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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To evaluate the zonal differences in risk and pattern of pedicle screw perforations in adolescent idiopathic scoliosis (AIS) patients. ⋯ Overall pedicle perforation rate was 8.4%. Highest rate of critical medial perforation was at the convex MT zone and the transitional PT/MT zone, whereas highest rate of critical anterior perforation was at the concave PT zone and the transitional PT/MT zone. The rate of symptomatic perforations was 0.1%.
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To identify risk factors, in 12 patients with junctional breakdown (JBD) after thoraco-sacral fusions and to test a software locating maximal bending moment on full spine EOS images. ⋯ This study confirms the importance of harmonious distribution of lumbar (GLL, ULL, and ILL) and thoracic curves (TK, T1-T5 segment) in thoraco-sacral fusions. All patients showed an exaggerated ULL, resulting in a posterior shift and increased lever arm at the thoraco-lumbar junction, leading to JBD.