Spine
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Comparative Study
S1 screw bending moment with posterior spinal instrumentation across the lumbosacral junction after unilateral iliac crest harvest.
A biomechanical study comparing fixation across the lumbosacral junction. ⋯ There is a significant decrease in the flexion-extension moment on the S1 screw when extending long posterior constructs to either the ilium or S2 sacral screw. There is no biomechanical advantage of the iliac bolt over the S2 screw in decreasing the moment on the S1 screw in flexion and extension. Adding anterior support to long posterior constructs significantly decreases the moment on the S1 screw. Adding distal posterior fixation to either the ilium or S2 decreases the moment on S1 screws more than adding anterior support. Further, adding anterior support when bilateral distal fixation past S1 is already present does not significantly decrease the moment on the S1 screws in flexion and extension.
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This investigation compared the gait of revision and primary spinal deformity patients about to undergo surgical reconstruction with that of a group of able-bodied controls. ⋯ This investigation is an objective report describing the compromised gait and walking endurance of adult patients with spinal deformity before spinal fusion surgery. Results supported subjective observations regarding the preoperative gait of these patients and presented results difficult to observe in a clinical setting. The techniques appear useful in providing objective information regarding the gait abilities of these patients.
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A retrospective study. ⋯ Thoracic pedicle screw fixation is a reliable method of treating spinal deformities, with an excellent deformity correction and a high margin of safety.
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Clinical Trial
Minimum 2-year analysis of sacropelvic fixation and L5-S1 fusion using S1 and iliac screws.
An analysis of lumbosacral fusions for high-grade spondylolisthesis fusions with reduction and long fusions to the sacrum in ambulatory adults. ⋯ Bilateral iliac screws coupled with bilateral S1 screws provide excellent distal fixation for lumbosacral fusions with a high fusion rate (95.1%) in high-grade spondylolisthesis and long fusions to the sacrum. Previous iliac crest harvesting does not prevent ipsilateral screw placement (34 of 36 patients) or additional iliac harvesting (78 of 80 patients).