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Spine Deformity

Xudong J Li, Lawrence G Lenke, Earl Thuet, Lee A Tan, Alexander Tuchman
BACKGROUND: Transcranial motor evoked potential (TcMEP) is widely used intraoperatively to monitor spinal cord and nerve root function. To our knowledge, there is no report regarding TcMEP signal loss purely caused by patient positioning during the spinal procedure. PURPOSE: The objective of this article is to report an intraoperative TcMEP signal loss of a patient with fixed sagittal imbalance posture along with mild hip contractures. STUDY DESIGN: A retrospective case report...
September 2018: Spine Deformity
S Rajasekaran, Rishi Mugesh Kanna, Manindra Bhushan, Anupama Maheswaran, Ajoy Prasad Shetty, Siddharth N Aiyer
STUDY DESIGN: Case report OBJECTIVE: To present three cases of coronal vertebral dislocation due to congenital multiple thoracic and lumbar pedicle agenesis. SUMMARY OF BACKGROUND DATA: Congenital pedicle agenesis is an uncommon condition and is frequently identified as an incidental finding on diagnostic imaging in asymptomatic individuals. This agenesis is frequently limited to a single level and is commonly seen in the cervical and lumbar spine. METHODS: We report three patients who presented with multiple thoracic and lumbar pedicle agenesis resulting in coronal vertebral dislocation...
September 2018: Spine Deformity
Michelle Cameron Welborn, Jacques D'Astous, Susan Bratton, John Heflin
STUDY DESIGN: IRB-approved retrospective single cohort study. OBJECTIVES: To review our ten-year history with EDF (Elongation Derotation Flexion) casting in patients with infantile idiopathic scoliosis (IIS) to better understand which factors predict successful outcomes. SUMMARY OF BACKGROUND DATA: Numerous studies have demonstrated the efficacy of EDF casting in the treatment of progressive infantile idiopathic scoliosis. But none have reproduced the success of Mehta's even with early intervention...
September 2018: Spine Deformity
Samuel Rosenfeld, John Schlechter, Benjamin Smith
OBJECTIVES/SUMMARY OF BACKGROUND DATA: Segmental sublaminar spinal instrumentation without fusion results in guided growth and correction of deformity in early-onset scoliosis (EOS). The purpose of this study is to report the outcomes of a series of children with low-tone EOS that were treated surgically with a modification of a Luque trolley technique. METHODS: This study is a retrospective chart and radiographic review of a single-center series of 13 consecutive children who met inclusion criteria with documented progression of scoliosis greater than 25°...
September 2018: Spine Deformity
John A Heflin, Graham T Fedorak, Angela P Presson, Jessica V Morgan, John T Smith
OBJECTIVE: To report on the surgical learning curve in treating early-onset scoliosis with rib-based distraction. SUMMARY OF BACKGROUND DATA: The idea of a surgical learning curve proposes improved outcomes with experience. Early-onset scoliosis (EOS) is a challenging condition to treat and complication rates are high. METHODS: All patients from a single experienced spine surgeon's practice who had undergone placement of rib-based distraction constructs between 2002 and 2013 were identified...
September 2018: Spine Deformity
Justin K Scheer, Joseph A Osorio, Justin S Smith, Frank Schwab, Robert A Hart, Richard Hostin, Virginie Lafage, Amit Jain, Douglas C Burton, Shay Bess, Tamir Ailon, Themistocles S Protopsaltis, Eric O Klineberg, Christopher I Shaffrey, Christopher P Ames
STUDY DESIGN: Retrospective review of prospective multicenter adult spinal deformity (ASD) database. OBJECTIVE: To create a model based on baseline demographic, radiographic, health-related quality of life (HRQOL), and surgical factors that can predict patients meeting the Oswestry Disability Index (ODI) minimal clinically important difference (MCID) at the two-year postoperative follow-up. SUMMARY OF BACKGROUND DATA: Surgical correction of ASD can result in significant improvement in disability as measured by ODI, with the goal of reaching at least one MCID...
