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Scoliosis surgery

Alpesh A Patel, Shah-Nawaz M Dodwad, Barrett S Boody, Surabhi Bhatt, Jason W Savage, Wellington K Hsu, Nan E Rothrock
STUDY DESIGN: Prospective, cohort study. OBJECTIVE: Demonstrate validity of PROMIS physical function, pain interference, and pain behavior computer adaptive tests (CATs) in surgically treated lumbar stenosis patients. SUMMARY OF BACKGROUND DATA: There has been increasing attention given to patient reported outcomes associated with spinal interventions. Historical patient outcome measures have inadequate validation, demonstrate floor/ceiling effects, and infrequently used due to time constraints...
March 19, 2018: Spine
George H Thompson, Connie Poe-Kochert, Christina K Hardesty, Jochen Son-Hing, R Justin Mistovich
BACKGROUND: Vancomycin powder has been demonstrated to be safe in children, and yet there are no data on its use to reduce surgical site infections (SSIs) in surgery for early-onset scoliosis. METHODS: We performed a retrospective study of our patients treated for early-onset scoliosis in the period of 2010 to 2016. In 2010, we updated our standardized perioperative growing spine care path. The only later change was the gradual introduction of intrawound vancomycin powder...
March 21, 2018: Journal of Bone and Joint Surgery. American Volume
C Ranieri, S Di Tommaso, D C Loconte, V Grossi, P Sanese, R Bagnulo, F C Susca, G Forte, A Peserico, A De Luisi, A Bartuli, A Selicorni, D Melis, M Lerone, A D Praticò, G Abbadessa, Y Yu, B Schwartz, Martino Ruggieri, Cristiano Simone, Nicoletta Resta
Postzygotic mutations of the PIK3CA [phosphatidylinositol-4,5-bisphosphate 3-kinase catalytic subunit alpha] gene constitutively activate the PI3K/AKT/mTOR pathway in PIK3CA-related overgrowth spectrum (PROS) patients, causing congenital mosaic tissue overgrowth that even multiple surgeries cannot solve. mTOR inhibitors are empirically tested and given for compassionate use in these patients. PROS patients could be ideal candidates for enrolment in trials with PI3K/AKT pathway inhibitors, considering the "clean" cellular setting in which a unique driver, a PIK3CA mutation, is present...
March 16, 2018: Neurogenetics
Brian C Goh, Amit Jain, Paul D Sponseller
CASE: A 12-year-old girl with osteogenesis imperfecta (OI) underwent posterior spinal arthrodesis (from T2 to the sacrum) for double major-curve scoliosis. She developed complete paralysis of all of the extremities 24 hours after surgery, without evidence of ischemia or infarction. The rods were removed, and the neurologic status improved; there was full restoration of strength within 1 week. She then underwent in situ fixation. At the 2-year follow-up, there had been no lapse in neurologic function...
March 14, 2018: JBJS Case Connector
X Sun, L Xu, Z H Chen, X Chen, C Z Du, S Li, Z Liu, B P Qian, B Wang, Z Z Zhu, Y Qiu
Objective: To evaluate the correction result of traditional dual growing rods on apical vertebral rotation. Methods: This study recruited 19 early-onset scoliosis patients (6 boys and 13 girls) who had received traditional dual growing rods treatment at Department of Spine Surgery, Nanjing Drum Tower Hospital from January 2009 to July 2015. The age at initial surgery was (5.7±1.7)years(range, 3 to 9 years). Measurements of primary curve magnitude, height of T(1)-S(1), apical vertebral translation(AVR), apical vertebral body-rib ratio, apical vertebral rotation, thoracic rotation and rib hump were compared between pre-operatively, post-operatively, and at latest follow-up, through a paired- t test...
March 1, 2018: Zhonghua Wai Ke za Zhi [Chinese Journal of 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
Byoung Hun Lee, Seung-Jae Hyun, Ki-Jeong Kim, Tae-Ahn Jahng, Yongjung J Kim, Hyun-Jib Kim
OBJECTIVE: The aim of this study was to investigate clinical and radiological outcomes of patients who underwent posterior vertebral column resection (PVCR) by a single neurosurgeon in a single institution. METHODS: Thirty-four consecutive patients with severe spinal deformities who underwent PVCR between 2010 and 2016 were enrolled. The radiographic measurements included a kyphotic angle of PVCR levels (VCR angle), sagittal vertical axis (SVA), thoracic kyphosis, lumbar lordosis (LL), and spinopelvic parameters...
