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Displaying items by tag: growing spine
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The recent investigations of convex anterior vertebral body stapling have offered promising early results with use of improved implants and techniques. The use of a shape memory alloy staple tailored to the size of the vertebral body, the application of several staples per level, the instrumentation of the Cobb levels of all curves, and the employment of minimally invasive thoracoscopic approaches all offer substantial improvements over previous fusionless techniques. Patient selection may also play a role in the current success of these fusionless treatments, with perhaps the ideal candidates for this intervention possessing smaller and more flexible curves. Long-term results of the effects on the instrumented motion segments and adjacent spine are not yet available.
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Progressive scoliosis in the growing child poses a unique challenge. The surgeon aims to attain maximal curve correction while maintaining spinal and thoracic growth. Nonoperative treatments include bracing and serial casting (both with questionable results). The classic surgical treatment has been spine fusion with less than optimal results. This has resulted in the development of fusionless interventions for children with scoliosis. These include growing rods, intervertebral body stapling, and the vertical expandable prosthetic titanium rib. Each of these offers unique advantages and disadvantages.
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