Re: The graf ligamentoplasty procedure. Comparison with posterolateral fusion in the management of low-back pain.
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Biomedical subjects
Publications and source records attributed to C Salanova.
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PURPOSE OF THE STUDY: To analyze post operative imbalance after C.D.I. (Cotrel Dubousset Instrumentation) for idiopathic scoliosis according to the fused area, particularly the lower level of fusion. To recall a classification for determination of fusion area based on preoperative standing coronal radiograph. PATIENTS AND METHODS: To be included in this study the patients had to have an adolescent idiopathic scoliosis, at least two years of post operative follow up. 122 patients met the criteria; mean follow up was 3 years, 5 months (minimum 2 years, maximum 9 years). Scoliotic curves were classified as single structural (81), double structural (41). Balance was clinically analyzed by plumbline, radiographically by a plumbline dropped from C7 to the sacrum and measuring deviation from the midpoint of the sacrum in centimeters. A curve with a deviation of 10 mms or less was considered as balanced. RESULTS: Imbalance in single structural curves was 70% when using stable vertebra (King) or "other vertebra" (beyond stable vertebra or one or two levels upper stable vertebra). Using end vertebra (J. Moe), (elected vertebra - C. Salanova) imbalance was 10%. In double structural (41 cas) imbalance was 50% using stable, or "other vertebra" 10% when elected vertebra was fused. DISCUSSION: In this study there was a strong relationship between the lower level of fusion and imbalance.
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The author reports a ten-years experience of the Milwaukee brace in the treatment of idiopathic scoliosis. 168 patients were treated and the results are analysed according to age at onset of treatment, severity of the curves, type of scoliosis. It is concluded that this bracing is worthwile as well for young children as for teenagers, the goal of the treatment being to prevent physical and psychological distress in adult life.
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