Study Design: A retrospective comparative study.
Objective: The aim of this study was to analyze the exact distal fusion level in the treatment of major thoracolumbar and lumbar (TL/L) adolescent idiopathic scoliosis (AIS) using rod derotation (RD) and direct vertebral rotation (DVR) following pedicle screw instrumentation (PSI).
Summary Of Background Data: Proper determination of distal fusion level is a very important factor in deformity correction and preservation of motion segments in the treatment of major TL/L AIS.
Methods: AIS patients with major TL/L curves (n = 64) treated by PSI with RD and DVR methods with a minimum 2-year follow-up were divided into AL3 (flexible) and BL3 (rigid) according to the flexibility and rotation by preoperative bending radiographs.
Results: There was no significant difference in TL/L (major) curve between the AL3 and BL3 groups postoperatively (P = 0.933) and at the last follow-up (P = 0.144). In addition, there was no significant difference in thoracic (minor) and compensatory (caudal) curve postoperatively (thoracic curve: P = 0.828, compensatory curve: P = 0.976); however, there was a significant difference in compensatory (caudal) curve at the last follow-up (P = 0.041). The overall prevalence of unsatisfactory results was 28.1% (18/64 patients), and the prevalence was 15.2% (7/46) in the AL3 group and 61.1% (11/18) in the BL3 group, which was significantly different (P < 0.05).
Conclusion: Lowest instrumented vertebra (LIV) would be selected at L3 (EV) when the curve is flexible; L3 crosses CSVL with a rotation of less than grade II in preoperative bending radiographs. However, if the curve is rigid, LIV should be extended to L4 (EV + 1) in order to prevent the adding-on phenomenon in the treatment of major TL/L AIS using RD and DVR following PSI.
Level Of Evidence: 4.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1097/BRS.0000000000001998 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Application of Transverse Process Hooks at Distal Thoracic Vertebrae in Uppermost Vertebral Instrumentation for Adult Spinal Deformity Surgery: Special Focus on Delayed-Onset Neurologic Deficits.
Neurospine
December 2024
Department of Neurosurgery, Spine and Spinal Cord Institute, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
Objective: We aimed to investigate the incidence of delayed-onset neurological deficits (DONDs), DOND-related reoperation rates following adult spinal deformity (ASD) surgery, and efficacy of transverse process hooks (TPHs) at the uppermost instrumented vertebra (UIV) compared to pedicle screws (PSs).
Methods: We included 90 consecutive patients who underwent instrumented fusion from the sacrum to the distal thoracic spine for ASD, with a minimum follow-up of 24 months. Clinical and radiological outcomes were compared between 33 patients in the TPH group and 57 patients in the PS group, using the Scoliosis Research Society-22 Outcomes questionnaire (SRS-22), Medical Outcomes Study Questionnaire Short-Form 36 (SF-36), and various spinal sagittal parameters.
LINE-1 (L1) retrotransposition is widespread in many cancers, especially those with a high burden of chromosomal rearrangements. However, whether and to what degree L1 activity directly impacts genome integrity is unclear. Here, we apply whole-genome sequencing to experimental models of L1 expression to comprehensively define the spectrum of genomic changes caused by L1.
View Article and Find Full Text PDFHigh-Grade Sarcomatous Transformation of Hybrid Hemosiderotic Fibrolipomatous Tumor-Myxoinflammatory Fibroblastic Sarcoma with Novel Gene Fusion.
Int J Surg Pathol
January 2025
Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA, USA.
Hemosiderotic fibrolipomatous tumor (HFLT) and myxoinflammatory fibroblastic sarcoma (MIFS) are rare, locally aggressive soft tissue tumors with a predilection for distal extremities of middle-aged adults. Hybrid tumors (HFLT-MIFS) demonstrate overlapping features of both and share recurrent translocation (1;10) (p22; q24). We describe a tumor with high-grade sarcomatous transformation of a hybrid HFLT-MIFS, with a novel gene fusion, presenting as a right foot soft tissue mass in an 85-year-old woman.
View Article and Find Full Text PDF3D CT to 2D X-ray image registration for improved visualization of tibial vessels in endovascular procedures.
Int J Comput Assist Radiol Surg
January 2025
Department of Medical Biophysics, University of Toronto, Toronto, Canada.
Article Synopsis
- The study aims to improve visualization of arteries during endovascular procedures for peripheral artery disease by using an image registration technique that fuses X-ray and CT angiography images.
- The method involved aligning digital images based on the positions of the bones and achieved successful registration in most cases, with accurate alignment of less than 1 mm in distance.
- The results indicate that this technique is clinically viable for guiding interventions, as it allows for early detection of potential complications like guidewire perforations while maintaining a reasonable processing time.
Surgical options and outcomes for treatment of osteoarthritis of the scaphotrapeziotrapezoidal joint.
J Hand Surg Eur Vol
January 2025
Institut de la main Nantes-Atlantique, Saint-Herblain, France.
Osteoarthritis of the scaphotrapeziotrapezoidal joint is frequent but often pain-free or well tolerated with non-surgical treatment. Surgical options are numerous and none seems to have clear evidence of superiority. In addition to well-established procedures, such as scaphotrapeziotrapezoidal joint arthrodesis, distal scaphoid resection and trapeziectomy, more recent surgical techniques have been reported.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!