in a long-term follow-up. ⋯ The curves of patients with adolescent idiopathic scoliosis with a moderate or smaller size at maturity did not deteriorate beyond their original curve size at the 16-year follow-up. No patients treated primarily with a brace went on to undergo surgery, whereas 6 patients (10%) in the observation group required surgery during adolescence compared with none after maturity. Curve progression was related to immaturity.
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Multicenter Study
Complications in posterior fusion and instrumentation for degenerative lumbar scoliosis.
Radiographic analysis was performed retrospectively. Outcomes and complications were collected prospectively. ⋯ The complication rate after posterior fusion and instrumentation for degenerative lumbar scoliosis was 68%. Abundant blood loss was a significant risk factor for early perioperative complications. The improvement of Oswestry disability index was less in patients with late complications.
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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 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
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.