Spine
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Multicenter Study
Classification of high-grade spondylolistheses based on pelvic version and spine balance: possible rationale for reduction.
Retrospective review of a radiographic database of high-grade spondylolisthesis patients in comparison with asymptomatic controls. ⋯ Analysis of sagittal alignment of high-grade spondylolisthesis patients revealed distinct groups termed "balanced" and "unbalanced" pelvis. The PT and SS were similar in controls and balanced pelvis patients. Unbalanced pelvis patients had a sagittal spinal alignment that differed from the balanced pelvis and control groups. Treatment strategies for high-grade spondylolisthesis should reflect the different mechanical strain on the spinopelvic junction in each group; reduction techniques might be considered in patients with an unbalanced pelvis high-grade spondylolisthesis.
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Multicenter Study
The relationship between thoracic hyperkyphosis and the Scoliosis Research Society outcomes instrument.
A retrospective chart review and radiographic analysis. ⋯ These findings indicate that higher kyphosis magnitudes were associated with increased pain, lower self-image, and decreased function and activity. Patients with thoracic hyperkyphosis were significantly more symptomatic than normal subjects in all domains. The r values for this analysis of kyphosis (0.40-0.66), in fact were substantially greater than those previously reported for scoliosis magnitude versus SRS Questionnaire scores (0.16-0.26), suggesting this instrument may be even better suited for the evaluation of hyperkyphosis patients.
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Comparative Study
Posterior lumbar interbody fusion versus posterolateral fusion in adult isthmic spondylolisthesis.
A prospective study with historical controls. ⋯ Type of fusion, PLIF or PLF, does not affect the 2-year outcome of surgical treatment of adult isthmic spondylolisthesis. Despite the theoretical advantages of PLIF, no improvement on patient outcome compared with posterolateral fusion could be demonstrated, questioning the need of anterior support in short lumbar fusions.
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Prospective clinical trial of vertical expandable prosthetic titanium rib (VEPTR) surgery in patients with congenital thoracic scoliosis with thoracic insufficiency syndrome and cervical tilt. ⋯ Mid-thoracic VEPTR opening wedge thoracostomy can stabilize cervical tilt associated with thoracic congenital scoliosis and fused ribs and may be an alternative to cervicothoracic spine fusion or hemi-vertebrectomy in some young children.
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Comparative Study
Adjacent segment disease followinglumbar/thoracolumbar fusion with pedicle screw instrumentation: a minimum 5-year follow-up.
Retrospective radiographic outcomes analysis. ⋯ Patients over the age of 50 were at higher risk of developing clinical ASD than those 50 years old or younger. Length of fusion was a significant risk factor in the development of ASD in the lumbar spine. Fusion up to L1-L3 increased the risk of ASD when compared with L4 and L5. Circumferential fusion, as opposed to posterolateral fusion, was not a statistically significant risk factor for the development of ASD.