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pediatric scoliosis correction

M Burhan Janjua, Brandon Toll, Shashank Ghandi, Michael E Sebert, Dale M Swift, Joshua M Pahys, Amer F Samdani, Steven W Hwang
OBJECTIVE: This study aims to elucidate surgical risk factors in neuromuscular scoliosis (NMS) with respect to wound site infection after spinal fusion. METHODS: A retrospective review was performed of all patients treated surgically for NMS between January 2008 and December 2016 (minimum 6 months' follow-up). A sub-cohort of 60 patients with minimum 2 years of follow-up data was also analyzed. RESULTS: In 102 patients (53 boys and 49 girls), the mean age at surgery was 14...
February 15, 2019: Pediatric Neurosurgery
Subaraman Ramchandran, Stephen George, Jahangir Asghar, Harry Shufflebarger
STUDY DESIGN: Single-center retrospective study. OBJECTIVE: To analyze two-year postoperative outcomes following spinopelvic fixation in pediatric patients using the anatomic trajectory (AT) portal for iliac screws. SUMMARY: Iliac fixation is crucial in situations requiring fusion to sacrum. Challenges include complex anatomy, pelvic deformation, severe deformity, and previous surgery. The PSIS portal requires significant dissection, rod connectors, and complex bends...
March 2019: Spine Deformity
Amanda N Fletcher, Richard M Schwend
STUDY DESIGN: Retrospective case series. OBJECTIVES: The purpose of this study is to (1) describe the development of our Spinal Deformity Program; (2) assess the surgical outcomes, including health-related quality of life (HRQOL), radiographic measures, and complications; and (3) explore predictors for HRQOL outcomes. SUMMARY OF BACKGROUND DATA: The Scoliosis Research Society (SRS) is very interested in international program site development to provide safe surgical care for children in low- and middle-income countries (LMICs)...
March 2019: Spine Deformity
Yichen Meng, Tao Lin, Wei Shao, Rui Gao, Xuhui Zhou
RATIONALE: Nuss procedure is a safe and popular minimally invasive surgical technique for the correction of pectus excavatum in adolescents. Acquired scoliosis over 50 degrees after Nuss procedure has never been reported. PATIENT CONCERNS: A 14-year-old boy was referred to pediatric surgery for pectus excavatum deformity. He underwent a successful Nuss procedure. At follow up, the patient was noted having an asymmetric back whole spine X-ray showed a right-sided thoracic curve with a Cobb angle of 54 degrees...
January 2019: Medicine (Baltimore)
Sergey V Vissarionov, Nikolay A Krutelev, Victor P Snischuk, Monzurul Alam, Artem P Kravchenko, Yong-Ping Zheng, Nikita O Khusainov
Study design: Cohort study. Objectives: The objectives of this study were examination, observation and surgical interventions of pediatric patients with diastematomyelia, a rare congenital deformity of the spinal cord. Setting: Spine surgery and neurosurgery clinic under ministry of health, the Russian Federation. Methods: Twenty children (1-18 years of age) with diastematomyelia participated in this study. Diagnosis was based on subjects' medical history, results of clinical examination, spine radiography in anteroposterior and lateral views, and neurophysiological examinations...
2018: Spinal Cord Series and Cases
Carlos Marqués, Javier Pizones, José Miguel Sánchez-Márquez, Montserrat Martín-Baldan, Nicomedes Fernández-Baíllo, Francisco Javier Sánchez Pérez-Grueso
STUDY DESIGN: Report of four cases. OBJECTIVE: To describe a series of pediatric patients with surgical scoliosis after chest wall resections due to Askin tumors. SUMMARY OF BACKGROUND DATA: Askin tumors are a rare type of chest wall solid tumors that can develop in children. Treatment involves chemotherapy and extensive surgical resection, including disarticulation of several ribs. This can cause thoracogenic scoliosis, with very scarce data found in the literature regarding its treatment and prognosis...
January 2019: Spine Deformity
Jason B Anari, Patrick J Cahill, John M Flynn, David A Spiegel, Keith D Baldwin
Pelvic instrumentation for neuromuscular scoliosis has been part of neuromuscular scoliosis surgery since the era of the Luque Galveston construct. Unit Rod (Medtronic Sofamor-Danek, Nashville, TN) instrumentation brought with it the concept of cantilever correction by placing the implants in the pelvis and then gradually bringing the rod to the spine by sequentially tightening the sublaminar wires, with the goal of creating a level pelvis over a straight spine. More recently surgeons have utilized pedicle screw constructs in which the corrective strategies have varied...
