Spine
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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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A radiographic review of 78 consecutive patients with degenerative rotatory lumbar scoliosis. ⋯ In degenerative scoliotic curves, lateral translation is associated with rotation. Increased rotary olisthesis does not lead to decreased dural sac area. Anteroposterior olisthesis is inversely correlated to the dural sac anteroposterior diameter and cross-sectional area. With increased segmental Cobb angle, foraminal cross-sectional area enlarges in the convexity and does not decrease in the concavity. Presence of intervertebral rotation alone does not appear to be associated with reduced neural canal dimensions. Ligamentum flavum hypertrophy, posterior disc bulging, and bony overgrowth are more likely to contribute to stenosis irrespective of scoliosis.
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Comparative Study Clinical Trial
Prospective radiographic and clinical outcomes of dual-rod instrumented anterior spinal fusion in adolescent idiopathic scoliosis: comparison with single-rod constructs.
Anterior single or dual-rod instrumentation may be performed for the treatment of main thoracic, thoracolumbar, or lumbar adolescent idiopathic scoliosis (AIS) curves. ⋯ In this largest, to our knowledge, single-center report of dual-rod constructs for patients with AIS, a similar amount of radiographic deformity correction was obtained when compared to single-rod implants. However, the absence of any pseudarthroses in the 60 patients with dual-rod is a distinct advantage.
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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.