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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Case Reports
Bilateral reconstructive costoplasty for razorback deformity correction in adolescent idiopathic scoliosis.
Correcting the chest wall deformity is an important goal of scoliosis surgery. A prominent rib hump deformity may not be adequately addressed by scoliosis correction alone. It has been shown that costoplasty in conjugation with scoliosis correction and instrumented spinal fusion is superior to spinal fusion alone in addressing the chest wall deformity. In cases of severe rib hump deformity unilateral convex side costoplasty alone might not adequately restore thoracic cage symmetry necessitating for additional concave side rib cage reconstruction. ⋯ Bilateral costoplasty in conjugation with scoliosis correction may provide a safe and effective method for the treatment of severe rib cage deformities associated with thoracic scoliosis. It should be considered in the presence of prominent rib hump deformity, where scoliosis correction alone or with unilateral costoplasty is unlikely to provide adequate correction.
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Comparative Study
Comparison between walking test and treadmill test for intermittent claudication associated with lumbar spinal canal stenosis.
To clarify the priorities of the walking test and the treadmill test for intermittent claudication of lumbar canal stenosis. ⋯ The walking test detected significantly more symptoms that were not detected at rest than the treadmill test.
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To analyze risk factors for an increase in proximal junctional angle (PJA) after posterior selective thoracolumbar/lumbar (TL/L) curve fusion in patients with adolescent idiopathic scoliosis (AIS). ⋯ Location of LIV above or equal to L3, higher postoperative LL and deteriorative negative SVA with surgery were potential risk factors for increased PJA during follow-up. Postoperative LIV inclination more than 5ºmight be also an indicator for an increase in PJA.
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Abnormal anthropometry including comparably lower weight and body mass index (BMI) in the adolescent idiopathic scoliosis (AIS) population is increasingly recognised, however, no study has examined postoperative weight loss or its clinical relevance in these relatively thin patients. This study aimed to assess perioperative nutritional status as well as clinically severe involuntary weight loss and its impact on outcomes in patients with AIS undergoing posterior spinal fusion (PSF). A further objective was to compare preoperative anthropometric measurements of the current AIS cohort with healthy controls. ⋯ This study demonstrated that clinically severe postoperative weight loss >10%, identified in almost one-third of this AIS cohort, was associated with significantly increased wound infection incidence. Early detection and prevention of severe postoperative weight loss in patients with AIS who undergo spinal fusion may be beneficial in reducing wound infection risk. This study confirms a body of literature indicating the significantly lower weight and BMI in patients with AIS compared with healthy controls.
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Fenestration is the gold standard surgery for lumbar spinal canal stenosis in Japan. Several previous studies have analyzed the reoperation rates in large numbers of patients undergoing several surgical procedures such as laminectomy with or without instrumented spinal fusion; however, there have been few studies focusing solely on fenestration. The purpose of this study was to calculate the reoperation rates after fenestration using the survival function method. ⋯ Fenestration can be performed at low cost using standard spinal surgery equipments. The reoperation rates of this procedure were lower than previously reported for several other surgical procedures.