Spine
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Comparative Study Clinical Trial Controlled Clinical Trial
Recognition and treatment of the proximal thoracic curve in adolescent idiopathic scoliosis treated with Cotrel-Dubousset instrumentation.
A retrospective radiographic and clinical review of a consecutive series of patients with adolescent idiopathic scoliosis (AIS) instrumented/fused with Cotrel-Dubousset instrumentation (CDI) was undertaken. ⋯ When these aforementioned criteria are present and surgical correction with CDI is planned, we recommend extending the instrumentation up to T2 to produce level shoulders and maintain coronal balance.
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Comparative Study Clinical Trial Controlled Clinical Trial
Radiographic analysis of sagittal plane alignment and balance in standing volunteers and patients with low back pain matched for age, sex, and size. A prospective controlled clinical study.
A global and segmental study on standing lateral radiographs of 100 volunteers and 100 patients who had low back pain was undertaken to further define sagittal plane alignment and balance. The volunteer control group and the patient group were matched for age, sex, and size. ⋯ Definitions of sagittal balance are provided as well as additional sagittal plane data by which to compare corrections and fusions for different spinal disorders.
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Comparative Study
The Ste-Justine Adolescent Idiopathic Scoliosis Cohort Study. Part IV: Surgical correction and back pain.
This study determined whether the prevalence, nature, and consequences of back pain in adulthood among persons who underwent Harrington rod instrumentation was related to the number of vertebrae fused, distal level of hook insertion, and degree of correction. ⋯ Among the 723 AIS subjects who had surgery at Ste. Justine's Hospital, 555 completed the questionnaire on back pain. Overall, 73% of patients treated surgically reported back pain in the past year. Proportions varied little by presurgery characteristics or by degree of surgical correction. The distal level of fusion did not influence, in any consistent way, the occurrence of back pain in later life nor the degree of disability associated with back pain. This study does not provide any evidence that extending the level of fusion down even as far as L4 will increase the prevalence of back pain in adulthood.
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This study analyzed the sizes and angles of vertebrae and discs in Chinese subjects. Lateral lumbar spine radiograph films were taken of subjects in upright and 60 degrees flexion positions to evaluate disc height and angle changes. ⋯ The dimensions of lumbar vertebral bodies and discs, in upright and flexion positions, appear to be similar between Chinese and Western populations.
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Sensory- and motor-evoked potentials were recorded after high thoracic (T2) epidural electrical stimulation of the spinal cord. Under general anesthesia, 22 cats underwent single or repetitive spinal cord stimulation. ⋯ These findings indicate that spinal cord stimulation activates sensory and motor tracts that can be recorded at various sites along the central or the peripheral nervous system.