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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Early-onset spinal deformities present multiple challenges to the surgeon. They may be rapidly progressive and unresponsive to conservative treatment, necessitating surgical intervention at an early age. ⋯ The growing rod is one of the first, most evolved, most popular and one of the most heatedly discussed technique of fusionless spinal instrumentation.
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The purpose of this study was to provide the readers with a reliable source of animal models currently being utilized to perform state-of-the-art scoliotic research. ⋯ All these different animal models compel us to believe that the clinical phenotype of what we call idiopathic scoliosis may well be caused by a variety of different underlying pathologies.
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To review the literature on the use of extreme lateral interbody fusion (XLIF) in adult spinal deformity, to discuss on its limits and advantages and to propose a guide to surgical strategy. ⋯ XLIF is a promising MIS option for adult deformity. Specific surgical strategies are needed to avoid imbalance and define ideal fusion levels and methods. An XLIF-based MIS strategy with a reduced number of levels of lumbar scoliosis can lead to significant advantages. Evaluation of the incidence, complications, their avoidance and real impact on patients' outcomes is necessary to better understand the advantages of this approach. Studies comparing effectiveness and safety of traditional versus XLIF approaches are needed to assist evidence-based decision making.
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The surgical approach in the treatment of idiopathic thoracic scoliosis depends on the type of curve involved. In anterior correction, the rib hump is corrected by derotating the thoracic spine. In posterior scoliosis surgery, additional rib hump resection is sometimes necessary to achieve an optimal cosmetic result. The aim of this study was to compare pulmonary function in these two patient groups. ⋯ The severe deterioration in group A is caused by the substantial trauma with double thoracotomy in contrast to rib hump resection. For patients with severe restrictive pulmonary distress, posterior instrumentation in combination with rib hump resection would be preferable to an anterior procedure involving double thoracotomy. Respiratory physiotherapy exercise should be administered in order to minimise postoperative pulmonary distress. In conclusion opening of the chest wall leads to deterioration of pulmonary function with improvement to the preoperative values after 6 months in the posterior and after 24 months in the anterior group.
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The percutaneous insertion technique requires surgical skill and experience. However, there have been few clinical reports evaluating the accuracy of minimally invasive pedicle screw placement using the conventional fluoroscopy method. The purpose of this study was to evaluate the accuracy of percutaneous pedicle screw placement in the treatment of thoracic and lumbar spine fractures using two-plane conventional fluoroscopy. ⋯ This study demonstrates the feasibility of placing percutaneous posterior thoracolumbar pedicle screws with the assistance of conventional fluoroscopy. Minimally invasive transpedicular instrumentation is an accurate, reliable and safe method to treat a variety of spinal disorders, including thoracic and lumbar spine fractures.