Spine
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Retrospective case analysis. ⋯ With long fusions to the sacrum in the treatment of spinal deformity, the use of bilateral S1 screws alone may allow for screw loosening/pullout and/or L5-S1 cage/graft collapse/subsidence. Adding bilateral iliac screws and an anterior structural cage/graft at L5-S1 will protect the S1 screws, but may still allow L5-S1 rod breakage/dislodgement because of lumbosacral pseudarthrosis. Revision surgery in these patients remains a challenge.
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Data collected prospectively from the Prospective Pediatric Scoliosis Study (PPSS) were analyzed statistically to address the hypothesis that covered specific aspects of treatment and its outcome. ⋯ There were no statistically significant baseline differences among the three instrumentation construct groups based on mean scores for the six SRS domains. None of the SRS domains had differences among the instrumentation constructs in change scores or significant differences among the instrumentation constructs.
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A retrospective radiographic study. ⋯ LIV tilt is a very important radiographic parameter that strongly correlates to postoperative global and regional coronal balance. In patients with Lenke 5C curves undergoing posterior spinal fixation using pedicle screw constructs, preoperative LIV tilt equal to or exceeding 25° and failure of postoperative LIV tilt to reduce below 8° correlate with a high risk of developing postoperative global coronal imbalance.
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Retrospective study. ⋯ Comparable bone density exists among adult scoliosis patients with no correlation between BMD and curve magnitude, fusion and complication rates. The difference in BMD of the hip and of spine cannot be fully explained in the review. These results will guide in surgical planning, patient selection on the treatment options.
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Retrospective radiographic review. ⋯ CBT and DVR can broaden the current curve criteria of MTCL curves for STF to have more MTCL curves treatable with STF and optimize instrumented thoracic and spontaneous lumbar correction. A more effective surgical technique can not only improve instrumented thoracic and spontaneous lumbar correction but also can broaden the MTCL curve criteria for STF to have more MTCL curves treatable with STF.