Spine
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Comparative Study
Anterior/posterior spinal instrumentation versus posterior instrumentation alone for the treatment of adolescent idiopathic scoliotic curves more than 90 degrees.
A retrospective review of patients with adolescent idiopathic scoliosis (AIS), with curves more than 90 degrees treated with either a combined anterior/posterior spinal fusion or a posterior spinal fusion alone. ⋯ In this patient population with often restrictive preoperative pulmonary function, a posterior-only approach with the use of an all-pedicle screw construct has the advantage of providing the same correction as an anterior/posterior spinal fusion, without the need for entering the thorax and more negatively impacting pulmonary function.
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Comparative Study
Selective posterior thoracic fusions for adolescent idiopathic scoliosis: comparison of hooks versus pedicle screws.
A retrospective review of adolescent idiopathic scoliosis (AIS) patients with major thoracic-compensatory lumbar C modifier curves treated with a selective posterior fusion using an all-hook construct versus pedicle screw construct. ⋯ Selective thoracic fusion of main thoracic-compensatory lumbar C modifier AIS curves with pedicle screws allowed for better thoracic correction and less postoperative coronal decompensation than seen with hooks.
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Retrospective study. ⋯ The overall prevalence of pseudarthrosis following long adult spinal deformity instrumentation and fusion to S1 was 24%. Thoracolumbar kyphosis, osteoarthritis of the hip joint, thoracoabdominal approach (vs. paramedian approach), positive sagittal balance > or = 5 cm at 8 weeks postoperatively, older age at surgery (older than 55 years), and incomplete sacropelvic fixation significantly increased the risks of pseudarthrosis to an extent that was statistically significant. Scoliosis Research Society 24 outcomes scores at ultimate follow-up were adversely affected when pseudarthrosis developed.
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A retrospective study. ⋯ A sagittal Cobb angle difference between lumbar lordosis and thoracic kyphosis of > 20 degrees (higher lumbar lordosis) is advisable in most circumstances to achieve optimal sagittal balance.
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Retrospective clinical cohort study. ⋯ Researchers and clinicians should be aware of the potential for non-injury-related factors to delay recovery, and be aware of the interaction between the initial intensity of a patient's pain and other covariates when confirming these results.