Rib Bone Research Articles

Antioxidant and modified atmosphere packaging prevention of discoloration in pork bones during retail display

The objective of this study was to evaluate the ability of antioxidants to prevent discoloration in pork rib bones. Pork rib bones were removed from carcasses, frozen (−20 °C, 24 h), split lengthwise, exposed to antioxidant solutions (ascorbic acid, citric acid, propyl gallate or ascorbic/EDTA mix), packaged (modified atmosphere [80% O 2 and 20% CO 2] or air), then displayed in a retail case at 4 °C for 8 days. Dark pigment formation was visually evaluated during the display period. Instrumental color was determined at the end of the 8-day display period. Visual bone discoloration increased over time for all treatments. After 2 days of display, samples treated with propyl gallate were visually redder, less discolored and less green/black than samples treated with other antioxidants. After 8 days of display, propyl gallate-treated samples had higher a* and b* values, as well as chroma (intensity). However, this difference was no longer large enough to be visually detected.

Use of Bone Morphogenetic Protein-2 for Adult Spinal Deformity

Prospective, single-center, nonblinded clinical and radiographic analysis of consecutive adult deformity patients treated with recombinant human bone morphogenetic protein-2 (rhBMP-2) without iliac or rib bone graft supplementation. To determine the ability of rhBMP-2 to achieve both anterior and posterior spinal fusion in patients undergoing multilevel fusions for adult spinal deformity. The literature concerning one-level anterior fusions, and potentially one-level posterior fusions, using rhBMP-2 has demonstrated clinical efficacy. No published data exist on the use of rhBMP-2 in multilevel spine fusions. Prospective analysis of patients treated with rhBMP-2 in multilevel anterior and posterior fusions with a minimum 1-year follow-up. There were a total of 95 patient samples (70 total patients; 25 patients had rhBMP-2 used circumferentially): 46 anterior fusions (Group 1), 41 posterior fusions (Group 2), and 8 patients were "compassionate use" fusions (Group 3). In the anterior fusion group (n = 46), mean rhBMP-2/level was 10.8 mg in titanium mesh cages without any bone graft or other substance. The posterior fusion group had only local bone graft, no harvested rib or iliac bone graft (n = 41). The mean rhBMP-2/level was 13.7 mg. The "compassionate use" group (n = 8 patients) consisted of patients who had prior surgeries, prior iliac harvesting, and substantial comorbidities and therefore a higher concentration and different carrier was used. No local bone graft, no harvested bone was used. The mean rhBMP-2/level was 28.6 mg. The median dose was 40 mg for Group 3. For the anterior fusion group (n = 46), operative levels were deemed fused in 89 of the 93 (96%) levels. For the posterior fusion group (n = 41), a solid fusion was assessed in 110 of the 118 (93%) operative levels. For the "compassionate-use" patients, the overall fusion rate was 100% (52 of 52 operative levels). With the use of rhBMP-2, a high rate of apparent fusion was observed for anterior (96%) and posterior (93%) fusions in adult spinal deformity patients. Use of rhBMP-2 results in a promising early fusion rate without the graft harvest site morbidity.

Crescimento alométrico de osso, músculo e gordura em cortes da carcaça de cordeiros Texel segundo os métodos de alimentação e peso de abate

