Letter to the Editor: Celiac Artery Syndrome After Correction of Kyphoscoliosis
Publication date: September 2019Source: Spine Deformity, Volume 7, Issue 5Author(s): Devan D. Patel, Steven F. DeFroda, Alan H. Daniels (Source: Spine Deformity)
Source: Spine Deformity - September 6, 2019 Category: Orthopaedics Source Type: research

Editorial Board
Publication date: September 2019Source: Spine Deformity, Volume 7, Issue 5Author(s): (Source: Spine Deformity)
Source: Spine Deformity - September 6, 2019 Category: Orthopaedics Source Type: research

Instructions for Authors
Publication date: September 2019Source: Spine Deformity, Volume 7, Issue 5Author(s): (Source: Spine Deformity)
Source: Spine Deformity - September 6, 2019 Category: Orthopaedics Source Type: research

Table of Contents (continued)
Publication date: September 2019Source: Spine Deformity, Volume 7, Issue 5Author(s): (Source: Spine Deformity)
Source: Spine Deformity - September 6, 2019 Category: Orthopaedics Source Type: research

Patient Safety in Spinal Deformity Surgery: The Development of Standard Work Protocols, Moral Hazard in Decision Making, and the Need for Prospective Validation and Protocol Adoption
Publication date: September 2019Source: Spine Deformity, Volume 7, Issue 5Author(s): Sig Berven (Source: Spine Deformity)
Source: Spine Deformity - September 6, 2019 Category: Orthopaedics Source Type: research

Denis Sise Drummond, MD, FRS(C) (1934–2019)
Publication date: September 2019Source: Spine Deformity, Volume 7, Issue 5Author(s): (Source: Spine Deformity)
Source: Spine Deformity - September 6, 2019 Category: Orthopaedics Source Type: research

State-of-the-Art Reviews: Safety in Complex Spine Surgery
Publication date: September 2019Source: Spine Deformity, Volume 7, Issue 5Author(s): Rajiv Sethi, Michael Bohl, Michael VitaleAbstractThe surgical correction of spinal deformities carries a high risk of perioperative morbidity. As the incidence of debilitating spinal deformities continues to increase, so too does our obligation to search for ways to enhance safety in our delivery of surgical care. Standardized work processes and other lean manufacturing methodologies have the potential to improve efficiency, safety, and hence value in our delivery of surgical care to patients with complex spine pathologies by reducing vari...
Source: Spine Deformity - September 6, 2019 Category: Orthopaedics Source Type: research

The Role of Potentially Modifiable Factors in a Standard Work Protocol to Decrease Complications in Adult Spinal Deformity Surgery: A Systematic Review, Part 1
ConclusionPreoperative hemoglobin, bone density, body mass index, preoperative albumin/prealbumin, and smoking status all are potentially modifiable risk factors that are associated with increased complications in the adult spine surgery population. Developing a Standard Work Protocol for patient evaluation and optimization should include these factors.Level of EvidenceLevel II. (Source: Spine Deformity)
Source: Spine Deformity - September 6, 2019 Category: Orthopaedics Source Type: research

The Role of Potentially Modifiable Factors in a Standard Work Protocol to Decrease Complications in Adult Spinal Deformity Surgery: A Systematic Review, Part 2
ConclusionGaps in the existing literature limit our ability to evaluate if all of the patient and surgical factors selected for this review are associated with increased or decreased complications and reoperations in ASD surgery. However, for both intraoperative TXA usage and optimized intraoperative fluid management that were supported by good evidence, developing Standard Work Protocols may optimize care.Level of EvidenceLevel II. (Source: Spine Deformity)
Source: Spine Deformity - September 6, 2019 Category: Orthopaedics Source Type: research

Local Application of Vancomycin in Spine Surgery Does Not Result in Increased Vancomycin-Resistant Bacteria—10-Year Data
ConclusionsTopical vancomycin within the surgical site is not correlated with vancomycin-resistant bacteria. However, there was an increased incidence of gram-negative organisms in infections after vancomycin application in the wound versus no vancomycin. Continued surveillance with prospectively collected randomized data is necessary to better understand bacterial evolution against current antimicrobial techniques.Level of EvidenceLevel III. (Source: Spine Deformity)
Source: Spine Deformity - September 6, 2019 Category: Orthopaedics Source Type: research