September 2018: Spine Deformity
Peter L Zhou, John Y Moon, Jared C Tishelman, Thomas J Errico, Themistocles S Protopsaltis, Peter G Passias, Aaron J Buckland
STUDY DESIGN: Retrospective radiographic review. OBJECTIVES: To understand the effect of variability in sacral endplate selection in transitional lumbosacral vertebrae (TLSV) and its impact on pelvic, regional, and global spinal alignment parameters. BACKGROUND: TLSV can have the characteristics of both lumbar and sacral vertebrae. Difficulties in identification of the S1 endplate may come from nomenclature, number of lumbar vertebrae, sacra, and morphology and may influence the interpretation and consistency of spinal alignment parameters...
September 2018: Spine Deformity
Hideyuki Arima, Steven D Glassman, John R Dimar, Yukihiro Matsuyama, Leah Y Carreon
STUDY DESIGN: Retrospective case-control matched cohort from a single institution. OBJECTIVE: To examine the contribution of nonmechanical factors to the incidence of proximal junctional failure (PJF) after adult spinal deformity (ASD) surgery. SUMMARY OF BACKGROUND DATA: Multiple studies have reported on the prevalence of PJF following surgery for ASD. However, little is known about the contribution of nonmechanical factors to the incidence of PJF...
September 2018: Spine Deformity
Isaac O Karikari, Lawrence G Lenke, Keith H Bridwell, Ryoji Tauchi, Michael P Kelly, Patrick A Sugrue, David B Bumpass, Aladine A Elsamadicy, Owoicho Adogwa, Ramin Lalezari, Linda Koester, Kathy Blanke, Jeffrey Gum
STUDY DESIGN: Retrospective cohort study. OBJECTIVE: To determine if severe sagittal malalignment (SM) patients without fixed deformities require a three-column osteotomy (3CO) to achieve favorable clinical and radiographic outcomes. SUMMARY OF BACKGROUND DATA: 3CO performed for severe SM has significantly increased in the last 15 years. Not all severe SM patients require a 3CO. METHODS: Severe SM patients (sagittal vertical axis [SVA] >10 cm) who underwent deformity correction between 2002 and 2011...
September 2018: Spine Deformity
A Noelle Larson, Charles Gerald T Ledonio, Ann M Brearley, Daniel J Sucato, Leah Y Carreon, Alvin H Crawford, David A Stevenson, Michael G Vitale, Christopher L Moertel, David W Polly
BACKGROUND: Scoliosis in patients with neurofibromatosis type I (NF1) can manifest as dystrophic or nondystrophic curves. Dystrophic scoliosis is rapidly progressive, rendering treatment challenging. Radiographic characteristics have been reported to predict dystrophic scoliosis, but their reliability and predictive value have not been well described. The purpose of this study is to assess the interobserver reliability for eight radiographic characteristics of dystrophic scoliosis and to evaluate the sensitivity and specificity of these characteristics relative to the gold standard of a definitive clinical diagnosis...
September 2018: Spine Deformity
John E Lonstein
STUDY DESIGN: The current literature on outcomes of early fusions for early-onset scoliosis (EOS) has a short follow-up of 7.7 to 12.5 years, with many patients not at the end of growth. The forced vital capacity (FVC) at follow-up ranged from 40.8% to 64% of predicted. A study was undertaken to evaluate the long-term outcome of these fusions. METHODS: The study is of congenital patients who had a fusion under age 8 years, with the current age being >20 years...
September 2018: Spine Deformity
Kan Min, Lukas Jud, Mazda Farshad
STUDY DESIGN: retrospective comparative study. INTRODUCTION: The standard surgical technique for double major adolescent idiopathic scoliosis (AIS) has been the fusion of both thoracic and thoracolumbar/lumbar curves from the posterior approach. Although short anterior correction is established in AIS with single thoracic or thoracolumbar/lumbar curves, anterior correction in double major curves has not yet been described. The purpose of this study is to compare this novel technique with standard posterior pedicle screw instrumentation in double major AIS...
