The rotation of preoperative-presumed lowest instrumented vertebra: Is it a risk factor for distal adding-on in Lenke 1A/2A curve treated with selective thoracic fusion?

AbstractPurposeTo investigate whether the rotation of preoperative-presumed lowest instrumented vertebra (LIV) is a risk factor for adding-on (AO) in adolescent idiopathic scoliosis (AIS) treated with selective posterior thoracic fusion (sPTF).MethodsA total of 196 AIS patients of Lenke type 1A or 2A with minimum 2-year follow-up after sPTF with all pedicle screw instrumentation were included. Radiographical parameters were measured as follows: preoperative rotation angle of presumed LIV and LIV  + 1, LIV + 1/LIV rotation difference, postoperative rotation angle of LIV and LIV derotation angle on CT scans. Patients were classified into AO group and non-AO group during the follow-up. The parameters were compared between the two groups to investigate risk factors for AO.ResultsAmong 196 patients, 40 (20.4%) patients developed with AO at the final follow-up. Compared with non-AO group, patients with AO had significantly larger preoperative rotation angle of presumed LIV (8.8 ° ± 3.4° vs. 3.4° ± 2.9°,P 
Source: European Spine Journal - Category: Orthopaedics Source Type: research

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Publication date: Available online 13 March 2020Source: Journal of Clinical NeuroscienceAuthor(s): Masaaki Machino, Noriaki Kawakami, Tetsuya Ohara, Toshiki Saito, Ryoji Tauchi, Shiro Imagama
Source: Journal of Clinical Neuroscience - Category: Neuroscience Source Type: research
Abstract OBJECTIVE: Achieving fusion at the lumbosacral junction poses many technical challenges. No data exist in the literature comparing radiographic or clinical outcomes between the different surgical techniques of transsacral fixation (TSF) with rods and transforaminal lumbar interbody fusion (TLIF) in conjunction with iliac fixation. The purpose of this study was to compare the clinical outcomes and radiographic fusions of TSF to TLIF in patients with adult spinal deformity undergoing long fusions across the lumbosacral junction. METHODS: Patients with primary adult spinal deformity who underwent long f...
Source: Journal of Neurosurgery.Spine - Category: Neurosurgery Authors: Tags: J Neurosurg Spine Source Type: research
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
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
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
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