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Spine Deformity

Jonathan D Crews, Marina Mina, Eric Johnson, Janette Guillen, James Simmons, Ajeya Joshi
STUDY DESIGN: Case-control study. OBJECTIVES: To identify risk factors for surgical site infections (SSIs) following vertical expandable prosthetic titanium rib (VEPTR) surgery in children. SUMMARY OF BACKGROUND DATA: VEPTR surgery is a growth-sparing approach for early-onset scoliosis and chest or rib abnormalities. SSIs are an important complication following VEPTR surgery. We aimed to identify modifiable risk factors for SSIs following VEPTR surgery...
November 2018: Spine Deformity
Selina Poon, Hillard T Spencer, Reginald S Fayssoux, Ronen Sever, Robert H Cho
OBJECTIVES: To evaluate the maximal force generated by magnetically controlled growing rods (MCGRs) at three different lengthened positions. SUMMARY OF BACKGROUND DATA: The introduction of MCGRs has been met with great enthusiasm by surgeons managing early-onset scoliosis. These devices offer the potential to decrease the cost and morbidity associated with repeated surgeries, compared to traditional growing rods. One potential negative consequences of growing rod treatments is the law of diminishing returns, where the spine length gained decrease with each subsequent lengthening...
November 2018: Spine Deformity
Fady J Baky, Todd A Milbrandt, Randall Flick, A Noelle Larson
BACKGROUND: Early-onset scoliosis (EOS) is a potentially life-threatening condition that requires early intervention to prevent severe deformity and pulmonary compromise. Observational studies have demonstrated that children receiving multiple procedures requiring general anesthesia are at a higher risk for adverse neurocognitive outcomes. We sought to characterize anesthetic exposure in EOS patients and to determine risk factors for increased exposure. We hypothesized that patients treated for EOS were at risk of receiving large amounts of cumulative anesthesia in childhood because of the need for early intervention to preserve pulmonary function...
November 2018: Spine Deformity
Kee-Yong Ha, Sang-Il Kim, Young-Hoon Kim, Hyung-Youl Park, Joo-Hyun Ahn
STUDY DESIGN: A retrospective comparative cohort study. OBJECTIVE: To investigate the causes of jack-knife posture (JKP) without proximal junctional kyphosis (PJK) and to compare the causes of PJK and JKP without PJK. SUMMARY OF BACKGROUND DATA: PJK causing stooping posture could be inevitable after long instrumented lumbar fusion for degenerative sagittal imbalance. However, few studies have addressed JKP without PJK, which is a different type of sagittal malalignment...
November 2018: Spine Deformity
Jun S Kim, Varun Arvind, Eric K Oermann, Deepak Kaji, Will Ranson, Chierika Ukogu, Awais K Hussain, John Caridi, Samuel K Cho
STUDY DESIGN: Cross-sectional database study. OBJECTIVE: To train and validate machine learning models to identify risk factors for complications following surgery for adult spinal deformity (ASD). SUMMARY OF BACKGROUND DATA: Machine learning models such as logistic regression (LR) and artificial neural networks (ANNs) are valuable tools for analyzing and interpreting large and complex data sets. ANNs have yet to be used for risk factor analysis in orthopedic surgery...
November 2018: Spine Deformity
Nicholas Schroeder, Andriy Noschenko, Evalina Burger, Vikas Patel, Christopher Cain, David Ou-Yang, Christopher Kleck
STUDY DESIGN: Retrospective single-center. OBJECTIVES: To investigate changes in pelvic incidence from flexion to extension. To assess interobserver error in the measurement of pelvic incidence. BACKGROUND: Pelvic incidence (PI) has been considered a static parameter since it was originally described. But recent studies have shown that PI can change with age and after spinal procedures. Changes in PI based on position have not been investigated...
November 2018: Spine Deformity
Sayf S A Faraj, Toon F M Boselie, Alba Vila-Casademunt, Marinus de Kleuver, Roderick M Holewijn, Ibrahim Obeid, Emre Acaroglu, Ahmet Alanay, Frank Kleinstück, Francisco S Pérez-Grueso, Ferran Pellisé
STUDY DESIGN: Retrospective study of prospectively collected data. OBJECTIVES: The purpose of this study was to evaluate the relationship between apical vertebral axial rotation and pretreatment patient-reported health-related quality of life (HRQOL), disability, and pain in patients with adult degenerative scoliosis (ADS) using a novel radiographic software tool. SUMMARY OF BACKGROUND DATA: Recent studies have demonstrated that in ADS, sagittal and coronal plane deformity are weakly to moderately associated with HRQOL, disability, and pain...