September 2018: Spine Deformity
Søren Ohrt-Nissen, Tanvir Bari, Benny Dahl, Martin Gehrchen
STUDY DESIGN: Retrospective cohort study. OBJECTIVES: To investigate spinopelvic alignment and spine shape in patients surgically treated for adolescent idiopathic scoliosis (AIS) and to assess the distribution and clinical applicability of the Roussouly classification. SUMMARY OF BACKGROUND DATA: How spinopelvic alignment is affected in AIS patients is not well established. Roussouly et al. proposed a classification based on the sagittal spinal profile and spinopelvic alignment that may have clinical utility in these patients...
September 2018: Spine Deformity
T Barrett Sullivan, Nikolas Marino, Fredrick G Reighard, Peter O Newton
STUDY DESIGN: Retrospective review; literature comparison. OBJECTIVES: To review the literature on the relationship between lumbar lordosis (LL) and pelvic incidence (PI) and evaluate this relationship in asymptomatic adolescents while testing the validity of previously reported adult correlation models between LL and PI in an adolescent population. SUMMARY OF BACKGROUND DATA: Accurate understanding of the normal spinopelvic relationship is critical when considering surgical fusion of the lumbar spine...
September 2018: Spine Deformity
Sumeet Garg, Nikki Bloch, Morgan Potter, Hannah Quick, Claire Palmer, Nicole Michael, Courtney O'Donnell, Mark Erickson
STUDY DESIGN: Retrospective cohort study. OBJECTIVES: Evaluate the effectiveness of topical vancomycin in reducing surgical site infection (SSI) in pediatric patients undergoing posterior spinal fusion (PSF). SUMMARY OF BACKGROUND DATA: There has been increased interest in use of topical vancomycin to reduce SSI in spine surgery with mixed results reported in the literature. In Summer 2012, our institution implemented the use of topical vancomycin in definitive primary and revision PSF as part of our infection control protocol...
September 2018: Spine Deformity
Panagiotis Korovessis, Vasileios Syrimpeis, Vasileios Tsekouras, Konstantinos Vardakastanis, Peter Fennema
STUDY DESIGN: Α series study. OBJECTIVES: To evaluate the relationships between the effectiveness of brace in reduction of scoliosis angle, axial trunk rotation (ATR), and patients' compliance, in skeletally immature females with moderate adolescent idiopathic scoliosis (AIS), treated with Chêneau brace for a minimum of three years. SUMMARY OF BACKGROUND DATA: According to some authors, braces are ineffective, whereas others find that braces stop scoliosis progression and that the outcome has been related to patient's compliance...
September 2018: Spine Deformity
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
Michael A Bohl, Michael A Mooney, Joshua S Catapano, Kaith K Almefty, Jay D Turner, Steve W Chang, Mark C Preul, Edward M Reece, U Kumar Kakarla
STUDY DESIGN: Cadaveric feasibility study and case report. OBJECTIVE: To determine if it is feasible to rotate pedicled vascularized bone graft (VBG) from L1 to S1 via a posterior approach. SUMMARY OF BACKGROUND DATA: VBG has been used to successfully augment fusion rates in various skeletal pathologies. Pedicled VBG has numerous advantages over free-transfer VBG, including the maintenance of a robust vascular supply to the graft without the need for vascular anastomoses...
September 2018: Spine Deformity
Philip Saville, Rikesh A Gandhi, Harvey E Smith, Vincent Arlet
PURPOSE: Cervical spines previously posteriorly instrumented and fused with a kyphotic deformity represent a surgical challenge. Current treatment strategies include C7 pedicle subtraction osteotomy or a posterior-anterior-posterior approach, which carry the risk of significant complications. The objective of this study was to attempt to achieve lordosis with multiple anterior cervical discectomy and fusion (ACDF) cages to overpower the posterior instrumentation. METHODS: Four adult cadaveric specimens were selected and underwent C3-C7 posterior laminectomy with posterior instrumentation in a kyphotic alignment using a 3...
September 2018: Spine Deformity
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
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