Mohammad Ali Erfani, MD; Hormoz Nooraee, MD; Iman Shahriari, MD
Abstract
Background: The more common technique in instrumentation of adolescent idiopathic scoliosis has been multisegmental fixation and use of hooks and rods. This study is aimed at locking at short-term results of hybrid fixation with pedicular screws in lumbar area and hooks in thoracic area of scolotic curves.Methods: ...
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Background: The more common technique in instrumentation of adolescent idiopathic scoliosis has been multisegmental fixation and use of hooks and rods. This study is aimed at locking at short-term results of hybrid fixation with pedicular screws in lumbar area and hooks in thoracic area of scolotic curves.Methods: Thirty four cases (28 girls, 6 boys) of adolescent idiopathic scoliosis that had received spinal fusion with pedicular screw in lumbar and hook in thoracic area for rod fixation and instrumentation were retrospectively evaluated, with mean age of 14.4 (11-27) years and 33.6 (24-72) months follow-ups. The correction of coronal, sagital, rotational deformities and maintenance of correction at follow-up were assessed. Clinical evaluation according to Scoliosis Research Society questionnaire (SRS-24) was also performed.Results: The initial average coronal angle of 63.2 degrees improved to 27.1 degrees after surgery. This corresponded with the observed correction in preoperative bending films. 60 percent de-rotation and 55 percent improvements in deviation from midline axis were also observed. The angulations of first vertebra and first disc below fusion showed, respectively, 51 and 70 percent improvement. According to Lenke's classification, the ''lumbar modifier'' in sagital plane of (+) 1.1 degrees changed to (-) 8.9 degrees.Conclusions: Use of pedicular screws in lumbar region during instrumentation of adolescent idiopathic scoliosis produces better correction and lowers the chance of ''correction loss'' in short time.
Mohammad Ali Erfani, MD; Hormoz Nooraee, MD; Omidreza Momenzadeh, MD
Abstract
Background: Most investigations agree that unstable thoracolumbar fractures require surgical treatment. There is, however, debate on the best approach-anterior, posterior or combined. We are reporting our short and mid-term results on a «posterior only» approach with ligamentotaxis-dependent canal ...
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Background: Most investigations agree that unstable thoracolumbar fractures require surgical treatment. There is, however, debate on the best approach-anterior, posterior or combined. We are reporting our short and mid-term results on a «posterior only» approach with ligamentotaxis-dependent canal decompression with a segmental instrumentation system.Methods: 37 consecutive patients with thoracic and lumbar vertebrae fractures over 4 year period, with a mean follow-up of 30 months, (12-46 months) were studied. The cases underwent subjective and objective evaluation, using the Denis back pain scale, functional independent measure, employment status, neurologic Frankel grading and radiographic indices of vertebral angles and height change.Results: Twenty patients were pain-free, 35 were functionally independent. Frankel neurological grading showed 1.6 points average recovery. The mean preoperative kyphoitc angle of 19.1º improved 1.1º post surgery and to 5.1º at final follow-up. There were 3 minor infections and one hardware failure.Conclusions: Posterior spinal decompression and instrumentation for unstable thoracic and lumbar fractures is safe, effective and is associated with effective, achievement of radiographic correction, and is easier than anterior approach.