O experimento teve como objetivo estudar o crescimento alométrico dos diferentes tecidos do pescoço, costela, paleta e perna em relação ao peso do corte de cordeiros e cordeiras. Foram utilizados 22 machos inteiros e 23 fêmeas da raça Texel. Desses, sete foram abatidos no início do experimento e os demais, aos pesos de 25 ou 33kg. As ovelhas mais cordeiros foram distribuídos em três métodos de alimentação: M1 -Silagem de milho e concentrado, apenas aos cordeiros até o desmame, aos 60 dias; M2 - Silagem de milho e concentrado, apenas aos cordeiros até o desmame, aos 45 dias e M3 - Silagem de milho e concentrado para ovelha mais cordeiro até o desmame com 60 dias. Após o desmame, os cordeiros receberam silagem mais concentrado. Foi utilizado um delineamento inteiramente casualizado em arranjo fatorial 3 x 2 x 2 (3 métodos, 2 sexos e 2 pesos de abate). A determinação do crescimento foi obtida através da equação log y = log.a + b log.x, utilizando-se o logaritmo do peso de osso, músculo e gordura em função do logaritmo do peso do corte. Observou-se que o osso do pescoço e da costela foram precoce (b<1) em ambos os sexos, com coeficientes de alometria variando de 0,61 a 0,79; 0,81 a 0,88. O músculo foi isométrico (b=1) no pescoço e precoce (b<1) na costela com exceção dos machos do método um e três que apresentaram crescimento isométrico (b=1). A gordura foi tardia (b>1) independente de sexo e método de alimentação com coeficientes de alometria variando de 1,78 a 2,15 (pescoço) e 1,51 a 1,65 (costela). Na paleta, o osso foi precoce em ambos os sexos, com coeficientes de alometria variando de 0,76 a 0,79 e 0,54 a 0,58 respectivamente para machos e fêmeas. O músculo apresentou crescimento isométrico (b=1), independente de sexo e peso de abate. A gordura foi tardia (b>1) independente de peso de abate e sexo, com coeficientes de alometria variando de 1,80 a 2,12. Na perna o osso apresentou crescimento precoce nas fêmeas e isométricas nos machos, com coeficientes de alometria variando de 0,57 a 0,63 e 0,78 a 0,80 respectivamente para ambos os sexos O músculo apresentou crescimento isométrico (b=1), independente de sexo e peso de abate. A gordura foi tardia (b>1) independente de peso de abate e sexo com coeficientes de alometria variando de 1,80 a 2,12.

Characterization of Osteocrin Expression in Human Bone

Osteocrin (Ostn), a bone-active molecule, has been shown in animals to be highly expressed in cells of the osteoblast lineage. We have characterized this protein in human cultured primary human osteoblasts, in developing human neonatal bone, and in iliac crest bone biopsies from adult women. In vivo, Ostn expression was localized in developing human neonatal rib bone, with intense immunoreactivity in osteoblasts on bone-forming surfaces, in newly incorporated osteocytes, and in some late hypertrophic chondrocytes. In adult bone, Ostn expression was specifically localized to osteoblasts and young osteocytes at bone-forming sites. In vitro, Ostn expression decreased time dependently (p<0.02) in osteoblasts cultured for 2, 3, and 6 days. Expression was further decreased in cultures containing 200 nM hydrocortisone by 1.5-, 2.3-, and 3.1-fold (p<0.05) at the same time points. In contrast, alkaline phosphatase expression increased with osteoblast differentiation (p<0.05). Low-dose estradiol decreased Ostn expression time dependently (p<0.05), whereas Ostn expression in cultures treated with high-dose estradiol was not significantly changed. These results demonstrate that Ostn is expressed in human skeletal tissue, particularly in osteoblasts in developing bone and at sites of bone remodeling, suggesting a role in bone formation. Thus, Ostn provides a marker of osteoblast lineage cells and appears to correlate with osteoblast activity.

Distribution of ethyl glucuronide in rib bone marrow, other tissues and body liquids as proof of alcohol consumption before death

Postmortem ethyl glucuronide (EtG) concentrations in rib bone marrow, liver, muscle, fat tissue, urine, blood and bile have been determined by LC–MS/MS. Samples have been taken from twelve corpses during autopsies. In nine corpses EtG could be detected, corresponding blood ethanol concentrations (BAC) were 0.04–0.37 g%. In three cases, no EtG was found; two of these cases showed postmortem BACs – possibly due to putrefaction – of 0.01 and 0.1 g%. In rib bone marrow, which is easily accessible during autopsy, EtG concentrations (0.77–9.36 μg/g) have been lower than in blood (2.24–20.46 μg/mL) in eight of nine cases and comparable or higher than in muscle tissue. Therefore, rib bone marrow has been found suitable as matrix for EtG determination. The highest EtG concentrations have been found in urine in all but one case, where the resorption of ethanol had been incomplete. Second highest EtG concentrations have been detected in liver samples. In two cases with putrefaction, EtG could not be detected. In these cases, the detectable ethanol might have been produced partially or in total by postmortem fermentation. However, instability of EtG during putrefaction cannot be totally excluded which might result in a total loss of EtG.

