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Spine osteotomy

Alexander A Theologis, Gregory M Mundis, Stacie Nguyen, David O Okonkwo, Praveen V Mummaneni, Justin S Smith, Christopher I Shaffrey, Richard Fessler, Shay Bess, Frank Schwab, Bassel G Diebo, Douglas Burton, Robert Hart, Vedat Deviren, Christopher Ames
OBJECTIVE The aim of this study was to evaluate the utility of supplementing long thoracolumbar posterior instrumented fusion (posterior spinal fusion, PSF) with lateral interbody fusion (LIF) of the lumbar/thoracolumbar coronal curve apex in adult spinal deformity (ASD). METHODS Two multicenter databases were evaluated. Adults who had undergone multilevel LIF of the coronal curve apex in addition to PSF with L5-S1 interbody fusion (LS+Apex group) were matched by number of posterior levels fused with patients who had undergone PSF with L5-S1 interbody fusion without LIF (LS-Only group)...
October 21, 2016: Journal of Neurosurgery. Spine
Junlin Yang, Zifang Huang, Michael Grevitt, Jun Li, Fobao Li, Jingfan Yang
STUDY DESIGN: To report a new technique. OBJECTIVE: To introduce a new method of precise correction controlling for ankylosing spondylitis kyphosis. SUMMARY OF BACKGROUND DATA: The exact angle method is excellent for calculating the pedicle subtraction osteotomy angle but is difficult to perform during surgery. In this study, the precise rod bending technique was proposed as a new method for precise correction controlling for ankylosing spondylitis kyphosis through illustrative cases...
November 2016: Clinical Spine Surgery
Wenhao Hu, Bin Wang, Hongyu Run, Xuesong Zhang, Yan Wang
BACKGROUND: It is estimated that upwards of 50,000 individuals suffer traumatic fracture of the spine each year, and the instability of the fractured vertebra and/or the local deformity results in pain and, if kyphosis increases, neurological impairment can occur. There is a significant controversy over the ideal management. The purpose of the study is to present clinical and radiographic results of pedicle subtraction osteotomy and disc resection with cage placement in correcting post-traumatic thoracolumbar kyphosis...
October 12, 2016: Journal of Orthopaedic Surgery and Research
C Josten, C-E Heyde, U J Spiegl
Treating vertebral body fractures is challenging when there is relevant pre-existing spinal degeneration. Both vertebral body fractures and spinal degeneration are related to the physiological aging process. The increases in both are linked to increases in life expectancy. Several factors promote spinal degeneration and increase fracture risk, such as disc degeneration, spinal imbalance and osteoporosis. The main diagnostic and therapeutic challenge is to identify the sources of pain and to start appropriate therapy...
October 2016: Zeitschrift Für Orthopädie und Unfallchirurgie
H Keil, M Kreinest, U Kneser, T Kremer, M Schnetzke, P A Grützner, S Matschke
This article presents the case of a high-grade deformity of the thoraco-lumbar spine. The patient suffered from a sarcoma that was radically resected. Due to adjuvant radiation, the patient suffered from a radiation injury with chronic fistula. In a two-stage approach, the deformity was corrected by a closing-wedge osteotomy of L3 with elongation of the present dorsal spondylodesis (Th10-L4) to Th8 and the iliac bone. Soft-tissue reconstruction was achieved by a free latissimus dorsi flap that was anastomosed to an axillary arterio-venous loop...
September 14, 2016: Der Unfallchirurg
Babar Kayani, Mathew David Sewell, Johnson Platinum, Andre Olivier, Timothy W R Briggs, Deborah M Eastwood
BACKGROUND: Congenital indifference to pain with anhidrosis (CIPA) is a rare hereditary neuropathy, which is associated with defective sensation to noxious stimuli and autonomic dysfunction. The objective of the study was to report on the orthopaedic manifestations of this condition and provide an evidence-based approach for management. METHODS: Retrospective review of 14 consecutive patients with CIPA referred to a single tertiary centre. Mean age of diagnosis was 2...
September 6, 2016: European Journal of Paediatric Neurology: EJPN
Jeffrey L Gum, Leah Y Carreon, Jacob M Buchowski, Lawrence G Lenke, Steven D Glassman
BACKGROUND: Increased awareness regarding the importance of the sagittal spinal profile has led to more aggressive correction of sagittal malalignment. The utilization trends of pedicle subtraction osteotomy (PSO) for sagittal plane correction in spinal deformity surgery have not been well characterized. METHODS: A commercially available database (PearlDiver, Inc) was queried for both Private Payor and 5 % Medicare claims from 2008 to 2011. Revision and clarification of the coding guidelines for PSO were introduced in 2008...
