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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
Zifang Huang, Xueshi Li, Yaolong Deng, Wenyuan Sui, Hengwei Fan, Jingfan Yang, Junlin Yang
BACKGROUND: Single-stage spine-shortening osteotomy without treating spinal cord malformations may have potential advantages for the treatment of severe congenital scoliosis (CS) with type I split spinal cord malformation (SSCM); however, the study of this technique was limited. OBJECTIVE: To evaluate the safety and efficacy of a single-stage spine-shortening osteotomy in the treatment of severe CS associated with type I SSCM. METHODS: A retrospective study was designed to compare 2 case series including 12 severe CS patients with type I SSCM and 26 patients with type A cord function (without spinal cord malformations, evoked potential abnormalities, and neurological dysfunctions preoperatively) treated with a single-stage spine-shortening posterior vertebral column resection (PVCR)...
July 27, 2018: Neurosurgery
Robert K Eastlack, Justin B Ledesma, Stacie Tran, Amrit Khalsa, Paul Park, Praveen V Mummaneni, Dean Chou, Adam S Kanter, Neel Anand, Pierce Nunley, Frank La Marca, Richard G Fessler, Juan S Uribe, Gregory M Mundis
INTRODUCTION: MIS correction for ASD may reduce the need the need for postoperative skilled nursing (SNF) or rehabilitation facility placement following surgery. The likelihood of requiring placement in a facility, rather than home disposition, may be influenced by a variety of factors. Additionally, the association of discharge location on outcomes and complication rates has not been elucidated in these patients. In this study, we aimed to define factors predicting disposition to SNF/rehab, and the rates of complications occurring in patients sent home vs...
July 10, 2018: World Neurosurgery
Aaron J Buckland, John Y Moon, Randal R Betz, Baron S Lonner, Peter O Newton, Harry L Shufflebarger, Thomas J Errico
STUDY DESIGN: Observational cohort study of prospective database registry. OBJECTIVE: To determine the incidence of neurological complications in AIS patients undergoing surgical treatment with PO. SUMMARY OF BACKGROUND DATA: Despite the widespread use of Ponte Osteotomies (PO) in adolescent idiopathic scoliosis (AIS) correction, outcomes and complications in patients treated with this technique have not been well characterized. METHODS: A multicenter prospective registry of patients undergoing surgical correction of AIS was queried at 2-year follow up for patient demographics, surgical data, deformity characteristics and peri-operative complications...
July 12, 2018: Spine
Z K Xu, G Chen, F C Li, Q X Chen
Objective: To investigate the surgical outcome of minimally invasive surgery(MIS) for severe degenerative lumbar scoliosis(DLS) and put forward a two-stage MIS surgical strategy. Methods: Prospective study of MISDEF Ⅲ DLS patients from June 2016 to August 2017 in the Second Affiliated Hospital of Zhejiang University was carried out, excluding the patients whose apex vertebrae of scoliosis was above L(1/2) level or whose facet joint got spontaneous fusion. Fifty-three patients were included in this study for staging evaluation and MIS surgical treatment...
July 3, 2018: Zhonghua Yi Xue za Zhi [Chinese medical journal]
Tianhao Wang, Yongfei Zhao, Guoquan Zheng, Yao Wang, Chunguo Wang, Zheng Wang, Yan Wang
BACKGROUND: Defining the postoperative pelvic tilt (PT) individually can help to reconstruct sagittal balance. However, the postoperative actual PT is hardly restored to theoretical value. Some cases with theoretical postoperative PT was overcorrected and still did not have normal horizontal visual field after surgery. The objective of this study is to describe the pelvic tilt change after spinal osteotomy in ankylosing spondylitis (AS) kyphotic deformity and evaluate the effect on clinical outcomes...
July 9, 2018: Journal of Orthopaedic Surgery and Research
Liang Xu, Xi Chen, Jun Qiao, Zhonghui Chen, Benlong Shi, Song Li, Changzhi Du, Qingshuang Zhou, Zezhang Zhu, Yong Qiu, Xu Sun
STUDY DESIGN: Retrospective radiographical clinical study. OBJECTIVE: To investigate the incidence and risk factors of coronal imbalance (CI) after three-column osteotomy (3-CO) in patients with thoracolumbar congenital kyphoscoliosis (CKS). SUMMARY OF BACKGROUND DATA: The incidence and risk factors of postoperative CI have been reported in adolescent idiopathic and degenerative lumbar scoliosis. However, limited data exists for patients with CKS after 3-CO...
