Predictors of variability in the length of surgery of posterior instrumented arthrodesis in patients with adolescent idiopathic scoliosis
The most common corrective surgery for adolescent idiopathic scoliosis (AIS) is posterior instrumented spinal fusion, which is a relatively lengthy procedure. Longer procedures are known to have higher rates of negative outcomes and higher economic costs across the surgical specialties. The purpose of this study is to identify the factors that influence the length of this operation in AIS patients. This was an institutional review board-approved, retrospective cohort study. All primary posterior instrumented arthrodesis procedures in 2011–2013 performed by three surgeons on AIS patients at a tertiary care hospital were included. Age, race, sex, BMI, Cobb angle, curve flexibility, Lenke classification, number of levels fused, number of screws used, osteotomy use, intraoperative O-arm use, and length of surgery (time from incision to closure) were obtained from the electronic medical record. Multivariable linear regression analysis was used to determine independent predictors of length of surgery, and standardized regression coefficients were calculated to compare the relative magnitude of significant variables. A total of 95 procedures were included. The average length of surgery was 375±72.7 min. The multivariable linear regression analysis contained the variables Cobb angle, number of screws used, osteotomy use, Lenke curve type, surgeon, patient age, and sex. The regression identified the number of screws used [β=4.72, P=0.003, 95% confidence interv...
Conditions: Adult Spinal Deformity; Scoliosis; Kyphosis; Sagittal Imbalance Intervention: Procedure: Index or spine revision surgery for complex adult spinal deformity Sponsors: International Spine Study Group Foundation; Medtronic; Globus Medical Inc; SI-BONE, Inc. Recruiting
Conclusions: This is the first study that follows AIS patients treated with spine stapling to skeletal maturity. Staples likely changed natural history in some of our patients. Initial percentage of correction on first standing postoperative PA x-rays was the only predictor of success. Stapling was safe without any long-term complications. Level of Evidence: Level III—retrospective study.
Conclusions: Three-dimensional reconstruction of the rib cage using biplanar stereoradiography is a reliable method to estimate preoperative thoracic parameters in patients with AIS. Level of Evidence: Level IV—diagnostic study.
Conclusions: Our goals for NF-1 scoliosis are to obtain deformity correction, to achieve stable instrumentation by using longer fusion levels and to attain a solid fusion mass that can tolerate continual erosion during the long-term follow-up. We achieve this by using a circumferential approach for EOS associated with NF-1. Level of Evidence: Level IV—case series.
Conclusions: We developed consensus-based BPG for the use and implementation of HGT for pediatric spinal deformity. This can serve as a measure to help drive future research as well as give new surgeons a place to begin their practice of HGT. Level of Evidence: Level V—expert opinion.
Conclusions: In a large group of children treated for idiopathic EOS, we found a high prevalence of commonly associated conditions—hip dysplasia, torticollis, plagiocephaly, metatarsus adductus, and clubfoot. In 6.2% of our sample, a diagnosis of hip dysplasia was not made in a timely manner despite routine radiographic spine follow-up. With increasing subspecialization within pediatric orthopaedics, surgeons need to maintain vigilance in assessing the entire child. Level of Evidence: Level IV.
Authors: Ximena S Abstract Tetralogy of Fallot is the most common congenital heart malformation that produces cyanosis. It consists of four different defects of the heart: ventricular septal defect, pulmonary artery stenosis (blockage of blood flow from the right ventricle to the lungs), right ventricle hypertrophy and dextroposition of aorta. Echocardiography is essential in establishing the diagnosis of patients with cardiac malformation. Patients with Fallot tetralogy present a higher frequency of major non-cardiac congenital disorders. The association with congenital scoliosis influences vital and functional ov...
Conclusions. The TRACE ordinal scale has been converted into a Rasch-consistent, interval-level measure of trunk aesthetics in IS patients and can be used to compare different populations. Its main flaw is low reliability, likely because of the small number of items. TRACE can be used as an outcome measure and in everyday clinical evaluation of IS, even if new developments of the scale are advised.
Discussion/conclusionThe results suggest An asymmetrical vestibulomotor transformation in the adolescents with idiopathic scoliosis is suggested.
Progressive Early-Onset Scoliosis (EOS) in children may lead to surgical interventions with growth-friendly implants, which require repeated lengthening procedures in order to allow adequate growth. Quality of...