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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Observational Study
Geometric morphometrics of adolescent idiopathic scoliosis: a prospective observational study.
Adolescent idiopathic scoliosis is the most prevalent type of scoliosis, and its consequences on the human torso have not been deeply studied. In spite of being a 3D condition, clinical management is circumscribed to 2D images among health-care professionals. GMM is a well-recognized tool in the study of 3D shape and symmetry. ⋯ The greater asymmetry observed in AIS was expectable, but the similarity of areas of asymmetry in both groups made us suspect of directional asymmetry in the human torso that could explain the high prevalence of right scoliosis observed in nature. The shape of the torso and the asymmetry should be considered as variables to study in AIS due to its correlation with Cobb angle. Progression of the deformities was not observed in our study, maybe due to short-term follow-up.
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A cluster analysis describing spine and torso shape in Lenke type 1 adolescent idiopathic scoliosis.
The purpose of this work is to identify the variability and subtypes of the combined shape of the spine and torso in Lenke type 1 adolescent idiopathic scoliosis (AIS). ⋯ These clusters represent a new description of Lenke 1 AIS that comprises both coronal and sagittal measures of the spine combined with a measure of torso asymmetry. Automated identification of the clusters is accurate. The ability to identify subtypes of deformity, based on parameters that affect both the spine and the torso in AIS, leads to as better understanding of the totality of the deformity seen.
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While posterior-alone techniques have been successful for most pediatric spinal deformities, anterior spinal release may be useful for severe rigid deformities. Traditional lateral-positioned video-assisted thoracoscopic surgical release (VATSR) followed by prone posterior spinal fusion (PSF) has been criticized for adding extensive operative morbidity. We aimed to reduce its disadvantages by performing prone VATSR and PSF simultaneously and evaluate its long-term outcomes. ⋯ Our simultaneous prone VATSR and PSF technique showed significantly lower operative time, blood loss, and hospital stay compared with the traditional sequential VATSR and PSF method, suggesting its value in treating rigid deformities.
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There are distinct differences in strategy amongst experienced surgeons from different 'scoliosis schools' around the world. This study aims to test the hypothesis that, due to the 3-D nature of AIS, different strategies can lead to different coronal, axial and sagittal curve correction. ⋯ Curve correction by derotation may lead to thoracolumbar lordosis and therefore higher risk for proximal junctional kyphosis. Focus on sagittal plane by posteromedial translation, however, results in more residual coronal and axial deformity.