Spine
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Three-dimensional analysis of thoracic apical sagittal alignment in adolescent idiopathic scoliosis.
Retrospective review of a series of adolescent idiopathic scoliosis patients. ⋯ This 3D analysis of thoracic scoliosis demonstrated a consistent loss of kyphosis within the 5 thoracic apical vertebrae. The true apical sagittal profile was found to be overestimated by an average of 10 degrees as compared to the perceived alignment from standard lateral radiographs.
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Retrospective cohort study of consecutive patients undergoing primary fusion with segmental fixation for adult spinal deformity. ⋯ Using a strict definition of reoperation for a well-defined cohort, in the presence of relevant risk factors, many patients undergoing primary fusion for adult spinal deformity required reoperation. The results indicate that complex medical and surgical factors contribute to the treatment challenges posed by patients with adult spinal deformity. This represents the largest cohort reported to date of patients undergoing primary fusion using third-generation instrumentation techniques.
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Retrospective review. ⋯ Patients with scoliosis and OTRC have a greater risk of adding-on proximally and of loss of correction with anterior-only instrumentation; they may also have less predictable lumbar correction from selective thoracic fusion. However, after combined surgery, they have results similar to those of more skeletally mature patients.
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Retrospective study. ⋯ The distal end of a fusion for thoracic hyperkyphosis should include the SSV. Levels that include the first lordotic vertebra but not the SSV are not always appropriate to prevent postoperative distal junctional kyphosis.
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Retrospective study. ⋯ This is the first long-term (minimum 5 years) follow-up study focusing on patient outcomes after an anterior thoracolumbar approach for adult spinal deformity treatment. This approach appears to be associated with an appreciable high rate of postoperative pain (32.3%), bulging (43.5%), and functional disturbance (24.2%). Therefore, surgeons should use caution when recommending this approach to future adult spinal deformity patients.