Spine
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Systematic review. ⋯ Despite high fusion rates there is a growing body of evidence that the use of BMP in PLIF and TLIF constructs does not come without potential complication. There are appreciable rates of BMP-specific complications, which include heterotopic ossification within the epidural space or neuroforamina, postoperative radiculitis, and endplate osteolysis with interbody device subsidence.
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Multivariate analysis of prospectively collected registry data. ⋯ After univariate and multivariate analyses, Medicaid insurance status was found to be a risk factor for postoperative complications. This corresponds to an ever-growing body of medical literature that has shown similar trends and raises the concern of underinsurance.
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Multicenter Study
Clinically significant differences exist between curves in operative idiopathic early-onset scoliosis and adolescent idiopathic scoliosis.
Retrospective analysis. ⋯ Significant radiographical differences exist between operative IEOS and AIS curves. IEOS curves are greater in magnitude, more kyphotic, less well compensated, and have a more caudal apex and stable vertebra. These findings suggest that younger patients may require more distal instrumentation and that proximal fixation techniques should consider the additional pullout forces created by the greater kyphosis.
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Cohort study. ⋯ Meaningful classifications exist for sagittal plane posture in young adolescent boys, both on gross body segment and lumbopelvic level. In terms of clinical importance, that is, low back pain and neck pain prevalence, postural subgrouping strategies based on the orientation of gross body segments are suggested to be superior when compared with lumbopelvic grading.