Safety of Pedicle Screws in Adolescent Idiopathic Scoliosis Surgery.

Safety of Pedicle Screws in Adolescent Idiopathic Scoliosis Surgery. Asian Spine J. 2017 Dec;11(6):998-1007 Authors: Chan CYW, Kwan MK Abstract To review existing publications on the safety of pedicle screw insertions in adolescent idiopathic scoliosis (AIS). Despite having increased risk for neurological and visceral injuries, the use of pedicle screws have led to increased correction rates in scoliosis surgery. A review was performed on topics pertinent to pedicle screw insertion in AIS, which included pedicle morphometry in AIS, structures at risk during pedicle screw insertion, and accuracy and safety of various pedicle screw insertion techniques. The importance of computer navigation and future research regarding pedicle screw placement in AIS were also briefly reviewed. Many authors have reported abnormal pedicle anatomy in AIS. Injury to the neural structures was highest over the apical region, whereas aortic injury was the highest at T5 and T10. In the proximal thoracic spine, the esophagus could be injured even with screws as short as 25 mm. Overall pedicle perforation rates for perforations>0 and>2 mm (assessed by computed tomography) ranged from 6.4% to 65.0% and 3.7% to 29.9%, respectively. The critical pedicle perforation (>2 mm excluding lateral thoracic) and anterior perforation (>0 mm) rates was reported to range from 1.5% to 14.5% and 0.0% to 16.1%, respectively. Pedicle perforation rates were lower with the use of computer na...
Source: Asian Spine Journal - Category: Orthopaedics Tags: Asian Spine J Source Type: research

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Conclusion: PSP was effective for sacral insufficiency fractures and showed good long-term outcomes. Combined compression fractures in the thoracolumbar spine and degenerative lumbar pathologies could be possible poor outcome predictors. PMID: 32455518 [PubMed - as supplied by publisher]
Source: Journal of Korean Neurosurgical Society - Category: Neurosurgery Tags: J Korean Neurosurg Soc Source Type: research
Study Design. Prospective experimental study with on-site simulation. Objective. To compare the accuracy and efficiency of different techniques for pedicle screw instrumentation (PSI). Summary of Background Data. Improving the safety and efficiency of PSI is a critical step to reduce the complication rates and the cost of scoliosis surgery. Innovative operative techniques for PSI have shown to safely improve efficiency, thereby reducing cost. Surgical simulation is a valuable tool to study different operative techniques. Methods. Five spine fellows instrumented 20 simulation models of a scoliotic spine with 10 p...
Source: Spine - Category: Orthopaedics Tags: SURGERY Source Type: research
We report a case of double-level lumbar spondylolysis at L4 and L5 that was successfully treated with the double "smiley face" rod method. A healthy 29-year-old man who presented with a 6-year history of chronic low back pain was referred to us for surgical treatment. Plain radiographs and computed tomography of the lumbar spine revealed bilateral pars defects at L4 and L5 without slip or scoliosis. The patient underwent direct repair of the pars defects using the double smiley face rod method at L4 and L5. There were no intraoperative or postoperative complications, and the patient had improved clinically by 1 y...
Source: Journal of Medical Investigation - Category: General Medicine Tags: J Med Invest Source Type: research
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Source: Journal of Pediatric Orthopaedics - Category: Orthopaedics Tags: Scoliosis Source Type: research
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Source: Journal of Spinal Disorders and Techniques - Category: Surgery Tags: Primary Research Source Type: research
AbstractPurposeTo investigate airway development and airway resistance by computed tomographic three-dimensional (3D) reconstruction of the bronchial tree in patients with adolescent idiopathic scoliosis (AIS). We evaluated factors predicting postoperative respiratory complications to provide timely treatment, prevent complications, and improve operative and anesthetic safety.MethodsFrom August 2015 to August 2017, 53 AIS patients with a mean age of 15.4  years (range 10–20 years) were included in this study. Scoliotic parameters on radiographs were analyzed. Airway resistance was obtained by pulmonary func...
Source: European Spine Journal - Category: Orthopaedics Source Type: research
Publication date: Available online 13 March 2020Source: Journal of Clinical NeuroscienceAuthor(s): Masaaki Machino, Noriaki Kawakami, Tetsuya Ohara, Toshiki Saito, Ryoji Tauchi, Shiro Imagama
Source: Journal of Clinical Neuroscience - Category: Neuroscience Source Type: research
AbstractPurposeTo investigate whether the rotation of preoperative-presumed lowest instrumented vertebra (LIV) is a risk factor for adding-on (AO) in adolescent idiopathic scoliosis (AIS) treated with selective posterior thoracic fusion (sPTF).MethodsA total of 196 AIS patients of Lenke type 1A or 2A with minimum 2-year follow-up after sPTF with all pedicle screw instrumentation were included. Radiographical parameters were measured as follows: preoperative rotation angle of presumed LIV and LIV  + 1, LIV + 1/LIV rotation difference, postoperative rotation angle of LIV and LIV derotation angle o...
Source: European Spine Journal - Category: Orthopaedics Source Type: research
CONCLUSION: The results of this study showed that with appropriate experience freehand positioning of pedicle screws is associated with comparable accuracy and less radiation exposure for patients than navigation procedures. With respect to the young age of patients, a radiation-induced long-term risk for malignant diseases should be taken into consideration. PMID: 32112224 [PubMed - as supplied by publisher]
Source: Der Orthopade - Category: Orthopaedics Authors: Tags: Orthopade Source Type: research
Abstract OBJECTIVE: Achieving fusion at the lumbosacral junction poses many technical challenges. No data exist in the literature comparing radiographic or clinical outcomes between the different surgical techniques of transsacral fixation (TSF) with rods and transforaminal lumbar interbody fusion (TLIF) in conjunction with iliac fixation. The purpose of this study was to compare the clinical outcomes and radiographic fusions of TSF to TLIF in patients with adult spinal deformity undergoing long fusions across the lumbosacral junction. METHODS: Patients with primary adult spinal deformity who underwent long f...
Source: Journal of Neurosurgery.Spine - Category: Neurosurgery Authors: Tags: J Neurosurg Spine Source Type: research
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