Intra- and Interrater Reliability of Cobb Angle Measurements on the Plane of Maximum Curvature Using Ultrasound Imaging Method
ConclusionThe PMC Cobb and VAR can be measured reliably on US images. Future studies should validate the PMC Cobb angle and to include a wider Cobb angle range on participants. (Source: Spine Deformity)
Source: Spine Deformity - December 24, 2018 Category: Orthopaedics Source Type: research
Influence of Intraoperative Neuromonitoring on the Outcomes of Surgeries for Pediatric Scoliosis in the United States
ConclusionsReported use of IONM in this database was significantly less compared with other databases, suggesting that IONM might be underreported in the NIS database. Nevertheless, in this database, IONM was significantly associated with increased home discharge. Hospital charges and LOS were not affected by IONM. There was a trend toward lower risk of neurologic complications with IONM use, though this finding was not statistically significant. (Source: Spine Deformity)
Source: Spine Deformity - December 24, 2018 Category: Orthopaedics Source Type: research
Implementing a Multidisciplinary Clinical Pathway Can Reduce the Deep Surgical Site Infection Rate After Posterior Spinal Fusion in High-Risk Patients
ConclusionsImplementation of a multidisciplinary pathway aimed to reduce infection in patients at high risk for SSI after spinal fusion led to a significant reduction in deep SSI rate. It is impossible to attribute the drop in the deep SSI rate to any one factor. Our results demonstrate that adherence to a protocol using multiple strategies to reduce infection results in a lower SSI rate, lower care costs, and improved patient-related outcomes.Level of EvidenceLevel III. (Source: Spine Deformity)
Source: Spine Deformity - December 24, 2018 Category: Orthopaedics Source Type: research
Radiographic, Pulmonary, and Clinical Outcomes With Halo Gravity Traction
ConclusionsOur study again demonstrated that HGT achieves radiographic improvement safely and effectively in severe spinal deformity. We demonstrated a positive correlation between improvement in PFTs and increase in thoracic height seen with HGT. Additionally, improvement in weight Z score was seen in the entire population and the most at risk patients for malnutrition, results that have not been shown before.Level of EvidenceLevel IV. (Source: Spine Deformity)
Source: Spine Deformity - December 24, 2018 Category: Orthopaedics Source Type: research
Incidence of Intraspinal and Extraspinal MRI Abnormalities in Patients With Adolescent Idiopathic Scoliosis
ConclusionsSignificant MRI abnormalities were noted in patients with AIS, and some patients required further evaluation prior to surgery. Additional study including cost-effectiveness analysis is needed to better define the role of preoperative MRI in patients with AIS.Level of EvidenceLevel II. (Source: Spine Deformity)
Source: Spine Deformity - December 24, 2018 Category: Orthopaedics Source Type: research
The Link Between the 3D Spino-pelvic Alignment and Vertebral Body morphology in Adolescent Idiopathic Scoliosis
ConclusionsThe ΔAPVH depended on the scoliotic curve type and was significantly different from the controls only at the apical levels. Morphological changes in the scoliotic vertebrae, measured as anterior-posterior differences in the vertebral height, are related to the sagittal spinal profile suggesting the morphology of the vertebra contributes to the sagittal curvatures of the spine in AIS; nonetheless, such relationship between the vertebral morphology and the sagittal profile was not evident in non-scoliotic controls. (Source: Spine Deformity)
Source: Spine Deformity - December 24, 2018 Category: Orthopaedics Source Type: research
The 3D Sagittal Profile of Thoracic Versus Lumbar Major Curves in Adolescent Idiopathic Scoliosis
ConclusionsThere is a substantial average loss of thoracic kyphosis (∼15°–25°) for both primary thoracic and primary thoracolumbar/lumbar AIS curves compared to normal adolescents. Three-dimensional assessment of scoliosis allows the “true” deformity to be measured by correcting for error due to out-of-plane measurement associated with conventional 2D measurements.Level of EvidenceLevel II, prognostic. (Source: Spine Deformity)
Source: Spine Deformity - December 24, 2018 Category: Orthopaedics Source Type: research
Three-Dimensional Radiographic Analysis of Two Distinct Lenke 1A Curve Patterns
