The spine journal : official journal of the North American Spine Society
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Acute correction of severe spinal deformities significantly increases the risk of neurologic complications. Previously used methods to safely correct these deformities include halo-traction devices and internal distraction rods. ⋯ This report is the first to note the safety and efficacy of the MCGR in treating young patients with severe spinal deformities. This technique allows correction of the deformity while the patient is awake so that neurology can be continuously monitored. The patient is also ambulatory throughout the distraction process and can be distracted on an outpatient basis. Repeated surgery can be avoided, and the MCGR has been shown to be safe and effective with this case illustration.
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Prognosis of minor lumbar curve correction after selective thoracic fusion in idiopathic scoliosis is well defined. However, the prognosis of minor thoracic curve after isolated anterior fusion of the major lumbar curve has not been well described. ⋯ Selective anterior fusion of the major thoracolumbar/lumbar curve was an effective method for the treatment of Lenke Type 5C curves. Minor thoracic curves did not progress after selective fusion of thoracolumbar/lumbar curves in minimum 2-year follow-up.
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Neuromuscular scoliosis could develop at a young age and progress beyond skeletal maturity. An early spinal fusion arrests growth of the spine and thorax, risking the development of secondary thoracic insufficiency syndrome. Vertical expandable prosthetic titanium rib (VEPTR) is a fusionless technique aiming at correction of the deformity with preservation of growth potential. ⋯ Early results of VEPTR for neuromuscular scoliosis are encouraging. Follow-up till skeletal maturity will best determine future indications.
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Postoperative malalignment of the cervical spine may alter cervical spine mechanics and put patients at risk for clinical adjacent segment pathology requiring surgery. ⋯ Our results suggest that malalignment of the cervical spine following an ACF at C5-C6 has an effect on the development of clinical adjacent segment pathology requiring surgery.