November 2018: Spine Deformity
Charles H Crawford, Steven D Glassman, Leah Y Carreon, Christopher I Shaffrey, Tyler R Koski, Christine R Baldus, Keith H Bridwell
STUDY DESIGN: Longitudinal cohort. OBJECTIVE: To report on the prevalence and indications for unplanned reoperations following index surgery in the Adult Symptomatic Lumbar Scoliosis NIH-sponsored Clinical Trial. SUMMARY OF BACKGROUND DATA: Reoperation following adult spinal deformity surgery exposes the patient to additional surgical risk, increases the cost of care, and decreases the potential cost-effectiveness of the intervention. Accurate data regarding the prevalence and indication for reoperation will facilitate future efforts to minimize risk...
November 2018: Spine Deformity
James R Gregory, June C Smith, Sarah M Brown-Riley, Alexis M Elward, Scott J Luhmann
STUDY DESIGN: Prospective consecutively enrolled cohort. OBJECTIVES: To evaluate paraspinal muscle concentration of intravenously administered vancomycin, at predetermined time points, during posterior spinal fusion (PSF) with instrumentation in neuromuscular scoliosis (NMS). SUMMARY: Surgical site infection (SSI) after PSF for NMS can be a devastating complication, which may lead to prolonged antibiotic use, multiple additional surgical procedures, pseudarthroses, and sepsis...
November 2018: Spine Deformity
M Wade Shrader, William Wood, Miranda Falk, Lee S Segal, Carla Boan, Greg White
BACKGROUND: Posterior spinal fusion (PSF) in children with cerebral palsy (CP) carries a high risk of complications and morbidity. The purpose of this study is to investigate the impact of using two attending surgeons on blood loss, operative time, and complications in this fragile population. METHODS: This was a prospective, matched cohort analysis of patients with CP who underwent PSF with two attending surgeons. These were matched with a control group that had a single-surgeon team, assisted by a senior resident or PA...
November 2018: Spine Deformity
Alvin H Crawford, Hono Caus Gr, Adam P Schumaier, Francesco T Mangano
STUDY DESIGN: Literature review with supplementary case examples. OBJECTIVES: The objective of this article was to review neurofibromatosis type 1 (NF1) and the associated spinal pathology with a focus on the disorder's manifestations in the immature cervical spine. SUMMARY OF BACKGROUND DATA: NF1 is one of the most common inheritable genetic disorders. The disorder is associated with spinal deformities, long bone dysplasia, and osteoporosis...
November 2018: Spine Deformity
Etka Kurucan, David N Bernstein, Caroline Thirukumaran, Amit Jain, Emmanuel Nganku Menga, Paul T Rubery, Addisu Mesfin
STUDY DESIGN: Analysis of a national database. OBJECTIVE: To analyze trends in spinal fusion surgery for neurofibromatosis type I (NF-1) patients and to compare the surgical approaches. SUMMARY OF BACKGROUND DATA: The preferred surgical approach for fusion treatment of spinal deformity in NF is not well established. METHODS: We identified 548 patients with a diagnosis of NF-1 who had received spinal fusion surgery between 2003 and 2014...
November 2018: Spine Deformity
Jaysson T Brooks, Tracey P Bastrom, Carrie E Bartley, Baron S Lonner, Suken A Shah, Firoz Miyanji, Jahangir Asghar, Peter O Newton, Burt Yaszay
STUDY DESIGN: Multicenter review of prospectively collected data. OBJECTIVE: The purpose of this study was to evaluate whether a UIV of T2 reliably results in level shoulders postoperatively. SUMMARY OF BACKGROUND DATA: Adolescent idiopathic scoliosis (AIS) patients with a risk of a high left shoulder postoperatively are generally recommended to have instrumentation to T2, those with neutral shoulders a T3 UIV, and those with an elevated right shoulder are recommended a UIV of T4 or below in order to achieve postoperative shoulder balance...
