Moderate scoliosis continues to progress at 30-year follow-up: a call for concern?

Purpose: This natural history study reports long-term radiographic and clinical outcomes of patients with diagnosis of AIS with curves between 30° and 50°. Our purpose was to determine if any intervention in the natural history is warranted.

Methods: This was a longitudinal descriptive study at a single institution.

MRI measurement of neuroforaminal dimension at the index and supradjacent levels after anterior lumbar interbody fusion: a prospective study.

Background: Anterior interbody fusion has previously been demonstrated to increase neuroforaminal height in a cadaveric model using cages. No prior study has prospectively assessed the relative change in magnetic resonance imaging (MRI) demonstrated neuroforaminal dimensions at the index and supradjacent levels, after anterior interbody fusion with a corticocancellous allograft in a series of patients without posterior decompression. The objective of this study was to determine how much foraminal dimension can be increased with indirect foraminal decompression alone via anterior interbody fusion, and to determine the effect of anterior lumbar interbody fusion on the dimensions of the supradjacent neuroforamina.

Therapeutic drug monitoring in the treatment of active tuberculosis.

Background: Therapeutic drug monitoring (TDM) is used to optimize dosing that maximizes therapeutic benefit while minimizing toxicity. In the treatment of active tuberculosis (TB), TDM is not routine, yet low levels of anti-TB drugs can be associated with poorer treatment outcomes.

Methods: In a retrospective case control study, patients with active TB in whom TDM was performed were considered cases and compared with controls who did not undergo TDM, and matched according to year of diagnosis and the results of direct smear microscopy.

Radiculopathy in degenerative lumbar scoliosis: correlation of stenosis with relief from selective nerve root steroid injections.

Objective: The purpose is to define the origin of radiculopathy of patients with degenerative lumbar scoliosis-stenosis and to assess the correlation between percentage of initial radicular leg pain relief with selective nerve root injections and lateral canal dimensions.

Design: Retrospective clinical study.

Setting And Patients: Thirty-six consecutive patients (average age 72) from Twin Cities Spine Center with degenerative lumbar scoliosis (average major curve 25°) and radicular symptoms were studied.

Incidence and risk factors for proximal and distal junctional kyphosis following surgical treatment for Scheuermann kyphosis: minimum five-year follow-up.

Study Design: Retrospective case review at a single center.

Objective: To analyze the incidence and risk factors associated with proximal junctional kyphosis (PJK) and distal junctional kyphosis (DJK) in patients undergoing instrumented spinal fusion for Scheuermann kyphosis.

Summary Of Background Data: Previously reported risk factors for junctional kyphosis include improper end vertebrae selection, curve correction greater than 50%, or excessive junctional soft tissue dissection.

Can c7 plumbline and gravity line predict health related quality of life in adult scoliosis?

Study Design: This study prospectively evaluated the health related quality of life (HRQOL) of 73 adults presenting with scoliosis at a single institution, as related to their spinal (C7 plumbline) and global (gravity line) balance.

Objective: To assess the influence of sagittal and coronal balance on HRQOL in adult scoliosis.

Summary Of Background Data: Many surgeons believe that achieving adequate spinal balance is important in the management of adult spinal deformity, but the evidence supporting this concept remains limited.

A concomitant posterior approach improves fusion rates but not overall reoperation rates in multilevel cervical fusion for spondylosis.

Study Design: Retrospective comparative study of 2 approaches to multilevel fusion for cervical spondylosis in consecutive patients at a single institution.

Objective: To provide justification for a concomitant posterior approach in multilevel cervical fusion for spondylosis by demonstrating decreased pseudarthrosis and reoperation rates.

Summary Of Background Data: Among the factors that affect cervical rates is the number of levels, such that increasing the number of levels leads to lower fusion rates.

Cervical degenerative index: a new quantitative radiographic scoring system for cervical spondylosis with interobserver and intraobserver reliability testing.

Background: The lack of a widely available scoring system for cervical degenerative spondylosis encouraged the authors to establish and validate a systematic quantitative radiographic index.

Materials And Methods: This study included intraobserver and interobserver reliability testing among three reviewers with different years of experience. Each observer independently scored four cervical radiographs of 48 patients at separate intervals, and statistical analysis of the grading was performed.

Perioperative complications in revision anterior lumbar spine surgery: incidence and risk factors.

Study Design: This is a retrospective review of 129 consecutive anterior lumbar revision surgeries in 108 patients. It is a single-center, multi-surgeon study.

Objective: To determine occurrence rates and risk factors for perioperative complications in revision anterior lumbar fusion surgery.