Conclusion3D spinal analysis demonstrates that 1AR and AL curves are distinctly different in all three planes. Although the treatment-based Lenke classification system combines these two curve patterns into one curve type, the 3D assessment suggests there are clear features that differentiate these curve patterns. The differing features of the nonstructural lumbar curves may help define the variance in fusion level selection and risk of adding-on for these two curve patterns.Level of EvidenceLevel II, prognostic. (Source: Spine Deformity)
Source: Spine Deformity - December 24, 2018 Category: Orthopaedics Source Type: research
Expansion Thoracoplasty as a Life-Saving Procedure in an Adolescent With Severe Spinal Deformity and Sacral Agenesis
ConclusionsThis case demonstrates that improvement and stabilization of respiratory function can be achieved with instrumented ET in a skeletally mature adolescent with severe TIS and spinal deformity. (Source: Spine Deformity)
Source: Spine Deformity - December 24, 2018 Category: Orthopaedics Source Type: research
Patients’ Perceptions of Breast Asymmetry Improve After Spinal Fusion for Adolescent Idiopathic Scoliosis
ConclusionBreast asymmetry is a significant concern of many AIS patients, including males, and correlates with preoperative curve magnitude. SF results in significant improvement in patient perception of breast/chest wall asymmetry, with 76% of patients reporting good outcomes at two years postoperation.Level of EvidenceLevel 2. (Source: Spine Deformity)
Source: Spine Deformity - December 24, 2018 Category: Orthopaedics Source Type: research
Surgery for the Adolescent Idiopathic Scoliosis Patients After Skeletal Maturity: Early Versus Late Surgery
ConclusionTreatment of the adult scoliosis patient who has undergone an estimated natural history of progression is characterized by greater levels fused, operative time, and higher complication rates than the AIS counterpart. Longer-term follow-up of AIS is needed to define the benefits of early intervention of relatively asymptomatic adolescent patients versus late treatment of symptomatic disease in the adult. (Source: Spine Deformity)
Source: Spine Deformity - December 24, 2018 Category: Orthopaedics Source Type: research
Major Complications at Two Years After Surgery Impact SRS Scores for Adolescent Idiopathic Scoliosis Patients
ConclusionsWhen timing is considered, the SRS-22 demonstrates the ability to discriminate between patients with and without a complication. Active experience of a major complication impacted SRS-22 scores, in particular, the rate of worsening scores for pain, self-image, function, and total score.Level of EvidenceLevel III. (Source: Spine Deformity)
Source: Spine Deformity - December 24, 2018 Category: Orthopaedics Source Type: research
Trends in Treatment of Scheuermann Kyphosis: A Study of 1,070 Cases From 2003 to 2012
ConclusionsDespite unchanged demographics and operative rates in SK, there has been a shift from combined to isolated posterior approaches, with a concurrent increase in levels treated. A combined approach was associated with increased complication rates, LOS, and total charges compared to isolated approaches. Awareness of these inherent differences is important for surgical decision making and patient education.Levels of EvidenceLevel III. (Source: Spine Deformity)
Source: Spine Deformity - December 24, 2018 Category: Orthopaedics Source Type: research
Preoperative Variables Associated With Respiratory Complications After Pediatric Neuromuscular Spine Deformity Surgery
ConclusionPediatric NMS patients undergoing PSF that have history of pneumonia or gastrostomy tube present at time of surgery are at increased risk for postoperative respiratory complications. The univariate associations of tracheostomy presence and low transferrin levels with postoperative respiratory complications deserve further examination.Level of EvidenceLevel II. (Source: Spine Deformity)
Source: Spine Deformity - December 24, 2018 Category: Orthopaedics Source Type: research
Do All Patients With Cerebral Palsy Require Postoperative Intensive Care Admission After Spinal Fusion?
ConclusionBecause of their heterogeneous makeup, CP patients should be evaluated individually and their postoperative disposition should not be based on institutional tradition but instead on objective surgical factors. For those patients with surgical times less than 4 hours, discussions should be held regarding the safety of a postoperative disposition to a regular floor.Level of EvidenceLevel III. (Source: Spine Deformity)
Source: Spine Deformity - December 24, 2018 Category: Orthopaedics Source Type: research
