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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This study aims to investigate the use of biplanar radiography for assessing congenital scoliosis due to hemivertebra in 3D. ⋯ Biplanar radiography can be considered an interesting tool for clinical follow-up of congenital scoliosis as it overcomes some limitations of the analyses based on CT or anteroposterior X-ray: head to feet acquisition, low radiation dose and provides a set of automatically computed postural and morphological parameters in 3D.
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The purpose of this study is to review our operative experience of congenital kyphosis or kyphoscoliosis undergoing either pedicle subtraction osteotomy (PSO) or posterior vertebral column resection (pVCR) according to certain criteria we have established. ⋯ If selected appropriately, both PSO and pVCR procedures can achieve compatible and satisfactory correction results in the surgical treatment of congenital kyphosis or kyphoscoliosis.
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Direct apical vertebral rotation represents an important goal of posterior surgery for thoracic adolescent idiopathic scoliosis (AIS), so as to obtain a better cosmetic effect and to avoid posterior thoracoplasty. However, the real effectiveness in correction of vertebral rotation, using posterior only procedures, is still open to debate. The aim of the present study is to compare the correction of axial apical rotation obtained with direct rotation procedure versus simple concave rod rotation, in patients treated by posterior fusion for thoracic AIS using pedicle screw-only construct. ⋯ The direct vertebral rotation obtained significantly better final results, when compared to simple concave rod rotation, both concerning correction of apical vertebral rotation and magnitude of MT curve. On the other hand, the DR group presented a little reduction in T5-T12 kyphosis at follow-up, in comparison with concave rod rotation procedure. Both procedures were found to be satisfying from patients' perspective. Nevertheless overall complication rate was higher in the simple concave rod rotation group, related mainly to thoracoplasty (2 cases), which was never necessary in direct rotation patients.
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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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Adolescent scar contracture kyphoscoliosis is a very rare disease. ⋯ Based this grand round case and relevant literature, we discuss the different options for the treatment of adolescent scar contracture scoliosis.