Spine
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Comparative Study
Analysis of retrieved growth guidance sliding LSZ-4D devices for early onset scoliosis and investigation of the use of nitinol rods for this system.
Analysis of volumetric wear loss of retrieved growth guidance sliding devices LSZ-4D for treatment of early onset scoliosis and laboratory in vitro wear test for comparison of wear resistance of alloys Nitinol, Ti, and cobalt chromium (CoCr). ⋯ Application of wear-resistant coatings on Ti components in growth guidance sliding devices for the treatment of early onset scoliosis will be useful. High wear resistance of Nitinol combined with its superelastic and shape memory properties could make application of Nitinol rods for spinal instrumentation beneficial.
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This is an ambispective analysis of a prospectively followed cohort of patients with cervical spondylotic myelopathy (CSM). ⋯ Global sagittal alignment and SVA interactively associate with quantitative MRI spinal cord signal abnormalities and worse CSM-related disability. The reciprocal relationships of SVA effect in patients with kyphosis and those with lordosis may reflect an optimal spinal alignment to achieve during surgical management.
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Retrospective case series. ⋯ CSC visualized on MRI correlates poorly with the upper extremity reflex examination in patients with cervical myelopathy. Of the pathological reflexes, Hoffman sign has the strongest association with CSC, but still was only positive in 67% of cases. More sensitive clinical measures need to be developed to more accurately associate CSC detected on MRI to the clinical severity of cervical spondylotic myelopathy.
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A retrospective case series. ⋯ Scoliosis Research Society patient questionnaire-22 scores and radiographical parameters other than the correction rate were equivalent between the 2 groups. A short fusion strategy, in which the upper instrumented vertebra is 1-level caudal to the upper EV, is applicable to posterior correction and fusion surgery with pedicle-screw constructs for Lenke type 5C curves.
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Comparative Study
Outcomes of bracing in juvenile idiopathic scoliosis until skeletal maturity or surgery.
Retrospective comparative study. ⋯ The average age at diagnosis of 88 patients with JIS was 8.4 ± 1.4 years, with a female to male ratio of approximately 8:1. Pretreatment, Risser score was zero for 80 patients (91%); 72 (92%) of the females were premenarche; and primary Cobb angles ranged from 20° to 71°. Of the 88 patients, 60 (68%) had used a thoracolumbosacral orthosis exclusively; 28 (32%) patients used "other braces" (Milwaukee, Charleston, or a combination of braces), with an average treatment duration of 3.6 ± 1.9 years.As per Scoliosis Research Society definitions, a "non-curve-progression" (≤5° change) group consisted of 25 (28%) patients; and a "curve-progression" group consisted of 63 (72%) patients where the curve had progressed 6° or more.Of the 88 patients, 44 (50%) underwent surgery. The operative rate was higher for patients with curves 30° or more than those with curves 20° to 29° prior to brace treatment (37/58 [64%] vs. 7/30 [23%], respectively; P = 0.001); other braces compared with thoracolumbosacral orthosis (19/28 [68%] vs. 25/60 [42%], respectively; P = 0.02); Lenke I and III curves compared with Lenke VI curves (33/54 [61%] vs. 2/14 [14%], respectively; P = 0.007).