Surgical Outcomes of Anterior Versus Posterior Fusion in Lenke Type 1 Adolescent Idiopathic Scoliosis

Study Design. Retrospective study. Objective. To describe surgical results in two and three dimensions and patient-reported outcomes of scoliosis treatment for Lenke type 1 idiopathic curves with an open anterior or posterior approach. Summary of Background Data. Different surgical techniques have been described to prevent curve progression and to restore spinal alignment in idiopathic scoliosis. The spine can be accessed via an anterior or a posterior approach. However, the surgical outcomes, especially in three dimensions, for different surgical approaches remain unclear. Methods. Cohorts of Lenke curve type 1 idiopathic scoliosis patients, after anterior or posterior spinal fusion were recruited, to measure curve characteristics on conventional radiographs, before and after surgery and after 2 years follow-up, whereas the vertebral axial rotation, true mid-sagittal anterior–posterior height ratio of individual structures, and spinal height differences were measured on 3D reconstructions of the pre- and postoperative supine low-dose computed tomography (CT) scans. Additionally, the intraoperative parameters were described and the patients completed the Scoliosis Research Society outcomes and the 3-level version of EuroQol Group questionnaires postoperatively. Results. Fifty-three patients with Lenke curve type 1 idiopathic scoliosis (26 in the anterior cohort and 27 in the posterior cohort) were analyzed. Fewer vertebrae were instrumented in the anterior...
Source: Spine - Category: Orthopaedics Tags: DEFORMITY Source Type: research

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Study Design. A retrospective study. Objective. The purpose of this study was to evaluate the morphology of rib regeneration and to analyze the influence of demographics and curve characteristics on regeneration potential after thoracoplasty in the treatment of adolescent idiopathic scoliosis (AIS). Summary of Background Data. Studies on the physiological effects after thoracoplasty have been performed for several decades. However, rib cage anatomical regeneration patterns and reformation have been rarely studied. Methods. A total of 120 AIS patients who underwent thoracoplasty with deformity correction were inc...
Source: Spine - Category: Orthopaedics Tags: DEFORMITY Source Type: research
Adolescent idiopathic scoliosis (AIS) is a spinal deformity that can affect young children. It requires frequent exposure to X-rays to monitor the deformity, which can lead to the development of radiation-induced cancer later in life. The aim of this study is to test the accuracy of using scan projection radiography (SPR) in computed tomography (CT) scans for AIS assessment. This scanning mode delivers low radiation compared with conventional radiography.
Source: Radiography - Category: Radiology Authors: Source Type: research
Conclusion. A pedicle screw insertion at the T3 or T4 vertebra on the concave side is not always possible in cases of a structural proximal thoracic curve; however, the pedicle width of the T2 vertebra is very wide and safe for the standard pedicle screw insertion. These results should be considered when the surgeon decides the upper instrumented vertebra or the correction method for the structural proximal thoracic curve. Level of Evidence: 3
Source: Spine - Category: Orthopaedics Tags: DEFORMITY Source Type: research
Scoliosis is defined as a deformity of the spine with lateral curvature in the coronal plane. It requires regular X-ray imaging to monitor the progress of the disorder, therefore scoliotic patients are frequently exposed to radiation. It is important to lower the risk from these exposures for young patients. The aim of this work is to compare organ dose (OD) values resulting from Scan Projection Radiograph (SPR) mode in CT against projection radiography and EOS ® imaging system when assessing scoliosis.
Source: Radiography - Category: Radiology Authors: Source Type: research
Study Design. Cross-sectional study. Objective. To establish the relevance of the conventional two-dimensional (2D) rib vertebra angle difference (RVAD) and the relationship with the complex three-dimensional (3D) apical morphology in scoliosis. Summary of Background Data. The RVAD, also known as Mehta angle, describes apical rib asymmetry on conventional radiographs and was introduced as a prognostic factor for curve severity in early onset scoliosis, and later applied to other types of scoliosis as well. Methods. An existing idiopathic scoliosis database of high-resolution computed tomography scans used in pre...
Source: Spine - Category: Orthopaedics Tags: Deformity Source Type: research
CONCLUSIONS Temporary fixation to the occiput provides increased biomechanical stability for spinal stabilization in young children, without permanently eliminating motion and growth at the CVJ. This technique can be considered in children who require longer instrumentation constructs for temporary stabilization, but who only need fusion in more limited areas where spinal instability exists. PMID: 28965445 [PubMed - in process]
Source: Neurosurgical Focus - Category: Neurosurgery Authors: Tags: Neurosurg Focus Source Type: research
Abstract BACKGROUND: Describing the morphologic features of the thoracic pedicle in patients with adolescent idiopathic scoliosis is necessary for placement of pedicle screws. Previous studies showed inadequate reliability owing to small sample size and heterogeneity of the patients surveyed. QUESTIONS/PURPOSES: To use CT scans (1) to describe the morphologic features of 2718 thoracic pedicles from 60 female patients with Lenke Type 1 adolescent idiopathic scoliosis and 60 age-, sex-, and height-matched controls; and (2) to classify the pedicles in three types based on pedicle width and analyze the distributi...
Source: Clinical Orthopaedics and Related Research - Category: Orthopaedics Authors: Tags: Clin Orthop Relat Res Source Type: research
Conclusion Plain radiographs are widely used as screening tools for pediatric spondylolysis. CT scan is considered the gold standard but exposes the patient to a significant amount of ionizing radiation. Evidence is fair and promising that MRI is comparable to CT.
Source: Spine Deformity - Category: Orthopaedics Source Type: research
Conclusion Radiograph is a poor diagnostic modality for observing screw position. Level of Evidence Level IV.
Source: Spine Deformity - Category: Orthopaedics Source Type: research
Conclusion. Although uncommon, metallosis should be considered in the differential diagnosis of any late presenting case of pain, infection-like symptoms, or neurologic deficits after pediatric PSF. CT myelography and serum chromium levels may help guide diagnosis; however, surgical exploration is needed for definitive diagnosis and treatment. Level of Evidence: 4
Source: Spine - Category: Orthopaedics Tags: Case Report Source Type: research
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