Predicting the Natural Course of Hemivertebra in Early Childhood: Clinical Significance of Anteroposterior Discordance Based on Three-dimensional Analysis

Study Design. A retrospective cohort, radiographic study. Objective. The aim of this study was to compare the progression of scoliosis owing to single hemivertebra (HV) during early childhood, according to the anteroposterior discordance obtained from the three-dimensional computed tomography (3D-CT) studies. Summary of Background Data. Previous studies have utilized 3D-CT for the classification of congenital spinal deformities and have introduced the concept of two types of deformity: unison and discordant anomalies. However, there have been no further studies on the clinical significance of these discordant deformities, especially in the identification of deformities that will progress and require an operation. Methods. We retrospectively analyzed 97 cases of single HV with thoracolumbar scoliosis, diagnosed in children before the age of 3 years and followed up past the age of 6 years. The segmentation of the anterior and posterior components, and anteroposterior discordance of the HV were evaluated using 3D-CT images. Coronal segmental curve angle (SCA) and balance were measured using whole spine plain radiographs. Results. Using 3D-CT, 41 (42.3%) cases of unison HV and 56 (57.7%) discordant HV were identified. Unison HV comprised 21 (21.6%) cases of fully segmented (FS) unison HV and 20 (20.6%) cases of semi-segmented unison HV with corresponding anterior and posterior segmentation. Fifty-six cases of discordant HV were further classified into 4 different ty...
Source: Spine - Category: Orthopaedics Tags: DEFORMITY Source Type: research

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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.
Source: Journal of Pediatric Orthopaedics - Category: Orthopaedics Tags: Scoliosis 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
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...
Source: Spine - Category: Orthopaedics Tags: DEFORMITY Source Type: research
This study aimed to identify factors associated with decreased LV after PSF in AIS patients.MethodsWe retrospectively reviewed 111 consecutive AIS patients who were between 10 and 20  years of age and were treated by PSF at our facility. We assessed age at surgery, sex, height, body weight, Risser stage, Lenke classification, radiographic parameters, pulmonary function tests, and LV. Factors associated with a postoperative decrease in LV were identified by multivariable analysi s.ResultsThe mean total LV had increased at the 2-year follow-up, although marginally significant (p = .06), and there was a sig...
Source: European Spine Journal - Category: Orthopaedics 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
Authors: Balikci T, Kıyak G, Heydar AM, Bawaneh MK, Bezer M Abstract Study Design: Prospective analysis of collected data. Purpose: We determine the need for the use of mid-length pedicle screws (screws with 2.5-mm long increments) during posterior spinal instrumentation. Overview of Literature: Many biomechanical studies have been performed showing that increasing the pedicle screw insertion depth provides an improved resistance to pullout, cyclic loading, and derotational forces, but no intermediate length screws were used. Methods: We prospectively evaluated 120 patients who received posterior segme...
Source: Asian Spine Journal - Category: Orthopaedics Tags: Asian Spine J 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
This study aimed to compare the performance of dual-energy X-ray absorptiometry (DXA) and quantitative computed tomography (QCT) in evaluating bone mineral density (BMD) of patients with Duchenne muscular dystrophy and scoliosis. Methodology: Twenty-nine participants (mean age 19.72 ± 6.13 years) underwent whole spine radiography, DXA before and after traction, and QCT alone without traction. Scoliosis and vertebral rotation angles obtained before and after traction were compared, and BMD values from DXA were compared to those obtained via QCT.
Source: Journal of Clinical Densitometry - Category: Radiology Authors: Source Type: research
ConclusionLenke type 5 curves show a significantly higher PI than controls, whereas the Lenke type 1 curves did not differ from controls. This suggests a role of pelvic morphology and spino-pelvic alignment in the pathogenesis of idiopathic scoliosis. Further longitudinal studies should explore the exact role of the PI in the initiation and progression of different AIS types.Graphical abstract These slides can be retrieved under Electronic Supplementary Material.
Source: European Spine Journal - Category: Orthopaedics Source Type: research
Conclusions: In patients with proximal anchor failure of GR, especially if there is increase of coronal deformity and/or PJA, possible spinal encroachment should be kept in mind. Level of Evidence: Level IV—retrospective case series.
Source: Journal of Pediatric Orthopaedics - Category: Orthopaedics Tags: Scoliosis/Kyphosis Source Type: research
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