Spine
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Review Meta Analysis
Physiotherapy rehabilitation post first lumbar discectomy: a systematic review and meta-analysis of randomized controlled trials.
Systematic review and meta-analysis. ⋯ Inconclusive evidence exists for the effectiveness of outpatient physiotherapy post first lumbar discectomy. Best practice remains unclear.
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Multicenter Study
Selective thoracic fusion in adolescent idiopathic scoliosis: factors influencing the selection of the optimal lowest instrumented vertebra.
Analysis of multicenter, prospectively collected data. ⋯ When performing a selective thoracic fusion of Lenke type 1B, 1C, and 3C AIS curves in which the SV was at/or below the EV, the greatest correction of the main thoracic and compensatory lumbar curves occurred when the LIV was at/or at least one level distal to the SV. This more distal LIV did not result in an increased rate of truncal imbalance.
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Randomized Controlled Trial
Posterior multilevel vertebral osteotomy for severe and rigid idiopathic and nonidiopathic kyphoscoliosis: a further experience with minimum two-year follow-up.
Prospective randomized study. ⋯ PMVO exhibited satisfactory clinical and radiologic results in patients with severe and rigid scoliosis associated with hyperkyphosis at minimum 2-year follow-up. It can be safely applied with modifications in original technique for complex congenital scoliosis with multilevel hemi or block vertebrae and idiopathic/nonidiopathic spinal deformities.
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A systematic review of randomized controlled trials. ⋯ When fusion of the motion segment is considered to be the working mechanism for pain relief and functional improvement, iliac crest autograft appears to be the golden standard. When ignoring fusion rates and looking at complication rates, a cage as a golden standard has a weak evidence base over iliac crest autograft, but not over discectomy.
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Multicenter Study
The Scoliosis Research Society Health-Related Quality of Life (SRS-30) age-gender normative data: an analysis of 1346 adult subjects unaffected by scoliosis.
Prospective, cross-sectional study. ⋯ This study reports population medians, means, standard deviations, percentiles, and confidence intervals for the domains of the SRS-30 HRQOL instrument. Clinicians must be mindful of age-gender differences when assessing deformity populations. Generational decreases noted in the older adult volunteer scores may provide a basis for future investigators to interpret observed score decreases in patient cohorts at long-term follow-up.