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Xu Sun, Liang Xu, Zhonghui Chen, Benlong Shi, Xi Chen, Song Li, Changzhi Du, Qingshuang Zhou, Yong Qiu, Zezhang Zhu
STUDY DESIGN: Retrospective study. OBJECTIVE: The current study aimed to evaluate the effectiveness of the hybrid growing rod (GR) technique for the treatment of young children with congenital scoliosis (CS). SUMMARY OF BACKGROUND DATA: Congenital vertebral anomalies within long-spanned kyphoscoliosis was difficult to be managed by either definitive spinal fusion or standard GR technique. Hybrid technique of one-stage posterior osteotomy with short fusion and GR distraction was proposed in previous studies...
January 29, 2019: Spine
Raj M Amin, Micheal Raad, Amit Jain, Morsi Khashan, Hamid Hassanzadeh, Steven M Frank, Khaled M Kebaish
BACKGROUND CONTEXT: Surgery for adult spinal deformity (ASD) is increasingly common. Although outcomes of ASD surgery have been studied extensively, to our knowledge, no data exist regarding factors predicting nonroutine discharge in this population. Nonroutine discharge is defined as discharge to a health care facility after surgery rather than to home. PURPOSE: To determine which patient and surgical factors predict nonroutine discharge after ASD surgery. DESIGN: This is a retrospective study...
February 2019: Spine Journal: Official Journal of the North American Spine Society
J K Giriraj Harshavardhan, Bharghava Ram Uppalapati, P Gopinath Menon
Introduction: Fibrous dysplasia is a rare benign disorder of the skeletal system characterized by fibro-osseous proliferation with intervening areas of normal or immature bone in the intramedullary region. It can either be a monostotic (involves one bone) or a polyostotic (involves more than one bone) presentation and usually occurs equally in males and females. Deformities such as scoliosis and shepherd's crook deformity are frequently encountered in the polyostotic form. We report the management of a rare managed case of bilateral shepherd's crook deformity of the proximal femur with impending neck of femur fracture...
May 2018: Journal of Orthopaedic Case Reports
Masashi Uehara, Jun Takahashi, Shota Ikegami, Hiroki Oba, Shugo Kuraishi, Toshimasa Futatsugi, Takashi Takizawa, Ryo Munakata, Michihiko Koseki, Hiroyuki Kato
BACKGROUND: Reducing the number of screw insertions while maintaining good clinical outcomes can improve the efficiency and cost-effectiveness of scoliosis surgery. However, the optimal minimum number of pedicle screws remains unclear. This study searched for factors to estimate the fewest number of pedicle screws required between end vertebrae in relation to preoperative main thoracic curve flexibility. METHODS: Sixty-nine subjects (4 male and 65 female, mean age: 14...
December 1, 2018: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
Jing Feng, Juan Zhou, Mi Huang, Ping Xia, Wei Liu
BACKGROUND: To compare the clinical and radiological outcomes of the surgical correction of Lenke type 1 to 4 scoliosis by using a multilevel Ponte osteotomy procedure with posterior selective segmental pedicle screw constructs or posterior release and selective segmental pedicle screw constructs only in patients with adolescent thoracic idiopathic scoliosis. METHODS: Retrospective analysis of 65 patients, 32 treated with the multilevel Ponte procedure (Group A) and 33 with posterior soft tissue release only (Group B)...
November 29, 2018: Journal of Orthopaedic Surgery and Research
(no author information available yet)
OBJECTIVEVenous thromboembolic events (VTEs) are a common cause of morbidity and mortality after spine surgery. Patients admitted to the intensive care unit (ICU) following spine surgery exhibit high-risk clinical characteristics.METHODSThe authors retrospectively analyzed 1269 ICU patients who had undergone spine surgery between January 1, 2009, and May 31, 2015. Relevant demographic, procedural, and outcome variables were collected.RESULTSPatients admitted to the ICU postoperatively had a postoperative VTE rate of 10...
October 1, 2018: Journal of Neurosurgery. Spine
Daniela Ghisi, Alessandro Ricci, Sandra Giannone, Tiziana Greggi, Stefano Bonarelli
Background: Acute pancreatitis has been described as potential complication of both abdominal and non-abdominal surgeries. The pathogenetic mechanism underlying acute pancreatitis in spine surgery may include intraoperative hemodynamic instability causing prolonged splanchnic hypoperfusion, as well as mechanical compression of the pancreas due to scoliosis correction, with a higher risk in cases of more extended fusions, especially in young adults with lower body mass index (BMI). Case presentation: We report here a case of postoperative acute pancreatitis with benign evolution in a young female patient after the first and second surgery of a two-stage correction of right thoracic idiopathic scoliosis...
