Spine
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Multicenter Study Clinical Trial
Does treatment (nonoperative and operative) improve the two-year quality of life in patients with adult symptomatic lumbar scoliosis: a prospective multicenter evidence-based medicine study.
Prospective observational cohort study with matched and unmatched comparisons. Level II evidence. ⋯ It would appear from this study that common nonoperative treatments do not change the QOL in patients with ASLS at 2-year follow-up. However, operative treatment does significantly improve the QOL for this group of patients. Our conclusions are limited by the fact that we were only able to follow-up 45% of the nonoperative group to 2-year follow-up, in spite of extensive efforts on our part to accomplish such.
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Comparative Study Clinical Trial
Transforaminal lumbar interbody fusion versus anterior lumbar interbody fusion as an adjunct to posterior instrumented correction of degenerative lumbar scoliosis: three year clinical and radiographic outcomes.
Prospective, nonrandomized consecutive single surgeon series. ⋯ With current deformity correction techniques, both ALIF and TLIF are effective in DLS surgery. Anterior surgery is not routinely required to treat all cases of DLS.
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Retrospective review of a prospectively accrued patient cohort. ⋯ A posterior-based VCR is a safe but challenging technique to treat severe primary or revision pediatric spinal deformities. Intraoperative SCM (especially motor-evoked potentials) is mandatory to prevent spinal cord-related neurologic complications. Dramatic radiographic and clinical correction of these deformities can be obtained via a posterior-only approach.
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Clinical and radiologic assessment derived from a prospective multicenter data base of adolescent idiopathic scoliosis (AIS) patients. ⋯ Major curve correction at 2 years correlates most with the implant density that is correction increases with the number of implants used within the measured Cobb levels. Although the absolute number of screws used did not correlate with correction, there was an advantage in lumbar and thoracic curves to using screws compared to hooks. Sagittal contour in the thoracic spine became less kyphotic than the higher the implant density.
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Comparative Study
Long adult spinal deformity fusion to the sacrum using rhBMP-2 versus autogenous iliac crest bone graft.
Comparative study. ⋯ The pseudarthrosis rate in the BMP group compares favorably to pseudarthrosis rate in ICBG group, suggesting that the use of rhBMP-2 without iliac harvesting leads to a competitive fusion rate in long adult spinal deformity surgery, while avoiding ICBG harvest site morbidity.