Spine
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STUDY DESIGN A retrospective analysis of primary cases of adult idiopathic scoliosis treated with long instrumented fusions from the thoracic spine proximally to segments that range from T11 to L4 distally. ⋯ Patients with adult idiopathic scoliosis and long fusions had similar pseudarthrosis rates, but higher rates of transition syndrome when lowest instrumented vertebra was L3-L4 relative to levels T11-L2. When categorized by age, complication rates were similar in each group. Patients with pseudarthroses or other diagnoses requiring revision surgery had lower SRS-24 total scores than those without (P = 0.02 and P = 0.01, respectively).
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A prospective study. ⋯ Segmental pedicle screw fixation with "direct vertebral rotation" showed better rotational and coronal correction than "simple rod derotation."
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A prospective, cross-sectional analysis of patients with operative idiopathic scoliosis comparing Scoliosis Research Society's Outcomes Instrument (SRS-24) scores from both parents and patients obtained separately on the same day along with pertinent radiographic data. ⋯ Based on SRS-24 data, parents typically scored higher than their children in the operative treatment of idiopathic scoliosis in total score, self-image, and overall satisfaction. Some parent-patient scores correlated better with increasing age of the patient, and later in the postoperative period.
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A retrospective study. ⋯ The free hand technique of thoracic pedicle screw placement performed in a step-wise, consistent, and compulsive manner is an accurate, reliable, and safe method of insertion to treat a variety of spinal disorders, including spinal deformity.
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A morphometric analysis of thoracic pedicles in vertebrae from scoliotic specimens. ⋯ These results are of critical importance for clinicians performing spinal corrective surgery in patients with AIS. Pedicle width is significantly diminished on the concavity of scoliotic curves. Our results advocate caution in the use of pedicle screws in the thoracic spine especially on the concave side of the curve.