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Growing spine

Malick Bachabi, Anna McClung, Jeff B Pawelek, Ron El Hawary, George H Thompson, John T Smith, Michael G Vitale, Behrooz A Akbarnia, Paul D Sponseller
BACKGROUND: Distraction-based techniques allow spinal growth until skeletal maturity while preventing curve progression. METHODS: Two multicenter early-onset scoliosis databases were used to identify patients with idiopathic spine abnormalities treated with traditional growing rods (TGR) or vertically expandable titanium ribs (VEPTR). Patients underwent at least 4 lengthenings and had at least 5-year follow-up. Significance was set at P<0.05. RESULTS: In total, 50 patients treated with TGR and 22 treated with VEPTR were included...
June 8, 2018: Journal of Pediatric Orthopedics
Klane K White, Viviana Bompadre, Suken A Shah, Gregory J Redding, Walter F Krengel, William G Mackenzie
PURPOSE: Severe, early-onset spinal deformity is common in patients with skeletal dysplasia. These deformities often present at young ages and are associated with significant pulmonary dysfunction. The objective of this study is to verify the effectiveness of growth-friendly spinal instrumentation systems in promoting growth in patients with skeletal dysplasia and early-onset kyphoscoliosis. METHODS: A retrospective, multicenter comparative cohort study was performed...
July 2018: Spine Deformity
Christina K Hardesty, Robert P Huang, Ron El-Hawary, Amer Samdani, Paloma Bas Hermida, Teresa Bas, Mehmet Bülent Balioğlu, David Gurd, Jeff Pawelek, Richard McCarthy, Feng Zhu, Scott Luhmann
STUDY DESIGN: This is a review of the current literature on early-onset scoliosis (EOS) techniques and treatment written by the Growing Spine Committee of the Scoliosis Research Society. OBJECTIVES: The Growing Spine Committee of the Scoliosis Research Society sought to update the information available on the definition and treatment of EOS, including new information about existing techniques. SUMMARY OF BACKGROUND DATA: EOS represents a diverse, heterogeneous, and clinically challenging group of spinal disorders occurring in children under the age of 10...
July 2018: Spine Deformity
Taylor J Jackson, Daniel Miller, Susan Nelson, Patrick J Cahill, John M Flynn
STUDY DESIGN: Prospective survey. OBJECTIVES: To evaluate the reliability of low-dose stereoradiography compared to standard hand bone age films for assessing Sanders skeletal maturity stage in patients with idiopathic scoliosis. SUMMARY OF BACKGROUND DATA: The Sanders skeletal maturity staging system is a valuable tool in the care of juvenile and adolescent spine scoliosis, but obtaining dedicated hand films adds additional time, radiation, and expense to the clinic visit...
July 2018: Spine Deformity
Carol C Hasler
Early-onset scoliosis (EOS) describes a wide array of diagnoses and deformities exposed to growth. This potentially life-threatening condition is still 1 of the biggest challenges in pediatric orthopaedics. The enlightenment of Bob Campbell's thoracic insufficiency syndrome concept and the negative impact of the earlier short and straight spine fusion approach on respiratory function and survival have fueled the evolution of EOS care. Despite all the progress made, growth-friendly spine surgery remains to be a burden to patients and caregivers...
July 2018: Journal of Pediatric Orthopedics
Aixing Pan, Yong Hai, Jincai Yang, Yangpu Zhang, Yaoshen Zhang
STUDY DESIGN: A retrospective case series. OBJECTIVE: We sought to evaluate the prevalence and risk factors of proximal junctional kyphosis (PJK) after growing-rod surgery in patients with early onset scoliosis (EOS). SUMMARY OF BACKGROUND DATA: Growing-rod surgery is the primary treatment in patients with progressive EOS when conservative treatment fails. PJK is one of the most commonly reported postoperative complications. MATERIALS AND METHODS: We retrospectively evaluated 50 patients (24 boys and 26 girls) diagnosed with EOS who underwent growing-rod surgery...
May 31, 2018: Clinical Spine Surgery
Zachary J Grabel, Allison Boden, Dale N Segal, Stephanie Boden, Andrew H Milby, John G Heller
BACKGROUND CONTEXT: There is growing concern that the microbial profile of surgical site infection (SSI) in the setting of prophylactic vancomycin powder may favor more resistant and uncommon organisms. PURPOSE: To demonstrate the impact of prophylactic intraoperative vancomycin powder on microbial profile, antibiotic regimen, length of stay, and reoperation rate in spine surgical site infection. STUDY DESIGN/SETTING: Retrospective cohort study...
