Marc A. Asher 1936-2019
Publication date: May 2019Source: Spine Deformity, Volume 7, Issue 3Author(s): (Source: Spine Deformity)
Source: Spine Deformity - May 2, 2019 Category: Orthopaedics Source Type: research
Respects to Yves Cotrel 1925-2019
Publication date: May 2019Source: Spine Deformity, Volume 7, Issue 3Author(s): (Source: Spine Deformity)
Source: Spine Deformity - May 2, 2019 Category: Orthopaedics Source Type: research
Radiation in Spine Deformity: State-of-the-Art Reviews
ConclusionsThis article will help guide surgeons to make appropriate decisions regarding the need for imaging studies and advocate for low-dose imaging protocols within their facilities.Level of EvidenceV. (Source: Spine Deformity)
Source: Spine Deformity - May 2, 2019 Category: Orthopaedics Source Type: research
Halo Gravity Traction for Severe Pediatric Spinal Deformity: A Clinical Concepts Review
Publication date: May 2019Source: Spine Deformity, Volume 7, Issue 3Author(s): Amy L. McIntosh, Brandon S. Ramo, Charles E. JohnstonAbstractFor the past 35 years, we have used halo gravity traction (HGT) to treat patients with a wide variety of underlying spinal deformities. This clinical concepts review will cover the indications, contraindications, HGT technique details, and our preferred method of dynamic HGT. Emphasis will be placed on our protocol, and recommendations that help to avoid complications. HGT is best applied by a standardized team approach intending to medically and nutritionally optimize the patient in p...
Source: Spine Deformity - May 2, 2019 Category: Orthopaedics Source Type: research
Biomechanical Analysis of Wide Posterior Releases Compared With Inferior Facetectomy and Discectomy in the Thoracolumbar and Lumbar Spine
ConclusionsWide posterior release of the thoracolumbar spine allows significant correction and may be superior to inferior facetectomy in axial rotation. Although complete discectomy with PLL resection would likely allow greater correction, a more clinically realistic partial discectomy confers similar corrective potential in vitro compared with wide posterior release.Level of EvidenceNot applicable. (Source: Spine Deformity)
Source: Spine Deformity - May 2, 2019 Category: Orthopaedics Source Type: research
The Management of Kyphosis in Metatropic Dysplasia
ConclusionsThoracic kyphosis in metatropic dysplasia does not uniformly progress in all patients and therefore can be initially observed. In those who progress, several surgical options exist including growth-friendly constructs that have demonstrated success without a higher rate of complications.Level of EvidenceLevel IV. (Source: Spine Deformity)
Source: Spine Deformity - May 2, 2019 Category: Orthopaedics Source Type: research
Minimum 20-Year Health-Related Quality of Life and Surgical Rates After the Treatment of Adolescent Idiopathic Scoliosis
ConclusionWe found a low rate of adult scoliosis surgery in the braced population, and a low rate of revision surgery at the 30-year follow-up in patients undergoing spine fusion for AIS between 1975 and 1992. No detected differences in patient-reported outcomes were found between the braced, surgical, and observed populations at a mean of 30 years' follow-up.Level of EvidenceLevel III, therapeutic. (Source: Spine Deformity)
Source: Spine Deformity - May 2, 2019 Category: Orthopaedics Source Type: research
Delay to Surgery Greater Than 6 Months Leads to Substantial Deformity Progression and Increased Intervention in Immature Adolescent Idiopathic Scoliosis (AIS) Patients: A Retrospective Cohort Study
ConclusionAIS patients who are premenarchal, TRC open, or Risser 0 who delay surgery greater than 6 months risk clinically significant Cobb angle progression, which is statistically greater than their more mature peers. Clinical ramifications of this remain unclear. Skeletally mature patients do not progress rapidly, allowing elective timing of surgical intervention.Level of EvidenceLevel III. (Source: Spine Deformity)
Source: Spine Deformity - May 2, 2019 Category: Orthopaedics Source Type: research
Quantifying Anterior Chest Wall Deformity in Adolescent Idiopathic Scoliosis: Correlation With Other Deformity Measures and Effects of Anterior Thoracoscopic Scoliosis Surgery