March 2018: Journal of Korean Neurosurgical Society
Taylor J Jackson, Burt Yaszay, Joshua M Pahys, Anuj Singla, Firoz Miyanji, Suken A Shah, Paul D Sponseller, Peter O Newton, John M Flynn, Patrick J Cahill
BACKGROUND: For large scoliosis, 2 strategies to maximize correction include intraoperative traction and/or anterior release. It is unclear which patients will benefit the most form either approach. The purpose of our study is to compare the radiographic, perioperative clinical outcomes, and health-related quality of life (HRQoL) outcomes of 2 approaches when used in severe neuromuscular scoliosis in the setting of cerebral palsy (CP). METHODS: In total, 23 patients with minimum 2-year follow-up, major curves ≥100 degrees, and in whom treatment included posterior spinal fusion were evaluated...
March 8, 2018: Journal of Pediatric Orthopedics
Keila M Maher, Kwadwo Owusu-Akyaw, Jingzhu Zhou, Mary Cooter, Allison K Ross, Robert K Lark, Brad M Taicher
INTRODUCTION: Surgical correction of pediatric scoliosis is associated with significant blood loss. Minimizing estimated blood loss and blood transfusion is beneficial as transfusions have been associated with increased morbidity, including risk of surgical site infections, longer hospitalizations, and increased cost. Although there is evidence that African-American or Black adults are more likely to require intraoperative blood transfusion compared with Caucasian or White adults, the reasons for this difference are unclear...
March 9, 2018: Paediatric Anaesthesia
Angelo G Aulisa, Vincenzo Guzzanti, Francesco Falciglia, Marco Giordano, Marco Galli, Lorenzo Aulisa
BACKGROUND: The recent literature showed positive results for bracing of patients with idiopathic scoliosis above 45° who refused surgery. However, no one has investigated whether other parameters can affect the results. AIM: The aim of this study was to evaluate the effectiveness of bracing in idiopathic scoliosis with curves above 40° and to verify the mechanical and biological parameters which go beyond the simple bend value expressed in Cobb degrees. DESIGN: This is an observational controlled cohort study nested in a prospective clinical on-going database including 1,238 patients with idiopathic scoliosis...
March 7, 2018: European Journal of Physical and Rehabilitation Medicine
Shunan Liu, Yuancheng Zhang, Hongda Bao, Peng Yan, Zezhang Zhu, Zhen Liu, Bangping Qian, Yong Qiu
BACKGROUND: A proper restoration of sagittal alignment is essential in AIS patients, but few studies provided a formula to predict an optimal surgical thoracic kyphosis (TK) gain in adolescent idiopathic scoliosis (AIS) patients. A formula was recently proposed (LL = (PI+TK)/2 + 10) to predict the optimal lumbar lordosis (LL) in adult spinal deformity patients, which has not been validated in adolescents. The aim of this study is to establish a formula with TK and pelvic parameters in normal adolescents and predict an optimal TK with this formula pre- and post-operatively in Lenke 1 AIS patients...
March 7, 2018: BMC Musculoskeletal Disorders
Xianda Gao, Linfeng Wang, Jingtao Zhang, Peng Wang, Yong Shen
STUDY DESIGN: This is retrospective study. OBJECTIVE: Our purpose is to examine the state of the L5-S1 disk after long fusion arthrodesis stopping at L5 in adult scoliosis, and to identify the risk factors for disk degeneration. SUMMARY OF BACKGROUND DATA: The long fusion arthrodesis surgery for adult scoliosis has shown to have good clinical results. However, there is still some controversy with reference to the potential caudal extents of the fusion, that is, L5 or S1...
March 2, 2018: Clinical Spine Surgery
Turgut Akgül, Kerim Sarıyılmaz, Murat Korkmaz, Okan Özkunt, Özcan Kaya, Fatih Dikici
Study Design: Retrospective analysis of adolescent idiopathic scoliosis. Purpose: This study aimed to investigate the influence of distinct distal fusion levels on spinopelvic parameters in patients with adolescent idiopathic scoliosis (AIS) who underwent posterior instrumentation and fusion surgery. Overview of Literature: The distal fusion level selection in treatment of AIS is the one of milestone to effect on surgical outcome. Most of the paper focused on the coronal deformity correction and balance...