May 30, 2018: Spine Journal: Official Journal of the North American Spine Society
Kevin Y Chang, Wellington K Hsu
As the use of minimally invasive spine (MIS) fusion approaches continues to grow, increased scrutiny is being placed on its outcomes and efficacies against traditional open fusion surgeries. While there are many factors that contribute to the success of achieving spinal arthrodesis, selecting the optimal fusion biologic remains a top priority. With an ever-expanding market of bone graft substitutes, it is important to evaluate each of their use as it pertains to MIS techniques. This review will summarize the important characteristics and properties of various spinal biologics used in minimally invasive lumbar surgeries and compare their fusion rates via a systematic review of published literature...
2018: Minimally Invasive Surgery
Jun Zhang, Adan Omar, Addisu Mesfin
STUDY DESIGN: Observational study. OBJECTIVE: To evaluate the online ratings of spine surgeons and variables that may affect online ratings. SUMMARY OF BACKGROUND DATA: Physician review Web sites (PRW) are rapidly growing for-profit businesses. Most orthopedic surgeons are rated on at least one PRW as are other surgical specialists. To date the online ratings of spine surgeons have not been evaluated. METHODS: Cervical Spine Research Society surgeon ratings on five physician rating Web sites were performed in April 2016: "healthgrade...
June 15, 2018: Spine
Vijay Joshi, Stephen D Cassivi, Todd A Milbrandt, A Noelle Larson
Adolescent idiopathic scoliosis affects children aged 11-18 years. Severe disease may necessitate spinal fusion. Vertebral body tethering gradually corrects scoliosis as the patients grow. The application of video-assisted thoracic surgery to the thoracic spine is a new area for further development.
May 17, 2018: European Journal of Cardio-thoracic Surgery
John T Martin, Sarah E Gullbrand, Aaron J Fields, Devina Purmessur, Ashish D Diwan, Thomas R Oxland, Kazuhiro Chiba, Farshid Guilak, Judith A Hoyland, James C Iatridis
This study investigated current trends in spine publications of the membership of Orthopaedic Research Society Spine Section (ORS3) and the more global and clinically focused International Society for the Study of the Lumbar Spine (ISSLS). The PubMed database was probed to quantify trends in the overall number of articles published, the number of journals these articles were published in, and the number of active scientists producing new manuscripts. We also evaluated trends in flagship spine journals ( Spine , European Spine Journal , and The Spine Journal ) and in the Journal of Orthopaedic Research...
March 2018: JOR spine
Matthew Bank, Katie Gibbs, Cristina Sison, Nawshin Kutub, Angelos Paptheodorou, Samuel Lee, Adam Stein, Ona Bloom
Objective: To identify clinical or demographic variables that influence long-term mortality, as well as in-hospital mortality, with a particular focus on the effects of age. Summary and Background Data: Cervical spine fractures with or without spinal cord injury (SCI) disproportionately impact the elderly who constitute an increasing percentage of the US population. Methods: We analyzed data collected for 10 years at a state-designated level I trauma center to identify variables that influenced in-hospital and long-term mortality among elderly patients with traumatic cervical spine fracture with or without SCI...
2018: Geriatric Orthopaedic Surgery & Rehabilitation
Ramon Velazquez, Eric Ferreira, An Tran, Emily C Turner, Ramona Belfiore, Caterina Branca, Salvatore Oddo
Misfolded and hyperphosphorylated tau accumulates in several neurodegenerative disorders including Alzheimer's disease, frontotemporal dementia with Parkinsonism, corticobasal degeneration, progressive supranuclear palsy, Down syndrome, and Pick's disease. Tau is a microtubule-binding protein, and its role in microtubule stabilization is well defined. In contrast, while growing evidence suggests that tau is also involved in synaptic physiology, a complete assessment of tau function in the adult brain has been hampered by robust developmental compensation of other microtubule-binding proteins in tau knockout mice...
May 10, 2018: Aging Cell
Braydon Connell, Jonathan J Oore, Joshua M Pahys, George H Thompson, Tricia St Hilaire, Tara Flynn, Ron El-Hawary
OBJECTIVE: To evaluate the radiographic results and complications of growth-friendly (GF) surgery in the treatment of early-onset scoliosis (EOS) associated with Goldenhar syndrome. BACKGROUND: Goldenhar syndrome has been associated with spinal deformity, which may be progressive. Efficacy and complication rate of GF treatment has not been reported for this population of patients with EOS. METHODS: Patients with Goldenhar syndrome and EOS with two years' follow-up were identified from two international multicenter EOS databases...