November 2018: Spine Deformity
Robert Tung, Mason Uvodich, John T Anderson, Katie Carpenter, Ashley Sherman, Rafael Lozano
STUDY DESIGN: Retrospective. OBJECTIVES: We aimed to determine if heavier patients with adolescent idiopathic scoliosis (AIS) had more preserved thoracic kyphosis (TK), and as a result, more preserved pulmonary function. SUMMARY OF BACKGROUND DATA: Some believe that childhood weight is predictive of adult sagittal plane parameters, with heavier children having greater TK as adults. Generally, thoracic scoliosis is coupled with loss of TK, which is associated with worsening pulmonary function...
November 2018: Spine Deformity
Gabriela A Villamor, Lindsay M Andras, Joshua Yang, David L Skaggs
STUDY DESIGN: Prospective, randomized control study. OBJECTIVES: To determine whether the SRS-22r (SRS-22) has a negative effect on the body image of females with adolescent idiopathic scoliosis (AIS) using the Body Appreciation Scale (BAS). SUMMARY: The SRS-22 is a validated questionnaire designed by the Scoliosis Research Society (SRS) to assess outcomes of scoliosis patients. Parents and nursing staff have expressed concern that the questionnaire may incite body image concerns when administered to teenagers with AIS...
November 2018: Spine Deformity
Kei Watanabe, Masayuki Ohashi, Toru Hirano, Keiichi Katsumi, Hirokazu Shoji, Tatsuki Mizouchi, Naoto Endo, Kazuhiro Hasegawa
STUDY DESIGN: A retrospective cohort study. OBJECTIVES: To investigate the relationship between skeletal muscle status of the trunk and the progression of adolescent idiopathic scoliosis (AIS) during adulthood. SUMMARY OF BACKGROUND DATA: To date, studies evaluating the risk factors for progression of AIS have principally focused on radiographic parameters. METHODS: Eighty-two women with AIS managed conservatively, who had a major curve ≥30° at skeletal maturity (Risser grade ≥4), were enrolled...
November 2018: Spine Deformity
Baron S Lonner, Yuan Ren, Vidyadhar V Upasani, Michelle M Marks, Peter O Newton, Amer F Samdani, Karen Chen, Harry L Shufflebarger, Suken A Shah, Daniel R Lefton, Hussein Nasser, Colin T Dabrowski, Randal R Betz
HYPOTHESIS: The frequency of disc degeneration (DD) in the distal mobile segments will increase over time following surgery for adolescent idiopathic scoliosis (AIS). DESIGN: Retrospective review of a prospective AIS registry. INTRODUCTION: Durability of surgical outcomes is essential for maintenance of quality of life as well as for family decision making and for assessment of the value of a healthcare intervention. We assessed DD, its risk factors, and association with health-related quality of life 10 years after AIS surgery...
November 2018: Spine Deformity
Courtney Toombs, Baron Lonner, Suken Shah, Amer Samdani, Patrick Cahill, Harry Shufflebarger, Burt Yaszay, Paul Sponseller, Peter Newton
STUDY DESIGN: Preoperative and two-year follow-up health-related quality of life (HRQOL) data were prospectively collected in 82 Scheuermann kyphosis (SK) and 995 adolescent idiopathic scoliosis (AIS) patients using the Scoliosis Research Society-22 patient questionnaire (SRS-22) outcomes instrument in a multicenter study. Visual analog scale (VAS) scores were also collected for the SK population. OBJECTIVES: This study assessed changes in HRQOL prospectively and compared them to those occurring in AIS...
November 2018: Spine Deformity
John E Lonstein
INTRODUCTION: Selective thoracic fusions (STFs) were introduced by Moe to treat the structural thoracic curve when a more flexible lumbar component existed. It is unknown how the curves behave and how the patients function beyond 20 years after surgery. METHODS: Of the 152 eligible patients with STF, 67 were traced and contacted and 40 completed outcome questionnaires (Oswestry Disability index [ODI], Scoliosis Research Society-30 [SRS-30]) and had follow-up standing radiographs...
November 2018: Spine Deformity
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
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