October 18, 2018: World Journal of Orthopedics
Jennifer M Bauer, Jeffrey A Moore, Rajiv Rangarajan, Brian S Gibbs, Petya K Yorgova, Geraldine I Neiss, Kenneth Rogers, Peter G Gabos, Suken A Shah
STUDY DESIGN: Prospective database review. OBJECTIVES: Determine if use of intraoperative 3D imaging of pedicle screw position provides clinical and cost benefit. SUMMARY OF BACKGROUND: Injury or reoperation from malpositioned pedicle screws in adolescent idiopathic scoliosis (AIS) surgery occurs but is increasingly considered to be a never-event. To avoid complications, intraoperative 3D imaging of screw position may be obtained. METHODS: A prospective, consecutive AIS database at a high-volume pediatric spine center was examined three years before and after implementation of an intraoperative low-dose computed tomographic (CT) scan protocol...
November 2018: Spine Deformity
Ena Nielsen, Lindsay M Andras, Laura Bellaire, Nicholas D Fletcher, Anas Minkara, Michael G Vitale, Michael Troy, Michael Glotzbecker, David L Skaggs
STUDY DESIGN: Multicenter retrospective OBJECTIVE.: To compare pelvic obliquity correction and reoperation rate in neuromuscular scoliosis patients who had their pelvis included in a posterior spinal fusion (pelvic fusion, PF) at their index procedure vs revision procedures. SUMMARY OF BACKGROUND DATA: There is limited information on outcomes specific to fusing to the pelvis for neuromuscular scoliosis in a revision operation versus index surgery. METHODS: Charts and radiographs were reviewed of patients with PF for neuromuscular scoliosis from 01/2003 to 08/2015 at 4 high volume pediatric spine centers with > 2 year follow-up...
October 5, 2018: Spine
Azeem Tariq Malik, Jeffery Kim, Elizabeth Yu, Safdar N Khan
STUDY DESIGN: Retrospective cohort study. OBJECTIVE: Analyze risk factors associated with a non-home discharge following spinal fusions in adolescent idiopathic scoliosis (AIS). SUMMARY OF BACKGROUND DATA: Current evidence is limited with regard to which patient-level and provider/hospital-level factors predict a non-home discharge disposition following spinal fusions in AIS. Identifying these factors can allow providers to identify which patients would ultimately require facility care and can be discharged early to these facilities to reduce hospital costs...
September 21, 2018: Spine
Nikita Cobetto, Carl-Eric Aubin, Stefan Parent
STUDY DESIGN: Computational simulation of lateral decubitus and anterior vertebral body growth modulation (AVBGM). OBJECTIVES: To biomechanically evaluate lateral decubitus and cable tensioning contributions on intra- and postoperative correction. SUMMARY OF BACKGROUND DATA: AVBGM is a compression-based fusionless procedure to treat progressive pediatric scoliosis. During surgery, the patient is positioned in lateral decubitus, which reduces spinal curves...
September 2018: Spine Deformity
Sarah Dupuis, Carole Fortin, Christiane Caouette, Isabelle Leclair, Carl-Éric Aubin
BACKGROUND: Global postural re-education (GPR) is a physiotherapy treatment approach for pediatric idiopathic scoliosis (IS), where the physiotherapist qualitatively assesses scoliotic curvature reduction potential (with a manual correction) and patient's ability to self-correct (self-correction). To the author's knowledge, there are no studies regarding GPR applied to IS, hence there is a need to better understand the biomechanics of GPR curve reduction postures. The objective was to biomechanically and quantitatively evaluate those two re-education corrections using a computer model combined with experimental testing...
June 21, 2018: BMC Musculoskeletal Disorders
Megan Mignemi, Dong Tran, Brandon Ramo, B Stephens Richards
STUDY DESIGN: Single-institution, retrospective review of prospectively collected data on pediatric patients with adolescent idiopathic scoliosis (AIS) undergoing spinal fusion with a minimum two-year follow-up. OBJECTIVE: To determine the rate of reoperation in AIS patients undergoing spine fusion from 2008 to 2012. SUMMARY OF BACKGROUND DATA: Recent trends in the surgical treatment of AIS have included increased use of all-pedicle screw constructs, smaller implants, more posterior-only approaches, and improved correction techniques...