The temporal and spatial expression of the novel Ca ++-binding proteins, Scarf and Scarf2, during development and epidermal differentiation

During the process of epidermal differentiation, intracellular and extracellular calcium (Ca ++) concentrations induce an array of signaling pathways [Berridge, M.J., Lipp, P., Bootman, M.D., 2000. The versatility and universality of calcium signaling. Nature Rev. Mol. Cell. Biol. 1, 11–21]. Keratinocytes follow a complex Ca ++-dependent program of differentiation moving from the basal proliferative layer, through the spinous and granular differentiated layers to ultimately culminate in the formation of the cornified layer of the epidermis. Members of the Ca ++-binding proteins play a central role in the transduction of Ca ++ signals. Utilizing a suppressive subtractive hybridization screen comparing basal and differentiated keratinocytes, we identified the novel Ca ++-binding protein genes, Scarf ( skin Calmodulin- related factor) and Scarf2, which have homology to calmodulin (CaM). In this study, we present a comprehensive analysis of the expression pattern for Scarf and Scarf2 transcripts and proteins in the developing mouse. To examine Scarf2 expression during embryogenesis, we performed in situ hybridization, and detected expression in the hair follicle, skin and nasal epithelium. These results showed substantial overlap with the previously reported Scarf gene expression [Hwang, M., Morasso, M.I., 2003. The novel murine Ca2+-binding protein, Scarf, is differentially expressed during epidermal differentiation. J. Biol. Chem. 278, 47827–47833]. Comparing the expression patterns of Scarf and Scarf2 proteins in neonatal and adult mouse skin with several structural epidermal proteins, i.e. keratin 14 (K14), keratin 1 (K1), loricrin (LOR) and filaggrin (FIL) showed that their expression overlaps K1, an early marker of keratinocyte differentiation. Interestingly, Scarf and Scarf2 were also detected in the tongue and oral epithelia, rib bone undergoing ossification and in the medullar region of thymus.

Fracture toughness of manatee rib and bovine femur using a chevron-notched beam test

Bone is an anisotropic material with a hierarchical structure consisting of organic matrix, minerals and water. Fracture toughness ( K C ) has been shown to be a good index to assess the mechanical performance of bone. A chevron-notched (CN) beam test, a standard fracture mechanics test successfully applied to many other materials, was used to determine the transverse-direction fracture toughness in manatee rib and bovine femur cortical bone. Although human and bovine bone has been well studied, there is virtually no information on the toughness of manatee rib bone. As a biological material, manatee rib is interesting for study in that it is a highly mineralized bone. Three major advantages of the CN specimen test are: (1) it is easier to reach plane strain condition; (2) there is no fatigue-precracking needed; and (3) it is relatively easy to produce stable crack propagation before catastrophic fracture. The fracture toughness values of manatee rib and bovine femur were measured to be 4.5±0.5 MPa m 1/2 and 5.8±0.5 MPa m 1/2, respectively. Based on the microstructures shown in SEM images, two features that contributed to the greater fracture toughness of bovine femur were identified as greater osteon density and lesser porosity.

Activation analysis methods and applications

Rib bones of Brazilian people were analyzed by neutron activation analysis to evaluate element composition. Freeze-dried cortical and trabecular tissues, separately, and calcinated total rib tissues were analyzed. The concentrations of the Ba, Br, Ca, Cl, Fe, K, Mg, Mn, Na, P, Rb, Sr, and Zn elements were determined. Comparisons between the results obtained in cortical and trabecular bones indicated significant differences in the concentration for several elements. Results obtained in cortical and trabecular bones were also compared with literature values.

Effects of packaging on bone marrow discoloration in beef arm, rib, shoulder blade, and thoracic vertebra bones (2005)

Meat retailers have reported bone marrow discoloration to be a problem, especially in modified-atmosphere packages (MAP). To evaluate causes of bone marrow discoloration in different beef bones and packaging systems, 36 beef arm bones, ribs, shoulder blades, and thoracic vertebrae from USDA Select and Choice carcasses were obtained from a commercial abattoir, cut into 1-inch-thick sections at 4 days postmortem, and packaged into 1) polyvinyl chloride film (PVC) overwrap; 2) high-oxygen (80% O2, 20% CO2) MAP; or 3) ultra-low-oxygen (70% N2, 30% CO2) MAP. Packages were displayed under continuous fluorescent lighting for 4 days at 35.6 F. Ribs, shoulder blades, and thoracic vertebrae packaged in PVC and high-oxygen MAP developed undesirable gray or black discoloration during display. In ultra-low-oxygen MAP, mean visual-color scores were acceptable throughout display. The a* values (larger values equate to redder color) for ribs, shoulder blades, and thoracic vertebrae decreased (P<0.05) over time. Arm-bone marrow had less oxidation and dramatically less total iron and hemoglobin than did marrow from ribs and thoracic vertebrae. The much larger amounts of iron and hemoglobin in ribs and thoracic vertebrae likely correspond to marrow discoloration. In summary, bone marrow discoloration occurs in ribs, shoulder blades, and thoracic vertebrae packaged in PVC or high-oxygen MAP. Bones packaged in ultralow-oxygen MAP or arm bones packaged in PVC or high-oxygen MAP had minimal oxidation and discoloration. Introduction

