Adult thoracolumbar and lumbar scoliosis treated with long vertebral fusion to the sacropelvis: a comparison between new hybrid selective spinal fusion versus anterior-posterior spinal instrumentation.

Background Context: Combined anteroposterior spinal fusion with instrumentation has been used for many years to treat adult thoracolumbar/lumbar scoliosis. This surgery remains a technical challenge to spine surgeons, and current literature reports high complication rates.

Purpose: The purpose of this study is to validate a new hybrid technique (a combination of single-rod anterior instrumentation and a shorter posterior instrumentation to the sacrum) to treat adult thoracolumbar/lumbar scoliosis.

Long-term magnetic resonance imaging follow-up demonstrates minimal transitional level lumbar disc degeneration after posterior spine fusion for adolescent idiopathic scoliosis.

Study Design: Retrospective cohort study.

Objective: To describe long-term clinical and imaging results focusing on the uninstrumented lumbar spine after posterior spinal fusion for adolescent idiopathic scoliosis.

Summary Of Background Data: Although previous studies found rates of low back pain after long fusion for adolescent idiopathic scoliosis which are comparable to rates found in the general population, many surgeons believe that the long lever arm associated with the fusion mass will result in increased stress at uninstrumented caudal intervertebral discs and accelerated degenerative changes.

Treatment of degenerative spondylolisthesis: potential impact of dynamic stabilization based on imaging analysis.

Intraspinous and pedicle screw-based (PSB) dynamic instrumentation systems have been in use for a decade now. By direct or indirect decompression, these devices theoretically establish less painful segmental motion by diminishing pathologic motion and unloading painful disks. Ideally, dynamics should address instability in the early stages of degenerative spondylolisthesis before excessive translation occurs.