Spine
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Prospective clinical-radiographic study. ⋯ Changes in thoracic kyphosis on fulcrum bending due to natural coupling of deformities are directed towards "self-normalization." There is no difference in the sagittal plane deformity correction with the use of hook-rod system or pedicle screw-rod constructs. This can be used as a guideline for exact preoperative rod contouring to reduce the stress on the bone-implant interface and the rate of postoperative failures. The findings also suggest that it is not how big or strong the implants are, but rather the natural curve behavior will at least partially determine the final sagittal outcome.
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Retrospective review. ⋯ Patients with spine fractures and ASD are at high risk for complications and death and should be counseled accordingly. Multilevel posterior segmental instrumentation allows effective fracture healing. AS and DISH patients represent similar patient populations for the purpose of treatment and future research.
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Retrospective database review. ⋯ PPAC and LOS varied by region. Although there was no significant difference in treatment type based on age or region, older patients tended to have more complex procedures and a higher LOS. This did not translate into a significant change in PPAC based on age. These data point to the need for further studies examining reasons for geographic variability in idiopathic scoliosis surgeries.
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An in vivo clinical trial, and an in vitro cadaveric biomechanical and micromorphologic analysis. ⋯ Vertebroplasty using viscoplastic bone cement is clinically feasible and can effectively improve the vertebral strength and reduce the cement infiltration depth. The risk of cement leakage can also be decreased by using viscoplastic bone cement.
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The assignment of adolescent idiopathic scoliosis (AIS) curves into curve types (1-6), as described by Lenke et al, was evaluated by 12 independent observers using the original description versus a decisional tree algorithm. ⋯ Transfer of a computer algorithm, a decision tree, to a clinical diagram improved both accuracy ofAIS classification. Algorithmic diagrams could prove beneficial to increase classification reliability due to their systematic approach.