Operating Room Personnel Determine Efficiency of Pediatric Spinal Fusions for Scoliosis
ConclusionsAnesthesiologists have a significant effect before and surgeons have a significant effect after entry into the OR. Identification of this variability provides an opportunity to study the differences in habits and processes of high- and low-efficiency teams, which can then be applied to all teams with the goal of improving performance of all surgical teams.Level of EvidenceLevel IV, case series. (Source: Spine Deformity)
Source: Spine Deformity - September 6, 2019 Category: Orthopaedics Source Type: research

Timing of Complications After Posterior Spinal Fusions in Pediatric Spine Deformity
ConclusionUnderstanding the timing of complications is important for patients and providers, as it reflects the need of heightened awareness and low thresholds of testing during periods of highest risks to catch complications, launch appropriate optimization protocols, and minimize the cost burden associated with readmissions.Level of EvidenceLevel IV. (Source: Spine Deformity)
Source: Spine Deformity - September 6, 2019 Category: Orthopaedics Source Type: research

Treatment of Idiopathic Scoliosis With Vertebral Body Stapling
ConclusionsAlthough early outcomes after VBS appear to parallel the results of bracing, stapling does not affect the percentage of patients ultimately requiring PSIF. Initial curve correction degraded over time in younger patients with significant growth remaining, and high rates of progression in this group, even with bracing, merits investigation into more efficacious treatment strategies.Level of EvidenceLevel III. (Source: Spine Deformity)
Source: Spine Deformity - September 6, 2019 Category: Orthopaedics Source Type: research

A Comparison of Maximal Voluntary Ventilation and Forced Vital Capacity in Adolescent Idiopathic Scoliosis Patients
Publication date: September 2019Source: Spine Deformity, Volume 7, Issue 5Author(s): Gabriela A. Villamor, Lindsay M. Andras, Greg Redding, Priscella Chan, Joshua Yang, David L. SkaggsAbstractStudy DesignProspective, single center.ObjectiveTo compare maximal voluntary ventilation (MVV) and forced vital capacity (FVC) testing in the outpatient scoliosis clinic to determine their relative feasibility and sensitivity in assessing pulmonary function in the AIS population.Summary of Background DataEvidence of compromised pulmonary function in patients with severe AIS is well established. The American Thoracic Society (ATS) has ...
Source: Spine Deformity - September 6, 2019 Category: Orthopaedics Source Type: research

The Effect of Expansion Thoracostomy on Spine Growth in Patients with Spinal Deformity and Fused Ribs Treated with Rib-Based Growing Constructs
ConclusionsPatients who underwent expansion thoracostomy at the time of rib expansion device implantation achieved greater improvement in T1–S1 height than those who underwent implantation of rib expansion device alone. Further work is needed to evaluate whether expansion thoracostomy impacts pulmonary function. (Source: Spine Deformity)
Source: Spine Deformity - September 6, 2019 Category: Orthopaedics Source Type: research

Body Image Disturbance Improvement After Operative Correction of Adolescent Idiopathic Scoliosis
This study was conducted to evaluate responsiveness to change in the BIDQ-S associated with surgical treatment of AIS two years postoperatively to complete the validation of this questionnaire.MethodsSeventy-five consecutive operative AIS patients were enrolled and completed BIDQ-S and Scoliosis Research Society–22 (SRS-22) at preoperative and two-year postoperative visits. Demographic and radiographic data were collected. Preoperative and two-year postoperative BIDQ-S (1 = best, 5 = worst) and SRS-22 scores (1 = worst, 5 = best) were compared using paired t test. Correlations between BIDQ-S and SRS-22 scores were ev...
Source: Spine Deformity - September 6, 2019 Category: Orthopaedics Source Type: research

Bone Remodeling and Disc Morphology in the Distal Unfused Spine After Spinal Fusion in Adolescent Idiopathic Scoliosis
Publication date: September 2019Source: Spine Deformity, Volume 7, Issue 5Author(s): Saba Pasha, Lachlan Smith, Wudbhav N. SankarAbstractBackgroundMorphologic changes in the vertebral body in adolescent idiopathic scoliosis (AIS) have been associated with curve development and progression. Yet, after an AIS spinal surgery, the impact of the global and local spinal realignment on the vertebral body and intervertebral disc morphologic changes, particularly in the distal unfused spine, have not been determined.Questions/PurposesTo determine the changes in the unfused lumbar vertebrae and disc morphology two years after spinal...
Source: Spine Deformity - September 6, 2019 Category: Orthopaedics Source Type: research