July 2018: Spine Deformity
Nikita Cobetto, Carl-Eric Aubin, Stefan Parent
STUDY DESIGN: Numerical planning and simulation of immediate and post-two-year growth modulation effects of Anterior Vertebral Body Growth Modulation (AVBGM). OBJECTIVES: To develop a planning tool based on a patient-specific finite element model (FEM) of pediatric scoliosis integrating growth to computationally assess the 3D biomechanical effects of AVBGM. SUMMARY OF BACKGROUND DATA: AVBGM is a recently introduced fusionless compression-based approach for pediatric scoliotic patients presenting progressive curves...
July 2018: Spine Deformity
Altuğ Duramaz, Semra Yılmaz, Nezih Ziroğlu, Burcu Bursal Duramaz, Tayfun Kara
PURPOSE: The purpose of this prospective study was to evaluate the effects of deformity correction on body image, quality of life, self-esteem, depression and anxiety in patients with adolescent idiopathic scoliosis (AIS) who underwent surgery. METHODS: Between June 2014 and July 2015, 41 consecutive patients who underwent surgery for AIS were compared with the control group of 52 healthy patients regarding the changes in the pre- and postoperative quality of life and psychiatric status of patients with deformity correction...
September 2018: European Spine Journal
Kushagra Verma, Casey Slattery, Henry Duah, Kawdwo P Yankey, Gregory Mundis, Oheneba Boachie-Adjel
BACKGROUND: Early-onset scoliosis (EOS) remains a challenging pediatric spine condition to manage. Some severe deformities can be managed with a vertebral column resection (VCR), which is fraught with high complication rates and the outcomes have not been well reported. The purpose of this study is to provide an assessment of operative, radiographic, and clinical outcomes from children diagnosed with severe EOS treated with a VCR. METHODS: We performed a retrospective review of prospectively collected data...
August 2018: Journal of Pediatric Orthopedics
Jonathan Dallas, Katherine D Sborov, Bradley S Guidry, Silky Chotai, Christopher M Bonfield
OBJECTIVE Many patients undergoing spinal fusion for neuromuscular scoliosis have preexisting neurosurgical implants, including ventricular shunts (VSs) for hydrocephalus and baclofen pumps (BPs) for spastic cerebral palsy. Recent studies have discussed a possible increase in implant complication rates following spinal fusion, but published data are inconclusive. The authors therefore, sought to investigate: 1) the rate of implant complications following fusion, 2) possible causes of these complications, and 3) factors that place patients at higher risk for implant-related complications...
July 2018: Journal of Neurosurgery. Pediatrics
Y L Tian, J Geng, F Wang, Y P Zheng
Congenital scoliosis, a commonly seen disease occurring in children, can not only affect the growth, but also can uglify the individual which can severely affect the health and quality of life of children. To investigate the efficacy of posterior hemivertebra resection in combination with screw rod internal fixation in the treatment of congenital hemivertebra scoliosis, 115 patients were randomly divided into an observation group and a control group. Patients in the observation group were treated by posterior hemivertebra resection in combination with screw rod internal fixation, while patients in the control group were treated by posterior hemivertebra resection only...
March 2018: Journal of Biological Regulators and Homeostatic Agents
Ankit Patel, Sameer Ruparel, Tarun Dusad, Gaurav Mehta, Vishal Kundnani
OBJECTIVE Spinal osteotomy in pediatric patients is challenging due to various factors. For correction of severe rigid kyphoscoliosis in children, numerous techniques with anterior or posterior or combined approaches, as well as multilevel osteotomies, have been described. These techniques are associated with prolonged operative times and large amounts of blood loss. The purpose of this study was to evaluate the clinical and radiologically confirmed efficacy of a modification of the apical spinal osteotomy (ASO) technique-posterior-only single-level asymmetric closing osteotomy-in pediatric patients with severe rigid kyphoscoliosis...
March 30, 2018: Journal of Neurosurgery. Pediatrics
Keila M Maher, Kwadwo Owusu-Akyaw, Jingzhu Zhou, Mary Cooter, Allison K Ross, Robert K Lark, Brad M Taicher
INTRODUCTION: Surgical correction of pediatric scoliosis is associated with significant blood loss. Minimizing estimated blood loss and blood transfusion is beneficial as transfusions have been associated with increased morbidity, including risk of surgical site infections, longer hospitalizations, and increased cost. Although there is evidence that African-American or Black adults are more likely to require intraoperative blood transfusion compared with Caucasian or White adults, the reasons for this difference are unclear...
April 2018: Paediatric Anaesthesia
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