Spine
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Comparative Study
Surgical treatment of adult scoliosis: is anterior apical release and fusion necessary for the lumbar curve?
A retrospective study. ⋯ Posterior segmental spinal instrumentation and fusion without anterior apical release of lumbar curves in adult scoliosis demonstrated better total SRS outcome scores and no differences in radiographic parameters without differences in clinical complications. However, the use of BMP in some of these patients (44%) may have also contributed to these differences.
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Comparative Study
Comparison of radiographic outcomes for the treatment of scoliotic curves greater than 100 degrees: wires versus hooks versus screws.
A retrospective comparative study. ⋯ All 4 constructs were able to achieve and maintain acceptable correction safely without permanent neurologic deficit and all demonstrated acceptable implant failure rate. Pedicle screw constructs in the apical levels demonstrated the best coronal correction, smallest loss of correction, and greatest amount of apical vertebral translation correction of the major Cobb angle compared with the other constructs without neurologic complications.
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A retrospective consecutive case series. ⋯ A central hook-rod construct is a safe, quick, controlled, and effective method for spinal osteotomy site closure. It may add strength to the overall construct and avoids the placement of direct compression force on the main pedicle screw fixation points that may lead to screw loosening during the osteotomy site closure, and ultimately to fixation failure.
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Case Reports
Inferior vena cava syndrome following percutaneous vertebroplasty with polymethylmethacrylate.
A case of inferior vena cava syndrome following percutaneous vertebroplasty is described herein. ⋯ This case illustrates the need for clinicians to be critically aware of the potential occurrence of inferior vena cava syndrome among patients who have undergone percutaneous vertebroplasty, especially when multiple levels of vertebra are injected as part of the vertebroplasty procedure.
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A retrospective review comparing patients who had postoperative ketorolac and those who did not following posterior spinal fusion and instrumentation (PSFI) for adolescent idiopathic scoliosis (AIS). ⋯ Ketorolac does not increase the incidence of developing a pseudoarthrosis when used as an adjunct for postoperative analgesia following a PSFI for AIS using segmental spinal instrumentation and iliac crest bone graft. The differences seen here compared with adults may be due to the greater healing potential in these young patients. We recommend utilization of ketorolac after surgery to supplement pain management when necessary.