Back Pain and Its Change After Surgery in Adolescents and Young Adults With Idiopathic Scoliosis
Publication date: September 2019Source: Spine Deformity, Volume 7, Issue 5Author(s): Tamás F. Fekete, Anne F. Mannion, Daniel Haschtmann, Markus Loibl, Frank S. Kleinstück, Dezső J. JeszenszkyAbstractStudy DesignA retrospective analysis of prospectively collected data from patients aged 12–30 years, operated for AIS in our hospital from 2005 to 2014 and registered in our local patient outcomes database linked to EUROSPSINE's Spine Tango Registry.ObjectivesTo investigate whether in patients with AIS and notable back pain surgery is associated with significant pain relief and whether age influences outcome...
Source: Spine Deformity - September 6, 2019 Category: Orthopaedics Source Type: research

The Risk of Proximal Junctional Kyphosis Decreases in Patients With Optimal Thoracic Kyphosis
This study aimed to investigate the preoperative risk factors for proximal junctional kyphosis (PJK) in adult spinal deformity (ASD) surgery.Summary of Background DataThe cause of PJK is still unclear, although some risk factors have been reported in ASD surgery.MethodsA total of 185 patients who were followed up for more than two years and underwent ASD surgery were recruited. PJK was defined as a proximal junctional angle ≥20° or reoperation due to PJK within two years after surgery. These patients were divided into PJK and non-PJK groups. Whole-spine standing radiography was performed before and immediately, one ...
Source: Spine Deformity - September 6, 2019 Category: Orthopaedics Source Type: research

Spinopelvic Parameters Depending on the Angulation of the Sacral End Plate Are Less Reproducible Than Other Spinopelvic Parameters in Adult Spinal Deformity Patients
ConclusionThese are to our knowledge the first estimates of measurement error for sagittal spinopelvic parameters in ASD patients. Despite near excellent ICCs, we found considerable measurement error for parameters depending on the angulation rather than the location of the sacral end plate.Level of EvidenceLevel II. (Source: Spine Deformity)
Source: Spine Deformity - September 6, 2019 Category: Orthopaedics Source Type: research

The Effects of Preoperative Steroid Therapy on Perioperative Morbidity and Mortality After Adult Spinal Deformity Surgery
Publication date: September 2019Source: Spine Deformity, Volume 7, Issue 5Author(s): Samuel J.W. White, William A. Ranson, Brian Cho, Zoe B. Cheung, Ivan Ye, Oscar Carrillo, Jun S. Kim, Samuel K. ChoAbstractStudy DesignRetrospective cohort analysis.ObjectivesTo identify the effects of preoperative steroid therapy on 30-day perioperative complications after adult spinal deformity (ASD) surgery.Summary of Background DataChronic steroid therapy has demonstrated therapeutic effects in the treatment of various medical conditions but is also known to be associated with surgical complications. There remains a gap in the literatur...
Source: Spine Deformity - September 6, 2019 Category: Orthopaedics Source Type: research

Relationship Between Preoperative Plasma Fibrinogen Concentration, Perioperative Bleeding, and Transfusions in Elective Adult Spinal Deformity Correction
This study sought to investigate the relationship between preoperative (preop) fibrinogen, bleeding, and transfusion requirements in adult spinal deformity corrections.Summary of Background DataBlood loss after major spinal reconstruction increases the risks and costs of surgery. Preoperative fibrinogen levels may predict intra- and postoperative blood loss.MethodsData were collected from clinic charts and hospital medical records of all 142 of a single surgeon's consecutive adult spine patients undergoing 7 or more levels deformity correction surgeries from January 2011 to December 2014. t tests were used to compare perio...
Source: Spine Deformity - September 6, 2019 Category: Orthopaedics Source Type: research

