Spine deformity
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The purpose of this study was to assess L4-S1 inter-vertebral coronal motion of the unfused distal segments of the spine in patients with adolescent idiopathic scoliosis (AIS) after instrumented fusion with regards to postoperative time and fusion length, independently. ⋯ Motion in the unfused distal lumbar segments did not vary within the >10-year follow-up period. However, in patients with a primary thoracic curve and a nonstructural lumbar curve, the choice to fuse longer versus shorter may have significant consequences. The summed motion from L4 to S1 is 50% greater in patients fused longer compared with those patients with a selective fusion, in which postoperative motion is shared by more unfused segments. The implications of this focal increased motion are unknown, and further research is warranted but can be surmised.
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Retrospective study. ⋯ Level III.
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Case report. ⋯ Late fracture through a long fusion mass is a rare long-term complication of spine fusion for idiopathic scoliosis. In this case report, we report successful treatment of a fracture with a long lever arm of a solid posterior fused spine with posterior instrumented fusion multiple levels above and below the fracture.
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Biomechanical analysis of proximal junctional kyphosis (PJK) through numerical simulations. ⋯ Simulated posteriorly shifted sagittal alignment was associated with higher PJK risks, whereas extending instrumentation proximally allowed a lower mechanical risk of PJK. Preserving PJ intervertebral elements and using a more flexible anchorage at UIV help reduce the biomechanical risks of PJK.