Spine
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This is a retrospective study of 50 patients with adolescent idiopathic scoliosis with curves measuring 35 degrees to 45 degrees who were treated with a Boston brace. ⋯ These long-term data confirm that the Boston brace when used 18 or more hours per day is effective in preventing progression of large curves at a mean of 9.8 years after bracing is discontinued.
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Three types of anterior thoracolumbar multisegmental fixation were biomechanically compared in construct stiffness and rod-screw strain. ⋯ For single-rod fixation, increased rod diameter neither markedly improved construct stiffness nor affected rod-screw strain, indicating the limitations of a single-rod system. In thoracolumbar anterior multisegmental instrumentation, the dual-rod fixation provides higher construct stiffness and less rod-screw strain compared with single-rod fixation.
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A retrospective study. ⋯ Idiopathic thoracic scoliosis with a proximal thoracic curve of more than 25 degrees and level or elevated left shoulder should be considered a double thoracic curve pattern and should be treated by fusing both the proximal and the distal curves when using segmental instrumentation.
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Comparative Study
A comparison of the effects of patient-controlled analgesia with intravenous opioids versus Epidural analgesia on recovery after surgery for idiopathic scoliosis.
Epidural infusion was compared with standard patient-controlled analgesia (PCA) in 50 patients after surgical correction of adolescent idiopathic scoliosis with respect to certain postoperative parameters. ⋯ Epidural infusion of opioids with bupivacaine is safe and effective for controlling postoperative pain after PSIF without an increased complication rate when compared with PCA. In the current study, patients tolerated a full diet and were discharged from the hospital an average of 0.5 days earlier than PCA-treated patients.