Spine
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Comparative Study
Comparison of Smith-Petersen versus pedicle subtraction osteotomy for the correction of fixed sagittal imbalance.
Clinical, radiographic, and outcomes assessment comparing two surgical techniques. Clinical data were collected prospectively. The radiographic analysis was done retrospectively. ⋯ When comparing three or more SPOs (14 patients) to one pedicle subtraction procedure (41 patients), the correction in kyphosis was nearly identical. There was a significantly greater likelihood of decompensating the patient to the concavity with three or more SPOs than with a single PSO (P < 0.02). The blood loss was substantially greater with the PSO group (P < 0.001).
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Comparative Study
Evaluation of pedicle screw placement in the deformed spine using intraoperative plain radiographs: a comparison with computerized tomography.
A retrospective study. ⋯ Intraoperative plain radiographs alone using 3 radiographic criteria were very sensitive to detect lateral wall pedicle screw violations, specific for assessing for medial wall violations, and highly accurate for both. This result confirms the ability of careful intraoperative plain radiographic assessment after pedicle screw insertion to detect malpositioned screws, to allow for possible revision during the index operation.
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Comparative Study
Long-term outcome in neuromuscular scoliosis fused only to lumbar 5.
Outcomes are retrospectively compared for patients with neuromuscular scoliosis after instrumented surgery and fusion to the pelvis versus lumbar 5 fusion alone. ⋯ Instrumentation and fusion to L5 is a less technically difficult procedure, requires less surgical time, has decreased blood loss, and less risk of infection compared to instrumented pelvic fusion. Postoperative and long-term follow-up indicates that L5 fusion can correct scoliosis and pelvic obliquity, comparable to results of sacrum fusion.
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Comparative Study
Monaxial versus multiaxial thoracic pedicle screws in the correction of adolescent idiopathic scoliosis.
Radiographic outcome analysis following thoracic fusion of Lenke Type I adolescent idiopathic scoliosis (AIS) curves with segmental pedicle screw fixation. ⋯ Both monaxial and multiaxial thoracic pedicle screws provide excellent coronal deformity correction for thoracic fusion of main thoracic AIS. Monaxial screws provide superior derotation and restoration of thoracic symmetry as noted by significantly greater correction of the AVB-R, RH, and ARSD.
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Comparative Study
Comparison of single and dual growing rod techniques followed through definitive surgery: a preliminary study.
Retrospective analysis of patients treated with single and dual growing rods who had completed their course of treatment, had definitive fusion, and had a minimum of 2 years follow-up. ⋯ The use of growing rods is effective in controlling severe spinal deformities and allowing spinal growth. Dual rods are stronger than single rods and, therefore, provide better initial correction and maintenance of correction. The use of an apical fusion does not appear to be effective over the course of treatment.