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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Comparative Study
Computed tomography evaluation of rotation correction in adolescent idiopathic scoliosis: a comparison of an all pedicle screw construct versus a hook-rod system.
Retrospective review with historical cohort. ⋯ Our study finds axial rotation correction using APSs and a direct vertebral body derotation technique was significantly greater than that obtained with the HR construct.
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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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Prospective clinical study. ⋯ When performing a prone thoracoscopic release for severe thoracic deformity, excellent coronal plane correction is achieved. There does not appear to be any detrimental effect on pulmonary function when a prone thoracoscopic release using double lung ventilation is added to a PSFI. This technique can be efficacious in achieving excellent deformity correction without adversely affecting pulmonary function and is recommended when treating severe spinal deformity. Adding a thoracoplasty provided a negative effect on pulmonary function and limited the benefits of performing a thoracoscopic release to the PSFI patients.
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A matched cohort comparison of adult idiopathic scoliosis (AdIS) patients treated with all pedicle screw constructs compared to hook/hybrid constructs. ⋯ Pedicle screw correction of AdIS is safe and effective. Compared to hook/hybrid constructs, these patients displayed significantly improved correction of the major curve (even in the absence of anterior releases), maintenance of thoracic kyphosis, and a lower revision rate. Similar SRS scores and blood loss were noted. The hook/hybrid patients had significantly longer operative times. The use of BMP-2 in 7 patients and TLIF/ALIF also in 7 of the pedicle screw patients may have decreased the need for revision surgery up to the latest follow-up.