Short-Term Outcomes of Staged Versus Same-Day Surgery for Adult Spinal Deformity Correction
Publication date: September 2019Source: Spine Deformity, Volume 7, Issue 5Author(s): Alexander H. Arzeno, Jayme Koltsov, Todd F. Alamin, Ivan Cheng, Kirkham B. Wood, Serena S. HuAbstractStudy DesignRetrospective cohort study.ObjectivesAssess differences between staged (≤3 days) and same-day surgery in perioperative factors, radiographic measures, and complications.Summary of Background DataSurgical adult spinal deformity correction may require combined anterior and posterior approaches. To modulate risk, some surgeons perform surgery that is expected to be longer and/or more complex in two stages. Prior studies comparin...
Source: Spine Deformity - September 6, 2019 Category: Orthopaedics Source Type: research

Use of an Accelerated Discharge Pathway in Patients With Severe Cerebral Palsy Undergoing Posterior Spinal Fusion for Neuromuscular Scoliosis
ConclusionsAdoption of a standardized postoperative pathway reduced LOS by 19% in nonambulatory CP patients. Overall, complications, including pulmonary, trended lower in the AD group. Early discharge appears to be possible in this challenging patient population. Although the AD pathway may not be appropriate for all patients, the utility of the AD pathway in optimizing care for more routine PSF for this patient subset appears to be worthwhile.Level of EvidenceLevel III, therapeutic. (Source: Spine Deformity)
Source: Spine Deformity - September 6, 2019 Category: Orthopaedics Source Type: research

Scoliosis in Patients With Friedreich Ataxia: Results of a Consecutive Prospective Series
ConclusionsThe prevalence of scoliosis in FA was high (71%), and thoracic hyperkyphosis, with anterior misalignment, was frequently observed, which might be related to the anterior imbalance frequently encountered in patients with an ataxia. Posterior fusion including sacral instrumentation was only performed in nonambulatory patients, and the loss of ambulation was not associated with spinal surgery.Level of EvidenceLevel IV. (Source: Spine Deformity)
Source: Spine Deformity - September 6, 2019 Category: Orthopaedics Source Type: research

Distraction-Based Surgeries Increase Spine Length for Patients With Nonidiopathic Early-Onset Scoliosis—5-Year Follow-up
Publication date: September 2019Source: Spine Deformity, Volume 7, Issue 5Author(s): Yehia ElBromboly, Jennifer Hurry, Kedar Padhye, Charles Johnston, Anna McClung, Amer Samdani, Michael Glotzbecker, Abdallah Attia, Tricia St. Hilaire, Ron El-Hawary, Children's Spine Study Group, Growing Spine Study GroupAbstractStudy DesignRetrospective, comparative.ObjectivesTo determine if distraction-based surgeries will increase spine length in patients with nonidiopathic EOS and whether etiology affects final spine length.Summary of Background DataAs early-onset scoliosis (EOS) has many etiologies, it is unclear whether etiology affe...
Source: Spine Deformity - September 6, 2019 Category: Orthopaedics Source Type: research

Outcomes of Primary and Conversion Magnetically Controlled Growth Rods Are Different at Two-Year Follow-up: Results of North American Release
ConclusionsPatients with primary MCGR insertion can be expected to have greater radiographic correction and spine length gain than those with conversion from growth-friendly instrumentation to MCGR, most likely because of increased spine stiffness in conversion patients. The rate of complications, primarily implant-related, remains higher in conversion than in primary insertion patients.Level of EvidenceLevel III. (Source: Spine Deformity)
Source: Spine Deformity - September 6, 2019 Category: Orthopaedics Source Type: research

Letter to the Editor Concerning: “Celiac Artery Syndrome After Correction of Kyphoscoliosis” by van Urk P.R., Littooij A.S., van Gestel J.P.J., Kruyt M.C., Spine Deformity 7(2019):176–179
Publication date: September 2019Source: Spine Deformity, Volume 7, Issue 5Author(s): P.R. van Urk, A.S. Littooij, J.P.J. van Gestel, M.C. Kruyt (Source: Spine Deformity)
Source: Spine Deformity - September 6, 2019 Category: Orthopaedics Source Type: research

Pulmonary Function After Convex Thoracoplasty in Adolescent Idiopathic Scoliosis Patients Treated by Posteromedial Translation
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)
Source: Spine Deformity - September 6, 2019 Category: Orthopaedics Source Type: research

