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 rotation or translation of vertebrae in adolescent idiopathic scoliosis (AIS) patients could cause the relative migrations of surrounding vital structures and lead to smaller safe zones for pedicle screw insertion. This study aimed to determine the changed relative position of trachea to spine in the proximal thoracic curve (T1-T4) and to analyze the potential risks of tracheal injuries from pedicle screw insertions in AIS patients. ⋯ This CT-based study demonstrates that the FPT curve has a smaller safe zone with respect to tracheal injury during screw insertion. Spine surgeons should choose the appropriate screw length to avoid anterior wall perforation.
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Since early 1990s pedicle screws in thoracic spine have been used in posterior correction of adolescent idiopathic scoliosis (AIS). Long-term results are scarce. We report clinical, radiological and pulmonary function results of 48 consecutive patients with 10-year minimal follow-up. ⋯ Posterior correction of thoracic AIS with pedicle screw instrumentation is safe and produces a long-term stable correction and high patient satisfaction. An implant density of 50 % is sufficient to achieve these results. LIV can be the distal end vertebra or one below the distal end vertebra depending on the position of the distal end vertebra to the centre sacral line. The preoperative pulmonary function does not change on long term.
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Brace treatment has served as a vital non-surgical procedure for immature adolescent idiopathic scoliosis (AIS) patients with a mild or moderate curve. For the patients who fail in bracing and resort to surgery, it is unclear whether prior full-time brace treatment significantly influences outcomes. This study aims to investigate whether prior brace treatment has a negative impact upon the flexibility and correctability of the main curve in patients with AIS. ⋯ Good surgical correction can be achieved in AIS patients who have been unsuccessful with prior brace treatment. However, a history of prior brace treatment leads to a trend of lowering the curve flexibility, and in turn, negatively impacts upon the curve correctability.
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The aim of the present research is to evaluate the relationship between an X-ray-based method (i.e. the Raimondi method) and rasterstereography in the evaluation of vertebral rotation (VR) in a sample of adolescent idiopathic scoliosis (AIS) patients. ⋯ Rasterstereographic evaluation of VR shows a good correlation with the Raimondi method, thereby confirming the possibility to use this non-invasive method for deformity assessment in AIS patients.
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Posterior instrumented spinal fusion is indicated for progressive scoliosis that develops in Duchenne muscular dystrophy (DMD) patients. Whilst spinal fusion is known to improve quality of life, there is inconsistency amongst the literature regarding its specific effect on respiratory function. Our objective was to determine the effect of scoliosis correction by posterior spinal fusion on respiratory function in a large cohort of patients with DMD. Patients with DMD undergoing posterior spinal fusion were compared to patients with DMD not undergoing surgical intervention. ⋯ Severity of scoliosis was not a key determinant of respiratory dysfunction. Posterior spinal fusion did not reduce the rate of respiratory function decline. These two points suggest that intrinsic respiratory muscle weakness is the main determinant of decline in respiratory function in DMD.