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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To evaluate the available evidence for the clinical effectiveness of the EOS(®) 2D/3D X-ray imaging system for the evaluation and monitoring of scoliosis and other relevant orthopaedic conditions. ⋯ The available clinical evidence for EOS(®) is limited to establishing its basic technical ability. The technical advancements associated with EOS(®) (the ability to generate a full body scan and to construct a three-dimensional model from synchronously acquired lateral and posteroanterior images) have not been evaluated in terms of their ability to improve patient outcomes. Whilst radiation dose is a concern for orthopaedic patients who require repeated imaging, it is difficult to quantify the reductions in radiation dose seen with EOS(®) in terms of patient health benefits. Clinical studies that investigate the impact of EOS(®) on patient management are required.
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Severe spinal deformity is a complex morphological deformation that occurs and develops in three-dimensional space combined with abnormal development and morphology of anatomical structures, which presents great difficulties in the process of transpedicular screw placement. This study tried to explore the methods of transpedicular screw placement in surgical correction of severe spinal deformities. ⋯ The five-step remedial method proved to be an effective supplementary method for transpedicular screw placement to treat patients with severe spinal deformities. The key points include a detailed preoperative plan, a meticulous hand drilling sensation, and an experienced probing technique for screw tract.
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The purpose of this study was to investigate the incidence of neural axis abnormalities in patients with presumed "idiopathic" thoracolumbar or lumbar scoliosis by magnetic resonance imaging (MRI) and try to determine which clinical and radiographic characteristics correlate with neural axis abnormalities on MRI in these patients. ⋯ We recommend the routine use of MRI in the patients with one or more of the following characteristics: right curves, long curve span, apex at thoracolumbar spine and hyperthoracic kyphosis.
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Predictors of marked improvement versus failure to improve following surgery for adult scoliosis have not been identified. Our objective was to identify factors that distinguish between patients with the best and worst outcomes following surgery for adult scoliosis. ⋯ Not all patients achieve favorable outcomes following surgery for adult scoliosis. Baseline and peri-operative factors distinguishing between patients with the best and worst outcomes were predominantly patient factors, including BMI, depression/anxiety, smoking, and pain severity; not comorbidities, severity of deformity, operative parameters, or complications.