2018: Scoliosis and Spinal Disorders
Daniel E Choi, Michael J Vives, Harsh Shah, Caixia Zhao, Anuradha Patel, Sanjeev Sabharwal
Most studies have excluded postoperative drain volumes in analyzing blood loss associated with scoliosis surgery. We sought to analyze patient and surgical factors that influenced postoperative drain outputs. A retrospective review was conducted on 50 consecutive patients who had undergone posterior spinal fusion with pedicle screw instrumentation and subfascial drain placement over a 6-year period at a single institution for adolescent idiopathic scoliosis. Postoperative drain volumes were correlated to patient factors, surgical variables, and change in postoperative hemoglobin values...
November 13, 2018: Journal of Pediatric Orthopedics. Part B
Jianning Shao, Bryan S Lee, Dominic Pelle, Maxwell Y Lee, Jason Savage, Joseph E Tanenbaum, Thomas E Mroz, Michael P Steinmetz
The use of intraoperative multimodal monitoring (IOM) in spinal deformity surgeries is well documented. In particular, pedicle subtraction osteotomy (PSO), a corrective procedure for sagittal deformity of the spine, often involves IOM usage. By providing immediate feedback to the operating surgeon, IOM has the potential to eliminate or at least minimize the risk of iatrogenic neurological injury. However, despite the widespread usage of IOM, there is currently no standardization of IOM usage in complex spine surgeries, including lumbar PSOs, and decisions concerning IOM utilization are often driven by surgeon experience and preference...
November 6, 2018: Clinical Spine Surgery
Jamal N Shillingford, Joseph L Laratta, Hemant Reddy, Alex Ha, Ronald A Lehman, Lawrence G Lenke, Charla R Fischer
STUDY DESIGN: Retrospective review of prospectively collected data. OBJECTIVE: Analyze the Scoliosis Research Society (SRS) Morbidity & Mortality (M&M) database to assess the incidence and characteristics related to postoperative surgical site infection (SSI) after spinal deformity surgery. SUMMARY OF BACKGROUND DATA: Infections involving spinal instrumentation are associated with greater rates of disability. Rates of postoperative SSI after spinal deformity surgery range from 1...
November 2018: Spine Deformity
Courtney E Baker, Tanya Marvi, Thomas M Austin, Shelby Payne, Megan E Mignemi, David Gailani, Allison P Wheeler, Thanh T Nguyen, Steven A Lovejoy, Jeffrey E Martus, Gregory A Mencio, Jonathan G Schoenecker
BACKGROUND: Children undergoing posterior spinal fusion experience high blood loss often necessitating transfusion. An appropriately activated coagulation system provides hemostasis during surgery, but pathologic dysregulation can cause progressive bleeding and increased transfusions. Despite receiving antifibrinolytics for clot stabilization, many patients still require transfusions. AIMS: We sought to examine the association of dilutional coagulopathy with blood loss and blood transfusion in posterior spinal fusion for pediatric scoliosis patients...
November 2018: Paediatric Anaesthesia
Tarush Rustagi, Richard A Tallarico, William F Lavelle
Background: Three-column osteotomy is an effective means of correcting fixed sagittal plane deformities. Deformity correction surgeries may be associated with early postoperative neurological deficits often presenting as palsies involving the lumbar roots. The objective was to retrospectively assess a subset of our series of adult deformity correction surgeries and analyze neurological deficits and associated patient and surgical factors. Methods: Hospital records of 17 patients from a single center were examined...
April 2018: International Journal of Spine Surgery
Oussama Abousamra, Paul D Sponseller, Baron S Lonner, Suken A Shah, Michelle C Marks, Patrick J Cahill, Joshua M Pahys, Peter O Newton
BACKGROUND: Intraoperative blood loss during posterior spinal fusion for adolescent idiopathic scoliosis (AIS) has been reportedly associated with multiple factors. This study aims to investigate the effect of thoracic kyphosis on blood loss in AIS spinal fusion. METHODS: Patients with AIS who underwent posterior-only procedures for Lenke I and II type curves were identified. All included patients had intraoperative tranexamic acid. Difference in estimated blood loss per blood volume (EBL/BV) was identified between hypokyphotic curves (-), normal curves (N), and hyperkyphotic curves (+) classified based on Lenke sagittal modifier...