ConclusionsAnterior chest wall deformity is independent from the posterior chest wall measures RH and PDA, indicating that the anterior chest wall deformity is not reflected in the posterior rib cage. The correlation between Cobb angle and CWA indicates that the deformity in the spine and the deformity in the ribs are related, and shows that the anterior chest wall deformity is improved post thoracoscopic anterior scoliosis fusion surgery as the lateral deviation of the spine is corrected.Level of EvidenceLevel III. (Source: Spine Deformity)
Source: Spine Deformity - May 2, 2019 Category: Orthopaedics Source Type: research
A Novel Posterior Rod-Link-Reducer System Provides Safer, Easier, and Better Correction of Severe Scoliosis
ConclusionIn a matched cohort, the use of the RLR exhibited greater coronal Cobb correction, shorter operative time, and was less likely to have critical neuro-monitoring changes compared with the TCT group. The RLR provides safer and improved correction for severe curves without adding surgical risk.Level of EvidenceLevel III. (Source: Spine Deformity)
Source: Spine Deformity - May 2, 2019 Category: Orthopaedics Source Type: research
A Comparison of Muscular Activity During Gait Between Walking Sticks and a Walker in Patients With Adult Degenerative Scoliosis
ConclusionsThe use of walking sticks can potentially promote trunk and lower extremity neuromuscular control and gait mechanics comparable to gait without any assistive devices. Although the differences in magnitudes between comparisons were small and should be cautiously interpreted on a case-by-case basis, based on this study's results and our anecdotal experience treating patients with ADS, we recommend the use of walking sticks to assist with their gait prior to and after surgical intervention.Level of EvidenceLevel III. (Source: Spine Deformity)
Source: Spine Deformity - May 2, 2019 Category: Orthopaedics Source Type: research
Validation of a Simplified SRS-Schwab Classification Using a Sagittal Modifier
ConclusionsDespite the correlation between SRS-Schwab classification and surgical indication, it is complex to use, with a total of 27 possibilities regarding sagittal modifiers. This simplification into three categories offers more readability, without losing any significant information, and could replace Schwab sagittal modifiers. In association with other parameters, they could be used for decision-making.Level of EvidenceLevel II. (Source: Spine Deformity)
Source: Spine Deformity - May 2, 2019 Category: Orthopaedics Source Type: research
Do Curve Characteristics Influence Stenosis Location and Occurrence of Radicular Pain in Adult Degenerative Scoliosis?
ConclusionLSS is frequent in lumbar scoliosis. Relationships exist between curve characteristics and symptomatic LSS in lumbar scoliosis; especially, concavity of the lumbosacral contra-curve and the junctional level between the lumbar curve and the lumbosacral contra-curve. Therefore, accurate analysis of stenosis in ASD seems mandatory, to at least perform decompression because perfect planned treatment for stenosis and scoliosis correction might not always be possible because of the patient's general health status.Level of EvidenceLevel 4. (Source: Spine Deformity)
Source: Spine Deformity - May 2, 2019 Category: Orthopaedics Source Type: research
Evolution in Surgical Approach, Complications, and Outcomes in an Adult Spinal Deformity Surgery Multicenter Study Group Patient Population
ConclusionsFrom 2009 to 2016, despite an increasingly elderly, medically compromised, and obese patient population, complication rates decreased. Evolving strategies may result in improved treatment of ASD patients.Level of EvidenceLevel IV. (Source: Spine Deformity)
Source: Spine Deformity - May 2, 2019 Category: Orthopaedics Source Type: research
The Pros and Cons of Operating Early Versus Late in the Progression of Cerebral Palsy Scoliosis
ConclusionsBeing proactive (Cobb <70°) has no advantage in terms of decreasing risks or improving outcomes compared to curves 70°–90°. However, delaying surgery to a curve greater than 90° increases the risk of infection, blood loss, and the need for anterior/posterior procedures. Ideally, surgery should be recommended for curves less than 90°. (Source: Spine Deformity)
Source: Spine Deformity - May 2, 2019 Category: Orthopaedics Source Type: research
