Pedicle screw instrumentation constructs have become a cornerstone in the treatment of adult spinal deformity and instability. They are known to provide greater rigidity and enhanced ability to correct and maintain spinal alignment. Biomechanical data, however, demonstrate that increased construct stiffness is associated with increased loading within adjacent segments [1– 9]. Increasingly stiff...

BACKGROUND Incidence of complications and reoperations between pedicle screw (PS) and hybrid instrumentations (HI) are still controversial in adolescent idiopathic scoliosis (AIS) patients. A systematic review and meta-analysis were performed to compare overall complications, reoperations, and radiographic outcomes between the 2 constructs. METHODS Strictly followed the PRISMA 2009 guidelines...

Study Design This is a retrospective study. Objective The objective of this study was to assess the sagittal stable vertebra (SSV) versus the first lordotic vertebra (FLV) as the inferior fusion level in patients undergoing spinal surgery for thoracic hyperkyphosis. The main outcome of interest was the development of distal junctional kyphosis (DJK). Summary of Background Data Prior research ha...

BACKGROUND Correction of a focal kyphotic deformity at times requires performing a pedicle subtraction osteotomy, which is accompanied by loss of pedicles as anchor points at the affected level in addition to significant blood loss. To help alleviate these two issues, a novel osteotomy technique for correction of kyphosis using a transforaminal approach to the thoracic vertebral body is describ...

STUDY DESIGN A retrospective study. OBJECTIVE To analyze the long-term proximal junctional change in adolescent idiopathic scoliosis (AIS) following segmental posterior spinal instrumentation and fusion 5 years or more after surgery. SUMMARY OF BACKGROUND DATA No study has concentrated on time-dependent long-term proximal junctional change in AIS following segmental posterior spinal instrum...

STUDY DESIGN Retrospective study. OBJECTIVE To determine the optimal osteotomized vertebra (OV) and lowest instrumented vertebra (LIV) in ankylosing spondylitis (AS) kyphosis. SUMMARY OF BACKGROUND DATA Although most of AS kyphosis cases are treated by pedicle subtraction osteotomy (PSO), few studies have focused on the selection of the LIV relative to distal OV. METHODS We reviewed all A...

Background: Proximal junctional failure (PJF) is a known complication following posterior spinal fusion surgery and can be defined simply as proximal kyphosis that requires surgical revision of the instrumentation. PJF associated with pain, decreased neurologic function, infection, increased morbidity. There little literature on this topic in children especially specific techniques for surgery....