Spine
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A retrospective study of postoperative pain management with intrathecal morphine. ⋯ Intrathecal morphine in the moderate dose range of 9 to 19 microg/kg (mean 14 microg/kg), provides safe and effective postoperative analgesia in the immediate postoperative period for patients with idiopathic scoliosis undergoing PSF and SSI. Higher doses did not result in significantly better analgesia and had a greater frequency of respiratory depression requiring PICU admission.
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Multicenter Study
Predicting outcome and complications in the surgical treatment of adult scoliosis.
prospective, multicenter. ⋯ By applying the classification of adult deformity and considering baseline health status, models for predicting outcome can be established. Further work will refine these models and permit clinical validation. This effort will help establish reliable clinical models such that treatment algorithms can be established for the challenging patients suffering from adult spinal deformity.
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Comparative Study
Anterior spinal fusion versus posterior spinal fusion for moderate lumbar/thoracolumbar adolescent idiopathic scoliosis: a prospective study.
A prospective study. ⋯ ASF versus PSF comparison in treating moderate lumbar/thoracolumbar AIS did not show significant differences in regards to safety or efficacy but demonstrated shorter fusion levels, reduced surgical trauma and costs in ASF.
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Multicenter Study Comparative Study
Age-gender matched comparison of SRS instrument scores between adult deformity and normal adults: are all SRS domains disease specific?
Prospective, observational study. ⋯ Our findings confirm the SRS instrument has excellent discriminate validity in the adult population. It appears to be disease-specific in the domains of pain, appearance and activity in adult spinal deformity patients who have not had prior surgery.
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Multicenter Study Comparative Study Clinical Trial
Return of shoulder girdle function after anterior versus posterior adolescent idiopathic scoliosis surgery.
Multicenter, prospective, cohort study. ⋯ Approach-related differences in shoulder morbidity do exist in the treatment of primary thoracic curves in AIS. Specifically, OASF imparts a significantly greater magnitude and duration of postoperative shoulder dysfunction than do the TASF or PSF approaches. Nonetheless, these negative effects are transient as shoulder function in those patients treated via an open thoracotomy normalized by the 1-year postoperative time-point at the latest. Accordingly, viewed in isolation, shoulder morbidity should not deter surgeons from using an open anterior approach in the surgical treatment of AIS.