Congenital thoracic scoliosis with unilateral unsegmented bar, convex hemivertebrae, and fused concave ribs with severe progression after posterior fusion at age 2: 40-year follow-up after revision anterior and posterior surgery at age 8.

Study Design: Case report with 40-year follow-up after definitive surgery.

Objective: To show that extensive spine fusion in a young child can control the curve and does not necessarily lead to early death.

Summary Of Background Data: Recent efforts to avoid early spine fusion by using either progressive lengthening of spinal or rib cage implants are based on the theory that early spine fusion is deleterious and results in early death due to pulmonary compromise.

L5 hemivertebra resection and T12-S1 fusion in a 14-year-old female with a 36-year follow-up.

Study Design: Case report.

Objective: To demonstrate a 36-year follow-up of a rare operation.

Summary Of Background Data: There have been no reports of follow-up of pediatric hemivertebra excision and fusion into midadult life.

Severe neurofibromatosis kyphoscoliosis, posterior wedge osteotomy, halo-traction, and anterior autograft strut fusion, with 28-year follow-up.

Study Design: Case report with very long-term follow-up.

Objective: To demonstrate the lasting value of correction and stabilization with multiple anterior autogenous strut grafting.

Summary Of Background Data: Although anterior strut grafting has been shown to be ideal for neurofibromatosis kyphosis, there have been no reports as to whether the benefit is maintained or lost over many years.

Repeatability test of C7 plumb line and gravity line on asymptomatic volunteers using an optical measurement technique.

Study Design: Prospective cohort evaluation of C7 plumb line (C7PL) and gravity line (GL) in different standing positions in asymptomatic volunteers.

Objective: To evaluate the repeatability of C7PL and GL in different standing positions using an optical method.

Summary Of Background Data: Both C7PL and GL have been used to assess spinal balance.

Effect of number of fusion levels on S1 screws in long fusion construct in a calf spine model.

Study Design: In vitro biomechanical study evaluating the effect of fusion levels on simulated S1 screws on calf spines.

Objective: To measure the stresses of simulated S1 screws as a function of increasing fusion levels in long-fusion construct.

Summary Of Background Data: Extension of long fusion to sacrum remains a difficult clinical challenge despite the recent knowledge and technology.

Surgical outcomes of decompression, decompression with limited fusion, and decompression with full curve fusion for degenerative scoliosis with radiculopathy.

Study Design: A retrospective clinical cohort study at a single spine center of patients with degenerative scoliosis and radiculopathy severe enough to require surgery.

Objective: To evaluate the functional outcomes of 3 surgeries for degenerative scoliosis with radiculopathy; decompression alone, decompression and limited fusion, and decompression and full curve fusion.

Summary Of Background Data: Although these 3 surgical treatments have all been described for this problem, there exists little information as to what outcomes to expect.

The Moe Maximal Correction Test to determine true curve flexibility: a historical note with current application.

This is not a prospective randomized clinical trial or a consecutive case series, but rather the description of a technique developed years ago, but still applicable. As spine surgeons, we wish to know the true correctability of a curvature before determining the best method of treatment. Do we need to do a posterior surgery only? Do we need to do a combined anterior and posterior surgery? Do we need to place the patient in preoperative skeletal traction? Although many different techniques have been described for the determination of true curve flexibility, the Moe Maximal Correction Test has never before been described.

Development and growth of anterior spine surgery in Minnesota.

Until the 1960s, it was not possible to directly access the thoracic vertebrae in order to correct conditions such as congenital kyphosis. Attempts to treat problems using traditional posterior spine surgeries often failed, leaving patients paraplegic. Using a procedure initially done in Hong Kong, surgeons from the University of Minnesota in 1966 became some of the first in the United States to access the thoracic spine from the anterior position, allowing for correction of deformities.

Scoliosis secondary to a hemivertebra: seven patients with gradual improvement without treatment.

Study Design: Retrospective case series.

Objective: To make clinicians aware of this unusual natural history.

Summary Of Background Data: Nonprogressive and progressive scolioses due to hemivertebrae have been abundantly documented in the literature.

Long-term follow-up of adolescent idiopathic scoliosis patients who had Harrington instrumentation and fusion to the lower lumbar vertebrae: is low back pain a problem?

Study Design: Retrospective functional and radiographic analysis.

Objective: To analyze the back pain and disability in patients who had instrumentation and fusion to L2, L3, L4, or L5, at least 10 years previously, and to compare them with a control group of the same age, sex, weight, and height.

Summary Of Background Data: Considerable confusion exists as to the incidence and severity of low back problems in patients with adolescent idiopathic scoliosis fused to the lower lumbar spine.

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.

A correlation of radiographic and functional measurements in adult degenerative scoliosis.

Study Design: Retrospective functional and radiographic analysis of symptomatic patients with de novo degenerative lumbar and thoracolumbar scoliosis.

Objective: To evaluate the radiographic parameters of symptomatic patients presenting with de novo degenerative adult scoliosis and correlate them with functional scores.

Summary Of Background Data: Previous studies have been inconclusive as to the correlation of radiographic parameters and clinical symptomatology.

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.

Functional and radiological outcomes of 360 degrees fusion of three or more motion levels in the lumbar spine for degenerative disc disease.

Study Design: This is a single-center, multisurgeon, retrospective study of radiologic and functional outcome measures at a minimum 2-year follow-up.

Objective: We studied the radiologic and functional outcomes following 3 or more motion segment fusions of the lumbar spine for low back pain due to multilevel degenerative disc disease.

Summary Of Background Data: Good functional outcomes have been reported for 1 or 2-level fusions, but there are no reports dealing specifically with 3 or more level fusions.

Cervical degenerative changes in idiopathic scoliosis patients who underwent long fusion to the sacrum as adults: incidence, severity, and evolution.

Background: To date, there have been no published studies of the degenerative changes in the cervical spine in adult idiopathic scoliosis patients with thoracic and lumbar curves severe enough to require major reconstructive surgery.

Materials And Methods: The primary study group was 48 adult patients who had previously undergone a fusion from T10 or higher to the sacrum as an adult for idiopathic scoliosis. These were compared to 38 adults with unfused idiopathic scoliosis of 30 degrees -50 degrees and to 42 symptomatic adults presenting with cervical pain.

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.

Ultra-long-term follow-up of pediatric spinal deformity problems: 23 patients with a mean follow-up of 51 years.

Background: The aim of this study was to analyze the true outcomes of a unique cohort of patients with spinal deformities who were treated as children and followed for 40 or more years.

Methods: Altogether, 23 patients were reviewed who had been originally treated in our community, whose original charts and radiographs were still available, and who had undergone recent evaluation.

Results: The diagnoses were congenital deformity in eight, adolescent idiopathic scoliosis in four, poliomyelitis in three, infantile idiopathic scoliosis in two, spondylolisthesis in two, and one each of tuberculosis and dwarfism.

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.

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.

Congenital thoracic scoliosis with unilateral unsegmented bar and concave fused ribs: rib osteotomy and posterior fusion at 1 year old, anterior and posterior fusion at 5 years old with a 36-year follow-up.

Study Design: Case report.

Objective: To document the 36-year follow-up of a patient with a fusion at age 1 year for congenital scoliosis with a unilateral unsegmented bar, convex hemivertebrae, and fused concave ribs.

Summary And Background Data: Although early spine fusion has been recommended as a life-saving measure for this problem, very little information exists as to the long-term effect of such treatment.