To report an original technique for the surgical correction of adolescent idiopathic scoliosis (AIS) based on hybrid construct using polyester bands placed under the thoracic transverse processes.
We reviewed 105 patients operated between 2013 to 2017 for AIS with a minimum of 2 years follow-up. Clinical and radiological data, including 2D measurements of scoliosis parameters preoperatively, and at 3- and 24-months postoperatively were analyzed. Radiological analysis was performed by two independent observers using KEOPS (Smaio, Lyon-France, CE 2014) database.
Mean age was 14.6 ± 2 years. Mean follow-up was 23.7 ± 1.2 months. Most curves were classified as Lenke-1 (78%). The average number of vertebra involved in the construct was 10.9 ± 1.3 (range 7-13). A mean of 12.8 implants were used per construct (mean implant density 0.59). The number of subtransverse bands placed averaged 3 (range 1-5 bands). The mean frontal Cobb angle decreased from 57.9 to 21.2 ° (p < 0.05) postoperatively. The average T4-T12 kyphosis increased from 20.2°to 32.4° (p < 0.05) postoperatively and no loss of correction was observed at 2 years follow-up. We encountered one case of transverse process fracture intraoperativley. No neurological complications were observed. In the postoperative period, 4 cases were diagnosed with distal junctional failure, three of which required an extension of the construct, while the fourth case was treated by bracing.
The use of subtransverse band is an efficient and safe method for the surgical correction of AIS. This technique incorporates technical ease (minimal risk of neurological injury), provides good frontal correction and restores thoracic kyphosis. Results are maintained over a two-year period.

暂无摘要。

Pedicle aplasia is an uncommon congenital anomaly most frequently involving the absence of a single pedicle at a single vertebral level. Bilateral pedicle aplasia at multiple levels is exceedingly rare and has only been described once previously in the literature. While single-level pedicle aplasia is often asymptomatic and discovered incidentally, pedicle aplasia of multiple levels may produce severe spinal deformities and neurological deficits. Due to the rarity of this condition, optimal management remains uncertain. In this case report, the authors describe the surgical management of a healthy 9-year-old boy who presented with frequent falls, difficulty running, and severe thoracic kyphotic deformity and was found to have bilateral pedicle aplasia from T3 to T9. A review of the literature regarding pedicle aplasia is also presented.

[Purpose] This case presents the reduction of both forward head posture and thoracic hyperkyphosis in a young male with chronic back pain and headaches by a comprehensive posture rehabilitation program as a part of Chiropractic BioPhysics® methods. [Participant and Methods] A 32 year old male presented with constant pain and headaches for seven years since he was involved in a work related injury. He had seen five different MDs, undergone multiple imaging tests, and received multiple prescriptions, thirteen steroid injections and was recommended for a spine surgery that he had denied. He was on long-term disability. Upon comprehensive posture and spine assessment, the patient had exaggerated forward head translation and thoracic hyperkyphosis. The patient was treated 36 times over 13-weeks with cervical and thoracic extension exercises, traction, and manipulation. [Results] After treatment the patient reported dramatic improvement in symptoms as indicated on valid disability questionnaires and substantial improvements in posture. [Conclusion] Posture-related pain and disability is not often addressed in allopathic medicine but substantial posture improvements are achievable in short time periods as this case illustrates. Poor postures in young patients should be corrected to avoid long-term consequences. Radiography as used in spinal rehabilitation is safe and reliable.

METHODS: A case series was carried out.
BACKGROUND: There is a lack of evidence exploring the effectiveness of group exercise classes for people with nonspecific shoulder pain (NSSP). Also, there is a lack of research that measures potential reductions in thoracic kyphosis after exercise interventions in people with NSSP.
OBJECTIVE: To observe changes in shoulder pain, disability, and thoracic kyphosis in 2 groups of people with NSSP, after 2 different types of group exercise classes.
METHODS: People with NSSP received a 6-week block of exercises classes containing either shoulder exercises alone (shoulder group, n = 20) or a mixture of shoulder and thoracic extension exercises (thoracic group, n = 19). The Disabilities of the Arm, Shoulder and Hand questionnaire for disability and the Numeric Rating Scale for pain were measured at baseline, 6 weeks, and 6 months. Thoracic kyphosis was measured at baseline and 6 weeks using the manual inclinometer.
RESULTS: Significant and clinically meaningful improvements in Numeric Rating Scale and Disabilities of the Arm, Shoulder and Hand were demonstrated in both groups at 6-week and 6-month follow-up (P < .001). Effect sizes ranged from 0.78-1.16 in the shoulder group and 0.85-1.88 in the thoracic group. Thoracic kyphosis did not change beyond measurement error in either group.
CONCLUSIONS: Group exercise classes can improve shoulder pain and disability in people with NSSP. Resting thoracic kyphosis did not change after either exercise intervention, which suggests that the treatment effect was not due to a change in static thoracic spine posture.