July 2, 2018: Spine
Thomas J Buell, Avery L Buchholz, John C Quinn, Jeffrey P Mullin, Juanita Garces, Marcus D Mazur, Mark E Shaffrey, Chun-Po Yen, Christopher I Shaffrey, Justin S Smith
Pedicle subtraction osteotomy (PSO) is an effective technique to correct fixed sagittal malalignment. A variation of this technique, the "trans-discal" or "extended" PSO (Schwab grade IV osteotomy), involves extending the posterior wedge resection of the index vertebra to include the superior adjacent disc for radical discectomy. The posterior wedge may be resected in asymmetric fashion to correct concurrent global coronal malalignment.This video illustrates the technical nuances of an extended asymmetrical lumbar PSO for adult spinal deformity...
June 16, 2018: Operative Neurosurgery (Hagerstown, Md.)
Raphael de Rezende Pratali, Samuel Machado Martins, Francisco Prado Eugenio Dos Santos, Carlos Eduardo Gonçales Barsotti, Carlos Eduardo Algaves Soares de Oliveira
Objective: To analyze and characterize data about clinical outcome and complication rates in three-column osteotomies (3 CO) for treatment of rigid adult spine deformity (ASD). Methods: Baseline and postoperative clinical outcomes, considering the Oswestry Disability Index (ODI) and Scoliosis Research Society-22 (SRS-22) questionnaires, radiographic parameters, and demographic data of patients who underwent 3 CO procedure for fixed ASD treatment were collected. Surgical characteristics and reports of perioperative complications were recorded, as well as those that occurred at a minimum follow-up of 12 months...
March 2018: Revista Brasileira de Ortopedia
Xi-Nuo Zhang, Xiang-Yao Sun, Yong Hai, Xiang-Long Meng, Yun-Sheng Wang
Adult degenerative scoliosis (ADS) surgery is known for its high incidence of complications. The propose of this study was to determine current complication rates and the predictors of medical complications in surgical ASD patients. A retrospective study of 153 ADS patients who underwent long level spinal fusion with 2-year follow-up between 2012 and 2017. The patient- and surgical-related risk factors for each individual medical complication were identified by using univariate testing. All patients were divided into groups with and without medical complication, infection, neurological complications, and cardiopulmonary complications, respectively...
August 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Yogesh Kishorkant Pithwa
STUDY DESIGN: Retrospective analysis of prospectively collected data. PURPOSE: To assess the relative advantages of implant constructs with and without pedicle screws in the concave apex for correcting scoliosis. OVERVIEW OF LITERATURE: Concave apical pedicles in scoliosis can be narrow and dysplastic. Neural structures also migrate toward concavity, leaving little room for error while inserting pedicle screws into the concave apex. METHODS: Patients (n=35) undergoing scoliosis surgery from September 2004 to September 2009 with minimum 5-year follow-up period were included...
June 2018: Asian Spine Journal
Q H Zhao, Z Z Zhu, X Sun, B L Shi, B Wang, B P Qian, Z Liu, C Z Du, L Xu, Y Qiu
Objective: To evaluate the effectiveness of Scoliosis Research Society (SRS)-Schwab grade Ⅳ osteotomy in the treatment of post-traumatic thoracolumbar kyphosis (PTK). Methods: From October 2012 to January 2015, a total of 31 patients [12 males, 19 females, mean age (43±10) years] with symptomatic PTK undergoing SRS-Schwab grade Ⅳ osteotomy in Nanjing Drum Tower Hospital were retrospectively reviewed.Radiographic changes were evaluated with preoperative, postoperative and follow-up X-ray.The measurements included thoracic kyphosis (TK), lumbar lordosis (LL), thoracolumbar kyphosis (TLK), focal kyphosis (FK), pelvic incidence (PI), pelvic tilt (PT), sacral slope (SS) and sagittal vertical axis (SVA)...
May 22, 2018: Zhonghua Yi Xue za Zhi [Chinese medical journal]
Javier Pizones, Mar Pérez Martín-Buitrago, José Miguel Sánchez Márquez, Nicomedes Fernández-Baíllo, Montserrat Baldan-Martin, Francisco Javier Sánchez Pérez-Grueso
STUDY DESIGN: Retrospective comparative analysis. OBJECTIVE: Study early-onset scoliosis (EOS) graduated patients to establish founded criteria for graduation decision making and determine the risks and benefits of definitive fusion. SUMMARY OF BACKGROUND DATA: EOS is treated by growth-friendly techniques until skeletal maturity. Afterwards, patients can be "graduated," either by definitive fusion (posterior spinal fusion [PSF]) or by retaining the previous implants (Observation) with no additional surgery...
