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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To retrospectively evaluate the outcome of C1-2 transarticular screws combined with C1 laminar hooks fixation. ⋯ The C1-2 transarticular screws combined with C1 laminar hooks fixation is a reliable technique for atlantoaxial instability.
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Until now there have been many reports on hemivertebra resection. But there were no large series on the posterior hemivertebra resection with bisegmental fusion. This is a retrospective study to evaluate the surgical outcomes of posterior hemivertebra resection only with bisegmental fusion for congenital scoliosis caused by fully segmented non-incarcerated hemivertebra. ⋯ Posterior hemivertebra resection with bisegmental fusion allows for early intervention in very young children. Excellent correction can be obtained while the growth potential of the unaffected spine could be preserved well. However, it is not indicated for the hemivertebra between L5 and S1. The most common complication of this procedure is implant failure. Furthermore, in the very young children we noted that although solid fusion could be observed in the fusion level, implants migration may still happen during the time of adolescence, when the height of the body developed rapidly. So a close follow-up is necessary.
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Since early 1990s pedicle screws in thoracic spine have been used in posterior correction of adolescent idiopathic scoliosis (AIS). Long-term results are scarce. We report clinical, radiological and pulmonary function results of 48 consecutive patients with 10-year minimal follow-up. ⋯ Posterior correction of thoracic AIS with pedicle screw instrumentation is safe and produces a long-term stable correction and high patient satisfaction. An implant density of 50 % is sufficient to achieve these results. LIV can be the distal end vertebra or one below the distal end vertebra depending on the position of the distal end vertebra to the centre sacral line. The preoperative pulmonary function does not change on long term.
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Computer models and human surrogates used to study the forces and motion of the human neck under various loading conditions are based solely on adult data. Pediatric computer models and dummy surrogates used to improve the safety of children could be improved with the inclusion of previously unavailable pediatric muscle data. ⋯ The cross-sectional area and the power-law functions determined by the data in this study provide a means of calculating muscle cross-sectional area for young children, where such data are currently unavailable. This will provide an opportunity to develop more representative pediatric neck models.
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The rotation or translation of vertebrae in adolescent idiopathic scoliosis (AIS) patients could cause the relative migrations of surrounding vital structures and lead to smaller safe zones for pedicle screw insertion. This study aimed to determine the changed relative position of trachea to spine in the proximal thoracic curve (T1-T4) and to analyze the potential risks of tracheal injuries from pedicle screw insertions in AIS patients. ⋯ This CT-based study demonstrates that the FPT curve has a smaller safe zone with respect to tracheal injury during screw insertion. Spine surgeons should choose the appropriate screw length to avoid anterior wall perforation.