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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C-reactive protein (CRP) has been shown to be a powerful parameter for detecting acute postoperative spinal implant infections (PSII) with a high sensitivity and specificity. However, little data are available on the performance of CRP in the diagnosis of delayed PSII. The aim of the current study was therefore to establish cutoff values for diagnosing delayed infection based on serum CRP. ⋯ Serum CRP showed low sensitivity and specificity for diagnosis of delayed PSII, even after applying cutoffs optimized by using receiver operating curve analysis, because of the high incidence of low-virulent pathogens. These slides can be retrieved under Electronic Supplementary Material.
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Scoliosis with spondylolisthesis was described in 4.4-48%. No information on clinical impact or outcome is available. ⋯ The prevalence of low-grade isthmic L5-spondylolisthesis in AIS patients was 7.8%. The presence of low-grade isthmic spondylolisthesis did not influence the curve type of AIS nor did it affect the course or long-term outcome. 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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Clinical photography has proven to be reliable for posture assessment in adolescents and young adults with idiopathic scoliosis. This paper attempts to elucidate whether clinical photography is capable of distinguishing the distinctive characteristics in trunk deformity of the different Lenke patterns in patients with severe scoliosis candidate for surgery. ⋯ Clinical photography is a valid method for assessing trunk asymmetry in severe idiopathic scoliosis. Specifically, for waist area measurements, robust cutoff values can be determined to discriminate among different curve patterns according to Lenke classification. 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.