Zygomatic arch reconstruction with autogenous rib bone graft in a post irradiated patient -- a case report

Reconstruction of zygomatic arch using an autogenous free non-vascularised bone graft is presented. The zygomatic arch was resected along with the masseter and part of temporalis muscle following a histologically diagnosed case of chondrosarcoma. She received radiotherapy 3 weeks post-operatively to the site. The resultant facial asymmetry was unacceptable to the patient. She was therefore rescheduled for reconstruction of the zygomatic arch despite the anticipated attendant risk of avascular bed for the graft. Bone grafting was done 44 months post irradiation and the patient had been followed up for 38 months without evidence of rejection. We evaluated other sites of possible bone of similar contour and thickness to the zygomatic arch; we found the rib most suitable, despite the poor quality of rib as graft material, because it is a dense, thick bicortical bone with low proportion of cancellous bone, although it is the second most favoured donor site for free bone graft. The advantages of the rib as a graft are that it presents a contour that could be shaped to fit many defects, it is available in sufficient length up to 12-18 cm to fit large defects, the donor site regenerates when the periosteum is preserved.

Cumulative Sperm Whale Bone Damage and the Bends

Diving mosasaurs, plesiosaurs, and humans develop dysbaric osteonecrosis from end-artery nitrogen embolism ("the bends") in certain bones. Sixteen sperm whales from calves to large adults showed a size-related development of osteonecrosis in chevron and rib bone articulations, deltoid crests, and nasal bones. Occurrence in animals from the Pacific and Atlantic oceans over 111 years made a pathophysiological diagnosis of dysbarism most likely. Decompression avoidance therefore may constrain diving behavior. This suggests why some deep-diving mammals show periodic shallow-depth activity and why gas emboli are found in animals driven to surface precipitously by acoustic stressors such as mid-frequency sonar systems.

Effects of Processing Techniques on the Forensic DNA Analysis of Human Skeletal Remains

Human remains processed by forensic anthropologists may potentially be used for genetic analysis. Therefore, the condition of the deoxyribonucleic acid (DNA) in processed remains may become an issue for future analysis. Processing techniques employed by anthropologists are highly variable and scanning electron microscopy reveals significant alterations to the bone surface depending upon the technique used. Such damage to the bone indicates differences may exist in quality and quantity of DNA extracted. This study assessed how five processing procedures used by major forensic anthropology laboratories around the country affects the amounts of DNA extracted from human rib bones and the subsequent DNA analysis. The DNA was analyzed using the short tandem repeat (STR) locus CSF1PO and amelogenin. The findings indicate processing procedures used by forensic anthropologists do not adversely affect DNA analysis but prolonged exposure to heat during processing may decrease the yield of information from the DNA.

Prevalence of bone marrow micrometastases in esophagogastric cancer patients with and without neoadjuvant chemoradiotherapy

Background Bone marrow micrometastases are present in a high proportion of patients undergoing curative resection for esophagogastric cancer. The incorporation of preoperative systemic therapies into these patients’ treatment is widely practiced. This study investigates the effect of neoadjuvant chemoradiotherapy (CRT) on the incidence of micrometastases and the viability of detected tumor cells. Materials and methods Rib bone marrow was obtained from patients ( n = 106) in three centers, who were selected for potentially curative resection. Patients received neoadjuvant CRT plus surgery ( n = 55), or surgery alone ( n = 51). To detect micrometastases, mononuclear cells were isolated from fresh marrow and immediately stained immunohistochemically with an anti-cytokeratin-18 antibody using the APAAP technique. Tumor cell viability was assessed by immunohistochemical staining of marrow cell cultures for cytokeratin-positive cells. Results Micrometastases were detected in fresh marrow in 42% (23/55) of patients who received neoadjuvant CRT plus surgery, and in 67% (34/51) of patients treated with surgery alone. Viable tumor cells were demonstrated in 10 of 18 marrow cultures from CRT plus surgery cases. In this patient subset, combination of results of staining fresh and cultured marrow significantly increased micromet detection to 78%. Conclusions A significant proportion of patients with esophagogastric cancer have disseminated viable tumor cells at time of surgery, irrespective of pre-operative treatment. The use of marrow culture in parallel with fresh marrow staining may increase the detection of micrometastases. The persistence of tumor cells resistant to systemic therapy may explain why these regimens fail in a majority of patients.

