Methods. Forty-five patients (mean age: 64.4 year) with adult degenerative lumbar scoliosis were reviewed retrospectively with a minimum 2 years. The mean number of levels fused was 6.1 +/- 1.6 segments. The upper instrumented vertebra ranged from T9 to L2. The lower instrumented vertebra was L5 and S1 in 24 and 21 patients, respectively.
Sagittal decompensation (SD) developed in 19 patients. The most significant risk factors of SD were preoperative sagittal imbalance and high pelvic incidence. The preoperative sagittal C7 plumb was more positive (67.9 mm) in the decompensation group than in the balance group (37.0 mm) CA4P cost (P = 0.002). There was a significant difference in pelvic incidence between 61.7 in the GSK J4 decompensation and 54.9 in the balance group (P = 0.01). The preoperative lumbar lordosis was hypolordotic in the decompensation group, however, it was not found to be a risk factor. Pseudarthrosis was identified at the lumbosacral junction in 5 patients, and 4 of them (80%) had SD. SD developed in 55% of patients who had loosening of the distal screws and 50% of patients with hypolordotic lumbar fusion. Distal adjacent
segment disease was more likely to cause SD than proximal adjacent segment disease.
Conclusion. Sagittal decompensation is common after long posterior instrumentation and fusion for degenerative lumbar scoliosis. It is mostly associated with complications at the distal segments, including pseudarthrosis and implant failure at the lumbosacral selleckchem junction. Restoration of optimal lumbar lordosis and secure lumbosacral fixation is necessary especially in patients with preoperative sagittal imbalance and high pelvic incidence in order to prevent sagittal decompensation after surgery.”
“We report a case of adnexal torsion in a singleton pregnancy at 27 weeks of gestation. Adnexal torsion during pregnancy is a rare condition, and it is quite exceptional during the third trimester. The symptoms are non-specific and can be confused with other acute abdominal
disorders. In our case, ultrasound allowed an accurate preoperative diagnosis.”
“Study Design. Prospective comparative study on 100 patients with positive family history for idiopathic scoliosis.
Objective. To evaluate the concordance rate for curve pattern and side in family members with idiopathic scoliosis.
Summary of Background Data. The pathogenesis of idiopathic scoliosis has been the subject of extensive research. It is termed multifactorial with a genetic component. Similar curve shape has been reported in twins with idiopathic scoliosis.
Methods. We included prospectively 100 patients with idiopathic scoliosis when a relative of them was also affected with idiopathic scoliosis, and spine radiographs were available for both.