The Role of Cross-Links in Posterior Spinal Fusion for Cerebral Palsy–Related Scoliosis

Conclusion. At 2 years after PSF to treat CP-related scoliosis, patients had no significant differences in the degree of correction achieved, the maintenance of correction, or the rate of complications between those whose fusion constructs used cross-links and those whose constructs did not. Level of Evidence: 3
Source: Spine - Category: Orthopaedics Tags: DEFORMITY Source Type: research

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This article provides insight into the various imaging techniques for these musculoskeletal issues and aids in better care for patients with cerebral palsy.
Source: Physical Medicine and Rehabilitation Clinics of North America - Category: Rehabilitation Authors: Source Type: research
We developed a novel device, dynamic spinal brace (DSB), with the basic concept of automatic correction by maximizing posture control. Herein, we report the structure of the DSB and preliminary treatment outcomes for scoliosis in patients with cerebral palsy. The study cohort comprised 219 patients with cerebral palsy treated for scoliosis with Cobb angle of at least 20° and follow-up of more than 3 years under the DSB. Cobb angle, trunk shift, and pelvic obliquity were assessed by semi-sitting radiography, and a questionnaire on daily lifestyle was collected. The immediate correction of these parameters by wearing DSB...
Source: Journal of Pediatric Orthopaedics B - Category: Orthopaedics Tags: CEREBRAL PALSY Source Type: research
Publication date: May 2019Source: Spine Deformity, Volume 7, Issue 3Author(s): Steven M. Hollenbeck, Burt Yaszay, Paul D. Sponseller, Carrie E. Bartley, Suken A. Shah, Jahangir Asghar, Mark F. Abel, Firoz Miyanji, Peter O. NewtonAbstractStudy DesignRetrospective review of prospective data.ObjectiveTo delineate a curve threshold where further delay of surgery significantly increased the risks for patients with cerebral palsy (CP) scoliosis.Summary of Background DataTwo approaches exist in the management of CP scoliosis: a proactive one where surgery is recommended once there is a risk of progression (Cobb> 50°) and a...
Source: Spine Deformity - Category: Orthopaedics Source Type: research
Publication date: March 2019Source: Spine Deformity, Volume 7, Issue 2Author(s): Subaraman Ramchandran, Stephen George, Jahangir Asghar, Harry ShufflebargerAbstractStudy DesignSingle-center retrospective study.ObjectiveTo analyze two-year postoperative outcomes following spinopelvic fixation in pediatric patients using the anatomic trajectory (AT) portal for iliac screws.SummaryIliac fixation is crucial in situations requiring fusion to sacrum. Challenges include complex anatomy, pelvic deformation, severe deformity, and previous surgery. The PSIS portal requires significant dissection, rod connectors, and complex bends. T...
Source: Spine Deformity - Category: Orthopaedics Source Type: research
Conclusion. Correction of pelvic obliquity for children with CP-related scoliosis was achieved postoperatively using unit rods, SAI screws, and iliac screws. Implant-related complications and reoperations were most common in the iliac screw group. At 5-year follow-up, the iliac screw group had loss of major curve correction and less correction of pelvic obliquity than the unit rod and SAI screw groups. Level of Evidence: 3
Source: Spine - Category: Orthopaedics Tags: DEFORMITY Source Type: research
ConclusionsMany of the methods tested had excellent reliability in this study, but our data suggest the Maloney method is the most reliable method of measuring pelvic obliquity on a frontal view radiograph.Level of EvidenceLevel III, retrospective, comparative study.
Source: Spine Deformity - Category: Orthopaedics Source Type: research
Conclusions: Both intraoperative traction and anterior surgery were used to aid correction in severe CP scoliosis. Anterior surgery did not offer superior correction or better HRQoL, and was associated with increased operative times, whereas intraoperative traction was associated with greater correction of POB. Intraoperative traction may be a viable alternative to an anterior release in severe CP scoliosis. Level of Evidence: Level II.
Source: Journal of Pediatric Orthopaedics - Category: Orthopaedics Tags: Cerebral Palsy Source Type: research
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 36.1±10.4 months (range, 20 to 65.6 months). Femoral VDRO and Dega transiliac osteotomy were performed in all cases. None of the patients were administ...
Source: Eklem Hastaliklari ve Cerrahisi - Category: Orthopaedics Tags: Eklem Hastalik Cerrahisi Source Type: research
t E Abstract Background and purpose - Surveillance of scoliosis in individuals with cerebral palsy (CP) is important for ensuring timely diagnosis and identification of curve progression. We analyzed the incidence of scoliosis in relation to age, sex, and gross motor function in a population-based cohort of individuals with CP. Patients and methods - This was a prospective register study of all 1,025 individuals born 1990-2012 in southern Sweden (1.4 million inhabitants) in the Swedish surveillance program for CP, which included>95% of the total population of people with CP in the area. Annual clinical examinat...
Source: Acta Orthopaedica - Category: Orthopaedics Authors: Tags: Acta Orthop Source Type: research
CONCLUSION: Many non-ambulant adults with cerebral palsy experience postural asymmetry associated with windswept hips, scoliosis, pelvic obliquity, and limb contracture. Options for non-radiographic monitoring of postural asymmetry should be identified, and conservative interventions formally were evaluated in this population. Implications for rehabilitation The common postural asymmetries of windswept hips, scoliosis, pelvic obliquity, and limb contracture require standardised clinical measurement. Radiography is most commonly used to monitor postural asymmetry in this population, but standardised positioning is not appli...
Source: Disability and Rehabilitation - Category: Rehabilitation Authors: Tags: Disabil Rehabil Source Type: research
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