Hemoglobin Levels Pre- and Posttreatment as a Surrogate for Disease Severity in Early-Onset Scoliosis
Publication date: July 2019Source: Spine Deformity, Volume 7, Issue 4Author(s): Michael Glotzbecker, Patricia Miller, Michael Vitale, Leah DeWitt, Alexandra Grzywna, Jeffrey Sawyer, Joshua Pahys, Patrick Cahill, John Emans, Children's Spine Study GroupAbstractStudy DesignProspective cohort.ObjectiveTo compare preoperative hemoglobin levels to postoperative hemoglobin levels in patients with early-onset scoliosis (EOS).Summary of Background DataElevated hemoglobin (Hgb) may be a marker for preoperative hypoxia in patients with EOS and thoracic insufficiency syndrome (TIS). The changes in Hgb level after treatment may be a s...
Source: Spine Deformity - June 13, 2019 Category: Orthopaedics Source Type: research

Editorial Board
Publication date: July 2019Source: Spine Deformity, Volume 7, Issue 4Author(s): (Source: Spine Deformity)
Source: Spine Deformity - June 13, 2019 Category: Orthopaedics Source Type: research

Instructions for Authors
Publication date: July 2019Source: Spine Deformity, Volume 7, Issue 4Author(s): (Source: Spine Deformity)
Source: Spine Deformity - June 13, 2019 Category: Orthopaedics Source Type: research

Table of Contents
Publication date: July 2019Source: Spine Deformity, Volume 7, Issue 4Author(s): (Source: Spine Deformity)
Source: Spine Deformity - June 13, 2019 Category: Orthopaedics Source Type: research

Sacropelvic Fixation: A Comprehensive Review
Publication date: July 2019Source: Spine Deformity, Volume 7, Issue 4Author(s): Mostafa H. El Dafrawy, Micheal Raad, Louis Okafor, Khaled M. KebaishAbstractSacropelvic fixation is indicated in various clinical settings, most notably long spinal arthrodesis, reduction of high-grade spondylolisthesis, and complex sacral fractures. The sacropelvis is characterized by complex regional anatomy and poor bone quality. These factors make achieving solid fusion across the lumbosacral junction challenging. However, a better understanding of spinal biomechanics at that level has led to much higher fusion rates than those of the past....
Source: Spine Deformity - June 13, 2019 Category: Orthopaedics Source Type: research

In Vivo Assessment of Thoracic Vertebral Shape From MRI Data Using a Shape Model
ConclusionsMagnetic resonance images and shape modeling provides a reliable method for characterizing vertebral shape in vivo. The method is able to identify differences between vertebral levels and between individuals. The use of these methods may be advantageous for performing repeated measurements in longitudinal studies.Level of EvidenceN/A. (Source: Spine Deformity)
Source: Spine Deformity - June 13, 2019 Category: Orthopaedics Source Type: research

Analysis of Center of Mass and Gravity-Induced Vertebral Axial Torque on the Scoliotic Spine by Barycentremetry
ConclusionResults suggest that AIS patients can maintain the COM of each body segment close to their gravity line, irrespective of the severity and asymmetry of their deformity. Moreover, torque analysis shed some light on the importance of junctional vertebrae in the spinal deformity and, potentially, in the vicious cycle determining scoliosis progression.Level of EvidenceLevel III. (Source: Spine Deformity)
Source: Spine Deformity - June 13, 2019 Category: Orthopaedics Source Type: research

Evidence of Intrinsic Impairment of Osteoblast Phenotype at the Curve Apex in Girls With Adolescent Idiopathic Scoliosis
ConclusionsIntrinsic differences that affect osteoblast function are exhibited by spinal facet osteoblasts at the curve apex in AIS patients.Level of EvidenceLevel IV, Prognostic. (Source: Spine Deformity)
Source: Spine Deformity - June 13, 2019 Category: Orthopaedics Source Type: research

Finite Element Based-Analysis for Pre and Post Lumbar Fusion of Adult Degenerative Scoliosis Patients
Publication date: July 2019Source: Spine Deformity, Volume 7, Issue 4Author(s): Ram Haddas, Ming Xu, Isador Lieberman, James YangAbstractStudy DesignPre-post cohort finite elements (FE).ObjectivesTo investigate the effect of adjacent load transfer pre and post fusion surgery of lumbar scoliotic spines using FE models.Summary of Background DataAdult degenerative scoliosis (ADS) results from age-related changes, leading to segmental instability, deformity, and stenosis. FE study is capable of capturing the biomechanical parameters internal to the bones and connective soft tissues of the spine, which is difficult to measure b...
Source: Spine Deformity - June 13, 2019 Category: Orthopaedics Source Type: research