2016: Scoliosis and Spinal Disorders
Juan Gómez-Hoyos, Anthony Khoury, Ricardo Schröder, Eric Johnson, Ian J Palmer, Hal D Martin
PURPOSE: To assess the relation between ischiofemoral impingement (IFI) and lumbar facet joint load during hip extension in cadavers. METHODS: Twelve hips in 6 fresh T1-to-toes cadaveric specimens were tested. A complete pretesting imaging evaluation was performed using computed tomography scan. Cadavers were positioned in lateral decubitus and fixed to a dissection table. Both legs were placed on a frame in a simulated walking position. Through a posterior lumbar spine approach L3-4 and L4-5 facet joints were dissected bilaterally...
September 3, 2016: Arthroscopy: the Journal of Arthroscopic & related Surgery
R Wejnold Jørgensen, C Dippmann, L Dahl, J Stürup
BACKGROUND: The amount of patients referred with longstanding, non-arthritic hip pain is increasing, as are the treatment options. Left untreated hip dysplasia, acetabular retroversion and femoroacetabular impingement (FAI) may lead to osteoarthritis (OA). Finding the right treatment option for the right patient can be challenging in patients with non-arthritic hip pain. PURPOSE: The purpose of this study was to categorize the radiographic findings seen in patients with longstanding hip pain, suspect for an intraarticular pathology, and provide a treatment algorithm allocating a specific treatment option for each clinical condition...
2016: Open Orthopaedics Journal
Guoquan Zheng, Kai Song, Ziming Yao, Yonggang Zhang, Xiangyu Tang, Zheng Wang, Xuesong Zhang, Keya Mao, Geng Cui, Yan Wang
STUDY DESIGN: A prospective case series study. OBJECTIVE: To describe and assess a two-level osteotomy method for the management of severe thoracolumbar kyphosis (TLK) in patients with ankylosing spondylitis (AS). SUMMARY OF BACKGROUND DATA: To achieve better postoperative outcomes in these patients, a sophisticated preoperative surgical plan is required. Most deformities are managed using a one-level osteotomy and a two-level osteotomy is seldomly reported...
September 1, 2016: Spine
Hiroaki Nakashima, Shiro Imagama, Hiroki Matsui, Yasutsugu Yukawa, Koji Sato, Tokumi Kanemura, Mitsuhiro Kamiya, Kenyu Ito, Yukihiro Matsuyama, Naoki Ishiguro, Fumihiko Kato
STUDY DESIGN: Retrospective multicenter study. OBJECTIVE: Although untethering surgery has been a standard treatment in patients with adult tethered cord syndrome (TCS), spine-shortening osteotomy (SSO) has recently been performed as an alternative technique. The purpose of this study was to compare the clinical outcomes of the two procedures for TCS in adults. METHODS: Fourteen patients (37.7 ± 12.5 years) with TCS were enrolled at 6 hospitals...
September 2016: Global Spine Journal
Javier Pizones, Felisa Sánchez-Mariscal, Lorenzo Zúñiga, Enrique Izquierdo
INTRODUCTION: During thoracic curve correction, the tightening of the sublaminar wires through concavity creates a medial and a dorsal translation of the spine. However, little is known about the effect of the sublaminar wires on the axial plane. METHODS: This is prospective case series analysis of 30 consecutive surgical patients with main thoracic adolescent idiopathic scoliosis. All of the patients were fused with hybrid instrumentation (apical concavity-sublaminar wires) and differential rod contouring (over-kyphosis concavity/under-kyphosis convexity)...
October 2016: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
Mingyuan Yang, Changwei Yang, Haijian Ni, Yuechao Zhao, Ming Li
T1 sagittal angle has been reported to be used as a parameter for assessing sagittal balance and cervical lordosis. However, no study has been performed to explore the relationship between T1 sagittal angle and sagittal balance, and whether T1 sagittal angle could be used for osteotomy guidelines remains unknown. The aim of our study is to explore the relationship between T1 sagittal angle and sagittal balance, determine the predictors for T1 sagittal angle, and determine whether T1 sagittal angle could be used for osteotomy guidelines to restore sagittal balance...
2016: PloS One
Mehmet Elmadağ, Gökçer Uzer, Fatih Yıldız, Hasan H Ceylan, Mehmet A Acar
OBJECTIVE: The aim of this cadaveric study was to investigate the efficacy of the modified Stoppa approach in Ganz periacetabular osteotomy (PAO). METHODS: The Ganz PAO was performed on 10 hemipelvises with normal hips, from 5 cadavers using the modified Stoppa approach through the Pfannenstiel incision. All of the osteotomies were performed under fluoroscopic control and direct visualizing the osteotomy site from the same incision. After the osteotomy, the acetabulum was medialized and redirected anterolaterally, and fixed with 2 screws...