May 2018: Spine Deformity
Peter G Passias, Dennis Vasquez-Montes, Gregory W Poorman, Themistocles Protopsaltis, Samantha R Horn, Cole A Bortz, Frank Segreto, Bassel Diebo, Chris Ames, Justin Smith, Virginie LaFage, Renaud LaFage, Eric Klineberg, Chris Shaffrey, Shay Bess, Frank Schwab
BACKGROUND CONTEXT: Distal junctional kyphosis (DJK) is a primary concern of surgeons correcting cervical deformity. Identifying patients and procedures at higher risk of developing this condition is paramount in improving patient selection and care. PURPOSE: The present study aimed to develop a risk index for DJK development in the first year after surgery. STUDY DESIGN/SETTING: This is a retrospective review of a prospective multicenter cervical deformity database...
April 27, 2018: Spine Journal: Official Journal of the North American Spine Society
Isaac O Karikari, Keith H Bridwell, Aladine A Elsamadicy, Lawrence G Lenke, Patrick Sugrue, David Bumpass, Azeem Ahmad, Jeffrey Gum
Study Design: Retrospective cohort study. Objectives: To analyze the impact of performing a formal decompression in patients with adult lumbar scoliosis with symptomatic spinal stenosis on perioperative complications and long-term outcomes. Methods: Adult patients undergoing at least 5 levels of fusion to the sacrum with iliac fixation from 2002 to 2008 who had a minimum 5-year follow-up at one institution were studied. Patients who had 3-column osteotomy were excluded from the study...
April 2018: Global Spine Journal
Peter G Passias, Gregory W Poorman, Cole A Bortz, Rabia Qureshi, Bassel G Diebo, Justin C Paul, Samantha R Horn, Frank A Segreto, Alexandra Pyne, Cyrus M Jalai, Virginie Lafage, Shay Bess, Frank J Schwab, Hamid Hassanzadeh
BACKGROUND CONTEXT: With advances in the understanding of adult spinal deformity (ASD), more complex osteotomy and fusion techniques are being implemented with increasing frequency. Patients undergoing ASD corrections infrequently require extended acute care, longer inpatient stays, and are discharged to supervised care. Given the necessity of value-based health care, identification of clinical indicators of adverse discharge disposition in ASD surgeries is paramount. PURPOSE: Using the nationwide and surgeon-created databases, the present study aimed to identify predictors of adverse discharge disposition after ASD surgeries and view the corresponding differences in charges...
April 9, 2018: Spine Journal: Official Journal of the North American Spine Society
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
Amer Sebaaly, Clément Sylvestre, Yehya El Quehtani, Guillaume Riouallon, Daniel Larrieu, Louis Boissiere, Jean Paul Steib, Pierre Roussouly, Stéphane Wolff, Ibrahim Obeid
STUDY DESIGN: This was a retrospective multicentric study. OBJECTIVE: The objective of this study was to determine the different risk factors for development of proximal junctional kyphosis (PJK) in patients with adult scoliosis. SUMMARY OF BACKGROUND DATA: This study was conducted as the reasons for development of PJK in adult scoliosis are still not clear. MATERIALS AND METHODS: In total, 314 patients met the inclusion criteria...
April 2018: Clinical Spine Surgery
Murat Oto, İlker Abdullah Sarıkaya, Ozan Ali Erdal, Ali Şeker
OBJECTIVES: This study aims to review the efficacy of femoral varus derotation osteotomy (VDRO) and Dega transiliac osteotomy in the treatment of hip subluxation and dislocation of cerebral palsy (CP) patients. PATIENTS AND METHODS: This retrospective study included 25 hips of 22 CP patients (9 males, 13 females; mean age 8.7 years; range 4 to 18 years) who were operated due to hip subluxation and dislocation between July 2010 and December 2015. The mean follow-up period was 36...
April 2018: Eklem Hastalıkları Ve Cerrahisi, Joint Diseases & related Surgery
Tae Sik Goh, Jong Ki Shin, Myung Soo Youn, Jung Sub Lee
Study Design: A prospective study. Purpose: To identify associations between psychiatric factors and patient-reported outcomes after corrective surgery in patients with lumbar degenerative kyphosis (LDK). Overview of Literature: Thus far, to the best of our knowledge, patient factors that may help predict patient-reported outcomes after corrective surgery for LDK have not been studied. Methods: We prospectively investigated 46 patients with LDK who underwent surgical correction with a minimum follow-up of 2 years...
February 2018: Asian Spine Journal
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