Reliability and Concurrent Validity of a Culturally Adapted Persian Version of the Brace Questionnaire in Adolescents With Idiopathic Scoliosis
ConclusionsThe culturally adapted Persian version of the BrQ can be used to assess the quality of life of adolescents with idiopathic scoliosis who wear a brace.Level of EvidenceII. (Source: Spine Deformity)
Source: Spine Deformity - June 13, 2019 Category: Orthopaedics Source Type: research

Adolescent Idiopathic Scoliosis Care in an Underserved Inner-City Population: Screening, Bracing, and Patient- and Parent-Reported Outcomes
Publication date: July 2019Source: Spine Deformity, Volume 7, Issue 4Author(s): Bassel G. Diebo, Frank A. Segreto, Maximillian Solow, James C. Messina, Karen Paltoo, Steven A. Burekhovich, Lee R. Bloom, Frank S. Cautela, Neil V. Shah, Peter G. Passias, Frank J. Schwab, Saba Pasha, Virginie Lafage, Carl B. PaulinoAbstractStudy DesignRetrospective review of a prospectively collected database.ObjectivesThis preliminary investigation sought to identify the quality of care adolescent idiopathic scoliosis (AIS) patients from our large, underserved community had received before presenting at this institution's clinic.Summary of B...
Source: Spine Deformity - June 13, 2019 Category: Orthopaedics Source Type: research

Technical Consideration for TLIF Cage Retrieval and Deformity Correction With Anterior Interbody Fusion in Lumbar Revision Surgeries
Publication date: July 2019Source: Spine Deformity, Volume 7, Issue 4Author(s): M. Burhan Janjua, Nissim Ackshota, Vincent ArletAbstractIntroductionSymptomatic pseudoarthrosis after transforaminal lumbar interbody fusion (TLIF) could result in sagittal malalignment. Revision posterior surgery with TLIF cage removal poses a challenge intraoperatively. The authors have proposed salvage anterior approach for cage removal and have discussed unique experience with the correction in their deformity patients.MethodsAll patients with symptoms of clinical deformity or symptomatic pseudoarthrosis operated from January of 2012 to Feb...
Source: Spine Deformity - June 13, 2019 Category: Orthopaedics Source Type: research

Do We Need Postoperative Chest Radiographs After Posterior Spinal Fusion for Adolescent Idiopathic Scoliosis?
ConclusionsPneumothorax is uncommon after PSIF for AIS. The need for intervention is even less common. Routine postoperative chest radiographs are of questionable value after PSIF for AIS.Level of EvidenceLevel III. (Source: Spine Deformity)
Source: Spine Deformity - June 13, 2019 Category: Orthopaedics Source Type: research

Intraoperative Computed Tomography–Guided Navigation for Pediatric Spine Patients Reduced Return to Operating Room for Screw Malposition Compared With Freehand/Fluoroscopic Techniques
ConclusionPatients with pedicle screws placed with CT-guided navigation had a lower rate of severely malpositioned screws and unplanned returns to the OR. There was no significant difference in blood loss or operative time when controlling for number of levels fused.SignificanceIn the era of health care “never-events,” return to OR for screw malposition could certainly be deemed unacceptable. Use of intraoperative CT-guided navigation thus far eliminated return to OR for screw malposition in a complex cohort of pediatric spinal deformity patients, without measurable increase in operative time or blood loss. (So...
Source: Spine Deformity - June 13, 2019 Category: Orthopaedics Source Type: research

Effect of the Ultrasonic Bone Scalpel on Blood Loss During Pediatric Spinal Deformity Correction Surgery
Publication date: July 2019Source: Spine Deformity, Volume 7, Issue 4Author(s): Sean Wahlquist, Scott Nelson, Phillip GlivarAbstractStudy DesignRetrospective cohort.ObjectiveDetermine the effect of the ultrasonic bone scalpel (UBS) on intraoperative blood loss and surgical time.Summary of Background DataThe UBS has shown beneficial effects in limiting blood loss in spinal surgery, but no study has examined its effect in patients with neuromuscular scoliosis.MethodsClinical records were reviewed for patients aged 9–18 who underwent posterior spinal fusion surgery of five or more levels for scoliosis correction by the ...
Source: Spine Deformity - June 13, 2019 Category: Orthopaedics Source Type: research

