Spine
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Comparative Study
Spontaneous proximal thoracic curve correction after isolated fusion of the main thoracic curve in adolescent idiopathic scoliosis.
Retrospective clinical, radiographic, and patient outcome review of surgically treated adolescent idiopathic scoliosis. ⋯ Spontaneous proximal thoracic curve correction consistently occurs after instrumented correction of the main thoracic curve. Furthermore, this spontaneous correction is as good as or slightly better after an ASF versus PSF of the MT curve. The preoperative side bender radiographs (PT curve flexibility) positively correlate with the postoperative spontaneous PT curve correction.
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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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Retrospective review of the results of submuscular rod placement with and without limited apical fusion for the treatment of severe spinal deformities in young children. ⋯ This technique is useful in the management of severe spinal deformities in young children who have either failed, or have a contraindication to, orthotic management. Complications are relatively frequent but well tolerated.
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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.