European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society
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We present an uncommon and yet interesting congenital anomaly and discuss the difficulties with diagnosis and controversies in management. C1 arch deficiency is an important consideration in the differential diagnosis of neck pain in children. ⋯ No definitive guidelines exist for the management of this congenital anomaly. Indications for surgical intervention prior to any neurological disturbance are unclear, and restricting a child from partaking in healthy activity may not be necessary. We discuss the anomaly and identified management strategies as reported in the literature so far.
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There exist not much data regarding the surgical treatment of pure congenital kyphosis (CK) in the literature. The purpose of this study was to evaluate the results of closing wedge osteotomy with posterior instrumented fusion in patients with congenital kyphotic deformity. ⋯ Closing wedge osteotomy with posterior instrumented fusion is an efficient method of surgical treatment in terms of sagittal balance restoration and deformity correction in patients with congenital kyphosis.
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In our article, we would like to introduce a new auxiliary implant called the CAB hook, for use in posterior approach scoliosis surgery. ⋯ As with all new surgical techniques and implants after the short learning curve, we were able to improve the degree of correction and decrease the time of surgery. One of the advantages of the CAB hook is that besides a few implant-specific instruments, no special instrumentation is required for insertion, and image intensifier need not be used.
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To identify factors that can affect postoperative shoulder balance in AIS. ⋯ Significant relations were found between correction rate of middle, and distal curvature, and postoperative shoulder balance. In addition, preoperative shoulder level difference can be a determinant of postoperative shoulder balance.
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Sagittal malalignment is frequently observed in adult scoliosis. C7 plumb line, lumbar lordosis and pelvic tilt are the main factors to evaluate sagittal balance and the need of a vertebral osteotomy to correct it. We described a ratio: the lumbar lordosis index (ratio lumbar lordosis/pelvic incidence) (LLI) and analyzed its relationships with spinal malalignment and vertebral osteotomies. ⋯ LLI is a statistically validated parameter for sagittal malalignment analysis. It can be used as a mathematical tool to detect spinal malalignment in adult scoliosis and guides the surgeon decision of realizing a vertebral osteotomy for adult scoliosis sagittal correction. It can be used as well for the interpretation of clinical series in adult scoliosis.