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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This study examined for factors contributing to postoperative pain in adolescent idiopathic scoliosis (AIS), including those of sagittal alignment and lumbar disc degeneration. ⋯ While preoperative lumbar disc degeneration was not associated with pre- or postoperative pain in AIS, higher preoperative pain and higher postoperative T5-12 kyphotic angle had significant associations with augmented postoperative pain. Higher preoperative pain was related to increased Risser grade and lower mental health score. These slides can be retrieved under Electronic Supplementary Material.
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To define the longitudinal rotation axis around which individual vertebrae rotate, and to establish the various extra- and intravertebral rotation patterns in thoracic adolescent idiopathic scoliosis (AIS) patients, for better understanding of the 3D development of the rotational deformity. ⋯ In AIS, the vertebrae rotate away around an axis that is localized posterior to the spine. The distance between this axis and the spine is minimal at the apex and increases gradually to the neutral zones. The vertebral axial rotation is accompanied by smaller amounts of intravertebral rotation and local mechanical torsion, which increases toward the apical region. The altered morphology and alignment are important for a better understanding of the 3D pathoanatomical development of AIS and better therapeutic planning for bracing and surgical intervention. These slides can be retrieved under Electronic Supplementary Material.
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Conventional diagnosis of spinal tuberculosis (TB) is based on a combination of clinical features, laboratory tests and imaging studies, since none of these individual diagnostic features are confirmatory. Despite the high sensitivity of MRI findings in evaluating spinal infections, its efficacy in diagnosing spinal TB is less emphasized and remains unvalidated through tissue studies. ⋯ Our study validated different MRI findings with tissue studies and showed spinal infections with large abscess with thin wall, subligamentous spread of abscess and vertebral collapse were highly suggestive of spinal tuberculosis. These slides can be retrieved under Electronic Supplementary Material.
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Thoracic hypokyphosis following AIS correction may be associated with reduced lumbar lordosis with potential adverse effects on the global sagittal balance. In the present study, we were interested in how the amount of thoracic kyphosis influences the sagittal profile and balance in selective thoracic (STF) and thoracolumbar fusions. ⋯ A critical thoracic kyphosis of 23° and more should be aimed for in hypokyphotic patients to potentially avoid post-operative sagittal plane deterioration with mechanical and likely also clinical consequences. These slides can be retrieved under Electronic Supplementary Material.
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The current classifications of adolescent idiopathic scoliosis (AIS) aim to guide surgical decision making. However, variance exists within treatment recommendations and suboptimal outcomes have been observed while following these guidelines based on two-dimensional images. We used previously developed 3D classification for right thoracic AIS patients and aimed to determine the variation in surgical decision making and the risk of suboptimal outcomes in each subtype according to our classification. ⋯ Following the preoperative 3D classification of the AIS patients, we showed that the UIV and LIV selection has a different impact on the surgical outcomes in each of the five subtypes. The proposed 3D classification has the potential for risk stratification following a posterior spinal surgery in right thoracic AIS. These slides can be retrieved under Electronic Supplementary Material.