Amidic modification of valproic acid reduces skeletal teratogenicity in mice

The antiepileptic drug valproic acid (VPA) is well known to cause neural tube and skeletal defects in both humans and animals. The amidic VPA analogues valpromide (VPD) and valnoctamide (VCD) have much lower teratogenicity than VPA inducing exencephaly in mice. The objective of this study was to investigate the teratogenic effects of VPA, VPD, and VCD on the skeleton of NMRI mice. Pregnant NMRI mice were given a single subcutaneous injection of VPA (400 and 800 mg/kg), VPD (800 mg/kg), or VCD (800 mg/kg) on the morning of gestation day (GD) 8. Cesarean section was carried out on GD 18. Live fetuses were double-stained for bone and cartilage and their skeletons were examined. Significant increases in fetal loss and exencephaly rate were observed with VPA at 800 mg/kg compared to the vehicle control. There were no significant differences between either VPD or VCD and the control groups for any parameter at cesarean section. A number of abnormalities were dose-dependently induced at high incidences by VPA in both the cartilage and bone of vertebrae, ribs and sternum. In contrast, lower frequencies of abnormality were exhibited with VPD and VCD than VPA in all skeletons affected by VPA. These findings clearly indicate that VPD and VCD are distinctly less teratogenic than VPA in the induction of not only neural tube defects, but also skeletal abnormalities. A structure-teratogenicity relationship of VPA on the skeleton is suspected.

INAA of cortical and trabecular bone samples from animals

Instrumental neutron activation analysis (INAA) was applied to determine Ba, Br, Ca, Cl, Fe, K, Mg, Mn, Na, P, Sr and Zn in bovine and porcine rib bones. Precise results were obtained in analyses of freeze-dried cortical and trabecular bones separately, and also of whole bone ashes. Cortical tissues presented higher concentrations of Ba, Ca, Mg, Mn, Na, P, Sr and Zn than those obtained in trabecular ones. Comparisons were also made between the results obtained for bovine and porcine rib bones.

Study for imaging of inside bone using FM-chirp pulse compression system

We measured the attenuation of ultrasound in animal bone in vitro, and determined successfully the correct dynamic range for the detection of echo signals from inside the bone. It was possible to display a B-mode image of a 6-mm thick porcine rib bone using a high frequency (5 MHz) transducer. However, it was difficult to obtain the image of a large bone (20-mm thick femur). This paper describes a possibility of the improvement for the detection of echoes from inside the bone using the FM-chirp pulse. An ultrasonic wave generator that generates the FM-chirp pulse for a frequency range of 100 KHz to 5 MHz was fabricated. And the pulse was transmitted from a transducer and received by a hydrophone in the water. The received waveform and the frequency spectrum were displayed on an oscilloscope. We measured the amplitude spectrum of the received waves before and after inserting a sample bone between the transducer and the hydrophone. In the experiment, three types of focused transducers (0.5, 1 and 2.25 MHz) and three kinds of sample bones (spine, femur and rib of a pig) were used. From the results of the measurement, we could find the useful information for imaging of inside the bone.

Bone formation in the presence of platelet-rich plasma vs. bone morphogenetic protein-7