Quality, Safety, and Value of Innovating Classic Operative Techniques in Scoliosis Surgery: Intraoperative Traction and Navigated Sequential Drilling
This study aims to measure and describe the clinical and financial implications of the systematic implementation of intraoperative skull-femoral traction (IOSFT) and navigated sequential drilling (NSD) for posterior spinal instrumentation and fusion (PSIF) in adolescent idiopathic scoliosis (AIS) at our institution.Summary of Background DataPSIF has been the standard surgical treatment for AIS. This retrospective single-center quality improvement study describes the perioperative outcomes and impact on health resource utilization following the systematic application of two classic surgical strategies modified using current...
Source: Spine Deformity - June 13, 2019 Category: Orthopaedics Source Type: research

What Factors Are Associated With Kyphosis Restoration in Lordotic Adolescent Idiopathic Scoliosis Patients?
Publication date: July 2019Source: Spine Deformity, Volume 7, Issue 4Author(s): Peter O. Newton, Kuan Wen Wu, Tracey P. Bastrom, Carrie E. Bartley, Vidyadhar V. Upasani, Burt Yaszay, Harms Study GroupAbstractStudy DesignReview of a prospective adolescent idiopathic scoliosis (AIS) multicenter registry.ObjectiveTo evaluate predictors of surgical thoracic kyphosis restoration in AIS patients with lordotic preoperative thoracic sagittal profiles.Summary of Background DataPrior work on kyphosis-producing techniques has yielded mixed findings and has focused on the sagittal plane in 2D.MethodsA validated formula to predict 3D T...
Source: Spine Deformity - June 13, 2019 Category: Orthopaedics Source Type: research

Lumbar Retrolisthesis Compensates Spinal Kyphosis
ConclusionsSubjects with lumbar retrolisthesis showed greater spinal kyphosis and worse spinopelvic alignments. Subjects with lower-generated lumbar retrolisthesis showed worse spinopelvic alignment and HRQOL than subjects with upper-generated lumbar retrolisthesis and multiple ones and those without it.Level of EvidenceLevel IV. (Source: Spine Deformity)
Source: Spine Deformity - June 13, 2019 Category: Orthopaedics Source Type: research

Rigorous Correction of Sagittal Vertical Axis Is Correlated With Better ODI Outcomes After Extensive Corrective Fusion in Elderly or Extremely Elderly Patients With Spinal Deformity
ConclusionsRigorous realignment of sagittal vertical axis is correlated with ODI outcomes, especially in very elderly patients.Level of EvidenceLevel 4. (Source: Spine Deformity)
Source: Spine Deformity - June 13, 2019 Category: Orthopaedics Source Type: research

Revision Risk After Primary Adult Spinal Deformity Surgery: A Nationwide Study With Two-Year Follow-up
ConclusionsThe revision risk within 2 years after primary ASD surgery was 19.9% nationwide in Denmark, and implant failure was the most common reason for revision. Increased comorbidity and age were separately associated with increased risk of revision.Level of EvidenceLevel II. (Source: Spine Deformity)
Source: Spine Deformity - June 13, 2019 Category: Orthopaedics Source Type: research

Cultural Variations in the Minimum Clinically Important Difference Thresholds for SRS-22R After Surgery for Adult Spinal Deformity
Publication date: July 2019Source: Spine Deformity, Volume 7, Issue 4Author(s): Hideyuki Arima, Leah Y. Carreon, Steven D. Glassman, Yu Yamato, Tomohiko Hasegawa, Daisuke Togawa, Sho Kobayashi, Go Yoshida, Tatsuya Yasuda, Tomohiro Banno, Shin Oe, Yuki Mihara, Hiroki Ushirozako, Yukihiro MatsuyamaAbstractStudy DesignLongitudinal cohort.ObjectiveTo calculate the minimum clinically important difference (MCID) threshold values for the Scoliosis Research Society–22R (SRS-22R) in Japanese patients with adult spinal deformity (ASD) and to compare the results with previously reported values in a North American population.Sum...
Source: Spine Deformity - June 13, 2019 Category: Orthopaedics Source Type: research