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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Computed tomography can be used for three-dimensional (3D) evaluation of adolescent idiopathic scoliosis (AIS) patients, but at the expense of high radiation exposure, and with the limitation of being performed in the supine position. These drawbacks can now be avoided with low-dose stereoradiography, even in routine clinical use. The purpose of this study was to determine the 3D postoperative correction of AIS patients treated by posteromedial translation. ⋯ Low-dose stereoradiography provided 3D reconstructions of the fused and unfused spine in routine clinical use. Postoperative 3D analysis showed that posteromedial translation enhanced sagittal balance correction, without sacrificing frontal or axial correction of the deformity.
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Corrective three dimensional (3D) effect of different braces is debatable. We evaluated differences in in-brace radiographic correction comparing a custom thoracic-lumbo-sacral-orthosis (TLSO) (T) brace to a Chêneau type TLSO (C) brace using 3D EOS reconstruction technology. Our primary research question was the 3D effect of brace on the spine and in particularly the apical vertebra rotation (AVR). ⋯ By utilizing a novel 3D reconstruction technology, we were able to demonstrate that braces differ in their immediate effects on the spine. Although clinical relevance should be evaluated in a future trial we feel that the ability to measure treatment effects in 3D, and especially the transverse plane, is an important tool when evaluating different treatments.
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The clinical outcome of polytrauma patients underwent spine fixation was analyzed and correlated both to surgical time (early versus delayed) and to fixation type (open versus percutaneous). ⋯ In polytrauma patients an early spine fixation improves clinical outcome. Patients underwent percutaneous screw fixation showed a better outcome compared to open surgery group obtained despite worst clinical conditions.
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Posterior-only approach arthrodesis by all-pedicle screw instrumentation has a correction rate similar to correction obtained by traditional combined anterior/posterior approach surgery and avoids the complications associated with the thoracic approach. ⋯ Posterior spinal fusion with pedicle screw-only instrumentation obtains a good and stable correction of severe scoliosis; compared to hybrid instrumentation, it allows a greater coronal correction of the deformity and less correction loss at the follow-up.
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Surgical strategy for thoracic disc herniation (TDH) remains controversial. We have performed posterior thoracic interbody fusion (PTIF) by bilateral total facetectomies with pedicle screw fixation. The objectives of this retrospective study are to demonstrate the surgical outcomes of PTIF for TDH. ⋯ PTIF has produced satisfactory outcomes for myelopathy due to TDH. Therefore, PTIF is one of the surgical treatments of choice for patients with TDH causing myelopathy.