Spine
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Multicenter Study Comparative Study
Pelvic or lumbar fixation for the surgical management of scoliosis in duchenne muscular dystrophy.
This retrospective study evaluates two groups of patients with scoliosis and Duchenne muscular dystrophy, treated with two different surgical stabilization methods. ⋯ Lumbar fixation to L5 is adequate if the surgery is performed early, soon after becoming wheelchair bound, and with smaller curves and minimal pelvic obliquity. Use of pedicle screws in lumbar spine provides a solid foundation to maintain the correction over the period of relatively short life expectancy of these children. Pelvic fixation may be necessary in older children, who have larger curves and established pelvic obliquity. In the presence of deteriorating lung function, this is associated with a greater morbidity and higher complication rate.
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Review Case Reports
Unilateral calf hypertrophy seen in lumbosacral stenosis: case report and review of the literature.
A case report of a patient with neurogenic unilateral calf hypertrophy and review of the literature are reported. ⋯ Although the patient had bilateral L5 radiculopathies, he only had hypertrophy in the distribution of his right S1 radiculopathy. This supports the hypothesis that dysfunction of the S1 nerve root or its distribution is a predisposing factor to develop neurogenic muscle hypertrophy. Furthermore, patients presenting with unilateral calf hypertrophy need a careful diagnostic evaluation for S1 radiculopathy as well as to exclude asymmetric presentation of systemic neuromuscular conditions.
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Multicenter Study Clinical Trial
A multicenter study of the outcomes of the surgical treatment of adolescent idiopathic scoliosis using the Scoliosis Research Society (SRS) outcome instrument.
A multicenter study of the outcomes of the surgical treatment of adolescent idiopathic scoliosis using the Scoliosis Research Society Questionnaire (SRS 24). ⋯ Preoperative pain exists in our adolescent scoliosis population. Pain scores were improved in our study population at the 2-year postsurgical follow-up. Statistically significant improvements were likewise seen in the General Self-Image, Function From Back Condition, and Level of Activity domains. The present study demonstrates the ability of surgery to improve the outcome of patients afflicted with adolescent idiopathic scoliosis.
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This is a clinical study that examines the results of partial reduction and fibular dowel graft placement for high-grade isthmic spondylolisthesis. ⋯ Fibular strut grafting is a useful surgical adjunct in high-grade spondylolisthesis that is partially reduced. Clinical and radiographic outcomes were satisfactory. Our experience shows that there is no significant difference between allograft and autograft. All struts healed and remodeled by the ultimate follow-up, and there was only one instance of fibula fracture.
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Multicenter Study Clinical Trial
A multicenter study analyzing the relationship of a standardized radiographic scoring system of adolescent idiopathic scoliosis and the Scoliosis Research Society outcomes instrument.
A multicenter study examining the association between radiographic and outcomes measures in adolescent idiopathic scoliosis. ⋯ The Cobb angle measure of the major deformity has a small, but statistically significant, correlation with the reported Total Pain, General Self-Image, and General Function as measured by the Scoliosis Research Society outcomes instrument. None of the radiographic measures in this population correlated with postoperative domain scores of the Scoliosis Research Society outcomes tool.