Growth factors contained in platelet-rich plasma (PRP) have recently been proposed to enhance maturation of bone grafts and, in combination with anorganic bovine bone, to support repair in the treatment of small bone defects in maxillofacial surgery. Bone morphogenetic proteins (BMP) carried in a matrix may be able to replace the autologous bone graft in the treatment of critical size defects. However, no studies have compared the bone stimulating capacity of PRP and BMP. Likewise there is no data comparing the effects of PRP in either an autologous bone graft or in anorganic bovine bone. We augmented the mandible of Wistar rats ( n=28) on both sides with either anorganic bovine bone (Bio-Oss) or autologous rib bone. On the test side we applied either 20 μl of autologous PRP or 10 μl of rhBMP-7 (4 groups, n=7). In addition, bone induction was evaluated in an extraskeletal site ( n=14). A polychrome sequential labeling was performed. The animals were sacrificed by intra-vital perfusion on day 50. Undecalcified ground sections were evaluated by microradiography, digitized histomorphometry and under fluorescent light. The qualitative analysis of fluorochrome labels suggested that PRP and rhBMP-7 accelerated bone growth. However, histomorphometric analysis revealed no significant differences in the area of newly mineralized bone under either the influence of PRP or rhBMP-7 on autologous bone graft. Likewise, the addition of PRP to anorganic bovine bone showed no statistical difference to the control group. The strongest bone stimulating effect was seen for the combination of rhBMP-7 with anorganic bovine bone ( p=0.028). In the extraskeletal model, newly formed bone was evident in the presence of rhBMP-7, but not of PRP. In conclusion, according to the histomorphometry, the addition of platelet-rich plasma failed to enhance bone formation on anorganic bovine bone and on autologous bone grafts.

The concerted action of Meox homeobox genes is required upstream of genetic pathways essential for the formation, patterning and differentiation of somites.

The paraxial mesoderm of the somites of the vertebrate embryo contains the precursors of the axial skeleton, skeletal muscles and dermis. The Meox1 and Meox2 homeobox genes are expressed in the somites and their derivatives during embryogenesis. Mice homozygous for a null mutation in Meox1 display relatively mild defects in sclerotome derived vertebral and rib bones, whereas absence of Meox2 function leads to defective differentiation and morphogenesis of the limb muscles. By contrast, mice carrying null mutations for both Meox genes display a dramatic and wide-ranging synthetic phenotype associated with extremely disrupted somite morphogenesis, patterning and differentiation. Mutant animals lack an axial skeleton and skeletal muscles are severely deficient. Our results demonstrate that Meox1 and Meox2 genes function together and upstream of several genetic hierarchies that are required for the development of somites. In particular, our studies place Meox gene function upstream of Pax genes in the regulation of chondrogenic and myogenic differentiation of paraxial mesoderm.

Our posthuman lingo

The English language is preparing for a radical revision of what we call human following the developments in biomedical engineering such as: the possibility of torso fat and rib bones rejiggered to form angel-like alar appendages; cochlear implants enabling some deaf people to hear and which may soon be used to enhance normal hearing; and an arm implanted with a chip that communicated via RF with sensors scattered around the building enabling doors to open and lights to turn on automatically whenever the subject approached. The author describes the meanings of words used to describe these areas such as: cyborg, neomorph, homomorph and ultrahumans amongst others.

Anterior endoscopic discectomy and fusion for adolescent idiopathic scoliosis.

A review of adolescent patients with idiopathic scoliosis undergoing endoscopic release and spinal fusion. To describe the indications, techniques, results, and complications of thoracic anterior endoscopic scoliosis surgery. Anterior endoscopic treatment of thoracic adolescent idiopathic scoliosis has become an alternative method of surgical treatment. Twenty-one patients with adolescent idiopathic scoliosis have undergone a thoracic anterior endoscopic release and fusion followed by posterior instrumentation and fusion. Indications for the endoscopic fusion were large curve magnitude, skeletal immaturity, and/or thoracic hyperkyphosis. Eleven patients have undergone anterior endoscopic instrumentation and fusion for thoracic scoliosis curves between 45 degrees and 70 degrees, using a single screw/single rod construct and autogenous rib bone graft. Results from the anterior endoscopic release and fusion procedures followed by a posterior instrumentation and fusion had an average preoperative curve of 82 degrees (range, 41 degrees -125 degrees ), with postoperative correction to 28 degrees (range, 5 degrees -60 degrees ) showing 70% correction. For patients undergoing an anterior endoscopic instrumentation and fusion, the average preoperative Cobb measurement of 53 degrees (range, 44 degrees -62 degrees ) was corrected to an average 26 degrees (range, 18 degrees -38 degrees ) for an average correction rate of 51%. One patient undergoing an anterior endoscopic release was converted to an open procedure for end plate bony bleeding without sequelae. One patient with an anterior endoscopic instrumentation and fusion had revision anterior surgery for a distal set screw dislodgment and subsequent posterior instrumentation and fusion for pseudarthrosis. The use of both anterior endoscopic release and fusion combined with either anterior instrumentation or separate posterior instrumentation and fusion continues to evolve. Surgeons treating patients with these techniques must understand that there are specific indications for them and many technique options available to optimize surgical results.