The objective of this study was to discuss the variables influencing alignment mechanisms of the spine, with particular consideration of post-surgical alignment in adolescent idiopathic scoliosis. The analysis is based on information currently available in the literature, and on the authors' own experience, which includes surgical material from over 2200 cases of idiopathic scoliosis. Over...

BACKGROUND Previous studies report an increase in thoracic kyphosis after anterior approaches and a flattening of sagittal contours following posterior approaches. Difficulties with measuring sagittal parameters on radiographs are avoided with reformatted sagittal CT reconstructions due to the superior endplate clarity afforded by this imaging modality. METHODS A prospective study of 30 Lenke...

BACKGROUND The authors sought to demonstrate the safety and effectiveness of the multilevel stabilization screw (MLSS) technique in decreasing the incidence of proximal junctional failure in long segmental instrumented fusions for adult degenerative scoliosis. METHODS Institutional review board approval was obtained and all patients with adult spinal deformity who underwent the MLSS technique...

Proximal functional kyphosis (PJK) is a common complication (26-39%) following multilevel instrumented fusion for spinal deformities. It is defined as a focal segmental kyphosis of more than 10 degrees between upper instrumented vertebra (UIV) and 2 levels cranial to UIV (UIV+2); and a focal increase in kyphosis of more than 10 degrees between UIV and UIV+2 [1]. Although the clinical impact of ...

STUDY DESIGN Retrospective review of a prospectively collected pediatric orthopedic spine database. OBJECTIVE To investigate whether pelvic incidence (PI) changes during growing rod treatment and to report the effects of PI, if any, on complications during treatment. SUMMARY OF BACKGROUND DATA Growing rods have been demonstrated to correct spinal deformity in early onset scoliosis while all...

Background: The purpose of this study was to use magnetic resonance imaging (MRI)-based assessments of multifidus muscle to predict development of proximal junctional kyphosis (PJK). Methods: We retrospectively reviewed 62 patients with lumbar degenerative disease (LDD) who underwent fusion of L5 and all the upper instrumented vertebrae (UIVs) in the thoracolumbar spine (T9-L2), with ≥2 years’ ...