Spine
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We reviewed three-dimensional (3D) computed tomography (CT) images of congenital spinal deformities and proposed a new classification based on the information obtained. ⋯ The large volume of information that can be obtained by evaluating 3D CT images of congenitally deformed vertebrae can be a great help in developing a strategy for surgical treatment. We need to develop a new classification of congenital scoliosis based on the perspective of 3D imaging to understand the etiology and embryology, as well as to determine an operative strategy.
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Practice Guideline
Guidelines for management of scoliosis in Rett syndrome patients based on expert consensus and clinical evidence.
Modified Delphi technique. ⋯ Evidence- and consensus-based guidelines were successfully created and have the potential to improve care of a complex comorbidity in a rare condition and stimulate research to improve the current limited evidence base.
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Bench-top and retrospective analysis to assess vertebral rotation based on the appearance of bilateral pedicle screws in patients with adolescent idiopathic scoliosis (AIS). ⋯ An accurate assessment of vertebral rotation can be performed radiographically, using screw lengths and screw tip-to-rod distances of bilateral segmental pedicle screws and a trigonometric calculation. These data support the use of a simple radiographic grading system to approximate apical vertebral rotation in AIS patients treated with bilateral apical pedicle screws.
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Review Meta Analysis
Rehabilitation after lumbar disc surgery: an update Cochrane review.
Cochrane systematic review of randomized controlled trials. ⋯ Exercise programs starting 4 to 6 weeks postsurgery seem to lead to a faster decrease in pain and disability than no treatment. High intensity exercise programs seem to lead to a faster decrease in pain and disability than low intensity programs. There were no significant differences between supervised and home exercises for pain relief, disability, or global perceived effect. There is no evidence that active programs increase the reoperation rate after first-time lumbar surgery.
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Meta Analysis Comparative Study
A meta-analysis of circumferential fusion versus instrumented posterolateral fusion in the lumbar spine.
A meta-analysis of circumferential fusion versus instrumented posterolateral fusion (PLF) in the lumbar spine. ⋯ Compared with instrumented PLF, circumferential fusion can increase the fusion rate and reduce the reoperation rate, but it can also increase the complication rate and the amount of blood loss. No significant difference was found in the global assessment of clinical outcome about the 2 fusion procedures.