February 2018: Asian Spine Journal
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
Thamrong Lertudomphonwanit, Michael P Kelly, Keith H Bridwell, Lawrence G Lenke, Steven J McAnany, Prachya Punyarat, Timothy P Bryan, Jacob M Buchowski, Lukas P Zebala, Brenda A Sides, Karen Steger-May, Munish C Gupta
BACKGROUND CONTEXT: Risk factors associated with rod fracture (RF) following adult spinal deformity (ASD) surgery fused to the sacrum remain debatable and the impact of RF on patient-reported outcomes (PROs) after ASD surgery has not been investigated. PURPOSE: To evaluate the prevalence of and risk factors for RF and determine PROs change associated with RF after ASD surgery fused to the sacrum. STUDY DESIGN/SETTING: Retrospective single-center cohort...
February 28, 2018: Spine Journal: Official Journal of the North American Spine Society
Matthew E Oetgen
Evidence-based medicine (EBM) is a process of decision-making aimed at making the best clinical decisions as they relate to patients' health. The current use of EBM in pediatric spine surgery is varied, based mainly on the availability of high-quality data. The use of EBM is limited in idiopathic scoliosis, whereas EBM has been used to investigate the treatment of pediatric spondylolysis. Studies on early onset scoliosis are of low quality, making EBM difficult in this condition. Future focus and commitment to study quality in pediatric spinal surgery will likely increase the role of EBM in these conditions...
April 2018: Orthopedic Clinics of North America
Gregory W Poorman, Peter G Passias, Rabia Qureshi, Hamid Hassanzadeh, Samantha Horn, Cole Bortz, Frank Segreto, Amit Jain, Michael Kelly, Richard Hostin, Christopher Ames, Justin Smith, Virginie LaFage, Douglas Burton, Shay Bess, Chris Shaffrey, Frank Schwab, Munish Gupta
OBJECT: Cost-utility analysis, a special case of cost-effectiveness analysis, estimates the ratio between the cost of an intervention to the benefit it produces in number of quality-adjusted life years. Cervical deformity correction has not been evaluated in terms of cost-utility and in the context of value-based health care. Our objective, therefore, was to determine the cost-utility ratio of cervical deformity correction. METHODS: Retrospective review of a prospective, multicenter cervical deformity database...
February 27, 2018: Spine Journal: Official Journal of the North American Spine Society
Jérémy Allia, Jean-Luc Clément, Virginie Rampal, Béatrice Leloutre, Olivier Rosello, Federico Solla
STUDY DESIGN: Monocentric study comparing results of simultaneous translation on 2 rods (ST2R) with derotation connectors (prospective series) or without derotation connectors (retrospective series) in Adolescent Idiopathic Scoliosis (AIS) surgery. OBJECTIVE: The objective of this study was to assess if derotation connectors influence axial, coronal, and sagittal results in AIS surgery. SUMMARY OF BACKGROUND DATA: Conventional reduction techniques remain limited in their ability to reduce axial torsion...
February 28, 2018: Clinical Spine Surgery
Prashanth J Rao, Christine Chau, Kevin Phan, Ralph J Mobbs
OBJECTIVE: The role of bacterial infection in the causation of disc degeneration and its consequences is controversial. The current evidence is limited to underpowered studies, with the majority of such studies having only an internal contaminant arm, and only one study having a control arm with a non-degenerate disc population. The Degenerate-disc Infection Study with Contaminant Control (DISC) study includes a control arm and an internal contaminant control to resolve these shortcomings...
February 2018: Orthopaedic Surgery
Shoji Seki, Yasuhito Yahara, Hiroto Makino, Yoshiharu Kawaguchi, Tomoatsu Kimura
BACKGROUND: Ponte osteotomy is a useful method in posterior spinal release. However, it is unclear whether Ponte osteotomy itself contributes to vertebral derotation in surgery for adolescent idiopathic scoliosis (AIS) patients compared to inferior facetectomy alone. This study aimed to assess the effect of Ponte osteotomy on the magnitude of periapical vertebral body rotation compared to inferior facetectomy alone. This study was a prospective collected data. METHODS: The study included 63 patients with AIS (Thoracic curve type, 35; thoracolumbar/lumbar curve type, 27), who underwent surgery between August 2011 and January 2015...
February 22, 2018: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
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