Influence of Distal Fusion Level on Sagittal Spinopelvic and Spinal Parameters in the Surgical Management of Adolescent Idiopathic Scoliosis.

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. The literature have lack of knowledge about spinopelvic changing after surgical treatment and the relation with distal fusion level. We evaluate the spinopelvic and pelvic parameter alteration after fusion surgery in treatment of AIS. Methods: A total of 100 patients with AIS (88 females and 12 males) were retrospectively reviewed. Patients were assigned into the following three groups according to the distal fusion level: lumbar 2 (L2), lumbar 3 (L3), and lumbar 4 (L4). Using a lateral plane radiograph of the whole spine, spinopelvic angular parameters such as thoracic kyphosis (TK), lumbar lordosis (LL), pelvic incidence (PI), sacral slope (SS), and pelvic tilt (PT) were radiologically assessed. Results: The mean age was 15±2.4 years, and the mean follow-up period was 24.27±11.69 months. Regarding the lowest instrumented vertebra, patients were categorized as follows: 30 patients in L2 (group 1), 40 patients in L3 (group 2), and 30 patients in L4 (group 3). TK decreased from 36.60±13.30 degrees preoperatively to 26.00&plu...
Source: Asian Spine Journal - Category: Orthopaedics Tags: Asian Spine J Source Type: research

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CONCLUSIONS: This predictive model formula for calculating the potential postoperative height gain after surgical treatment can be used preoperatively to inform idiopathic scoliosis patients of what outcomes they may expect from posterior spinal instrumentation and fusion (taking into account the model's uncertainty). PMID: 32470942 [PubMed - as supplied by publisher]
Source: Journal of Neurosurgery.Spine - Category: Neurosurgery Authors: Tags: J Neurosurg Spine Source Type: research
Authors: Kobayashi K, Ando K, Nakashima H, Machino M, Morozumi M, Kanbara S, Ito S, Inoue T, Yamaguchi H, Mishima K, Ishiguro N, Imagama S Abstract Study Design: Single-center retrospective study in pediatric patients. Purpose: The purpose of the study was to investigate the effects of the presence and severity of leg-length discrepancy (LLD) on scoliosis in children. Overview of Literature: LLD is a common orthopedic problem that can result in standing imbalance, low back pain, and stress fractures. It may cause structural changes in the spine over time, but the exact effect of LLD on scoliosis is unknown....
Source: Asian Spine Journal - Category: Orthopaedics Tags: Asian Spine J Source Type: research
ConclusionCurve progression can be predicted by the underlying vertebral abnormalities. However, it cannot predict cord and other organ-system anomalies. Thus, all patients with congenital scoliosis must undergo MRI of the spine, electro- and echocardiography and ultrasonography of the abdomen to detect occult abnormalities and optimize the patient prior to deformity correction.
Source: European Spine Journal - Category: Orthopaedics Source Type: research
Conclusions: Prophylactic neurosurgery may be beneficial for decreasing the risk of correction surgery in SMS patients with large syrinx (S/C ratio >0.7). After the intervention of syrinx prior to scoliosis correction, SMS patients with large syrinx could obtain similar clinical and radiographic outcomes of treatment with pedicle-screw-based spinal instrumentation and fusion compared to the patients with small syrinx.
Source: Neurology India - Category: Neurology Authors: Source Type: research
AbstractPurposeSurgical correction for AIS has evolved from all hooks to hybrids or all screw constructs. Limited literature exists reporting outcomes using PHDS for posterior spinal fusion (PSF). This is the largest  series in evaluating results of PHDS technique.MethodsA retrospective review of consecutive AIS patients undergoing PSF by a single surgeon between 2006 and 2015 was performed. All eligible patients met a minimum 2-year follow-up. Patient demographics and radiographical parameters (radiographic shoulder height (RSH), T1 tilt, clavicle angle) at baseline, 6-week and 2-year post-operation were recorded. Th...
Source: European Spine Journal - Category: Orthopaedics 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
Conclusion. Age>70 years, osteoporosis, and PJA greater 0° were identified as significant risk factors for PJF. Therefore, the TLJ level can be considered as UIV selectively for patients younger than 70 years without osteoporosis and with lordotic preoperative PJA. Level of Evidence: 3
Source: Spine - Category: Orthopaedics Tags: DEFORMITY Source Type: research
This study aimed to identify the risk factors for postoperative distal adding-on, including proximal radiographic parameters, in Lenke type 1 AIS. Preoperative and postoperative radiographs of 34 consecutive patients with Lenke type 1 curve who underwent selective thoracic fusion were analyzed. The patients were divided into an adding-on group and a no-adding-on group according to the presence of adding-on at a 2-year follow-up. The 2 groups were compared with regard to age at surgery, Lenke lumbar modifier, Risser grade, instrumentation type, and radiographic parameters. Distal adding-on was noted in 10 patients (29%). ...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research
ConclusionThe proposed classification model, the originality of which is the coupling of a CNN with discriminant analysis, can be used to automatically label radiographs for the presence of scoliosis treatment. This information is usually missing from DICOM metadata, so such method could facilitate the use of large databases. Furthermore, the same model architecture could potentially be applied for other radiograph classifications, such as sex and presence of scoliotic deformity.
Source: International Journal of Computer Assisted Radiology and Surgery - Category: Intensive Care Source Type: research
ConclusionWe found substantial clavicular growth potential after age 18  years, when growth is thought to be nearly finished, as well as remodeling potential even up to age 25 years. Further research is needed, but our findings suggest that strategies for managing clavicle fracture in adults may not be applied universally to adolescents and young adults.
Source: HSS Journal - Category: Orthopaedics Source Type: research
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