Patient-reported Outcomes Following Surgical Intervention for Adolescent Idiopathic Scoliosis: A Systematic Review and Meta-Analysis

Conclusions: Moderate evidence suggests that spinal fusion improves quality of life for adolescents with idiopathic scoliosis in medium and long-term follow-up. Our results may help inform patient expectations regarding surgery. OCEMB Level of Evidence: Level I—systematic review and meta-analysis of prospective studies.
Source: Journal of Spinal Disorders and Techniques - Category: Surgery Tags: Systematic Review Source Type: research

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AbstractPurposeThree-column osteotomies at L5 or the sacrum (LS3COs) are technically challenging, yet they may be needed to treat lumbosacral kyphotic deformities. We investigated radiographic and clinical outcomes after LS3CO.MethodsWe analyzed 25 consecutive patients (mean age 56  years) who underwent LS3CO with minimum 2-year follow-up. Standing radiographs and health-related quality-of-life scores were evaluated. A new radiographic parameter [“lumbosacral angle” (LSA)] was introduced to evaluate sagittal alignment distal to the S1 segment.ResultsFrom preoperatively to the final follow-up, significant i...
Source: European Spine Journal - Category: Orthopaedics Source Type: research
We describe a comprehensive, multidisciplinary treatment approach for lumbar vertebral hemangiomas (VHs) with spinal stenosis and radiculopathy. A 59-year-old female presented with 1 year of pain predominantly in the lower back, with pain in the left buttock and proximal left anterior thigh as well and magnetic resonance imaging of the lumbar spine demonstrated lumbar scoliosis and an L3 vertebral lesion suspicious for hemangioma. A computed tomography guided biopsy was done, which supported the diagnosis. Definitive treatment entailed preoperative angiography and embolization, followed by L3 laminectomy, right L3 pedicle ...
Source: Journal of Craniovertebral Junction and Spine - Category: Orthopaedics Authors: Source Type: research
Conclusions: Our evidence suggests that the L5-KAL can serve as an indicator of the thoracic curve change in Scheuermann's disease and postural kyphosis patients and should be considered in clinical practice. PMID: 31940713 [PubMed - as supplied by publisher]
Source: Asian Spine Journal - Category: Orthopaedics Tags: Asian Spine J Source Type: research
Study Design. Retrospective review of a prospectively collected database. Objective. To define a simplified singular measure of cervical deformity (CD), C2 slope (C2S), which correlates with postoperative outcomes. Summary of Background Data. Sagittal malalignment of the cervical spine, defined by the cervical sagittal vertical axis (cSVA) has been associated with poor outcomes following surgical correction of the deformity. There has been a proliferation of parameters to describe CD. This added complexity can lead to confusion in classifying, treating, and assessing outcomes of CD surgery. Methods. A prospectiv...
Source: Spine - Category: Orthopaedics Tags: DIAGNOSTICS Source Type: research
ConclusionOur meta-analysis suggested that long fusion terminating at L5 or the sacrum was similar in scoliosis correction, overall complication rate, revision rate, and improvement in pain and disability. However, fusion to L5 had advantages in lower rate of pseudarthrosis, implant-related complications, and proximal adjacent segment disease, while fusion to the sacrum had advantages in the restoration of lumbar lordosis, maintenance of sagittal balance, and absence of distal adjacent segment disease.Graphic abstractThese slides can be retrieved under Electronic Supplementary Material.
Source: European Spine Journal - Category: Orthopaedics Source Type: research
This study sought to define the range of PROMIS mobility, pain interference, and peer relationships scores for adolescents treated for AIS. Furthermore, correlations between these domains and equivalent domains in the legacy PRO, SRS-22, were determined. Methods. Pediatric PROMIS and SRS-22 were obtained at routine clinical visits for AIS at a tertiary care children's hospital from January 2017 to October 2017. Spearman correlations were performed to examine the associations between three pediatric PROMIS domains and the SRS-22 domains. Only patients who completed both PRO measures were included in the analyses. Radiogr...
Source: Spine - Category: Orthopaedics Tags: DEFORMITY Source Type: research
CONCLUSIONS: This study further refines the generally accepted LL = PI + 10° by showing that patients under the age of 50 years should have more LL compared to PI, whereas after the 5th decade the relationship is reversed. SVA was not as sensitive across age groups, exhibiting a marked increase only in the 7th decade of life. Given the reliable increase of CL with age, and the stability of T1 slope/CL, this represents another important relationship that should be maintained when performing cervical deformity/fusion surgery. This study has important implications for evaluating adult patients with spinal deformities and ...
Source: Journal of Neurosurgery.Spine - Category: Neurosurgery Authors: Tags: J Neurosurg Spine Source Type: research
This study examined for factors contributing to postoperative pain in adolescent idiopathic scoliosis (AIS), including those of sagittal alignment and lumbar disc degeneration.MethodsA total of 101 consecutive patients who underwent posterior spinal fusion for AIS and who were followed for a minimum of 2  years were included in this investigation. We assessed Lenke curve type, age, Risser grade, body mass index (BMI), radiographic parameters, lumbar disc degeneration, correction rate, number of fused vertebrae, lowest instrumented vertebra, preoperative SRS-22r survey mental health score, and pre- and postoperative SR...
Source: European Spine Journal - Category: Orthopaedics Source Type: research
ConclusionResults of the current study demonstrated that thoracoplasty associated with posteromedial translation technique did not alter PFT results at two years postoperation. The morbidity of the procedure is limited, and it can therefore be considered in patients with high cosmetic demand and significant residual rib hump after main curve correction. However, hump height and pain evaluation would be interesting data in a prospective study.Level of EvidenceLevel IV.
Source: Spine Deformity - Category: Orthopaedics Source Type: research
Lumbar lateral listhesis has been found to be associated with radicular leg pain in adult scoliosis. This relationship, however, has yet to be specified by making a simple grading/classification system of lateral listhesis that stratifies the risk of leg pain. Such a classification could better alert surgeons of potential involvement of nerve impingement early in the evaluation, especially in such emerging settings as “telehealth" wherein history inquiry and image review may take place separately.
Source: The Spine Journal - Category: Orthopaedics Authors: Source Type: research
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