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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The human standing position requires permanent reciprocal spino-pelvic adjustments to obtain a dynamic and economic posture. This study focuses on a hypokyphotic Lenke 1 adolescent idiopathic scoliosis (AIS) patients cohort and points out their particular lumbo-pelvic adaptive mechanisms to maintain a neutral sagittal balance. ⋯ Hypokyphotic Lenke 1 AIS patients use lumbo-pelvic compensatory mechanisms to maintain their global balance with a poor effectiveness. Subjects with a low PI have a restricted range of LL adaptation. Attention should be paid during surgical planning not to overcorrect lordosis in the instrumented levels in case of non-selective fusion, that may induce posterior shift of the fusion mass and expose to junctional syndromes and poor functional outcomes in this particular patients.
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To investigate the predictive role of rib-vertebral angle (RVA) measurements in early adolescent idiopathic scoliosis (AIS) girls with right thoracic curve during brace treatment. ⋯ The initial RVAD ≥20° and CRVA ≤68° serve as valid factors in predicting the risk of curve progression during bracing in early AIS. Constant watch on RVAD and CRVA can help to more accurately predict the effectiveness of bracing in these patients.
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To prospectively evaluate the quality of life (QoL), functionality, and body image of subjects who had undergone surgery for adolescent idiopathic scoliosis (AIS) 5-12 years previously, and to identify the outcome predictors. ⋯ Patients who underwent surgery for AIS a minimum of 5 years earlier had impaired self-reported physical QoL compared to control subjects, but they nevertheless performed better than before their surgery. Greater size of the residual hump and greater distal extension of the fusion area are negatively correlated with final self reported outcome.
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The main treatment for congenital scoliosis is posterior hemivertebra resection with bilateral transpedicular fixation. Reports describing posterior unilateral intervertebral fusion and transpedicular screw fixation are rare, with no long-term follow-up results, especially in older children. Retrospective analysis of the long-term outcomes of unilateral fusion and fixation after hemivertebra resection for congenital scoliosis. ⋯ Unilateral transpedicular screw fixation provides satisfactory correction of the spinal deformity in both very young and older children. Unilateral intervertebral fusion and transpedicular fixation represents an advisable alternative method for the correction of congenital scoliosis and has advantages of reduced trauma, less surgery time and lower expense. Furthermore, the non-fused concave side offers the opportunity for correction of subsequent spine deformity.
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The introduction of magnetic expansion control growth rods for the surgical management of EOS has gained popularity. However, there are no published studies on the incidence of proximal junctional kyphosis (PJK) using this technique. ⋯ The incidence of PJK in EOS patients treated with magnetic rods is favourably comparable to that reported with traditional growth rods. Also, children who are male, syndromic, hyperkyphotic, and younger must be monitored closely.