European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society
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There is controversy regarding the appropriate proximal fusion level for adult degenerative scoliosis. Ideally, the horizontal vertebra is chosen for the upper instrumented vertebra to create a balanced spine. Fusion to T10 is recommended to prevent junctional problems at the proximal adjacent segment. The purpose of this retrospective study was to determine the optimal proximal fusion level for adult degenerative lumbar scoliosis. ⋯ Proximal adjacent segment disease developed more commonly when the proximal fusion stopped at the UEV or below in adult degenerative lumbar scoliosis. UIV must be above UEV in the coronal plane. Fusion to T11 or T12 was acceptable when UIV was above UEV, since there was no significant difference in the rate of proximal adjacent segment between fusion to T10 and fusion to T11 or T12.
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To evaluate the available evidence for the clinical effectiveness of the EOS(®) 2D/3D X-ray imaging system for the evaluation and monitoring of scoliosis and other relevant orthopaedic conditions. ⋯ The available clinical evidence for EOS(®) is limited to establishing its basic technical ability. The technical advancements associated with EOS(®) (the ability to generate a full body scan and to construct a three-dimensional model from synchronously acquired lateral and posteroanterior images) have not been evaluated in terms of their ability to improve patient outcomes. Whilst radiation dose is a concern for orthopaedic patients who require repeated imaging, it is difficult to quantify the reductions in radiation dose seen with EOS(®) in terms of patient health benefits. Clinical studies that investigate the impact of EOS(®) on patient management are required.
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Randomized Controlled Trial
Ultra-short-course chemotherapy for spinal tuberculosis: five years of observation.
This study aimed to explore the feasibility of ultra-short-course chemotherapy in the treatment of spinal tuberculosis. ⋯ With thorough focus debridement, bone grafting, and internal fixation, the efficacy of ultra-short chemotherapy was similar to that of standard chemotherapy for the treatment of spinal tuberculosis. The ultra-short-course chemotherapy can shorten the course of treatment and reduce drug side effects.