Spine
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A retrospective study of 26 patients with degenerative flat back treated with corrective osteotomy. ⋯ Degenerative flat back could be classified into two types based on pelvic position during walking: one with posterior pelvic tilt and the other with marked anterior pelvic tilt. In the former type, corrective surgery improved the stooping. In the latter, corrective surgery was ineffective, resulting in postoperative persistent stooping.
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Prospective clinical cases series. ⋯ Anterior instrumented fusions for adolescent idiopathic scoliosis using a single solid rod had good radiographic and clinical outcomes. Consideration should be given to alternate techniques in larger adolescents (>70 kg) with thoracic hyperkyphosis (>40 degrees ), and smoking should be avoided. Poor radiographic outcomes did not correlate with final Scoliosis Research Society scores.
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Retrospective review of a consecutive clinical series. ⋯ The transpedicular wedge resection osteotomy is an effective procedure for the management of fixed sagittal deformity and is generalizable for multiple etiologies. Simultaneous correction of coronal deformity is possible. The clinical value of the procedure is demonstrated in high rates of patient satisfaction.
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A retrospective study was performed with the use of magnetic resonance imaging to evaluate the type and degree of soft tissue disruption associated with flexion-distraction injuries of the subaxial spine. ⋯ Unilateral and bilateral facet dislocations of the subaxial spine are associated with damage to numerous soft tissue structures that provide stability to the lower cervical spine. Damage to the posterior longitudinal ligament did not occur consistently in unilateral facet dislocations. Bilateral facet dislocations were associated significantly with disruption to the posterior and anterior longitudinal ligaments and left facet capsule, as compared with unilateral facet dislocations. Magnetic resonance imaging allows visualization of these disruptions.
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A case report of a bilateral lumbosacral dislocation without a fracture is presented. ⋯ Lumbosacral dislocations are rare injuries. The authors demonstrate the feasibility of a posterior lumbar interbody fusion procedure in combination with posterolateral instrumentation and fusion.