September 26, 2018: Journal of Pediatric Orthopedics
Graham T Fedorak, John T Smith, John A Heflin
CASE: We utilized a novel staged approach for an adolescent with severe kyphoscoliosis; it involved 8 weeks of initial halo-gravity traction as well as implantation and expansion (every 2 weeks) of a magnetically controlled growing rod over 6 months, followed by spinal fusion. The patient was a 13-year-old girl with an untreated idiopathic deformity (thoracic scoliosis with a curve of 145° and kyphosis with a curve of 120°). No osteotomies other than inferior facetectomies were required at the final fusion, and the final scoliosis curve was 57°, a correction of 60...
July 2018: JBJS Case Connector
John M Flynn, Brendan M Striano, Wallis T Muhly, Blair Kraus, Wudbhav N Sankar, Vaidehi Mehta, Michael Blum, Barbara DeZayas, Jeffrey Feldman, Ron Keren
BACKGROUND: As high-quality health care becomes increasingly expensive, improvement projects are focused on reducing cost and increasing value. To increase value by reducing operating room (OR) utilization, we studied the effect of a dedicated team approach for posterior spinal fusion (PSF) for scoliosis. METHODS: With institutional support, an interdisciplinary, dedicated team was assembled. Members developed standardized protocols for anesthetic management and patient transport, positioning, preparation, draping, imaging, and wake-up...
September 19, 2018: Journal of Bone and Joint Surgery. American Volume
Masafumi Kashii, Sadaaki Kanayama, Taichi Kitaoka, Takahiro Makino, Takashi Kaito, Motoki Iwasaki, Takuo Kubota, Takehisa Yamamoto, Keiichi Ozono, Hideki Yoshikawa
The purpose of this study was to clarify the prevalence of scoliosis and determine risk factors for the development of scoliosis in young children with osteogenesis imperfecta (OI) who underwent intravenous pamidronate (PAM) therapy. Thirty-four young children with OI who had no scoliosis at the first PAM administration underwent cyclic PAM therapy alone. The medical records and radiographs of these patients were retrospectively reviewed. We examined the relationship between scoliosis (Cobb angle ≥ 10) and type of OI (Sillence classification: types I, III, and IV), physical mobility, Z-scores of bone mineral density in L2-4 of the lumbar spine (L2-4 BMD Z-scores), age of patients at first treatment with PAM, pelvic frontal tilt and leg-length discrepancy...
September 5, 2018: Journal of Bone and Mineral Metabolism
Sebastien Pesenti, Tejbir Pannu, Jessica Andres-Bergos, Renaud Lafage, Justin S Smith, Steve Glassman, Marinus de Kleuver, Ferran Pellise, Frank Schwab, Virginie Lafage
PURPOSE: Although many risk factors for surgical site infection (SSI) following spinal fusion have been described in the literature, methodologies and study cohorts vary widely. Patient- and procedure-specific risk factors for (SSI) can be identified via a meta-analysis. We sought to review the existing data and isolate significant risk factors for SSI in patients undergoing thoracolumbar spinal fusion. METHODS: The literature was searched through December of 2016...
October 2018: European Spine Journal
Leo Fradet, Xiaoyu Wang, Dennis Crandall, Carl-Eric Aubin
STUDY DESIGN: Computer biomechanical simulations to analyze risk factors of proximal junctional failure (PJF) following adult scoliosis instrumentation. OBJECTIVE: To evaluate the biomechanical effects on the proximal junctional spine of the proximal implant type, tissue dissection, and lumbar lordosis (LL) restoration. SUMMARY OF BACKGROUND DATA: PJF is a severe proximal junctional complication following adult spinal instrumentation requiring revision surgery...
September 2018: Spine Deformity
Y Qiu
This review mainly focused on the etiology and the surgical strategy for adolescent idiopathic scoliosis (AIS) treatment. Genome-wide association study on the etiology of AIS using samples from more than 5 000 patients and 6 000 normal controls showed two genes: LBX1-AS1 on 10q24.32 and TNIK on 3q26.2 highly related to AIS initiation and progression. Regarding the conservative treatment of AIS, bracing is the only well-documented effective non-operative management in the early stage of AIS. For the patients with Cobb angle smaller than 80°, balancing spine, saving fusion level and restoring thoracic kyphosis are the basic objectives in surgical management...
August 1, 2018: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
Mehmet Nuri Erdem, Ismail Oltulu, Sinan Karaca, Seçkin Sari, Mehmet Aydogan
STUDY DESIGN: A retrospective clinical study. PURPOSE: To analyze the surgical outcomes of intraoperative halo-femoral traction (HFT) in patients with adolescent idiopathic scoliosis (AIS) with Cobb angles between 70° and 90° and flexibility <35%. OVERVIEW OF LITERATURE: Numerous methods have been described to achieve adequate correction and successful results in the surgical treatment of AIS patients with a Cobb angle >70°...
August 2018: Asian Spine Journal
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