Clinical and radiological outcome of anterior-posterior fusion versus transforaminal lumbar interbody fusion for symptomatic disc degeneration: a retrospective comparative study of 133 patients.

Abundant data are available for direct anterior/posterior spine fusion (APF) and some for transforaminal lumbar interbody fusion (TLIF), but only few studies from one institution compares the two techniques. One-hundred and thirty-three patients were retrospectively analyzed, 68 having APF and 65 having TLIF. All patients had symptomatic disc degeneration of the lumbar spine.

Revision lumbar arthrodesis for the treatment of lumbar cage pseudoarthrosis: complications.

Study Design: A study documenting major complications encountered in revision procedures for lumbar cage pseudoarthrosis.

Objective: To document the perioperative complications associated with revision surgery for threaded cylindrical cage pseudoarthrosis.

Summary Of Background Data: Pseudoarthrosis after cylindrical cage placement manifests as persistent or recurrent pain and disability after surgery.

Complications in long fusions to the sacrum for adult scoliosis: minimum five-year analysis of fifty patients.

Study Design: A retrospective study of complications with minimal 5-year follow-up of 50 adults with scoliosis with fusion from T10 or higher to S1.

Objectives: To document the perioperative and long-term complications and instrumentation problems, and to attempt to determine variables which may influence these problems. It is not a study of curve correction, balance, or functional outcome.

Degenerative lumbar scoliosis associated with spinal stenosis.

Background Context: Degenerative de novo scoliosis is commonly present in older adult patients with spinal pain. The degenerative process including disc bulging, facet arthritis, and ligamentum flavum hypertrophy contributes to the appearance of symptoms of spinal stenosis in these patients.

Purpose: The etiology, prevalence, biomechanics, classification, symptomatology, and treatment of degenerative lumbar scoliosis in association with spinal stenosis are reviewed.

Stepwise methodology for plain radiographic assessment of pedicle screw placement: a comparison with computed tomography.

Objective: The objective of this study is to evaluate the effectiveness of a specific methodology for plain radiographic assessment of lumbar pedicle screw position.

Purpose: To evaluate the effectiveness of using orthogonal plain radiographs and a systematic method of interpretation, developed by the senior author, in assessing the placement of lumbar and lumbosacral pedicle screws.

Study Design: This was an adult cadaver study of the accuracy of using plain radiographs or computed tomography to assess pedicle screw position.

Scoliosis associated with syringomyelia: clinical and radiologic correlation.

Study Design: A retrospective review with statistical correlations of 112 patients having both scoliosis and syringomyelia was performed.

Objective: To determine whether there were significant correlations between the type of scoliosis, location of the syrinx, size of the syrinx, clinical manifestation of the syrinx, and associated lesions such as cord tethering and Chiari malformation (Chiari I or Arnold-Chiari II).

Summary Of Background Data: The coexistence of scoliosis and syringomyelia has been described previously, but these detailed correlations have had minimal attention.

Functional outcome analysis including preoperative and postoperative SF-36 for surgically treated adult isthmic spondylolisthesis.

Study Design: Prospective and retrospective outcome analysis following arthrodesis for adult isthmic spondylolisthesis in 31 patients.

Objective: To examine whether or not patients having such surgery have a functional improvement in their lives.

Summary Of Background Data: The literature is full of articles concerning adolescent spondylolisthesis, the union rate for adult spondylolisthesis, the ability to reduce deformities, and the outcome of surgery for degenerative spondylolisthesis, but very scant on the postoperative functional outcome of adults with isthmic spondylolisthesis.

Value of treating primary causes of syrinx in scoliosis associated with syringomyelia.

Study Design: Retrospective chart and radiologic analysis.

Objectives: To analyze the value and risks of neurosurgical procedures for syringomyelia and of fusion procedures for scoliosis.

Summary Of Background Data: There are few reports on the benefit of neurosurgical procedures on scoliosis, as well as the risk of fusion procedures on scoliosis related to syringomyelia.

The crankshaft phenomenon after posterior spinal arthrodesis for congenital scoliosis: a review of 54 patients.

Study Design: Retrospective chart and radiographic reviews were conducted.

Objective: To identify the incidence of and any possible risk factors for the crankshaft phenomenon after posterior spinal arthrodesis for congenital scoliosis.

Summary Of Background Data: Studies have shown the crankshaft problem to be common after posterior arthrodesis for infantile and juvenile idiopathic scoliosis, but the few reports available show it to be much less common for congenital scoliosis.