Spine
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Thirty-four patients having advanced spinal tuberculosis with angulated kyphotic deformity who underwent posterior en bloc spondylectomy were reviewed. ⋯ The purpose of this article is more to describe the technique of posterior en bloc spondylectomy in patients with spine tuberculosis with kyphotic deformity. From the results of this preliminary study, en bloc spondylectomy for the treatment of spinal tuberculosis with angulated kyphotic deformity can be a safe and effective technique.
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Comparative Study
Long adult spinal deformity fusion to the sacrum using rhBMP-2 versus autogenous iliac crest bone graft.
Comparative study. ⋯ The pseudarthrosis rate in the BMP group compares favorably to pseudarthrosis rate in ICBG group, suggesting that the use of rhBMP-2 without iliac harvesting leads to a competitive fusion rate in long adult spinal deformity surgery, while avoiding ICBG harvest site morbidity.
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Case report. ⋯ Literature of vascular abnormalities in association with Klippel-Feil syndrome takes the form of anecdotal reports. Aortic coarctation, vertebral artery dissection, aneurysms, persistent trigeminal artery, and abnormal origin of internal carotid are described. An unusual association of carotid internal agenesis and Klippel-Feil syndrome is reported with a literature review.
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Multicenter Study Comparative Study
Pain and disability determine treatment modality for older patients with adult scoliosis, while deformity guides treatment for younger patients.
Multi-center, retrospective review. ⋯ Counter to previous reports, age, comorbidities, and sagittal balance did not influence treatment modality for AS. Operative treatment for younger patients was driven by increased coronal plane deformity. Conversely, pain and disability mandated treatment for older patients, independent of radiographic measures. These findings suggest that AS patients do not become uniformly disabled with age, and that disability can not be solely predicted by radiographic findings. These data should be considered when considering treatment for AS.
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Multicenter Study Clinical Trial
Does treatment (nonoperative and operative) improve the two-year quality of life in patients with adult symptomatic lumbar scoliosis: a prospective multicenter evidence-based medicine study.
Prospective observational cohort study with matched and unmatched comparisons. Level II evidence. ⋯ It would appear from this study that common nonoperative treatments do not change the QOL in patients with ASLS at 2-year follow-up. However, operative treatment does significantly improve the QOL for this group of patients. Our conclusions are limited by the fact that we were only able to follow-up 45% of the nonoperative group to 2-year follow-up, in spite of extensive efforts on our part to accomplish such.