August 2016: Acta Orthopaedica et Traumatologica Turcica
Xiaoyong Sheng, Shaojun Ren
INTRTODUCTION: Osteoporotic vertebral collapse (OVC) with delayed neurological deficits (DND) is one severe subtype of OVC, for which surgical intervention is more complicated and difficult. Although many individual case reports and series have described the surgery for stabilization and neurological decompression of OVC with DND, no systematic review has been published. METHODS: We searched eligible studies in PubMed, SCOPUS, EMBASE and ISIWeb of Knowledge for eligible studies and conducted comprehensive analysis...
September 2016: International Journal of Surgery
Themistocles Protopsaltis, Nicolas Bronsard, Alex Soroceanu, Jensen K Henry, Renaud Lafage, Justin Smith, Eric Klineberg, Gregory Mundis, Han Jo Kim, Richard Hostin, Robert Hart, Christopher Shaffrey, Shay Bess, Christopher Ames
PURPOSE: To describe reciprocal changes in cervical alignment after adult spinal deformity (ASD) correction and subsequent development of proximal junctional kyphosis (PJK). This study also investigated these changes using two novel global sagittal angular parameters, cervical-thoracic pelvic angle (CTPA) and the T1 pelvic angle (TPA). METHODS: Multicenter, retrospective consecutive case series of ASD patients undergoing thoracolumbar three-column osteotomy (3CO) with fusion to the pelvis...
July 20, 2016: European Spine Journal
Jun Hu, Bang-Ping Qian, Yong Qiu, Bin Wang, Yang Yu, Ze-Zhang Zhu, Jun Jiang, Sai-Hu Mao, Zhe Qu, Yun-Peng Zhang
PURPOSE: To evaluate whether acetabular orientation (abduction and anteversion) can be restored by lumbar pedicle subtraction osteotomy (PSO) in ankylosing spondylitis (AS) patients with thoracolumbar kyphosis. MATERIALS AND METHODS: A total of 33 consecutive AS patients with thoracolumbar kyphosis undergoing one-level lumbar PSO were retrospectively reviewed. Radiographical measurements included sagittal vertical axis, global kyphosis, thoracic kyphosis, local kyphosis, lumbar lordosis, pelvic incidence, sacral slope, and pelvic tilt...
July 19, 2016: European Spine Journal
Kee-Yong Ha, Seung-Woo Suh, Young-Hoon Kim, Sang-Il Kim
PURPOSE: The objective of this study is to report the progression of congenital hyperlordoscoliosis in a 2-year-old patient and the use of multiple surgical interventions in the treatment of hyperlordoscoliosis of the thoracic spine. METHODS: A 2-year-old patient with thoracic hyperlordosis underwent observation for 1 year. To halt the progression of hyperlordosis, a posterior laminectomy was carried out to remove all the fused segments. Despite surgery, lordosis progressed via spontaneous autofusion with development of scoliosis with unilateral unsegmented bar...
July 18, 2016: European Spine Journal
Justin K Scheer, Lloyd Hey, Michael LaGrone, Michael Daubs, Christopher P Ames
INTRODUCTION: In adult spinal deformity (ASD) surgery the use of 2 experienced attending surgeons can decrease the operative time and estimated blood loss, and may be a key factor in witnessed decreased major complication prevalence. However, it is unclear how the practice of 2 surgeons is currently being used. METHODS: An electronic, 27-question survey regarding the use of a single or 2 attending surgeons during ASD correction was administered to the Scoliosis Research Society membership by the Adult Deformity Committee...
August 2016: Neurosurgery
Khoi Duc Than, Stacie Nguyen, Paul Park, Dean Chou, Frank La Marca, Juan S Uribe, Todd Douglas Vogel, Pierce D Nunley, Robert Eastlack, Neel Anand, Adam S Kanter, Praveen V Mummaneni, Gregory M Mundis
INTRODUCTION: This study aims to compare differences in incidence and type of complications (COMP) between circumferential minimally invasive surgery (cMIS, ie MIS transforaminal lumbar interbody fusion [TLIF] and/or lumbar lateral interbody fusion [LLIF] with MIS screws) and hybrid approaches (HYB, ie MIS LLIF ± with open screws). METHODS: A retrospective review of a multicenter MIS deformity database was performed. Inclusion criteria for this database: age >18 years, and at least one of the following: coronal Cobb angle (CCA) >20, SVA >5 cm, PI-LL >10, and PT > 20...
August 2016: Neurosurgery
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