May 2018: Spine Deformity
Pooria Hosseini, Behrooz A Akbarnia, Stacie Nguyen, Jeff Pawelek, John Emans, Peter F Sturm, Paul D Sponseller
INTRODUCTION: In addition to patient characteristics, consideration of length of construct to number of anchored levels ratio and rod diameter should be a part of preoperative planning to minimize implant-related complications (IRCs). IRCs including rod breakage, anchor dislodgement, and pullout are among the most common adverse events in traditional growing rods (TGRs). The current study hypothesized that anchor type and configuration are associated with IRC. METHODS: Patients with (1) age ≤10 years at surgery; (2) spine-based dual TGR; (3) minimum 2-year follow-up; and (4) available imaging...
May 2018: Spine Deformity
Matthew E Oetgen, Allison Matthews, Yunfei Wang, Laurel Blakemore, Jeff Pawelek, Anna McClung, Paul Sponseller, Francisco Sanchez Perez-Grueso, Behrooz Akbarnia
STUDY DESIGN: Comparative cohort study. OBJECTIVE: To compare coronal deformity control, lengthening efficacy, and sagittal alignment between distraction-based growing rod constructs utilizing tandem versus wedding band connectors. SUMMARY OF BACKGROUND DATA: Different construct designs exist for growing rod treatment of early-onset scoliosis. All use a version of a rod connector, with the two main types being tandem and wedding band. Little data exist to quantify the impact of connector choice on radiographic outcomes of treatment...
May 2018: Spine Deformity
Nicholas Feinberg, Hiroko Matsumoto, Chun Wai Hung, Tricia St Hilaire, Jeff Pawelek, Jeffrey R Sawyer, Behrooz A Akbarnia, David L Skaggs, Benjamin D Roye, David P Roye, Michael G Vitale
STUDY DESIGN: Expert consensus building using combined Delphi method and Nominal group technique. OBJECTIVES: To identify the current state of equipoise surrounding the use of magnetically controlled growing rods (MCGRs) and to determine consensus for planning a randomized controlled trial (RCT) with MCGRs. BACKGROUND: The use of MCGRs for the treatment of early-onset scoliosis (EOS) is a new technology. Optimal use has not been thoroughly investigated and much uncertainty exists...
May 2018: Spine Deformity
Regina P Woon, Lindsay M Andras, Hilali Noordeen, Stephen Morris, John Hutchinson, Suken A Shah, Jeff Pawelek, Charles E Johnston, David L Skaggs
STUDY DESIGN: Surgeon survey. OBJECTIVES: To determine if magnetic resonance imaging (MRI) following implantation of magnetically controlled growing rods (MCGRs) is associated with any adverse events. SUMMARY OF BACKGROUND DATA: Magnetically controlled growing rods have been shown to reduce the need for repeated surgical procedures and improve costs when compared to traditional growing rods, but concerns about MRI compatibility exist. MRIs are often clinically indicated in the EOS population...
May 2018: Spine Deformity
Daniel S Yanni, Aurora S Cruz, Alexander Y Halim, Amandip S Gill, Michael G Muhonen, Robert F Heary, Ira M Goldstein
Pediatric spinal trauma can present a surgeon with difficult management decisions given the rarity of these cases, pediatric anatomy, and a growing spine. The need to stabilize a traumatically unstable pediatric spine can be an operative challenge given the lack of instrumentation available. The authors present a surgical technique and an illustrative case that may offer a novel, less disruptive method of stabilization. A 2-year-old girl presented after an assault with an L1-2 fracture subluxation with lateral listhesis and fractured jumped facets exhibited on CT scans...
May 4, 2018: Journal of Neurosurgery. Pediatrics
Dominik Saul, Klaus Dresing
Spinal injuries in children and adolescents are rare injuries, but consequences for the growing skeleton can be devastating. Knowledge of accident causes, clinical symptoms and diagnostics should be part of every trauma department treating these patients. We retrospectively analyzed patients with radiographically proven vertebral fractures of the spine. After clinical examination and tentative diagnosis the fractures and injuries were proven with conventional X-ray, computed tomography (CT) scans or magnetic resonance imaging (MRI)...
March 22, 2018: Pediatric Reports
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