Spine
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A consecutive series of patients with adolescent idiopathic scoliosis (AIS), treated between 1968 and 1977 before 21 years of age with either distraction and fusion using Harrington rods (ST, n = 156; 145 females and 11 males) or with brace (BT, n = 127; 122 females and 5 males), were followed at least 20 years after completion of the treatment. ⋯ For both brace treated and surgically treated AIS patients, spinal mobility and muscle endurance were reduced more than 20 years after completed treatment. The physical function was not severely restricted.
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Comparative Study
Three-dimensional analysis of 2 fusionless scoliosis treatments: a flexible ligament tether versus a rigid-shape memory alloy staple.
Experimental scoliosis was created and subsequently corrected in goats. The 3-dimensional (3-D) effects of the treatments were analyzed. ⋯ The data in this study show the ability of a ligament tether attached to a bone anchor to correct scoliosis modestly in the coronal plane, but not in the sagittal or transverse plane. In addition, although a significant decrease in the deformity score was shown initially in this group (P < 0.001), the effect was lost over time. The final deformity in the bone anchor/ligament tether group wassignificantly less than either the stapled or untreated groups (P < 0.03). Further study is warranted to provide a better understanding of the 3-D effects of fusionless scoliosis treatments.
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A retrospective review of the clinical and radiographic outcomes of reduction by temporary instrumentation of L4 and monosegmental fusion of L5/S1 in patients with high-grade developmental spondylolisthesis. ⋯ Reduction of L5/S1 with temporary instrumentation of L4 and monosegmental fusion of L5/S1 is an effective technique for the treatment of high-grade developmental spondylolisthesis. A complete reduction of local deformity and excellent correction of overall sagittal profile can be achieved. Fusion of the primarily healthy segment L4/5 can be avoided.
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Comparative Study
Minimum 5-year analysis of L5-S1 fusion using sacropelvic fixation (bilateral S1 and iliac screws) for spinal deformity.
Clinical radiographic and outcomes investigation. ⋯ For high-grade spondylolisthesis and long adult deformity fusions to the sacrum, a montage of bilateral S1 screws and iliac screws were effective in protecting the sacral screws from failure. Pseudarthrosis at L5-S1 was manifested by rod breakage at that level. We saw no evidence of a long-term effect of the iliac screws predisposing the sacroiliac joints to degeneration at follow-up ranging from 5 to 10 years.
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Comparative Study
Effects of pelvic skeletal asymmetry on trunk movement: three-dimensional analysis in healthy individuals versus patients with mechanical low back pain.
Comparative analysis and correlational research design were used to investigate the association between anthropometry and biomechanical performance among asymptomatic subjects and patients with low back pain (LBP). ⋯ This study demonstrates objective differences in patterns of lumbar movement between asymptomatic subjects and patients with LBP. The study also demonstrates that subtle anatomic abnormality in the pelvis is associated with altered mechanics in the lumbar spine. We suggest that asymmetry of lumbar movement may be a better indicator of functional deficit than the absolute range of movement in LBP.