Spine
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Multicenter Study
Surgical rates and operative outcome analysis in thoracolumbar and lumbar major adult scoliosis: application of the new adult deformity classification.
Multicenter prospective consecutive clinical series. ⋯ This investigation appears to offer the first comprehensive analysis of classification, treatment, and outcomes in a large adult deformity patient group. Significant treatment patterns and outcomes are coming to light as is the impact of surgical strategy.
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Multicenter Study
The impact of perioperative complications on clinical outcome in adult deformity surgery.
Retrospective case-control series. ⋯ This study suggests that risk for minor complications may be a less substantial obstacle than previously assumed for surgical treatment in adult spinal deformity. In contrast, major complications were reported in approximately 10% of cases and adversely affected outcome as evidenced by the deterioration in SF-12 general health scores at 1 year after surgery.
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Multicenter Study
Operative management of Scheuermann's kyphosis in 78 patients: radiographic outcomes, complications, and technique.
A retrospective multicenter review of 78 patients with Scheuermann's kyphosis treated operatively was conducted. ⋯ This is one of the largest reported series of Scheuermann's kyphosis treated operatively to our knowledge. A high rate of junctional kyphosis, especially at the proximal end, is associated with surgery for Scheuermann's kyphosis using current techniques. Proximal junctional kyphosis is associated with higher magnitude of kyphosis at follow-up, less percent correction; its magnitude correlated directly with pelvic incidence. Loss of correction is less in patients undergoing combined anteroposterior surgery. Pelvic incidence correlates directly with lordosis but not kyphosis, suggesting that these parameters are not causative of Scheuermann's kyphosis.
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Multicenter Study
Neural complications in the surgical treatment of adolescent idiopathic scoliosis.
Multicenter, prospective, consecutive clinical series. ⋯ The neural complication rate was 0.69%. Two thecal penetrations were due to medial placement of pedicle screws, and 1 was due to dissection during spine exposure. If these are eliminated, as they imply intraspinal entry but not direct neural injury, together with 1 positional neurapraxia, which is remote from the surgical field, our complication rate is 0.38%. This is consistent with other studies in the North American Literature, including multiple reports from the Scoliosis Research Society. Common themes are significant curve correction producing neural stretch and the use of sublaminar wires. None of the neural injuries was permanent. These results reaffirm that surgical treatment of adolescent idiopathic scoliosis has a low but real neural complication rate.